: Within both popular and academic literature, concerns have been expressed about the implications of antidepressant use on character development. In this paper, I identify specific versions of these worries and argue that they are misguided. I begin by arguing that the obligation to suffer if it will bring about a noble character is imagined. Legitimate concerns about character enhancement remain, but they do not count against most antidepressant use. Thus there is no moral prohibition against antidepressant use. Furthermore, (...) some of the calls for caution about antidepressant use, such as those expressed by the President's Council on Bioethics, are overstated. (shrink)

Mental and substance use disorders have been identified as the leading cause of global disability, and the global burden of mental illness is concentrated among those experiencing disability due to serious mental illness. Music has been studied as a support for SMIs for decades, with promising results; however, a lack of synthesized evidence has precluded increased uptake of and access to music-based approaches. The purpose of this scoping review was to identify the types and quantity of research at intersections of (...) music and SMIs, document evidentiary gaps and opportunities, and generate recommendations for improving research and practice. Studies were included if they reported on music's utilization in treating or mitigating symptoms related to five SMIs: schizophrenia, bipolar disorder, generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. Eight databases were searched; screening resulted in 349 included studies for data extraction. Schizophrenia was the most studied SMI, with bipolar disorder studied the least. Demographics, settings, and activity details were found to be inconsistently and insufficiently reported; however, listening to recorded music emerged as the most common musical activity, and activity details appeared to have been affected by the conditions under study. RCTs were the predominant study design, and 271 unique measures were utilized across 289 primary studies. Over two-thirds of primary studies reported positive results, with 2.8% reporting worse results than the comparator, and 12% producing indeterminate results. A key finding is that evidence synthesis is precluded by insufficient reporting, widely varied outcomes and measures, and intervention complexity; as a result, widespread changes are necessary to reduce heterogeneity, increase replicability and transferability, and improve understandings of mechanisms and causal pathways. To that end, five detailed recommendations are offered to support the sharing and development of information across disciplines. (shrink)

Ayahuasca is a psychoactive traditional plant medicine preparation used by the indigenous tribes of the Upper Amazon in their shamanic traditions. Its use has become popular amongst Westerners seeking alternative means of healing, and the medicine has now spread across the globe via syncretic spiritual healing traditions such as the Santo Daime Church. Despite the increased use of the medicine, little research exists on its effectiveness for healing depression. The existing literature does not contain a detailed self-reported phenomenological account (...) of ayahuasca healing a case of depression. The aim of this paper is to share a personal account of healing depression using ayahuasca in a Santo Daime ritual in Johannesburg, South Africa. This experience was unplanned and unexpected and resulted in a profoundly transformative healing process. Based on my experience, I describe ayahuasca’s ingestion as having created a powerful mind-body-spirit connection that resulted in what appeared and felt like a profound reconfiguration of the bio-electrical energy system in my body and a powerful anti-depressant action on my mind. These effects were catalyzed by a strong intention to heal and trust in and take responsibility for myself. Other South African Santo Daime members have reported healing of depression with ayahuasca, although in longer and different processes. It appears that the medicine engages the individual’s unique collective self (life-history, physical and mental disposition, beliefs and intents) resulting in different outcomes for different individuals. Thus, from my own and others’ experience, I describe ayahuasca as a spiritual medicine; one that promotes enhanced awareness and deeper connection to one’s core self, to others and the greater universe, while facilitating the manifestation of one’s intentions and beliefs. This encounter with ayahuasca provided me a first-hand experience of learning and healing from the medicine, making real to me the indigenous Amazonian description of plants as being teachers and doctors. (shrink)

Motivation has been the subject of much research in the sport psychology literature, whereas athlete mental health has received limited attention. Motivational complexities in elite sport are somewhat reflected in the mental health literature, where there is evidence for both protective and risk factors for athletes. Notably, few studies have linked motivation to mental health. Therefore, the key objective of this study was to test four mental health outcomes in the motivational sequence posited by the Hierarchical Model of (...) Intrinsic and Extrinsic Motivation: motivational climate  basic psychological needs  motivation  mental health outcomes. Elite team-sport athletes (140 females, 75 males) completed seven psychometric inventories of motivation-related and mental health variables. Overall, the athletes reported positive motivational patterns, with autonomous motivation and task climate being more prevalent than their less adaptive counterparts. Elevated depressive symptoms and poor sleep quality affected nearly half of the cohort. Structural equation modelling supported pathways between motivational climate, basic needs, motivation, and mood, depressive symptoms, sleep quality, and trait anxiety. Specifically, a task climate was positively associated with the three basic psychological needs, and an ego climate was positively associated with competence. Autonomy and relatedness had positive and negative associations with autonomous and controlled forms of motivation, respectively. Controlled motivation regulations were positively associated with the four mental health outcomes. Integrated regulation had a negative association with anxiety, and intrinsic regulation had a positive association with depressive symptoms. These findings highlight the complexities of and interrelations between motivation and mental health among athletes, and support the importance of considering mental health as an outcome of motivation. (shrink)

Background: This article aims to review research manuscripts in the past 5 years that focus on the effects of debt on depression, anxiety, stress, or suicide ideation in Asian countries.Methods: A search for literature based on the PRISMA guidelines was conducted on Medline, PubMed, Web of Science, Scopus, and ScienceDirect, resulting in nine manuscripts meeting inclusion criteria. The studies were conducted in Thailand, Korea, Singapore, Pakistan, India, Cambodia, and China.Results: The findings of the studies show that there is evidence (...) to support that being in debt is related to Asian participants experiencing depression, anxiety, stress, or suicide ideation. However, the studies are limited to quantitative studies only. The definition of debt is also unclear in most manuscripts. Few manuscripts also examined how other factors influence the relationship between debt and mental illness.Conclusion: There are limited studies on the psychological effects of debt on the Asian population. Future studies should focus on the relationship between debt and psychological well-being among this population. (shrink)

Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end (...) their life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis. The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1. (shrink)

