scholarly journals Ethnicity and quality of antipsychotic prescribing among in-patients in south London

2008 ◽  
Vol 193 (2) ◽  
pp. 161-162 ◽  
Author(s):  
Anne Connolly ◽  
David Taylor
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
High Dose ◽  
Median Dose ◽  
Black And White ◽  
Prescribing Quality ◽  
Black Patients

SummaryEthnicity may influence treatment decisions in mental disorders. We undertook a survey of the prescribing of antipsychotics for in-patients in three south London mental health trusts. A total of 255 patients (152 White, 103 Black) were included. Median dose of antipsychotic (% of licensed dose) was 58.3% for White and 50.0% for Black patients (adjusted effect size=0.14, 95% CI −0.34 to 0.63). High-dose antipsychotics were prescribed to 15.1% of White and 11.7% of Black patients (adjusted odds ratio (OR)=0.5, 95% CI 0.19–1.33), and antipsychotic polypharmacy was recorded for 25.7% and 31.1% respectively (adjusted OR=3.05, 95% CI 1.44–6.46). Prescribing quality was similar for Black and White patients.

Quality of service and commitment to tobacco dependence treatment for individuals living with mental disorders in France: A pilot study

2021 ◽  
pp. 002076402110429
Author(s):  
João M Castaldelli-Maia ◽  
Priscila D Gonçalves ◽  
Danielle R Lima ◽  
Helena F Moura ◽  
Gisèle Apter
Keyword(s):  
Mental Health ◽  
Quality Of Service ◽  
Pilot Study ◽  
Mental Disorders ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Tobacco Dependence ◽  
Treatment Quality ◽  
Tobacco Treatment

Background: There are remarkably high smoking rates in patients living with mental disorders (PLWMD), and the absence of a specific treatment policy for smoking cessation for these patients worldwide. The present study aimed to (i) investigate the quality of service and commitment to tobacco dependence treatment, and (ii) produce high-quality French versions of the Index of Tobacco Treatment Quality (ITTQ) and Tobacco Treatment Commitment Scale (TTCS). Methods: ITTQ and TTCS were used to assess French mental health professionals ( n = 80). Both scales were translated from their original language following standard procedures (i.e. forward translation). Descriptive analysis for total score, each factor and item were calculated for the entire sample, followed by subgroup analysis by gender, and role of the practitioner. Results: Nurses presented higher levels of both treatment commitment and treatment quality in their mental health care units, compared to psychiatrists, and residents. Overall, counseling offering was low and there was a perception that it is unfair to take tobacco away from PLWMD. In the other hand, there were high levels of smoking assessment and perceptions that nicotine dependence should be included in drug treatment programs. Conclusions: There is a gap in tobacco treatment implementation for French PLWMD. The present pilot study alerts about the problem, and should stimulate larger studies validating such measures for wide use with French-speaking mental health professionals. French nurses presented higher levels of both treatment commitment and quality, and could be in a leadership position for such implementation. Encouraging the implementation of tobacco counseling within conventional mental health treatment is critical to improve cessation rates among this population. There is a potential for the sustainability of tobacco treatment interventions since the levels of commitment observed here were higher than in previous studies conducted abroad.

Racial Disparities in Invasive Management for Patients With Acute Myocardial Infarction With Chronic Kidney Disease

2021 ◽  
Author(s):  
Jennifer A. Rymer ◽  
Shuang Li ◽  
Patrick H. Pun ◽  
Laine Thomas ◽  
Tracy Y. Wang
Keyword(s):  
Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Racial Disparities ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Logistic Regression Models ◽  
Black Patients ◽  
Invasive Management ◽  
White Patients

Background: Due to increased risks of contrast nephropathy, chronic kidney disease (CKD) can deter consideration of invasive management for patients with myocardial infarction (MI). Black patients have a higher prevalence of CKD. Whether racial disparities exist in the use of invasive MI management for patients with CKD presenting with MI is unknown. Methods: We examined 717 012 White and 99 882 Black patients with MI treated from 2008 to 2017 at 914 hospitals in the National Cardiovascular Data Registry Chest Pain—MI Registry. CKD status was defined as estimated glomerular filtration rate (eGFR) ≥90 mL/(min·1.73 m 2 ; no CKD), eGFR <90 but ≥60 (mild), eGFR <60 but ≥30 (moderate), and eGFR <30 or dialysis (severe). We used multivariable logistic regression models to examine the interaction of race and CKD severity in invasive MI management. Results: Among those with MI, Black patients were more likely than White patients to have CKD (eGFR <90; 61.4% versus 58.5%; P <0.001). Among those with MI and CKD, Black patients were more likely than White patients to have severe CKD (21.2% versus 12.4%; P <0.001). Patients with CKD were more likely than those without CKD to have diabetes or heart failure; Black patients with CKD were more likely to have these comorbidities when compared with White patients with CKD (all P <0.0001). Black race and CKD were associated with a lower likelihood of invasive management (adjusted odds ratio, 0.78 [95% CI, 0.75–0.81]; adjusted odds ratio, 0.72 [95% CI, 0.70–0.74]; P <0.001 for both). At eGFR levels ≥10, Black patients were significantly less likely than White patients to undergo invasive management. Conclusions: Black patients with MI and mild or moderate CKD were less likely to undergo invasive management compared with White patients with similar CKD severity. National efforts are needed to address racial disparities that may remain in the invasive management of MI.

