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Objective: To examine the effect of the diagnosis of asymptomatic disease on health-related quality of life (HRQoL)., Design: Secondary analysis of a national data set., Method: We analysed adult participants in the 2011-2012 National Health and Nutrition Examination Survey (NHANES) of the civilian non-institutionalized US general population. Across three asymptomatic diseases (glucose intolerance, hyperlipidaemia, and hypertension), we examined four groups (without disease; with disease but no diagnosis; with disease and diagnosis but no treatment; and with disease, diagnosis, and treatment). For each asymptomatic disease, we examined group differences in self-rated health (ordinal logistic regression) and Healthy Days outcomes (number of the last 30 days that physical health was not good, mental health was not good, or inactive; regression). Models were adjusted for age, sex, smoking status, insurance status, income, education, race, body mass index, and comorbid conditions., Results: Analyses included 6012 respondents (glucose intolerance), 2772 respondents (hyperlipidaemia), and 5524 respondents (hypertension). In adjusted models, those who did not know about their disease had the same self-rated health scores as those without the disease, those with the disease without treatment, and those with disease and treatment. In adjusted analyses of the Healthy Days questions, those with unknown disease reported the same number of unhealthy days as those without disease with the exception of glucose intolerance. Conversely, in four of the nine possible comparisons, those with known disease without treatment reported more unhealthy days than those with who did not know about their disease., Conclusions: In adjusted analyses, individuals knowing about their asymptomatic disease are more likely to experience decrements in healthy days compared to those without knowledge of their asymptomatic disease. Statement of contribution What is already known on this subject? There has been sparse evidence that diagnosis of asymptomatic diseases is related to reduced health-related quality of life in population studies. Previous studies have included patients receiving treatment, which impedes the ability to isolate the effects of diagnosis from the effects of treatment. What does this study add? This report examines three asymptomatic health conditions: glucose intolerance, hyperlipidaemia, and hypertension. Those who did not know about their health condition generally had the same health-related quality of life scores as those without health conditions. Conversely, those diagnosed with disease but not receiving treatment reported worse health-related quality of life., (© 2018 The British Psychological Society.)

Medical training, practice and research are traditionally organized around body systems and disease categories. There is, however, a disciplinary split over the question of whether the clinical diagnosis is the central issue in describing an individual with an illness. Data from two studies, one institutional and one population based (The Pediatric Ambulatory Care Treatment Study and the National Health Examination Survey--Cycles II and III), are used to test the usefulness of diagnostic groupings in examining correlates of illness. A series of analyses of variance with the diagnostic groupings as the independent variable and a range of psychological, social and educational measures as the dependent variables reveal only the number of significant differences expected by chance. The only area in which a pattern of significant differences is found in the family's interaction with the health care delivery system. These results indicate that there is more variability within diagnostic groupings than between them and suggest that diagnosis is not a helpful categorization in the examination of psychological and social variables. While not surprising to social scientists, these data suggest the need for a major reorientation of the research paradigm when examining the psychological, social, rehabilitative and preventive issues raised by chronic illness in children and families.

In regard to everyday problems with older patients on the emergency wards of our hospitals the usual diagnostic procedures are obviously not very helpful in uncovering the multiple problems these patients have. They need a comprehensive assessment which includes evaluation of the patient in several domains, namely physical, mental, socioeconomic, functional and environmental status. The multidisciplinary character of the comprehensive geriatric assessment and its problems and goals are discussed.

Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis. A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators. 82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders. While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE. Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges. • No study has examined mental health prevalence rates in individuals with PAE but not FASD. • 57 articles including 29,644 individuals with alcohol exposure were found and analyzed. • 82 % of individuals with alcohol exposure have at least one co-occurring disorder • Older individuals, females, and those with an FASD diagnosis had higher prevalences of multiple disorders.. • These findings help inform both the diagnosis and support of individuals with alcohol exposure [ABSTRACT FROM AUTHOR]

Introduction: The medical and social definitions of neurodivergence have become a common topic of discussion in recent years, and the ways that we define, measure and report on conditions within the neurodivergent umbrella are changing. The objective of this study was to analyze differences in mental health symptom presentation at intake and compare treatment outcomes among three groups: clients with an affirming neurodivergent diagnosis, clients without an affirming diagnosis, and neurotypical clients. Methods: Data were collected at intake and discharge. Clients self-reported neurodivergent identity, neurodivergent diagnoses, as well as the severity of depression symptoms, anxiety symptoms and self-harm frequency. One-way multivariate analysis of variance tests were run to assess differences in mental health symptoms at intake and discharge based on neurodivergent identity and corresponding diagnosis. When MANOVAs indicated significant differences, follow-up univariate one-way ANOVAs were conducted for each dependent variable. Results: Neurodivergent clients reported significantly worse mental health symptoms at intake than neurotypical clients, regardless of diagnosis status. Additionally, clients who identified as neurodivergent but did not report an affirming medical diagnosis reported significantly worse mental health symptoms than those who did report an affirming medical diagnosis. By discharge from IOP treatment, no significant differences were found in symptom change scores between neurodivergent and neurotypical individuals, or neurodivergent individuals with an affirming diagnosis and those without. Discussion: These findings highlight the importance of acknowledging client identity as a key component of mental health treatment. The act of validating symptoms and experiences, allowing accommodations when requested, and exploring identity formation regardless of diagnosis, allowed all clients who identified as neurodivergent to benefit from treatment. [ABSTRACT FROM AUTHOR]

