Mental Illness

Background. Cardiovascular disease (CVD) and depression are the leading causes of disability in the U.S. Using electronic health record data, we describe the CVD burden among persons with mental illness enrolled in the Penn State Psychiatry Clinical Assessment and Rating Evaluation System (PCARES) Registry between 2015 and 2020. Methods. CVD burden assessment included prevalence of CVD conditions (any major CVD or individual CVD risk factors), indicated medication prescriptions for CVD risk factors, and mean levels of body mass index (BMI, kg/m²), glycosylated hemoglobin (HbA1C, %), glucose (mg/dl), and lipids (mg/dl). We compared the CVD burden between the PCARES sample to a representative sample of adults from the U.S. general population (NHANES 2013-2016) using one-sample chi-square/-tests for proportions/means. The CVD burden in NHANES participants was adjusted to PCARES age, race, and sex statistics. Results. The PCARES sample () had a mean (SE) age of 42.4 (0.3) years and comprised 63.0% women, 85.0% non-Hispanic Caucasians, and 41.0% with major depressive disorder. CVD burden was higher in the PCARES sample compared to NHANES participants for any major CVD (8.6% vs. 4.6%), diabetes (18.4% vs. 10.4%), BMI (30.3 vs. 28.3), HbA1C (6.1 vs. 5.6), cholesterol (185.6 vs. 181.7), triglycerides (153.3 vs. 136.1), and indicated antihypertensive (94.3% vs. 76.9%) and cholesterol-lowering (49.5% vs. 36.7%) medications (Bonferroni-corrected for each outcome). The CVD burden was lower in the PCARES sample compared to NHANES participants for hypertension (45.9% vs. 50.4%), dyslipidemia (43.2% vs. 61.9%), HDL-C (48.4 vs. 41.4), and LDL-C (107.9 vs. 112.0) (Bonferroni-corrected for each outcome). Glucose levels (110.9 vs. 111.9) and indicated antidiabetic medications (87.4% vs. 86.6%) were similar in the two samples (). Conclusions. The CVD burden was higher in persons with mental illness compared to the U.S. general population. Integrated mental and physical healthcare services could reduce long-term disability among persons with mental illness.

Background. The COVID-19 pandemic is by far the most significant public health crisis in the 21st century, arousing many psychological concerns like post-traumatic stress disorder (PTSD). Aims. This study is aimed at revealing gender differences and similarities in PTSD symptoms among Chinese adults during COVID-19 pandemic. Methods. Data used in this study were from an online cross-sectional study conducted in February 2020 via a web-based platform. We analyzed data from 558 Chinese adults (334 men and 224 women) with PCL-5 scores over the PTSD criteria. A network analysis was performed to explore the structure of PTSD symptoms for subgroups of men and women. Results. The results showed intrusive thoughts and emotional cue reactivity, together with negative beliefs and negative trauma-related emotions, presented strong positive connections in both men and women. A negative connection between intrusive thoughts and self-destructive/reckless behavior existed among women but not men. Regarding centrality symptoms, women and men had flashbacks and self-destructive/reckless behavior in common, but with differential orders. The most central symptom of PTSD was self-destructive/reckless behavior for women and difficulty concentrating for men. Conclusion. We urge that self-destructive/reckless behaviors and flashbacks, as potential core symptoms of COVID-19-related PTSD, be given more attention in future pandemic-related psychiatric intervention programs.

Background. Healthcare workers during the COVID-19 pandemic played an effective role in providing preventive and curative measures. Scientific evidence confirmed that the outbreak of this disease has caused numerous psychological problems such as pre- and posttraumatic stress disorder (PTSD), anxiety, depression, and anger at a global level. This study is aimed at investigating the general health of healthcare workers and its relationship with anxiety, anger, and posttraumatic stress disorder during the outbreak of COVID-19. Methods. This research was a cross-sectional study conducted on 455 healthcare workers of four teaching hospitals in Kerman, southeast of Iran. The convenience sampling method was used. The research tools included the 12-Item General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), the trait anxiety section of State-Trait Anxiety Inventory (STAI), and the trait anger section of Trait-State Anger Expression Inventory 2 (STAXI-2). Data analysis was done in IBM SPSS Statistics version 25 and using Pearson’s correlation tests, independent -test, ANOVA, and multivariate linear regression. Results. 28.1% () of the participants had mental health disorders. The mean score of anxiety was which was at moderate to high level of anxiety. The mean score of anger was which was at the moderate level. The mean score of PTSD was which was less than the midpoint of the questionnaire, i.e., the score of 44. The results of the multiple linear regression model that showed anxiety, anger, gender, and hospital were predictors of mental health (). Conclusion. The results of the present study showed that about a quarter of the healthcare workers faced with the COVID-19 pandemic had mental health disorders and suffered from moderate to high anxiety, moderate anger, and PTSD. It was also observed in this study that there was a weak to moderate significant correlation between general health and anxiety, anger, and PTSD in healthcare workers. So, healthcare workers need a lot of social and psychological support.

