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This chapter explores the complex nature of depression, a mood disorder affecting millions worldwide. It discusses the various symptoms, causes, and types of depression, highlighting the interplay between biological, psychological, and social factors. The chapter emphasizes the importance of early recognition and treatment, as well as the potential for music therapy to offer significant benefits. It looks at how music can evoke emotions, regulate moods, and foster social connection, serving as a valuable tool for managing depression. The chapter also explores specific music therapy techniques, such as improvisation and targeted playlists, that can aid in emotional expression, self-regulation, and the cultivation of resilience. The chapter concludes by underlining the importance of a holistic approach to depression treatment, combining music therapy with conventional therapies and lifestyle changes for optimal results.
This final part summarizes key insights and practical strategies from the book, offering a concise overview of music’s therapeutic potential. It includes practical tips for music meditation and engaging in physical activity with music, highlighting their benefits for emotional regulation, stress reduction, and overall well-being. The part also addresses the potential negative side effects of music and provides guidance for seeking emergency help when experiencing severe emotional distress. Concluding remarks emphasize the transformative power of music and its potential to enhance our lives in countless ways.
Childbirth influences maternal and new-born’s future health, with the Epigenetic Impact of Childbirth (EPIIC) hypothesis proposing that labour stress affects foetal gene expression. This study explores how birth experiences relate to DNA methylation in infants, breastfeeding and mother-infant bonding. Data from the Avon Longitudinal Study of Parents and Children was used, including 14,541 pregnant women. The ARIES subset of 1,022 mother-child pairs provided DNA methylation profiles. Maternal birth experience (MBE) was evaluated, with mother-infant bonding and breastfeeding. Statistical analysis involved linear regression and epigenome-wide association study. Half of the mothers reported at least one negative childbirth event, with 7% experiencing three or more adverse events. Negative MBE correlated with shorter breastfeeding duration and weaker mother-infant bonding. No significant CpG associations with MBE were found. While positive MBE is linked to improved mother-infant bonding and breastfeeding, no significant changes in DNA methylation profiles were observed in the offspring. Further research is needed to understand MBE’s long-term impact on child health.
Mental health problems commonly persist from childhood to adulthood. This study tested whether young adult life transitions can improve adult mental health symptoms after adjusting for childhood mental health symptoms.
Methods
The analysis uses data from the prospective, representative Great Smoky Mountains Study. Life transitions (e.g., high school completion, partnering, parenthood, and living independently) were assessed up to three times in young adulthood (ages 18 to 26; 3,241 observations). A cumulative variable counted the number of young adult transitions. Emotional, substance use, and antisocial personality symptoms were assessed at age 30 (1,154 participants or 81.2% of the original sample). Propensity models adjusted for early life adversities and psychiatric symptoms.
Results
Multiple young adult transitions were common (m = 4.62; SD = 1.57). After adjusting for childhood mental health problems and adversities, each additional transition was significantly associated with a reduction in subsequent adult emotional symptoms (β = −0.34, 95% CI: −0.59, −0.08, p = 0.01) and adult antisocial personality disorder symptoms (β = −0.08, 95% CI: −0.14, −0.02, p < 0.001. These associations were stronger in males than in females. Young adult transitions were not associated with reductions in subsequent substance use symptoms (β = −0.04; 95% CI: −0.11, 0.03, p = 0.30). Young adult transitions related to educational milestones and consistent employment were associated with the largest reductions in symptoms.
Conclusions
In this cohort study, life transitions during young adulthood were associated with reduced emotional and behavioral symptoms in adulthood. These transitions may constitute a potential mental health turning point and a specific, modifiable target for social policies.