Depression is a major public health issue and the literature has consistently showed that the rates of depression increase dramatically during youth transition to adulthood, and gender differences merge in this period. Positive youth development framework is focused on strengths that make young people more resistant to negative outcomes, like depression, and more capable to choose a positive life direction. The aim of the study was to examine the relationship between the 5Cs of PYD and depression in Croatia and (...) Spain, as well as to analyze gender differences. This research was conducted within the PYD Cross-National Project. High school and university students from Eastern Croatia and Southern Spain participated in the study. There were 584 students from Croatia and 768 students from Spain, who filled in self-reports of PYD and depression. Results showed that male participants presented more Competence and Confidence, while female participants reported more Connection, Caring, Character, overall PYD, but also more depressive symptoms. Furthermore, Confidence and Connection were negative correlates of depressive symptoms, with neither Spain nor Croatia showing remarkable gender differences. These results may have some implications concerning the promotion of the 5Cs of PYD as a recommendable approach to promote youth mental health in Croatia and Spain from a gender perspective. Youth mental health services and initiatives that engage the partnership of youth contexts, such as the family, schools and neighborhoods, should not only address risk factors for mental health problems, but also protecting factors as the 5Cs, thus providing a more inclusive and sustainable support for youth well-being. (shrink)

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological treatment. (...) This study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach, offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that ADIT was acceptable for patients with complex/major depression, that they were likely to refer to ADIT in the future that the use of arts was likely to improve accessibility the use of arts was likely to improve outcomes and that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol. (shrink)

BackgroundThe literature shows the negative psychological impact of the coronavirus disease 2019 outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not.ObjectivesThis survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units.DesignA cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress.SettingA total of 1,244 physicians and nurses (...) from five general hospitals in Belgium, working in COVID-19 care units, non-COVID-19 care units, or both were informed of the study.ParticipantsSix hundred forty-seven healthcare workers participated in the survey.MeasurementsValidated instruments were used to assess the outcomes: the PFI, the ISI, and the DASS-21.ResultsResults showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes.LimitationsThe mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time.ConclusionDirectly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented.Protocol RegistrationClinicalTrials.gov, identifier NCT04344145. (shrink)

This book is an investigation into cultural variations in experiences of depression. With the aid of empirical data, and with a phenomenological outlook, the analyses presented aim to give a comparative account of the significance of culture in shaping cross-cultural variations, as seen in Iran and the UK. Through analysis of elements of Iranian culture such as literature and folk theories, and important pillars of current social make-up of the country like experience of Iran-Iraq war, the Islamic revolution and (...) its dominant religious discourse, variations in conceptions, experiences and narratives of depression are accounted for. Some of the themes explored include discussions of particular symptoms of depression such as guilt, hopelessness, loss of meaning and somatic symptoms; social stigmas and help-seeking behaviours; changes in relations with others; and metaphors used to convey experiences of depression. The findings of the empirical data examined challenge the universalist approach to psychiatry as science and practice, as well as theoretical notions like idioms of distress that aim to account for cross-cultural variations of mental illness. Instead, it is claimed that a better understanding of the workings of mental illness is achieved by situating individuals and their experience in a meaning-making sociocultural context. (shrink)

Since 1991, the Patient Self-Determination Act (PSDA) has required all health care institutions that receive Federal funds to inform patients upon admission of their rights to make decisions about medical care and to execute advance directives. Implementation of the PSDA presents a special challenge for state mental hospitals. The relevance and possible negative therapeutic impact of discussing end of life decisions at the time of an acute psychiatric admission has recently been raised in the literature. Other ethical dilemmas arising (...) from the interplay between mental illness and informed consent for medical treatment, particularly for older patients committed to state mental hospitals, have been highlighted by the PSDA. In this article we discuss some of the issues raised by implementation of the PSDA in this setting. (shrink)

ABSTRACTThis essay introduces the notion of a literary clinical practice for which it remains essential to continue to consider those texts that open up a place for a readership, or audience, or even a civilization to consider the endlessly generative failure of its literature to write mental health. Concerned with mental illness that is an effect of language on the subject, the body, and of the enigma of the truth as cause, psychoanalysis is the crucial interlocutor for any literary (...) clinical concern with the maladies of literature and society. In order to re-assess the utility of Shakespeare’s Hamlet to contemporary problems such as depression – perhaps the dominant symptom of our time – this essay attempts a reconsideration of Jacques Lacan’s famous seminar on Hamlet from the perspective of the contemporary clinic of the Lacanian orientation in psychoanalysis led by Jacques-Alain Miller. (shrink)

BackgroundYouth are increasingly aware of the negative effects of climate change on the planet and human health, but this knowledge can often come with significant affective responses, such as psychological distress, anger, or despair. Experiencing major “negative” emotions, like worry, guilt, and hopelessness in anticipation of climate change has been identified with the term eco-anxiety. Emerging literature focuses on adults' experience; however, little is known about the ways in which children and youth experience eco-anxiety.ObjectivesThe aim of this review was (...) to: identify the available evidence on the topic of eco-anxiety in children, clarify the mental health consequences brought by the awareness of climate change in this population, and identify knowledge gaps in the literature and considerations for future research.MethodsGiven that the research on the topic of eco-anxiety in children is limited, that there are very few randomized controlled trials, and that the goal is not to analyze individual studies in-depth, a scoping review was used. Keywords pertaining to the themes of eco-anxiety, climate change and children were used as search terms in five databases. Journal articles using qualitative and quantitative methods, as well as gray literature were examined by two independent reviewers. A descriptive-analytical method was used to chart the data that emerged from the literature. Eighteen articles were considered in the final analysis.ResultsEvidence confirms that children experience affective responses and eco-anxiety in reaction to then awareness of climate change. Mental health outcomes include depression, anxiety, and extreme emotions like sadness, anger, and fear. Youth from vulnerable communities, like indigenous communities, or those who have strong ties to the land are often identified as being emotionally impacted by climate change. The literature analyzed also describes how children and youth are coping with eco-anxiety, including maladaptive and adaptive responses. Preliminary considerations for parents, teachers and educators, mental health care providers, school systems, adults and people of power include adding age-appropriate climate education to the school curriculum, considering youth's emotions, and promoting healthy coping through empowerment. Important gaps exist in the definition of eco-anxiety in youth, as various characterizations of this emerging concept are found across articles. (shrink)

The number of homebound individuals in the United States is on the rise, causing health-care professionals to expand in-home health services to help meet the increased demand. Due to the prevalence of feelings of isolation and depression in this population, it is imperative that mental health professionals join this effort to increase access to mental health services. Delivering psychotherapy in clients’ homes presents many advantages to these homebound individuals, but there is a dearth of literature addressing how therapists should (...) handle unique ethical issues that arise in this type of setting. This article addresses ethical considerations and guidelines for in-home provision of mental health services. General ethical issues related to home-based psychotherapy include boundaries, confidentiality and privacy, competency, insurance coverage, and autonomy. Issues pertaining to different categories of homebound individuals, including persons with agoraphobia, chronic illnesses, and older adults, are then discussed in turn. Recommendations on how to best manage these issues by applying the American Psychological Association’s, the American Counseling Association’s, and the National Association of Social Workers’ Ethics Codes are provided. (shrink)