Over the past few years, malingered psychosis has had a progressive occurrence since a great deal of attention has been directed to the closures of long-stay psychiatric institutions and care in the community. Therefore, malingered psychosis needs to be identified to conduct precise forensic assessments and prevent miscarriages of justice and misuse of restricted healthcare resources. Although, over the past decades, researchers have introduced a number of workable psychometric strategies and tools for diagnosing true psychosis, it is still sometimes challenging to differentiate between true and malingered psychosis. Hence, identifying reliable and innovative diagnostic alternatives seems crucial. Accordingly, a summary of gathered evidence is provided by the present review for enhancing future evaluation of oropharyngeal microbiome composition as a practical indicator for diagnosing true psychosis in a forensic psychiatric setting. As per the systematic search terms (namely, “diagnostic marker,” “oropharyngeal microbiome,” “forensic psychiatric setting,” “psychosis,” and “oropharyngeal microbiota”), relevant English publications were searched from January 1, 1980, to September 15, 2023, in Scopus, the Web of Science, Embase, Cochrane Library, PubMed, and Google Scholar databases. Finally, eight articles were included in the present review. Also, we adopted the narrative technique so that the material synthesis leads to a cohesive and compelling story. The results revealed that the periodontal disease and saliva microbiome were possibly associated with true psychosis. Thus, since oropharyngeal microbial compositions are highly different among healthy controls and patients with true psychosis, future research can take advantage of saliva to differentiate between fake and true fake psychosis throughout the initial stages of forensic psychiatric assessment. As a substrate of interest, saliva could also be used for characterizing the various stages of psychosis under a forensic psychiatric setting.

Background. Substance use is prevalent among patients with mental illness in low- and middle-income countries, including Tanzania. This heightened prevalence not only increases the risk of developing mental disorders and substance use disorders but also contributes to poor treatment outcomes for these patients. Despite these concerns, the current prevalence of substance use and its associated factors in this population remains unclear in Tanzania. Therefore, this study is aimed at determining the 12-month period prevalence of self-reported substance use and associated factors among patients with mental illness. Methods. We conducted a cross-sectional analytical study among patients with mental illness at Muhimbili National Hospital in Dar es Salaam, Tanzania. Respondents were selected using a systematic random sampling technique. Data on self-reported substance use were collected using the World Health Organization’s (WHO) alcohol, smoking, and substance involvement screening test (ASSIST) V3.0. IBM SPSS version 25 was employed for data analysis, utilizing frequencies and percentages to determine the prevalence of self-reported substance use. The study employed bivariate and multiple logistic regression analyses to investigate the association between patient characteristics and self-reported substance use, with statistical significance set at a value of < 0.05. Results. A total of 364 patients were enrolled in the study, with 215 (59.1%) being male and a mean (SD) age of 35.57 (±9.01) years. Among the participants, 119 (32.7%) reported substance use. The most commonly used substances were alcohol (21.7%), tobacco (19.8%), and cannabis (12.9%). Factors significantly associated with self-reported substance use included younger age (AOR: 1.829; 95% CI: 1.112, 3.010; ), male gender (AOR: 2.346; 95% CI: 1.397, 3.939; ), positive family history of mental illness (AOR: 2.247; 95% CI: 1.364, 3.701; ), and a family history of substance use (AOR: 3.804; 95% CI: 2.305, 6.276; ). Conclusions. A significant proportion, amounting to one-third of patients, reported substance use, highlighting the imperative need for targeted measures within this population. The implementation of routine substance use screening programs for patients with mental illness is crucial, alongside gender-sensitive and age-specific interventions. Consideration of patients’ family history of mental illness and substance use should be an integral part of these measures.

Background. Over the past two years, the ongoing COVID-19 pandemic has resulted in a staggering number of biopsychosocial deficits in the general population that have impacted the physical, psychological, and social aspects of their health and well-being. Objectives. This paper highlights the biopsychosocial characteristics of COVID-19 patients cared for in public and private health facilities in Kandahar, Afghanistan. Methods. A cross-sectional study was performed using telephone interviews of patients tested positive for COVID-19 between March 2020 and March 2021. The Pashto version of Depression, Anxiety, and Stress Scale-21 (DASS-21) was administrated to all patients. Independent -test and ANOVA analyses were used to assess the effects of sociodemographic and clinical characteristics on DASS-21 total scores and on each subscale separately. Results. Of all 477 participants, the vast majority (95%) had characteristic symptoms of COVID-19, such as fever, sore throat, cough, and headache. Of all participants, 472 (99%) had symptoms of anxiety, 462 (96.9%) had depression, and 463 (97.1%) had stress. Patients who scored significantly higher on the DASS-21 scale were more likely to have female sex, old age, low level of education, spouse separation, comorbid medical conditions, and being admitted to intensive care units. Conclusion. This study confirmed the previously described epidemiological and clinical characteristics of patients with severe COVID-19. The results indicated a high burden of mental health problems in severe COVID-19 patients. Hence, we recommend that policymakers in Afghanistan take proper measures for the timely provision of efficient and quality mental health services during every disaster and postdisaster era.