TY - JOUR AU - Quilty, Lena AU - Agic, Branka AU - Coombs, Michelle AU - Kristy, Betty-Lou AU - Shakespeare, Jill AU - Spafford, Adrienne AU - Besa, Reena AU - Dematagoda, Shadini AU - Patel, Alina AU - Persaud, Rebecca AU - Buckley, Leslie PY - 2021/6/7 TI - Benefits of Digital Health Resources for Substance Use Concerns in Women: Scoping Review JO - JMIR Ment Health SP - e25952 VL - 8 IS - 6 KW - women KW - female KW - gender-specific KW - digital health KW - internet KW - mobile app KW - technology KW - technology interventions KW - technology-based intervention KW - web-based intervention KW - substance use concerns KW - trauma N2 - Background: Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well. Objective: The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma. Methods: This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized. Results: The 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified. Conclusions: Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak. UR - https://mental.jmir.org/2021/6/e25952 UR - http://dx.doi.org/10.2196/25952 UR - http://www.ncbi.nlm.nih.gov/pubmed/34096879 ID - info:doi/10.2196/25952 ER - TY - JOUR AU - Sanatkar, Samineh AU - Heinsch, Milena AU - Baldwin, Andrew Peter AU - Rubin, Mark AU - Geddes, Jenny AU - Hunt, Sally AU - Baker, L. Amanda AU - Woodcock, Kathryn AU - Lewin, J. Terry AU - Brady, Kathleen AU - Deady, Mark AU - Thornton, Louise AU - Teesson, Maree AU - Kay-Lambkin, Frances PY - 2021/6/7 TI - Factors Predicting Trial Engagement, Treatment Satisfaction, and Health-Related Quality of Life During a Web-Based Treatment and Social Networking Trial for Binge Drinking and Depression in Young Adults: Secondary Analysis of a Randomized Controlled Trial JO - JMIR Ment Health SP - e23986 VL - 8 IS - 6 KW - digital mental health KW - personality KW - negative affect KW - study engagement KW - life quality N2 - Background: Mental health and alcohol use problems are among the most common causes of disease burden in young Australians, frequently co-occur (comorbidity), and lead to significant lifetime burden. However, comorbidities remain significantly underdetected and undertreated in health settings. Digital mental health tools designed to identify at-risk individuals, encourage help-seeking, or deliver treatment for comorbidity have the potential to address this service gap. However, despite a strong body of evidence that digital mental health programs provide an effective treatment option for a range of mental health and alcohol use problems in young adults, research shows that uptake rates can be low. Thus, it is important to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e?mental health interventions for comorbidity. Objective: In this study, we seek to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e?mental health interventions for comorbid alcohol and mood disorders. The aim is to determine the importance of personality (ie, Big Five personality traits and intervention attitudes), affective factors (ie, depression, anxiety, and stress levels), and baseline alcohol consumption in predicting intervention trial engagement at sign-up, satisfaction with the online tool, and quality of life at the end of the iTreAD (Internet Treatment for Alcohol and Depression) trial. Methods: Australian adults (N=411) aged between 18 and 30 years who screened positive for depression and alcohol use problems signed up for the iTreAD project between August 2014 and October 2015. During registration, participants provided information about their personality, current affective state, alcohol use, treatment expectations, and basic demographic information. Subsequent follow-up surveys were used to gauge the ongoing trial engagement. The last follow-up questionnaire, completed at 64 weeks, assessed participants? satisfaction with web-based treatment and quality-of-life outcomes. Results: Multiple linear regression analyses were used to assess the relative influence of predictor variables on trial engagement, treatment satisfaction, and quality-of-life outcomes. The analyses revealed that the overall predictive effects of personality and affective factors were 20% or lower. Neuroticism constituted a unique predictor of engagement with the iTreAD study in that neuroticism facilitated the return of web-based self-assessments during the study. The return of incentivized follow-up assessments predicted treatment satisfaction, and state-based depression predicted variance in quality-of-life reports at study completion. Conclusions: Our findings suggest that traditional predictors of engagement observed in face-to-face research may not be easily transferable to digital health interventions, particularly those aimed at comorbid mental health concerns and alcohol misuse among young adults. More research is needed to identify what determines engagement in this population to optimally design and execute digital intervention studies with multiple treatment aims. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN): 12614000310662; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365137&isReview=true. International Registered Report Identifier (IRRID): RR2-10.1186/s12889-015-2365-2 UR - https://mental.jmir.org/2021/6/e23986 UR - http://dx.doi.org/10.2196/23986 UR - http://www.ncbi.nlm.nih.gov/pubmed/34096873 ID - info:doi/10.2196/23986 ER - TY - JOUR AU - Cheng, Qijin AU - Lui, Carrie AU - Ip, Lam Flora Wai AU - Yip, Fai Paul Siu PY - 2021/6/18 TI - Typology and Impact of YouTube Videos Posted in Response to a Student Suicide Crisis: Social Media Metrics and Content Analyses JO - JMIR Ment Health SP - e15551 VL - 8 IS - 6 KW - suicide KW - suicide prevention KW - social media KW - infodemiology KW - internet KW - digital health KW - YouTube KW - impact evaluation KW - network visualization N2 - Background: Videos relating to suicide are available on YouTube, but their characteristics and impacts have seldom been examined. Objective: This study aimed to examine YouTube videos posted in response to a sudden spate of student suicides in Hong Kong during the 2015-2016 school year and evaluate the impacts of those videos. Methods: Keyword search was performed on YouTube, and relevant videos were identified. Video typology was examined through content analysis, specifically grouping the videos by who uploaded the videos, what presentation formats were used in the videos, whether the videos were originally created by the uploaders, and whether the videos disclosed the uploaders? personal experiences with suicide. Impacts of the videos were assessed in terms of reach (measured by view count), engagement (measured by comment count), and insights (measured as to what extent the comments to each video could reveal personal suicide risk and attitude toward help-seeking). Statistical analysis was conducted to compare the impacts of different types of videos. The 7 most impactful videos that were originally created by the YouTubers were selected for further analysis. They were compared with 7 videos uploaded by the same YouTubers right before the student suicide videos and 7 right after the student suicide videos. The comparison focused on their impacts and the network structure of the comments to those videos. Results: A total of 162 relevant YouTube videos were identified. They were uploaded by 7 types of stakeholders, and the most common format was one person talking to the camera. A total of 87.0% (141/162) of the videos were originally created by the uploaders and only 8.0% (13/162) of the videos disclosed uploader personal experiences with suicide. The uploader profiles being popular or top YouTubers and the video containing disclosure of the uploader?s personal experiences were found to be significantly correlated with greater impacts (P<.001). Focusing on the 7 most impactful original videos, it is found that those videos generated more engagement, especially more interactions between the viewers, and more insights than regular videos uploaded by the same YouTubers. Conclusions: When responding to a youth suicide crisis, videos made by key opinion leaders on YouTube sharing their own experiences of overcoming suicide risks could generate significant positive impacts. These types of videos offer a precious opportunity to craft online campaigns and activities to raise suicide prevention awareness and engage vulnerable youth. UR - https://mental.jmir.org/2021/6/e15551/ UR - http://dx.doi.org/10.2196/15551 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/15551 ER - TY - JOUR AU - Blease, Charlotte AU - Salmi, Liz AU - Hägglund, Maria AU - Wachenheim, Deborah AU - DesRoches, Catherine PY - 2021/6/21 TI - COVID-19 and Open Notes: A New Method to Enhance Patient Safety and Trust JO - JMIR Ment Health SP - e29314 VL - 8 IS - 6 KW - COVID-19 KW - patient portals KW - electronic health records KW - patient safety KW - patient-centered care UR - https://mental.jmir.org/2021/6/e29314 UR - http://dx.doi.org/10.2196/29314 UR - http://www.ncbi.nlm.nih.gov/pubmed/34081603 ID - info:doi/10.2196/29314 ER - TY - JOUR AU - Blitz, Rogério AU - Storck, Michael AU - Baune, T. Bernhard AU - Dugas, Martin AU - Opel, Nils PY - 2021/6/9 TI - Design and Implementation of an Informatics Infrastructure for Standardized Data Acquisition, Transfer, Storage, and Export in Psychiatric Clinical Routine: Feasibility Study JO - JMIR Ment Health SP - e26681 VL - 8 IS - 6 KW - medical informatics KW - digital mental health KW - digital data collection KW - psychiatry KW - single-source metadata architecture transformation KW - mental health KW - design KW - implementation KW - feasibility KW - informatics KW - infrastructure KW - data N2 - Background: Empirically driven