scholarly journals Psychosocial characteristics and needs of mothers with psychotic disorders

2001 ◽  
Vol 178 (5) ◽  
pp. 427-432 ◽  
Author(s):  
Louise M. Howard ◽  
R. Kumar ◽  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Psychotic Disorders ◽  
Descriptive Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
Psychosocial Characteristics ◽  
Black African ◽  
Factors Associated ◽  
Younger Age

BackgroundIt is not known whether mothers with psychotic disorders are clinically and socially distinct from women with psychoses who have not had children.AimsTo determine the proportion of mothers in an epidemiologically representative population of women with psychotic disorders, to examine the factors associated with having children, and to examine the factors associated with having children ‘looked after’ by social services.MethodDescriptive analysis and two case–control studies.ResultsSixty-three per cent of women with psychotic disorders were mothers. There were no clinical differences between women with or without children, but mothers were more likely to be older and live in unsupported accommodation. Having had a ‘looked after’ child was associated with Mental Health Act detention, younger age, a forensic history and being Black African.ConclusionMany women with psychoses are mothers. Mothers with psychoses are as disabled and have as many needs as women with psychoses without children.

scholarly journals Causal Factors of Effective Psychosocial Outcomes in Online Mental Health Communities

2020 ◽  
Author(s):  
Koustuv Saha ◽  
Amit Sharma
Keyword(s):  
Mental Health ◽  
Online Community ◽  
Psychosocial Outcomes ◽  
Case Control ◽  
Case Control Studies ◽  
Causal Factors ◽  
Health Distress ◽  
Health Communities ◽  
Mental Health Distress ◽  
And Control

Online mental health communities enable people to seek and provide support, and growing evidence shows the efficacy of community participation to cope with mental health distress. However, what factors of peer support lead to favorable psychosocial outcomes for individuals is less clear. Using a dataset of over 300K posts by ∼39K individuals on an online community TalkLife, we present a study to investigate the effect of several factors, such as adaptability, diversity, immediacy, and the nature of support. Unlike typical causal studies that focus on the effect of each treatment, we focus on the outcome and address the reverse causal question of identifying treatments that may have led to the outcome, drawing on case-control studies in epidemiology. Specifically, we define the outcome as an aggregate of affective, behavioral, and cognitive psychosocial change and identify Case (most improved) and Control (least improved) cohorts of individuals. Considering responses from peers as treatments, we evaluate the differences in the responses received by Case and Control, per matched clusters of similar individuals. We find that effective support includes complex language factors such as diversity, adaptability, and style, but simple indicators such as quantity and immediacy are not causally relevant. Our work bears methodological and design implications for online mental health platforms, and has the potential to guide suggestive interventions for peer supporters on these platforms.

scholarly journals Patient factors associated with the use of psychotropic polypharmacy in patients under the care of a community mental health team in the West of Ireland

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S106-S106
Author(s):  
Karthika Srikumar ◽  
Richard Walsh ◽  
Donnchadh Walsh ◽  
Sonn Patel ◽  
Sheila O'Sullivan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychotic Disorders ◽  
Drug Regimen ◽  
Psychotropic Medications ◽  
Community Mental Health Team ◽  
Patient Factors ◽  
Mental Health Team ◽  
Health Team ◽  
Factors Associated

