Bio-behavioral scientific evidence alters judges' sentencing decision-making: A quantitative analysis.

The present study surveyed judges to examine how they consider and apply scientific information during sentencing determinations. Judges in criminal courts are increasingly asked to assess and make decisions based on evidence surrounding psychiatric disorders, with unclear results on sentencing outcomes. We qualitatively interviewed 34 judges who have presided over criminal cases in 16 different states and also administered vignette surveys during the interviews. We asked them to make sentencing decisions for hypothetical defendants in cases presenting evidence of either no psychiatric disorder, an organic brain disorder, or past trauma, as well as to rate the importance of different goals of sentencing for each case. Results indicated that the case presenting no evidence of a mental health condition received significantly more severe sentences as compared to either psychiatric condition. Judges' ratings of sentencing goals showed that the importance of retribution was a significant mediator of this relationship. Trauma was not deemed to be as mitigating as an organic brain disorder. These results provide unique insights into how judges assess cases and consider sentencing outcomes when presented with scientific information to explicate defendants' behavior. We propose ways forward that may help better integrate scientific understandings of behavior into criminal justice decision-making.

The correlation between cumulative burden of mental disorders and self-harm, shame, and insight in young female patients with schizophrenia.

This study delves into the correlation between the cumulative burden of mental disorders and self-harm, shame, and insight in young female patients with schizophrenia. A prospective randomized controlled study was used to recruit 62 female schizophrenia patients who met the recruitment conditions from January 2022 to December 2023. The participants were randomly divided into an experimental group (31 cases) and a control group (31 cases) using a computer-based random number distribution method. The experimental group underwent an 8-week Mindfulness-Based Cognitive Therapy (MBCT) intervention, while the control group received conventional treatment. Data was collected using the Modified EI-SHS scale, the Link's Stigma Scale (LSS), the Five-factor Mindfulness Scale (FFMQ), and the Self-awareness and Therapeutic Attitude Questionnaire (ITAQ) before and after the intervention. One-way ANOVA and repeated measure ANOVA were used to compare and analyze the two groups of data. The experimental group exhibited a significant reduction in EI-SHS and LSS scores (100.26 ± 11.48 vs. 88.35 ± 10.09, 112.81 ± 12.30 vs. 100.50 ± 13.52, p < 0.01), coupled with significant increase in FFMQ and ITAQ scores (113.77 ± 12.25 vs. 128.31 ± 14.09, 14.03 ± 4.18 vs. 17.30 ± 2.96, p < 0.01). A positive correlation was found between overall stigma scores and mood disorder scores (r = 0.379, P < 0.011). Correlation analysis revealed a negative correlation between mindfulness (self-awareness) and stigma (r = -0.128, P = 0.025). MBCT effectively reduced stigma in young women with schizophrenia and improved coping tendencies, cognitive status, and attitudes toward mental illness, ultimately reducing the cumulative burden of mental disorders and self-harm in these patients. Increased levels of mindfulness correspond to improved cognitive status and a more positive attitude toward treatment for mental illness. It is of great value to promote MBCT in female patients with schizophrenia.

Perceptions of mental disorder causes, treatments, and prevention among the general population in Saudi Arabia.