Preoperative depression is an underappreciated comorbidity that has important implications for postoperative outcomes. Screening for symptoms of depression before surgery can identify patients with or without a previous diagnosis of depression who could benefit from perioperative interventions to improve mood. Preoperative screening programmes are feasible to implement, although care must be taken to ensure that patients who are most likely to benefit are included. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Beyond the challenges of diagnosis, complexity measurement in clients with mental illness is an important but under-recognized area. Accurate and appropriate psychiatric diagnoses are essential, and further complexity measurements could contribute to improving patient understanding, referral, and service matching and coordination, outcome evaluation, and system-level care planning. Myriad conceptualizations, frameworks, and definitions of patient complexity exist, which are operationalized by a variety of complexity measuring tools. A limited number of these tools are developed for people with mental illness, and they differ in the extent to which they capture clinical, psychosocial, economic, and environmental domains. Guided by the PRISMA Extension for Scoping Reviews, this review evaluates the tools best suited for different mental health settings. The search found 5345 articles published until November 2023 and screened 14 qualified papers and corresponding tools. For each of these, detailed data on their use of psychiatric diagnostic categories, definition of complexity, primary aim and purpose, context of use and settings for their validation, best target populations, historical references, extent of biopsychosocial information inclusion, database and input technology required, and performance assessments were extracted, analyzed, and presented for comparisons. Two tools—the INTERMED, a clinician-scored and multiple healthcare data-sourced tool, and the VCAT, a computer-based instrument that utilizes healthcare databases to generate a comprehensive picture of complexity—are exemplary among the tools reviewed. Information on these limited but suitable tools related to their unique characteristics and utilities, and specialized recommendations for their use in mental health settings could contribute to improved patient care. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorders (ASD) present deficits in regulation of their emotions which have a great impact on their mental health and well-being. There are several studies showing the connection between executive functions deficits and emotion dysregulation in the context of an ASD diagnosis. Our study aims to investigate which among the executive functions can predict the emotional dysregulation in children with ASD, if there is an association between the ASD specific characteristics and their ability to regulate their emotions and to identify if there are possible mediators of this relationship. To reach our objective, we enrolled 60 children with ASD (mean age 8.5 years) whose parents completed standardised measurements for executive functions, emotional dysregulation, and ASD characteristics. We found a positive association between ASD characteristics' severity and emotional dysregulation, as well as some significant predictors among specific executive functions and emotional dysregulation. Moreover, executive functioning mediates the relationship between the ASD characteristics and emotion regulation. Our research provides a better understanding of the relationship between ASD characteristics, executive functions, and emotion regulation. [ABSTRACT FROM AUTHOR]

Influence from bias is unavoidable in clinical decision-making, and mental health assessment seems particularly vulnerable. Individuals with intellectual disabilities have increased risk of developing co-occurring mental disorder. Due to the inherent difficulties associated with intellectual disabilities, assessment of mental health in this population often relies on a different set of strategies, and it is unclear how these may affect risk of bias. In this theoretical paper, we apply recent conceptualisations of bias in clinical decision-making to the specific challenges and strategies in mental health assessment in intellectual disabilities. We suggest that clinical decision-making in these assessments is particularly vulnerable to bias, including sources of bias present in mental health assessment in the general population, as well as potential sources of bias which may be specific to assessments in this population. It follows that to manage potential bias, triangulating information from multi-informant, multi-method, interdisciplinary assessment strategies is likely to be necessary. [ABSTRACT FROM AUTHOR]

Background Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown. Methods A Preferred Reporting Items for Systematic Review and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology–compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, posttraumatic stress, and insomnia in this population. MEDLINE, Web of Science, Cochrane Central Register, KCI Korean Journal database, SciELO, Russian Science Citation Index, and Ovid-PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyses and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors. Results A total of 208 studies (n = 654 413; median age = 60.7 years; 25.5% women) were identified. Among the patients, 19.5% reported depressive symptoms (95% confidence interval [CI] = 17% to 21%), 17.8% anxiety symptoms (95% CI = 14% to 21%), 34.3% distress (95% CI = 29% to 39%), 17.7% posttraumatic symptoms (95% CI = 6% to 41%), and 43.8% insomnia symptoms (95% CI = 35% to 52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95% CI = 7% to 13%), 5.6% anxiety (95% CI = 2% to 10%), 9.6% insomnia (95% CI = 1% to 40%), and 1% posttraumatic stress (95% CI = 0% to 84.5%). Suicide pooled incidence was 161.16 per 100 000 individuals per year (95% CI = 82 to 239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared with surgery and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress. Conclusions Patients with head and neck cancer presented notable prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential. [ABSTRACT FROM AUTHOR]

Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current "waitlist crisis" for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12-53 months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n = 29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result.

Abstract The purpose of this article is to analyze the existing literature on the role of identity in mental illness and self-diagnostic behavior among individuals on social media. In this paper, we consolidate existing frameworks for illness identity formation based on principles of social contagion and community formation principles to conceptualize abnormal behaviors related to social media use, including Munchausen’s by Internet, mass social media-induced illness, and mass sociogenic illness. The importance of a diagnosis in personal identity formation and ingroup involvement is an emergent theme in this review. Social media communities represent a cultural antithesis of the medical establishment by rejecting healthcare expertise and creating spaces whose membership is only afforded through a psychiatric diagnosis for individuals to participate in shared experiences. Clinical implications of these findings include tools to identify and dismantle harmful self-pathologizing of normal behavioral variants in young adults who present with specific symptomatology.

