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Comendador L, Jiménez-Villamizar MP, Losilla JM, Sanabria-Mazo JP, Mateo-Canedo C, Cebrià AI, Sanz A, Palao DJ. Effect of synchronous remote-based interventions on suicidal behaviours: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e075116. [PMID: 38056944 PMCID: PMC10711844 DOI: 10.1136/bmjopen-2023-075116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Suicide is among the leading causes of preventable death worldwide. The impact of suicide affects the personal, social and economic levels. Therefore, its prevention is a priority for public health systems. Previous studies seem to support the efficacy of providing active contact to people who have made a suicide attempt. The current systematic review and meta-analysis aims to investigate the efficacy of distance suicide prevention strategies implemented through synchronous technology-based interventions. METHODS AND ANALYSIS This protocol is designed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The bibliographical searches were conducted in the databases PubMed, PsycINFO, Scopus and Web of Science in April 2022, with no restrictions on the time of publication and limited to publications in English or Spanish. The search strategy was performed using free-text terms and Medical Subject Headings terms: suicide, follow-up, synchronous, remote, telehealth, telephone, hotline, video-conference and text message. Two reviewers will independently conduct study screening, selection process, data extraction and risk of bias assessment. The analysis and synthesis of the results will be both qualitative and quantitative. A narrative synthesis, presented in a comprehensive table, will be performed and meta-analysis will be conducted, as appropriate, if sufficient data are provided. ETHICS AND DISSEMINATION The present review and meta-analysis will not require ethical approval, as it will use data collected from previously published primary studies. The findings of this review will be published in peer-reviewed journals and widely disseminated. PROSPERO REGISTRATION NUMBER CRD42021275044.
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Affiliation(s)
- Laura Comendador
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
- Parc Taulí Research and Innovation Institute, Sabadell, Spain
| | - María Paola Jiménez-Villamizar
- Department of Basic, Developmental, and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep-Maria Losilla
- Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Juan P Sanabria-Mazo
- Department of Basic, Developmental, and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Corel Mateo-Canedo
- Department of Basic, Developmental, and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Ana Isabel Cebrià
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
- Parc Taulí Research and Innovation Institute, Sabadell, Spain
| | - Antoni Sanz
- Department of Basic, Developmental, and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Diego J Palao
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
- Parc Taulí Research and Innovation Institute, Sabadell, Spain
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Lewis-Fernández R, Chen CN, Olfson M, Interian A, Alegría M. Clinical significance of psychotic-like experiences across U.S. ethnoracial groups. Psychol Med 2023; 53:7666-7676. [PMID: 37272381 PMCID: PMC10755236 DOI: 10.1017/s0033291723001496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Prevalence of psychotic-like experiences (PLEs) - reports of hallucinations and delusional thinking not meeting criteria for psychotic disorder - varies substantially across ethnoracial groups. What explains this range of PLE prevalence? Despite extensive research, the clinical significance of PLEs remains unclear. Are PLE prevalence and clinical severity differentially associated across ethnoracial groups? METHODS We examined the lifetime prevalence and clinical significance of PLEs across ethnoracial groups in the Collaborative Psychiatric Epidemiology Surveys (N = 11 139) using the Composite International Diagnostic Interview (CIDI) psychosis symptom screener. Outcomes included mental healthcare use (inpatient, outpatient), mental health morbidity (self-perceived poor/fair mental health, suicidal ideation or attempts), and impairment (role interference). Individuals with outcome onsets prior to PLE onset were excluded. We also examined associations of PLEs with CIDI diagnoses. Cox proportional-hazards regression and logistic regression modeling identified associations of interest. RESULTS Contrary to previous reports, only Asian Americans differed significantly from other U.S. ethnoracial groups, reporting lower lifetime prevalence (6.7% v. 8.0-11.9%) and mean number (0.09 v. 0.11-0.18) of PLEs. In multivariate analyses, PLE clinical significance showed limited ethnoracial variation among Asian Americans, non-Caribbean Latinos, and Afro-Caribbeans. In other groups, mental health outcomes showed significant ethnoracial clustering by outcome (e.g. hospitalization and role interference with Caribbean-Latino origin), possibly due to underlying differences in psychiatric disorder chronicity or treatment barriers. CONCLUSIONS While there is limited ethnoracial variation in U.S. PLE prevalence, PLE clinical significance varies across U.S. ethnoracial groups. Clinicians should consider this variation when assessing PLEs to avoid exaggerating their clinical significance, contributing to mental healthcare disparities.