This study investigates the community's perception of mental health in Saudi Arabia, emphasizing its influence on attitudes toward the causes, treatment, and prevention of mental health issues. This understanding is vital for creating evidence-based mental health interventions. A cross-sectional national mental health screening was conducted in 2023, utilizing proportional quota sampling for age, gender, and regional representation among 4547 Saudi participants aged 18-90, randomly selected from national databases. Data were gathered using the ZDataCloud system. The study covered all 13 administrative regions of Saudi Arabia: Riyadh, Makkah, Madinah, Qassim, Eastern Province, Asir, Tabuk, Hail, Northern Borders, Jazan, Najran, Baha, and Al-Jouf. The majority (86.5%) had no personal history of mental health diagnosis or treatment. Key findings identified psychological trauma (78.36%) and substance abuse (72.88%) as primary perceived causes of mental disorders. Preferred treatments included non-pharmacological psychotherapies (74.97%) and pharmacological methods (71.08%). Prevention strategies focused on raising awareness of mental illness (80.4%) and enhancing positive relationships (70.6%). A multivariate logistic regression analysis revealed significant associations between demographic variables and perceptions of mental disorder causes, treatments, and prevention strategies. Females were more likely than males to perceive psychological trauma, drug and alcohol abuse, and domestic violence and sexual harassment as causes of mental disorders. Regarding treatments, females and those with personal or close connections to mental health issues were more likely to endorse non-pharmacological psychotherapy and Roquia in the Qur'an. For prevention strategies, females, those with a mental health diagnosis, and those living with someone diagnosed with a mental disorder were more likely to endorse increasing awareness, positive social relationships, and physical activity. The study suggests integrating religious and social beliefs into mental health programs to enhance community engagement and effectiveness.

Recognition of psychological comorbidity and psychotherapeutic treatment status of ventricular assist device patients.

BACKGROUND: Due to its high impact on quality of life and mental health, close monitoring and often psychotherapy is recommended for patients with a ventricular assist device (VAD). This study investigates the psychological comorbidity and the corresponding psychotherapeutic treatment situation of VAD patients. Special attention is also given to the professional perspective VAD team (assistant and senior cardiologists and specialized nurses). METHODS: We conducted a cross-sectional observational study. Data from 50 VAD patients (mean age = 53.52, standard deviation = 13.82 years, 84.0% male) and their VAD team were analyzed. The presence of a psychological disorder was evaluated by structured clinical interviews for DSM-IV (SCID-I-Interviews). Patients answered a questionnaire regarding their current psychotherapeutic treatment status and their attitude towards psychotherapy. The VAD team answered a questionnaire about the patients' needs for psychotherapy and indicated whether they addressed this topic with the patient. Data were analyzed descriptively, by analysis of variance and t-test. RESULTS: A total of 58% of VAD patients suffered from at least one significant psychological disorder, 79.3% of those were not in psychotherapy. The VAD team could not identify the patients who suffered from a psychological disorder (F = 1.90; p = 0.18). They perceived more need for psychotherapy than they addressed with their patients (T = 3.39; p < 0.001). CONCLUSIONS: While there is a high psychological morbidity among VAD patients, only few receive psychotherapy. Psychological comorbidity is not easily detected by the VAD team. Standardized psychosocial care could be implemented by regular psychological assessments and further information of patients and their VAD teams.

Diagnosis of mental disorders using machine learning: Literature review and bibliometric mapping from 2012 to 2023.

Background: Mental disorders (MDs) are becoming a leading burden in non-communicable diseases (NCDs). As per the World Health Organization's 2022 assessment report, there was a steep increase of 25 % in MDs during the COVID-19 pandemic. Early diagnosis of MDs can significantly improve treatment outcome and save disability-adjusted life years (DALYs). In recent times, the application of machine learning (ML) and deep learning (DL)) has shown promising results in the diagnosis of MDs, and the field has witnessed a huge research output in the form of research publications. Therefore, a bibliometric mapping along with a review of recent advancements is required. Methods: This study presents a bibliometric analysis and review of the research, published over the last 10 years. Literature searches were conducted in the Scopus database for the period from January 1, 2012, to June 9, 2023. The data was filtered and screened to include only relevant and reliable publications. A total of 2811 journal articles were found. The data was exported to a comma-separated value (CSV) format for further analysis. Furthermore, a review of 40 selected studies was performed. Results: The popularity of ML techniques in diagnosing MDs has been growing, with an annual research growth rate of 17.05 %. The Journal of Affective Disorders published the most documents (n = 97), while Wang Y. (n = 64) has published the most articles. Lotka's law is observed, with a minority of authors contributing the majority of publications. The top affiliating institutes are the West China Hospital of Sichuan University followed by the University of California, with China and the US dominating the top 10 institutes. While China has more publications, papers affiliated with the US receive more citations. Depression and schizophrenia are the primary focuses of ML and deep learning (DL) in mental disease detection. Co-occurrence network analysis reveals that ML is associated with depression, schizophrenia, autism, anxiety, ADHD, obsessive-compulsive disorder, and PTSD. Popular algorithms include support vector machine (SVM) classifier, decision tree classifier, and random forest classifier. Furthermore, DL is linked to neuroimaging techniques such as MRI, fMRI, and EEG, as well as bipolar disorder. Current research trends encompass DL, LSTM, generalized anxiety disorder, feature fusion, and convolutional neural networks.