Objective: The objective of this review was to gain new insight into the rare condition, Austrian syndrome: the triad of endocarditis, meningitis and pneumonia caused by Streptococcus pneumoniae. Methods: A systematic review of case reports was conducted using the PRISMA guideline. Cases were rigorously screened to meet a set of well-defined inclusion criteria. Relevant data was aggregated and reported using descriptive statistics. Results: Seventy-one cases from 69 case reports were included in the final review. The mean age was 56.5 years with a male-to-female ratio of 2.4:1. Alcoholism was reported in 41% of patients. Altered mental state (69%) and fever (65%) (mean temperature on admission = 38.9°C) were the commonest presenting symptoms. The mean duration of symptoms before presentation to the hospital was 8 days. The aortic valve was most commonly affected (56%). The mean duration of antibiotic therapy was 5.6 weeks. Seventy percent of patients were admitted to the intensive care unit (ICU). Fifty-six percent of patients had valvular surgery. The average length of stay in the hospital was 36.9 days. Mortality was recorded in 28% of patients. Conclusion: Austrian syndrome is rare but deadly. The true incidence is unknown but is commoner in middle-aged men and in alcoholics. Affected patients are usually critically unwell, often requiring ICU admission and prolonged hospital stays. Treatment is aggressive including prolonged courses of antibiotics and often, surgery. Despite these, the case fatality rate is high, with death occurring in over a quarter of patients. Surgery appears to be associated with better prognosis. [ABSTRACT FROM AUTHOR]

There is a dearth of research into the experience of adult diagnosis of autism spectrum disorder, and targeted research is needed to understand the needs of these adults. The aim of this coproduced review was to assess existing qualitative data on the lived experience of receiving an autism spectrum disorder diagnosis, identify recurring themes, and synthesize them into a visual model representing the journey through diagnosis. Using thematic analysis, we analyzed qualitative data from 24 studies of adult experiences of autism spectrum disorder diagnosis from PsycINFO, Embase, MEDLINE, and CINAHL. Thirty-two "descriptive" themes and three superordinate themes were identified. These themes represented how factors relating to identity and relationships are impacted by the diagnosis of autism spectrum disorder and the role of adaptation and assimilation. While the diagnostic process was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the diagnosis process explicitly considers needs in relation to: the impact of the diagnosis on identity, interactions with other people, choices regarding disclosure, and whether and how to make informed adaptations. There is little research looking at the experience of individuals diagnosed with autism spectrum disorder as adults. Adults diagnosed with autism spectrum disorder face different challenges than children, and more research is needed to better understand those challenges. For this review, autistic and non-autistic researchers looked at research on the experience of receiving a diagnosis of autism spectrum disorder as an adult. We looked for themes in people's experience leading up to diagnosis, going through the diagnostic process, and living their life after diagnosis. We analyzed 24 studies and found three overarching themes that captured thirty-two themes describing the experience of diagnosis. The three overarching themes expressed issues with identity and relationships before and after the diagnosis and identified that the diagnosis of autism spectrum disorder in adulthood impacted people's adaptation to and assimilation (i.e. the making sense of and internalizing the diagnosis) of autism spectrum disorder. While the diagnostic process itself was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences and had effects on identity and self-esteem. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the impact of the diagnosis on people's identity and choices about telling others about their diagnosis, and whether and how people want to make adaptations, should be discussed and thought through in the process of diagnosis. [ABSTRACT FROM AUTHOR]

Mental disorders in children and adolescents may follow different trajectories, such as remission, change of diagnosis, or addition of two or more comorbid diagnoses, showing a heterotypic pattern. This study aims to describe the main diagnostic trajectories across a broad range of mental disorder diagnostic categories, from childhood to adolescence and from adolescence to young adulthood in a clinical population. A prospective study was conducted among a clinical sample of children and adolescents who were aged 3–17 years at the face-to-face baseline interview. Electronic health records of these participants were reviewed 10 years later. The diagnostic stability over time was examined using the kappa coefficient, and factors associated with stability were explored using simple logistic regression. The study included a sample of 691 participants. The kappa coefficient for diagnostic stability across all diagnoses was 0.574 for the transition from childhood to adulthood, 0.614 from childhood to adolescence, and 0.733 from adolescence to adulthood. Neurodevelopmental diagnoses had the highest stability. Factors associated with higher diagnostic stability included family history of mental disorders, receiving psychopharmacological treatment, and symptom severity at baseline. We found a variable diagnostic stability across different diagnoses and age categories. The different life transitions represent complex periods that should not be overlooked from a clinical standpoint. An appropriate transition from child and adolescent mental health services to adult mental health services may have a positive impact on children and adolescents with mental disorders. [ABSTRACT FROM AUTHOR]

Delays in identifying pediatric autism spectrum disorder (ASD) remain problematic despite directives aimed at improving early detection and intervention. Caregiver mental health concerns could be one explanation for this documented delay, necessitating further inquiry into mental health factors that predict delayed age of ASD diagnosis. This study investigated the impact of caregiver mental health concerns, diagnoses within the three-generation family history, and demographic data on delayed ASD diagnosis using a sample of caregivers of children with ASD (N = 63). Factors that predicted a delayed response between the time when a child was suspected of having developmental delay and when the child presented for a developmental diagnostic evaluation were examined. Mental health concerns were assessed by using standardized screening tools for traumatic childhood experiences, depression, and anxiety. The average time between suspicion of developmental delay and the child's presentation for a diagnostic evaluation was 36 months. Female gender of the child and family histories that contain intellectual disability, learning concerns, neurological concerns, or Tourette's syndrome predicted prolonged time to diagnostic evaluation. Adverse childhood events (ACEs) experienced by caregivers were identified as predictors of generalized anxiety disorder and depression. A positive correlation was found between caregiver generalized anxiety disorder and depression. Caregiver type, child gender, and child ethnicity predicted generalized anxiety but not depression. Health care providers should address identified predictors for delayed ASD diagnostic evaluations with caregivers upon initial suspicion of developmental delay. Practice recommendations for health care providers include assessing a three-generation family history and evaluating caregiver mental health concerns. Further, identifying protective factors to improve caregiver resiliency may reduce this disparity. [ABSTRACT FROM AUTHOR]