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Affiliation(s)
- Roberto Lewis-Fernández
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Chih-nan Chen
- Department of Economics, National Taipei University, Taipei, Taiwan, Republic of China
| | - Mark Olfson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Alejandro Interian
- Mental Health and Behavioral Sciences, VA New Jersey Healthcare System, Lyons, NJ, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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Wong SYS, Chan SKC, Yip BHK, Wang W, Lo HHM, Zhang D, Bögels SM. The Effects of Mindfulness for Youth (MYmind) versus Group Cognitive Behavioral Therapy in Improving Attention and Reducing Behavioral Problems among Children with Attention-Deficit Hyperactivity Disorder and Their Parents: A Randomized Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2023; 92:379-390. [PMID: 38043516 PMCID: PMC10794968 DOI: 10.1159/000534962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION There is a lack of studies evaluating mindfulness-based interventions for children with attention-deficit hyperactivity disorder (ADHD) compared with an evidence-based control. This randomized controlled trial (RCT) evaluated the effects of mindfulness for youth (MYmind) in improving children's attention, behavior, and parent-related outcomes versus cognitive behavioral therapy (CBT). METHODS A total of 138 families of children with ADHD aged 8-12 years were recruited from the community with 69 randomized to MYmind and 69 to CBT. Participants were assessed at baseline, immediately after intervention, at 3 months and 6 months. The primary outcome was the attention score of the Sky Search subtest of the Test of Everyday Attention for Children (TEA-Ch). Secondary outcomes were child behavior and parent-related assessments. Linear mixed models were used to assess the efficacy of MYmind compared with CBT. RESULTS Both MYmind and CBT significantly improved children's attention score at 6 months (MYmind: β = 1.48, p = 0.013, Cohen's d = 0.32; CBT: β = 1.46, p = 0.008, d = 0.27). There were significant within-group improvements in most secondary outcomes. No significant difference was shown for both primary or secondary outcomes between the two arms at any time point. CONCLUSIONS Both MYmind and CBT appeared to improve children's attention and behavior outcomes, although no difference was found between these two interventions. This is the largest RCT so far comparing MYmind and CBT although there was loss of follow-up assessments during the pandemic. Further RCTs adopting a non-inferiority design are needed to validate the results.
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Affiliation(s)
- Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Stanley Kam Chung Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Benjamin Hon Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Wenyue Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Herman Hay Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Susan M. Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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Woods SB, Roberson PNE, Abdelkhaleq H. Family strain, but not family support, is linked to worse pain interference among midlife adults reporting new chronic pain. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2023; 41:467-477. [PMID: 37410420 PMCID: PMC10770288 DOI: 10.1037/fsh0000825] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Although family relationship quality has been linked to later chronic pain incidence for aging adults, it is unclear whether the quality of these relationships is linked to the impact of pain. We estimated longitudinal associations between family relationship quality (i.e., family support and family strain) and pain interference for adults who develop novel chronic pain across 10 years of midlife. METHOD We conducted a secondary analysis of data from the Midlife in the United States (MIDUS) study. Using path analysis, we tested whether family support and strain reported by participants (54% female, age M = 54.8 years) who denied having chronic pain at the study's second wave (MIDUS 2, 2004-2006) but reported chronic pain 10 years later (MIDUS 3, 2014-2016; N = 406) was associated with the interference of that pain with daily activities after accounting for key covariates, including sociodemographics, depression symptoms, global physical health, and MIDUS 3 reports of family support and strain. RESULTS The hypothesized model demonstrated good fit to the data based on multiple model fit indices. Greater family strain at baseline, but not family support, was significantly associated with greater pain interference 10 years later. DISCUSSION Findings build on prior studies to suggest that not only are stressful family relationships likely associated with the odds of developing chronic pain, but they are also linked to the interference of that chronic pain when it develops. We recommend biopsychosocial screening in primary care that captures family relationship quality and can inform best practices for nonpharmacological, family-based pain management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Sarah B. Woods
- University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Dallas TX, USA
| | | | - Haneen Abdelkhaleq
- University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Dallas TX, USA
