Brain Research on Mental Disorders: A Criticism

Objective: To expose the problems and inherent limitations of neuroscience-based brain research on mental disorders. Method: Discussion of the theory underlying brain research on mental disorders, followed by a systematic evaluation of typical studies. Results: The fundamental problem is that brain researchers fail to differentiate between biological mental disorders in which brain processes cause the disorder (notably schizophrenia, bipolar disorder, and melancholic depression) and learned mental disorders in which brain processes mediate but do not cause the disorder (which is the case with reactive depression, reactive anxiety, OCD, and PTSD). Researchers have been unsuccessful in identifying mechanisms in the brain that cause biological mental disorders, and will never be able to locate the innumerable specific neural connections that mediate learned mental disorders. Moreover, the author’s review of typical studies in this field shows that they have serious problems with theory, measurement, and data analysis, and that their findings cannot be trusted. Conclusions: Neuroscience-based brain research on mental disorders, unlike other neurological research, has been an expensive failure and it is not worth continuing.

Causal relationship between circulating vitamin C and 25-hydroxyvitamin D concentrations and common mental disorders-a Mendelian randomization study

Mental disorders seriously affect people’s health and social stability.This Mendelian randomization(MR)study was designed to investigate the causal relationship between circulating vitamin C(VC)or 25-hydroxyvitamin D(25(OH)D)levels and mental disorders.The data used for the MR analysis were derived from the summary genome-wide association studies(GWAS)database for VC and 25(OH)D and from the Finn Gen consortium for fourteen mental disorders.Based on the inverse variance weighted(IVW)method,we found a potential causal association between circulating VC and anxiety disorders(IVW:OR=1.139,95%CI:1.023-1.269,P=0.018).However,no causal association was found between VC or 25(OH)D and other mental disorders(P>0.05).In the reverse MR analysis,individuals with Alzheimer’s disease was causally associated with higher concentrations of circulating VC(P=0.012),while individuals with anxiety disorders had a negative association between the concentrations of 25(OH)D(P=0.012).However,the current evidence does not support a causal relationship between VC or 25(OH)D and other mental disorders.In addition,there was no causal association between circulating VC and 25(OH)D(P>0.05).Future studies are needed to confirm these findings and to elucidate the mechanisms of potential causality.

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic psychiatry.In Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue.However,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated standards.AIM To explore current as well as optimized learning strategies for risk assessment in AIH decision making.METHODS We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.RESULTS The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.CONCLUSION This underscores the pressing need for structured training protocols in AIH consultations.Moreover,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

Evidence-Based Design Application of Water Landscaping for Rehabilitation Gardens for Patients with Mental Disorders

The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.

Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Real-world effectiveness and safety of direct-acting antivirals in hepatitis C virus patients with mental disorders

BACKGROUND It is estimated that 58 million people worldwide are infected with the hepatitis C virus(HCV).Patients with severe psychiatric disorders could not be treated with previously available interferon-based therapies due to their unfavorable side effect profile.This has changed with the introduction of direct-acting antivirals(DAA),although their real-life tolerance and effectiveness in patients with different psychiatric disorders remain to be demonstrated.AIM To evaluate the effectiveness and safety of DAA in patients with various mental illnesses.METHODS This was a retrospective observational study encompassing 14272 patients treated with DAA for chronic hepatitis C in 22 Polish hepatology centers,including 942 individuals diagnosed with a mental disorder(anxiety disorder,bipolar affective disorder,depression,anxiety-depressive disorder,personality disorder,schizophrenia,sleep disorder,substance abuse disorder,and mental illness without a specific diagnosis).The safety and effectiveness of DAA in this group were compared to those in a group without psychiatric illness(n=13330).Antiviral therapy was considered successful if serum ribonucleic acid(RNA)of HCV was undetectable 12 wk after its completion[sustained virologic response(SVR)].Safety data,including the incidence of adverse events(AEs),serious AEs(SAEs),and deaths,and the frequency of treatment modification and discontinuation,were collected during therapy and up to 12 wk after treatment completion.The entire study population was included in the intent-to-treat(ITT)analysis.Per-protocol(PP)analysis concerned patients who underwent HCV RNA evaluation 12 wk after completing treatment.RESULTS Among patients with mental illness,there was a significantly higher percentage of men,treatmentnaive patients,obese,human immunodeficiency virus and hepatitis B virus-coinfected,patients with cirrhosis,and those infected with genotype 3(GT3)while infection with GT1b was more frequent in the population without psychiatric disorders.The cure rate calculated PP was not significantly different in the two groups analyzed,with a SVR of 96.9% and 97.7%,respectively.Although patients with bipolar disorder achieved a significantly lower SVR,the multivariate analysis excluded it as an independent predictor of treatment non-response.Male sex,GT3 infection,cirrhosis,and failure of previous therapy were identified as independent negative predictors.The percentage of patients who completed the planned therapy did not differ between groups with and without mental disorders.In six patients,symptoms of mental illness(depression,schizophrenia)worsened,of which two discontinued treatments for this reason.New episodes of sleep disorders occurred significantly more often in patients with mental disorders.Patients with mental illness were more frequently lost to follow-up(4.2%vs 2.5%).CONCLUSION DAA treatment is safe and effective in HCV-infected patients with mental disorders.No specific psychiatric diagnosis lowered the chance of successful antiviral treatment.