The purpose of this article is to analyze the existing literature on the role of identity in mental illness and self-diagnostic behavior among individuals on social media. In this paper, we consolidate existing frameworks for illness identity formation based on principles of social contagion and community formation principles to conceptualize abnormal behaviors related to social media use, including Munchausen's by Internet, mass social media-induced illness, and mass sociogenic illness. The importance of a diagnosis in personal identity formation and ingroup involvement is an emergent theme in this review. Social media communities represent a cultural antithesis of the medical establishment by rejecting healthcare expertise and creating spaces whose membership is only afforded through a psychiatric diagnosis for individuals to participate in shared experiences. Clinical implications of these findings include tools to identify and dismantle harmful self-pathologizing of normal behavioral variants in young adults who present with specific symptomatology. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vitiligo is a chronic skin disorder characterized by the loss of pigmentation, resulting in white patches on the skin. The condition arises from the destruction of melanocytes, the cells responsible for producing melanin, the pigment that gives colour to the skin, hair, and eyes. Although the exact etiology of vitiligo remains elusive, it is believed to involve a complex interplay of genetic, autoimmune, and environmental factors. This overview provides the key aspects of vitiligo, including its epidemiology, pathogenesis, clinical manifestations, and current treatment approaches. The prevalence of vitiligo varies globally, affecting individuals of all ethnic backgrounds and age groups. The autoimmune hypothesis proposes that the immune system mistakenly targets and attacks melanocytes, leading to their destruction. Triggering factors, such as oxidative stress, viral infections, and neural factors, may contribute to the initiation and progression of vitiligo. Clinically, vitiligo can significantly impact the quality of life for affected individuals, both psychologically and socially. The distribution and extent of involvement vary, and the condition can affect any part of the body. Various treatment modalities are available for vitiligo, ranging from topical corticosteroids and calcineurin inhibitors to phototherapy and surgical interventions. While these approaches may help to re-pigment the skin to some extent, there is no definitive cure, and the outcomes can be unpredictable. Ongoing research is focused on understanding the molecular mechanisms underlying vitiligo and developing targeted therapies to address the root causes of the disease. [ABSTRACT FROM AUTHOR]

Background: Disorders associated with cognitive impairment impose a significant burden on both families and society. Previous studies have indicated that gait characteristics under dual-task as reliable markers of early cognitive impairment. Therefore, digital gait detection has great potential for future cognitive screening. However, research on digital biomarkers based on smart devices to identify cognitive impairment remains limited. The aim of this study is to explore digital gait biomarkers by utilizing intelligent wearable devices for discriminating mild cognitive impairment and dementia. Methods: This study included 122 subjects (age: 74.7 ± 7.7 years) diagnosed with normal cognition (NC, n = 38), mild cognitive impairment (MCI, n = 42), or dementia (n = 42). All subjects underwent comprehensive neuropsychological assessments and cranial Magnetic Resonance Imaging (MRI). Gait parameters were collected using validated wearable devices in both single-task and dual-task (DT). We analyzed the ability of gait variables to predict MCI and dementia, and examined the correlations between specific DT-gait parameters and sub-cognitive functions as well as hippocampal atrophy. Results: Our results demonstrated that dual-task could significantly improve the ability to predict cognitive impairment based on gait parameters such as gait speed (GS) and stride length (SL). Additionally, we discovered that turn velocity (TV and DT-TV) can be a valuable novel digital marker for predicting MCI and dementia, for identifying MCI (DT-TV: AUC = 0.801, sensitivity 0.738, specificity 0.842), and dementia (DT-TV: AUC = 0.923, sensitivity 0.857, specificity 0.842). The correlation analysis and linear regression analysis revealed a robust association between DT-TV and memory function, as well as the hippocampus atrophy. Conclusion: This study presents a novel finding that DT-TV could accurately identify varying degrees of cognitive impairment. DT-TV is strongly correlated with memory function and hippocampus shrinkage, suggests that it can accurately reflect changes in cognitive function. Therefore, DT-TV could serve as a novel and effective digital biomarker for discriminating cognitive impairment. [ABSTRACT FROM AUTHOR]

Hauntology has become an increasingly alluring concept in social sciences to reflect upon everyday life and how subjects dwell upon scenarios pervaded not only by the potency of the actual but also the haunting of the past and the virtual. Drawing on the concept of 'hauntology', we inquire about recurring temporalities and spectrality themes concerning the 'controversial' diagnosis of attention deficit hyperactivity disorder (ADHD) in Chile. Using participant observation and in-depth interviews with health practitioners, teachers, school staff, diagnosed children, and their peers from 3-year-long research, we examine how the performance of the diagnosis by clinicians at times can produce a modification of the temporality of the diagnosed children from that moment forth. Amidst tension created by educational policies, ideas of well-being, pedagogical practices, and everyday living, the diagnosis keeps repeating its agentic capacity while resisting its decay, becoming ever-present and actual. Once cast, the diagnosis acts as a repeating force that can shape every experience, cancelling the possibility for the child to become different by unfolding out of the diagnosis. [ABSTRACT FROM AUTHOR]