Incident infection during the first year of treatment – A comparison of clozapine and paliperidone palmitate long-acting injection

2022 ◽  
pp. 026988112110589
Author(s):  
Shubhra Mace ◽  
Olubanke Dzahini ◽  
Victoria Cornelius ◽  
Hadar Langerman ◽  
Ebenezer Oloyede ◽  
...  
Keyword(s):  
Mental Health ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Paliperidone Palmitate ◽  
First Year ◽  
Risk Of Infection ◽  
Long Acting ◽  
First Time ◽  
Health Trust ◽  
Incident Infection

Background: To examine the risk of infection in patients prescribed clozapine compared with patients prescribed paliperidone palmitate long-acting injection (PPLAI). Method: A retrospective, 1-year, cohort study conducted on events occurring in eligible patients beginning treatment for the first time with clozapine or PPLAI between June 2017 and June 2019 in a UK mental health trust providing in-patient and out-patient services. Results: The study included 64 patients starting clozapine and 120 patients starting PPLAI. Incidence of infection was greater in clozapine starters than in PPLAI starters (28% vs 6%; p = 0.001; adjusted odds ratio 5.82 (95% confidence interval (CI) = 2.15–15.76, p = 0.001). Infectious episodes in clozapine patients were not related to changes in neutrophil counts. Incident infection in the clozapine group was highest in the first 3 months of treatment. The most commonly reported infection in the clozapine group was chest infection; however, the majority of infections were non-chest-related. Conclusion: Patients starting clozapine showed a substantially increased likelihood of infection compared with patients starting PPLAI.

Enhancing Mental Health

2021 ◽  
pp. 264-269
Author(s):  
Parvind Gambhir
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Health Priorities ◽  
Face To Face ◽  
Online Platforms ◽  
Diabetes Technology ◽  
The World ◽  
Challenging Situation

Mental health is one of the health priorities in the 21st century along with cardiovascular, cancer, and diabetes. Technology nowadays is most sought for getting any information. There are numerous online platforms that have been developed to assist in assessment, provide feedback, suggest management, and thereafter monitor mental disorders in target patients with a view to enhancing the quality of mental health care provided by traditional face-to-face services. In the current situation where the world is facing a challenging situation in COVID-19, technology has become highly sought after for managing the health of patients.

Prevalence and epidemiological associates of novel psychedelic use in the United States adult population

2019 ◽  
Vol 33 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
James D Sexton ◽  
Michael S Crawford ◽  
Noah W Sweat ◽  
Allyson Varley ◽  
Emma E Green ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Psychological Distress ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Adult Population ◽  
The United States ◽  
Psychosocial Characteristics ◽  
Illicit Use ◽  
Directed Research

Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances. Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes. Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008–2016 of the National Survey on Drug Use and Health (weighted n=234,914,788). Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1–1.9)) and past year suicidal planning (aOR=1.6 (1.1–2.4)). Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.

scholarly journals The effect of the 2008 recession on well-being and employment status of people with and without mental health problems

2019 ◽  
Vol 30 (4) ◽  
pp. 761-766 ◽  
Author(s):  
Unnur Jónsdóttir ◽  
Edda Björk þórðardóttir ◽  
Thor Aspelund ◽  
þórarinn Jónmundsson ◽  
Kristjana Einarsdóttir
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Odds Ratio ◽  
Employment Status ◽  
Adjusted Odds Ratio ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Problems ◽  
Study Cohort ◽  
Increased Risk

