Danielsmith8943

Background Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p less then 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death. Conclusion Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.Objective Suicide attempts of the older adults are known to be more serious than that of the younger adults. https://www.selleckchem.com/products/mdivi-1.html Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department. Methods Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age less then 65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups. Results Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p less then 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p less then 0.001), male sex (B = -0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = -0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale. Conclusions Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.In this conceptual paper, we outline the many challenges on the road to personalized psychotherapy, using the example of cognitive behavior therapy (CBT) for depression. To optimize psychotherapy for the individual patient, we need to find out how therapy works (identification of mechanisms of change) and for whom it works (identification of moderators). To date, psychotherapy research has not resulted in compelling evidence for or against common or specific factors that have been proposed as mechanisms of change. Our central proposition is that we need to combine the "how does it work?"-question with the "for whom does it work?"-question in order to advance the field. We introduce the personalized causal pathway hypothesis that emphasizes the links and distinction between individual patient differences, therapeutic procedures and therapy processes as a paradigm to facilitate und understand the concept of personalized psychotherapy. We review the mechanism of change literature for CBT for depression to see what we have learned so far, and describe preliminary observational evidence supporting the personalized causal pathway hypothesis. We then propose a research agenda to push the ball forward exploratory studies into the links between individual differences, therapeutic procedures, therapy processes and outcome that constitute a potential causal pathway, making use of experience sampling, network theory, observer ratings of therapy sessions, and moderated mediation analysis; testing and isolation of CBT procedures in experiments; and testing identified causal pathways of change as part of a personalized CBT package against regular CBT, in order to advance the application of personalized psychotherapy.Background The Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. Certain factors like age, an immunocompromised state, and social impoverishment, etc. can add to health vulnerabilities during this pandemic. One such group is older transgender adults, who often bear a combination of these risks. As the world is aging fast, their numbers have also been increasing. With this in mind, this study explores the lived experiences and psychosocial challenges of older transgender adults during the COVID-19 pandemic in India. Methods A qualitative approach was used. Ten individuals with "transgender" identity above the age of 60 were recruited with consent through purposive sampling. In-depth interviews were conducted on the telephone using a pre-designed interview schedule. They were recorded, translated, and transcribed verbatim. Hasse's adaptation of Colaizzi's phenomenological method was used for analysis. Independent coding and respondent validation were used to ensure the rigor of data. Results The super-arching categories (with themes) were marginalization ("second" priority, stigma, social disconnection), the dual burden of "age" and "gender" (ageism, othering, and psychosexual difficulties), and multi-faceted survival threats (physical, emotional, financial) during the pandemic. Social rituals, spirituality, hope, and acceptance of "gender dissonance" emerged as the main coping factors, whereas their unmet needs were social inclusion, awareness related to COVID-19, mental health care, and audience to their distress. Conclusion The elderly gender minorities are at increased emotional and social risks during the ongoing pandemic, and their voices are mostly unheard. The need for policy implementation and community awareness about their social welfare is vital to improving their health and well-being.