scholarly journals Clinical Correlates of Deliberate Self-Harm Among Migrant Trauma-Affected Subgroups

2021 ◽  
Vol 12 ◽  
Author(s):  
Francesca Baralla ◽  
Martina Ventura ◽  
Nikolay Negay ◽  
Anteo Di Napoli ◽  
Alessio Petrelli ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Deliberate Self Harm ◽  
History Of ◽  
Self Harm ◽  
Post Traumatic ◽  
Resilience Capabilities

Introduction: Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health. Migrants with a history of PTEs are more likely to inflict deliberate self-harm (DSH), a spectrum of behavior that includes non-suicidal self-injury (NSSI). With reference to a nonclinical sample of trauma-exposed migrants, this study aims to explore the prevalence of DSH and to assess the association with sociodemographic characteristics and clinical conditions, with particular attention to post-traumatic stress disorder (PTSD) symptoms, resilience capabilities, and feelings of hopelessness.Methods: A sample of migrants underwent a baseline evaluation at an outpatient department of the National Institute for Health, Migration and Poverty (INMP). Migrants with a history of torture, rape, or other severe forms of psychological, physical, or sexual violence were invited to undergo screening at the Institute's Mental Health Unit. Trauma-exposed migrants completed a series of self-report questionnaires that assessed the presence of PTSD, depression, anxiety, suicidal ideation, resilience, and feelings of hopelessness, in addition to DSH. Univariate and multivariate log-binomial regression models were used to test the association of age and clinical characteristic of migrants with DSH. Prevalence ratio (PR) with 95% confidence intervals (95% CI) and p-values were estimated.Results: A total of 169 migrants (76.9% males), aged between 18 and 68 years, M = 28.93; SD = 8.77), were selected. Of the sample, 26.6% were frequently engaging in some form of DSH, and 30.2% were diagnosed with at least one trauma-related disorder. DSH behaviors were most common in single and unemployed migrants as well as in subjects with post-traumatic stress symptoms, feelings of anxiety, hopelessness, low capability of resilience, and suicidal ideation. Taking into account age and hopelessness, we found that PTSD and low resilience capabilities were associated with a higher risk of DSH [PR adj: 2.21; 95% CI: (1.30–3.75) and PR adj: 2.32; 95% CI: (1.16–4.62), respectively].Conclusion: Given the association between trauma exposure and DSH among migrants, exploring the presence of DSH behavior within the immigrant community is crucial for the implementation of measures to develop intervention in a clinical setting.

scholarly journals Paranoia in patients attending child and adolescent mental health services

2021 ◽  
pp. 000486742098141
Author(s):  
Jessica C Bird ◽  
Emma C Fergusson ◽  
Miriam Kirkham ◽  
Christina Shearn ◽  
Ashley-Louise Teale ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Network Analyses ◽  
Self Harm ◽  
Post Traumatic ◽  
Peer Difficulties

Objective: Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services. Method: A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later. Results: Most of the adolescents had affective disorders ( n = 195), self-harm/suicidality ( n = 82), or neurodevelopmental conditions ( n = 125). Few had suspected psychosis ( n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time. Conclusion: Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.

Identification and Referral of Patients at Risk for Post-traumatic Stress Disorder: A Literature Review and Retrospective Analysis

2015 ◽  
Vol 81 (9) ◽  
pp. 904-908 ◽  
Author(s):  
Aaron Bolduc ◽  
Brice Hwang ◽  
Christopher Hogan ◽  
Varun K. Bhalla ◽  
Elizabeth Nesmith ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Health Professionals ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Mental Health Disorder ◽  
Post Traumatic Stress ◽  
Patients At Risk ◽  
History Of ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) is a well-established psychological disorder after severe traumatic injury but remains poorly recognized. Recent changes in the “Resources for Optimal Care of the Injured Trauma Patient 2014” stress the need for comprehensive screening and referral for PTSD and depression after injury. Our purpose was to review the current PTSD literature and perform a retrospective chart review to evaluate screening at our institution. We hypothesized a lack of documentation and thus referral of these patients to mental health professionals. We performed a literature review of 43 publications of risk factors for PTSD in the civilian adult population followed by a retrospective review. Records were analyzed for basic demographics, risk factors found in the literature, and referrals to mental health providers. Risk factors included amputation, dissociative symptoms, female gender, history of mental health disorder, and peri-traumatic emotionality. Traumatic amputation status and gender were recorded in all patients. History of mental health disorder was present in 11.5 per cent patients, absent in 80.75 per cent, and not recorded in 7.75 per cent with an overall documentation of 91.75 per cent. Dissociative symptoms and peri-traumatic emotionality were recorded in 0.5 per cent and 1.0 per cent of patients, respectively. Only 13 patients of 400 (3.25%) were referred to mental health professionals. Despite extensive evidence and literature supporting risk factors for the development of PTSD, identification and treatment at our level 1 trauma center is lacking. There is a need for consistent screening among trauma centers to identify PTSD risk factors and protocols for risk reduction and referrals for patients at risk.

