The world is grappling with a mental health crisis. In Europe, antidepressant consumption has more than doubled in the last 20 years.The husband of a Watford woman who died by suicide hopes a menopause event will help others in similar situations.Blackburn ranked second for Samsung S21 searches and 10th for PlayStation 5, while Preston topped the PS5 and Nintendo Switch lists.

“We are ready to provide Italy with a government that can competently and consciously tackle our present-day challenges and emergencies,” said Meloni.In a cluster randomized controlled trial, Shulin Chen and colleagues investigate whether integrated care management of depression and hypertension leads to greater improvements as compared to usual care in older adults attending rural Chinese primary care clinics.Despite growing awareness that children and teenagers can get depressed, substantial gaps remain in diagnosis and treatment. Despite growing awareness that children and teenagers can get depressed, substantial gaps remain in diagnosis and treatment.

Trends in psychotropic drug consumption among French military personnel during the COVID-19 epidemic

Background The coronavirus disease (COVID-19) pandemic may have had significant mental health consequences for military personnel, which is a population already exposed to psychological stress. To assess the potential impact of the COVID-19 pandemic, we analyzed the dispensing of three classes of psychotropic drugs (anxiolytics, hypnotics, and antidepressants) among French military personnel. Methods A retrospective analysis was conducted using the individualized medico-administrative data of persons insured by the National Military Social Security Fund from the National Health Data System. All active French military personnel aged 18–64 who received outpatient care and to whom drugs were dispensed between January 1, 2019, and April 30, 2021, were included from the French national health database. Rate ratios of dispensed anxiolytics, hypnotics and antidepressants (based on drug reimbursement) were estimated from negative binomial regressions before and after the start of the COVID-19 pandemic. Results Three hundred eighty-one thousand seven hundred eleven individuals were included. Overall, 45,148 military personnel were reimbursed for anxiolytics, 10,637 for hypnotics, and 4328 for antidepressants. Drugs were dispensed at a higher rate in 2020 and 2021 than in 2019. There was a notable peak at the beginning of the first lockdown followed by a decrease limited to the duration of the first lockdown. During the first lockdown only, there were temporary phenomena including a brief increase in drug dispensing during the first week followed by a decrease during the rest of lockdown, possibly corresponding to a stocking-up effect. For the study period overall, while there was a significant downward trend in psychotropic drug dispensing before the occurrence of COVID-19 (p < 0.001), the pandemic period was associated with an increase in dispensed anxiolytics (rate ratio, 1.03; 95% CI, 1.02–1.04, p < 0.05), hypnotics (rate ratio, 1.13; 95% CI, 1.11–1.16, p < 0.001) and antidepressants (rate ratio, 1.12; 95% CI, 1.10–1.13, p < 0.001) in the military population. Conclusions The COVID-19 pandemic has probably had a significant impact on the mental health of French military personnel, as suggested by the trends in dispensed psychotropic drugs. The implementation of mental health prevention measures should be investigated for this population.Antidepressant drug trials typically exclude those who need help most. Now regulators and some researchers are asking if there needs to be a change in how these drugs are tested.Researchers question use of antidepressants, prescribed to one in six UK adults. Is it time for obesity to be treated as a mental-health concern? Is it time for obesity to be treated as a mental-health concern?.

