Tag: Mental Disorder

Creativity & its Role in the Treatment & Recovery of those with Mental Disorders

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Research Paper Title

Creativity, mental disorders and their treatment: recovery-oriented psychopharmacotherapy.

Background

This paper discusses interrelations between creativity, mental disorders and their treatment.

The psychology of creativity is very important for successful psychopharmacotherapy, but our knowledge about creativity is still insufficient.

Even that which is known is not within the armamentarium of most practicing psychiatrists.

  • In the first part of this article creativity and possible associations between creativity, mental health, and well-being are described.
  • The second part deals with the intriguing relationship between creativity and mental disorders.
  • The third part emphasizes the role of creativity in the treatment of mental disorders.

This paper ends by underlining the importance of a creativity-enhancing oriented, and personal recovery-focused psychopharmacotherapy in helping psychiatric patients achieve fulfilled and purposeful lives.

Reference

Jakovljevic, M. (2020) Creativity, mental disorders and their treatment: recovery-oriented psychopharmacotherapy. Psychiatria Danubina. 25(3), pp.311-315.

Linking Brain Imagery, Brain Tumours, and Cognitive & Mental Disorders in Adults

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Research Paper Title

Brain tumours, cognitive and mental disorders in adults.

Background

Cognitive and mental disorders are observed in 15-20% of brain tumours, and can be the first symptoms.

The severity of cognitive deficits varies from attention and reasoning disorders to major syndromes such as delirium, amnesic syndrome or dementia.

Mental disorders range from apathy, irritability to major depressive or psychotic symptoms.

Cognitive and mental disorders are related to many factors including the localisation and nature of the tumour, peritumoral and remote changes, and personal susceptibility.

The diagnosis of brain tumour is presently made by brain imagery, but the difficulty remains to determine when imagery is to be used in cognitive or mental disorders.

Reference

Derouesne, C. (2020) Brain tumors, cognitive and mental disorders in adults. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement. 13(2), pp.187-194. doi: 10.1684/pnv.2015.0533.

What are the Incidence Rates of Treated Mental Disorders in Childhood & Adolescence?

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Research Paper Title

Incidence Rates of Treated Mental Disorders in Childhood and Adolescence in a Complete Nationwide Birth Cohort.

Background

To investigate incidences, cumulative incidence rates, and risk factors of diagnosed mental disorders in a complete nationwide birth cohort across the entire period of childhood and adolescence.

Methods

Based on nationwide Danish registries, the entire cohort of all children born in 1995 was followed up to 31 December 2013. Data for children who migrated during the period were censored in the time analyses, and death before age 18 years was considered a competing risk. Incidence rates and cumulative incidence rates for any first-time-diagnosed mental disorder and 10 major categories of mental disorders according to ICD-10 criteria were calculated for 68,982 individuals. In addition, the effects of age, sex, and further child- and family-related risk factors on mental disorders were analysed.

Results

The incidences of any mental disorder, substance use disorders, depression, and anxiety disorders showed an increase in adolescence, whereas those for autism spectrum disorders, attention-deficit/hyperactivity disorder, conduct disorder, and tic disorder increased during childhood and decreased thereafter. Males had higher incidence rates of any mental disorders, substance use disorders, autism spectrum disorders, ADHD, conduct disorder, and tic disorder. Females had higher risks for depressive, anxiety, obsessive-compulsive, and eating disorders. Several other risk and protective factors for any mental disorder were identified. The cumulative incidence rate at age 18 years amounted to 11.02% for any mental disorder.

Conclusions

These findings provide the most comprehensive estimates of the development, incidence rates, and contributing risk factors of registered mental disorders for the entire period of childhood and adolescence that have been calculated so far.

Reference

Steinhausen, H-C. & Jakobsen, H. (2020) Incidence Rates of Treated Mental Disorders in Childhood and Adolescence in a Complete Nationwide Birth Cohort. The Journal of Clinical Psychiatry. 80(3):17m12012. doi: 10.4088/JCP.17m12012.