Diabetes mellitus type 2 as an underlying,comorbid or consequent state of mental disorders

Somatic disturbances that occur in parallel with psychiatric diseases are a major challenge in clinical practice.Various factors contribute to the development of mental and somatic disorders.Type 2 diabetes mellitus(T2DM)is a significant health burden worldwide,and the prevalence of diabetes in adults is increasing.The comorbidity of diabetes and mental disorders is very common.By sharing a bidirectional link,both T2DM and mental disorders influence each other in various manners,but the exact mechanisms underlying this link are not yet elucidated.The potential mechanisms of both mental disorders and T2DM are related to immune and inflammatory system dysfunction,oxidative stress,endothelial dysfunction,and metabolic disturbances.Moreover,diabetes is also a risk factor for cognitive dysfunction that can range from subtle diabetesassociated cognitive decline to pre-dementia and dementia.A complex relationship between the gut and the brain also represents a new therapeutic approach since gut-brain signalling pathways regulate food intake and hepatic glucose production.The aim of this minireview is to summarize and present the latest data on mutual pathogenic pathways in these disorders,emphasizing their complexity and interweaving.We also focused on the cognitive performances and changes in neurodegenerative disorders.The importance of implementing integrated approaches in treating both of these states is highlighted,along with the need for individual therapeutic strategies.

The Relationship between Mental Disorders and Personality of Outpatients in a Psychiatric Clinic in Nanjing, China

Psychosis has increasingly become a social problem,emphasizing the need to understand the relationship between mental disorders and personality.This study aimed to investigate the relationship between mental disorders and personality among psychiatric outpatients based on real-world data.Symptom Checklist 90(SCL-90)and Eysenck Personality Questionnaire(EPQ)were used to evaluate the personality and psychopathological symptoms of patients(n=8409)in the Psychiatric Outpatient Department at Nanjing Drum Tower Hospital.t-test was used to compare scores between patients and national norms.Pearson’s correlation coefficient and path analysis were used to explore the relationship between mental health status and personality.The correlation coefficient between the neuroticism(N)score and each factor score of the SCL-90 test,as well as the correlation between psychoticism(P)and hostility and paranoia,exceeded 0.4.Path analysis revealed that the standardized path coefficients of N score and SCL-90 were all higher than 0.4.In addition,the standardized path coefficient of hostility and paranoia on P score were 0.313 and 0.280,respectively.Interpersonal sensitivity,depression and obsessive-compulsive symptoms were affected by extraversion(E)score,with standardized path coefficients of-0.149,-0.138,and-0.105,respectively.The path analysis also showed the direct and indirect effects of age,gender,education,and marital status on SCL-90.Patients characterized as melancholic had higher scores in all factors of SCL-90.In conclusion,mental health was related to personality traits of neuroticism,psychoticism and introversion.

Progress in Application of CBT Therapy in Patients with Post-stroke Mental Disorders

The application effects of CBT therapy in patients with post-stroke mental disorders were summarized to better understand the application effects of CBT therapy in patients with post-stroke mental disorders,so as to provide reference suggestions for better providing psychological treatment to patients with post-stroke mental disorders.