Background Few studies have evaluated mental health disorders comprehensively among patients with prostate cancer on long-term follow-up. The primary aim of our study was to assess the incidence of mental health disorders among patients with prostate cancer compared with a general population cohort. A secondary aim was to investigate potential risk factors for mental health disorders among patients with prostate cancer. Methods Cohorts of 18 134 patients with prostate adenocarcinomas diagnosed between 2004 and 2017 and 73470 men without cancer matched on age, birth state, and follow-up time were identified. Mental health diagnoses were identified from electronic health records and statewide health-care facilities data. Cox proportional hazard models were used to estimate hazard ratios. All statistical tests were 2-sided. Results The hazard ratios for mood disorders, including depression, among prostate cancer survivors increased for all follow-up periods compared with the general population. The hazard ratios for any mental illness increased with Hispanic, Black, or multiple races; people who were underweight or obese; those with advanced prostate cancer; and those undergoing their first course cancer treatment. We also observed statistically significantly increased hazard ratios for mental health disorders among patients with lower socioeconomic status (P  < .0001) and increasing duration of androgen-deprivation therapy (P  = .0348). Prostate cancer survivors had a 61% increased hazard ratio for death with a depression diagnosis. Conclusion Prostate cancer diagnosis was associated with a higher risk of mental health disorders compared with the general population, which was observed as long as 10-16 years after cancer diagnosis. Providing long-term mental health support may be beneficial to increasing life expectancy for patients with prostate cancer. [ABSTRACT FROM AUTHOR]

Introduction: Obsessive compulsive disorder (OCD) is a prevalent mental health disorder which is characterised by high levels of morbidity. Most individuals with OCD do not receive adequate psychotherapeutic intervention. Research suggests that taboo intrusive thoughts are less likely to be recognised as OCD in comparison to more recognisable forms. Stigma attributions are higher for individuals with taboo intrusive thoughts. The aim of this study is to examine psychotherapists' capacity to recognise different forms of OCD, their recommendations for psychotherapeutic intervention, and stigma attributions towards clients with OCD symptoms. Methodology: Five hundred fourteen psychotherapists in Ireland were randomly assigned a vignette describing a client with different OCD presentations—paedophilia, aggressive, religious, homosexuality, contamination and symmetry. Participants gave their interpretations of the presenting symptoms, their therapy recommendations and rated their confidence in their responses. Perceived dangerousness and willingness to work with the client were also investigated. Results: The taboo intrusive thoughts vignettes were significantly less likely to be recognised as OCD than the contamination and symmetry vignettes. Participants attributed greater levels of stigma to clients with aggressive and paedophilia intrusive thoughts. Recommendations for evidence‐based therapies were low. Participants who recognised OCD were significantly more likely to recommend an evidence‐based therapy. Confidence was a poor predictor of OCD identification and evidence‐based therapy recommendation. Conclusions: The results suggest a lack of awareness of certain types of OCD presentation amongst psychotherapists, the meaning of the symptoms and of evidence‐based psychotherapeutic interventions for OCD. The implications of this, and possible applications of these results, are discussed. [ABSTRACT FROM AUTHOR]

Background: The Major Depression Inventory (MDI) is a patient‐reported outcome measure used by general practitioners to assist with diagnosing and evaluation of the severity of a patient's depression. However, recent studies have questioned the structural validity of the MDI. Objectives: We proposed a modified version (mMDI) of the MDI with fewer response categories and four rephrased items and aimed to compare the psychometric properties of the changes in a joint cohort of patients from general practice and mental health associations. Methods: We used Rasch analysis, confirmatory factor analysis, and the area under the receiver operating curve (AUROC) to assess the validity and reliability of the two versions. Equipercentile linking was used to compute cut‐off points for the mMDI. Results: For both versions, local dependence was found between the three item pairs (loss of interest, lack of energy), (lack of self‐confidence, feelings of guilt), and (concentration problems, feeling restless/slowed down). The mMDI displayed lower measurement error in the upper end of the scale and better item level fit for three of the four reformulated items compared to the MDI. For the MDI, 5.3% of the respondents gave improbable responses; the corresponding number was 3.4% for the mMDI. The mMDI displayed better fit to a one‐factor model compared to the MDI. When comparing the correlation of the scales with the WHO‐5 instrument, the corresponding AUROC estimates for the mMDI and MDI were found to be 0.93 (0.92; 0.96) and 0.91 (0.87; 0.94), respectively. The cut‐off points for mild, moderate, and severe depression in the mMDI were found to be 17, 20, and 23, respectively. Conclusion: The proposed changes of the MDI are psychometrically sound upgrades of the original. [ABSTRACT FROM AUTHOR]

Background: Pre-existing mental health diagnoses may contribute to greater emotional symptom burden and prolonged recovery after concussion. Hypothesis: Youth with pre-existing mental health diagnoses will have greater emotional symptom burden, greater risk for delayed return to exercise, and more prolonged recovery from concussion than those without those diagnoses. Study Design: Prospective cohort. Level of Evidence: Level 3. Methods: A prospective registry of youth concussion was examined for differences in emotional symptom burden after injury to develop a predictive risk model for prolonged recovery. The impact of individual and total number of pre-existing mental health diagnoses (0, 1, 2, and 3+) was assessed, and multivariable logistic regression was performed to identify factors associated with prolonged recovery. Results: Among a cohort of 3105 youth with concussion, those with a history of mental health diagnoses, in a dose-response fashion, had greater postinjury emotional symptom burden (7 emotional symptoms vs 4; P < 0.01), visio-vestibular dysfunction (65% abnormal vs 56% abnormal; P < 0.01), later return to symptom-limited exercise (23 vs 21 days; P < 0.01), and overall longer concussion recovery (38 days, interquartile range [IQR] 18, 80) versus 25 days (IQR 13, 54; P < 0.01). Boys with prolonged recovery after concussion had greater emotional symptom burden than girls (5 emotional symptoms vs 3; P < 0.01). Conclusion: Pre-existing mental health diagnoses are associated with greater postinjury emotional symptom burden and longer concussion recovery in a dose-response fashion. Visiovestibular deficits and delayed return to exercise are also associated with pre-existing mental health diagnoses and prolonged recovery. Boys with prolonged recovery from concussion experience greater emotional symptom burden than girls. Clinical Relevance: Addressing pre-existing mental health diagnoses is essential to concussion management. Boys with prolonged recovery from concussion may particularly benefit from interventions to address their higher emotional symptom burden. Interventions, including a home visio-vestibular exercise program and symptom-limited exercise, may contribute to improving time to concussion recovery. [ABSTRACT FROM AUTHOR]

