Psychiatric services最新文献

{"title":"Prevalence of Past-Year Mental and Substance Use Disorders, 2021-2022.","authors":"Heather Ringeisen, Mark Edlund, Heidi Guyer, Jill Dever, Lisa Carpenter, Mark Olfson, Michael First, Paul Geiger, Dan Liao, Andy Peytchev, Christine Carr, Lydia Chwastiak, Lisa B Dixon, Maria Monroe-Devita, T Scott Stroup, Jeff Swanson, Marvin Swartz, Robert Gibbons, Leyla Stambaugh, Natalie Bareis, Thomas E Smith, Ronald C Kessler","doi":"10.1176/appi.ps.20240329","DOIUrl":"https://doi.org/10.1176/appi.ps.20240329","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to estimate the past-year prevalence of mental and substance use disorders, including schizophrenia spectrum disorders (schizophrenia, schizoaffective, or schizophreniform disorder), among U.S. adults ages 18-65 years from samples of households and prisons and stratified samples from selected homeless shelters and state psychiatric hospitals. Such information is vital to meet the treatment needs of individuals with these disorders.</p><p><strong>Methods: </strong>The Mental and Substance Use Disorders Prevalence Study (MDPS) was conducted between October 2020 and October 2022. Interviewers administered a structured clinical interview for the <i>DSM-5</i> (N=5,679 participants; N=4,764 in households). Weighted past-year prevalence estimates of mental and substance use disorders were calculated. Level of impairment and the likelihood that a disorder was caused by the COVID-19 pandemic were assessed.</p><p><strong>Results: </strong>The prevalence estimates of lifetime and past-year schizophrenia spectrum disorders were 1.8% (95% CI=1.3%-2.5%) and 1.2% (95% CI=0.9%-1.8%), respectively. The most common past-year disorders were major depressive disorder (15.5%, 95% CI=13.6%-17.5%) and generalized anxiety disorder (GAD; 10.0%, 95% CI=8.3%-12.1%). About one in 10 participants had at least one substance use disorder (10.6%, 95% CI=8.7%-12.9%). Half of those with an MDPS mental disorder had moderate or serious impairment.</p><p><strong>Conclusions: </strong>The prevalence rates of lifetime and past-year schizophrenia spectrum disorders were two to four times higher than previously reported. The prevalence rates of major depressive disorder and GAD were substantially higher than reported in past national studies. Almost 20% of these cases were likely due to the pandemic. Increased mental health treatment resources are urgently needed.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240329"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Risk Factors for Physical Assault in a Large Inpatient Behavioral Health System.","authors":"Tobias Wasser, Kevin Xia, David M O'Sullivan, Andre Newfield, Caren Teitelbaum","doi":"10.1176/appi.ps.20250075","DOIUrl":"https://doi.org/10.1176/appi.ps.20250075","url":null,"abstract":"<p><strong>Objective: </strong>To enhance understanding of the risk for violence in inpatient psychiatric environments, the authors studied assaultive behavior in a large health care system to explore the demographic, clinical, and other factors associated with the likelihood of patients' committing a physical assault.</p><p><strong>Methods: </strong>In this retrospective chart review study, 3 years of data were collected from a single-state health care system spanning >330 inpatient psychiatric beds across six separate hospitals. The system's risk management database was queried for all physical assaults during the study period (2021-2023), and these assaults were cross-matched with patients' electronic medical record data. Descriptive and inferential statistical analyses were conducted to investigate differences between patients who had committed an assault during the study period and those who had not.</p><p><strong>Results: </strong>A total of 15,186 unique inpatients were evaluated, and 556 physical assaults committed by 359 (2.4%) patients during the study period were identified. Patients who committed an assault were significantly more likely to be male, be younger, identify as Black or African American, have a psychotic disorder, be subject to conservatorship, have been admitted involuntarily, and have a known history of assault. Patients with a comorbid substance use disorder were significantly less likely to engage in assault.</p><p><strong>Conclusions: </strong>This study represents one of the largest investigations into rates of assault by patients in U.S. inpatient psychiatric hospitals. By attaining a greater understanding of risk factors for inpatient assault, this study may contribute to the development of risk assessment and management methodologies.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20250075"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Self-Reported Postpartum Depressive Symptoms and Provider Identification of Depression.","authors":"Amy Ehntholt, Wei Zhang, Dana E Cohen, Emily DeLorenzo, Douglas Done, Audrey Erazo-Trivino, Stephanie Mack, Trang Nguyen, Loretta Santilli, Thomas E Smith","doi":"10.1176/appi.ps.20240535","DOIUrl":"https://doi.org/10.1176/appi.ps.20240535","url":null,"abstract":"","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240535"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Cohort Study of Racial-Ethnic Disparities in Receipt of Electroconvulsive Therapy, 2016-2021.","authors":"Steven Sprenger, Gerardo Corsi, Alexandre Koumtchev, Natalie Hurlock","doi":"10.1176/appi.ps.20240400","DOIUrl":"https://doi.org/10.1176/appi.ps.20240400","url":null,"abstract":"<p><strong>Objective: </strong>Electroconvulsive therapy (ECT) is an effective treatment for severe depression, but racial-ethnic disparities in its receipt have long been observed, and previous studies have had limited generalizability. This study aimed to determine whether racial-ethnic disparities persist in contemporary treatment environments after adjustment for various demographic factors.