Older People: Physical Health, Check; Mental Health, Overlooked

Published on by Andrew Marshall1 Comment

Research Paper Title

Promoting active ageing in older people with mental disorders living in the community: An integrative review.

Background

Approximately 15% of older people aged 60 and above are experiencing a mental disorder. However, they are commonly unrecognised from health care providers.

Therefore the purpose of this research was to critically synthesise the evidence in relation to the promotion of active ageing in older people, including those with mental disorders.

Methods

This study is an integrative review. Articles published between January 2002 and March 2017 in English and in Thai were identified through searches of the databases CINAHL, MEDLINE, EMBASE, PsycINFO, and Thai LIS, as well as through manual searching.

Methodologically high-quality research articles were included if they addressed the promotion of active ageing and related concepts, the impact of mental disorders on active ageing and related concepts, the perspective of older people regarding active ageing, and issues related to working with older people with mental health problems living in the community.

Results

A total of 18 articles were included. The findings show that there is little evidence regarding the promotion of active ageing in older people with mental disorders.

Older people with mental disorders were less likely to achieve successful ageing compared with those without mental disorders, suggesting they need support from health care providers. However, there are several barriers to care and working with older people with mental disorders at the community level.

Conclusions

Of concern is that health professionals focus on the physical health of older people while mental health issues are overlooked.

Reference

Kenbubpha, K., Higgins, I., Chan, S.W-C. & Wilson, A. (2020) Promoting active ageing in older people with mental disorders living in the community: An integrative review. International Journal of Nursing Practice. 24(3):e12624. doi: 10.1111/ijn.12624. Epub 2018 Mar 30.

Mitochondria & Mental Disorders: Is There a Link?

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Research Paper Title

Mitochondrial Involvement in Mental Disorders: Energy Metabolism and Genetic and Environmental Factors.

Background

Mental disorders, such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ), are generally characterised by a combination of abnormal thoughts, perceptions, emotions, behaviour, and relationships with others.

Multiple risk factors incorporating genetic and environmental susceptibility are associated with development of these disorders.

Mitochondria have a central role in the energy metabolism, and the literature suggests energy metabolism abnormalities are widespread in the brains of subjects with MDD, BPD, and SZ.

Numerous studies have shown altered expressions of mitochondria-related genes in these mental disorders.

In addition, environmental factors for these disorders, such as stresses, have been suggested to induce mitochondrial abnormalities.

Moreover, animal studies have suggested that interactions of altered expression of mitochondria-related genes and environmental factors might be involved in mental disorders.

Further investigations into interactions of mitochondrial abnormalities with environmental factors are required to elucidate of the pathogenesis of these mental disorders.

Reference

Iwata, K. (2020) Mitochondrial Involvement in Mental Disorders: Energy Metabolism and Genetic and Environmental Factors. Advances in Experimental Medicine and Biology. doi: 10.1007/978-3-030-05542-4_3.

Can Exercise & Physical Activity Induce Improvements for Mental Disorders?

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Research Paper Title

Exercise and physical activity in mental disorders: clinical and experimental evidence.

Background

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders.

This review summarises studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment.

Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups.

Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes.

Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.

Reference

Zschucke, E., Gaudlitz, K. & Strohle, A. (2020) Exercise and physical activity in mental disorders: clinical and experimental evidence. Journal of Preventive Medicine and Public Health. 46 Suppl 1(Suppl 1), pp.S12-21. doi: 10.3961/jpmph.2013.46.S.S12. Epub 2013 Jan 30.

What does mental health have to do with well-being?

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Research Paper Title

What does mental health have to do with well-being?

Background

Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods.

Institutions, practitioners, and theorists often identify positive mental health with well-being.

There are strong reasons, however, to keep the concepts of well-being and positive mental health separate.

Someone with high positive mental health can have low well-being, someone with high well-being can have low positive mental health, and well-being and positive mental health sometimes conflict.

But, while positive mental health and well-being are not identical, there is an informative conceptual connection between them.

Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well-being.