AimsPsychiatric polypharmacy refers to the prescription of two or more psychotropic medications to any one patient. This definition is purely quantitative and does not take into account whether such a prescription is detrimental, or unnecessary. In many cases, polypharmacy has been implemented in challenging illnesses, and some studies have shown that it can improve overall outcomes for certain patients. Evidence suggests that the prevalence of psychotropic polypharmacy is increasing, despite advances in psychosocial interventions. The aim of this study was to assess the current prevalence of polypharmacy among patients being treated by a community mental health team (CMHT), and the patient factors associated with its use.MethodWe performed a cross-sectional study of all patients registered with a CMHT in a mixed urban/rural area on a single date. Case records were examined to determine the most recently prescribed drug regimen for each patient. Clinical chart diagnoses were recorded and each one independently verified by the team consultant using ICD-10. A number other sociodemographic variables were recorded. Using Microsoft Excel, we analysed the medications prescribed as well as rates and levels of polypharmacy based on multiple different patient characteristics.ResultOf the 245 patients, the mean age was 56.3 and 51.2% (n = 126) were female. Psychotropic polypharmacy was seen in 62% (n = 152) of patients. 33% (n = 82) of patients were on two psychotropic medications, and of this subset, a combination of one antipsychotic and one antidepressant was the most common drug regimen, seen in 16.7% (n = 41) of all patients. Polypharmacy was more prevalent in females, with 68% (n = 85) being on two or more psychotropics, in comparison to 58% of male patients. In relation to age, patients aged between 51 to 65 years had the highest prevalence of polypharmacy, at a rate of 71% (n = 49). Among all primary diagnoses, polypharmacy was most common in patients with affective disorders, with 80% (n = 40) of this patient cohort on two or more medications. Second to this was psychotic disorders, with polypharmacy seen in 65% (n = 62) of this group.ConclusionWe found that psychotropic polypharmacy is highly prevalent in psychiatric patients being treated in a community setting. Certain demographics and patient factors, such as age, gender and psychiatric diagnosis influenced the rate of polypharmacy and certain drug combinations were more commonly prescribed than others.

scholarly journals Knowledge about mammography and associated factors: population surveys with female adults and elderly

2013 ◽  
Vol 16 (4) ◽  
pp. 930-942 ◽  
Author(s):  
Ione Jayce Ceola Schneider ◽  
Marui Weber Corseuil ◽  
Antonio Fernando Boing ◽  
Eleonora d'Orsi
Keyword(s):  
Associated Factors ◽  
Elderly Women ◽  
Descriptive Analysis ◽  
Age Groups ◽  
The Elderly ◽  
Cancer Information ◽  
Population Surveys ◽  
Factors Associated ◽  
Younger Age ◽  
Adjusted Model

The purpose of this paper is to describe the knowledge about mammography and to identify associated factors in female adults and elderly. Data were obtained from two population surveys, one with female adults and another with elderly women from Florianópolis (SC) in 2009 - 2010. A descriptive analysis of the variables was carried out, the appropriate mean of responses about mammography was estimated and crude and adjusted Poisson regression was conducted to identify associated factors. Among adults, 23.1% answered all of the questions appropriately and the appropriate average responses was 7.2 (95%CI 7.1 - 7.3) in a total of 9. In the adjusted model, older age, higher education and income were associated with knowledge about mammography. For the elderly, 15.3% answered all questions appropriately and the average of appropriate responses was 6.4 (95%CI 5.2 - 6.5) and the factors associated with knowledge about mammography in the adjusted model were younger age groups, increased education and income, and identification of mammography as the main diagnostic method for breast cancer. Information about mammography can neither be transmitted in a clear way nor be easily understood; there are also demographic and socioeconomic differences concerning the knowledge about the exam.

scholarly journals Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case–control studies

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015934 ◽  
Author(s):  
Sebastià March ◽  
Joana Ripoll ◽  
Matilde Jordan Martin ◽  
Edurne Zabaleta-del-Olmo ◽  
Carmen Belén Benedé Azagra ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Personal Characteristics ◽  
Case Control ◽  
Undergraduate Training ◽  
Case Control Studies ◽  
Community Characteristics ◽  
Factors Associated ◽  
Community Activities ◽  
Secondary Sources ◽  
Health Promoting

ObjectiveSpanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities.DesignTwo case–control studies.SettingPerformed in primary care of five Spanish regions.SubjectsIn the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not.Main outcome measuresTeam, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources.ResultsThe first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1).ConclusionsProfessional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs.

