Mental Health

Treatment adherence associated with conventional and atypical antipsychotics in a large state Medicaid program

by John R Lloyd

Menzin J, Boulanger L, Friedman M, Mackell J, Lloyd JR., Psychiatr Serv. 2003 May;54(5):719-23.

Objectives: Rates of medication adherence over a one-year period were assessed among outpatients with schizophrenia... more Objectives: Rates of medication adherence over a one-year period were assessed among outpatients with schizophrenia who initiated therapy with conventional or atypical antipsychotic agents. Methods: Data were drawn from paid medical and pharmacy claims for a random sample of 10 percent of all California Medicaid (“Medi-Cal”) recipients. Outpatients
with schizophrenia who were aged 18 years or older and who initiated monotherapy with a conventional or atypical antipsychotic medication in the last quarter of 1997 were identified. The percentages of patients who discontinued antipsychotic therapy or who had a switch in medications over a one-year period were determined. The use of selected
concomitant medications was also assessed. Data were analyzed by means of chi square tests and multivariate statistics that adjusted for demographic and clinical differences between medication groups.
Results: A total of 298 patients who initiated therapy with a conventional (N=93) or atypical (N=205) antipsychotic medication were identified. The groups were similar in mean age (about 42 years) and gender distribution (about 54 percent were male). Compared with patients who received conventional antipsychotics, those receiving atypical antipsychotics
were significantly less likely to have a switch in medication and
to use concomitant anticholinergic and anxiolytic medications. In each group, antipsychotic medication was available for about 60 percent of days over one year of follow-up. Conclusions: Compared with the use of conventional antipsychotics, the use of atypical antipsychotic medications was associated with significantly less treatment switching and less use of concomitant medications. However, undertreatment, evidenced
by a lack of prescription refills, occurred among patients taking both medication classes, which highlights the need for further research on nonadherence. (Psychiatric Services 54:719–723, 2003)

Epigenetic mechanism mediating the impact of child adversity on life-long adverse behavior

by Andrés Ginestet

Although epidemiological data provide evidence that early life experience plays a critical role in human development,... more Although epidemiological data provide evidence that early life experience plays a critical role in human development, the mechanism of how this works remains in question. Recent data from human and animal literature suggest that epigenetic changes, such as DNA methylation, are involved not only in cellular differentiation, but also in the modulation of genome function in response to early life experience affecting gene
function and the phenotype. Such modulations may serve as a mechanism for life-long genome adaptation.
These changes seem to be widely distributed across the genome and to involve central and peripheral systems. Examining the environmental circumstances associated with the onset and reversal of DNA methylation will be critical for understanding risk and resiliency.

Parenting and the emotional and behavioural adjustment of young children in families with a parent with bipolar disorder

by Robert Dempsey

Calam, R., Jones, S., Sanders, M., Dempsey, R., & Sadhnani, V. (in press). Parenting and the emotional and behavioural adjustment of young children in families with a parent with bipolar disorder. Behavioural and Cognitive Psychotherapy.

Background: Children of parents with bipolar disorder are at increased risk of disturbance.

Aims: This... more Background: Children of parents with bipolar disorder are at increased risk of disturbance.

Aims: This study examined relationships between parental mood, parenting, household organization and child emotional and behavioural adjustment in families with a parent with bipolar disorder to determine areas of specific need for parenting support.

Method: 48 parents were recruited through advertisements via self-help organizations. The study was conducted online. Parental mood and activity was assessed by self-report questionnaires (CES-D, ISS, MDQ and SRM); parenting was assessed using the Parenting Scale (PS). The SDQ was used to assess the parent’s view of their child’s emotional and behavioural difficulties. The Confusion, Hubbub and Order Scale (CHAOS) assessed household organization.

Results: Parents reported high levels of difficulties across all measures and scores were above clinical cut-offs on most scales. Children were reported as showing high levels of disturbance on the SDQ, including all sub-scales. Parenting and depression scores were significantly positively correlated, as were depression, parenting and CHAOS score. Regression analyses indicated that CHAOS was the strongest predictor of Total Difficulties and Emotional Symptoms on the SDQ.

Conclusions: Families are likely to benefit from interventions tailored to meet their parenting needs.