scholarly journals Prevalence of Lifetime Self-Injurious Thoughts and Behaviors in a Global Sample of 599 Patients Reporting Prospectively Confirmed Diagnosis with Premenstrual Dysphoric Disorder

2021 ◽  
Author(s):  
Tory A. Eisenlohr-Moul
Keyword(s):  
Suicidal Ideation ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Premenstrual Dysphoric Disorder ◽  
Post Traumatic Stress ◽  
History Of ◽  
Post Traumatic ◽  
And Behaviors ◽  
Suicidal Thoughts And Behaviors

Background: Suicide is the second leading cause of death among Americans ages 10 to 34. Recent increases in suicide rates among those assigned female at birth are particularly alarming. A large body of evidence points to menstrual cycle influences on self-injurious thoughts and behaviors (STBs), suggesting that neurobiological hormone sensitivities such as those observed in premenstrual dysphoric disorder (PMDD) may drive risk for suicide in females. However, existing studies of the prevalence of STBs in PMDD have used cross-sectional self-report measures of PMDD with poor validity. As a first step to establishing more accurate prevalence rates of STBs in PMDD, we examined the lifetime prevalence of STBs in a large global survey of patients reporting a diagnosis of PMDD based on daily ratings. Method: Individuals with self-reported PMDD symptoms were invited to an online survey through online support groups for PMDD and social media posts from accounts focused on PMDD awareness and information. Participants reported on demographics, whether they had been diagnosed with PMDD by a healthcare provider using daily ratings, STBs using the Columbia Suicide Severity Rating Scale, and history of various lifetime comorbid psychiatric diagnoses. Results: 2,689 unique participants completed the survey. Of those, 599 (23%) reported a provider diagnosis with PMDD based on two months of daily ratings and were included in analyses. We observed high rates of lifetime active suicidal ideation (72%), planning (49%), intent (42%), preparing for an attempt (40%), and attempt (34%), as well as non-suicidal self-injury (51%). The majority (70%) of the sample reported at least one lifetime comorbid psychiatric diagnosis by a medical provider. STB rates were only slightly attenuated among those reporting no history of diagnosed psychiatric comorbidities (i.e., PMDD only). Predictors of lifetime suicidal ideation included nulliparity, low-to-moderate (vs. high) income, and history of diagnosis with major depression or post-traumatic stress disorder. Predictors of lifetime attempts among those reporting lifetime ideation included older age, nulliparity, lower income, and history of diagnosis with post-traumatic stress disorder or borderline personality disorder.Conclusions: These data indicate high rates of STBs among those reporting prospective medical diagnosis of PMDD and highlight the need for more prospective research on mechanisms and prevention of STBs in PMDD. Clinical practice guidelines for PMDD should accommodate comorbidities and recommend frequent screenings for STB risk. Suicidal thoughts and behaviors should be considered for inclusion in future iterations of the DSM PMDD diagnostic criteria.

scholarly journals Mental Health Problems Due to Social Isolation During the COVID-19 Pandemic in a Mexican Population

2021 ◽  
Vol 9 ◽  
Author(s):  
Alma Delia Genis-Mendoza ◽  
José Jaime Martínez-Magaña ◽  
María Lilia López-Narváez ◽  
Thelma Beatriz González-Castro ◽  
Isela Esther Juárez-Rojop ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Social Isolation ◽  
Traumatic Stress ◽  
Eating Habits ◽  
Mexican Population ◽  
Personal Hygiene ◽  
Post Traumatic Stress ◽  
Symptoms Of Depression ◽  
Post Traumatic

Introduction: Social isolation due to the COVID-19 pandemic has been identified as a risk factor of several mental disorders. Therefore, the present work aimed to evaluate the effect of social isolation experienced during the COVID-19 pandemic on the mental health of a Mexican population.Materials and Methods: A cross-sectional online survey was conducted in individuals of 18 years of age and over. The questioner was structured to identify onset or worsening of psychiatric symptoms due to social isolation by COVID-19. The survey included changes in eating habits, changes in personal hygiene habits, the starting the use or increased the use of psychoactive substances, symptoms of depression or post-traumatic stress.Results: A total of 1,011 individuals were included in the analysis. The majority were women (68.84%). Changes in eating habits were reported in 38.51% of the participants, 67.80% reported having their physical self-perception distorted or having started a low-calorie diet. Regarding symptoms of depression, 46.10% participants indicated to have at least one depressive symptom, and 4.46% reported suicidal ideation during social isolation. Interestingly, 6.09% of individuals reported that they used to have depressive symptoms prior the COVID-19 pandemic and those symptoms decreased due to social isolation. Additionally, 2.27% of individuals presented symptoms of post-traumatic stress due to the possibility of getting COVID-19.Conclusions: In this work we identified how social isolation has impacted the mental health of the Mexican population. We observed that practically all the symptoms evaluated were affected during isolation, such as personal hygiene and eating habits. Depression and suicidal ideation were the ones that increased the most in the general population, while in individuals who had symptoms of depression before isolation, these symptoms decreased during social isolation.