personalized diagnostic applications and treatment stratification is widely perceived as a major hallmark in psychiatry. However, databased personalized decision making requires standardized data acquisition and data access, which are currently absent in psychiatric clinical routine. Objective: Here, we describe the informatics infrastructure implemented at the psychiatric Münster University Hospital, which allows standardized acquisition, transfer, storage, and export of clinical data for future real-time predictive modelling in psychiatric routine. Methods: We designed and implemented a technical architecture that includes an extension of the electronic health record (EHR) via scalable standardized data collection and data transfer between EHRs and research databases, thus allowing the pooling of EHRs and research data in a unified database and technical solutions for the visual presentation of collected data and analyses results in the EHR. The Single-source Metadata ARchitecture Transformation (SMA:T) was used as the software architecture. SMA:T is an extension of the EHR system and uses module-driven engineering to generate standardized applications and interfaces. The operational data model was used as the standard. Standardized data were entered on iPads via the Mobile Patient Survey (MoPat) and the web application Mopat@home, and the standardized transmission, processing, display, and export of data were realized via SMA:T. Results: The technical feasibility of the informatics infrastructure was demonstrated in the course of this study. We created 19 standardized documentation forms with 241 items. For 317 patients, 6451 instances were automatically transferred to the EHR system without errors. Moreover, 96,323 instances were automatically transferred from the EHR system to the research database for further analyses. Conclusions: In this study, we present the successful implementation of the informatics infrastructure enabling standardized data acquisition and data access for future real-time predictive modelling in clinical routine in psychiatry. The technical solution presented here might guide similar initiatives at other sites and thus help to pave the way toward future application of predictive models in psychiatric clinical routine. UR - https://mental.jmir.org/2021/6/e26681 UR - http://dx.doi.org/10.2196/26681 UR - http://www.ncbi.nlm.nih.gov/pubmed/34106072 ID - info:doi/10.2196/26681 ER - TY - JOUR AU - Gooding, Piers AU - Kariotis, Timothy PY - 2021/6/10 TI - Ethics and Law in Research on Algorithmic and Data-Driven Technology in Mental Health Care: Scoping Review JO - JMIR Ment Health SP - e24668 VL - 8 IS - 6 KW - digital psychiatry KW - digital mental health KW - machine learning KW - algorithmic technology KW - data-driven technology KW - artificial intelligence KW - ethics KW - regulation KW - law KW - mobile phone N2 - Background: Uncertainty surrounds the ethical and legal implications of algorithmic and data-driven technologies in the mental health context, including technologies characterized as artificial intelligence, machine learning, deep learning, and other forms of automation. Objective: This study aims to survey empirical scholarly literature on the application of algorithmic and data-driven technologies in mental health initiatives to identify the legal and ethical issues that have been raised. Methods: We searched for peer-reviewed empirical studies on the application of algorithmic technologies in mental health care in the Scopus, Embase, and Association for Computing Machinery databases. A total of 1078 relevant peer-reviewed applied studies were identified, which were narrowed to 132 empirical research papers for review based on selection criteria. Conventional content analysis was undertaken to address our aims, and this was supplemented by a keyword-in-context analysis. Results: We grouped the findings into the following five categories of technology: social media (53/132, 40.1%), smartphones (37/132, 28%), sensing technology (20/132, 15.1%), chatbots (5/132, 3.8%), and miscellaneous (17/132, 12.9%). Most initiatives were directed toward detection and diagnosis. Most papers discussed privacy, mainly in terms of respecting the privacy of research participants. There was relatively little discussion of privacy in this context. A small number of studies discussed ethics directly (10/132, 7.6%) and indirectly (10/132, 7.6%). Legal issues were not substantively discussed in any studies, although some legal issues were discussed in passing (7/132, 5.3%), such as the rights of user subjects and privacy law compliance. Conclusions: Ethical and legal issues tend to not be explicitly addressed in empirical studies on algorithmic and data-driven technologies in mental health initiatives. Scholars may have considered ethical or legal matters at the ethics committee