Mental health teaching to UK psychology undergraduates: report of a survey

by john cromby

One of the limitations on developing more progressive applied psychology training is the teaching received by students... more One of the limitations on developing more progressive applied psychology training is the teaching received by students at undergraduate level. In this study, we focus on the provision of teaching about mental health or its equivalents (e.g. abnormal psychology and clinical psychology) on UK undergraduate psychology programmes. Most students who go on to train as clinical psychologists will have received teaching on modules like these. A survey questionnaire was sent to 109 university departments which might offer a module in mental health mental health module and 348 individuals who might be involved in such modules. The majority of programmes responding offered a mental health module, which was available each year as an optional subject. A number of findings on the content and delivery of the modules are reported and a number of recommendations are made including more involvement from practitioners and service users.

Does intergenerational mobility shape psychological distress? Sorokin revisited

by Jason Houle

Co-authored with Molly Martin

Drawing from Sorokin's hypothesis that socially mobile individuals are at greater risk of experiencing psychological... more Drawing from Sorokin's hypothesis that socially mobile individuals are at greater risk of experiencing psychological distress than their non-mobile counterparts, we investigate whether intergenerational occupational mobility influences psychological distress, as measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Using data for men from the Wisconsin Longitudinal Study (WLS) and Sobel's Diagonal Mobility Models, we find little evidence for Sorokin's hypothesis; mobile individuals are no more likely to be psychologically distressed than their non-mobile counterparts. In fact, one group of mobile men – those who left their farming origins – are actually less distressed than the sons who remain as farmers and non-mobile men in higher-ranked social classes. We speculate that this reflects the fact that farming became very arduous during the late 20th century and these mobile sons of farmers appreciate their improved life chances. Our findings suggest that the association between mobility and psychological distress varies across specific class backgrounds and is contingent upon the broader social and economic context.

The Image in the Mirror and the Number on the Scale: Weight, Weight Perceptions, and Adolescent Depressive Symptoms

by Jason Houle

The first two authors (Michelle Frisco and Jason Houle) were equal contributors to this manuscript.

Double jeopardy and health congruency theories suggest that adolescents’ joint experience of their weight and weight... more Double jeopardy and health congruency theories suggest that adolescents’ joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study of Adolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.

Adolescent Weight and Depressive Symptoms: For Whom is Weight a Burden?

by Jason Houle

Co-authored with Michelle Frisco and Molly Martin

Objective. Adolescent weight and depressive symptoms are serious population health concerns in their own right and as... more Objective. Adolescent weight and depressive symptoms are serious population health concerns in their own right and as they relate to each other. This study asks whether relationships between weight and depressive symptoms vary by sex and race/ethnicity because both shape experiences of weight and psychological distress.

Methods. Results are based on multivariate analyses of National Longitudinal Study of Adolescent Health (Add Health) data.

Results. There are no associations between adolescent girls' weight and depressive symptoms, but these associations vary considerably among boys. Underweight is associated with depressive symptoms among all boys and subpopulations of white and Hispanic boys. Among Hispanic boys, those who are overweight (vs. normal weight) have a lower probability of reporting depressive symptoms. Finally, among normal weight boys, Hispanics and blacks are more likely to report depressive symptoms than whites.

Conclusions. Findings are a reminder that understanding population health issues sometimes requires a focus on subpopulations, not simply the population as a whole.

The Impact of Sexual Harassment on Depressive Symptoms During the Early Occupational Career

by Jason Houle

Co-authored with Jeremy Staff, Jeylan Mortimer, Chris Uggen, and Amy Blackstone. Published in Society and Mental Health, 2011.

Sexual harassment has been theorized as a stressor with consequences for the physical and mental health of its... more Sexual harassment has been theorized as a stressor with consequences for the physical and mental health of its targets. Though social scientists have documented a negative association between sexual harassment and mental health, few longitudinal studies have investigated the association
between sexual harassment and depressive symptoms. Using longitudinal survey data from the Youth Development Study, combined with in-depth interviews, this article draws on Louise
Fitzgerald’s theoretical framework, stress theory, and the life course perspective to assess the impact of sexual harassment on depressive affect during the early occupational career. In support of Fitzgerald’s model, our findings confirm that sexual harassment is a stressor that is associated with increased depressive symptoms. Our quantitative results show that women and men who experience more frequent sexual harassment at work have significantly higher levels of depressed
mood than non-harassed workers, even after controlling for prior harassment and depressive symptoms. Moreover, we find evidence that sexual harassment early in the career has long-term effects on depressive symptoms in adulthood. Interviews with a subset of our survey respondents
point to a variety of coping strategies and reveal further links between harassment and other aspects of mental health, such as anger and self-doubt.

