Jmir Mental Health最新文献

{"title":"Exploring the Psychological and Physiological Insights Through Digital Phenotyping by Analyzing the Discrepancies Between Subjective Insomnia Severity and Activity-Based Objective Sleep Measures: Observational Cohort Study.","authors":"Ji Won Yeom, Hyungju Kim, Seung Pil Pack, Heon-Jeong Lee, Taesu Cheong, Chul-Hyun Cho","doi":"10.2196/67478","DOIUrl":"10.2196/67478","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is a prevalent sleep disorder affecting millions worldwide, with significant impacts on daily functioning and quality of life. While traditionally assessed through subjective measures such as the Insomnia Severity Index (ISI), the advent of wearable technology has enabled continuous, objective sleep monitoring in natural environments. However, the relationship between subjective insomnia severity and objective sleep parameters remains unclear.</p><p><strong>Objective: </strong>This study aims to (1) explore the relationship between subjective insomnia severity, as measured by ISI scores, and activity-based objective sleep parameters obtained through wearable devices; (2) determine whether subjective perceptions of insomnia align with objective measures of sleep; and (3) identify key psychological and physiological factors contributing to the severity of subjective insomnia complaints.</p><p><strong>Methods: </strong>A total of 250 participants, including both individuals with and without insomnia aged 19-70 years, were recruited from March 2023 to November 2023. Participants were grouped based on ISI scores: no insomnia, mild, moderate, and severe insomnia. Data collection involved subjective assessments through self-reported questionnaires and objective measurements using wearable devices (Fitbit Inspire 3) that monitored sleep parameters, physical activity, and heart rate. The participants also used a smartphone app for ecological momentary assessment, recording daily alcohol consumption, caffeine intake, exercise, and stress. Statistical analyses were used to compare groups on subjective and objective measures.</p><p><strong>Results: </strong>Results indicated no significant differences in general sleep structure (eg, total sleep time, rapid eye movement sleep time, and light sleep time) among the insomnia groups (mild, moderate, and severe) as classified by ISI scores (all P>.05). Interestingly, the no insomnia group had longer total awake times and lower sleep quality compared with the insomnia groups. Among the insomnia groups, no significant differences were observed regarding sleep structure (all P>.05), suggesting similar sleep patterns regardless of subjective insomnia severity. There were significant differences among the insomnia groups in stress levels, dysfunctional beliefs about sleep, and symptoms of restless leg syndrome (all P≤.001), with higher severity associated with higher scores in these factors. Contrary to expectations, no significant differences were observed in caffeine intake (P=.42) and alcohol consumption (P=.07) between the groups.</p><p><strong>Conclusions: </strong>The findings demonstrate a discrepancy between subjective perceptions of insomnia severity and activity-based objective sleep parameters, suggesting that factors beyond sleep duration and quality may contribute to subjective sleep complaints. Psychological factors, such as stress, dysfunctional sleep beliefs, and","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e67478"},"PeriodicalIF":4.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and Maintenance of a Digital Therapeutic Alliance in People Living With Negative Symptoms of Schizophrenia: Two Exploratory Single-Arm Studies.","authors":"Cassandra Snipes, Cornelia Dorner-Ciossek, Brendan D Hare, Olya Besedina, Tim Campellone, Mariya Petrova, Shaheen E Lakhan, Abhishek Pratap","doi":"10.2196/64959","DOIUrl":"10.2196/64959","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based digital therapeutics represent a new treatment modality in mental health, potentially providing cost-efficient, accessible means of augmenting existing treatments for chronic mental illnesses. CT-155/BI 3972080 is a prescription digital therapeutic under development as an adjunct to standard of care treatments for patients 18 years of age and older with experiential negative symptoms (ENS) of schizophrenia. Individual components of CT-155/BI 3972080 are designed based on the underlying principles of face-to-face treatment. A positive therapeutic alliance between patients and health care providers is linked with improved clinical outcomes in mental health. Likewise, establishing a similar therapeutic alliance with a digital therapeutic (ie, digital working alliance [DWA]) may be important for engagement and treatment effectiveness of this modality.</p><p><strong>Objective: </strong>This study aimed to investigate the establishment and maintenance of a DWA between a beta version of CT-155/BI 3972080 (CT-155 beta) and adults with ENS of schizophrenia.