Metabolic syndrome (MetS) is associated with deteriorated mental health and health-related quality of life (HRQOL). Curcumin and probiotics improved MetS, mental health, and HRQOL. The present study aimed to investigate the effect of curcumin-probiotic (CurPro) co-supplementation in the form of drink powder on mental health and HRQOL in adults with overweight/obesity and MetS. A four-arm, randomized, double-blinded, placebo-controlled clinical trial with factorial design was conducted for adults with overweight/obesity and MetS (n=128). Participants were randomly allocated into four groups to receive one drink powder sachet containing 1 gr curcumin, 109 CFU probiotic (Lactobacillus acidophilus and Lactobacillus rhamnosus strains), curcumin-probiotic (CurPro, 1 gr curcumin, and 109 CFU probiotic), or placebo along with a low-calorie diet. Participants were assessed for dietary intake, physical activity, mental health, and HRQOL before and after the study. After 8 weeks of intervention, 104 participants finished the study. The CurPro intervention reduced stress (P=0.001) and anxiety (P=0.019) and improved general health (P=0.024) and overall HRQOL (P=0.011) scores of participants in comparison with the Placebo group. Results were not significant for depression, and HRQOL subdomains such as physical functioning, role limitations due to physical problems, bodily pain, vitality, social functioning, and role limitations due to emotional problems. Curcumin-probiotics co-supplementation could improve the mental health and HRQOL of adults with overweight/obesity and MetS. Further investigations in various populations or with different dosages or durations are recommended.
Mental health social care is an emerging and evolving field of practice and research within mental health care in the UK. It recognises the significant role played by social determinants in the development of mental illness and distress, and in recovery and well-being. By considering mental health social care as a distinct health and care research system, this paper outlines key priorities for research, funding and capacity building. It argues that mental health social care should be an essential component of mental health service delivery, and calls for a move towards holistic, person-centred care that addresses the social determinants of mental health, alongside biological and psychological factors.
Hypochondriacal disorder involves persistent anxiety about suffering from an undetected serious medical condition, despite medical reassurance. Hypochondriacal disorder significantly affects social relationships, occupational functioning and personal well-being. In university settings, where mental health concerns are prevalent, insights into prevalence of hypochondriacal disorder and associations with depression and other health challenges are essential.
Aims
This study examines the prevalence and correlates of hypochondriacal disorder among Norwegian university students, focusing on its associations with depression, mental distress and somatic symptom burden.
Method
The 2022 Students’ Health and Wellbeing Study, a national survey of Norwegian higher education students, included 59 536 participants aged 18–35. Participants were categorised based on a pre-defined diagnostic list of mental and somatic concerns, and participants were grouped as follows: hypochondriacal disorder only, depression only, comorbid hypochondriacal disorder and depression and controls. Validated instruments included the Somatic Symptom Scale-8, the Hopkins Symptoms Checklist, the Satisfaction With Life Scale, an abbreviated version of the University of California, Los Angeles, Three-Item Loneliness Scale and four items on suicidal ideation.
Results
Hypochondriacal disorder was reported by 0.86% (n = 457) of participants, with 52% also reporting depression. Those with hypochondriacal disorder had significantly worse mental and somatic health outcomes, especially when comorbid with depression, including elevated distress, suicidality, insomnia and poor quality of life.
Conclusion
Although uncommon, hypochondriacal disorder is linked to severe mental and somatic health burdens, particularly when co-occurring with depression. These findings highlight the need for integrated mental health strategies in academic settings to address hypochondriacal disorder and its frequent comorbidities.
Why, What, Who, When are a set of questions, sometimes referred to as the ‘WH calibration questions’ that help interrogate a concept in terms of its application and utility. In this article these questions are used to evaluate decisions made by footballers around their mental health (MH) and wellbeing. They allow us to examine the help-seeking behaviours of footballers, such as: Why seek help? What help is available? Who to go to? When’s the right time? The article examines the psychotherapies, mainly CBT, suitable for football players and offers practical examples of how clubs have supported their players. The roles of multi-disciplinary team members involved in promoting the wellbeing of players are discussed. The content of this paper is based on a review of the literature and personal knowledge of the authors’ experiences as MH clinicians in professional football clubs.
Key learning aims
(1) To show the extent to which professional footballers experience mental health difficulties, and the nature of these problems.
(2) To highlight the thought processes of footballers during their management of their mental health.
(3) To provide a description of the therapies available to footballers, and highlighting the forms of CBT in common use.
(4) To emphasise the need for a holistic approach to MH provision, and clarify the roles of people within football clubs who provide MH support.
(5) To reflect on the need for ‘in-house’ specialist mental health input within professional football clubs.
Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Physical inactivity is recognised as a global risk factor for premature mortality and morbidity. Engaging in physical activity and reducing sedentary behaviour significantly improves both mental and physical health at all ages. Lifestyle Medicine emphasises the importance of a person-centred approach to encourage physical activity during consultations. Physical activity guidelines in the UK recommend adults to engage in at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity weekly for health benefits. Sedentary behaviour is defined as low-energy expenditure activities while awake and is an independent risk factor for ill health. Clinical and community-based interventions, including brief advice and referral to physical activity programmes, are cost-effective and improve physical activity levels. Various tools exist to assess physical activity levels and fitness in clinical settings, aiding personalised healthcare. Personalised support and health coaching techniques, such as motivational interviewing, effectively promote physical activity. Physical activity reduces the risk of long-term conditions, improves weight management, and has positive effects on metabolism and immune pathways. Supporting increased physical activity as part of Lifestyle Medicine can prevent, treat, and potentially reverse chronic health conditions.
Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Social prescribing is a personalised care approach that connects individuals to community resources for health and wellbeing. There is a rich history of social prescribing initiatives in the UK, including the Peckham experiment and the Bromley-By-Bow Centre. There are six types of social prescribing resources: physical activity, arts and crafts, nature, social support, statutory services, and education. The NHS model for social prescribing includes link workers, referral systems, workforce development, and outcome frameworks. Challenges in measuring the effectiveness of social prescribing are many: differentiating between outputs and outcomes. Economically evaluating social prescribing is complex, and robust evaluations are needed. Principles for future success emphasise quality research and multidisciplinary collaboration. A comprehensive understanding of social prescribing is crucial to unlock its full potential.
More people than ever are receiving support for mental health crises, and instances of suicide continue to grow. Mental health funding has recently increased, focusing on improving services that provide an alternative to emergency departments, such as urgent helplines and crisis cafés. However, there is a lack of literature examining the efficacy of these services, despite research suggesting they may be associated with lower hospital admission rates.
Aims
We aimed to evaluate the perspectives of people with lived experience of accessing a variety of mental health crisis services in the UK.
Method
One-to-one interviews were conducted with 25 individuals as part of a qualitative grounded theory analysis.
Results
The following themes were identified as important for recovery: more than a diagnosis (a need for person-centred care); instilling hope for the future (access to creative spaces and community); and a safe space for recovery (out-of-hours crisis cafés). Many have credited crisis cafés with saving their lives and felt there should be increased funding provided for collaboration between the National Health Service (NHS) and the third sector. Participants highlighted the need for interim support for those awaiting therapy via the NHS and continuity of care as key areas for improvement.
Conclusions
NHS services are struggling to meet the mental health needs of the population, resulting in lengthy waiting times for therapy and an over-reliance on the third sector. While crisis cafés are currently provided at a low cost and appear to result in satisfaction, policymakers must ensure they receive adequate funding and do not become overburdened.
Women from minoritised ethnic communities experience inequalities in access, experience and outcomes of psychological therapy. Understanding the factors associated with these inequalities could inform improvements to mental health services.
Aims
To explore therapists’ experiences of providing treatment to women from minoritised ethnic communities, including insights on adaptations made at the delivery, content and wider organisation levels, and to gather suggestions about potential treatment improvements.
Method
Semi-structured interviews were conducted with 13 therapists working in two National Health Service Talking Therapies for anxiety and depression services and who had experience of treating women from minoritised ethnic communities. Data were analysed using thematic analysis.
Results
Three high-order themes were identified: incorporating ethnicity and culture in the delivery of psychological therapies, challenges associated with delivering therapeutic interventions to women from minoritised ethnic groups and improvements to services that could support better access, engagement and outcomes for women from minoritised ethnic groups.
Conclusions
Findings indicate that therapists viewed cultural adaptation and cultural sensitivity as important to the delivery of appropriate care for minoritised ethnic women. Challenges to appropriate care included limited service resources, communication and language barriers, stigma and existing access and engagement inequalities. Therapists suggested that, to deliver high-quality care and optimise outcomes, improvements are required in cultural sensitivity training, flexibility of service delivery, outreach work with communities to encourage uptake and reduce stigma, support for staff and workforce diversity.