Don't jump ship!

by john cromby

It's not always good to talk

by john cromby

Paranoia and social inequality

by john cromby

Depression: embodying social inequality

by john cromby

Memoir and the Diagnosis of Schizophrenia: Reflections on The Centre Cannot Hold; Me, Myself, and Them; and the ‘Crumbling Twin Pillars’ of Kraepelinian Psychiatry.

by Angela Woods

Mental Health Review (2011) Volume 16(3) pages 102-106

Multiple Forms of Perceived Discrimination and Health among Adolescents and Young Adults

by Eric Anthony Grollman

Published in the Journal of Health and Social Behavior, June 2012: http://hsb.sagepub.com/content/early/2012/05/14/0022146512444289.abstract

Research on perceived discrimination has overwhelmingly focused on one form of discrimination, especially race... more Research on perceived discrimination has overwhelmingly focused on one form of discrimination, especially race discrimination, in isolation from other forms. The present article uses data from the Black Youth Culture Survey, a nationally representative, racially and ethnically diverse sample of 1,052 adolescents and young adults to investigate the prevalence, distribution, and mental and physical health consequences of multiple forms of perceived discrimination. The findings suggest that disadvantaged groups, especially multiply disadvantaged youth, face greater exposure to multiple forms of discrimination than their more privileged counterparts. The experience of multiple forms of discrimination is associated with worse mental and physical health above the effect of only one form and contributes to the relationship between multiple disadvantaged statuses and health. These findings suggest that past research may misspecify the discrimination-health relationship and fails to account for the disproportionate exposure to discrimination faced by multiply disadvantaged individuals.

Unsung Heroes: Developing a better understanding of the emotional support needs of Service families

by Matt Fossey

Armed Forces families must be better supported to deal with the emotional and psychological impact of deployment,... more Armed Forces families must be better supported to deal with the emotional and psychological impact of deployment, according to a report released today by Centre for Mental Health.
The report, Unsung Heroes, also calls for urgent research into alcohol misuse, domestic violence and the impact of mental health problems on the partners and children of Service personnel and veterans.
The report, which is supported by The Royal British Legion and the veteran’s mental health charity Combat Stress, argues that while progress is being made to address the psychological needs of Service personnel and veterans themselves, the practical and emotional impact on their partners and children must also be taken into consideration.
Unsung Heroes examines the services already in place for families and identifies areas where more evidence, about both the need for services to support families and the effectiveness of these services is needed.
Sean Duggan, chief executive at Centre for Mental Health said today: “Our most pressing concern is the paucity of UK research into the emotional needs of armed forces families on the ‘home front’; which may mean that the needs of many families are going unmet.
“There is a very substantial body of research that highlights concern about the levels of alcohol use within the UK Armed Forces, yet little evidence about the impact of alcohol misuse on their families. It’s vital that this kind of research is undertaken as soon as possible and that we evaluate the existing support to ensure that Service families get the help they need.”
Sue Freeth, Director of Health and Welfare at the Royal British Legion said: “The Royal British Legion welcomes this latest research which is vital in being able to meet the needs of in-service and ex-serving personnel, but also their families. These findings are supported by our own case work experience. Ensuring families receive joined up information, advice care, and support so they do not experience any disadvantage is vital.”
Peter Poole, Director of Strategy, Policy & Performance at Combat Stress said: “Combat Stress specialises in working with Veterans with mental health problems – providing crucial treatment, supporting the Veteran in his or her recovery and helping them return to normal life. The report recognises the vital role that families can play in aiding their loved one’s treatment and recovery from mental ill-health and in providing a stable home environment for Serving personnel between deployments.”