BackgroundEndorsement of specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) alcohol use disorder (AUD) criteria have been shown to change significantly over time in men in their thirties who have persistent or recurrent AUD. However, few studies have documented whether the endorsement of AUD items changes over time in younger individuals or in women. We evaluated changes in the endorsement of AUD criteria in 377 men and women with persistent or recurrent AUD during their twenties.MethodsInformation on AUD-item endorsement over time was available for 223 men and 154 women aged 20-25 with persistent or recurrent AUD in at least three interviews in the Collaborative Study on the Genetics of Alcoholism. The statistical significance of endorsement changes over time was evaluated using the related-sample Cochran's Q test for the full sample and for men and women separately. Additional analyses evaluated sex differences in the patterns of change.ResultsIn the full sample, the predominant pattern was for a significant increase in the rates of endorsement for six of the seven alcohol dependence criteria but not in the four abuse criteria. A similar pattern was seen within men, but women had significant changes in only three of the seven dependence criteria.ConclusionsEndorsement of the seven alcohol dependence criteria among individuals with persistent or recurrent AUD in their twenties generally increased, but few changes were observed in the rates of endorsement of the four abuse criteria. These results are discussed in terms of how they reflect on the nature of AUD and the DSM criteria.

Though early ASD diagnosis is highly stable, this case report describes a rare situation in which symptoms resolved without intervention over a 4 month period. We do not recommend delaying diagnosis in symptomatic children who meet criteria but when major behavioral changes are reported after diagnosis, reevaluation may be beneficial.

Emotionally unstable personality disorder (EUPD) is a mental disorder impairing health and functioning and increasing suicide risk and it is a stigmatised condition among healthcare professionals. EUPD diagnosis may significantly affect self-concept, yet no previous investigation has explicitly examined this. To explore service user perspectives on (a) the impact of EUPD diagnosis on self-concept and (b) mediators of positive and negative impacts. Service user-led, qualitative semi-structured interviews with n = 10 participants with EUPD. Perceived impacts of diagnosis on self-concept were, broadly, negative. Factors mediating between positive and negative impacts included: exposure to online stigma and public understanding, the responses of relatives, friends, intimate partners and trusted communities, and the attitudes and behaviours of healthcare staff. There were indications that recent guideline and practice developments (guidelines recommending alternatives to inpatient admissions for people with EUPD and "recovery-focused" approaches to self-harm) may have worsened inpatient staff attitudes and led to more rejecting service user experiences. Mitigating negative impacts of EUPD diagnosis on self-concept may require addressing hateful, online content related to EUPD; revisiting use of the personality disorder label; improving medical communication around diagnosis and improving practice and policy in the management of EUPD in inpatient settings. [ABSTRACT FROM AUTHOR]

For many nurses working in primary care, chronic obstructive pulmonary disease (COPD) is a familiar condition. From carrying out annual reviews to supporting people living with the symptoms of cough, phlegm, breathlessness and managing their effect on day-to-day living, most community nurses will have some experience of supporting people living with COPD. Increasingly, though, community nurses are having to consider comorbidities as part of the review, as for many people living with COPD, this will be just one of the long-term conditions they have already been diagnosed with or of which they will be at risk. In this article, the relationship between COPD and other long-term conditions will be highlighted, along with recommendatio how to identify and manage comorbidities in order to holistically optimise outcomes.ns about [ABSTRACT FROM AUTHOR]

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Colombia is one of the countries where the armed conflict has been expressed through different forms of violence, causing the victims to experience multiple traumatic situations. The aim of this study is to compare the number of traumatic events experienced, the presence of symptoms of post-traumatic stress disorders (PTSD), and the deterioration of functioning among victims of forced displacement in the context of the armed conflict who meet and do not meet the diagnostic criteria for PTSD, through the application of the EGEP-5, which is an instrument that evaluates the presence of post-traumatic symptoms and diagnosis of PTSD. The study is non-experimental, cross-sectional, and descriptive in scope. The results showed that 45.6% of the total sample met all the PTSD criteria, presenting in turn a greater number of traumatic events, though polyvictimization was identified in the two study samples. [ABSTRACT FROM AUTHOR]

The present article explores the evolution of the models used in the medical field, from the biomedical model to the model offered by the framework of 4E Cognition. Additionally, the diagnosis and treatment of illness through the biomedical focus is critiqued due to its reductionist view of the complexity of the health-illness continuum and the human experience. The 4E Cognition model is proposed as a possibility for the practical application of the biopsychosocial model - be it that one of the principle critiques of this model is the difficulty of applicability - given so that the development of concrete interventions from an integrative perspective in the medical sciences are permitted. This article explores the application of the 4E Cognition model in the field of psychiatry and psychology, highlighting the potential role of Mobile Brain-Body Imaging (MoBI) technology for the diagnosis and treatment of diverse neuropsychiatric diagnoses from an integrative perspective that considers physiological, social, psychological, environmental, and structural elements. Finally, possible future directions in terms of research and the applicability of the development of interventions and treatments that are implementing these technologies are explored. [ABSTRACT FROM AUTHOR]