</p><p><strong>Methods: </strong>Two multicenter, exploratory, single-arm studies (study 1: CT-155-C-001 and study 2: CT-155-C-002) enrolled adults with schizophrenia and ENS receiving stable antipsychotic medication (≥12 weeks). Participants had access to CT-155 beta and were presented with daily in-app activities during a 3-week orientation phase that included lessons designed to facilitate building of a DWA. In study 2, the 3-week orientation phase was followed by an abbreviated active 4-week phase. Digital literacy at baseline was evaluated using the Mobile Device Proficiency Questionnaire (MDPQ). The mobile Agnew Relationship Measure (mARM) was used to assess DWA establishment after 3 weeks in both studies, and after 7 weeks in study 2 to assess DWA maintenance. Participant safety, digital literacy, and correlations between negative symptom severity and DWA were assessed in both studies.</p><p><strong>Results: </strong>Of the enrolled participants, 94% (46/49) and 86% (43/50) completed studies 1 and 2, respectively. Most were male (study 1: 71%, 35/49; study 2: 80%, 40/50). The baseline digital literacy assessed through MDPQ score was comparable in both studies (study 1: mean 30.56, SD 8.06; study 2: mean 28.69, SD 8.31) indicating proficiency in mobile device use. After 3 weeks, mARM scores (study 1: mean 5.16, SD 0.8; study 2: mean 5.36, SD 1.06) indicated that a positive DWA was established in both studies. In study 2, the positive DWA established at week 3 was maintained at week 7 (mARM: mean 5.48, SD 0.97). There were no adverse events (AEs) in study 1, and 3 nonserious and nontreatment-related AEs in study 2.</p><p><strong>Conclusions: </strong>A positive DWA was established between participants and CT-155 beta within 3 weeks. The second 7-week study showed maintenance of the DWA to the end of the study. Results support the establishment and main","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e64959"},"PeriodicalIF":4.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Digital Mental Health Interventions in the Workplace: Umbrella Review of Systematic Reviews.","authors":"Gillian Cameron, Maurice Mulvenna, Edel Ennis, Siobhan O'Neill, Raymond Bond, David Cameron, Alex Bunting","doi":"10.2196/67785","DOIUrl":"10.2196/67785","url":null,"abstract":"<p><strong>Background: </strong>There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings.</p><p><strong>Objective: </strong>The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting.</p><p><strong>Methods: </strong>A systematic search was conducted to identify systematic reviews relating to digital interventions for the workplace, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The review protocol was registered in the Open Science Framework. The following databases were searched: PubMed, Web of Science, MEDLINE, PsycINFO, and Cochrane Library. Data were extracted using a predefined extraction table. To assess the methodological quality of a study, the AMSTAR-2 tool was used to critically appraise systematic reviews of health care interventions.</p><p><strong>Results: </strong>The literature search resulted in 11,875 records, which was reduced to 14 full-text systematic literature reviews with the use of Covidence to remove duplicates and screen titles and abstracts. The 14 included reviews were published between 2014 and 2023, comprising 9 systematic reviews and 5 systematic reviews and meta-analyses. AMSTAR-2 was used to complete a quality assessment of the reviews, and the results were critically low for 7 literature reviews and low for the other 7 literature reviews. The most common types of digital intervention studied were cognitive behavioral therapy, mindfulness/meditation, and stress management followed by other self-help interventions. Effectiveness of digital interventions was found for many mental health symptoms and conditions in employee populations, such as stress, anxiety, depression, burnout, and psychological well-being. Factors such as type of technology, guidance, recruitment, tailoring, and demographics were found to impact effectiveness.</p><p><strong>Conclusions: </strong>This umbrella review aimed to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. Despite the low quality of the reviews, best practice guidelines can be derived from factors that impact the effectiveness of digital interventions in the workplace.</p><p><strong>Trial registration: </strong>OSF Registries osf.io/rc6ds; https://doi.org/10.17605/OSF.IO/RC6DS.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e67785"},"PeriodicalIF":4.