Addressing Psychosocial Disabilities Through Social Interventions for Individuals With Severe Mental Disorders.

Mental disorders are prevalent worldwide, often causing significant distress and impairment across various life domains. Furthermore, they may lead to psychosocial disabilities exacerbated by stigma, discrimination, and social exclusion that hinder full societal participation and frequently result in human rights violations denying access to education, work, high-quality health, and reproductive rights. Therefore, a comprehensive and coordinated response to mental health requires a biopsychosocial approach and the integration of holistic promotion, prevention, support, care, and rehabilitation. Effective interventions need to be recovery-focused and should include social interventions. This editorial discusses the social interventions that can be utilized to address psychosocial disabilities in individuals with severe mental disorders. There is a need for developing innovative strategies, tools, and digital solutions, the provision of psychoeducation and caregiver support, along with conducting recovery-oriented research and provider training. Furthermore, the focus should be more on strengths instead of pathology and on cultivating a mental health-promoting environment. This requires inclusive policies, increased advocacy to decrease stigma and promote human rights, redirecting funds to community-based services from long-stay mental hospitals, and a multisectoral collaboration between different sectors such as employment, education, health, housing, social, and judicial sectors to provide support across different life stages, facilitate access to human rights, and attain equal opportunities to help individuals with severe mental disorders reach their full potential and live a meaningful life.

Exploring the impact of 'hostile environment' policies on psychological distress of ethnic groups in the UK: a differences-in-differences analysis.

PURPOSE: In 2012, the UK government announced legislation changes and heightened immigration controls designed to create a 'hostile environment for illegal migration.' We measured changes in psychological distress among people from minoritised ethnic groups compared to White British controls before and throughout the implementation of these policies. METHODS: We used the UK Household Longitudinal Survey to estimate difference-in-difference models for six ethnic groups (Bangladeshi, African, Caribbean, Indian, Pakistani, and White British) in three eras: pre-policy (2009-2012); (2) transition (2012-2016); and (3) ongoing policy (2016-2020). We calculated the adjusted marginal mean psychological distress score at each era using the 12-item General Health Questionnaire (GHQ). RESULTS: In the pre-policy era, we found higher psychological distress for the Pakistani, Bangladeshi, and Caribbean groups compared to the White British group. We observed patterns consistent with increasing psychological distress during the transition era for the Pakistani and Bangladeshi groups, with further increases in the ongoing era for the Bangladeshi group. Levels of psychological distress the Indian and African groups were similar to the White British group in the pre-policy era and decreased over successive eras. A small decrease was observed in the Caribbean group across policy eras, while levels remained stable in the White British group. CONCLUSION: We found evidence that psychological distress increased among Pakistani and Bangladeshi individuals following the introduction of hostile environment policies but did not detect increased distress in other ethnic groups. This finding underscores the importance of disaggregating analyses by ethnic group to capture the distinct experiences.

The association between plant and animal protein intake with depression, anxiety, and stress.