Clinical Profile of Women with Mental Disorders in Dakar Hospitals

Introduction: In Senegal, knowledge of the clinical profile of mental disorders in women has not been the subject of many studies, even though it is of vital importance to those involved in mental health. Thus, the aim of our study was to describe the clinical aspects of psychiatric disorders in women hospitalized at Fann. Methodology: This was a cross-sectional, retrospective, and descriptive study over a five-year period. We identified 402 cases that met the selection criteria. The data collection form provided information on aspects of the clinical profile of mental disorders, such as medical, surgical, gynecological, obstetrical and psychiatric history, instigator of the request for care, diagnosis, duration and number of hospitalizations. ICD-10 was used for the various pathologies identified. Results: Asthma was noted in 7% of patients, as was hypertension. Gynecological surgery was found in 43 patients (11%). Eight patients were menopausal (2%). The mean number of gestations was 2.09, with a standard deviation of 2.257 and extremes between 0 and 10 gestations. Patients with a history of abortion numbered 58 (14%). The decision to hospitalize the patients was made by 96% (384 patients) of those around them. Hetero aggression was the most recurrent reason for hospitalization (19%). Pathology group F20-29 (schizophrenia, schizotypal disorder, and delusional disorders) was the majority group. Conclusion: The clinical profile of the mentally ill woman in Dakar is a woman in her mid-forties who most often presents with a personal psychiatric history, and her hospitalization is prompted by hetero-aggression and/or logorrhea. She usually suffers from schizophrenia and related disorders. Hospitalization usually lasts between 11 and 20 days.

Epidemiological Profile of Women with Mental Disorders in Hospital in Dakar

Introduction: Women are currently more likely than men to suffer from mental health problems. The prevalence of mental health problems among women is also increasing. However, few studies conducted in Africa provide epidemiological data on women. The aim of this study was to describe the epidemiological profile of women with mental health problems in Dakar. Methodology: This was a cross-sectional, retrospective, descriptive study over a five-year period, from 1 January 2017 to 31 December 2021. It concerned all women hospitalised for psychiatric reasons at the Psychiatry Department of Fann Hospital, Dakar, Senegal. The data collection form provided information on the sociodemographic profile, i.e., age, current address, marital status, ethnicity, religion, level of education, professional activity, and use of psychoactive substances. Results: The prevalence of mental disorders was 34.9% and concerned the following ICD-10 pathology groups [F00 - 09], [F10 - F19], [F20 - F29], [F30 - F39], [F40 - 48], [F50 - F59] and [F60 - F69]. The mean age of the patients was 37 years, with a standard deviation of 13 and extremes from 16 to 74 years. Most patients were unmarried (56%). Among the married patients, the monogamous regime was in the majority in our study: 56% compared with 44% for the polygamous regime. Women had to attend French school in 74% of cases. In our study, 32% of patients had reached university level. The majority were unemployed (67%). The notion of mourning was found in 214 patients (30.2%). The birth of one or more children marked the lives of 184 patients (26%). Divorce was noted in 103 patients (14.5%). Marital conflicts were experienced by 94 patients (13.3%). Twenty percent of the patients had used psychoactive substances. Conclusion: The epidemiological profile of a woman with a mental disorder in Dakar is that of a single woman in her forties who had attended university and was a housewife. She does not use psychoactive substances and has experienced at least one mourning in her life.

Psychedelic Drug Therapy for Mental Disorders?

Objective: Psychedelic drug therapy is banned in all countries of the world except Australia, where the government regulatory watchdog, the Therapeutic Goods Administration, is planning to allow approved psychiatrists, as of July 1, 2023, to prescribe psilocybin to treat depression and MDMA to treat post-traumatic stress disorder, a move precipitated by the U.S. Food and Drug Administration’s designation of these two drugs as “breakthrough therapy”. The objective of the present article is to demonstrate that the evidence on which the FDA and then the TGA relied is irretrievably flawed and should be dismissed. Method: Expert review of psychedelic therapy clinical trials and specifically of the methodology and measures used. Results: The present review demonstrates that the studies the U.S. FDA and the Australian TGA relied on to approve these two psychedelic drugs for therapy are irretrievably flawed. All future trials will follow the same procedure and are therefore bound to be flawed as well. Conclusions: Psychedelic drug studies have so far provided no trustworthy evidence of their effectiveness for treating mental disorders and are not likely to produce this evidence in the future. Psychedelic drug therapy is in any event impractical because of its specialized training requirements and very high treatment costs. It is also dangerous because false publicity about its effectiveness will almost certainly lead to unsupervised self-dosing with drugs that not only are illegal but have an unacceptably high addiction rate.

