Classifying Unstructured Text in Electronic Health Records for Mental Health Prediction Models: Large Language Model Evaluation Study.

Background: Prediction models have demonstrated a range of applications across medicine, including using electronic health record (EHR) data to identify hospital readmission and mortality risk. Large language models (LLMs) can transform unstructured EHR text into structured features, which can then be integrated into statistical prediction models, ensuring that the results are both clinically meaningful and interpretable.

Objective: This study aims to compare the classification decisions made by clinical experts with those generated by a state-of-the-art LLM, using terms extracted from a large EHR data set of individuals with mental health disorders seen in emergency departments (EDs).

Schizophrenia and retention in HIV care among adults insured through Medicaid in the United States: a population-based retrospective cohort study.

Background: People with schizophrenia spectrum disorders are at elevated risk of HIV, and people with both HIV and schizophrenia are at elevated risk of death compared to individuals with either diagnosis alone. Limited research has assessed the HIV care cascade, and in particular retention in care, among people with HIV (PWH) and schizophrenia in the U.S.

Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001-2019.

Background And Aim: Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.

Design: Annual, cross-sectional study, 2001-2019.

Completeness and quality of comprehensive managed care data compared with fee-for-service data in national Medicaid claims from 2001 to 2019.

Objective: To evaluate the completeness and quality of Medicaid comprehensive managed care (CMC) data in national MAX/TAF research files.

Study Setting And Design: This observational study compared CMC with fee-for-service (FFS) enrollee data in 2001-2019 Medicaid MAX/TAF inpatient, outpatient, and pharmacy files. Completeness was assessed as the proportion of enrollees with any claim and mean claims per enrollee with any claim.

Current Utilization of Bupropion Treatment in Children, Young Adults, and Adults in the United States.

While available for decades, the use of bupropion has increased in recent years. To provide an updated review on the use of bupropion, this article aimed to describe bupropion prescription details, potential indication, and treatment duration in children, young adults, and adults starting bupropion treatment. Individuals aged 6-64 newly initiating bupropion hydrochloride treatment were identified from commercial claims data (MarketScan, 1/1/2016-12/31/2022).

Trends in Opioid Use Disorder in the Veterans Health Administration, 2005-2022.

Importance: Given the personal and social burdens of opioid use disorder (OUD), understanding time trends in OUD prevalence in large patient populations is key to planning prevention and treatment services.

Objective: To examine trends in the prevalence of OUD from 2005 to 2022 overall and by age, sex, and race and ethnicity.

Design, Setting, And Participants: This serial cross-sectional study included national Veterans Health Administration (VHA) electronic medical record data from the VHA Corporate Data Warehouse.

Sex Differences in Antidepressant Acceptability According to Filled Prescription Sequences in a Nationwide Cohort Study.

The prevalence of depressive and anxiety disorders is higher in women than in men. In contrast, there is still no clear consensus on the existence of sex-related differences in the effectiveness of antidepressant treatments for these disorders. This real-world study used filled prescription sequences to compare antidepressant medications between women and men at a medication level according to their acceptability (ie, combination of efficacy and tolerability).

Mortality Risks of US Healthcare Workers.

Introduction: Physicians and nurses have lower annual mortality rates than the general population. One explanation for the low mortality rates of these healthcare workers emphasizes their specialized medical knowledge and greater access to healthcare while a second emphasizes their generally higher level of education. We evaluated the extent to which general educational level accounts for the lower all-cause mortality rates of US healthcare than non-healthcare workers.

Longitudinal trajectories of symptom change during antidepressant treatment among managed care patients with depression and anxiety.

Despite the high correlation between anxiety and depression, little remains known about the course of each condition when presenting concurrently. This study aimed to identify longitudinal patterns during antidepressant treatment in patients with depression and anxiety, and evaluate related factors associated with these patterns. By analyzing longitudinal self-report Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores that tracked courses of depression and anxiety over a three-month window among the 577 adult participants, six depression and six anxiety trajectory subgroups were computationally derived using group-based trajectory modeling.

