A fully automated conversational agent with artificial intelligence capabilities (Youper) for treating depression and anxiety: A nonrandomized feasibility trial (Preprint)

2019 ◽  
Author(s):  
Jose Hamilton Vargas ◽  
Thiago Antonio Marafon ◽  
Diego Fernando Couto ◽  
Ricardo Giglio ◽  
Marvin Yan ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Financial Incentives ◽  
Empirical Support ◽  
Digital Technologies ◽  
Feasibility Trial ◽  
Depression And Anxiety ◽  
Conversational Agents ◽  
Symptoms Of Depression ◽  
Viable Solution

BACKGROUND Mental health conditions, including depression and anxiety disorders, are significant global concerns. Many people with these conditions don't get the help they need because of the high costs of medical treatment and the stigma attached to seeking help. Digital technologies represent a viable solution to these challenges. However, these technologies are often characterized by relatively low adherence and their effectiveness largely remains empirical unverified. While digital technologies may represent a viable solution for this persisting problem, they often lack empirical support for their effectiveness and are characterized by relatively low adherence. Conversational agents using artificial intelligence capabilities have the potential to offer a cost-effective, low-stigma and engaging way of getting mental health care. OBJECTIVE The objective of this study was to evaluate the feasibility, acceptability, and effectiveness of Youper, a mobile application that utilizes a conversational interface and artificial intelligence capabilities to deliver cognitive behavioral therapy-based interventions to reduce symptoms of depression and anxiety in adults. METHODS 1,012 adults with symptoms of depression and anxiety participated in a real-world setting study, entirely remotely, unguided and with no financial incentives, over an 8-week period. Participants completed digital versions of the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7) at baseline, 2, 4, and 8 weeks. RESULTS After the eight-week study period, depression (PHQ-9) scores of participants decreased by 48% while anxiety (GAD-7) scores decreased by 43%. The RCI was outside 2 standard deviations for 93.0% of the individuals in the PHQ-9 assessment and 90.7% in the GAD-7 assessment. Participants were on average 24.79 years old (SD 7.61) and 77% female. On average, participants interacted with Youper 0.9 (SD 1.56) times per week. CONCLUSIONS Results suggest that Youper is a feasible, acceptable, and effective intervention for adults with depression and anxiety. CLINICALTRIAL Since this study involved a nonclinical population, it wasn't registered in a public trials registry.

scholarly journals Improving Mental Health in Pregnancy for Refugee Women: Protocol for the Implementation and Evaluation of a Screening Program in Melbourne, Australia (Preprint)

2019 ◽  
Author(s):  
Jacqueline Anne Boyle ◽  
Suzanne Willey ◽  
Rebecca Blackmore ◽  
Christine East ◽  
Jacqueline McBride ◽  
...  
Keyword(s):  
Mental Health ◽  
Postnatal Depression ◽  
Screening Program ◽  
Routine Care ◽  
Perinatal Mental Health ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Refugee Women ◽  
Health Disorders ◽  
In Pregnancy

BACKGROUND Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is one of the leading causes of maternal mortality postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program’s feasibility and acceptability to women and health care providers (HCPs). OBJECTIVE The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). METHODS This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. RESULTS The recruitment is complete, and data collection and analysis are underway. CONCLUSIONS It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/13271

Effectiveness of Prompt Mental Health Care: Preliminary results from a randomized controlled trial

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Knapstad ◽  
L V Lervik ◽  
S M M Saether ◽  
L E Aaroe ◽  
O R F Smith
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Mental Health Care ◽  
Controlled Trial ◽  
Sensitivity Analyses ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Randomized Controlled