Timely Endings and the Ethics of “Being Heard”

2015 ◽  
Author(s):  
Pamela Marsh
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Suicide Attempts ◽  
Holistic Approach ◽  
Psychiatric Ward ◽  
Post Traumatic Stress ◽  
Self Harm ◽  
Post Traumatic

The author reflects on her bout of complex post-traumatic stress disorder (C-PTSD) as well as her encounters with psychiatrists/psychotherapists and other mental health professionals. She recalls first being admitted to a psychiatric ward in 1996, to be followed by many more admissions for crisis intervention, self-harm, and suicide attempts. She says the therapy she received was sometimes traumatic and exacerbated the distress of her symptoms, while also significantly delaying her recovery. She thinks that the mental health care professionals, including psychiatrists, did not seem to understand what she was telling them about her thyroid illness. Had this been diagnosed and treated properly, its impact on her life would not have been as great as it was. Finally, she stresses the importance of a holistic approach in helping patients recover, recognizing when it is time to stop therapy, and the ethics of listening and “being heard” as part of psychotherapy.

Adolescents with suicidal behaviour: attendance at A&E and six month follow-up

2004 ◽  
Vol 21 (3) ◽  
pp. 78-84 ◽  
Author(s):  
Sharon Bolger ◽  
Peter O'Connor ◽  
Kevin Malone ◽  
Carol Fitzpatrick
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Young People ◽  
Psychological Functioning ◽  
Suicidal Behaviour ◽  
Deliberate Self Harm ◽  
History Of ◽  
Self Harm ◽  
Suicidal Crisis

AbstractObjectives: To review the clinical presentation, and Accident and Emergency Department clinical response to 14-20 year olds in suicidal crisis in inner city Dublin and to carry out a six month follow up of these young people.Method: A retrospective review of the case notes of all 14-20 year olds who had attended the Mater Hospital A&E department between June 2001 and May 2002 with suicidal behaviour or ideation was carried out in order to establish socio-demographic information, type of suicidal or self-harming behaviour, intervention in the A&E department, and discharge plan. Active outreach attempts were made to trace, contact and interview these young peoples at least six months after the initial presentation. Quantitative measures of psychological functioning at follow-up included the General Health Questionnaire, The Beck Depression Inventory and The Scale for Suicidal Ideation. A qualitative interview covered their recall of the reasons for their deliberate self harm, their view of their current psychological functioning and personal relationships, reported repetition of deliberate self harm, and their views of what type of services would be useful for young people with suicidal ideation or behaviour.Results: A total of 89 young people aged 14-20 years (male: female ratio = 2:3) presented to the Mater A&E department between June 2001 and May 2002 with deliberate self-harm, deliberate self-poisoning and/or suicidal ideation, and accounted for 108 presentations. They showed high levels of psychosocial disadvantage. Almost half had a history of previous contact with mental health services, while the same proportion had a history of previous deliberate self-harm. Drug overdose using paracetamol was the most common method used. Psychiatric assessment was documented in 66% of cases, and documented follow up recommendations were made in 60% of cases. Two thirds of the 89 young people who formed the study population were traced. Half of those contacted agreed to be interviewed and half refused. The majority of those interviewed described themselves as functioning better psychologically than at the time of the index attendance at the A&E department The quantitative measures supported this. One third of those interviewed reported repeated deliberate self-harm since their index attendance, for which most did not seek medical intervention. Many of the young people had clear views about the importance of talking to someone when in crisis. They described a service, which was informal, accessible on a 24-hour basis, and staffed by people with experience of mental health, alcohol and drug related disorders.Conclusions: This is a particularly vulnerable group of patients from a socio-demographic and mental health perspective. Their attendance at the A&E department provides a unique opportunity for an in-depth psychosocial assessment, which should be recorded in a systematic way to assist clinical audit, facilitate strategic mental health planning and may confer some therapeutic clinical benefit to at risk young people. An easily accessible, active DSH team specifically tailored for young people in the A&E department could provide assessment and short-term follow-up. This is the approach recommended by young people in suicidal crisis, whose views need to be heard.

scholarly journals The mental health of staff working in intensive care during COVID-19

2020 ◽  
Author(s):  
Neil Greenberg ◽  
Dale Weston ◽  
Charlotte Hall ◽  
Tristan Caulfield ◽  
Victoria Williamson ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Problem Drinking ◽  
Severe Depression ◽  
List Type ◽  
Post Traumatic Stress ◽  
Self Harm ◽  
Post Traumatic

