Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication and repetitive behaviours, highly restricted interests and/or sensory behaviours beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries. Although gross brain pathology is not characteristic of autism, subtle anatomical and functional differences have been observed in post-mortem, neuroimaging and electrophysiological studies. Initially, it was hoped that accurate measurement of behavioural phenotypes would lead to specific genetic subtypes, but genetic findings have mainly applied to heterogeneous groups that are not specific to autism. Psychosocial interventions in children can improve specific behaviours, such as joint attention, language and social engagement, that may affect further development and could reduce symptom severity. However, further research is necessary to identify the long-term needs of people with autism, and treatments and the mechanisms behind them that could result in improved independence and quality of life over time. Families are often the major source of support for people with autism throughout much of life and need to be considered, along with the perspectives of autistic individuals, in both research and practice.

/pdf/autism-spectrum-disorder-55g4bscnxz.pdf

Autism spectrum disorder

Background

The COVID-19 pandemic has created an unprecedented global crisis necessitating drastic changes to living conditions, social life, personal freedom and economic activity. No study has yet examined the presence of psychiatric symptoms in the UK population in similar conditions.

Aims

We investigated the prevalence of COVID-19 related anxiety, generalised anxiety, depression and trauma symptoms in a representative sample of the UK population during an early phase of the pandemic, and estimated associations with variables likely to influence these symptoms.

Method

Between March 23rd and March 28th 2020, a quota sample of 2025 UK adults 18 years and older, stratified by age, sex and household income, was recruited by online survey company Qualtrics. Participants completed measures of depression (PHQ9), generalised anxiety (GAD7), and trauma symptoms relating to the pandemic (ITQ). Bivariate and multivariate associations were calculated for age, gender, rural vs urban environment, presence of children in the household, income, loss of income, pre-existing health conditions in self and someone close, infection in self and someone close, and perceived risk of infection over the next month.

Results

Higher levels of anxiety, depression and trauma symptoms were reported compared to previous population studies, but not dramatically so. Meeting the criteria for either anxiety or depression, and trauma symptoms was predicted by young age, presence of children in the home, and high estimates of personal risk. Anxiety and depression symptoms were also predicted by low income, loss of income, and pre-existing health conditions in self and other. Specific anxiety about COVID-19 was greater in older participants.

Conclusions

The UK population, especially older citizens, were largely resilient in the early stages of the pandemic. However, several specific COVID-related variables are associated with psychological distress: particularly having children at home, loss of income because of the pandemic, as well as having a pre-existing health condition, exposure to the virus and high estimates of personal risk. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses.

/pdf/anxiety-depression-traumatic-stress-and-covid-19-related-35yoqfgo3w.pdf

Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic

OBJECTIVE: There is some evidence that men and women deal with stress in different ways; for example, a meta-analysis found that women prefer to focus on emotions as a coping strategy more than men do. However, sex differences in preferences for therapy is a subject little explored. DESIGN: A cross-sectional online survey. METHOD: Participants (115 men and 232 women) were recruited via relevant websites and social media. The survey described therapies and asked participants how much they liked each. Their coping strategies and help-seeking behaviour were assessed too. RESULTS: Survey data were analysed using multiple linear regression. After familywise adjustment of the alpha for multiple testing to p < .0125, and controlling for other relevant variables, men liked support groups more than women did (β = -.163, p < .010), used sex or pornography to cope with stress more than women did (Exp[B] = .280, p < .0002), and thought that there is a lack of male-friendly options more than women did (Exp[B] = .264, p < .002). The majority of participants expressed no preference for the sex of their therapist, but of those who did, men were only slightly more likely to prefer a female therapist whereas women were much more likely to prefer females (p < .0004). Even after familywise adjustment, there were still more significant findings than would be expected by chance (p < .001, two-tailed). CONCLUSIONS: Although there are many similarities in the preferences of men and women regarding therapy, our findings support the hypothesis that men and women show statistically significant differences of relevance to clinical psychologists. PRACTITIONER POINTS: Men are less inclined than women to seek help for psychological issues This study demonstrates that men and women show significant differences in some aspects of therapy, coping behaviour, and help-seeking It is possible that men would be more inclined to seek help if therapies catered more for men's preferences Practitioners can learn to improve the success of their practice by taking the gender of clients into account.

/pdf/gender-differences-in-preferences-for-psychological-m3fzdeou6y.pdf

Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking

Background:Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was ...

The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity.