Abstract Background Prompt Mental Health Care (PMHC) service is a Norwegian initiative, adapted from the English ‘Improved Access to Psychological Therapy’ (IAPT), aimed at improving access to primary care treatment for anxiety and depression. Thus far, both PMHC and IAPT have been evaluated by cohort studies only. Albeit yielding promising results, the extent to which these are attributable to the treatment thus remains unsettled. This study investigates the effectiveness of PMHC compared to treatment as usual (TAU) at six months follow-up. Methods Randomized controlled trial with parallel assignment in two PMHC sites from November 2015 to March 2018. Participants were 681 adults (aged ≥18 years) considered for admission to PMHC due to anxiety and/or mild to moderate depression. These were randomly assigned on a 70:30 ratio. Main outcomes were recovery rates and changes in symptoms of depression and anxiety between baseline and follow-up. Primary outcome data were available for 73%/67% in the PMHC/TAU group. Sensitivity analyses based on observed patterns of missingness were conducted. Results A reliable recovery rate of 58.5% was observed in the PMHC group and 31.9% in the TAU group, yielding a between-group effect size (ES) of 0.61 [95% CI 0.37-0.85, p<.001]. The differences in degree of improvement between PMHC and TAU yielded an ES of -0.88 [95% CI -1.23-0.43, p < 0.001] for symptoms of depression and -0.60 [95% CI -0.90-0.30, p < 0.001] for symptoms of anxiety in favour of PMHC. All sensitivity analyses pointed in the same direction with small variations in point estimates. Findings were slightly more robust for depressive than anxiety symptoms. Conclusions The PMHC treatment was substantially more effective than TAU in alleviating symptoms of anxiety and depression. This adaptation of IAPT is considered a viable supplement to existing health services to increase access of effective treatment for adults who suffer from anxiety and mild to moderate depression. Key messages This study is the first to evaluate the effectiveness of an IAPT-like treatment model in terms of a randomized controlled trial. Prompt Mental Health Care was substantially more effective than TAU in alleviating symptoms of depression and anxiety at 6-months follow-up.

scholarly journals Psychological correlates and binge drinking behaviours among Canadian youth: a cross-sectional analysis of the mental health pilot data from the COMPASS study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028558 ◽  
Author(s):  
Alexandra Butler ◽  
Isabella Romano ◽  
Karen Patte ◽  
Mark A Ferro ◽  
Margaret de Groh ◽  
...  
Keyword(s):  
Mental Health ◽  
Secondary Schools ◽  
Binge Drinking ◽  
Well Being ◽  
Secondary Outcome ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Large Sample ◽  
Symptoms Of Depression ◽  
Canadian Youth

ObjectiveThe objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012–2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.DesignCross-sectionalSetting14 secondary schools across Ontario and British Columbia, Canada.ParticipantsA sample of grade 9–12 students (n=6570) who participated in the Mental Health pilot of the COMPASS studyPrimary and secondary outcome measuresSelf-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)−10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener’s Flourishing Scale: 8–40).ResultsIn our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.ConclusionsConsistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.

scholarly journals Maintaining contact with blue-green spaces during the COVID-19 pandemic associated with positive mental health

2020 ◽  
Author(s):  
Sarai Pouso ◽  
Angel Borja ◽  
Lora E. Fleming ◽  
Erik Gómez-Baggethun ◽  
Mathew White ◽  
...  
Keyword(s):  
Mental Health ◽  
Well Being ◽  
Natural World ◽  
Decision Makers ◽  
Green Spaces ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Outdoor Spaces ◽  
Potential Benefits ◽  
Negative Impacts

There is growing evidence that exposure to the natural world (blue-green spaces) has potential benefits for mental health and well-being. The COVID-19 pandemic and the measures adopted to control it provide a natural experiment to investigate the links between nature exposure and mental health under extreme conditions. Using a survey distributed online and based on 6,080 responses, we tested three hypotheses: (1) people will show different levels of symptoms of depression and anxiety depending on the level of lockdown (severity) and ability to maintain contact with outdoor spaces; and (2) where access to outdoor public spaces was restricted, those with access to private outdoor spaces (2a) or even a green-blue nature view (2b) will show fewer symptoms of depression and anxiety and a more positive mood. Lockdown severity significantly affected mental health, while contact with nature helped people to cope with these impacts. The buffering effect of nature was especially relevant for those under strict lockdowns. People perceived that nature helped them to cope with lockdown measures; and emotions were more positive among individuals with accessible outdoor spaces and blue-green elements in their views. These findings can help decision-makers in developing potential future lockdown measures to mitigate the negative impacts, helping people to be more resilient and maintain better mental health.

scholarly journals Effects of a School-Based Intervention On Levels of Anxiety and Depression: A Cluster-Randomized Controlled Trial of The MindPower Program in Ten High Schools in Norway