Disrupted sleep patterns affect mental health, and researchers now hope that repairing circadian rhythms could ease symptoms. Disrupted sleep patterns affect mental health, and researchers now hope that repairing circadian rhythms could ease symptoms.Background Most adults fail to achieve remission from common mental health conditions based on pharmacological treatment in primary care alone. There is no data synthesising the reasons. This review addresses this gap through a systematic review and thematic synthesis to understand adults’ experiences using primary care for treatment-resistant mental health conditions (TRMHCs). We use the results to produce patient-driven recommendations for better support in primary care. Methods Eight databases were searched from inception to December 2020 for qualitative studies reporting research on people’s experience with TRMHCs in primary care. We included the following common mental health conditions defined by NICE: anxiety, depression, panic disorder, post-traumatic stress, and obsessive-compulsive disorder. Two reviewers independently screened studies. Eligible studies were analysed using an aggregative thematic synthesis. Results Eleven studies of 4456 were eligible. From these eleven studies, 4 descriptive themes were developed to describe a cycle of care that people with TRMHCs experienced in primary care. In the first stage, people preferred to self-manage their mental health and reported barriers that prevented them from seeing a GP (e.g., stigma). People felt it necessary to see their GP only when reaching a crisis point. In the second stage, people were usually prescribed antidepressants, but were sceptical about any benefits they had to their mental health. In the third stage, people self-managed their mental health (e.g., by adjusting antidepressant dosage). The fourth stage described the reoccurrence of mental health and need to see a GP again. The high-order theme, ‘breaking the cycle,’ described how this cycle could be broken (e.g., continuity of care). Conclusions People with TRMHCs and GPs could break the cycle of care by having a conversation about what to do when antidepressants fail to work. This conversation could include replacing antidepressants with psychological interventions like talking therapy or mindfulness.The newest antidepressants may help improve depression symptoms that don’t respond to SSRIs or other treatments. Get the details here.This guide will help you understand mental health services in Portugal and provide you with insights into prevention.

Menopausal depression takes a huge toll, but is underfunded and under-researched — that needs to change. Menopausal depression takes a huge toll, but is underfunded and under-researched — that needs to change.Scientists are gaining a better understanding of women’s midlife depression.Sasha, a 26-year-old animal behaviorist from Moscow, had seen a steady improvement in her mental health over the last three years.  Thanks to her passion for her job and rigorous micro-management of her medication, she was able to build a successful blog with a 27,000-strong audience and shake off a depression that plagued her from 2016-2018.  All of that progress was erased on Feb. 24, when Russian tanks rolled over the Ukrainian border.  “In total, I’ve relapsed.Science is only now uncovering the complex interaction between hormones, neurosteroids and mood disorders. Science is only now uncovering the complex interaction between hormones, neurosteroids and mood disorders.

What Are Vegetative Symptoms in Depression?

Vegetative symptoms refer to the more physical changes caused by depression. This includes trouble sleeping, low energy levels, and focus problems. Income changes probably impact mental health, particularly where they move individuals
out of poverty, although effect sizes are modest and certainty low. Effects are larger
for wellbeing outcomes, and potentially for income losses. To best support population
mental health, welfare policies need to reach the most socioeconomically disadvantaged.

Importance of recognizing mental health

10th October is World Mental Health Day; this year’s campaign is centred around “Making Mental Health & Well-Being for All a Global Priority”. Throughout this blog, we will discuss the importance of recognising mental health, touch on the impact of the COVID-19 pandemic, and finally take a closer look at bipolar disorder and depression, discussing how Real-World Evidence can be used to improve knowledge and outcomes for patients.

Prior to the pandemic, it was estimated that 1 in 8 people globally were living with a mental health disorder. During the pandemic, we saw large scale disruption to health systems across the globe exacerbating the already short supply of mental health services and creating a global crisis. Not only were existing services limited, but the WHO estimates that anxiety and depressive disorders increased by 25% globally during the first year of the pandemic, increasing the mental health crisis even further as more people require help and support. By the middle of 2020, one in five people in the UK were suffering from depression, twice the number in 2019, according to data released by the Office for National Statistics (ONS 2021) with women, aged 18-30 years old, people with pre-existing mental or physical health problems, those living in deprived areas, and ethnic minority communities most affected.

Mental health in the UK

While this blog intends to focus on bipolar disorder and depression, there are many other types of mental disorders. Mental disorders are often characterised by clinically significant disturbances in cognition, emotional regulation, or behaviour (WHO), such as but not limited to; anxiety, post-traumatic stress disorder (PTSD) and schizophrenia. In the UK, Mind, the mental health charity, estimate that 1 in 4 people will experience a mental health problem of some kind each year with mixed anxiety and depression being the most common. In any given week, 3 in 100 people will be diagnosed with depression and 2 in 100 people in their lifetime will receive a diagnosis for bipolar disorder. When looking at treatments for mental disorders, potentially as low as 1 in 8 are currently receiving any form of treatment. Mental health problems represent one of the single largest causes of disability in the UK (NHS England). This combined with the low treatment rate and high numbers of people diagnosed with mental health disorders are suggestive of a significant level of unmet need.

What are depression and bipolar disorder?