BACKGROUND: Recent evidence suggests that diet composition is a key biological factor related to the development of depressive disorders. The present study was conducted to investigate the animal and plant protein intake and their replacement in association with depression, anxiety, and stress in Iranian adults. METHOD: In this cross-sectional study, the dietary intake of 7169 subjects were assessed using a validated food frequency questionnaire. The depression, anxiety, and stress Scale - 21 (DASS-21) questionnaire was used to psychological disorders. Logistic regression was used to obtain odds ratios for depression, anxiety, and stress across quintiles of animal and plant protein. RESULTS: The participants' age range was 20-69 years. Individuals with the highest animal protein consumption had a lower chance for developing depression compared to those with the lowest intakes (OR = 0.73, 95%CI: 0.59-0.90; Ptrend < 0.01). Results also showed a significant association between animal protein intake and anxiety, such that subjects in the highest quintile of animal protein intake had 24% lower odds for anxiety compared to those in the lowest quintile (p < 0.05). We found a significant association between highest quintiles of animal protein intake and a 40% lower risk for stress among female individuals (Ptrend = 0.05). The multivariable-adjusted non-linear analyses also revealed that the replacement of plant protein with animal protein was significantly associated with the likelihood of depression and anxiety (P < 0.05). CONCLUSION: Animal protein intake might lower the odds of depression and anxiety particularly. Future prospective investigations are proposed to confirm these findings.

A perspective on epigenomic aging processes in the human brain and their plasticity in patients with mental disorders - a systematic review.

The debate surrounding nature versus nurture remains a central question in neuroscience, psychology, and in psychiatry, holding implications for both aging processes and the etiology of mental illness. Epigenetics can serve as a bridge between genetic predisposition and environmental influences, thus offering a potential avenue for addressing these questions. Epigenetic clocks, in particular, offer a theoretical framework for measuring biological age based on DNA methylation signatures, enabling the identification of disparities between biological and chronological age. This structured review seeks to consolidate current knowledge regarding the relationship between mental disorders and epigenetic age within the brain. Through a comprehensive literature search encompassing databases such as EBSCO, PubMed, and ClinicalTrials.gov, relevant studies were identified and analyzed. Studies that met inclusion criteria were scrutinized, focusing on those with large sample sizes, analyses of both brain tissue and blood samples, investigation of frontal cortex markers, and a specific emphasis on schizophrenia and depressive disorders. Our review revealed a paucity of significant findings, yet notable insights emerged from studies meeting specific criteria. Studies characterized by extensive sample sizes, analysis of brain tissue and blood samples, assessment of frontal cortex markers, and a focus on schizophrenia and depressive disorders yielded particularly noteworthy results. Despite the limited number of significant findings, these studies shed light on the complex interplay between epigenetic aging and mental illness. While the current body of literature on epigenetic aging in mental disorders presents limited significant findings, it underscores the importance of further research in this area. Future studies should prioritize large sample sizes, comprehensive analyses of brain tissue and blood samples, exploration of specific brain regions such as the frontal cortex, and a focus on key mental disorders. Such endeavors will contribute to a deeper understanding of the relationship between epigenetic aging and mental illness, potentially informing novel diagnostic and therapeutic approaches.

[The Hungarian adaptation of the Mental Health Quality of Life Questionnaire (MHQoL)]. / A Mentális Egészséggel Összefüggo Életminoség Kérdoív (MHQoL) magyar adaptációjának bemutatása.