Background Routine outcome monitoring of common mental health disorders (CMHDs), using patient reported outcome measures (PROMs), has been promoted across primary care, psychological therapy and multidisciplinary mental health care settings, but is likely to be costly, given the high prevalence of CMHDs. There has been no systematic review of the use of PROMs in routine outcome monitoring of CMHDs across these three settings. Objectives To assess the effects of routine measurement and feedback of the results of PROMs during the management of CMHDs in 1) improving the outcome of CMHDs; and 2) in changing the management of CMHDs. Search methods We searched the Cochrane Depression Anxiety and Neurosis group specialised controlled trials register (CCDANCTR-Studies and CCDANCTR-References), the Oxford University PROMS Bibliography (2002-5), Ovid PsycINFO, Web of Science, The Cochrane Library, and International trial registries, initially to 30 May 2014, and updated to 18 May 2015. Selection criteria We selected cluster and individually randomised controlled trials (RCTs) including participants with CMHDs aged 18 years and over, in which the results of PROMs were fed back to treating clinicians, or both clinicians and patients. We excluded RCTs in child and adolescent treatment settings, and those in which more than 10% of participants had diagnoses of eating disorders, psychoses, substance use disorders, learning disorders or dementia. Data collection and analysis At least two authors independently identified eligible trials, assessed trial quality, and extracted data. We conducted meta-analysis across studies, pooling outcome measures which were sufficiently similar to each other to justify pooling. Main results We included 17 studies involving 8787 participants: nine in multidisciplinary mental health care, six in psychological therapy settings, and two in primary care. Pooling of outcome data to provide a summary estimate of effect across studies was possible only for those studies using the compound Outcome Questionnaire (OQ-45) or Outcome Rating System (ORS) PROMs, which were all conducted in multidisciplinary mental health care or psychological therapy settings, because both primary care studies identified used single symptom outcome measures, which were not directly comparable to the OQ-45 or ORS.Meta-analysis of 12 studies including 3696 participants using these PROMs found no evidence of a difference in outcome in terms of symptoms, between feedback and no-feedback groups (standardised mean difference (SMD) -0.07, 95% confidence interval (CI) -0.16 to 0.01; P value = 0.10). The evidence for this comparison was graded as low quality however, as all included studies were considered at high risk of bias, in most cases due to inadequate blinding of assessors and significant attrition at follow-up.Quality of life was reported in only two studies, social functioning in one, and costs in none. Information on adverse events (thoughts of self-harm or suicide) was collected in one study, but differences between arms were not reported.It was not possible to pool data on changes in drug treatment or referrals as only two studies reported these. Meta-analysis of seven studies including 2608 participants found no evidence of a difference in management of CMHDs between feedback and no-feedback groups, in terms of the number of treatment sessions received (mean difference (MD) -0.02 sessions, 95% CI -0.42 to 0.39; P value = 0.93). However, the evidence for this comparison was also graded as low quality. Authors' conclusions We found insufficient evidence to support the use of routine outcome monitoring using PROMs in the treatment of CMHDs, in terms of improving patient outcomes or in improving management. The findings are subject to considerable uncertainty however, due to the high risk of bias in the large majority of trials meeting the inclusion criteria, which means further research is very likely to have an important impact on the estimate of effect and is likely to change the estimate. More research of better quality is therefore required, particularly in primary care where most CMHDs are treated.Future research should address issues of blinding of assessors and attrition, and measure a range of relevant symptom outcomes, as well as possible harmful effects of monitoring, health-related quality of life, social functioning, and costs. Studies should include people treated with drugs as well as psychological therapies, and should follow them up for longer than six months.

/pdf/routine-use-of-patient-reported-outcome-measures-proms-for-1bo5i4oakf.pdf

Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults.

TRENDS IN MENTAL ILLNESS: • One adult in six had a common mental disorder (CMD): about one woman in
five and one man in eight. Since 2000, overall rates of CMD in England steadily
increased in women and remained largely stable in men.
• Reported rates of self-harming increased in men and women and across age
groups since 2007. However, much of this increase in reporting may have been
due to greater awareness about the behaviour.
• Young women have emerged as a high-risk group, with high rates of CMD, selfharm,
and positive screens for posttraumatic stress disorder (PTSD) and bipolar
disorder. The gap between young women and young men increased.
• Most mental disorders were more common in people living alone, in poor physical
health, and not employed. Claimants of Employment and Support Allowance
(ESA), a benefit aimed at those unable to work due to poor health or disability,
experienced particularly high rates of all the disorders assessed.
TRENDS IN TREATMENT AND SERVICE USE: 
• One person in three with CMD reported current use of mental health treatment
in 2014, an increase from the one in four who reported this in 2000 and 2007.
This was driven by steep increases in reported use of psychotropic medication.
Increased use of psychological therapies was also evident among people with
more severe CMD symptoms.
• There were demographic inequalities in who received treatment. After controlling
for level of need, people who were White British, female, or in mid-life (especially
aged 35 to 54) were more likely to receive treatment. People in the Black ethnic
group had particularly low treatment rates.
• Socioeconomic inequalities in treatment use were less evident, although people
living in lower income households were more likely to have requested but not
received a particular mental health treatment.
• Since 2007, people with CMD had become more likely to use community services
and more likely to discuss their mental health with a GP.

Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. A survey carried out for NHS Digital by NatCen Social Research andthe Department of Health Sciences, University of Leicester

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Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. A survey carried out for NHS Digital by NatCen Social Research andthe Department of Health Sciences, University of Leicester