</p><p><strong>Methods: </strong>A retrospective study was conducted among patients with data in the HCA Healthcare Enterprise Data Warehouse who were diagnosed as having severe unipolar depression (<i>ICD-10</i> codes F32-F33) and who sought care in any of 162 inpatient and outpatient facilities between 2016 and 2021. Patients were grouped by self-reported racial-ethnic identity. The association between race-ethnicity and selected covariates was determined by using chi-square tests (α=0.05), and the relationship between race-ethnicity and ECT receipt, given selected predictor variables, was estimated by using logistic regression.</p><p><strong>Results: </strong>Analyses were conducted for 19,011 unique patients. Significant variation by race-ethnicity was found for all covariates (p<0.001). ECT was administered to 3% of White patients and 1% of non-White patients. Compared with all other race-ethnicities, the unadjusted odds ratio for ECT receipt among White patients was 3.12 (p<0.001). Patients from each non-White racial-ethnic group had significantly lower rates of ECT receipt compared with White patients, including Asian (adjusted OR [aOR]=0.43, p<0.001), Black (aOR=0.27, p<0.001), and Hispanic (aOR=0.39, p<0.001) patients and patients identifying as other race-ethnicity (aOR=0.53, p=0.001).</p><p><strong>Conclusions: </strong>In this nationwide study, significant disparities in ECT use, by self-identified racial-ethnic identity, were observed even after demographic covariates were controlled.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240400"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery Is Working: Piloting Individual Placement and Support With Assertive Community Treatment Teams.","authors":"Jacqueline A Pogue, Noah Lipton, I-Chin Chiang, Gary Scannevin, Tania Hameed, Helle Thorning, Paul J Margolies","doi":"10.1176/appi.ps.20240221","DOIUrl":"https://doi.org/10.1176/appi.ps.20240221","url":null,"abstract":"<p><strong>Objective: </strong>Employment rates are low among individuals receiving assertive community treatment (ACT) services in New York State (9% of approximately 6,400 individuals in 2023). This project aimed to increase employment rates by implementing the individual placement and support (IPS) model of supported employment within ACT services.</p><p><strong>Methods: </strong>To assess the effectiveness of IPS for ACT participants and what adaptations might be needed, IPS was piloted with six ACT teams from October 2021 to October 2022. The teams received live IPS training and monthly consultation. They took part in pre-post fidelity assessments, provided monthly performance data, and engaged in semistructured interviews at the conclusion of the pilot.</p><p><strong>Results: </strong>During the pilot, 109 ACT participants received IPS services. The monthly employment rate ranged from 25% to 46% and fluctuated over time. ACT participants receiving IPS started 71 jobs during the pilot. ACT teams demonstrated a culture shift that embraced employment and IPS principles such as zero exclusion. They dedicated a mean of 0.5 full-time equivalent (FTE) hours to providing IPS services, divided among one to six team members. The total IPS fidelity score increased (i.e., improved) by an adjusted mean of approximately 14 points from the start (77.5 points) to the end (91.8 points) of the pilot.</p><p><strong>Conclusions: </strong>Future efforts to implement IPS within ACT teams may need to incorporate extended or additional supports and ways to dedicate vocational specialist time to IPS service provision in order to achieve better employment outcomes.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240221"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity and Specificity of Cognitive Health Screening in a Coordinated Specialty Care Setting.","authors":"Alice M Saperstein, Cale N Basaraba, Melanie M Wall, Lisa B Dixon, Ilana Nossel, Iruma Bello, Alice Medalia","doi":"10.1176/appi.ps.20240524","DOIUrl":"https://doi.org/10.1176/appi.ps.20240524","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive health should be addressed as part of routine clinical care for people with schizophrenia spectrum disorder, including those with early psychosis. Providers need an efficient workflow that includes screening tools with adequate sensitivity and specificity to facilitate appropriate cognitive symptom management. This study aimed to examine the utility of a cognitive health screening protocol by analyzing data from 102 participants in OnTrackNY, a specialized network of programs for people experiencing early psychosis.</p><p><strong>Methods: </strong>Screening elicited participants' perceptions of the usefulness of better memory, attention, and critical thinking skills and aimed to detect the presence of cognitive difficulties via participant and clinician reports. The screening protocol's sensitivity and specificity for detecting cognitive impairment, as defined by scores on a brief cognitive assessment, were evaluated.</p><p><strong>Results: </strong>About half the sample had global cognitive impairment, whereas more than 90% demonstrated impairment in at least one cognitive domain. Screening items demonstrated high sensitivity to detect global (≥0.80) and specific cognitive impairment (≥0.74), such that individuals with objectively measured cognitive impairment were likely to be correctly identified, although specificity remained low (≤0.34).</p><p><strong>Conclusions: </strong>The screening protocol may best be considered as a means to initiate shared decision making for next steps, which may include brief cognitive assessment or more resource-intensive evaluation, and to inform appropriate treatment recommendations.