Abstract Background The world was hit hard by the 2008 recession which led to increased unemployment and financial strain. However, how the recession affected people with pre-existing mental health problems has been understudied. This study investigates the effect of the 2008 recession in Iceland on stress, well-being and employment status of people with regard to whether they are suffering from mental health problems. Methods The study cohort included participants (18–69 years old) of the ‘Health and Wellbeing of Icelanders’, a 3-wave survey conducted before (in 2007) and after (in 2009 and 2012) the recession in 2008. Self-assessed well-being was measured with the Short Warwick-Edinburgh Mental Well-being Scale and the 4-item Perceived Stress Scale. Logistic regression was used to assess the effect of the 2008 recession on self-assessed well-being and employment status in 2009 and 2012, using 2007 as a reference year. Results Participants with no pre-recession mental health problems were at increased risk of both poor well-being, (with adjusted odds ratio at 1.66, in 2009 and 1.64 in 2012) and higher perceived stress, (with adjusted odds ratio at 1.48 in 2009 and 1.53 in 2012), after the recession. Interestingly, no significant change in well-being and perceived stress was observed among participants suffering from pre-recession mental health problems. Both groups had increased risk of unemployment after the recession. Conclusion Results indicate that after recessions, the risk of stress and poor well-being increases only among those who do not suffer from pre-recession mental health problems.

Impact of Health-Related Quality of Life and Prediagnosis Risk of Major Depressive Disorder on Treatment Choice for Stage I Lung Cancer

2019 ◽  
pp. 1-8
Author(s):  
Ritchell van Dams ◽  
Tristan Grogan ◽  
Percy Lee ◽  
Rinaa Punglia ◽  
Ann Raldow
Keyword(s):  
Quality Of Life ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Treatment Choice ◽  
Stage I ◽  
Health Related Quality ◽  
Major Depressive ◽  
Related Quality ◽  
Health Related

PURPOSE We hypothesized that prediagnosis depressive symptoms and patient-reported health-related quality of life (HRQOL) would be associated with treatment choice for stage I non–small-cell lung cancer (NSCLC). METHODS Using the SEER and Medicare Health Outcomes Survey (SEER-MHOS)–linked data set, we identified patients age 65 years and older with stage I NSCLC diagnosed between 2004 and 2013 who completed the HOS 24 or fewer months before diagnosis. HRQOL was measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Medical Outcomes Study Short Form-36 and the Veterans RAND 12-Item Health Survey instruments. Major depressive disorder (MDD) risk was derived from responses to HOS questions that screen for depressive symptoms. Associations with treatment choice were assessed with multivariable multinomial logistic regression while controlling for prespecified patient characteristics. RESULTS We analyzed 515 evaluable patients, of whom 140 (27%) met criteria for risk of MDD. On univariable analysis, a higher proportion of patients who received radiotherapy (RT) versus surgery were at risk for MDD (34% v 22%, respectively; P = .011). On multivariable analysis, higher PCS and MCS scores were associated with a decreased likelihood of receiving RT compared with surgery (adjusted odds ratio per 10-point PCS increase, 0.60 [95% CI, 0.45 to 0.79; P < .001]; adjusted odds ratio per 10-point MCS increase, 0.61 [95% CI 0.46 to 0.80; P < .001]). CONCLUSION Among older patients with stage I NSCLC, there was a significant association between those who self-reported lower HRQOL and receipt of RT. There was also a nonsignificant association in MDD risk and increased likelihood of RT receipt. Additional studies are warranted to examine the impact of pretreatment HRQOL and MDD risk on clinical decision making.

Mental Disorders of Pregnant and Postpartum Women After Earthquakes: A Systematic Review

2014 ◽  
Vol 8 (4) ◽  
pp. 315-325 ◽  
Author(s):  
Jian-Hua Ren ◽  
Chung-Lim Vico Chiang ◽  
Xiao-Lian Jiang ◽  
Bi-Ru Luo ◽  
Xing-Hui Liu ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Family Relationships ◽  
Relevant Literature ◽  
Psychological Impact ◽  
Postpartum Women ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The Relationship

AbstractObjectiveThe aim of this review was to systematically search and critique relevant literature on the potential psychological impact of earthquakes on peripartum women to synthesize existing knowledge for further action.MethodsA search through 5 databases was conducted for relevant publications in English, and the results were screened through a set of inclusion and exclusion processes.ResultsEight articles were included. Depression and posttraumatic stress disorder were the most often reported mental disorders. Some factors (eg, family relationships and social support) were associated with mental disorders suffered by peripartum women after earthquakes. An assessment of the quality of the studies showed that most did not have high levels of evidence because of their cross-sectional design and limitations.ConclusionsAmong the factors that influenced the mental health of pregnant and postpartum women after earthquakes, family function appears to be one of the most important and deserves further exploration. Other mental health conditions such as minor psychiatric disorders should also be studied for their relationship with disasters and pregnancy. Well-designed studies are needed to enable a better understanding of the relationship between earthquakes and the mental disorders of peripartum women so that the most appropriate interventions can be proposed. (Disaster Med Public Health Preparedness. 2014;0:1–11)

scholarly journals Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review

2021 ◽  
pp. 1-32
Author(s):  
Jorien L. Treur ◽  
Marcus R. Munafò ◽  
Emma Logtenberg ◽  
Reinout W. Wiers ◽  
Karin J. H. Verweij
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Mental Disorders ◽  
Alcohol Drinking ◽  
Mendelian Randomization ◽  
Higher Educational Attainment ◽  
The Relationship

