Following Hawley's point of view regarding the definition and inclusiveness of human ecology, ecological data must include both a population and its characteristics and some measurements of the environment of this population. Following Hawley, an ecological investigation must select from available data and examine at least some of the relationships that may exist among these measurable population and environmental characteristics, in an effort to find and isolate the causes of mental disorders, particularly of those now called "functional."

The purpose of this study is to get a deeper understanding of staff who are exposed to threat and violence in the work with people with mental disabilities. Focus is aimed at the staff´s experience of that in their daily work can be exposed to threat and violence. The first question for the study is what definition the staff gives to threat and violence in the daily work with people with mental disabilities and the second one is what determines the decision in making/or not making a report in threat and violence in the daily work with people with mental disorders. To collect empirical data the study is based on seven individual semistructured interviews with staff working with people with mental disabilities. The theory used to analyse is the normalisationprocess. The analyse is based on the interview-participants views on how they define threat and violence, their view on the client and themselves and also reporting threat and violence. The result is that the staff is affected by different aspects and a conflict is made between context and individual. This conflict contributes to the decision in reporting and definition of threat and violence.

Nearly 46 million Americans meet the criteria for a mental disorder. Anxiety impacts 30% of these individuals in the United States. A mounting focus on mental health has prompted a growing response in both research and clinical contexts. Despite this increased attention, Asian Americans still face significant mental health disparities. Furthermore, the broad use of the term Asian Americans makes it difficult for researchers and clinicians to encapsulate the needs in this diverse group. Asian American adolescents are an at risk population due to the significant developmental and cultural stressors they face. Consequently, knowledge pertaining to this population’s mental health resource utilization becomes an important tool in providing care. A socioecological approach was used to investigate determinants relevant to anxiety and mental health resource utilization in Asian American adolescents. Current public health models do not adequately represent the interactions between the analyzed determinants. As such, a socioecological model was proposed which depicts the dynamic relationships surrounding Asian American adolescent mental health resource utilization. A dearth in current research makes it difficult to generalize this model for the whole population. Nevertheless, this model provides an important first step to understanding the unique situation that Asian American adolescents face.

No description available.

Adherence to combination antiretroviral therapy is important for achieving optimal HIV-related outcomes. Epidemiologic data indicate that persons with mental disorders are disproportionately affected by HIV/AIDS, which is concerning since having a mental disorder has been associated with poor adherence to medications for treatment of chronic disease states. The purpose of this study was to examine the relationship between the presence of mental disorders and adherence to combination antiretroviral therapy. Additionally, this study examined the relationship between adherence to psychotropic medications and adherence to antiretroviral therapy. Study data were collected from the Texas Medicaid Vendor Drug Program database and Texas Medicaid enrollment files. Adherence to and persistence with antiretroviral therapy, as well as adherence to psychotropic medications when applicable, were evaluated over a 12-month period in 1,321 patients starting a new combination antiretroviral regimen. The presence of a mental disorder was defined based on prescription claims for psychotropic medications. Proportion of days covered was used to calculate adherence, while persistence was defined as the number of days persistent with all antiretrovirals in the index regimen. Logistic regression was used to evaluate the relationship between psychotropic medication use and adherence to antiretroviral therapy (90% cut-off), as well as the relationship between adherence to psychotropic medications (80% cut-off) and adherence to antiretroviral therapy. The relationship between antiretroviral persistence and psychotropic medication use was evaluated using multiple linear regression. Factorial ANOVA was used to evaluate the interactions between race/ethnicity, gender, and psychotropic medication use in their effects on adherence to and persistence with antiretroviral therapy. No significant relationship was found between the presence of a mental disorder and adherence to or persistence with combination antiretroviral therapy in this study. However, the limitations of using psychotropic medication use as a proxy for mental disorders may have affected the results. Adherence to psychotropic medications overall (n = 501; OR = 3.37, 95% CI: 1.86 – 6.10; p < 0.001) and specifically to antidepressants (n = 443; OR = 4.23, 95% CI: 2.31 – 7.75; p < 0.001) was significantly associated with adherence to antiretroviral therapy, indicating a possible relationship between effective treatment for mental disorders and combination antiretroviral therapy adherence. While additional research is needed to clarify this relationship, these data support the need for an integrated approach to treatment of mental disorders and HIV/AIDS. / text