A depressive episode is very different to the short-lived emotional responses and usual mood fluctuations experienced during the challenges of everyday life. When in a depressive episode, a person not only experiences a depressed mood with feelings of sadness, irritability, emptiness, but also loss of pleasure or any interest in activities, nearly every day for at least two weeks. Alongside the depressed feelings and lack of interest, other symptoms present such as poor concentration, feelings of guilt, low self-worth, thoughts of self-harm, disrupted sleep, and appetite changes. The thoughts and feelings while in a depressive episode can be crippling and lead to an increased risk of suicide (WHO).

In bipolar disorder people experience alternating depressive episodes with periods of manic symptoms. The depressive episodes follow the same pattern and symptoms as depression more generally. Meanwhile manic symptoms are almost opposite in nature with people experiencing euphoria, increased energy, racing thoughts, increased self-esteem, decreased need for sleep, and impulsive reckless behaviour. Similar to depression, bipolar disorder also increases the risk of suicide (WHO).  Bipolar increases an individual’s risk of suicide by up to 20 times (Bipolar UK).

Treatment challenges

Whilst our understanding of these disorders has progressed including our understanding of the pathophysiology, there is still a large unmet need when it comes to finding effective treatment options. Antidepressants are the first line treatment for depression, and a large network meta-analysis showed the beneficial effects over placebo. However, a proportion of depressed patients do not reach remission. The STAR*D study showed that remission rates were lower for each subsequent treatment for depression, with only around 30% of patients responding to the first antidepressant and around two thirds of patients reaching full remission by the end of the study.

Individuals with bipolar disorder suffer from a multifaceted and unpredictable course of their disease characterised by manic or depressive symptoms. Mood stabilisers are the main treatment for bipolar disorder. Despite following treatment, patients are at high relapse risk. In fact, between 40% and 60% of patients with bipolar disorder who are treated with mood stabilisers relapse within 1-2 years with repeated relapses causing a downward spiral in quality of life.

Understanding potential mechanisms of action or treatment pathways that may be effective in preventing or treating both depression and bipolar disorder could help address the unmet need for effective treatment options.

Real World Evidence and Mental Health

The use of real-world data to better understand treatment pathways and unmet need in psychiatry is of growing importance to healthcare systems. The challenge we face in using real world data to address the unmet need in mental health disorders is that the most valuable data in electronic health records exists in psychiatrist notes in the form of unstructured, free-text data, and as such, are typically omitted from most databases (as they typically report only structured data). Whilst the structured data can provide real quantitative insights and projections, the richness of the unstructured data can provide context and valuable insights to a patient’s condition and quality of life and allows tailoring interventions to patient’s specific needs, therefore optimising the outcomes. Using structured data, we can define cases and controls based on the number of diagnostic codes they have for a certain disorder in combination with prescriptions of certain medications, or by excluding certain diagnostic codes due the overlap with the disease of interest (such as with depression and anxiety). The disadvantage is that there would be a risk of misclassification due to the diagnostic codes primarily being used for billing purposes rather than research purposes or due to differences in coding practices. However, when incorporating the unstructured data, one can use symptom level and outcomes related data to enhance the phenotypic precision. It has been shown that incorporating unstructured data significantly improves the accuracy of case detection above and beyond coded data alone. Most of the research using unstructured data has been done in US based hospital EMR databases.

To address this challenge within the UK, IQVIA is partnering with Akrivia Health, the world’s largest and most in-depth dataset focused on mental health to enhance real world evidence generation. Using artificial intelligence and natural language processing, we can access de-identified patient data containing end-to-end clinical pathways and cover each interaction and intervention that takes place between a patient and their clinician. Information is sourced from multiple Electronic Patient Records and comprises clinical notes patient histories, admission and discharge documents and clinical assessments.

By partnering with Akrivia Health to leverage their unique mental health dataset, IQVIA can use real world data to add value to every stage of the drug development and commercialization lifecycle to enable our customers to accelerate research within the mental health setting.