Research has demonstrated that policing is a stressful occupation and has a negative impact on police officers’ mental and physical health, performance, and interactions with citizens. Mental health at the workplace has become a concern due to the costs of depression, anxiety, burnout, and even suicide, which is high among police officers.To ameliorate occupational health, it is crucial therefore to identify stress and burnout levels on a regular basis. However, the instruments frequently used to measure stress have not valorized the (...) specificity of policing tasks. This study aims: i) conducting a literature review, to identify questionnaires used to assess occupational stress and burnout among police officers; ii) to analyze the psychometric characteristics of a Portuguese version of Operational Police Stress Questionnaire (PSQ-Op); and, using the PSQ-op and other questionnaires, iii) to identify operational stress, burnout, and distress levels among Portuguese police officers. The literature review identified 108 studies, which use a multiplicity of questionnaires to measure burnout or occupational stress among police officers, but few studies use specific police stress questionnaires. Sample sizes were mostly below 500 participants and studies were mainly developed in the last decade in the USA and Brazil, but also in another 24 countries, showing the extent of the interest in this topic. This study applied to 2057 police officers from National Portuguese Police, a force policing urban centers, the PSQ-Op, as well the Spanish Burnout Inventory and the Kessler Psychological Distress Scale.The results show that the psychometric properties of the Portuguese version of PSQ-Op are adequate. Factorial analysis revealed two dimensions defined as social and work issues, which were associated with measures of distress and burnout.Fit indices suggested a second-order solution called operational police stress. Overall, and considering the scale range of each questionnaire, the results showed moderate values of operational stress, distress, and burnout. However, considering their cut-off points, 85% of the sample presented high operational stress levels, 11% critical values for burnout, and 28% high distress levels, with 55% of the sample at risk of psychological disorder. These results reinforce the need to prevent stress and to invest in police officers’ occupational health. (shrink)

This paper introduces a novel conceptualisation of mental imagery; namely, that is grease for the mind’s gears (MGT). MGT is not just a metaphor. Rather, it describes an important and overlooked higher-order function of mental imagery: that it aids various mental faculties discharge their characteristic functional roles. MGT is motivated by reflection on converging evidence from clinical, experimental and social psychology and solves at least two neglected conceptual puzzles about mental imagery. The first puzzle concerns imagery’s architectural promiscuity; that is, (...) its ability to assist diverse mental faculties and perform many different functions when doing so. The second puzzle concerns how to square imagery’s architectural promiscuity with its psychopathological relevance; that is, its being a maintaining cause, and possibly even a partial constituent, of several psychological disorders, including post-traumatic stress disorder, bipolar disorder and major depressive disorder. Mental imagery helps and harms human psychology to extreme degrees and this is something that calls for elucidation. MGT says that instead of facing perplexing heterogeneities here, we instead face a significant unity. On this score, MGT is argued to be superior to the currently dominant conception of imagery in the philosophical literature; namely, as a perception-like state of mind. (shrink)

The means by which social environmental exposures influence risk of mental disorders is a persistent and still open question. A key candidate mechanism for the biologic mediation of environmental effects involves epigenetic factors, which regulate gene function without altering underlying DNA sequence. Recent work has shown that environmental exposures such as childhood abuse, family history of mental disorder, and low socioeconomic status (SES) associate with differential DNA methylation (5mC) – a relatively stable, but modifiable, epigenetic factor. However, the longitudinal relation (...) among SES, 5mC, brain function, and risk of depression remains to be elucidated. Here, we briefly review literature relevant to these associations and discuss recent findings that, for the first time, prospectively demonstrate sequential links between low SES, changes in 5mC, changes in brain function, and risk of depression in a cohort of adolescents. (shrink)

BackgroundDepression is common psychiatric morbidity in breast cancer survivors, seriously affecting patients’ quality of life and mental health. A growing body of research has investigated depression in breast cancer. However, no visual bibliometric analysis was conducted in this field. This study aimed to visualize the literature to identify hotspots and frontiers in research on breast cancer and depression.MethodsThe publications related to depression in breast cancer were retrieved in the Web of Science Core Collection between 1 January 2002 and 17 (...) March 2022. VOSviewer was used to identify co-occurrences and collaborations among countries, institutions, and keywords. CiteSpace was used to detect keyword bursts.ResultsA total of 7,350 articles and reviews related to depression in breast cancer were identified. From 2002 to 2022, the United States and the People’s Republic of China were the most productive countries in this field. The University of California, Los Angeles, and the University of Toronto were the most productive institutions in this field. The Journal of Psycho-oncology, followed by Supportive Care in Cancer and the Journal of Clinical Oncology, had the most publications on depression in breast cancer. Of the top 10 journals, seven were from the United States, two were from England, and one was from Germany. Five research hotspots of depression in breast cancer were identified by co-word analysis. Research on post-traumatic growth, spiritual interventions, cognitive-behavioral therapy, physical activity, and symptom cluster management of depression in breast cancer was relatively mature in the core hotspots. Burst detection of keywords on depression in breast cancer showed the latest hotspots, such as mental health, cancer survivor mortality, and activity.ConclusionThe research on depression in breast cancer is growing. Attention should be paid to the latest hotspots, such as mental health, cancer survivor, mortality, exercise, and physical activity. (shrink)

This study reviews the existing literature on psychiatric interventions for individuals affected by the COVID-19 epidemic. My article cumulates previous research on how extreme stressors associated with COVID-19 may aggravate or cause psychiatric problems. The unpredictability of the COVID-19 epidemic progression may result in significant psychological pressure on vulnerable populations. Persons with psychiatric illnesses may experience worsening symptoms or may develop an altered mental state related to an increased suicide risk. The inspected findings prove that psychological intervention measures for (...) patients affected by the epidemic should be designed and personalized adequately. Preventive measures seek to decrease infection rates and cut down the risk of the public healthcare system to eventually be overburdened. Throughout the COVID-19 crisis, people with psychiatric illnesses may confront a decrease in mental health services. As limitations in the current review, by focusing only on articles published in journals indexed in Web of Science, Scopus, and ProQuest, I inevitably disregarded other valuable sources. Subsequent research directions should clarify the effectiveness of online mental health services in providing remote psychiatric interventions to individuals affected by the COVID-19 epidemic. (shrink)