Family physicians play a pivotal role in the early detection, diagnosis, and management of mental health disorders within the community. This review article delves into the multifaceted responsibilities of family physicians in the realm of mental health care. Emphasizing the importance of primary care settings as the first point of contact for many patients, the article underscores the need for effective screening tools and methodologies tailored for these environments. The diagnostic precision of family physicians, often challenged by the broad spectrum of mental health symptoms, is explored alongside the potential implications of misdiagnoses. Furthermore, the article evaluates various treatment options, from pharmacological interventions to psychotherapy, and their applicability in primary care settings. The integration of technological advancements, such as electronic health records and telemedicine, is also discussed in the context of enhancing patient care. The review concludes by highlighting the importance of educating primary care physicians to not only pay close attention to the mental health of their patients, but also to be able to accurately screen and diagnose mental health issues using various diagnostic tools. Moreover, it is critical to develop more useful tools that can be used in the context of primary care settings. [ABSTRACT FROM AUTHOR]

Currently, the number of students in the UK with diagnoses of mental health or psychiatric conditions is rising, as are the number of students categorised as having a special educational need or disability (SEND). To support these students' objective evidence of deficit or difficulty is required, this usually takes the form of a legitimising diagnosis. However, in the case of mental health conditions, social, emotional and behavioural problems or even in some neurodevelopmental disorders, diagnosis is less useful as there are fundamental problems with the classification and understanding of mental health conditions. Despite this, the prevalence and importance of diagnosis remains in supporting students in education and those who are categorised as SEND. Therefore, this paper seeks to discuss the place that diagnosis has in education and the alternative models that exist in an effort to understand potential other avenues of supporting students and the benefits and limitations of these. [ABSTRACT FROM AUTHOR]

Summary: Cognitive behavioural therapy for insomnia (CBT‐I) is considered the front‐line treatment for insomnia. Despite the demonstrated effectiveness of CBT‐I, it is necessary to consider how CBT‐I may be tailored to different individuals. The purpose of the present review is to provide a summary of literature on tailoring CBT‐I to different individuals and provide directions for future research. This review focused on the following domains of adaptation: (i) tailoring CBT‐I components to individuals with comorbid mental or physical health conditions such as comorbid depression and pain; (ii) adapting CBT‐I delivery for different contexts in which individuals exist, such as inpatient, educational, and different social/cultural settings, (iii) adapting CBT‐I to specific individuals via case‐formulation in clinical settings. We highlight current gaps in the exploration of tailored CBT‐I, including a lack of research methodology to evaluate tailored interventions, a need for the integration of ongoing individualised assessment to inform treatment, and the necessary involvement of consumers and stakeholders throughout the research and treatment development process. Together, this review showed abundant adaptations in CBT‐I already exist in the literature. Future research is needed in understanding when and how to apply adaptations in CBT‐I and evaluate the benefits of these adaptations. [ABSTRACT FROM AUTHOR]

Background Adolescent and young adult cancer survivors experience mental health challenges, yet little is known about the evolution of these difficulties. This study explored mental health symptoms and utilization among long-term adolescent and young adult cancer survivors. Methods Using 30 432 respondents from the 2019 National Health Interview Survey, this study compared adults with a history of adolescent and young adult cancer (diagnosed when patients were between 15 and 39 years of age) to adults without adolescent and young adult cancer. Mental health symptom severity was measured using the Patient Health Questionnaire depression scale and 7-item Generalized Anxiety Disorder questionnaires. Care utilization constituted psychotherapy and mental health medication use. Inverse propensity score weights were used to balance demographics and combined with survey weights. Descriptive statistics, multivariable generalized linear models, and structural equation modeling with 2-sided tests were used for analysis. Results We compared 639 adolescent and young adult survivors with 29 793 controls. Survivors were, on average, 20.5 years (SE = 0.74) past their cancer diagnosis dates. After adjusting for survey and propensity score weights, adolescent and young adult survivors reported more severe depression (incidence rate ratio = 1.42, 95% confidence interval [CI] = 1.09 to 1.84, P  < .01) and anxiety (incidence rate ratio = 1.85, 95% CI = 1.55 to 2.21, P  < .001). They were more likely to use psychotherapy (odds ratio = 1.91, 95% CI = 1.16 to 3.17, P  < .05) and mental health medications (odds ratio = 1.89, 95% CI = 1.15 to 3.11, P  < .05). Time since diagnosis was negatively associated with symptoms and utilization. Structural equation modeling demonstrated mediation of utilization effect by symptom severity. Conclusions Adolescent and young adult survivors experience worse mental health in late survivorship, despite small improvements over time. We highlight the importance of survivorship care that addresses the long-term mental health needs of these survivors. [ABSTRACT FROM AUTHOR]