Reference

Keller, S. (2020) What does mental health have to do with well-being? Bioethics. 34(3), pp.228-234. doi: 10.1111/bioe.12702. Epub 2019 Nov 29.

What is the Social Impact of Health Insurance Care Utilisation in Low- & Middle-Income Countries?

Published on by Andrew Marshall1 Comment

Research Paper Title

The impact of social, national and community-based health insurance on health care utilisation for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic review.

Background

Whilst several systematic reviews conducted in Low- and Middle-Income Countries (LMICs) have revealed that coverage under social (SHI), national (NHI) and community-based (CBHI) health insurance has led to increased utilisation of health care services, it remains unknown whether, and what aspects of, these shifts in financing result in improvements to mental health care utilisation.

The main aim of this review was to examine the impact of SHI, NHI and CBHI enrolment on mental health care utilisation in LMICs.

Methods

Systematic searches were performed in nine databases of peer-reviewed journal articles: Pubmed, Scopus, SciELO via Web of Science, Africa Wide, CINAHL, PsychInfo, Academic Search Premier, Health Source Nursing Academic and EconLit for studies published before October 2018.

The quality of the studies was assessed using the Effective Public Health Practice Project quality assessment tool for quantitative studies.

Results

Eighteen studies were included in the review.

Despite some heterogeneity across countries, the results demonstrated that enrollment in SHI, CBHI and NHI schemes increased utilisation of mental health care.

This was consistent for the length of inpatient admissions, number of hospitalisations, outpatient use of rehabilitation services, having ever received treatment for diagnosed schizophrenia and depression, compliance with drug therapies and the prescriptions of more favourable medications and therapies, when compared to the uninsured.

The majority of included studies did not describe the insurance schemes and their organizational details at length, with limited discussion of the links between these features and the outcomes.

Given the complexity of mental health service utilisation in these diverse contexts, it was difficult to draw overall judgements on whether the impact of insurance enrollment was positive or negative for mental health care outcomes.

Conclusions

Studies that explore the impact of SHI, NHI and CBHI enrolment on mental health care utilisation are limited both in number and scope.

Despite the fact that many LMICs have been hailed for financing reforms towards universal health coverage, evidence on the positive impact of the reforms on mental health care utilisation is only available for a small sub-set of these countries.

Reference

Docrat, S., Besada, D., Cleary, S. & Lund, C. (2020) The impact of social, national and community-based health insurance on health care utilization for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic review. Health Economics Review. 10(1), pp.11. doi: 10.1186/s13561-020-00268-x.

What Does Mental Health Have to Do With Well-Being?

Published on by Andrew Marshall1 Comment

Research Paper Title

What Does Mental Health Have to Do With Well-Being?

Background

Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods.

Institutions, practitioners, and theorists often identify positive mental health with well-being.

There are strong reasons, however, to keep the concepts of well-being and positive mental health separate.

Someone with high positive mental health can have low well-being, someone with high well-being can have low positive mental health, and well-being and positive mental health sometimes conflict.

But, while positive mental health and well-being are not identical, there is an informative conceptual connection between them.

Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well-being.

Reference

Keller, S. (2020) What Does Mental Health Have to Do With Well-Being? Bioethics. 34(3), pp.228-234. doi: 10.1111/bioe.12702. Epub 2019 Nov 29.

Why is it Important to Identify Mental Health Problems among Employees in Physically Demanding Jobs?

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Research Paper Title

Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders?

Background

Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined.

Methods

The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012.

The researchers used 12,458 observations from 6159 employees, who were 40-60 years old at baseline.

CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+).

Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as “neither”, “work exposure only”, “CMD only”, and “both”.

Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up.

Additionally, synergy indices were calculated for the combined effects.

Results

Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither.

Synergy indices indicated that these associations were synergistic.

Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work.

Conclusions

Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.

Reference

Halonen J.I., Mänty, M., Pietiläinen, O., Kujanpää, T., Kanerva, N., Lahti, J., Lahelma, E., Rahkonen, O. & Lallukka, T. (2020) Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders? Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-019-01823-6. [Epub ahead of print].