Recently, the pandemic context in which the world finds itself has inspired studies that sought to evaluate to mental health and the way people are relating to the purpose of understanding and promoting improvements psychological health. The epidemiological and public health literature shows that social connection protects and promotes mental health, being an important clinical tool for reducing anxiety, depression, and stress. Thinking in the broad sense of connection, that is, feeling and perceiving oneself connected with the environment, applied (...) to the context of sport, it is suggested that social connection could be related to the interactions in the practice of sport. Although playing sports can promote mental health, there are few findings on the topic in the context of a pandemic and with physical sports and electronic sports players. In this sense, the present study aims to assess the extent to which social connection and mental health indicators are correlated in a sample of sports and e-sports players. The participants were 401 Brazilian physical sports and e-sports players, mostly male and single, who filled in the Social Connectedness Scale, the Depression, Anxiety and Stress Scale, and demographic questions. The results indicated that social connection was negatively correlated and also predict the anxiety, depression, and stress. When comparing sports and e-sports players, a statistically significant difference was identified in the levels of social connection [t = −3.41; sportsmean = 4.53 ; e-sportsmean = 4.14 ] and depression [t = 2.90; sportsmean = 1.10 ; e-sportsmean = 0.85 ]. These findings can serve as a theoretical basis for the development of intervention programs and promoting discussions that focus on the analysis of aspects promoting psychological health in sports context. (shrink)

One in three university students experiences mental health problems during their study. A similar percentage leaves higher education without obtaining the degree for which they enrolled. Research suggests that both mental health problems and academic underperformance could be caused by students lacking control and purpose while they are adjusting to tertiary education. Currently, universities are not designed to cater to all the personal needs and mental health problems of large numbers of students at the start of their studies. Within the (...) literature aimed at preventing mental health problems among students (e.g., anxiety or depression), digital forms of therapy recently have been suggested as potentially scalable solutions to address these problems. Integrative psychological artificial intelligence (AI) in the form of a chatbot, for example, shows great potential as an evidence-based solution. At the same time, within the literature aimed at improving academic success, the online life-crafting intervention in which students write about values and passions, goals, and goal-attainment plans has shown to improve the academic performance and retention rates of students. Because the life-crafting intervention is delivered through the curriculum and doesn’t bear the stigma that is associated with therapy, it can reach larger populations of students. But life-crafting lacks the means for follow-up or the interactiveness that online AI-guided therapy can offer. In this paper, we propose to integrate the current literature on chatbot interventions aimed at the mental health of students with research about a life-crafting intervention that uses an inclusive curriculum-wide approach. When a chatbot asks students to prioritize both academic as well as social and health-related goals and provides personalized follow-up coaching, this can prevent -often interrelated- academic and mental health problems. Right on-time delivery, and personalized follow-up questions enhance the effects of both -originally separated- intervention types. Research on this new combination of interventions should use design principles that increase user-friendliness and monitor the technology acceptance of its participants. (shrink)

BackgroundTranscranial magnetic stimulation (TMS) is an FDA approved treatment for major depression, migraine, obsessive compulsive disorder, and smoking addiction. TMS has gained popular media support, but media coverage and commercial reporting of TMS services may be contributing to the landscape of ethical issues.MethodsWe explore the differences between the academic and print media literature portrayals of TMS to evaluate their ethical impact for the public. We performed a comprehensive literature review using PubMed and NexisUni databases to evaluate the (...) class='Hi'>literature available on TMS from 2014 to 2019. Our sample consisted of 1632 academic articles and 468 print media articles for a total of 2100 articles. We then coded each article for seven specific top-level codes: (1) type of source, (2) year of publication, (3) purpose of TMS application, (4) age of subjects, (5) population, (6) overall tone, and (7) specification of TMS parameters. We also made some additional notes of the TMS parameters where specified and the breakdown of mental health applications.ResultsOur results indicated several discrepancies between the academic and the print media reporting about TMS technology, particularly with regards to tone and specificity. Namely, the academic sample was largely neutral and specific about the parameters under which TMS was being applied, while the print media sample was heavily optimistic and presented the application of TMS with far less specificity. There was some convergence between the two samples, such as the focus of both on therapy as the predominant TMS application.ConclusionsWe call upon the academic community to increase scrutiny of TMS services in order to ensure that people’s knowledge of health technologies is not unduly influenced by sensational claims and a general lack of adequate information. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, emphasizes diagnosis and statistically significant commonalities in mental disorders. As stated in the Introduction, “[i]t must be admitted that no definition adequately specifies precise boundaries for the concept of ‘mental disorder’ ” (DSM-IV, 1994, xxi). Further, “[t]he clinician using DSM-IV should ... consider that individuals sharing a diagnosis are likely to be heterogeneous, even in regard to the defining features of the diagnosis, and that boundary cases will be difficult to (...) diagnose in any but a probabilistic fashion” (DSM-IV, 1994, xxii). This article proposes that it may be helpful for clinicians to study narratives of illness which emphasize this heterogeneity over statistically significant symptoms.This paper examines the recorded experiences of unusually articulate sufferers of the disorder classified as Major Depression. Although sharing a diagnosis, Hemingway, Fitzgerald, and Styron demonstrated different understandings of their illness and its symptoms and experienced different resolutions, which may have had something to do with the differing meanings they made of it.I have proposed a word, autopathography, to describe a type of literature in which the author's illness is the primary lens through which the narrative is filtered. This word is an augmentation of an existing word, pathography, which The Oxford English Dictionary, Second Edition, defines as “a) [t]he, or a, description of a disease,” and “b) [t]he, or a, study of the life and character of an individual or community as influenced by a disease.” The second definition is the one that I find relevant and which I feel may be helpful to clinicians in broadening their understanding of the patient's experience. (shrink)