2021 ◽  
Author(s):  
Gry Anette Sælid ◽  
Nikolai Czajkowski ◽  
Leif Edvard Aarø ◽  
John Roger Andersen ◽  
Thormod Idsøe ◽  
...  
Keyword(s):  
Mental Health ◽  
High School ◽  
High School Students ◽  
Mixed Model ◽  
Large Population ◽  
Depression Scale ◽  
Control Group ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
School Based

Abstract BackgroundThe previous decade has shown increased symptoms of depression and anxiety among adolescents. To promote mental health and reduce mental illness, the government of Norway has, as in other countries, pledged that all schools must incorporate life-skills education. We report results from an evaluation of MindPower, a modification of the Coping With Depression (CWD) course, delivered universally in the classroom to secondary high school students, aged 15-16 years, in one county in Norway. The aim of the study was to evaluate the effect of MindPower on symptoms of depression and anxiety.MethodsWe utilized a two-groups` delayed intervention design where 110 first year high school classes were randomized into one of two intervention groups (IG1 and IG2). IG1 participated in MindPower while IG2 served as a control group for four months until the intervention started also in this group. IG1 and IG2 responded to questionnaires before and after the eight weeks course, at the start of the first and the second booster session, and at the five months follow up. Questionnaires, including online versions of the Hopkins Symptom Checklist (SCL-8) and the Reynolds Adolescent Depression Scale (RADS-2:SF), were administered to 1673 out of a total of 2384 students. SCL-levels were also compared with those from a large population study (UngData).ResultsAccording to mixed model analyses, SCL-8 and RADS-2:SF showed significant baseline differences between IG1 and IG2. In IG1 and IG2, both SCL-8 and RADS-2:SF showed a small but significant increase in mean scores throughout the study period, with markedly lower mean scores among boys. The SCL-levels were first lower for both girls and boys and then after the completion of MindPower the SCL-levels, equal to the SCL-levels in UngData.ConclusionsNo effects of the intervention were found. This large universal school-based trial suffered from considerable drop-out of participants. Experiences from implementation and evaluation of universal mental health promotion and preventive school interventions are thoroughly discussed, including, preparation, resources, support, time, realistic expectations, teacher selection and training, implementation, and research designs and more. Several empirically based, practical advices are presented. Clinical Trial registration 27/08/2018. Registration number NCT03647826.

scholarly journals Saúde mental e a prática de atividades físicas na quarentena: um ensaio de discussão teórica

2021 ◽  
Vol 19 (2) ◽  
pp. 107-112
Author(s):  
Matheus Cabanha Paniago Almada ◽  
Romano Deluque Júnior ◽  
Cesar Augusto Marton ◽  
Mariane Moreira Ramiro do Carmo
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Contact ◽  
Physical Activities ◽  
Theoretical Discussion ◽  
Depression And Anxiety ◽  
Health It ◽  
Negative Effects ◽  
Symptoms Of Depression ◽  
Physical Exercises

OBJETIVO: Discutir os modos como um estado de quarentena e de distanciamento social, por motivos de pandemia, alteram os hábitos de atividade física da população e incidem em impactos diante da saúde mental das pessoas inseridas no referido contexto. MÉTODOS: O presente estudo pretende ser um ensaio de discussão teórica, com delineamentos explicativos/analíticos, utilizando-se de artigos recentemente publicados e indexados, para identificar os pontos negativos e positivos do distanciamento social e da quarentena, bem como, discutir os seus efeitos na saúde mental. Pretende-se ainda, argumentar em favor da prática de atividades físicas, como ferramenta redutora da tensão e da ansiedade, tão características do atual cenário pandêmico. RESULTADOS: Considerando que uma situação de distanciamento social, ou de quarentena, alteram os hábitos da população, verifica-se que as mudanças de rotinas fazem emergir sentimentos de frustração e tédio, além disso, a falta de contato físico e social provoca a sensação de isolamento perante o resto do mundo e angústia aquele que vivencia o fenômeno. Uma estratégia para combater os efeitos negativos na saúde mental decorrente a quarentena e o iso-lamento social, é a prática de atividades físicas. Dentre os benefícios da prática de atividades físicas para a saúde mental, demonstrou-se que a mesma, quando feita regularmente, está associada a diminuição de sintomas de depressão e ansiedade. CONCLUSÃO: Sabendo dos impactos psicológicos que são gerados nesse período, e fazendo uma associa-ção com os estudos que demonstram os benefícios das atividades físicas, é possível afirmar que a prática dos pode ser uma estratégia eficiente de enfrentamento, porém, estudos es-pecíficos devem ainda ser realizados.ABSTRACT. Mental health and physical activity practice in quarantine: a theoretical discussion essay.OBJECTIVE: To discuss the ways in which a state of quarantine and social detachment, for reasons of a pandemic, changes the habits of the population and impacts on the mental health of people in the context. METHODS: The present study intends to be a theoretical discussion essay, with explanatory / analytical designs, which uses recently published and indexed articles, to identify the negative and positive points of social detachment and quarantine, as well as to discuss its effects on mental health. It is also intended to argue in favor of the practice of physical activities, as a tool to reduce tension and anxiety, so characteristic of the current pandemic scenario.  RESULTS: Considering that a situation of social detachment, or quarantine changes the habits of the population, it is also verified that changes in routines emerge feelings of frustration and boredom, in addition, the lack of physical and social contact causes feeling of isolation from the rest of the world and distressing those who experience the phenomenon. A strategy to combat the negative effects on mental health resulting from quarantine and social isolation, is the practice of physical exercises. Among the benefits of physical exercise for mental health, it has been shown that regular physical activity is associated with decreased symptoms of depression and anxiety. CONCLUSION: Knowing the psychological impacts that are generated in this period, and making an association with the studies that demonstrate the benefits of physical exercises, it is possible to say that the practice of activities can be an efficient coping strategy, however, specific studies must still be performed.