A Meta-Analysis of Pension Models for Patients with Mental Disorders

Objective:To analyze the pension models available for patients with mental disorders and design a more suitable one.Methods:A total of 135 pieces of literature in the database of China National Knowledge Infrastructure(CNKI)published from August 11,1970,to November 17,2022,were classified and analyzed.A knowledge map was drawn and the research context was sorted out from the aspects of temporal distribution,spatial distribution,research hotspots,and evolutionary trend,so as to reveal the research status and development trend in the field of pension for patients with mental disorders.Results:The temporal distribution of the literature in this review involved 20 disciplines,41 papers,2 information articles,40 authors,13 research levels,and 20 research institutions.In terms of research hotspots and evolutionary trends,the keywords“disability pension,”“pension institutions,”and“patients with mental disorders”play a fundamental role in the dynamic evolution and diversification of research topics in the field of the mental disorder pension model.Conclusion:There has been not much research on elderly care for patients with mental disorders,and it is still in the exploratory stage without a sustainable and stable research theme.In recent years,keywords such as“the combination of medical care,”“community care for the elderly,”and“intelligent care”for the elderly have become prominent and the number of related studies has increased,and the research quality in this field has also improved.Intelligent medical care for elderly patients with mental disorders will become the trend of future research.

Effects of mindfulness-based intervention programs on sleep among people with common mental disorders:A systematic review and meta-analysis

BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder.Although mindfulness has been suggested as an important component in alleviating insomnia,no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention(MBI)programs on sleep among people with depression or anxiety disorder.AIM To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder.METHODS Related publications in Embase,Medline,PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials.Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder.The fixed-effects model was used when heterogeneity was negligible,and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences(SMDs)and 95%confidence intervals(CIs).RESULTS We identified 397 articles,of which 10 randomised controlled trials,involving a total of 541 participants,were included in the meta-analysis.Studies of internet mindfulness meditation intervention(IMMI),mindfulness meditation(MM),mindfulness-based cognitive therapy(MBCT),mindfulness-based stress reduction(MBSR)and mindfulness-based touch therapy(MBTT)met the inclusion criteria.The greatest effect sizes are reported in favour of MBTT,with SMDs of-1.138(95%CI:-1.937 to-0.340;P=0.005),followed by-1.003(95%CI:-1.645 to-0.360;P=0.002)for MBCT.SMDs of-0.618(95%CI:-0.980 to-0.257;P=0.001)and-0.551(95%CI:-0.842 to-0.260;P<0.0001)were reported for IMMI and MBSR in the pooling trials,respectively.Significant effects on sleep problem improvement are shown in all reviewed MBI programs,except MM,for which the effect size was shown to be nonsignificant.CONCLUSION All MBI programs(MBTT,MBCT,IMMI and MBSR),except MM,are effective options to improve sleep problems among people with depression or anxiety disorder.

Maternal mental disorders in pregnancy and the puerperium and risks to infant health

Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.

Revisiting the Major Mental Disorders and Updating the Nosological Schema: A Synthesis