The Coronavirus disease 2019 pandemic is affecting many areas of life and has led to major changes in undergraduate medical education. Even before the COVID-19 pandemic, high mental burden of medical students has frequently been reported in the literature. Additional pandemic-specific stressors could exacerbate this situation. This study aimed to assess mental health outcomes among medical students during the first semester after the COVID-19 outbreak and perception of the students on how the learning environment has changed. In May 2020, (...) we conducted a cross-sectional survey among undergraduate medical students at a large medical school in Germany. The survey included validated mental health instruments and self-developed items to examine the perception of the study situation during the COVID-19 pandemic. Open-ended questions were analyzed by conventional content analyses. The response rate was 59.2%. Overall, 61.9% of the students reported distress levels above the cutoff. Year 1 students reported significantly higher levels of distress, anxiety and depression than students during their second to fourth year of studies. 48.3% of the students indicated a decrease in their study motivation since the beginning of the COVID-19 pandemic with significant differences between study years. The binary logistic regression model showed that male gender, being in study year 2, higher distress scores and higher symptoms of depression were significantly associated with a higher likelihood for experiencing serious worries. In the open-ended questions on current concerns related to the impact of the COVID-19 pandemic on their studies, students most frequently reported concerns about missing relevant practical learning experience, difficulties with self-regulated learning and self motivation as well as study-related worries. Year 4 students reported significantly more worries about the lack of practical training than students from study years 1 to 3. Analysis of gender differences showed that female students reported more frequently diverse worries. In contrast, female students shared more frequently helpful strategies in all the categories compared to male students. Our findings suggest that medical students experience significant levels of distress and mental burden during the COVID-19 pandemic and highlight the need for ongoing psychological and educational support for medical students during the COVID-19 pandemic and after. (shrink)

Introduction: Social media has become an integrated part of daily life, with an estimated 3 billion social media users worldwide. Adolescents and young adults are the most active users of social media. Research on social media has grown rapidly, with the potential association of social media use and mental health and well-being becoming a polarized and much-studied subject. The current body of knowledge on this theme is complex and difficult-to-follow. The current paper presents a scoping review of the published (...) class='Hi'>literature in the research field of social media use and its association with mental health and well-being among adolescents. Methods and analysis: First, relevant databases were searched for eligible studies with a vast range of relevant search terms for social media use and mental health and well-being over the past five years. Identified studies were screened thoroughly and included or excluded based on prior established criteria. Data from the included studies were extracted and summarized according to the previously published study protocol. Results: Among the 79 studies that met our inclusion criteria, the vast majority (94%) were quantitative, with a cross-sectional design (57%) being the most common study design. Several studies focused on different aspects of mental health, with depression (29%) being the most studied aspect. Almost half of the included studies focused on use of non-specified social network sites (43%). Of specified social media, Facebook (39%) was the most studied social network site. The most used approach to measuring social media use was frequency and duration (56%). Participants of both genders were included in most studies (92%) but seldom examined as an explanatory variable. 77% of the included studies had social media use as the independent variable. Conclusion: The findings from the current scoping review revealed that about ¾ of the included studies focused on social media and some aspect of pathology. Focus on the potential association between social media use and positive outcomes seems to be rarer in the current literature. Amongst the included studies, few separated between different forms of (inter)actions on social media, which are likely to be differentially associated with mental health and well-being outcomes. (shrink)

Phenomenological descriptions of depressed mental life offer a profound understanding of depression from the first-person perspective. In this paper, such descriptions are developed by drawing on the work by Ludwig Binswanger and on the autobiographical report of depression by Piet C. Kuiper . I will argue that Binswanger’s central claim in his phenomenological description of the depressed state of mind fails due to crucial misunderstandings of Edmund Husserl’s phenomenology. Nonetheless, by drawing on Kuiper’s first-hand account, I will develop a phenomenological (...) description of depressed mental life, highlighting the altered manner of pre-reflective valuing in depression and introducing the concept of a ‘depressive habituality.’ This term refers to the acquisition of a new set of habitualisations, especially on the foundational levels of automatic mental life. It offers explanations for the fact that it is not easy to recover from depression and that people may more easily become depressed again. (shrink)

Psychedelic-assisted Psychotherapy combines the use of psychedelic compounds, such as psilocybin, with psychotherapy. PAP has shown some promise as a novel treatment for Major Depressive Disorder, and empirical research suggests that its efficacy turns on the altered states induced by psychedelic compounds. In this paper we draw on the literature of phenomenology to explain the therapeutic potential of psychedelic experiences. Svenaeus characterises mental illness as a form of suffering that entails three distinct but related experiences of alienation or “unhomelike (...) being-in-the-world”: illness suffering, which relates to embodiment; existential suffering, which relates to self-narratives, and political suffering, which relates to social relationships. Ratcliffe further characterises the experience of MDD in phenomenological terms as a loss of pre-intentional possibility that manifests as excessive noematic feeling in the experience of embodiment, restrictive narratives in the construction of self, and disconnectedness in experience of the social world. We contend that PAP ameliorates the suffering associated with MDD by inducing and consolidating a state of broadened pre-intentional possibility—one that entails sudden, profound and enduring changes in embodiment, self-narratives, and social experience. We argue further that this phenomenological account is consistent with a bio-psycho-social model of mental health and illness, and we frame it as an argument supporting the plausibility of recent claims about treatment success. This helps to justify ongoing future empirical research in this setting. (shrink)