Background: Diagnosing inflammatory bowel disease (IBD) can be challenging. Patients have been found to experience significant diagnostic delay, which can lead to poorer clinical outcomes. The reasons for this delay are not fully understood, and exploring patients' perspectives can offer important insights. Aim: To explore the views and experiences of patients who self-report a delay in IBD diagnosis. Design & setting: Qualitative methodology using semi-structured interviews. Participants were recruited via social media and a national IBD charity. Method: Interviews were conducted by telephone between December 2018 and February 2019. Data were analysed using thematic analysis and drawing on the constant comparison method. Results: Sixteen interviews were carried out. Ten participants were female and six were male; participants were aged 20-65 years. Four main themes were identified: patient factors contributing to delay; primary care factors contributing to delay; systemic factors contributing to delay; and perceived consequences of delayed diagnosis. Participants reported initially not seeking help due to embarrassment or normalising their symptoms. Having consulted, participants reported further delay in receiving a diagnosis due to their perception that GPs had either mislabelled symptoms, expressed uncertainty, or not taken symptoms seriously. Systemic factors, including lack of access to test results and communication issues across primary and secondary care, were also cited as contributing to delayed diagnosis. Several participants felt that their delayed diagnosis led to poorer clinical outcomes. Conclusion: These findings can support patients and GPs in their conversations about symptoms that may indicate IBD, and potentially contribute to reducing diagnostic delay, as well as informing future primary care interventions. [ABSTRACT FROM AUTHOR]

Background/objectiveThe present study leveraged the expertise of an international group of posttraumatic stress and substance use disorder (PTSD+SUD) intervention researchers to identify which methods of categorizing interventions which target SUD, PTSD, or PTSD+SUD for populations with both PTSD+SUD may be optimal for advancing future systematic reviews, meta-analyses, and comparative effectiveness studies which strive to compare effects across a broad variety of psychotherapy types.MethodA two-step process was used to evaluate the categorization terminology. First, we searched the literature for pre-existing categories of PTSD+SUD interventions from PTSD+SUD clinical trials, systematic and literature reviews. Then, we surveyed international trauma and substance use subject matter experts about their opinions on pre-existing intervention categorization and ideal categorization nomenclature.ResultsMixed method analyses revealed that a proliferation of PTSD+SUD treatment research over the last twenty years brought with it an abundance of ways to characterize the treatments that have been evaluated. Results from our survey of experts (N = 27) revealed that interventions for PTSD+SUD can be classified in many ways that appear to overlap highly with one another. Many experts (11/27; 41%) selected the categories of 'trauma-focused and non-trauma focused' as an optimal way to distinguish treatment types. Although several experts reinforced this point during the subsequent meeting, it became clear that no method of categorizing treatments is without flaws.ConclusionOne possible categorization (trauma-focused/non-trauma focused) was identified. Revised language and nomenclature for classification of PTSD+SUD treatments are needed in order to accommodate the needs of this advancing field.

BackgroundNeurodegenerative diseases (NDDs) are increasingly prevalent and radically alter the lives of individuals and their informal care partners (together called a dyad). As symptoms progress, dyads are at risk for elevated emotional distress and declines in relationship functioning and quality of life. Psychosocial interventions delivered to dyads early after diagnosis have successfully prevented chronic emotional distress across several chronic illnesses including cancer and acute brain injury. Dyads with NDD could benefit from such interventions, however, they are limited. Because NDDs have symptom profiles that are distinct from other chronic illnesses, they require a unique framework and interventions. Given the limited dyadic interventions and unified symptoms across NDDs, a transdiagnostic framework may help to enhance scalability and efficiency. To address this problem, we developed a transdiagnostic framework that cuts across NDD physical and emotional diagnoses to inform cost-effective and sustainable NDD dyadic interventions.MethodsTo develop this framework, we conducted: (1) a narrative review on dyadic adjustment and existent dyadic interventions for those with NDDs, and (2) integrated findings to develop our NDD transdiagnostic framework for dyadic interventions early after diagnosis.ResultsFindings revealed no existent dyadic interventions for NDDs delivered shortly after diagnosis. Among available interventions, all were delivered later in disease progression, thereby focusing on dyadic challenges at more advanced stages. In addition, although research emphasized the influence of individual, dyadic, and contextual factors on dyads' early adjustment to NDDs, no conceptual model has been developed. Informed by theory and current research, we introduce an NDD transdiagnostic framework for couples' early biopsychosocial adjustment. This framework includes NDD specific: contextual factors, illness-related factors, individual and dyadic stressors, adaptive coping strategies, and dyads' resources.ConclusionsOur NDD transdiagnostic framework can be used to inform early dyadic psychosocial interventions that cut across all NDDs. This approach has important implications for implementation and scalability.

Beyond the challenges of diagnosis, complexity measurement in clients with mental illness is an important but under-recognized area. Accurate and appropriate psychiatric diagnoses are essential, and further complexity measurements could contribute to improving patient understanding, referral, and service matching and coordination, outcome evaluation, and system-level care planning. Myriad conceptualizations, frameworks, and definitions of patient complexity exist, which are operationalized by a variety of complexity measuring tools. A limited number of these tools are developed for people with mental illness, and they differ in the extent to which they capture clinical, psychosocial, economic, and environmental domains. Guided by the PRISMA Extension for Scoping Reviews, this review evaluates the tools best suited for different mental health settings. The search found 5345 articles published until November 2023 and screened 14 qualified papers and corresponding tools. For each of these, detailed data on their use of psychiatric diagnostic categories, definition of complexity, primary aim and purpose, context of use and settings for their validation, best target populations, historical references, extent of biopsychosocial information inclusion, database and input technology required, and performance assessments were extracted, analyzed, and presented for comparisons. Two tools—the INTERMED, a clinician-scored and multiple healthcare data-sourced tool, and the VCAT, a computer-based instrument that utilizes healthcare databases to generate a comprehensive picture of complexity—are exemplary among the tools reviewed. Information on these limited but suitable tools related to their unique characteristics and utilities, and specialized recommendations for their use in mental health settings could contribute to improved patient care.