Attitudes of Children, Adolescents, and Their Parents Toward Digital Health Interventions: Scoping Review.

BACKGROUND: The prevalence of mental health problems in children and adolescents is high. As these problems can impact this population's developmental trajectories, they constitute a public health concern. This situation is accentuated by the fact that children and adolescents infrequently seek help. Digital health interventions (DHIs) offer an opportunity to bridge the treatment gap between health care needs and patient engagement in care. Additional detailed research is needed to identify how children and adolescents can be empowered to access help through DHIs. In this context, an understanding of their attitudes toward digital health appears to be a necessary first step in facilitating the effective implementation of DHIs. OBJECTIVE: This study aimed to establish an inventory of children's, adolescents', and their parents' attitudes toward DHIs. METHODS: A scoping review following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) recommendations was performed using the MEDLINE, Embase, and PsycINFO databases. This research was conducted using 3 key concepts: "child and adolescent mental health service users," "digital health interventions," and "attitudes." Data extracted included the name of the publishing journal, the methodology used, the target population, the DHI studied, and the principal results. RESULTS: Of 1548 studies found, 30 (1.94%) were included in our analysis. Among these, 13 concerned satisfaction, 24 concerned preferences, 22 concerned the use of DHI, 11 concerned perception, and 10 concerned needs. CONCLUSIONS: The results of this study provide a better understanding of the factors influencing children's and adolescents' attitudes toward digital health and DHIs. The continued growth of DHIs can help reduce barriers to mental health care. Future research on these interventions should investigate the needs of the targeted populations to increase their engagement in care.

Social Representations of e-Mental Health Among the Actors of the Health Care System: Free-Association Study.

BACKGROUND: Electronic mental (e-mental) health offers an opportunity to overcome many challenges such as cost, accessibility, and the stigma associated with mental health, and most people with lived experiences of mental problems are in favor of using applications and websites to manage their mental health problems. However, the use of these new technologies remains weak in the area of mental health and psychiatry. OBJECTIVE: This study aimed to characterize the social representations associated with e-mental health by all actors to implement new technologies in the best possible way in the health system. METHODS: A free-association task method was used. The data were subjected to a lexicometric analysis to qualify and quantify words by analyzing their statistical distribution, using the ALCESTE method with the IRaMuTeQ software. RESULTS: In order of frequency, the terms most frequently used to describe e-mental health in the whole corpus are: "care" (n=21), "internet" (n=21), "computing" (n=15), "health" (n=14), "information" (n=13), "patient" (n=12), and "tool" (n=12). The corpus of text is divided into 2 themes, with technological and computing terms on one side and medical and public health terms on the other. The largest family is focused on "care," "advances," "research," "life," "quality," and "well-being," which was significantly associated with users. The nursing group used very medical terms such as "treatment," "diagnosis," "psychiatry"," and "patient" to define e-mental health. CONCLUSIONS: This study shows that there is a gap between the representations of users on e-mental health as a tool for improving their quality of life and those of health professionals (except nurses) that are more focused on the technological potential of these digital care tools. Developers, designers, clinicians, and users must be aware of the social representation of e-mental health conditions uses and intention of use. This understanding of everyone's stakes will make it possible to redirect the development of tools to adapt them as much as possible to the needs and expectations of the actors of the mental health system.

International study of the prevalence and factors associated with insomnia in the general population.