For more information, contact Rachel Armstrong: [email protected] or Akrivia Health: [email protected]

. Background While medicalization and pharmaceuticalization trends of feelings of anxiety and depression have been described in great detail, an empirical examination of these trends is to date lacking. The current study fills this gap in the literature by mapping the use of psychotropic medicines for feelings of anxiety and depression between 2004 and 2013 in Belgium, as well as by examining whether a social gradient might act as a mediator. Methods We analyzed data from three repeated cross-sectional waves (2004, 2008, and 2013) of the Belgian National Health Interview Survey (HIS). Multinomial logistic regression was applied to estimate odds in psychotropic drugs use over the observed period. Results Using an ideal-typical distinction between traditional anxiety drugs (psycholeptics) and depression drugs (psychoanaleptics), we found that treatment methods for feelings of anxiety and depression were converging. Persons having feelings of anxiety consumed less psycholeptic drugs, in favor of psychoanaleptic drugs throughout the observed period. Moreover, these results were partially mediated by educational level. Persons with higher education were less likely to consume psychotropic drugs than those with lower education, suggesting a trend of demedicalization for feelings of anxiety and depression. Limitations Our study observes a limited period, makes use of an ideal typical distinction between psycholeptic and psychoanaleptic drugs, and measurements may be biased by response-bias due to psychotropic drugs use. Conclusion Our study shows that psycholeptics increasingly give way to psychoanaleptics in the treatment of both anxiety and depression, despite several scientists calling their effectiveness for both disorders into question.This chart shows the cost of mental health as a percentage of GDP in Europe.

With mental health issues growing across Europe, psychedelics research and therapy are entering EU policymaking after having shown promising results for treating disturbs such as depression, PTSD, and anxiety.Neurogenesis can halt depressive symptoms or prevent them from emerging. Harnessing this phenomenon could open up treatment options. Neurogenesis can halt depressive symptoms or prevent them from emerging. Harnessing this phenomenon could open up treatment options.Classic psychedelic research is rapidly expanding. The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

A deep dive into clinical efficacy and safety of using psychedelic-assisted therapy for depression, anxiety, PTSD, substance use disorder, and other mental health disorders. We deserve a fuller picture of both the benefits and dangers of antidepressants. We’re interested to hear from UK healthcare professionals about their experience of mental health services for people with depression and anxiety since society opened up again. Q&A with Martin Price, vice president of Health Economics, Market Access and Reimbursement in Europe, Middle East and Africa at the Janssen Pharmaceutical Companies of Johnson & Johnson. Depression is disabling and highly prevalent. Intravenous (IV) ketamine displays rapid-onset antidepressant properties, but little is known regarding which patients are most likely to benefit, limiting personalized prescriptions. We identified randomized controlled trials of IV ketamine that recruited individuals with a relevant psychiatric diagnosis (e.g., unipolar or bipolar depression; post-traumatic stress disorder), included one or more control arms, did not provide any other study-administered treatment in conjunction with ketamine (although clinically prescribed concurrent treatments were allowable), and assessed outcome using either the Montgomery-Åsberg Depression Rating Scale or the Hamilton Rating Scale for Depression (HRSD-17). Individual patient-level data for at least one outcome was obtained from 17 of 25 eligible trials [pooled n = 809]. Rates of participant-level data availability across 33 moderators that were solicited from these 17 studies ranged from 10.8% to 100% (median = 55.6%). After data harmonization, moderators available in at least 40% of the dataset were tested sequentially, as well as with a data-driven, combined moderator approach. Robust main effects of ketamine on acute [~24-hours; β*(95% CI) = 0.58 (0.44, 0.72); p < 0.0001] and post-acute [~7 days; β*(95% CI) = 0.38 (0.23, 0.54); p < 0.0001] depression severity were observed. Two study-level moderators emerged as significant: ketamine effects (relative to placebo) were larger in studies that required a higher degree of previous treatment resistance to federal regulatory agency-approved antidepressant medications (≥2 failed trials) for study entry; and in studies that used a crossover design. A comprehensive data-driven search for combined moderators identified statistically significant, but modest and clinically uninformative, effects (effect size r ≤ 0.29, a small-medium effect). Ketamine robustly reduces depressive symptoms in a heterogeneous range of patients, with benefit relative to placebo even greater in patients more resistant to prior medications. In this largest effort to date to apply precision medicine approaches to ketamine treatment, no clinical or demographic patient-level features were detected that could be used to guide ketamine treatment decisions. Review Registration: PROSPERO Identifier: CRD42021235630.