Abstract
The March issue of the International Journal of Psychiatry in Medicine includes several studies examining psychiatric disorders in primary care settings, among university students, and in community-dwelling adults in Vietnam, Russia, and Ireland, several of which were conducted during the COVID-19 pandemic. Articles also address issues related to COVID-19 vaccination in adolescents with ADHD and among patients hospitalized in forensic psychiatric units, as well as psychotropic medication dispensing patterns before and after COVID-19. All seven of these articles involve original data-based research relevant to medical and psychiatric settings. A call for papers will also be announced for future issues targeting depression in the medically ill, moral injury, and chronic pain.
The first article in this issue addresses the prevalence and predictors of depressive disorders among 512 primary care patients seen in Ho Chi Minh, Vietnam. Nearly one in six patients have a depressive disorder, of whom more than half fulfill criteria for a major depressive disorder. Minority ethnic background and low socioeconomic status were significant predictors of depressive disorder. Only 2.5% of cases were detected by primary care physicians, causing the authors to recommend screening for depression in such clinics.
The next article examines changes in drinking motivation among 198 undergraduate students at a Northeastern U.S. university prior to and after onset of the COVID-19 pandemic, particularly after the onset of closures and stay-at-home orders. Results indicated that social and conformity motives for drinking significantly decreased, while motives related to coping with stress significantly increased from before to after the onset of COVID-19. Changes in enhancement and coping motives were significantly associated with increases in alcohol use, prompting the study’s authors to suggest that policies should be put in place to enhance student coping during the pandemic to address escalating alcohol use by students.
In the third article, researchers examine the prevalence and correlates of somatic and psychological distress during COVID-19 among 1236 Russian university students from several regions across Russia (conducted about a year prior to Russia’s invasion of the Ukraine). They found high rates of somatic burden (72%), depression (55%), anxiety (63%), and stress (55%), affecting the majority of students. Those at greatest risk were women and students who had contracted COVID-19, causing authors to recommend that targeted psychoeducation and preventative measures be taken to reduce student distress during the pandemic.
The next article examines the prevalence of ADHD among 634 adult psychiatric patients screened for ADHD at mental health clinics in Ireland. Of the 131 patients who screened positive, 110 agreed to undergo a structured psychiatric interview and clinical evaluation to confirm ADHD. Approximately 17% of participants met diagnostic criteria for adult ADHD. Only 3 cases (about 3%) were diagnosed with ADHD prior to evaluation. Comorbidity was high among those with ADHD, especially diagnoses of depression. Researchers concluded that a relatively high rate of undiagnosed ADHD was found among mental health patients in Ireland, emphasizing the importance of screening and ensuring appropriate treatment.
The fifth article examines COVID-19 vaccine compliance among 8241 adolescents with ADHD in Israel. Overall, 61% were vaccinated. Researchers found that older adolescents (ages 16-17, 60%) were more likely to be vaccinated then younger adolescents (ages 12-15, 49%). Adolescents least likely to be vaccinated were ultra-Orthodox Jewish (23%) and Arabs (35%). Authors recommended that vaccination efforts focus on younger adolescents, especially those from ultra-Orthodox Jewish and Arab faith traditions.
The sixth article examines correlates of COVID-19 vaccination among 229 inpatients at two Missouri forensic psychiatry hospitals in 2021. Data were collected by retrospective chart review of electronic medical records. Researchers found that 85% were vaccinated against COVID-19. Patients less likely to be vaccinated were those deemed incompetent to stand trial, whereas those more likely to receive the vaccine were patients with a higher body mass index, diagnosed with multiple comorbid conditions, not prescribed involuntary medications, those offered incentives, and those receiving the influenza vaccine. The authors concluded that this information may be useful when educating and offering COVID-19 vaccines to forensic psychiatry patients.
The last article in this issue examines medication dispensing patterns in Alberta, Canada, before and during the COVID-19 pandemic concerning 46 medications prescribed for mental health problems. Overall, dispensing rates for all medications were similar before and after the onset of COVID-19. However, eight medications (amitriptyline, escitalopram, fluoxetine, paroxetine, bupropion, desvenlafaxine, venlafaxine, and oxazepam, i.e., primarily antidepressant and anti-anxiety agents) showed a significant increase in dispensing rates after the onset of the pandemic that persisted for at least 13 months. Based on these findings, the authors concluded that a sustained higher level of prescribing may indicate a worsening of mental health, and that medication-dispensing patterns might be a useful indicator of population health during the present pandemic and also to help prepare community pharmacists for future pandemic planning.
Call for papers
Several special theme-based issues of IJPM are planned for the future. Readers are encouraged to submit original research or reviews focused on three specific areas.
The first call for papers is on Depression in the Medically Ill, a topic that primary care physicians and consultation-liaison psychiatrists often encounter one that affects compliance with treatments and medical outcomes. We are looking for quantitative studies that examine the diagnosis, prevalence, causes, and treatments for depression in primary care settings.
The second call for papers is on a topic receiving increasing attention in both psychiatry and medicine, Moral Injury. Moral injury occurs when individuals transgress moral/ethical values, often during high stress situations. This syndrome, which affects the perpetrator, the victim, or the observer, was first observed among active-duty military and war veterans suffering from PTSD, but has now been increasingly recognized among first responders (police, emergency medical technicians, firemen) and even in healthcare professionals during COVID-19 (who may have been placed in situations forcing actions that violated their moral standards as medical or nursing providers). Because moral injury affects the mental health of many experiencing severe trauma, and those who care for these individuals, this topic is relevant to IJPM readers.
Finally, the third special issue will focus on chronic pain, its prevalence, predictors, and treatment. With the recent limitations on the use of opioids for treating chronic pain, this has left medical practitioners with few options for relieving the suffering of these patients. However, novel treatments and alternative therapies, including various kinds of psychosocial and behavioral treatments, are now being developed to help relieve this burden. Chronic pain affects patients 24 hours per day, interfering with sleep, relationships, mobility, independence, and quality of life.
Please consider submitting a paper to IJPM that involves original research, systematic reviews, or meta-analyses on one or more of these topics, which will be prioritized in terms of review.