The number of people living in Palestine with mental disorders is significantly higher than the global average. Military occupation, violence and poverty contribute to collective trauma. International agencies have emphasised the need for collective action and systemic solutions. The Ministry of Health in Palestine, Medical Aid for Palestinians and the Royal College of Psychiatrists have collaborated to develop a national strategy for child and adolescent mental health, enhance psychiatric training and improve electroconvulsive therapy provision. The article details how this collaboration has demonstrated partnership and local ownership to empower Palestinian communities to make sustainable mental healthcare improvements.
Mental health conditions, particularly depression and anxiety, are highly prevalent and impose substantial health burdens globally. Despite advancements in machine learning, there is limited application of these methods in predicting common mental illnesses within community populations in low-resource settings.
Aims
This study aims to examine the prevalence and associated risk factors of common mental illnesses collectively (depression and anxiety) in a rural Bangladeshi community using machine learning models.
Method
This cross-sectional study surveyed 490 adults aged 18–59 in a rural Bangladeshi community. Depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-2) and Generalised Anxiety Disorder (GAD-2) scales. Machine learning models, including Categorical Boosting, the support vector machine, the random forest and XGBoost (eXtreme Gradient Boosting), were trained on 80% of the data-set and tested on 20% to evaluate predictive accuracy, precision, F1 score, log-loss and area under the receiver operating characteristic curve (AUC-ROC).
Results
Some 20.4% of participants experienced at least one common mental illness. Feature importance analysis identified house type, age group and educational status as the most significant predictors. SHAP (Shapley Additive exPlanations) values highlighted their influence on model outputs, and the XGBoost gain metric confirmed the importance of marital status and house type, with gains of 0.76 and 0.73, respectively. XGBoost delivered the best performance, achieving an F1 score of 71.01%, precision of 71.58%, accuracy of 71.15% and the lowest log-loss value of 0.56. The random forest had an accuracy of 78.21% and an AUC-ROC of 0.90.
Conclusions
The findings of this study suggest targeted interventions addressing housing and social determinants could improve mental health outcomes in similar rural settings. Further studies should consider longitudinal data to explore causal relationships.
Studies conducted during the COVID-19 pandemic found high occurrence of suicidal thoughts and behaviours (STBs) among healthcare workers (HCWs). The current study aimed to (1) develop a machine learning-based prediction model for future STBs using data from a large prospective cohort of Spanish HCWs and (2) identify the most important variables in terms of contribution to the model’s predictive accuracy.
Methods
This is a prospective, multicentre cohort study of Spanish HCWs active during the COVID-19 pandemic. A total of 8,996 HCWs participated in the web-based baseline survey (May–July 2020) and 4,809 in the 4-month follow-up survey. A total of 219 predictor variables were derived from the baseline survey. The outcome variable was any STB at the 4-month follow-up. Variable selection was done using an L1 regularized linear Support Vector Classifier (SVC). A random forest model with 5-fold cross-validation was developed, in which the Synthetic Minority Oversampling Technique (SMOTE) and undersampling of the majority class balancing techniques were tested. The model was evaluated by the area under the Receiver Operating Characteristic (AUROC) curve and the area under the precision–recall curve. Shapley’s additive explanatory values (SHAP values) were used to evaluate the overall contribution of each variable to the prediction of future STBs. Results were obtained separately by gender.
Results
The prevalence of STBs in HCWs at the 4-month follow-up was 7.9% (women = 7.8%, men = 8.2%). Thirty-four variables were selected by the L1 regularized linear SVC. The best results were obtained without data balancing techniques: AUROC = 0.87 (0.86 for women and 0.87 for men) and area under the precision–recall curve = 0.50 (0.55 for women and 0.45 for men). Based on SHAP values, the most important baseline predictors for any STB at the 4-month follow-up were the presence of passive suicidal ideation, the number of days in the past 30 days with passive or active suicidal ideation, the number of days in the past 30 days with binge eating episodes, the number of panic attacks (women only) and the frequency of intrusive thoughts (men only).