Volunteering, or taking part in unpaid work for the benefit of others, can be a powerful positive experience with returns to both individual well-being and community projects. Volunteering is positively associated with mental health in observational studies with community samples but has not been systematically examined as a potential part of treatment interventions with clinical adolescent samples. In this manuscript, we review the empirical evidence base connecting volunteerism to mental health and well-being, outline potential mechanisms based in the theoretical (...) class='Hi'>literature from developmental science, and discuss the existing clinical approaches that support community volunteering as a part of treatment. Drawing on this review, we propose that including volunteering as a component of clinical treatment approaches for adolescent depression can be a powerful intervention for adolescents. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Subjective Knowledge, Mental Disorders, and MedsHow to Parse the EquationMark D. Rego (bio)Keywordspsychopathology, antidepressants, suicidality, subjective experience, pre-reflectiveA few weeks, ago I was walking down the hall to my office when I spotted my brother-in-law coming the other way. This was odd on two accounts. First, he lives in Kentucky (I am in Connecticut) and second, he is at least a foot taller than the man in my hallway. (...) Nonetheless, I struggled to figure out why he was there. The resemblance was so striking it took me a minute or two to convince myself it was not him. Even after such convincing, the feeling that it was him remained.Later, I imagined that had I just returned from a crack cocaine den I would have been hypervigilant, if not paranoid, and consequently would be certain that my brother-in-law had arrived unannounced. Furthermore, I would probably assume that he was up to no good.How did I retain a strong feeling of recognition, the feeling that maybe it was really him, when I already concluded otherwise? And why, were I on crack cocaine, would the obvious facts be useless in rendering a decision about the identity of the man in the hall? Last, why would the post-cocaine man in the hall become a nefarious brother-in-law rather than a benign one?If I just computed some symbols to figure this out, wouldn't the feeling have gone away? If I activated a brother-in-law neural network, how did I come to acquire an evil brother-in-law neural network? And why wouldn't that go away either?In his article in this issue of Philosophy, Psychiatry, & Psychology, Hadreas looks at questions like these through the prism of before and after effects of people treated with selective serotonin reuptake inhibitors (SSRIs). Hadreas investigates the implications of a straightforward recomputation of self-awareness when treated with these medicines and finds such approaches unsatisfying and incomplete in their explanatory power. (My example looks at a type of awareness, but not specifically self-awareness, as does Hadreas. Furthermore, my paradigm asks about computational conclusions using language more common in psychiatric literature, whereas Hadreas uses standard philosophical terms. Although not isomorphic, I believe the interchange of the two remains true to the issues Hadreas is addressing). [End Page 57]In my example, there is clearly something else going on than the incorrect arrangement of symbols or the misfiring of nodes in a network that influences how I feel and what I think. Neither reason nor empiricism seem to serve me well here. Hadreas utilizes Husserl to begin to unpeel the layers of self-awareness and self-states that intermix to form the shifts and contradictions which are so common in psychiatric treatment (and in common experience as I describe).This is a welcome reckoning; the psychiatric literature is overflowing with unquestioned premises about the neuropsychiatric correlates of reason and empirical approaches (described more as computation and neural networks in the literature—again, not strictly analogous, but the same criticisms apply) Hadreas is critical of. Unfortunately, Hadreas has navigated through a sea of highly questionable assumptions about the psychopharmacology of depression to illustrate his points. This is due in large part to the common practice of consulting literary narratives and critics rather than one of immersion in the literature as a whole and the daily life of patients and active clinicians. He arrived at his destination despite this, because many of these details did not affect his particular analysis. However, to look forward to a continuation of this work and clarify some important issues I devote most of my commentary to these issues. The points I raise are more extensively discussed in a previous edition of this journal (Rego 2005).Affect to Reason ShiftLet's begin with the idea that SSRIs work by dampening emotions. An extension of this idea is that they dampen negative emotions and strengthen positive ones like assertiveness, confidence, and optimism. An even further development in this direction is that, by dampening strong emotions, cognitive enhancement takes place with SSRI treatment. A summary observation then is that SSRIs facilitate... (shrink)

Identifying biomarkers of developing mental disorder is crucial to improving early identification and treatment—a key strategy for reducing the burden of mental disorders. Cross-frequency coupling between two different frequencies of neural oscillations is one such promising measure, believed to reflect synchronization between local and global networks in the brain. Specifically, in adults phase–amplitude coupling (PAC) has been shown to be involved in a range of cognitive processes, including working and long-term memory, attention, language, and fluid intelligence. Evidence suggests that increased (...) PAC mediates both temporary and lasting improvements in working memory elicited by transcranial direct-current stimulation and reductions in depressive symptoms after transcranial magnetic stimulation. Moreover, research has shown that abnormal patterns of PAC are associated with depression and schizophrenia in adults. PAC is believed to be closely related to cortico-cortico white matter (WM) microstructure, which is well established in the literature as a structural mechanism underlying mental health. Some cognitive findings have been replicated in adolescents and abnormal patterns of PAC have also been linked to ADHD in young people. However, currently most research has focused on cross-sectional adult samples. Whereas initial hypotheses suggested that PAC was a state-based measure due to an early focus on cognitive, task-based research, current evidence suggests that PAC has both state-based and stable components. Future longitudinal research focusing on PAC throughout adolescent development could further our understanding of the relationship between mental health and cognition and facilitate the development of new methods for the identification and treatment of youth mental health. (shrink)

Ginger Hoffman and Jennifer Hansen’s study of gender dynamics in psychiatric disability memoirs makes several fruitful moves for the study of psychic diversity. Perhaps the most important is that the article encourages analytic philosophers to contribute to understanding how individual mental life is affected by the larger cultural context—which we can think of as the “mind/culture” problem. This is an important move because, for the most part, analytic philosophers have paid more attention to the mind/body problem than they have to (...) the mind/culture problem. Hoffman and Hansen are right that it would be valuable for analytic philosophy to join in the study of this equally complicated conceptual problem.... (shrink)

Social media plays a significant role in modern life, but excessive use of it during the COVID-19 pandemic has become a source of concern. Supported by the conservation of resources theory, the current study extends the literature on problematic social media usage during COVID-19 by investigating its association with emotional and mental health outcomes. In a moderated mediation model, this study proposes that problematic social media use by workers during COVID-19 is linked to fear of COVID-19, which is further (...) associated with depression. The current study tested trait mindfulness as an important personal resource that may be associated with reduced fear of COVID-19 despite problematic social media use. The study collected temporally separate data to avoid common method bias. Pakistani employees working in different organizations completed a series of survey questionnaires. The results supported the moderated mediation model, showing that problematic social media use during the current pandemic is linked to fear of COVID-19 and depression among employees. Furthermore, trait mindfulness was found to be an important buffer, reducing the negative indirect association between problematic social media use and depression through fear of COVID-19. These results offer implications for practitioners. The limitations of this study and future research directions are also discussed. (shrink)

Mentalization is a useful ability for social functioning and a crucial aspect of mentalizing is emotion regulation. Literature suggests programmes for children and adults to increase mentalizing abilities useful both for emotional and social competences. For this reason, the issue of how to prompt children’s mentalization has started to attract researchers’ attention, supporting the importance of the interpersonal dimension for the individual differences in the developmental of mentalization. The TiM (Thoughts in Mind) Project, a training programme based on the (...) explanation of mentalization mechanisms and designed for adults, deals with emotion regulation. Starting from the TiM Project, this study tests the effects of the TiM Child (TiM-C) training programme, over a control training programme, a conversational training designed for the school context, in children attending Year 2 of primary school. We designed a training based on narratives, followed by multiple-choice questions and conversations about mental states. Our results revealed significant improvements over the training period only in the TiM-C Project group for Metacognition, Emotion Regulation Strategies and a Theory of Mind task. As far as the educational implications, our findings suggest that it is possible to enhance mentalization through activities at school by promoting not only the understanding of the relations between mind and emotion, but also metacognitive skills. (shrink)