or institutional review board stage. If so, this consideration seldom appears in published materials in applied research in any detail. The form itself of peer-reviewed papers that detail applied research in this field may well preclude a substantial focus on ethics and law. Regardless, we identified several concerns, including the near-complete lack of involvement of mental health service users, the scant consideration of algorithmic accountability, and the potential for overmedicalization and techno-solutionism. Most papers were published in the computer science field at the pilot or exploratory stages. Thus, these technologies could be appropriated into practice in rarely acknowledged ways, with serious legal and ethical implications. UR - https://mental.jmir.org/2021/6/e24668 UR - http://dx.doi.org/10.2196/24668 UR - http://www.ncbi.nlm.nih.gov/pubmed/34110297 ID - info:doi/10.2196/24668 ER - TY - JOUR AU - Fulford, Daniel AU - Gard, E. David AU - Mueser, T. Kim AU - Mote, Jasmine AU - Gill, Kathryn AU - Leung, Lawrence AU - Mow, Jessica PY - 2021/6/15 TI - Preliminary Outcomes of an Ecological Momentary Intervention for Social Functioning in Schizophrenia: Pre-Post Study of the Motivation and Skills Support App JO - JMIR Ment Health SP - e27475 VL - 8 IS - 6 KW - schizophrenia KW - psychosis KW - social functioning KW - social skills KW - motivation KW - mHealth KW - smartphone KW - mobile phone N2 - Background: People with schizophrenia and other serious mental illnesses often lack access to evidence-based interventions, particularly interventions that target meaningful recovery outcomes such as social functioning and quality of life. Mobile technologies, including smartphone apps, have the potential to provide scalable support that places elements of evidence-based interventions at the palm of patients? hands. Objective: We aim to develop a smartphone app?called Motivation and Skills Support?to provide targeted social goal support (eg, making new friends and improving existing relationships) for people with schizophrenia enrolled in a stand-alone open trial. Methods: In this paper, we presented preliminary outcomes of 31 participants who used the Motivation and Skills Support app for 8 weeks, including social functioning pre- to postintervention, and momentary reports of treatment targets (eg, social motivation and appraisals) during the intervention. Results: The findings suggest that the intervention improved self-reported social functioning from baseline to treatment termination, particularly in female participants. Gains were not maintained at the 3-month follow-up. Furthermore, increased social functioning was predicted by momentary reports of social appraisals, including perceived social competence and the extent to which social interactions were worth the effort. Conclusions: The implications of these findings and future directions for addressing social functioning in schizophrenia using mobile technology have been discussed. Trial Registration: ClinicalTrials.gov NCT03404219; https://clinicaltrials.gov/ct2/show/NCT03404219 UR - https://mental.jmir.org/2021/6/e27475 UR - http://dx.doi.org/10.2196/27475 UR - http://www.ncbi.nlm.nih.gov/pubmed/34128812 ID - info:doi/10.2196/27475 ER - TY - JOUR AU - Stafford, Elizabeth AU - Brister, Teri AU - Duckworth, Ken AU - Rauseo-Ricupero, Natali AU - Lagan, Sarah PY - 2021/6/9 TI - Needs and Experiences of Users of Digital Navigation Tools for Mental Health Treatment and Supportive Services: Survey Study JO - JMIR Ment Health SP - e27022 VL - 8 IS - 6 KW - mental health KW - supportive services KW - perception KW - quality KW - satisfaction KW - needs KW - digital tools KW - directories KW - navigation N2 - Background: Despite a recent proliferation in web-based and digital resources that are designed to assist users in finding appropriate mental health treatment and supportive services, it can be overwhelming, confusing, and difficult for an individual or family member to access and use an appropriate navigation tool. As digital resources are increasingly sought after, there is an urgent need for a clearer understanding of digital navigation tools in order to help link individuals with the tool that is best suited to their needs. Objective: The objective of this study was to determine the needs of individuals seeking mental health treatment and supportive services and to quantify their experiences and satisfaction with available digital navigation tools. Methods: A survey was offered via an email newsletter and social media posting throughout the extended membership of the National Alliance on Mental Illness, which includes both individuals with a mental health condition and their family members and support networks. A 13-item anonymous survey, which consisted of multiple-choice and open response options, was developed to measure