scholarly journals T21. DEVELOPMENT OF PROTEOMIC PREDICTION MODELS FOR OUTCOMES IN THE CLINICAL HIGH RISK STATE AND PSYCHOTIC EXPERIENCES IN ADOLESCENCE: MACHINE LEARNING ANALYSES IN TWO NESTED CASE-CONTROL STUDIES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S238-S239
Author(s):  
David Mongan ◽  
Melanie Föcking ◽  
Colm Healy ◽  
Subash Raj Susai ◽  
Gerard Cagney ◽  
...  
Keyword(s):  
Body Mass Index ◽  
At Risk ◽  
Psychotic Disorders ◽  
Case Control ◽  
Plasma Samples ◽  
Clinical High Risk ◽  
Psychotic Experiences ◽  
Case Control Studies ◽  
False Discovery ◽  
Nested Case Control

Abstract Background Individuals at clinical high risk (CHR) of psychosis have an approximately 20% probability of developing psychosis within 2 years, as well as an associated risk of non-psychotic disorders and functional impairment. People with subclinical psychotic experiences (PEs) are also at risk of future psychotic and non-psychotic disorders and decreased functioning. It is difficult to accurately predict outcomes in individuals at risk of psychosis on the basis of symptoms alone. Biomarkers for accurate prediction of outcomes could inform the clinical management of this group. Methods We conducted two nested case-control studies. We employed discovery-based proteomic methods to analyse protein expression in baseline plasma samples in EU-GEI and age 12 plasma samples in ALSPAC using liquid chromatography mass spectrometry. Differential expression of quantified proteomic markers was determined by analyses of covariance (with false discovery rate of 5%) comparing expression levels for each marker between those who did not and did not develop psychosis in Study 1 (adjusting for age, gender, body mass index and years in education), and between those who did and did not develop PEs in Study 2 (adjusting for gender, body mass index and maternal social class). Support vector machine algorithms were used to develop models for prediction of transition vs. non-transition (as determined by the Comprehensive Assessment of At Risk Mental States) and poor vs. good functional outcome at 2 years in Study 1 (General Assessment of Functioning: Disability subscale score </=60 vs. >60). Similar algorithms were used to develop a model for prediction of PEs vs. no PEs at age 18 in Study 2 (as determined by the Psychosis Like Symptoms Interview). Results In Study 1, 35 of 166 quantified proteins were significantly differentially expressed between CHR participants who did and did not develop psychosis. Functional enrichment analysis provided evidence for particular implication of the complement and coagulation cascade (false discovery rate-adjusted Fisher’s exact test p=2.23E-21). Using 65 clinical and 166 proteomic features a model demonstrated excellent performance for prediction of transition status (area under the receiver-operating curve [AUC] 0.96, positive predictive value [PPV] 83.0%, negative predictive value [NPV] 93.8%). A model based on the ten most predictive proteins accurately predicted transition status in training (AUC 0.96, PPV 87.5%, NPV 95.8%) and withheld data (AUC 0.92, PPV 88.9%, NPV 91.4%). A model using the same 65 clinical and 166 proteomic features predicted 2-year functional outcome with AUC 0.72 (PPV 67.6%, NPV 47.6%). In Study 2, 5 of 265 quantified proteins were significantly differentially expressed between participants who did and did not report PEs at age 18. A model using 265 proteomic features predicted PEs at age 18 with AUC 0.76 (PPV 69.1%, NPV 74.2%). Discussion With external validation, models incorporating proteomic data may contribute to improved prediction of clinical outcomes in individuals at risk of psychosis.

scholarly journals Giving women WOICE postpartum: prevalence of maternal morbidity using the WHO-WOICE instrument

2019 ◽  
Author(s):  
Lamus MN ◽  
Stephanie Lozano ◽  
Charles CM ◽  
Guida JP ◽  
Parpinelli MA ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Logistic Regression ◽  
Descriptive Analysis ◽  
Perinatal Outcomes ◽  
Good Health ◽  
World Health ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Factors Associated

