Effect of Seclusion on Mental Health Status in Hospitalized Psychiatric Populations: A Trial Emulation using Observational Data.

The use of coercive practices, i.e., interventions against a person's will, is controversial. Recent observational studies highlighted their potential detrimental effects on patients' mental health, but this topic remains understudied. This study investigated the effect of a common coercive practice, seclusion (i.e., being locked in a closed room), on mental health using a trial emulation of observational data to allow causal inference. We used data from 1200 psychiatric inpatients, classified as being either secluded or non-secluded during their hospital stay. Inverse probability of treatment weighting was used to emulate the random assignment to the intervention. The primary outcome was the Health of the Nations Outcome Scales (HoNOS). The secondary outcome was the first item of the HoNOS, which focuses on overactive, aggressive, disruptive, or agitated behavior. Both outcomes were assessed at hospital discharge. There was a significant effect of seclusion with increases in both total HoNOS score (p = .002) and item 1 of the HoNOS (p = .01). Seclusion may have a negative causal effect of patients' mental health status and should therefore be avoided in mental health care settings. Training efforts should raise the awareness of the medical staff about potential adverse effects instead of therapeutic benefits

Extração de cumarinas de Pterocaulon balansae (Asteraceae)

O gênero Pterocaulon (Asteraceae) apresenta uma série de atividades biológicas que são atribuídas aos seus metabólitos secundários majoritários, as cumarinas. Considerando relatos da medicina popular, nos quais plantas deste gênero são utilizadas na forma de infusão ou decocto, procurou-se verificar se estes compostos majoritários seriam extraídos com a água. Sendo assim, o objetivo do trabalho foi verificar a possibilidade de extração de cumarinas de Pterocaulon balansae em meio aquoso, avaliar a influência da temperatura neste processo de extração e ainda analisar o perfil químico e quantificar as cumarinas totais de P. balansae nos extratos n-hexano e diclorometano. Para a realização da extração aquosa, o material vegetal seco e triturado foi submetido à extração em banho de recirculação de água em diferentes temperaturas (15 °C, 25 °C, 40 °C, 60 °C, 80 °C e 100 °C). A proporção de planta:solvente foi de 1:30 e o tempo de extração foi de 1 hora. Já para as extrações com solventes orgânicos, o material vegetal seco e triturado foi submetido à maceração, sendo que a proporção planta:solvente foi de 1:30 e realizou-se a extração até o esgotamento. A caracterização dos extratos foi realizada por Cromatografia Líquida de Alta Eficiência (CLAE), em aparelho equipado com detector de arranjo de diodos que registra espectros de UV no intervalo de 230 - 400 nm. Dessa maneira, foi possível concluir que a água, sendo utilizada como solvente nas preparações de uso medicinal, mostrou-se capaz de extrair as cumarinas presentes nas partes aéreas de Pterocaulon balansae e observou-se que em temperaturas mais elevadas ocorre um aumento no teor de extrato seco e uma maior extração destes compostos. Em relação ao perfil químico dos extratos n-hexano e diclorometano, observou-se que ambos são semelhantes, com o predomínio de cumarinas mais apolares e o líquido extrator n-hexano foi o que extraiu maior quantidade de cumarinas

A Nationwide Study of Inpatient Case Rate Incidence of Cannabis-Related Diagnoses in Switzerland.

Objectives: Cannabis is the most commonly used illicit substance and has been associated with mental health issues. In this study, we examined trends in hospitalizations due to cannabis use. Methods: Data were obtained from the Swiss Federal Statistics Office and comprised hospital main diagnoses, gender, age group and region of all psychiatric inpatient cases in Switzerland from 1998 to 2020. We performed trend analyses of annual case rates with cannabinoid-related diagnoses and compared them to trend analyses of alcohol-related and psychotic disorders. Results: Case rates of CRDs significantly increased in the observed time period. From all psychiatric main diagnoses, CRDs were overrepresented in the age groups of 15-24 and 25-44 years. Conclusion: We found a sharp increase in hospitalizations for CRD. Future studies should test whether changes in the upcoming cannabis regulation, which can facilitate the implementation of interventions to address mental health among users, impact future hospitalization rates of CRD