Our study presents the Hungarian adaptation of the Mental Health Quality of Life Questionnaire (MHQoL). BACKGROUND: In recent decades, there has been a shift in the field of healthcare, with a notable change in the ultimate goal of health interventions. Rather than merely reducing symptoms and prolonging life, the objective of health interventions is now to improve quality of life. A number of measures of quality of life have been developed, but the majority of these focus exclusively on physical health and do not fully cover the dimensions that are relevant to the quality of life of people with mental health problems. Van Krugten et al. have developed the Mental Health Quality of Life (MHQoL) questionnaire, which covers the seven most important dimensions of mental health-related quality of life. OBJECTIVES: Our research had the following two main aims. Firstly, it aimed to develop and test a Hungarian adaptation of the Mental Health Quality of Life (MHQoL) questionnaire. Secondly, it aimed to compare the results of healthy individuals and those with diagnosed psychiatric disorders. METHODS: A total of 189 individuals participated in the survey, with 157 classified as psychiatrically healthy and 32 diagnosed with a mental disorder, of which 20 were in acute psychiatric care and 12 were in outpatient care. The data were analysed using confirmatory factor analysis, reliability analysis and independent samples t-test. RESULTS: Our confirmatoriy factor analysis indicated that all items show a good fit with the model. The factor weights for each item were observed to range from 0.45 to 0.79. The Cronbach's α index obtained in our reliability analysis of the MHQoL demonstrated exceptional internal reliability: an index value of 0.81, with individual item- specific reliability coefficients ranging from 0.7 to 0.81. Independent samples t-tests were conducted to assess the statistical significance of differences in mean scores between respondents with and without a psychiatric diagnosis. The results indicated that there were significant differences in the means of the two groups for items pertaining to future vision, mood, relationships and physical health, as well as when comparing the mean scores of the MHQoL total score and the mean scores of psychological well-being. The majority of variables exhibited statistically significant differences from each other, with medium effect sizes. CONCLUSIONS: The results thus far indicate that the Hungarian version of the MHQoL is an effective instrument for differentiating between individuals with and without mental illness, based on psychometric indicators. Furthermore, it provides valuable insights into the domains in which psychiatric illnesses have the greatest impact on patients' quality of life. The objective of our future research is to further validate the MHQoL questionnaire in order to contribute to the concept of healthcare that focuses not only on eliminating symptoms but also on improving quality of life.

Mapping the World Health Organization Disability Assessment Scale 2.0 to the EQ-5D-5L in patients with mental disorders.

OBJECTIVE: The current study aims to develop an algorithm for mapping the WHODAS 2.0 to the EQ-5D-5 L for patients with mental disorders. METHODS: This cross-sectional study was conducted at the Institute of Mental Health and Community Wellness Clinics in Singapore between June 2019 and November 2022. We included four regression methods including the Ordinary Least Square (OLS) regression, the Tobit regression model (Tobit), the robust regression with MM estimator (MM), and the adjusted limited dependent variable mixture model (ALDVMM) to map EQ-5D-5 L utility scores from the WHODAS 2.0. RESULTS: A total of 797 participants were included. The mean EQ-5D-5 L utility and WHODAS 2.0 total scores were 0.615 (SD = 0.342) and 11.957 (SD = 8.969), respectively. We found that the EQ-5D-5 L utility score was best predicted by the robust regression model with the MM estimator. Our findings suggest that the WHODAS 2.0 total scores were significantly and inversely associated with the EQ-5D-5 L utility scores. CONCLUSION: This study provides a mapping algorithm for converting the WHODAS 2.0 scores into EQ-5D-5 L utility scores which can be implemented using a simple online calculator in the following web application: https://eastats.shinyapps.io/whodas_eq5d/.

Prevalence of common mental disorder and its association with perceived stigma and social support among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: When common mental disorders (CMD) co-occur with HIV/AIDS, they can complicate patient diagnosis, help-seeking behaviors, quality of life, treatment outcomes, and drug adherence. Thus, estimating the pooled prevalence of CMD and its association with perceived stigma and social support among people living with HIV/AIDS (PLWHA) in Ethiopia could potentially support policymakers and health professionals to understand the disease burden and set a solution to improve the mental well-being of PLWHA. METHODS: Popular databases such as PubMed, SCOPUS, EMBASE, and Psych-INFO as well as Google Scholar, AJOL, CINAHL, PILOTS and Web of Science were searched for the relevant articles conducted in Ethiopia. We included cross-sectional, case-control, and cohort studies in the review. The Comprehensive Meta-Analysis software version 3.0 was used to pool the results of the included studies. The Q- and I2-statistics were used to assess the heterogeneity between the included studies. We employed a random-effects meta-analysis model to estimate the pooled prevalence of CMD and to account for heterogeneity among the included studies. We also conducted a leave-one-out analyses, and stratified meta-analyses by gender (male and female). RESULTS: The studies included in this systematic review and meta-analysis were published between 2009 and 2021, recruiting a total of 5625 participants. The pooled estimated prevalence of CMD among PLWHA in Ethiopia was 26.1% (95% CI 18.1-36.0). The pooled estimated prevalence of CMD was significantly higher among females, at 39.5% (95% CI 21.2-39.0), compared to males, 26.9% (95% CI 15.6-31.7). Moreover, the pooled estimated prevalence of CMD in PLWHA ranged from 23.5 to 28.9% in the leave-one-out sensitivity analysis, indicating that the removal of any single study did not significantly affect the pooled estimate. The pooled effects (AOR) of Perceived HIV stigma and poor perceived social support on common mental disorder were 2.91, 95% CI (1.35-6.29) and 5.56, 95% CI (1.89-16.39), respectively. CONCLUSION: People living with HIV/AIDS (PLWHA) who received poor social support and those with HIV-related perceived stigma were found to have strong association with CMD. Therefore, it is advisable that all PLWHA attending ART clinic should be screened for CMD, social support and HIV-related perceived stigma.

