Tag: Mental health

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Enhancing Sleep and Mental Health: Longitudinal, Observational, Real-World Study From a Digital Mental Health Platform

Background: Poor sleep is closely linked to mental health challenges and workplace burnout. Mental health and workplace stressors can impair sleep, while good sleep quality supports cognitive and emotional resources to cope with daily challenges. Despite positive outcomes of maintaining good sleep, many people struggle to get enough restorative sleep at night. Given the bidirectional relationship between sleep and mental health, evidence-based digital mental health solutions may offer an accessible and scalable approach to improving sleep quality. Objective: This study examines whether engagement with an employer-sponsored, multimodal digital mental health platform is associated with improvements in sleep quality over time, and whether changes in sleep quality are associated with concurrent changes in mental health and burnout outcomes. Methods: This 12-month prospective, observational study followed working adults who were newly registered to an employer-sponsored digital mental health platform (Modern Health). The platform leveraged technology (mobile and web) to connect employees with comprehensive provider-led and self-guided care through therapy, coaching, on-demand digital resources, and group psychoeducational sessions. Participants [N=578; 61.1% (n=353) women; mean age 33.88, SD 8.73 years; 40.3% (n=233) people of color] completed measures of self-rated sleep quality, depression, anxiety, and burnout (exhaustion, cynicism, and professional efficacy) at baseline and after 3 and 12 months of accessing the platform. Upon registering for the platform, participants were given an initial care recommendation, but could flexibly engage in any combination of services. Participants in this study engaged with at least one care modality, including therapy, coaching, psychoeducation sessions, and self-guided mental health resources. We examined perceived sleep quality and associations with other study variables at baseline, changes in perceived sleep quality over time, and whether changes in sleep quality correlated with concurrent changes in mental health and burnout. Results: At baseline, 42% (243/578) reported poor sleep quality and were more likely to have higher levels of depression, anxiety, and burnout. A generalized linear mixed-effects model showed that each additional month of platform access was related to an increased odds of having good sleep quality by 3.7% (=.02). Linear mixed-effects models found that higher sleep quality over time was associated with lower depression, anxiety, exhaustion, cynicism, and efficacy (all <.001). Among participants reporting poor sleep quality at baseline, 44% (62/141) reported good sleep quality at 12 months. Within this subgroup, paired sample tests showed significant reductions in depression (−48.3%) and anxiety (−38.3%), and increased cynicism, burnout, though cynicism levels remained below the cutoff for high burnout (23.9%; all <.01). Conclusions: Use of an employer-sponsored digital mental health platform was associated with meaningful improvements in self-reported sleep quality over 12 months. These gains were associated with significant reductions in depression, anxiety, and burnout symptoms, highlighting broader well-being benefits of comprehensive mental health care.
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The Effectiveness and Mechanisms of Action of App-Based Interventions for Improving Mental Health and Workplace Well-Being: Randomized Controlled Trial

Background: Depression is the most common mental health disorder worldwide and frequently leads to workplace absence. As face-to-face treatment can be difficult to access, app-based interventions are a popular solution, although their effectiveness in working populations and their mechanisms of action are unclear. Deficits in executive function may contribute to the onset and maintenance of depression, and executive function training is proposed to improve symptoms by enhancing executive function. Responders to cognitive behavioral therapy (CBT) show improvements in executive function, suggesting that this may be one mechanism of action. Objective: This study investigated the effectiveness of app-based interventions (executive function or CBT-based) for reducing depressive and anxiety symptoms and improving workplace well-being, and assessed whether changes in executive function mediated improvements. Methods: A total of 228 participants (147 female participants) with mild-to-moderate symptoms of depression and anxiety were recruited online and randomly assigned to a waitlist control group, an executive function training group (NeuroNation app, Synaptikon GmbH), or a self-guided CBT group (Moodfit app, Roble Ridge LLC) for a 4-week intervention period. Participants assigned to the active intervention groups were asked to use their apps a minimum of 21 times during the intervention. Participants completed measures of depressive symptoms, anxiety symptoms, and workplace well-being, and a working memory task at baseline, postintervention, and follow-up (12 weeks). Results: Executive function training reduced anxiety (β=−2.79; =.004) and depressive (β=−2.77; =.02) symptoms at follow-up but not at postintervention, and it did not affect workplace well-being. There were no reductions in depressive or anxiety symptoms in the self-guided CBT group, though workplace well-being was improved at postintervention (β=3.72; =.02) and follow-up (β=4.46; =.02). Improvements in executive function did not mediate intervention-related changes in symptoms or workplace well-being. Self-reported adherence rates were high (executive function training: 48/54, 89%; self-guided CBT: 52/54, 96%), although attrition was high at follow-up (58% missing). Conclusions: These results suggest that app-based executive function training may be effective at managing symptoms of anxiety and depression in a working population, while self-guided CBT apps may improve workplace well-being. However, improving executive function did not appear to be a mechanism of action of either intervention. Trial Registration: ISRCTN 12730006; https://www.isrctn.com/ISRCTN12730006
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Trump administration warns against using federal dollars on fentanyl test strips