AbstractBackgroundIntensive Care Unit (ICU), anaesthetic and theatres staff have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental healthAimsTo identify the rates of probable mental health disorder in ICU and anaesthetic staff in six English hospitals during June and July 2020MethodsAn anonymised brief web-based survey comprising standardised questionnaires examining depression, anxiety symptoms, symptoms of Post Traumatic Stress Disorder (PTSD), wellbeing and alcohol use was administered to staff.Results709 participants completed the surveys comprising 291 (41%) doctors, 344 (48.5%) nurses, and 74 (10.4%) other healthcare staff. Over half (58.8%) reported good wellbeing, however 45.4% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6.3%), PTSD (39.5%), severe anxiety (11.3%) or problem drinking (7.2%). 13.4% of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past two weeks. We found that doctors consistently reported better mental health than nurses.ConclusionsWe found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. These results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19.Occ Med Statements: article should contain 3 statements (each max of 3 bullets of max 50 words each)What is already known about this subjectIntensive care unit (ICU) staff are regularly exposed to traumatic situations as part of their jobPrevious studies have shown them to be at risk of psychological and moral distressLittle is known about the mental health of ICU staff during the current pandemicWhat this study addsAlmost half of ICU staff report symptoms consistent with a probable diagnosis of post traumatic stress disorder, severe depression or anxiety or problem drinkingAround 1 in 7 ICU staff report recent thoughts of self-harm or of wanting to be better off deadNursing staff are more likely to report higher levels of distress than doctors or other clinical staffWhat impact this may have on practice or policyHealthcare managers need to prioritise staff mental health support and timely access to evidence based treatments for ICU staffSupervisors and managers should be aware that a substantial proportion of ICU staff may perform less well because of their current poor state of mental healthMore work is needed to understand whether the high levels of mental health symptoms identified in this study are truly indicative of high levels of clinical need for mental healthcare

scholarly journals Prevalence and associated factors with mental health outcomes among interns and residents physicians during COVID-19 epidemic in Panama: a cross-sectional study

2021 ◽  
Author(s):  
Edward A. Espinosa-Guerra ◽  
Edgar R. Rodríguez-Barría ◽  
Christl A. Donnelly ◽  
Jean-Paul Carrera
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Interns And Residents ◽  
History Of ◽  
Post Traumatic

AbstractBackgroundA new coronavirus SARS-CoV-2 was associated with a newly identified respiratory syndrome, COVID-19 in Wuhan, China, in early December 2019. SARS-CoV-2 rapidly spread across the globe resulting in 117 million cases and 2.59 million deaths by March 2021. Rapidly increased numbers of COVID-19 cases overwhelmed public health systems across the world, imposing increased working hours and workloads for health care workers. Here, we have evaluated the prevalence of health outcomes and associated factors of interns and resident physicians in Panama.MethodsA cross-sectional study was undertaken during July 23, 2020, to August 13, 2020, to evaluate the prevalence of health outcomes and associated factors in interns and residents across Panama. Snowball sampling was used to recruit participants. Then an electronic questionnaire with scales to evaluate anxiety disorders (GAD-7), depression (PHQ-9) and post-traumatic stress (IES-R) was evaluated. In addition, socio-demographic variables, clinical history of mental disorders and COVID-19 exposure were evaluated. Independent analyses for each mental health outcome were undertaken using a logistic regression analysis.ResultsA total of 517/1205 (42.9%) interns and residents were nationwide recruited. Of these 274 (53.0%) were interns and 243 (47.0%) residents. The overall prevalence of depression symptoms was 25.3%, 13.7% anxiety and 12.2% post-traumatic stress. At least, 9.3% participants reported having suicidal ideation.The most parsimonious model showed females had a higher prevalence of mental health disorders, in all results and the married participants were more likely to present depression (OR, 1.73; 95% CI, 1.03-2.91; P = 0.039) or at least one alteration to mental health (OR, 1.66; 95% CI, 1.03-2.68; P = 0.039). Resident physicians in surgical specialties were less likely to have post-traumatic stress (OR, 0.20; 95% CI, 0.06-0.63; P = 0.006) or at least one mental health disturbance (OR, 0.46; 95% CI, 0.26-0.83; P = 0.010). A history of psychological trauma and psychiatric pathology were risk factors for most of the disorders investigated.ConclusionsA high prevalence of mental health disorders was found, showing the need to mitigate this emotional burden among healthcare workers in the current context of the COVID-19 pandemic.

scholarly journals Physiological parameters of mental health predict the emergence of post-traumatic stress symptoms in physicians treating COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Traumatic Stress ◽  
A Priori ◽  
Treatment Strategies ◽  
Physiological Measures ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.

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