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Videoconferencing Therapist Guidance Into Stepped Care Internet-Delivered Cognitive Behavioral Therapy for Child and Adolescent Anxiety: Noninferiority Randomized Controlled Trial.","authors":"Sonja March, Susan H Spence, Larry Myers, Martelle Ford, Genevieve Smith, Caroline L Donovan","doi":"10.2196/57405","DOIUrl":"10.2196/57405","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Self-guided internet-delivered cognitive behavioral therapy (ICBT) achieves greater reach than ICBT delivered with therapist guidance, but demonstrates poorer engagement and fewer clinical benefits. Alternative models of care are required that promote engagement and are effective, accessible, and scalable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This randomized trial evaluated whether a stepped care approach to ICBT using therapist guidance via videoconferencing for the step-up component (ICBT-SC[VC]) is noninferior to ICBT with full therapist delivery by videoconferencing (ICBT-TG[VC]) for child and adolescent anxiety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants included 137 Australian children and adolescents aged 7 to 17 years (male: n=61, 44.5%) with a primary anxiety disorder who were recruited from participants presenting to the BRAVE Online website. This noninferiority randomized trial compared ICBT-SC[VC] to an ICBT-TG[VC] program, with assessments conducted at baseline, 12 weeks, and 9 months after treatment commencement. All ICBT-TG[VC] participants received therapist guidance (videoconferencing) after each session for all 10 sessions. All ICBT-SC[VC] participants completed the first 5 sessions online without therapist guidance. If they demonstrated response to treatment after 5 sessions (defined as reductions in anxiety symptoms to the nonclinical range), they continued sessions without therapist guidance. If they did not respond, participants were stepped up to receive supplemental therapist guidance (videoconferencing) for the remaining sessions. The measures included a clinical diagnostic interview (Anxiety Disorders Interview Schedule) with clinician-rated severity rating as the primary outcome and parent- and child-reported web-based surveys assessing anxiety and anxiety-related interference (secondary outcomes).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Although there were no substantial differences between the treatment conditions on primary and most secondary outcome measures, the noninferiority of ICBT-SC[VC] compared to ICBT-TG[VC] could not be determined. Significant clinical benefits were evident for participants in both treatments, although this was significantly higher for the ICBT-TG[VC] participants. Of the 89 participants (38 in ICBT-SC[VC] and 51 in ICBT-TG[VC]) who remained in the study, 26 (68%) in ICBT-SC[VC] and 45 (88%) in ICBT-TG[VC] were free of their primary anxiety diagnosis by the 9-month follow-up. For the intention-to-treat sample (N=137), 41% (27/66) ICBT-SC[VC], and 69% (49/71) ICBT-TG[VC] participants were free of their primary anxiety diagnosis. Therapy compliance was lower for the ICBT-SC[VC] participants (mean 7.39, SD 3.44 sessions) than for the ICBT-TG[VC] participants (mean 8.73, SD 3.08 sessions), although treatment satisfaction was moderate to high in both conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study provided further support for the benefits of low-intensity ICBT f","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e57405"},"PeriodicalIF":4.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Virtual Reality Intervention on Stigma, Empathy, and Attitudes Toward Patients With Psychotic Disorders Among Mental Health Care Professionals: Randomized Controlled Trial.","authors":"Jing Ling Tay, Yuanrong Qu, Lucas Lim, Rohan Puthran, Chye Lee Robert Tan, Rajkirren Rajendran, Ker Chiah Wei, Huiting Xie, Kang Sim","doi":"10.2196/66925","DOIUrl":"10.2196/66925","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have found that psychotic disorders are among the most stigmatized mental disorders. Of note, virtual reality (VR) interventions have been associated with improvements in attitudes and empathy and reduced stigma toward individuals with psychotic disorders, especially among undergraduates, but this has not been examined among mental health care professionals.</p><p><strong>Objective: </strong>We aimed to evaluate the effectiveness of a newly developed VR intervention for mental health care professionals to improve attitudes and empathy and reduce stigma toward people with psychotic disorders.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial and recruited eligible mental health care professionals from a tertiary mental health care institution. Both arms (VR intervention and VR control groups) were evaluated at baseline, postintervention, and 1-month follow up. The evaluation included outcomes related to attitudes (modified attitudes toward people with schizophrenia scale), stigma (social distance scale, personal stigma scale), and empathy (empathetic concern subscale of the Interpersonal Reactivity Index). The experience with the VR intervention was assessed using a user satisfaction questionnaire, and qualitative feedback was gathered.