Abstract Background There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE. Objective To evaluate the prevalence of non-severe maternal morbidities in puerperal women and analyses factors associated to impaired clinical, social and mental health conditions. Method A cross-sectional study with 519 postpartum women in a single encounter 6 to 12 weeks postpartum. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; The second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- altered if ≥10), functionality (WHODAS- altered when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with alterations was performed, with a logistic regression to investigate factors associated to impaired non-clinical and clinical conditions. Results 517 women were included, majority (54.3%) multiparous, ages between 20 and 34 years (65.4%) and with partner (75,6%). Over a quarter had (26.2%) preterm birth, however good perinatal outcomes. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance and 5.9% suffered violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and altered functioning in 4.4% of women. Logistic regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduces the perception of women on the presence of clinical morbidities. Conclusion During postpartum care, women presented high frequency of anxiety and depression and relevant frequency of substance use and violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.

scholarly journals Giving women WOICE postpartum: Prevalence of maternal morbidity using the WHO-WOICE instrument

2020 ◽  
Author(s):  
Martha Narvaez Lamus ◽  
Stephanie Lozano ◽  
Charles MPoca ◽  
Jose Paulo Guida ◽  
Mary Angela Parpinelli ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Logistic Regression ◽  
Descriptive Analysis ◽  
Perinatal Outcomes ◽  
Good Health ◽  
World Health ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Factors Associated

Abstract BackgroundThere are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE.ObjectiveTo evaluate the prevalence of non-severe maternal morbidities in puerperal women and analyses factors associated to impaired clinical, social and mental health conditions.MethodA cross-sectional study with 519 postpartum women in a single encounter 6 to 12 weeks postpartum. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; The second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- altered if ≥ 10), functionality (WHODAS- altered when ≥ 37.4) and data on violence and substance use. Subsequently, an evaluation of cases with alterations was performed, with a logistic regression to investigate factors associated to impaired non-clinical and clinical conditions.Results517 women were included, majority (54.3%) multiparous, ages between 20 and 34 years (65.4%) and with partner (75,6%). Over a quarter had (26.2%) preterm birth, however good perinatal outcomes. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance and 5.9% suffered violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and altered functioning in 4.4% of women. Logistic regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduces the perception of women on the presence of clinical morbidities.ConclusionDuring postpartum care, women presented high frequency of anxiety and depression and relevant frequency of substance use and violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.

scholarly journals Emergency Department Presentations and Youth Suicide: A Case-Control Study

2018 ◽  
Vol 64 (2) ◽  
pp. 88-97 ◽  
Author(s):  
Anne E. Rhodes ◽  
Mark Sinyor ◽  
Michael H. Boyle ◽  
Jeffrey A. Bridge ◽  
Laurence Y. Katz ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Problem ◽  
Health Problem ◽  
Psychotic Disorders ◽  
Case Control Study ◽  
Mental Health Problems ◽  
Time Frame ◽  
Case Control ◽  
Control Study

Objective: We estimate associations between emergency department (ED) diagnoses and suicide among youth to guide ED care. Method: This ED-based case-control study used data from the Office of the Chief Coroner and all EDs in Ontario, Canada. Cases ( n = 697 males and n = 327 females) were aged 10 to 25 years who died by suicide in Ontario between April 2003 and March 2014, with an ED contact in the year before their death. Same-aged ED-based controls were selected during this time frame. Crude and adjusted odds ratios (aORs) and 95% confidence intervals were calculated. Results: Among youth diagnosed with a mental health problem at their most recent ED contact (41.9% cases, 5% controls), suicide was elevated among nonfatal self-inflicted: ‘other’ injuries, including hanging, strangulation, and suffocation in both sexes (aORs > 14); cut/pierce injuries in males (aOR > 5); poisonings in both sexes (aORs > 2.2); and mood and psychotic disorders in males (aORs > 1.7). Among those remaining, ‘undetermined’ injuries and poisonings in both sexes (aORs > 5), ‘unintentional’ poisonings in males (aOR = 2.1), and assault in both sexes (aORs > 1.8) were significant. At least half of cases had ED contact within 106 days. Conclusions: The results highlight the need for timely identification and treatment of mental health problems. Among those with an identified mental health problem, important targets for suicide prevention efforts are youth with self-harm and males with mood and psychotic disorders. Among others, youth with unintentional poisonings, undetermined events, and assaults should raise concern.

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