Correction: Social connectedness as a determinant of mental health: A scoping review.

[This corrects the article DOI: 10.1371/journal.pone.

Cannabis Use and Cannabis Use Disorder Among U.S. Adults with Psychiatric Disorders: 2001-2002 and 2012-2013.

Background: Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S.

Medicaid expansion and medications to treat opioid use disorder in outpatient specialty care from 2010 to 2020.

Introduction: Medications for opioid use disorder (MOUD) are considered the first line treatment for opioid use disorder. As states expanded Medicaid beginning in 2014 under the Affordable Care Act, policymakers and public health officials were interested in the potential for expansion to increase access to MOUD. This study examined whether there were changes in MOUD use within outpatient admissions to specialty treatment facilities in Medicaid expansion states beyond the initial expansion period.

Emergency Department Utilization for Postpartum Behavioral Health Problems and Assault Injury During the COVID-19 Pandemic.

Distinctive stressors facing pregnant and postpartum individuals during the COVID-19 pandemic may have affected their emergency department (ED) care-seeking for behavioral health concerns and violence victimization. We tested whether the incidence of postpartum behavioral health and assault injury ED visits differed for individuals according to their months of postpartum pandemic exposure. We used statewide, longitudinally linked hospital and ED administrative claims data from California to classify all individuals with hospital deliveries between January 1, 2016, and December 31, 2020, according to their months of postpartum pandemic exposure.

Extracting social support and social isolation information from clinical psychiatry notes: comparing a rule-based natural language processing system and a large language model.

Objectives: Social support (SS) and social isolation (SI) are social determinants of health (SDOH) associated with psychiatric outcomes. In electronic health records (EHRs), individual-level SS/SI is typically documented in narrative clinical notes rather than as structured coded data. Natural language processing (NLP) algorithms can automate the otherwise labor-intensive process of extraction of such information.

Parenthood and All-cause Mortality in Older Adults with Schizophrenia: A Multicenter 5-Year Prospective Study.

Objective: The large body of literature examining the association between parenthood and mortality in the general population contrasts with a lack of studies among older adults with schizophrenia. Identifying potential protective factors of premature death in this population is important to help guide prevention measures. Here, we examined whether all-cause and cause-specific mortality rates significantly differ between older adults with schizophrenia with and without children, during a 5-year follow-up.

Characterizing Schizophrenia Spectrum Disorders: Results of the U.S. Mental and Substance Use Disorders Prevalence Study.

Objective: Current information on treatment and clinical characteristics of U.S. adults with schizophrenia spectrum disorders (i.

Nicotine dependence and incident psychiatric disorders: prospective evidence from US national study.

We examined the prospective associations between nicotine dependence and the likelihood of psychiatric and substance use disorders in the general adult population. Participants came from a nationally representative sample of US adults aged 18 years or older, who were interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001-2002; Wave 2, 2004-2005). The primary analyses were limited to 32,671 respondents (13,751 male (47.

High Out-of-Pocket Cost Burden of Mental Health Care for Adult Outpatients in the United States.

Objective: This report describes characteristics of patients who had high out-of-pocket (OOP) spending on mental health care relative to income.

Methods: A sample of 8,923 U.S.

Trends in Mental Disorders in Children and Adolescents Receiving Treatment in the State Mental Health System.

Objective: To examine recent trends in clinical diagnoses of children and adolescents receiving treatment in publicly funded mental health treatment services in the United States.

Method: Data on children and adolescents (≤17 years) receiving treatment from publicly funded mental health treatment services recorded in Mental Health Client-Level Data 2013-2021 (total number of records = 13,684,154) were used to examine temporal trends in the proportion of different child and adolescent psychiatric disorders. Trends were examined overall and in age, sex, racial/ethnic, and service strata focusing on community-based programs.