Recently, conciliating findings from molecular genetics, evolutionary biology, along with empirical clinical evidence regarding the major mental disorders (MMDs) namely bipolar affective disorder (BPAD), schizophrenia, obsessive compulsive disorder (OCD), the anxieties with depression, autism and attention deficit/hyperactivity disorder (ADHD) all point to a common neural-developmental origin. Genetic loci associated with schizophrenia do not directly lead to the disorder;instead, they code for the expression of lopsided, temperamental, variants in individuals that originate mainly from one part of our human nature which applies also, to the rest of the MMDs. These individuals contribute to the flexibility, robustness, and creative input of our species, concomitantly, they incur vulnerability to the development of a MMD as an evolutionary trade off. MMDs initially, are expressed as periodic epiphenomena on the underlying temperamental extreme variants of brain function. Their expressions tend to become permanent. Underlying, aberrant traits remain unaltered. Their clinical expressions are characterized by “either-or”, antithetical substitutes, in addition to co-occurring psychosis. The latter is a common occurrence to other assaults on brain function. Characteristic, “ether-or” symptoms are the result of a disturbed, overall, coordinating property of brain function, normally responsive to the smooth, synchronizing expression of all higher mental faculties. Clinical findings point to the need of modifying the current schema in order to better reflect their collective significance in order to help guide research to a new, more promising direction in elucidating their triggers, development, and mechanisms whereby opening a new horizon for therapy and treatment.

Evaluation of the Psychological Impact of COVID-19 Pandemic on Chinese Patients with Common Mental Disorders in Primary Care: A Cross-Sectional Study

Purpose: Our study aimed to evaluate the psychological impact of COVID-19 pandemic on Chinese patients with common mental disorders in primary care in Hong Kong. Method: A cross-sectional study was conducted on 102 Chinese patients with common mental disorders and being followed up in two public integrated mental health clinics in Hong Kong from 1st November 2020 to 31st January 2021. Patients would be evaluated about the impact of COVID-19 pandemic on their mood and daily life by using a questionnaire which assessed social distancing effects, financial impact, relationship with family, anxiety and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 Questionnaire (GAD-7) would also be used to assess patients’ mood symptoms. Factors which were related to COVID-19 pandemic and associated with anxiety or depressive symptoms would be analysed. Results: The mean age of the subjects was 58.0 years and more patients were female (77.5%). There were 84.3% and 72.5% of patients reported their anxiety and depressive symptoms being affected by COVID-19 pandemic respectively. It was found that 17.6% of patients had their income decreased or were unemployed. About one-third (30.4%) of patients indicated that their relationship with their family was worsened while 8.8% was improved. Social distancing was significantly associated with anxiety (p = 0.006) and depressive symptoms (p 0.001) in patients with common mental disorders. Conclusion: There was considerably more psychological impact including an increase in anxiety and depressive symptoms due to COVID-19 pandemic in Chinese patients with existing common mental disorders in primary care. Primary care physicians should raise their awareness of the psychological impact of COVID-19 pandemic on their patients. Our findings shed light on mental health care planning and preventive measures during the COVID-19 pandemic and potential subsequent pandemics.

Four Acupuncture Methods for Treating Mental Disorders

Acupuncture treatment has long been proved effective for mental disorders. Many points of the twelve regular channels and extra-ordinary points are named after 'Shen' (mind) such as Shenmen (HT 7), Shenting (GV 24), Shentang (BL 44), Shendao (GV 11), Benshen (GB 13), and Sishencong (EX-HN1). As their names indicate, these points yield specific therapeutic effects for disorders of the mind. Based on the above knowledge, we have made clinical observations on the acupuncture treatment for mental disorders, and obtained quite satisfactory therapeutic effects. The followings are four summarized methods.

Drug-abusing Offenders with Co-morbid Mental Disorders:Gender Differences in Problem Severity,Treatment Participation,and Recidivism

Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California＇s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use（relative to methamphetamine）,drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women＇s recidivism,while young age,outpatient treatment,and arrest history were predictors of men＇s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.

Nonprecsion (Standard) Psychosocial Interventions for the Treatment of Mental Disorders

Advances in precision treatment promise to greatly improve the extent to which therapies for mental disorders are better matched to patient characteristics.At the same,we need to ensure that more readily disseminable and available nonprecison treatments are further developed as well.These treatments refer to standardized interven-tions that do not have to be individualized and are more readily available.Impetus for this call stems from the treatment gap,namely,the huge difference in the proportion of individuals who are in need of mental health services and who actually receive any form of treatment.The prevalence rates for mental disorders worldwide are high and in low-,middle-,and high-income countries and the vast majority of individuals in need of services receive none.To address the need,we need interventions that can reach large numbers of individuals and espe-cially target those individuals least likely to receive services.Standardized treatments that can be widely applied may be in a better position at present to reach people in need who otherwise receive no care.