Psychiatry Rounds: Workplace Mental Health and More

Job Insecurity Takes a Toll. “The long-term negative consequences of job insecurity on employees' health and well-being have been demonstrated by several studies, but there is very little evidence on the daily experience of job insecurity and on the factors that may influence it. Therefore, we investigated whether short-term changes occur in the experience of job insecurity and whether these are influenced by daily co-worker conflicts. We carried out a diary study, in which 66 employees answered a questionnaire over the course of five working days. We conducted a multilevel analysis in which we included co-worker conflicts as a predictor, and type of contract, emotional stability, and aggregated job insecurity perceptions as control variables. Our results revealed that job insecurity varies on a daily level, and that 23 per cent of the variance could be explained at a within-person level. Co-worker conflicts were a significant positive predictor for perceived job insecurity in subsequent days after controlling for aggregated job insecurity perceptions at person level.” Do Co-Worker Conflicts Enhance Daily Worries about Job Insecurity: A Diary Study

Depression treatment and cardiac risks. Researchers examined the effect on long-term major adverse cardiac events of escitalopram treatment of depression in patients with recent acute coronary syndrome (ACE): “Among patients with depression following recent acute coronary syndrome, 24-week treatment with escitalopram compared with placebo resulted in a lower risk of major adverse cardiac events after a median of 8.1 years.” Effect of Escitalopram vs Placebo Treatment for Depression on Long-term Cardiac Outcomes in Patients With Acute Coronary Syndrome

Longest running mental health study. “The Centre for Addiction and Mental Health’s Ontario Student Mental Health and Well-Being Survey (OSDUHS) is the longest ongoing school survey of adolescents in Canada, and one of the longest in the world. The OSDUHS has been conducted every two years since 1977, and 2017 marks the study’s 40th anniversary. A total of 11,435 students in grades 7 through 12 from 52 school boards, 214 schools, and 764 classes participated in the 2017 OSDUHS, which was administered by the Institute for Social Research, York University. This report describes physical health indicators, mental health indicators, bullying, gambling and related problems, video gaming and related problems, and other risk behaviours among Ontario students in 2017 and changes since 1991, where available. All data are based on self-reports derived from anonymous questionnaires administered in classrooms between November 2016 and June 2017.” Mental Health and Well-Being Among Ontario Students.

Smart drugs ain’t that smart. “The use of drugs by people hoping to boost mental performance is rising worldwide, finds the largest ever study of the trend. In a survey of tens of thousands of people, 14% reported using stimulants at least once in the preceding 12 months in 2017, up from 5% in 2015. The non-medical use of substances - often dubbed smart drugs - to increase memory or concentration is known as pharmacological cognitive enhancement (PCE), and it rose in all 15 nations included in the survey. The study looked at prescription medications such as Adderall and Ritalin - prescribed medically to treat attention deficit hyperactivity disorder (ADHD) - as well as the sleep-disorder medication modafinil and illegal stimulants such as cocaine.” Use of ‘smart drugs’ on the rise

Not-so-hot commodity. Heatstroke is a severe, life-threatening illness that occurs with regularity during the summer months, particularly among psychiatric patients. Psychiatric patients in jails and prisons face a difficult challenge in that they may not have the freedom to change their environment to avoid heatstroke. In case you missed it, you can read more from this 2014 article, Heatstroke and Psychiatric Patients.

A puzzler. “Young people with autism unknowingly tuned up under-connected neural connections by playing a picture puzzle game that was rigged by their own brain activity, suggesting a potential intervention for improving social behavior.” “Covert” Neurofeedback Tunes-up the Social Brain in ASD. NIMH. July 17, 2018

Psychosis and eating disorders. “When we looked at individual behaviours, psychotic experiences at 13 years were associated with greater odds of binge eating at 18 years in the crude model,” said Solmi and colleagues. “…Findings provide further evidence that psychotic experiences could represent non-specific markers of adverse psychopathology … and extend their relevance to disordered eating behaviours, previously largely overlooked by the scientific literature. Our study, in the context of broader clinical and genetic studies, supports the hypothesis of shared causal pathways between psychotic illness and eating disorders, which requires further investigation. Finally, our results suggest that increased disordered behaviours, especially cycles of binge-eating and fasting, could partly account for increased rates of metabolic abnormalities in individuals with psychotic illness,63 although more research investigating these mechanisms is needed.” Longitudinal associations between psychotic experiences and disordered eating behaviours in adolescence: a UK population-based study.