scholarly journals Web-Based Graphic Representation of the Life Course of Mental Health: Cross-Sectional Study Across the Spectrum of Mood, Anxiety, Eating, and Substance Use Disorders

10.2196/16919 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e16919 ◽  
Author(s):  
Robin Leora Aupperle ◽  
Martin P Paulus ◽  
Rayus Kuplicki ◽  
James Touthang ◽  
Teresa Victor ◽  
...  

Background Although patient history is essential for informing mental health assessment, diagnosis, and prognosis, there is a dearth of standardized instruments measuring time-dependent factors relevant to psychiatric disorders. Previous research has demonstrated the potential utility of graphical representations, termed life charts, for depicting the complexity of the course of mental illness. However, the implementation of these assessments is limited by the exclusive focus on specific mental illnesses (ie, bipolar disorder) and the lack of intuitive graphical interfaces for data collection and visualization. Objective This study aimed to develop and test the utility of the Tulsa Life Chart (TLC) as a Web-based, structured approach for obtaining and graphically representing historical information on psychosocial and mental health events relevant across a spectrum of psychiatric disorders. Methods The TLC interview was completed at baseline by 499 participants of the Tulsa 1000, a longitudinal study of individuals with depressive, anxiety, substance use, or eating disorders and healthy comparisons (HCs). All data were entered electronically, and a 1-page electronic and interactive graphical representation was developed using the Google Visualization Application Programming Interface. For 8 distinct life epochs (periods of approximately 5-10 years), the TLC assessed the following factors: school attendance, hobbies, jobs, social support, substance use, mental health treatment, family structure changes, negative and positive events, and epoch and event-related mood ratings. We used generalized linear mixed models (GLMMs) to evaluate trajectories of each domain over time and by sex, age, and diagnosis, using case examples and Web-based interactive graphs to visualize data. Results GLMM analyses revealed main or interaction effects of epoch and diagnosis for all domains. Epoch by diagnosis interactions were identified for mood ratings and the number of negative-versus-positive events (all P values <.001), with all psychiatric groups reporting worse mood and greater negative-versus-positive events than HCs. These differences were most robust at different epochs, depending on diagnosis. There were also diagnosis and epoch main effects for substance use, mental health treatment received, social support, and hobbies (P<.001). User experience ratings (each on a 1-5 scale) revealed that participants found the TLC pleasant to complete (mean 3.07, SD 1.26) and useful for understanding their mental health (mean 3.07, SD 1.26), and that they were likely to recommend it to others (mean 3.42, SD 0.85). Conclusions The TLC provides a structured, Web-based transdiagnostic assessment of psychosocial history relevant for the diagnosis and treatment of psychiatric disorders. Interactive, 1-page graphical representations of the TLC allow for the efficient communication of historical life information that would be useful for clinicians, patients, and family members.

2020 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Lawrence J. Ouellet

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.


1994 ◽  
Vol 19 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Mary Margaret Kerr ◽  
Steven R. Forness ◽  
Kenneth A. Kavale ◽  
Bryan H. King ◽  
Connie Kasari

Children with conduct disorders are among the most frequent referrals for psychiatric or other mental health treatment; yet the diagnosis of conduct disorders is also frequently seen as a reason to exclude children or youth from special education and related mental health services. This article highlights the possibility that associated with conduct disorders or its symptoms may be a variety of other psychiatric disorders requiring very different interventions. Extrapolation of symptoms from classroom inattention or disruptive behavior and estimated prevalence are discussed.


2018 ◽  
Author(s):  
Christiane Eichenberg ◽  
Markus Schott ◽  
Adam Sawyer ◽  
Georg Aumayr ◽  
Manuela Plößnig

BACKGROUND Depression is one of the most common mental disorders in older adults. Unfortunately, it often goes unrecognized in the older population. OBJECTIVE The aim of this study was to identify how Web-based apps can recognize and help treat depression in older adults. METHODS Focus groups were conducted with mental health care experts. A Web-based survey of 56 older adults suffering from depression was conducted. Qualitative interviews were conducted with 2 individuals. RESULTS Results of the focus groups highlighted that there is a need for a collaborative care platform for depression in old age. Findings from the Web-based study showed that younger participants (aged 50 to 64 years) used electronic media more often than older participants (aged 65 years and older). The interviews pointed in a comparable direction. CONCLUSIONS Overall, an e-mental (electronic mental) health treatment for depression in older adults would be well accepted. Web-based care platforms should be developed, evaluated, and in case of evidence for their effectiveness, integrated into the everyday clinic.


2019 ◽  
Vol 65 (6) ◽  
pp. 527-538
Author(s):  
Eric Badu ◽  
Rebecca Mitchell ◽  
Anthony Paul O’Brien

Background: The clinical pathways for treating mental illness have received global attention. Several empirical studies have been undertaken on treatment pathways in Ghana. No study, however, has systematically reviewed the literature related to the pathways of mental health treatment in Ghana. Aim: This article aims to identify the pathways used to treat mental illnesses; examine the evidence about the possibility of collaboration between biomedical, faith and traditional healing pathways; and draw attention to the barriers hindering such collaboration. Methods: A search of the published literature was conducted using Medline, Embase, PsycINFO, CINAHL (EBSCO), Web of Science and Scopus databases. The search was limited to the articles that were published in English and released between 2000 and June 2018. The review synthesises both qualitative and quantitative data. Results: The findings showed that mental illnesses in Ghana are treated using a mixture of biomedical and faith-based and traditional healing services. Faith and traditional healing pathways are typically used as a preliminary source of cultural assessment before seeking biomedical treatment. There is an increasing desire for collaboration between biomedical, faith and traditional healing pathways. However, several individual factors (attitude or stigma, the perceived efficacy of treatment and differences in the treatment process) and health system factors (a lack of policy and regulation, a limited number of biomedical service providers, limited financial support and geographical isolation of services) jointly contribute to barriers precluding establishing such collaboration. Conclusion: This review recommends that policies, regulations, educational support and financial incentives should be developed to facilitate collaboration between biomedical, faith and traditional healing service provision.


2015 ◽  
Vol 66 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Rebecca K. Sripada ◽  
Paul N. Pfeiffer ◽  
Sheila A. M. Rauch ◽  
Kipling M. Bohnert

Author(s):  
Nancy Wolff

Research in mental health issues in prisoner populations essentially stopped in the mid 1970’s. It is now re-emerging as a critical component of improving mental health care and helping toward recovery for the incarcerated mentally ill. Mental illness, ranging from acute anxiety to schizophrenia, is endemic within prisons and jails. Unlike their free world counterparts, however, incarcerated people have a constitutional right to mental health treatment. Yet, despite the need for and right to mental health treatment, remarkably little reliable and valid evidence is available on the nature and level of mental illness among incarcerated people, the effects of incarceration on symptomatology, the availability and quality of medication, cognitive, and psychosocial treatment for disorders, and how context impacts the effectiveness of the treatment that is available. Evidence is absent because corrections-based research is constrained by regulation, financing, and inexperience. In this chapter, the history of prisoner research and the evolution of federal regulations to protect prisoners as human subjects will be reviewed and then discussed in terms of how regulation has impacted correctional mental health research, after first defining what is meant by research and why research is needed to inform policy and practice decisions. This will be followed by recommendations for building the correctional mental health research evidence base. The intent here is to help researchers, in collaboration with stakeholders, develop, design, and implement research studies, and disseminate evidence to advance science and the quality of care available to incarcerated people with mental illnesses within the current regulatory environment.


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