Over 50% of the world population will develop a psychiatric disorder in their lifetime.1 In the realm of psychiatric treatment, two primary modalities have been established: pharmacotherapy and psychotherapy. Yet, pharmacological interventions often take precedence as the initial treatment choice despite their comparable outcomes, severe side effects and disputed evidence of their efficacy. This preference for medication foregrounds a vital re-examination of what it means to be invasive in medical treatments, namely in psychiatric care. De Marco et al challenge the (...) standard account of invasiveness, presenting considerations that transcend the traditional criteria of physical intrusion.2 Through case studies centred on treatments for schizophrenia and depression, we aim to (1) reinforce De Marco et al ’s challenge to the standard account of invasiveness and (2) extend the dialogue to the moral imperative of redefining mental invasiveness. Our aims are to broaden the definition of mental invasiveness, aligning with De Marco et al ’s emphasis on context sensitivity, and to include the severity of side effects as a critical factor in this assessment. Redefining what is considered invasive in psychiatric treatment has profound implications for patient care and medical decision-making. Labelling treatments, namely medications, as invasive encourages both patients and healthcare providers to approach these options with a heightened level of scrutiny and care. This is …. (shrink)

A review of the literature was conducted to better understand the (potential) role of mental health professionals in physician-assisted suicide. Numerous studies indicate that depression is one of the most commonly encountered psychiatric illnesses in primary care settings. Yet, depression consistently goes undetected and undiagnosed by nonpsychiatrically trained primary care physicians. Noting the well-studied link between depression and suicide, it is necessary to question giving sole responsibility of assisting patients in making end-of-life treatment decisions to these physicians. Unfortunately, the (...) use of mental health consultation by these physicians is not a common occurrence. Greater involvement of mental health professionals in this emerging and debated area is advocated. Beyond describing mental health professionals' role in the assessment of patient competency or decision making capacity, other areas of potential involvement are described. A discussion of ethical principles relevant to this area follows, along with comments on the training necessary to adequately serve patient needs. (shrink)

As it becomes increasingly plausible that the mind–brain is explicable in naturalistic terms, science‐and‐religion scholars have the opportunity to engage creatively and proactively with facets of brain‐related research that better inform our understanding of human well‐being. That is, once mental health is recognized as being a whole‐body phenomenon, exciting theological conversations can take place. One fascinating area of research involves the “gut–brain axis,” or the interactive relationship between the microbiome in the gastrointestinal tract (i.e., gut bacteria), the central nervous system, (...) and mental health. A growing body of literature explores the immensely significant interactions between the gut microbiome and mental health issues involving depression, anxiety, gene expression, and stress responses. One's mental health does not occur in a disembodied state, but in a complex physical environment that is strongly influenced by environmental factors, many of which we can control. This article argues that science‐and‐religion can welcome scientific research in this area, creatively incorporating such insights into a theology of mental health and physical well‐being. (shrink)

High quality monitoring of mental health and well-being over an extended period is essential to understand how communities respond to the COVID-19 pandemic and how to best tailor interventions. Multiple community threats may also have cumulative impact on mental health, so examination across several contexts is important. The objective of this study is to report on changes in mental health and well-being in response to the Australian bushfires and COVID-19 pandemic. This study utilized an Experience-Sampling-Method, using the smartphone-based mood monitoring (...) application, MoodPrism. Participants were prompted once a day to complete a brief survey inquiring about symptoms of depression and anxiety, and several well-being indices, including arousal, emotional valence, self-esteem, motivation, social connectedness, meaning and purpose, and control. Participants were N = 755 Australians who downloaded and used MoodPrism, between 2018 and 2020. Results showed that anxiety symptoms significantly increased during the COVID-19 pandemic, but not during the bushfires. This may be explained by concurrent feelings of social connectedness maintained during the bushfires but not during the pandemic. In contrast, depressive symptoms increased significantly during the bushfires, which maintained during the pandemic. Most indices of well-being decreased significantly during the bushfires, and further again during the pandemic. Study findings highlight the unique responses to the bushfire and COVID-19 crises, revealing specific areas of resilience and vulnerability. Such information can help inform the development of public health interventions or individual clinical treatment, to improve treatment approaches and preparedness for potential future community disasters. (shrink)

BackgroundIn the early days of COVID-19 outbreak, the normally orderly health system was severely challenged by large numbers of feverish patients and shortage of healthcare workers. The outbreak played a harmful role in the mental health of these healthcare workers.ObjectiveWe aim to assess the prevalence of moderate or severe anxiety and depression symptoms of healthcare workers in different regions during COVID-19 disaster and identify the potential risk factors.MethodsWe did a cross-sectional study on ADS of healthcare workers in epicenter-Hubei province and (...) regions in lower epidemic-other provinces by questionnaire online. The data of ADS, the demographic characteristics, occupational exposure, physical condition, family situation, and coping styles were collected and analyzed.ResultsA total of 24.68% of the respondents had experienced moderate or severe ADS. Moderate or severe ADSs were in a higher prevalence in Hubei than other provinces. Suspicious symptoms on their own and in family members were independent risk factors of moderate or severe ADS of all health workers. Working on the frontline was the independent risk factor for participants in Hubei province, whereas quarantine was the independent risk factor for those in other provinces. Moreover, among all participants, those with negative coping style were more than four times more likely to have moderate or severe ADS than those with positive coping style.ConclusionModerate or severe ADSs were in a higher prevalence in healthcare workers of Hubei province during COVID-19 outbreak. The coping style may have major impact on ADS in such situation. (shrink)

Serious mental health disorders are increasing among college students and university counseling services are often overburdened. Mobile applications for mental health have been growing exponentially in the last decade and they are emerging in university settings as a promising tool to promote and intervene in college students' mental health. Additionally, considering the recent covid-19 pandemic, mHealth interventions, due to its nature and possibilities, may play an important role in these institutions. Our main objectives are to explore mhealth interventions in universities, (...) regarding its conceptual framework, acceptability and efficacy outcomes and understand its impact and contributions to address treatment delivery and psychological difficulties resulting from covid-19 pandemic. The literature search was conducted in scientific databases, namely, Web of Science, Pubmed, and Scopus. A search in app stores was not conducted, thus regarding commercially available apps, only those found in our database search were included in our review. We selected studies with mobile applications addressing psychological interventions for college students. A total of 2,158 participants were included in the 8 selected studies and most interventions were delivered through mobile apps only and based in cognitive behavioral therapy. Results suggested that college students accept and adhere to these interventions and preliminary evidence of efficacy was demonstrated in different disorders, such as stress, anxiety, depression and risky behaviors such as alcohol and tobacco abuse and sexual knowledge. We conclude that universities, particularly college counseling services, may benefit from mhealth interventions, not only to address college students' mental health but to decrease some of its difficulties related to lack of human resources. Specifically in covid-19 pandemic context, these interventions may contribute significantly by promoting and delivering psychological interventions at a safe distance. (shrink)