</p><p><strong>Results: </strong>Overall, 180 mental health care professionals participated and completed the study. Both groups showed improvements in attitude, social distance, and stigma scores but not the empathy score following the intervention. The VR intervention group had better user satisfaction than the VR control group. In addition, certain outcome measures were positively associated with specific factors including female gender, higher education level, certain job roles, years of work, and presence of loved ones with a mental disorder.</p><p><strong>Conclusions: </strong>Both the intervention and control VR groups of mental health care professionals showed improvements in attitudes, stigma, and social distance toward people with psychotic disorders. Future longitudinal studies may want to evaluate the impact of VR on caregivers and the public on these same and other outcome measures to reduce stigma and improve empathy toward individuals with psychotic disorders.</p><p><strong>Trial registration: </strong>clinicaltrials.gov NCT05982548; https://clinicaltrials.gov/study/NCT05982548.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e66925"},"PeriodicalIF":4.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Codeveloping an Online Resource for People Bereaved by Suicide: Mixed Methods User-Centered Study.","authors":"Edouard Leaune, Kushtrim Bislimi, Pauline Lau-Taï, Héloïse Rouzé, Benoit Chalancon, Laurène Lestienne, Pierre Grandgenevre, Margot Morgiève, Nathalie Laplace, Guillaume Vaiva, Julie Haesebaert, Emmanuel Poulet","doi":"10.2196/56945","DOIUrl":"10.2196/56945","url":null,"abstract":"<p><strong>Background: </strong>Although suicide bereavement is highly distressing and is associated with an increased risk of suicidal behaviors and mental and physical health impairments, those bereaved by suicide encounter difficulties accessing support. Digital resources offer new forms of support for bereaved people. However, digital resources dedicated to those bereaved by suicide are still limited.</p><p><strong>Objective: </strong>This paper aimed to develop and implement an evidence-based, innovative, and adaptive online resource for people bereaved by suicide, based on their needs and expectations.</p><p><strong>Methods: </strong>We performed a mixed methods, participatory, user-centered study seeking to build resources from the perspectives of people bereaved by suicide and professionals or volunteers working in the field of postvention. We used the Information System Research framework, which uses a three-stage research cycle, including (1) the relevance cycle, (2) the design cycle, and (3) the rigor cycle, and the Design Science Research framework.</p><p><strong>Results: </strong>A total of 478 people participated in the study, including 451 people bereaved by suicide, 8 members of charities, and 19 mental health professionals working in the field of postvention. The development stage of the resource lasted 18 months, from October 2021 to March 2023. A total of 9 focus groups, 1 online survey, 30 usability tests, and 30 semistructured interviews were performed. A website for people bereaved by suicide named \"espoir-suicide\" was developed that includes (1) evidence-based information on suicide prevention and bereavement, (2) testimonies of people bereaved by suicide, (3) a delayed chat to ask questions on suicide and bereavement to a specialized team of mental health professionals, and (4) an interactive nationwide resource directory. The mean system usability score was 90.3 out of 100 for 30 participants, with 93% (n=28) of them having a rating above 80. Since the implementation of espoir-suicide in March 2023, a total of 19,400 connections have been recorded, 117 local resources have been registered nationwide, and 73 questions have been posted in the chat.</p><p><strong>Conclusions: </strong>The use of a mixed methods, participatory, user-centered design allowed us to implement an evidence-based, innovative, and functional website for people bereaved by suicide that was highly relevant for fulfilling the needs and expectations of French people bereaved by suicide.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.3389/fpsyt.2021.770154.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e56945"},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators of User Engagement With Digital Mental Health Interventions for People With Psychosis or Bipolar Disorder: Systematic Review and Best-Fit Framework Synthesis.","authors":"Emily Eisner, Sophie Faulkner, Stephanie Allan, Hannah Ball, Daniela Di Basilio, Jennifer Nicholas, Aansha Priyam, Paul Wilson, Xiaolong Zhang, Sandra Bucci","doi":"10.2196/65246","DOIUrl":"10.2196/65246","url":null,"abstract":"<p><strong>Background: </strong>Digital mental health interventions (DMHIs) to monitor and improve the health of people with psychosis or bipolar disorder show promise; however, user engagement is variable, and integrated clinical use is low.