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240524"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Well-Being Model for Young Black Adults: Applying Coproduction Principles and Practices.","authors":"Crystal L Brandow, Hakim Asadi, Alexander Gamble, Margaret Swarbrick","doi":"10.1176/appi.ps.20240335","DOIUrl":"https://doi.org/10.1176/appi.ps.20240335","url":null,"abstract":"<p><p>Increasingly, mental health is regarded as fundamental to a person's overall health. As communities mobilize to improve mental health outcomes, activities designed to improve well-being can be integrated into these approaches. Although well-being is generally perceived as being associated with mental health, it has not been culturally operationalized for marginalized and oppressed groups. The authors participated in the coproduction of a well-being model for young Black adults and a workbook, filling a gap by translating research into practice. Researchers are encouraged to engage in strategies to jointly create well-being tools to support the mental health of individuals who have been underserved, understudied, and underrepresented.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240335"},"PeriodicalIF":3.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Mental Health Treatment and Reoffending Among Justice-Involved Youths.","authors":"Emaediong I Akpanekpo, Preeyaporn Srasuebkul, Tony Butler, Julian Norman Trollor, John Kasinathan, Dianna Kenny, David Mace Greenberg, Melanie Simpson, Claire Gaskin, Jocelyn Jones, Nabila Z Chowdhury, Anyiekere Ekanem, Azar Kariminia","doi":"10.1176/appi.ps.20240533","DOIUrl":"https://doi.org/10.1176/appi.ps.20240533","url":null,"abstract":"<p><strong>Objective: </strong>Unaddressed mental health needs of justice-involved youths increase the risk for reoffending and impede effective community integration. This study had three main objectives: to calculate the prevalence of mental disorders, to estimate the cumulative incidence of reoffending, and to examine patterns of nonmandated outpatient mental health treatment and its association with reoffending among justice-involved youths.</p><p><strong>Methods: </strong>Offending records from January 1, 1994, to March 31, 2022, were linked with mental health records from January 1, 2001, to March 31, 2022, for justice-involved youths supervised in both custodial (N=790) and community (N=766) settings in New South Wales, Australia. The association between mental health service contact and reoffending was assessed by using Cox proportional hazards regression.</p><p><strong>Results: </strong>Mental health issues were prevalent among 32% of girls and 29% of boys. Among custody-supervised youths, 49% reoffended within 12 months of release. Custody-supervised youths with mental health issues had a median time of 1 month until contact with mental health services after their release. Among community-supervised youths, 41% reoffended within 12 months of study entry. The median time until contact with mental health services for community-supervised youths with mental health issues was 6 months. Contact with mental health services was associated with lower hazards of reoffending among boys in custody (adjusted hazard ratio [aHR]=0.60, p=0.001) and under community supervision (aHR=0.43, p=0.045).</p><p><strong>Conclusions: </strong>Clinical engagement with mental health services can address criminogenic mental health problems among justice-involved youths and reduce criminal behavior.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240533"},"PeriodicalIF":3.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Wellness Model Developed by and for Individuals With Lived Experience.","authors":"Margaret Swarbrick, Lasheema Sanders-Edwards, Rita Cronise","doi":"10.1176/appi.ps.20240257","DOIUrl":"https://doi.org/10.1176/appi.ps.20240257","url":null,"abstract":"<p><p>This column explores the use of a wellness model developed by and for individuals with lived experience of mental health or substance use conditions. An overview of the model, including its development and rationale, is provided along with examples of the effective use of tools based on the wellness model. The use of this approach among members of a community wellness center is described. Firsthand experiences of the authors are used to illustrate their personal journeys in using the model for their own recovery and in peer support work.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"appips20240257"},"PeriodicalIF":3.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment Status Following Peer Specialist Certification: Results of a 3-Year Multistate Survey.","authors":"Laysha Ostrow, Judith A Cook, Morgan Pelot, Kila Robinett, Mark S Salzer, Jane K Burke-Miller","doi":"10.1176/appi.ps.20240166","DOIUrl":"10.1176/appi.ps.20240166","url":null,"abstract":"<p><strong>Objective: </strong>A cohort of certified peer specialists (CPSs) was surveyed to investigate factors affecting postcertification employment and retention.</p><p><strong>Methods: </strong>Survey data were collected in 2020, 2021, and 2022 from 591 CPSs in four states (North Carolina, Oregon, Pennsylvania, and Texas). The data were analyzed via percentages, means, and multilevel regression models.</p><p><strong>Results: </strong>Postcertification employment remained high: 76% (N=448 of 591) in 2020, 73% (N=329 of 448) in 2021, and 77% (N=279 of 364) in 2022. However, the proportion working in peer support positions declined significantly-from 73% (N=325 of 448) in 2020 to 63% (N=175 of 279) in 2022-despite the significantly higher job satisfaction, greater access to job benefits, and longer average job tenure reported by those working in peer support versus nonpeer jobs.</p><p><strong>Conclusions: </strong>Although the individuals who completed certification appeared to remain employed, a significant proportion appeared to leave peer support for other work. These trends should be monitored to evaluate investments in peer certification and service capacity.</p>","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"497-501"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}