Ce travail a été conçu comme une enquête préliminaire à l’étude de l’influence de la christianisation de l’Occident romain sur les conceptions, les traitements et les usages de la « folie » dans l’Antiquité tardive. Il examine les conceptions et les traitements de la maladie mentale proposés par les sources juridiques et médicales romaines, ainsi que les usages du thème de la « folie » dans les discours philosophique, tragique, comique et historiographique, comme dans la rhétorique judicaire et politique. Au moyen d’une approche d’inspiration fonctionnaliste, il entend rendre compte, simultanément, de l’autonomie de chacun de ces discours et de leurs points de rencontre au sujet de la « folie ». Ses principaux objectifs sont de dessiner les contours de la « folie » comme objet d’histoire et de clarifier la distribution des termes qui la désignent au sein du vaste champ sémantique dont elle est l’objet. / This work surveys conceptions and treatments of mental illness in the Roman Empire until the dawn of Late Antiquity. We investigate legal and medical sources and examine different uses of the idea of “madness” in wide ranging discourse from this period in philosophy, tragedy, comedy, history, as well as in legal or political rhetoric. The historical approach, inspired by functionalist social theories, is designed to further understand the autonomy, and/or analyze the encounters of each of these areas of discourse as they deal with madness. The underlying objective is to extricate the structure of madness concept as a matter of history and to clarify connotations and semantic references in the use of the many terms that refer to madness in Latin sources. The work also provides a preliminary investigation for the study of if, and how, the Christianizing of the western provinces of the Roman Empire influenced conceptions, treatments and uses of “madness” in Late Antiquity.

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients suffering from chronic diseases. Convenience sampling served as the method for selecting healthcare records that met the predetermined criteria. Two hundred established patients over 18 years of age were screened for depression at a primary care clinic in Maryland within a 10-week period following Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Study participants included 84 (42%) males and 116 (58%) females. Of these, 84 (42%) had minimal depression, 57 (29%) had mild depression, 23 (12%) had moderate depression, 24 (12%) had moderate-severe depression, and 12 (6%) had severe depression. The baseline report from the clinic revealed 0% depression screening practices yet the post-project chart review revealed a surprisingly high rate of depression diagnosis in 34 (17%) of 200 patients suffering from chronic illnesses. Identification of a reliable tool that would be used to screen depression among patients with chronic diseases at primary care clinics to mitigate the deleterious effects of depression and promote the well-being and health of patients and their families is important.

The following qualitative research study examined visual and thematic depictions of mental disorder in mainstream American film from 1988 to 2010. The research was an extension of an earlier investigation on portrayals of psychological disability in Hollywood movies (Levers, 1988, 2001). The theoretical and historical grounding for the project included Sander Gilman's (1982) scholarship on madness in the pictorial arts, the history and treatment of mental disorder over the course of time, social constructionism and the media, and research on media depictions of mental illness. The author employed two content analysis instruments (Levers, 1988, 2001) to record the appearance of icons, stereotypes, and positive portrayals of mental illness in 14 feature-length American films, which contain scenes of psychiatric hospitalization. Each film became a case study, and for each case, the author included content analysis findings, plot and character summaries, and discussion on mental disorder representation through images, speech, and themes. The multiple cases culminated in a filmography, which can be a resource for individuals interested in, and concerned about, the nature in which mental disorder is portrayed in popular, contemporary movies. The results from this study indicate that iconic and stereotypical representations of mental disorder have remained consistent since Levers' (1988, 2001) inquiries. The author identified 60 of 61 icons listed on the Icons of Madness viewing rubric (Levers, 1988, 2001) and all stereotypes and positive portrayals on the Thematic Portrayals of Mental Disorder viewing rubric (Levers, 1988, 2001). More specifically, the four most commonly depicted icons and the top five stereotypes were the same in both the present and Levers' (1988, 2001) studies. The one notable difference between these and Levers' (1988, 2001) results was the increased frequency of positive portrayals of mental illness; more positive portrayals occurred in this investigation as compared to Levers' earlier research. New icons, stereotypes, and positive portrayals of mental disorder not originally listed on the viewing rubrics were identified, too. The author discusses the present findings in light of future research possibilities, counselor education, and client advocacy. / School of Education; / Counselor Education and Supervision (ExCES) / PhD; / Dissertation;