Conclusions
Machine learning-based prediction models for STBs in HCWs during the COVID-19 pandemic trained on web-based survey data present high discrimination and classification capacity. Future clinical implementations of this model could enable the early detection of HCWs at the highest risk for developing adverse mental health outcomes.
This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic.
Methods
A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm’s Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn’s test was then applied to determine whether groups differed from each other.
Results
On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions.
Conclusions
Despite high compassion satisfaction, most surveyed health care providers from Ecuador’s public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.
Perinatal mental health disorders affect more than one in five people and obstetrician/gynecologists (Ob/Gyns) are the primary providers for women during the reproductive years when there is increased risk of psychiatric morbidity. Therefore, Ob/Gyns are charged with screening and treating these disorders. Despite the availability of effective strategies for detection and treatment, perinatal mental health disorders are underrecognized and undertreated, and have significant detrimental maternal and infant consequences. Obstetrician/gynecologists should be prepared to counsel patients on the benefits and risks of psycho-pharmacotherapy, initiate psycho-pharmacotherapy, and refer patients to appropriate resources when indicated. A validated screening tool should then be used to monitor for response to treatment or remission of symptoms. Psychotherapy should be considered a first-line treatment for mild-to-moderate perinatal depression and selective serotonin reuptake inhibitors be used as first-line pharmacotherapy for perinatal depression and anxiety. Pharmacotherapy should be individualized based on prior response to therapy and optimal dosing established to avoid undertreatment. The risks associated with inadequately treated mental health conditions as well as the perinatal risks associated with psychopharmacologic agents must be addressed. Furthermore, a discussion about duration of treatment, need for long term follow-up, and considerations for future pregnancy is needed.
This study exploratively analyzed the associations of well-being with psychological characteristics, socioeconomic status (SES), and the number of relocations after the Fukushima nuclear disaster.
Methods
Using a cross-sectional study design, an online questionnaire survey was administered to 416 residents of Fukushima and Tokyo each aged 20-59 years (832 in total) between August 25 and 26, 2018, which was 7 and a half years after the disaster. Categorical factor analysis and multiple regression analysis were performed to investigate associations of 5 well-being scales (positive emotion, negative-free emotion, life satisfaction and general happiness, positive characteristics, and positive functioning) with psychological characteristics, SES, and the number of relocations.
Results
Four of the well-being scales, except for negative-free emotion, were strongly associated with each other and showed similarities in the strength of their associations with psychological characteristics and SES. Among the items surveyed, psychological distress, mindfulness, and marital status were strongly associated with well-being among Fukushima residents. Contrarily, radiation risk perception or the number of relocations were not significantly associated with well-being.
Conclusions
Focusing on psychological distress is expected to have a significant impact on improving well-being after the disaster. In addition, assistance in avoiding unintended family separation may be helpful.
Childhood bereavement is a public health issue with significant mental health implications, including depression, intrusive grief, and suicidality. Theories suggest that children’s malleable processes, like coping and subjective views of themselves and their environment, influence adaptation to bereavement. Protective processes may mitigate mental health risks, while risk processes may exacerbate them. Using a sample of support-seeking, parentally-bereaved children (8–16 years; M = 11.39, SD = 2.43; 53% male; 67% White), this study employs latent profile analysis to identify baseline patterns of coping and subjective views; and examines how profile membership predicts depression symptoms, intrusive grief, and suicidality at 14-month and six-year assessments. Three profiles were identified: Low Protective-High Risk (34%), High Protective-Low Risk (23%), and High Protective-High Risk (43%). Profile membership predicted depression symptoms. Children in the Low Protective-High Risk profile showed higher depression symptoms than those in the other profiles 14-months later, while children in the High Protective-Low Risk profile unexpectedly showed higher depression symptoms six-years later compared to those in the Low Protective-High Risk profile. Profile membership did not predict intrusive grief or suicidality. Findings underscore the importance of person-centered approaches in understanding adaptation following parental death and raise questions about the association between baseline childhood protective processes and long-term depression symptoms.
Recent changes in US government priorities have serious negative implications for science that will compromise the integrity of mental health research, which focuses on vulnerable populations. Therefore, as editors of mental science journals and custodians of the academic record, we confirm with conviction our collective commitment to communicating the truth.