Giuntoli G, et al. (2011) Mental health, resilience and the recession in Bradford, York: Joseph Rowntree Foundation

by Dr Gianfranco Giuntoli

On 14 December 2011 Gianfranco was interviewed on BBC Leeds to report on the results of this study. Here you can find the radio interview: http://repository.leedsmet.ac.uk/main/view_record.php?identifier=5922&SearchGroup=research.

This study explores the impact of involuntary unemployment
at a time of economic recession on people’s everyday... more This study explores the impact of involuntary unemployment
at a time of economic recession on people’s everyday life and
mental well-being. It explores the relation between people’s
experiences of unemployment and two sets of resilience factors:
coping strategies and practical and emotional support.

The study consisted of 16 focus groups with 73 unemployed
people in a ‘transition phase’ in the job market: young
people (aged 18–25) who recently entered the job market
and older workers (aged 50–65) closer to retirement age.

The report covers the following questions:

• What has been the impact of job losses on
people’s everyday lives and well-being?

• What have been the experiences and views of help and
support from family, friends and formal services?

• What practice and policy recommendations
are there to promote mental well-being and
resilience during economic downturns?

Rosenfield, Sarah and Dawne M. Mouzon. Forthcoming, 2012. "Gender and Mental Health” in Carol S. Aneshensel and Jo C. Phelan. Handbook of the Sociology of Mental Health. 2nd edition. New York: Springer.

by Dawne Marie Mouzon

Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders... more Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders such as depression and anxiety, men exhibit more externalizing disorders such as substance abuse and anti-social behavior, which are problematic for others. These differences also vary by race and social class: for example, African Americans possess better mental health and thus a smaller gender gap in psychiatric problems. What explains these differences? We concentrate on conceptions of gender and gender practices. Research on gender and mental health suggests that conceptions of masculinity and femininity affect major risk factors for internalizing and externalizing problems, including the stressors men and women are exposed to, the coping strategies they use, the social relationships they engage in, and the personal resources and vulnerabilities they develop. This chapter investigates explanations in these areas for gender differences in general and by race and class.

Coping Strategies in Aymara Caregivers of Patients with Schizophrenia

by Claudia Miranda

Deinstitutionalization has forced families of patients with schizophrenia to take responsibility of informal care,... more Deinstitutionalization has forced families of patients with schizophrenia to take responsibility of informal care, without having the tools to exert their role properly. The aim of this study was to evaluate the coping strategies of caregivers of patients with schizophrenia, belonging to the Aymara ethnic group, (aborigines who are located on the highlands of Northern Chile). The studied sample comprised 45 caregivers of patients with schizophrenia users of the Mental Health Service of Arica, Chile. The results from the Family Coping Questionnaire (FCQ) show that both, Aymara and non-Aymara caregivers use the same coping strategies except for spiritual help which is more likely to be used by Aymara. This strategy might be related with the worldview they possess, thus the relation with the deities has a meaningful importance in the way of explaining and coping with different phenomena.

Education, empowerment and community based structural reinforcement: An HIV prevention response to mass incarceration and removal

by Laura McTighe

Co-authored with Jeffery Draine (Temple Uniersity) and Philippe Bourgois (University of Pennsylvania)
Published in the International Journal of Law and Psychiatry, July 2011

In the context of US urban jails, incarceration is often seen as an opportune intervention point for prevention... more In the context of US urban jails, incarceration is often seen as an opportune intervention point for prevention interventions in public health. For the detained individual, it is an opportunity to reflect on individual choices and the potential for changes in one's life course. For population focused public health professionals, jail detention facilities represent a concentration of health risks, and an opportunity to have an impact on a significant portion of those at risk for HIV and other health concerns. This paper presents an innovative education and empowerment model that bridges across jail walls, beginning on the inside, and continuing on the outside of jail where individuals continue to be challenged and supported toward positive health and social choices. The intervention also seeks to foment community activism in the communities to which jail detainees return, thus aiming to have a structural impact. This paper examines both the intervention model and the challenges of examining the effectiveness claims for the intervention at multiple levels.

Kant Concept Art

by Mark Singer

Tandem works include: "Seminal Ethics," "More Seminal Ethics Implications," "Addendum - More Seminal Ethics Implications" - also on this site.

The artist is P. Patten (USA).