Concurrent and simultaneous polydrug use among young Swiss males: use patterns and associations of number of substances used with health issues

Background: Simultaneous polydrug use (SPU) may represent a greater incremental risk factor for human health than concurrent polydrug use (CPU). However, few studies have examined these patterns of use in relation to health issues, particularly with regard to the number of drugs used. Methods: In the present study, we have analyzed data from a representative sample of 5734 young Swiss males from the Cohort Study on Substance Use Risk Factors. Exposure to drugs (i.e., alcohol, tobacco, cannabis, and 15 other illicit drugs), as well as mental, social and physical factors, were studied through regression analysis. Results: We found that individuals engaging in CPU and SPU followed the known stages of drug use, involving initial experiences with licit drugs (e.g., alcohol and tobacco), followed by use of cannabis and then other illicit drugs. In this regard, two classes of illicit drugs were identified, including first uppers, hallucinogens and sniffed drugs; and then "harder” drugs (ketamine, heroin, and crystal meth), which were only consumed by polydrug users who were already taking numerous drugs. Moreover, we observed an association between the number of drugs used simultaneously and social issues (i.e., social consequences and aggressiveness). In fact, the more often the participants simultaneously used substances, the more likely they were to experience social problems. In contrast, we did not find any relationship between SPU and depression, anxiety, health consequences, or health. Conclusions: We identified some associations with SPU that were independent of CPU. Moreover, we found that the number of concurrently used drugs can be a strong factor associated with mental and physical health, although their simultaneous use may not significantly contribute to this association. Finally, the negative effects related to the use of one substance might be counteracted by the use of an additional substanc

Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues

Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purpose

Evaluation of a brief universal suicide prevention programme in young people: a cluster-controlled trial in Swiss schools.

AIMS OF THE STUDY Suicide is one of the leading causes of death in young people. Therefore, suicide prevention in this age group is a public health priority. There is increasing evidence of the efficacy of suicide prevention programmes, but robust empirical studies are still needed. More precisely, data are needed for school-aged children, brief interventions and distal outcomes such as psychological distress or suicidal thoughts. In addition, to our knowledge, no study has yet scientifically evaluated a brief universal suicide prevention programme in Switzerland. This study investigated the efficacy and acceptability of a brief universal suicide prevention programme for school-aged youths. Primary outcomes included knowledge on suicide, perceived suicide awareness and knowledge of help-seeking resources. Secondary outcomes included acceptability coping skills, suicide-related behaviours and psychological distress. METHODS This non-randomised cluster-controlled trial was conducted in Swiss schools. A 90-minute workshop for universal suicide prevention was delivered to the intervention group (n = 209), and the control group had no intervention (n = 96). Measures were assessed at baseline and after one month. Acceptability was assessed at follow-up in the intervention group only. Data were analysed using three-level mixed effect models with an interaction term between group and time. RESULTS There were interaction effects between group and time for most outcomes: perceived suicide awareness (p 0.388). Participants found the workshop enjoyable, not upsetting, and worthwhile. CONCLUSIONS This study suggested that a brief suicide prevention programme could be beneficial and safe for school-aged youths. This brief programme may contribute to suicide prevention efforts

Is the Relationship Between Major Depressive Disorder and Self-Reported Alcohol Use Disorder an Artificial One?

Aims: Many studies have suggested a close relationship between alcohol use disorder (AUD) and major depressive disorder (MDD). This study aimed to test whether the relationship between self-reported AUD and MDD was artificially strengthened by the diagnosis of MDD. This association was tested comparing relationships between alcohol use and AUD for depressive people and non-depressive people. Methods: As part of the Cohort Study on Substance Use Risk Factors, 4352 male Swiss alcohol users in their early twenties answered questions concerning their alcohol use, AUD and MDD at two time points. Generalized linear models for cross-sectional and longitudinal associations were calculated. Results: For cross-sectional associations, depressive participants reported a higher number of AUD symptoms (β = 0.743, P Conclusion: MDD thus appeared to be a confounding variable in the relationship between alcohol use and AUD, and self-reported measures of AUD seemed to be overestimated by depressive people. This result brings into question the accuracy of self-reported measures of substance use disorders. Furthermore, it adds to the emerging debate about the usefulness of substance use disorder as a concept, when heavy substance use itself appears to be a sensitive and reliable indicator

Feasibility of home-based ELISA capillary blood self-testing for anti-SARS-CoV-2 antibodies.