</p><p><strong>Objective: </strong>This prospectively registered systematic review examined barriers and facilitators of clinician and patient engagement with DMHIs, to inform implementation within real-world settings.</p><p><strong>Methods: </strong>A systematic search of 7 databases identified empirical studies reporting qualitative or quantitative data about factors affecting staff or patient engagement with DMHIs aiming to monitor or improve the mental or physical health of people with psychosis or bipolar disorder. The Consolidated Framework for Implementation Research was used to synthesize data on barriers and facilitators, following a best-fit framework synthesis approach.</p><p><strong>Results: </strong>The review included 175 papers (150 studies; 11,446 participants) describing randomized controlled trials; surveys; qualitative interviews; and usability, cohort, and case studies. Samples included people with schizophrenia spectrum psychosis (98/150, 65.3% of studies), bipolar disorder (62/150, 41.3% of studies), and clinicians (26/150, 17.3% of studies). Key facilitators were a strong recognition of DMHIs' relative advantages, a clear link between intervention focus and specific patient needs, a simple, low-effort digital interface, human-supported delivery, and device provision where needed. Although staff thought patients would lose, damage, or sell devices, reviewed studies found only 11% device loss. Barriers included intervention complexity, perceived risks, user motivation, discomfort with self-reflection, digital poverty, symptoms of psychosis, poor compatibility with existing clinical workflows, staff and patient fears that DMHIs would replace traditional face-to-face care, infrastructure limitations, and limited financial support for delivery.</p><p><strong>Conclusions: </strong>Identified barriers and facilitators highlight key considerations for DMHI development and implementation. As to broader implications, sustainable business models are needed to ensure that evidence-based DMHIs are maintained and deployed.</p><p><strong>Trial registration: </strong>PROSPERO CRD42021282871; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=282871.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e65246"},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsible Design, Integration, and Use of Generative AI in Mental Health.","authors":"Oren Asman, John Torous, Amir Tal","doi":"10.2196/70439","DOIUrl":"10.2196/70439","url":null,"abstract":"<p><strong>Unlabelled: </strong>Generative artificial intelligence (GenAI) shows potential for personalized care, psychoeducation, and even crisis prediction in mental health, yet responsible use requires ethical consideration and deliberation and perhaps even governance. This is the first published theme issue focused on responsible GenAI in mental health. It brings together evidence and insights on GenAI's capabilities, such as emotion recognition, therapy-session summarization, and risk assessment, while highlighting the sensitive nature of mental health data and the need for rigorous validation. Contributors discuss how bias, alignment with human values, transparency, and empathy must be carefully addressed to ensure ethically grounded, artificial intelligence-assisted care. By proposing conceptual frameworks; best practices; and regulatory approaches, including ethics of care and the preservation of socially important humanistic elements, this theme issue underscores that GenAI can complement, rather than replace, the vital role of human empathy in clinical settings. To achieve this, an ongoing collaboration between researchers, clinicians, policy makers, and technologists is essential.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e70439"},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural Language Processing and Social Determinants of Health in Mental Health Research: AI-Assisted Scoping Review.","authors":"Dmitry A Scherbakov, Nina C Hubig, Leslie A Lenert, Alexander V Alekseyenko, Jihad S Obeid","doi":"10.2196/67192","DOIUrl":"10.2196/67192","url":null,"abstract":"<p><strong>Background: </strong>The use of natural language processing (NLP) in mental health research is increasing, with a wide range of applications and datasets being investigated.</p><p><strong>Objective: </strong>This review aims to summarize the use of NLP in mental health research, with a special focus on the types of text datasets and the use of social determinants of health (SDOH) in NLP projects related to mental health.</p><p><strong>Methods: </strong>The search was conducted in September 2024 using a broad search strategy in PubMed, Scopus, and CINAHL Complete. All citations were uploaded to Covidence (Veritas Health Innovation) software. The screening and extraction process took place in Covidence with the help of a custom large language model (LLM) module developed by our team. This LLM module was calibrated and tuned to automate many aspects of the review process.