The tendency to get involved in helping one’s family, friends, school, and community has many potential benefits such as greater compassion, concern for others, and social responsibility. Research interest in the benefits of contribution in adolescents has increased recently, but there are not many studies examining the effect of contribution on adolescents’ mental health. The present study focused on whether the contribution is associated with fewer self-rated depression symptoms in adolescents. We further tested whether self-regulation and academic performance can have (...) a mediating role in this association. A total of 423 secondary school students (233 female) from eastern Croatia participated in the study. Mean age was 16.78 (SD= 1.21). Students completed measures of self-regulation, depression symptoms, and contribution (helping one’s family, friends, or neighbors, mentoring peers, volunteering in one’s community, and participating in school organizations or boards), and gave information about age, gender, and academic performance. A hierarchical regression analysis revealed that contribution, self-regulation, and academic performance were related with lower levels of self-rated depression symptoms. Furthermore, mediation analysis indicated a significant indirect effect through two mediators, self-regulation and academic performance, which was stronger than a path containing only self-regulation. Academic performance alone was not a significant mediator. Our findings suggest that contribution could protect against depression by promoting self-regulation, leading to higher academic performance, and consequently fewer depression symptoms. (shrink)

Jay Asher’s novel Thirteen Reasons Why and its Netflix adaptation have enjoyed widespread popularity. While they draw needed attention to issues like bullying and teen estrangement, they may have an unintended effect: they mislead about the etiology of suicide and even glamorize it to a degree. The medical literature has shown that suicide is almost always the result of psychiatric disorder, not provocative stress, in much the same way an asthmatic crisis is primarily the result of an underlying medical (...) condition, not an allergic stimulus. Both the novel and Netflix series ignore this premise and even belittle the idea. Thus, while the story has artistic merits, it also has the potential to be destructive if accessed by young readers and viewers seeking guidance. Approximately ten percent of teens suffer from depression, and suicide recently surpassed homicide as the second-leading cause of death among persons ages ten to twenty-four in the United States. A more balanced view addressing these misconceptions is provided for teens, parents, and mental health professionals. (shrink)

IntroductionDuring the COVID-19 outbreak, many citizens were asked to stay at home in self-quarantine, which can pose a significant challenge with respect to remaining physically active and maintaining mental health. This study aimed to evaluate the prevalence of inadequate physical activity, anxiety, and depression and to explore the relationship of physical activity with anxiety and depression symptoms among Chinese college students during quarantine.MethodUsing a web-based cross-sectional survey, we collected data from 1,396 Chinese college students. Anxiety and depression were assessed with (...) the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively. The data on physical activity were collected by types of physical activity and the International Physical Activity Questionnaire.ResultsDuring the COVID-19 outbreak, about 52.3% of Chinese college students had inadequate physical activity. The rates of anxiety and depression symptoms were 31.0 and 41.8%, respectively. A high level of physical activity was significantly closely associated with low anxiety, while a moderate, or high level of physical activity was significantly closely associated with reduced depression after adjusting confounding demographic factors. Moreover, specific types of physical activity, such as stretching and resistance training, were negatively correlated with both anxiety and depression; doing household chores was negatively correlated with depression.ConclusionOur findings highlight specific levels and types of home-based physical activities that need to be taken into consideration to protect the mental health of college students during the COVID-19 epidemic. (shrink)

Most mental health research largely ignores or minimises gender and age differences in depression. In ‘Don't mind the gap: Why do we not care about the gender gap in mental health?’, Patalay and Demkowicz identify a dearth of research on the causal factors of depression in young women. They attribute this to an over-reliance on biological accounts of gender differences in depression. Patalay and Demkowicz conclude that a person-centred approach that meaningfully engages with the reports of young women with depression (...) is more likely to expose the social drivers of depression that impact this group. This commentary focuses on Patalay and Demkowicz's call to examine the patient's lived experience. We argue that there is an urgent need to reflect upon the methodologies involved in examining lived experience and how they can be best utilised. Ultimately, we advocate for an approach known as ‘phenomenological psychopathology’, through a phenomenological investigation of depression in young women, we can go some way towards closing the gender gap. (shrink)

This exploration aims to solve the problems of imperfect psychological health education system and poor educational effects on college students. Here, ideological and political education is integrated with mental health education to investigate the role of collaborative intervention in guiding college students to resist negative emotions. First, an overview is offered of research on ideological and political education, mental health education, and negative emotions by the literature survey method. Moreover, a comprehensive investigation is also conducted on research objects, through (...) the questionnaire, to understand the current situation of negative emotions of college students. And finally, an intervention experiment is taken on the negative emotions of college students by combining ideological and political education with mental health education. The results show that after 10 weeks of intervention experiment by combining ideological and political education with mental health education, there are significant differences in depression, negative emotions, somatization symptoms, and interpersonal problems between the treatment group and the control group. Besides, there are significant differences in depression, negative emotions, somatization symptoms, and interpersonal problems between sophomores in the treatment group and the control group. Moreover, there are significant differences in depression, negative emotions, somatization symptoms, and interpersonal problems between male participants in the treatment group and the control group. In summary, ideological and political education integrated with mental health education has a positive guidance effect on the negative emotions of college students, greatly improving the negative emotions of the students, helping the students to regulate their emotions, and benefiting their study and life a lot. The purpose of integrating ideological and political education with mental health education is to provide reference for refining the mental health education system of college students and strengthening the positive guidance of negative emotions of college students. (shrink)

BackgroundExposure to early life stress is alarmingly prevalent and has been linked to the high rates of depression documented in adolescence. Researchers have theorized that ELS may increase adolescents’ vulnerability or reactivity to the effects of subsequent stressors, placing them at higher risk for developing symptoms of depression.MethodsWe tested this formulation in a longitudinal study by assessing levels of stress and depression during the COVID-19 pandemic in a sample of adolescents from the San Francisco Bay Area who had been characterized (...) 3–7 years earlier with respect to exposure to ELS and symptoms of depression.ResultsAs expected, severity of ELS predicted levels of depressive symptoms during the pandemic [r = 0.26, p = 0.006], which were higher in females than in males [t = −3.56, p < 0.001]. Importantly, the association between ELS and depression was mediated by adolescents’ reported levels of stress, even after controlling for demographic variables.ConclusionsThese findings underscore the importance of monitoring the mental health of vulnerable children and adolescents during this pandemic and targeting perceived stress in high-risk youth. (shrink)