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs.

Introduction: Psychiatric patients suffer from oral diseases and side effects of antipsychotic medication. In particular, the typical antipsychotic drugs may cause severe hyposalivation with subsequent oral symptoms. We therefore aimed to compare oral health behavior and oral side effects of in-hospital patients taking typical vs. atypical antipsychotic drugs with the hypothesis that the former drugs cause more oral pain than the newer drugs. Methods: This cross-sectional questionnaire and interview study investigated subjective oral symptoms and their health behavior in 170 hospitalized psychiatric patients, comparing those taking typical vs. atypical antipsychotic drugs. Cross-tabulations and chi-square tests were used for analyses. Results: Persistent oral pain lasting throughout the day was reported by 46% in the typical, and 5% in the atypical antipsychotic group patients, respectively. In both groups, the pain was mainly in the tongue and buccal mucosa and was described as a burning sensation. A significantly higher prevalence of xerostomia was reported in the typical antipsychotic medication group (66%) compared with the atypical antipsychotic medication group (53%, p<0.01). Self-assessed dental health was assessed as poor by two-thirds of the patients of whom 69% reported toothbrushing once daily. Approximately half of them reported having had a visit to a dentist within the previous year. Of the women 28%, and of the men 17%, respectively, had received professional consultations for oral symptoms. Conclusion: The current results on psychiatrically hospitalized patients emphasize the need for awareness of oral discomfort and its subsequent effects on the quality of life in this challenging patient group. Focus should also be placed on a wide range of support encouraging the patients to maintain good daily oral hygiene and seek professional dental help when needed.

Prevalence and Factors Associated With Awareness of Precision Medicine Among Individuals With Depression and Anxiety.

OBJECTIVE: This study investigates the prevalence and determinants of awareness of precision medicine among a nationally representative sample of individuals with self-reported depression and anxiety in the United States." METHODS: Data were obtained from the Health Information National Trends Survey (HINTS) 5, Cycle 4, which is a study administered by the National Cancer Institute and is nationally representative. The survey, conducted between February and June 2020, targeted non-institutionalized, civilian US adults aged 18 years and older. Utilizing survey-weighted logistic regression, predictors of precision medicine awareness were assessed, encompassing sociodemographic, health-related, and technological factors. RESULTS: Among 890 individuals with self-reported depression and/or anxiety, approximately 15.3% reported awareness of precision medicine. Participants who had a higher level of education and those who had increased health-linked social media usage were three times more likely to be aware of precision medicine compared to those who did not. Old age was also positively associated with increased awareness. CONCLUSION: The present study's findings have disclosed an alarming lack of awareness of precision medicine, particularly among mentally ill persons with anxiety or depression, in which the targeted subgroups, including individuals with lower education levels and limited health-linked social media utilization, indicated lower levels of awareness. As such, it is recommended that such disparities be tackled using customized interventions along with educational initiatives, as this is likely to improve awareness levels while also ensuring equitable and increased access to precision medicine within the context of mental health.