participants? past use of and experiences with web-based, mobile, and phone-based navigation tools. The survey was available from April 9 through May 21, 2020. Results: A total of 478 respondents completed the survey; the majority of respondents were female (397/478, 83.1%) and aged ?35 years (411/478, 86%). Younger respondents were more likely to report seeking mental health services for themselves, while older respondents were more likely to be searching for such services on behalf of a family member. The majority of respondents seeking such services on behalf of a family member (113/194, 58.2%) required a combination of mental health treatment and supportive services. Furthermore, two-thirds of respondents (322/478, 67.4%) used a navigation tool to find treatment or services. The majority of respondents who provided feedback about their experiences with navigation tools (224/280, 80%) reported difficulties, with data availability and accuracy being the most commonly reported issues. Conclusions: The survey results suggest that issues with data availability and accuracy in available navigation tools remain a major barrier for locating timely and appropriate mental health treatment and supportive services within the population of individuals seeking such services. Particularly for individuals seeking care on behalf of a family member, improving the accuracy of and users? experiences with navigation tools could have a major impact on effectively connecting people to treatment and support services. UR - https://mental.jmir.org/2021/6/e27022 UR - http://dx.doi.org/10.2196/27022 UR - http://www.ncbi.nlm.nih.gov/pubmed/34106079 ID - info:doi/10.2196/27022 ER - TY - JOUR AU - Williams, Anne AU - Fossey, Ellie AU - Farhall, John AU - Foley, Fiona AU - Thomas, Neil PY - 2021/6/16 TI - Impact of Jointly Using an e?Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study JO - JMIR Ment Health SP - e25998 VL - 8 IS - 6 KW - digital mental health KW - tablet computers KW - therapeutic relationship KW - recovery narratives KW - lived experience video KW - personal recovery KW - schizophrenia KW - mobile phone N2 - Background: e?Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e?mental health resources together with their community mental health workers (MHWs) has received little attention. Objective: This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. Methods: We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study?s credibility. Results: A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs? experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building?their interactions when using the website together were more engaging and equal. Conclusions: Jointly using an e?mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e?mental health in community mental health practice is warranted. UR - https://mental.jmir.org/2021/6/e25998 UR - http://dx.doi.org/10.2196/25998 UR - http://www.ncbi.nlm.nih.gov/pubmed/34132647 ID - info:doi/10.2196/25998 ER - TY - JOUR AU - Chilman, Natasha AU - Morant, Nicola AU - Lloyd-Evans, Brynmor AU - Wackett, Jane AU - Johnson, Sonia PY - 2021/6/29 TI - Twitter Users? Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis JO - JMIR Ment Health SP - e25742 VL - 8 IS - 6 KW - Twitter KW - social media KW - qualitative KW - crisis resolution team KW - home treatment team KW - mental health KW - acute care KW - severe mental illness N2 - Background: Analyzing Twitter posts enables rapid access to how issues and experiences are socially shared and constructed among communities of health service users and providers, in ways that traditional qualitative methods may not. Objective: To enrich the understanding of mental health crisis care in the United Kingdom, this study explores views on crisis resolution teams (CRTs) expressed on Twitter. We aim to identify the similarities and differences among views expressed on Twitter compared with interviews and focus groups. Methods: We used Twitter?s advanced search function to retrieve public tweets on CRTs. A thematic analysis was conducted on 500 randomly selected tweets. The principles of refutational synthesis were applied to compare themes with those identified in a multicenter qualitative interview study. Results: The most popular hashtag identified was #CrisisTeamFail, where posts were principally related to poor quality of care and access, particularly for people given a personality disorder diagnosis. Posts about CRTs giving unhelpful self-management advice were common, as were tweets about resource strains on mental health services. This was not identified in the research interviews. Although each source yielded unique themes, there were some overlaps with themes identified via interviews and focus groups, including the importance of rapid access to care. Views expressed on Twitter were generally more critical than