Abstract Introduction. Approximately 88.000 cases of assault were reported to the Swedish police during 2010. Twenty-five percent of these cases were considered as violence against women. Intimate partner violence (IPV) is a worldwide issue and poses a major threat to women’s health. In Sweden, 17 women are killed each year by an intimate partner. This study aimed at increasing the knowledge of perpetrators of intimate partner homicide (IPH), in terms of type of mental disorder and type of deadly violence exerted. Method. A total of 49 forensic psychiatric investigations were obtained from the Swedish National Board of Forensic Medicine in Huddinge. Eighteen perpetrators of IPH were compared to 31 perpetrators of deadly violence in a non-intimate relationship. Comparisons were made by coding principal diagnoses as described in the forensic psychiatric investigations, and type of deadly violence exerted using the Cornell coding guide for violent incidents. Results. Perpetrators of IPH were, to a greater extent, diagnosed with a dysphoric or borderline personality disorder (BPD), whereas perpetrators of deadly violence in a non-intimate relationship were significantly more often diagnosed with an antisocial personality disorder (ASPD). Perpetrators of IPH used more deadly violence with reactive features, whereas perpetrators of deadly violence in a non-intimate relationship used significantly more deadly violence with instrumental features. Discussion. The results of this study are in agreement with previous research. In conclusion, perpetrators of IPH are more reactive in their deadly violence and less antisocial, in terms of being diagnosed with ASPD and previous convictions, compared to perpetrators of deadly violence in a non-intimate relationship. This may be helpful in terms of preventing future risk for IPV and IPH.

Background: Today, there are over 65 million refugees exist worldwide and arrival of the refugees has increased rapidly in Sweden as well. Refugees and asylum seekers may be more susceptible to mental disorders because of the traumatic events they encounter prior to immigration and adverse circumstances in the new country. Aim: A literature study was aimed at exploring different kind of mental ill health among immigrant refugees and the factors that affect their psychological ill health. Further aim of this study was also to find association between mental disorders observed in refugees and the factors responsible for them.  Method: Systematic literature study has chosen to provide an overall summary of the existing researches within the subject. A systematic search for relevant literature in PubMed and CINAHL was performed and it was limited to original research articles published between 1st January 2008 and 31st December 2017.  Data was extracted from 11 scientific quantitative articles. All the articles were reviewed for quality according to Forsberg &amp; Wengström’s review template. Results: Depression, post-traumatic stress disorder (PTSD), anxiety and somatization are common diagnoses among refugees. Many refugees experienced traumatic events in their home country and during escape. Unfavorable conditions like violence, murder, lack of food, shelter and money affect their mental health negatively. Landing in new country can be expressed in joy, but it did not stay for a long time with upcoming resettlement difficulties such as communication problems, discrimination, unemployment, separation from family and culture. Conclusion: Depression and PTSD were most common among refugees. Unemployment and language difficulties were the main reasons for their miserable mental health. There was an association between mental disorders and the factors like trauma in the home country and on the way to new destination as well as adoption difficulties in a new country.