Factors Related to the Recurrence of Sickness Absence Due to Common Mental Health Disorders: A Systematic Review.

PURPOSE: Employees who experience sickness absence (SA) due to common mental disorders (CMD) are at increased risk of recurrent sickness absence (RSA). This systematic literature review examines the factors at different levels in the work and non-work context that increase or decrease the likelihood of RSA due to CMD. The resulting knowledge enables more accurate identification of employees at risk of RSA. METHODS: We conducted a search in June 2023 using the following databases: PubMed, PsycInfo, Web of Science, Cumulative Index to Nursing & Allied Health Literature (Cinahl), Embase and Business Source Ultimate (BSU). Inclusion criteria were as follows: (self-)employees, CMD, related factors, RSA. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Individual, Group, Leader, Organisation and Overarching/social context (IGLOO) model were used to cluster the found factors and these factors were graded by evidence grading. RESULTS: Nineteen quantitative and one qualitative studies of mainly high and some moderate quality were included in this review. A total of 78 factors were found. These factors were grouped according to the IGLOO levels and merged in 17 key factors. After evidence grading, we found that mainly low socioeconomic status (SES) and the type of previous SA (short-term SA and SA due to CMD) are predictors of an increased risk of RSA. CONCLUSIONS: Having a low SES and previous experience of SA (short term, or due to CMD) are factors that predict the chance of RSA, implying the need for prolonged support from occupational health professionals after the employee has returned to work.

Supported employment coaches' difficulties and facilitators with clients diagnosed with personality versus other disorders: A qualitative study.

Aim: People with severe mental illnesses (SMI) face different occupational challenges than those diagnosed with personality disorders (PD). Supported employment (SE) has been validated for SMI patients but its effectiveness for individuals with PD remains unclear, and the reasons for this potential difference have not been explored. This study aimed to identify differences in SE practice for clients with SMI and those with PD. Methods: Six SE job coaches were interviewed about their experiences. A thematic analysis was run. Results: More difficulties and facilitators were mentioned regarding clients with PD than regarding clients with other SMI. For both, patients' symptoms were reported to negatively affect their (re)integration into the job market. However, in contrast to that of clients with SMI, the relation between symptoms and SE success for clients with PD involved difficult behaviors and their negative impact on the therapeutic relationship. Conclusion: In summary, SE practice seems to be undermined by PD and could benefit from adaptations, such as specific training for SE teams to help them in managing clients with this disorder.

Erratum: Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric hospital admissions in North Italian hospitals, 2017 to 2022: a quasi-experimental study interrupted time-series analysis.

[This corrects the article DOI: 10.3389/fpubh.2024.1393677.].

Stepped, evidence-based and integrated care service model vs. usual care for mental disorders: A randomized controlled trial (RECOVER).

Stepped, evidence-based and integrated care service models have the potential to be used as a reference for mental health services. RECOVER aimed to evaluate cost savings, effectiveness, and cost-effectiveness of such a model within a two arm, assessor- and data analysist-blinded RCT in Hamburg, Germany. Participants aged 16-79 years with mental disorders were randomly assigned either to RECOVER or treatment as usual (TAU). Primary outcomes comprised costs, effectiveness (combined symptoms, functioning, quality of life), and cost-effectiveness, hierarchically ordered. Outcomes were evaluated according to the ITT principle, group differences regarding costs with adjusted generalized linear models, effectiveness with ANCOVA models, and cost-effectiveness with the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curves (CEACs). Between 1/1/2018 and 12/31/2020, n = 891 were finally included (n = 477 in RECOVER, n = 444 in TAU). RECOVER was associated with significantly lower annual total costs (-22 %), health and social care costs (-25 %) and hospital costs (-50 %). Effectiveness analyses showed a significantly better outcome for RECOVER with the fully imputed data . The CEACs descriptively demonstrated that RECOVER was cost-effective with a probability of >95 %. Treatment in RECOVER resulted in substantial cost reductions with better cost-effectiveness. RECOVER can be recommended as a reference model for comprehensive and integrated mental health services.