scholarly journals Mental Health and Associated Demographic and Occupational Factors among Health Care Workers during the COVID-19 Pandemic in Latvia

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1381
Author(s):  
Laura Valaine ◽  
Gunta Ancāne ◽  
Artūrs Utināns ◽  
Ģirts Briģis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care System ◽  
Health Care Workers ◽  
Adverse Outcomes ◽  
Depression And Anxiety ◽  
Front Line ◽  
Occupational Factors ◽  
Symptoms Of Depression ◽  
Care Workers

Background and Objectives: The COVID-19 pandemic has negatively impacted the health care system. Front-line health care workers (HCWs) are at a higher risk of mental health adverse outcomes. The aim of this study was to evaluate the frequency of the symptoms of depression and anxiety and associated demographic and occupational factors among front-line HCWs in Latvia. Materials and Methods: A cross-sectional quantitative study was performed in a population of HCWs during the first wave of the COVID-19 pandemic in Latvia. The participants were interviewed between 28 April 2020 and 2 June 2020. Answers from 864 HCWs were obtained. The participants reported their demographics, work-related information, contacts with COVID-19-positive patients and completed two standardised questionnaires that assessed the symptoms of anxiety (GAD-7) and depression (PHQ-9). The gathered data were analysed by a chi-squared test and binary logistic regression. The data analysis was performed using SPSS v25. Results: A total of 209 (24.8%) participants had depression symptoms and 145 (17.2%) had anxiety symptoms. Health care workers older than 50 had a lower risk of both depression (OR 0.422 (95% CI, 0.262–0.680)) and anxiety (OR 0.468 (95% CI, 0.270–0.813)). General practitioners had more frequent symptoms of depression and anxiety than participants who worked at hospitals (32.8% (n = 63) versus 19.4% (n = 73) and 27.1% (n = 52) versus 10.3% (n = 39), respectively (p = 0.037; p < 0.000)). Working more than 48 h during the week was associated with a higher risk of depression (OR 2.222 (95% CI, 1.315–3.753)) and anxiety (OR 2.416 (95% CI, 1.272–4.586)). Conclusions: The vulnerability of the health care system before the COVID-19 pandemic led to significant mental health adverse outcomes of HCWs during the COVID-19 pandemic in Latvia. A further cohort study is needed to evaluate the dynamics of mental health and other predisposing factors of HCWs.

scholarly journals Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021119 ◽  
Author(s):  
Marc-André Bélair ◽  
Dafna E Kohen ◽  
Mila Kingsbury ◽  
Ian Colman
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Sedentary Behaviour ◽  
Parental Education ◽  
Family Income ◽  
Multinomial Logistic Regression ◽  
Depression And Anxiety ◽  
Joint Models ◽  
Sedentary Activity ◽  
Symptoms Of Depression