The Trump administration is doubling down on its opposition to harm reduction services for people who use illicit drugs. 

In an open letter on April 24, the federal agency overseeing addiction and mental health policy warned its grantees against using federal funds to buy harm reduction supplies including sterile syringes and pipes, or to distribute test strips for common drug supply adulterants like fentanyl, xylazine, and medetomidine. 

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Genetic risk for neurodevelopmental disorders as a potential factor affecting antipsychotic responsiveness in schizophrenia: a postmortem brain study

IntroductionSchizophrenia (SCZ) is a highly heritable neuropsychiatric disorder. Its genomic architecture reportedly overlaps with that of neurodevelopmental disorders, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, the effect of genomic risk for ADHD and ASD on SCZ symptoms remains unclear.MethodWe obtained genome-wide association study (GWAS) data from the postmortem brains of 24 patients with SCZ and 48 controls and calculated the polygenic risk scores (PRSs) for ADHD (ADHD-PRS) and ASD (ASD-PRS) using publicly available GWAS data. For 19 patients with SCZ whose antemortem clinical information was available, we conducted correlation analyses between PRSs, severity of SCZ symptoms, and the antipsychotic responsiveness score (ARS). Additionally, we divided the patients into two subgroups based on ADHD-PRS (high and low ADHD-PRS groups) and performed exploratory gene expression analyses and subsequent pathway analysis in the prefrontal cortex.ResultsThe ARS of positive symptoms (ARS-PS) demonstrated a suggestive negative correlation with ADHD-PRS and a positive correlation with ASD-PRS although these associations did not survive multiple testing correction. No correlation was observed between the ARS of general psychopathology or the ARS of negative symptoms and either ADHD-PRS or ASD-PRS. Gene expression analysis identified 1,773 DEGs, including neuropsychiatric disorder-related genes including CHRNB2. These DEGs were enriched in pathways associated with the neuronal system and mitochondrial function.DiscussionOur findings suggest that the genomic risk for neurodevelopmental disorders may affect the antipsychotic responsiveness of patients with schizophrenia and implicate translational alterations in potential marker molecules in this phenotype. Due to the limited sample size in the current study, further investigation on the large cohort is required to verify our exploratory findings.
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From collective restriction to critical action: the indirect effects of critical motivation and radical hope

IntroductionHistorically, Women of Color (WOC) in the United States have experienced systemic restrictions to their freedom and autonomy, which can have a lasting impact on their mental health and wellbeing. Conceptually, this type of collective autonomy restriction (CAR) experience may be associated with increased critical consciousness (CC), reflected in greater awareness of social and systemic oppression, commitment to and belief in one’s capacity to address social issues, and engagement in action; however, there is a dearth of research examining this association. Building on critical consciousness and hope literatures, we hypothesized that the association between CAR and critical action would be explained through serial pathways of increased critical motivation and greater radical or collective hope.Materials and MethodsA sample of 408 WOC completed an online survey administered through Prolific and hosted on Qualtrics. The survey included indicators of CAR, critical consciousness (critical motivation and critical actions), psychological hope, and radical hope. ResultsWe conducted structural equation modeling to test a serial mediation model exploring the associations among CAR, critical motivation, hope, and critical action. Findings indicated the association between CAR and critical action was fully mediated by the proposed serial mediation pathways (CAR → Critical Motivation → Radical Hope → Critical Action). The pathway through radical hope was stronger than through psychological hope. The direct effect of CAR on critical action was non-significant, indicating full mediation.DiscussionThese results highlight the role of radical hope as a potential pathway connecting critical awareness of collective autonomy restriction and critical motivation to engage in critical action aimed at social change. We extend the existing literature by demonstrating that awareness of oppression and motivation alone may be insufficient to explain the link between the first two dimensions of critical consciousness (critical reflection and critical motivation) and critical action. Limitations and implications for research and practice are discussed.