those obtained via face-to-face methods. Conclusions: Traditional qualitative studies may underrepresent the views of more critical stakeholders by collecting data from participants accessed via mental health services. Research on social media content can complement traditional or face-to-face methods and ensure that a broad spectrum of viewpoints can inform service development and policy. UR - https://mental.jmir.org/2021/6/e25742 UR - http://dx.doi.org/10.2196/25742 UR - http://www.ncbi.nlm.nih.gov/pubmed/34185017 ID - info:doi/10.2196/25742 ER - TY - JOUR AU - March, Sonja AU - Batterham, J. Philip AU - Rowe, Arlen AU - Donovan, Caroline AU - Calear, L. Alison AU - Spence, H. Susan PY - 2021/6/18 TI - Trajectories of Change in an Open-access Internet-Based Cognitive Behavior Program for Childhood and Adolescent Anxiety: Open Trial JO - JMIR Ment Health SP - e27981 VL - 8 IS - 6 KW - iCBT KW - child KW - adolescent KW - anxiety KW - online KW - trajectories of change N2 - Background: Although evidence bolstering the efficacy of internet-based cognitive behavioral therapy (iCBT) for treating childhood anxiety has been growing continuously, there is scant empirical research investigating the timing of benefits made in iCBT programs (eg, early or delayed). Objective: This study aims to examine the patterns of symptom trajectories (changes in anxiety) across an iCBT program for anxiety (BRAVE Self-Help). Methods: This study?s participants included 10,366 Australian youth aged 7 to 17 years (4140 children aged 7-12 years; 6226 adolescents aged 12-17 years) with elevated anxiety who registered for the BRAVE Self-Help program. Participants self-reported their anxiety symptoms at baseline or session 1 and then at the commencement of each subsequent session. Results: The results show that young people completing the BRAVE Self-Help program tend to fall into two trajectory classes that can be reliably identified in terms of high versus moderate baseline levels of anxiety and subsequent reduction in symptoms. Both high and moderate anxiety severity trajectory classes showed significant reductions in anxiety, with the greatest level of change being achieved within the first six sessions for both classes. However, those in the moderate anxiety severity class tended to show reductions in anxiety symptoms to levels below the elevated range, whereas those in the high symptom group tended to remain in the elevated range despite improvements. Conclusions: These findings suggest that those in the high severity group who do not respond well to iCBT on a self-help basis may benefit from the additional support provided alongside the program or a stepped-care approach where progress is monitored and support can be provided as necessary. UR - https://mental.jmir.org/2021/6/e27981 UR - http://dx.doi.org/10.2196/27981 UR - http://www.ncbi.nlm.nih.gov/pubmed/34142971 ID - info:doi/10.2196/27981 ER - TY - JOUR AU - Athanas, J. Argus AU - McCorrison, M. Jamison AU - Smalley, Susan AU - Price, Jamie AU - Grady, Jim AU - Wehner, Paul AU - Campistron, Julie AU - Schork, J. Nicholas PY - 2021/6/30 TI - Correction: Association Between Improvement in Baseline Mood and Long-Term Use of a Mindfulness and Meditation App: Observational Study JO - JMIR Ment Health SP - e28132 VL - 8 IS - 6 UR - https://mental.jmir.org/2021/6/e28132 UR - http://dx.doi.org/10.2196/28132 UR - http://www.ncbi.nlm.nih.gov/pubmed/34255702 ID - info:doi/10.2196/28132 ER - TY - JOUR AU - Cohrdes, Caroline AU - Yenikent, Seren AU - Wu, Jiawen AU - Ghanem, Bilal AU - Franco-Salvador, Marc AU - Vogelgesang, Felicitas PY - 2021/6/18 TI - Indications of Depressive Symptoms During the COVID-19 Pandemic in Germany: Comparison of National Survey and Twitter Data JO - JMIR Ment Health SP - e27140 VL - 8 IS - 6 KW - depressive symptoms KW - GEDA/EHIS survey KW - Twitter KW - COVID-19 KW - pandemic KW - social contact ban KW - temporal progression KW - data correspondence KW - public mental health surveillance KW - depression KW - survey KW - social media KW - data KW - infodemiology KW - infoveillance KW - mental health KW - public health KW - surveillance KW - monitoring KW - symptom N2 - Background: The current COVID-19 pandemic is associated with extensive individual and societal challenges, including challenges to both physical and mental health. To date, the development of mental health problems such as depressive symptoms accompanying population-based federal distancing measures is largely unknown, and opportunities for rapid, effective, and valid monitoring are currently a relevant matter of investigation. Objective: In this study, we aim to investigate, first, the temporal progression of depressive symptoms during the COVID-19 pandemic and, second, the consistency of the results from tweets and survey-based self-reports of depressive symptoms within the