BackgroundPhysical and sedentary activities have been identified as potentially modifiable risk factors for many diseases, including mental illness, and may be effective targets for public health policy and intervention. However, the relative contribution of physical activity versus sedentary behaviour to mental health is less clear. This study investigated the cross-sectional association between physical activity, sedentary activity and symptoms of depression and anxiety at age 14–15 in the National Longitudinal Survey of Children and Youth (NLSCY).MethodsRespondents aged 14–15 years between 1996 and 2009 who reported on symptoms of depression in the NLSCY were included (n=9702). Multinomial logistic regression was used to assess the relationship between physical and sedentary activity and symptoms of depression and anxiety. Joint models including both physical and sedentary activity were also explored. Models were adjusted for sex, ethnicity, immigration status, family income, parental education, recent major stressful life events and chronic health conditions.ResultsThe odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.43 (1.11 to 1.84) and 1.88 (1.45 to 2.45) times higher, respectively, in physically inactive youth relative to physically active youth. The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.38 (1.13 to 1.69) and 1.31 (1.02 to 1.69) times higher, respectively, in sedentary youth relative to non-sedentary youth. In joint models including both physical and sedentary activity, sedentary activity was not consistently associated with symptoms of depression and anxiety.ConclusionsBoth physical inactivity and sedentary activity appear to be significantly related to symptoms of depression and anxiety. The importance of distinguishing these two behaviours has relevance for research as well as policies targeting physical activity and mental health in youth.

scholarly journals Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

2020 ◽  
Vol 29 ◽  
Author(s):  
Henry J. Whittle ◽  
William R. Wolfe ◽  
Lila A. Sheira ◽  
Edward A. Frongillo ◽  
Kartika Palar ◽  
...  
Keyword(s):  
Mental Health ◽  
Food Insecurity ◽  
Psychotropic Medication ◽  
Medication Use ◽  
The United States ◽  
Psychotropic Medications ◽  
Structural Factors ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Living With Hiv

Abstract Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. Methods We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). Results Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose–response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36–3.13) and 1.99 (p < 0.01; 95% CI = 1.26–3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16–3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19–0.96). Conclusions Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.

Predictors of cosmetic surgery and its effects on psychological factors and mental health: a population-based follow-up study among Norwegian females

2011 ◽  
Vol 42 (3) ◽  
pp. 617-626 ◽  
Author(s):  
T. von Soest ◽  
I. L. Kvalem ◽  
L. Wichstrøm
Keyword(s):  
Mental Health ◽  
Drug Use ◽  
Risky Sexual Behavior ◽  
Cosmetic Surgery ◽  
Mental Health Problems ◽  
Survey Study ◽  
Depression And Anxiety ◽  
Limited Information ◽  
Symptoms Of Depression ◽  
Appearance Satisfaction

BackgroundThere is limited information about psychological predictors of cosmetic surgery and how cosmetic surgery influences subsequent changes in mental health and overall appearance satisfaction. To date, there is a lack of studies examining this issue, whereby representative population samples are assessed at an age before cosmetic surgery is typically conducted and followed up after such surgery has commonly been performed.MethodWe obtained data from a survey study following 1597 adolescent females from a representative Norwegian sample over a 13-year period. Participants provided information on cosmetic surgery, appearance satisfaction, mental health, risky sexual behavior, drug use and conduct problems at two time-points (overall response rate 67%).ResultsOf all participants, 78 (4.9%) reported having undergone cosmetic surgery, of whom 71 were operated on during the course of the study and seven before the first data collection. Symptoms of depression and anxiety [odds ratio (OR) 1.66, 95% confidence interval (CI) 1.07–2.57] and a history of deliberate self-harm (OR 2.88, 95% CI 1.46–5.68), parasuicide (OR 3.29, 95% CI 1.53–7.08) and illicit drug use (OR 2.46, 95% CI 1.07–5.82) predicted prospective cosmetic surgery. Moreover, those who underwent surgery during the course of the study experienced a greater increase than other females in symptoms of depression and anxiety (t=2.07, p=0.04) and eating problems (t=2.71, p<0.01). Patients' use of alcohol also increased more than among non-patients (t=2.47, p=0.01).ConclusionsA series of mental health symptoms predict cosmetic surgery. Cosmetic surgery does not in turn seem to alleviate such mental health problems.

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