Abstract Background Poor mental health has consistently been associated with substance use (smoking, alcohol drinking, cannabis use, and consumption of caffeinated drinks). To properly inform public health policy it is crucial to understand the mechanisms underlying these associations, and most importantly, whether or not they are causal. Methods In this pre-registered systematic review, we assessed the evidence for causal relationships between mental health and substance use from Mendelian randomization (MR) studies, following PRISMA. We rated the quality of included studies using a scoring system that incorporates important indices of quality, such as the quality of phenotype measurement, instrument strength, and use of sensitivity methods. Results Sixty-three studies were included for qualitative synthesis. The final quality rating was ‘−’ for 16 studies, ‘– +’ for 37 studies, and ‘+’for 10 studies. There was robust evidence that higher educational attainment decreases smoking and that there is a bi-directional, increasing relationship between smoking and (symptoms of) mental disorders. Another robust finding was that higher educational attainment increases alcohol use frequency, but decreases binge-drinking and alcohol use problems, and that mental disorders causally lead to more alcohol drinking without evidence for the reverse. Conclusions The current MR literature increases our understanding of the relationship between mental health and substance use. Bi-directional causal relationships are indicated, especially for smoking, providing further incentive to strengthen public health efforts to decrease substance use. Future MR studies should make use of large(r) samples in combination with detailed phenotypes, a wide range of sensitivity methods, and triangulate with other research methods.

Emergency department use at the end of life in elderly patients with gastrointestinal malignancies and mental health comorbidities.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 811-811
Author(s):  
Mehr Kashyap ◽  
Jeremy Phillip Harris ◽  
Daniel Tandel Chang ◽  
Erqi L. Pollom
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Abuse ◽  
Mental Disorders ◽  
Elderly Patients ◽  
End Of Life ◽  
Health Care Expenditures ◽  
Gastrointestinal Malignancies ◽  
The Impact

811 Background: Aggressive care at the end-of-life can contradict patients’ wishes, negatively impact patient quality of life, and contribute to overall health care expenditures. Patients with mental disorders (MD) often experience disparities in medical care and have poorer clinical outcomes. We investigated the impact of mental disorders on emergency department (ED) use at the end of life among elderly patients with gastrointestinal (GI) malignancies. Methods: We conducted a retrospective cohort study using the SEER-Medicare database. We identified patients aged 66 years and older with GI malignancies (colorectal, pancreatic, gastric, hepatic, biliary, esophageal, small bowel, and anal cancer) diagnosed between 2004 and 2013 who had recorded death. We assessed the association between MD (depression, bipolar disorder, psychotic disorder, anxiety, dementia, and substance abuse) and ED use within 30 days of death using logistic regression models. Results: Of the 160,367 decedents included, 54,461 (34.1%) had at least one MD diagnosis between one year prior to cancer diagnosis and death. Those with MD were more likely to use the ED more than once in the last 30 days of life (14.7% vs. 12.4% p < 0.01). ED use was highest among decedents with anxiety disorder (15.8%) and substance abuse (16.3%). Among decedents with mental disorders, risk factors associated with ED use at end of life include being male (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.10 – 1.22), younger (aOR 1.14, 95% CI 1.06 - 1.23), and black (aOR 1.33, 95% CI 1.23 – 1.45), living in a lower income zip code (1.21, 95% CI 1.13 – 1.30), and having a higher Charlson comorbidity score (aOR 1.71, 95% CI 1.56 – 1.87). ED use was also associated with pancreatic (aOR 1.16, 95% CI 1.08 - 1.25), hepatic (aOR 1.21, 95% CI 1.11 - 1.33), biliary (aOR 1.16, 95% CI 1.03 - 1.30) and esophageal (aOR 1.16, 95% CI 1.04 - 1.29) cancer compared to colorectal cancer. Conclusions: MD is associated with increased ED use at the end of life among elderly patients with GI cancer. Palliative and supportive care including mental health services early in the disease course may improve quality of end-of-life care in this vulnerable population.

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