</p><p><strong>Results: </strong>The screening process, assisted by the custom LLM, led to the inclusion of 1768 studies in the final review. Most of the reviewed studies (n=665, 42.8%) used clinical data as their primary text dataset, followed by social media datasets (n=523, 33.7%). The United States contributed the highest number of studies (n=568, 36.6%), with depression (n=438, 28.2%) and suicide (n=240, 15.5%) being the most frequently investigated mental health issues. Traditional demographic variables, such as age (n=877, 56.5%) and gender (n=760, 49%), were commonly extracted, while SDOH factors were less frequently reported, with urban or rural status being the most used (n=19, 1.2%). Over half of the citations (n=826, 53.2%) did not provide clear information on dataset accessibility, although a sizable number of studies (n=304, 19.6%) made their datasets publicly available.</p><p><strong>Conclusions: </strong>This scoping review underscores the significant role of clinical notes and social media in NLP-based mental health research. Despite the clear relevance of SDOH to mental health, their underutilization presents a gap in current research. This review can be a starting point for researchers looking for an overview of mental health projects using text data. Shared datasets could be used to place more emphasis on SDOH in future studies.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e67192"},"PeriodicalIF":4.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Dropout From a Virtual Agent-Based App for Insomnia Management in a Self-Selected Sample of Users With Insomnia Symptoms: Longitudinal Study.","authors":"María Montserrat Sanchez Ortuño, Florian Pecune, Julien Coelho, Jean Arthur Micoulaud-Franchi, Nathalie Salles, Marc Auriacombe, Fuschia Serre, Yannick Levavasseur, Etienne De Sevin, Patricia Sagaspe, Pierre Philip","doi":"10.2196/51022","DOIUrl":"10.2196/51022","url":null,"abstract":"<p><strong>Background: </strong>Fully automated digital interventions delivered via smartphone apps have proven efficacious for a wide variety of mental health outcomes. An important aspect is that they are accessible at a low cost, thereby increasing their potential public impact and reducing disparities. However, a major challenge to their successful implementation is the phenomenon of users dropping out early.</p><p><strong>Objective: </strong>The purpose of this study was to pinpoint the factors influencing early dropout in a sample of self-selected users of a virtual agent (VA)-based behavioral intervention for managing insomnia, named KANOPEE, which is freely available in France.</p><p><strong>Methods: </strong>From January 2021 to December 2022, of the 9657 individuals, aged 18 years or older, who downloaded and completed the KANOPEE screening interview and had either subclinical or clinical insomnia symptoms, 4295 (44.5%) dropped out (ie, did not return to the app to continue filling in subsequent assessments). The primary outcome was a binary variable: having dropped out after completing the screening assessment (early dropout) or having completed all the treatment phases (n=551). Multivariable logistic regression analysis was used to identify predictors of dropout among a set of sociodemographic, clinical, and sleep diary variables, and users' perceptions of the treatment program, collected during the screening interview.</p><p><strong>Results: </strong>The users' mean age was 47.95 (SD 15.21) years. Of those who dropped out early and those who completed the treatment, 65.1% (3153/4846) were women and 34.9% (1693/4846) were men. Younger age (adjusted odds ratio [AOR] 0.98, 95% CI 0.97-0.99), lower education level (compared to middle school; high school: AOR 0.56, 95% CI 0.35-0.90; bachelor's degree: AOR 0.35, 95% CI 0.23-0.52; master's degree or higher: AOR 0.35, 95% CI 0.22-0.55), poorer nocturnal sleep (sleep efficiency: AOR 0.64, 95% CI 0.42-0.96; number of nocturnal awakenings: AOR 1.13, 95% CI 1.04-1.23), and more severe depression symptoms (AOR 1.12, 95% CI 1.04-1.21) were significant predictors of dropping out. When measures of perceptions of the app were included in the model, perceived benevolence and credibility of the VA decreased the odds of dropout (AOR 0.91, 95% CI 0.85-0.97).</p><p><strong>Conclusions: </strong>As in traditional face-to-face cognitive behavioral therapy for insomnia, the presence of significant depression symptoms plays an important role in treatment dropout. This variable represents an important target to address to increase early engagement with fully automated insomnia management programs. Furthermore, our results support the contention that a VA can provide relevant user stimulation that will eventually pay out in terms of user engagement.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e51022"},"PeriodicalIF":4.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}