same time period. Methods: Based on a cross-sectional population survey of 9011 German adolescents and adults (n=4659, 51.7% female; age groups from 15 to 50 years and older) and a sample of 88,900 tweets (n=74,587, 83.9% female; age groups from 10 to 50 years and older), we investigated five depressive symptoms (eg, depressed mood and energy loss) using items from the Patient Health Questionnaire (PHQ-8) before, during, and after relaxation of the first German social contact ban from January to July 2020. Results: On average, feelings of worthlessness were the least frequently reported symptom (survey: n=1011, 13.9%; Twitter: n=5103, 5.7%) and fatigue or loss of energy was the most frequently reported depressive symptom (survey: n=4472, 51.6%; Twitter: n=31,005, 34.9%) among both the survey and Twitter respondents. Young adult women and people living in federal districts with high COVID-19 infection rates were at an increased risk for depressive symptoms. The comparison of the survey and Twitter data before and after the first contact ban showed that German adolescents and adults had a significant decrease in feelings of fatigue and energy loss over time. The temporal progression of depressive symptoms showed high correspondence between both data sources (?=0.76-0.93; P<.001), except for diminished interest and depressed mood, which showed a steady increase even after the relaxation of the contact ban among the Twitter respondents but not among the survey respondents. Conclusions: Overall, the results indicate relatively small differences in depressive symptoms associated with social distancing measures during the COVID-19 pandemic and highlight the need to differentiate between positive (eg, energy level) and negative (eg, depressed mood) associations and variations over time. The results also underscore previous suggestions of Twitter data?s potential to help identify hot spots of declining and improving public mental health and thereby help provide early intervention measures, especially for young and middle-aged adults. Further efforts are needed to investigate the long-term consequences of recurring lockdown phases and to address the limitations of social media data such as Twitter data to establish real-time public mental surveillance approaches. UR - https://mental.jmir.org/2021/6/e27140 UR - http://dx.doi.org/10.2196/27140 UR - http://www.ncbi.nlm.nih.gov/pubmed/34142973 ID - info:doi/10.2196/27140 ER - TY - JOUR AU - Cyranka, Katarzyna AU - Dudek, Dominika AU - Ma?ecki, Tadeusz Maciej AU - Matejko, Bart?omiej AU - Klupa, Tomasz PY - 2021/6/30 TI - Psychological Crisis Intervention for COVID-19 Lockdown Stress in Patients With Type 1 Diabetes Mellitus: Survey Study and Qualitative Analysis JO - JMIR Ment Health SP - e28097 VL - 8 IS - 6 KW - COVID-19 KW - pandemic KW - type 1 diabetes mellitus KW - crisis psychological intervention KW - anxiety KW - stress KW - psychosomatics KW - diabetes KW - type 1 KW - psychology KW - crisis situation KW - intervention N2 - Background: The COVID-19 pandemic has challenged the worldviews of most people. Social isolation after the COVID-19 lockdown has not only led to economic difficulties but also resulted in adverse psychological reactions. As in most countries, including Poland, this situation has been very challenging for patients with type 1 diabetes mellitus (T1DM). In Poland, a crisis intervention team for patients with T1DM was established. The goal of the team was to provide psychological support for these patients, if needed, and to present information concerning how these patients may obtain medical consultations and prescriptions. Objective: We aimed to analyze the psychological parameters and main emotional reactions of patients with T1DM during the COVID-19 lockdown. Methods: An email with information concerning the possibility of having a web-based consultation with psychologists and psychiatrists and an attached set of psychological tests was sent to all patients with T1DM who were under the care of an outpatient diabetes clinic. The consultations were performed by licensed clinical psychologists and psychologists. This study was approved by the Bioethics Committee of the Jagiellonian University in Krakow, Poland. Results: The patients who decided to use psychological support had statistically higher levels of anxiety (state P=.043; trait P=.022), stress (P=.001) than those of patients from the group who did not seek support. Conclusions: The presented intervention team may be perceived as an example of important and successful cooperation and communication between specialists of different fields of medicine (diabetology, psychiatry, and psychology) in a crisis situation. UR - https://mental.jmir.org/2021/6/e28097 UR - http://dx.doi.org/10.2196/28097 UR - http://www.ncbi.nlm.nih.gov/pubmed/33852411 ID - info:doi/10.2196/28097 ER -