OBJECTIVES: Insomnia is a public health problem with many repercussions. It affects a significant proportion of the general population worldwide, but the estimated prevalences in different countries are difficult to compare due to the use of heterogeneous methodologies. The objectives of the study were to compare the prevalence of insomnia in the general population in different sites around the world and to identify sociodemographic and mental health associated factors, using the same tool and within a single study. METHODS: This multicenter cross-sectional study is based on the Mental Health in the General Population survey (MHPG). It included several sites in France and 12 countries around the world with a representative sampling of the general population. The prevalence of short-term insomnia disorder was estimated by the occurrence within one month of at least one symptom, at a minimum frequency of three per week, with repercussions on everyday life. RESULTS: Out of the 57,298 participants, 11.3% had a diagnosis of short-term insomnia disorder, with significant differences in prevalence between sites, ranging from 2.3% to 25.5%. Insomnia was significantly related to having mood disorders, anxiety disorders, substance use disorders and psychotic disorders. Insomnia was also more common among women, older adults, working participants and those who practice a religion. CONCLUSIONS: The prevalence of insomnia was highly variable between sites, but the predictors appeared to be the same everywhere. Insomnia seemed to be more related to the presence of mood and anxiety disorders than a site-specific effect and thus may be a good indicator of mental health.

Analysis of the Recomposition of Norms and Representations in the Field of Psychiatry and Mental Health in the Age of Electronic Mental Health: Qualitative Study.

BACKGROUND: For the World Health Organization, electronic health (eHealth) is seen as an effective way to improve therapeutic practices and disease prevention in health. Digital tools lead to major changes in the field of mental medicine, but specific analyses are required to understand and accompany these changes. OBJECTIVE: Our objective was to highlight the positions of the different stakeholders of the mental health care system on eHealth services and tools, as well as to establish professional and user group profiles of these positions and the uses of these services. METHODS: In order to acquire the opinions and expectations of different categories of people, we carried out a qualitative study based on 10 focus groups (n=70, from 3-12 people per group) composed of: general practitioners, psychiatrists, psychologists, social workers, occupational therapists, nurses, caregivers, mental health services users, user representatives, and the general public. The analyses of focus group discussions were performed independently by four investigators through a common analysis grid. The constant comparative method was adopted within this framework. RESULTS: The interviewees expressed different problems that new technologies engender in the field of mental health. What was previously strictly under the jurisdiction of physicians now tends to be fragmented and distributed over different groups and locations. New technologies reposition care in the field of domestic, rather than therapeutic, activities, and thus the conception of care as an autonomous activity in the subject's life is questioned. The ideal of social autonomy through technology is part of the new logic of health democracy and empowerment, which is linked to a strong, contemporary aspiration to perform. Participants emphasized that there was the potential risk of a decrease in autonomy for the digitally engaged patient, while personal empowerment could become a set of obligations. CONCLUSIONS: This qualitative research highlights the heterogeneity of opinions among the groups and within each group. It suggests that opinions on electronic mental health devices are still far from being stabilized, and that a change management process should be set up to both regulate the development and facilitate the use of these tools.

[Specialized training in geriatric psychiatry during residency in France]. / La psychiatrie de la personne âgée au sein du diplôme d'études spécialisées de psychiatrie en France : résultat d'une enquête nationale.

Aging of the population is a growing concern in developed countries. Therefore, geriatric psychiatry has gradually emerged from general psychiatry. Many names have been proposed to term this sub-specialty: old age psychiatry (OAP), psychogeriatrics, geropsychiatry. A working group of the French federation of psychiatric trainees (AFFEP) set up an inventory of the theoretical instruction and clinical practice of OAP during the training of psychiatrists in France. Methods. A survey of both academic teaching and practical training for OAP was carried out in the 28 local AFFEP representatives of every French medical residency district, including overseas. We assessed the supply of general courses and seminars devoted to OAP during the training of French residents in psychiatry, and the offer of university or inter-university degrees as well as the possibility of specialized internship in every residency district. Results. 96% of French medical residency districts offered general courses of OAP with a mean volume of 11.5 hours along the four years of psychiatric training in France. Fifty percent of medical residency districts proposed at least one seminar devoted to OAP. Half of medical residency districts also offer a specialized university or inter-university degree. Concerning clinical practice, 86% of medical residency districts had one internship dedicated to OAP, in 39% of cases in teaching hospitals. Conclusion. Nationwide, there is an overall effort to make OAP available to French psychiatric residents by general courses and internship, but some disparity appeared in academic teaching (i.e. offering seminars and university/inter-university degrees) according to various residency districts.