Objectives Serological assays for the presence of anti-SARS-CoV-2 antibodies are crucially needed for research and monitoring of the SARS-CoV-2 pandemic. Antibodies are reliability detected in capillary blood, a minimally invasive and cost-effective alternative to venous blood testing. However, there is a limited knowledge on feasibility of capillary blood self-sampling. This study compared the feasibility of capillary blood self-testing in people aged less than 65 vs. people aged 65 or more. A secondary aim was to investigate the performance of the Hem-Col® (no additive) device compared to venous blood testing. Design and methods Data were collected in a prospective study in Switzerland (n = 106). Capillary blood was collected using the Hem-Col® (no additive) device. Feasibility was assessed using 1) collecting the recommended amount of capillary blood and 2) achieving all steps of capillary blood collection. A sample of 5 ml of venous blood was also collected. Results For the primary objective, 86.2%/62.1% of patients aged less than 65 collected the recommended amount of capillary blood/achieved all steps vs. 62.5%/39.6% of patients aged 65 or more (p = .006/p = .022). For the secondary objective, the correlation between capillary and venous blood was r = 0.992 and kappa = 1. Conclusions Capillary blood self-testing appeared as a feasible and reliable alternative to venous blood testing. Such alternative would improve access to serological testing and spare health care resources. However, the difference between age groups should be considered when using self-sampling devices. Help should be developed for older people, such as phone counseling or encouraging asking younger family members for help

Domestic homicide and other violent crimes: The same or different phenomena?

This study investigated correlates of domestic homicide (DH) and other violent crimes. Data were collected retrospectively from criminal justice files on 617 persons in Switzerland (DH = 47). Multinomial logistic regressions revealed that, overall, DH perpetrators were more likely to be older, female, married, to have a psychiatric hospitalization history, and to be under the influence of delusions when they committed the crime. In addition, they were less likely to have prior convictions. Furthermore, the characteristics associated to DH perpetrators were more similar to domestic violence perpetrators than those of persons who committed nondomestic offenses. Based on the current sample, data, and methods, DH appears to be better explained by specialist theories than generalist views of crime, suggesting that DH and the homicide of non-family members are different phenomena. Therefore, domestic offenders may require specific assessment and intervention methods. However, replications of this study are necessary to generalize the current findings

Longitudinal trajectories of mental health problems and their association with reoffending in a Dutch pre-trial prison cohort.

The burden of mental health problems in detained persons is high. At the same time, mental health problems are discussed as possible predictors of criminal recidivism. During detention, mental health tends to improve. The aims of the study were twofold: First, to identify group-based trajectories of mental health problems over the course of detention; second, to test the association between trajectories and criminal recidivism. A prospective cohort of 1,904 adult males detained in Dutch pre-trial detention facilities was assessed at three time points after imprisonment (week 3, month 3, and month 9). Mental health problems were measured using the Brief Symptom Inventory. Recidivism was defined as reconviction and re-incarceration up to 18 months post-release. We used group-based trajectory modeling and logistic regressions for the analyses. On average, self-reported mental health improved during incarceration. Two distinct groups of mental health trajectories were identified: The majority (81%) reported relatively low levels of mental health problems, remaining stable over time. A small group (19%) reported high distress after prison entry with improvements over time. Older age, pre-existing functional impairment due to alcohol or drug use, diagnosis of psychiatric disorders, debts, use of psychiatric care during detention, and a more severe experience of detention were associated with membership in the second group. Group membership did not predict reoffending. The study confirms prior findings illustrating a generally positive change in mental health symptoms during detention. The course of mental health was associated with pre-existing socio-demographic and psychological characteristics that seem worthy to be considered in correctional treatment plans. Changes in mental health did not result in better legal outcomes. An interesting avenue for future research would be to examine changes in specific mental health symptoms or disorders in relation to recidivism risk