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Iachina M, Ljungdalh P, Nørgård BM, Garvik O, Stenager E, Schiøttz-Christensen B. Psychiatric disorders, diagnosed in psychiatric clinics, in patients with back pain: A cohort study. Scand J Public Health 2023; 51:1153-1160. [PMID: 35674239 DOI: 10.1177/14034948221100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Aims: The aim of this study was to evaluate whether patients with a non-specific back pain disorder are more likely to be diagnosed with a psychiatric disorder than patients with a specific back pain disorder (such as a herniated disc or inflammatory back disorder). Methods: This was a retrospective cohort study using Danish registries. Results: Our study population included 24,518 patients younger than 61 years and 12,274 patients older than 61 years. In both subpopulations, 60% had a non-specific back pain diagnosis (BPD). In the younger subpopulation, 2.1% of the patients with a non-specific BPD and 1.3% of the patients with a specific BPD had a psychiatric diagnosis within one year of their BPD. In the older subpopulation, 0.6% of patients had a psychiatric diagnosis in both BPD groups. The most frequent psychiatric diagnoses were stress-related disorders. In the younger subpopulation, patients with non-specific back pain had a higher risk of being diagnosed with a psychiatric disorder than patients with specific back pain (adjusted odds ratio 1.56, 95% confidence interval 1.25-1.94). The type of BPD had no effect on the risk of having a psychiatric diagnosis among older patients. Conclusions: Patients with a non-specific back pain disorder younger than 61 years were more likely to be diagnosed with a psychiatric disorder than patients with a specific back pain disorder. We recommend that spine specialists pay special attention to patients younger than 61 years with a back pain disorder to prevent them from developing a psychiatric disorder.
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Affiliation(s)
- Maria Iachina
- Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark
| | - Pernille Ljungdalh
- Spine Centre of Southern Denmark, University Hospital Lillebaelt, Denmark
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark
| | - Olav Garvik
- Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark
| | - Elsebeth Stenager
- Psychiatric Research Unit, Aabenraa, Department of Regional Health Services Research, University of Southern Denmark, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, University Hospital Lillebaelt, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
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106
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Wislocki K, Kratz HE, Martin G, Becker-Haimes EM. The Relationship Between Trauma Exposure and Obsessive-Compulsive Disorder in Youth: A Systematic Review. Child Psychiatry Hum Dev 2023; 54:1624-1652. [PMID: 35488083 DOI: 10.1007/s10578-022-01352-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
Extant literature suggests a possible relationship between childhood trauma exposure and the development and trajectory of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD); however, this relationship is poorly understood. We conducted a systematic review that examined trauma exposure and OCS/OCD in youth. Primary inclusion criteria were English-language articles that addressed a sample with participants under 18 years of age. 46 articles met criteria for review, and were categorized into three groups of overlap: Post-traumatic Stress Disorder (PTSD) and OCS or OCD (n = 3), clearly defined Criterion A event trauma exposure and OCS or OCD (n = 30), and less well-defined potential trauma exposure and OCS or OCD (n = 13). There was mixed evidence linking trauma exposure and the development of OCS or OCD in youth. Major methodological limitations preclude formal conclusions. More research on co-occurring trauma exposure and OCD/OCS in youth is needed to advance research and improve treatment.
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Affiliation(s)
- Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA.
- Department of Psychological Science, University of California, Irvine, CA, USA.
| | - Hilary E Kratz
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Gerald Martin
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA
- Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia, PA, USA
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107
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Rudolph KE, Williams N, Díaz I. Efficient and flexible estimation of natural direct and indirect effects under intermediate confounding and monotonicity constraints. Biometrics 2023; 79:3126-3139. [PMID: 36905172 PMCID: PMC11037503 DOI: 10.1111/biom.13850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/16/2023] [Indexed: 03/12/2023]
Abstract
Natural direct and indirect effects are mediational estimands that decompose the average treatment effect and describe how outcomes would be affected by contrasting levels of a treatment through changes induced in mediator values (in the case of the indirect effect) or not through induced changes in the mediator values (in the case of the direct effect). Natural direct and indirect effects are not generally point-identified in the presence of a treatment-induced confounder; however, they may be identified if one is willing to assume monotonicity between the treatment and the treatment-induced confounder. We argue that this assumption may be reasonable in the relatively common encouragement-design trial setting, where the intervention is randomized treatment assignment and the treatment-induced confounder is whether or not treatment was actually taken/adhered to. We develop efficiency theory for the natural direct and indirect effects under this monotonicity assumption, and use it to propose a nonparametric, multiply robust estimator. We demonstrate the finite sample properties of this estimator using a simulation study, and apply it to data from the Moving to Opportunity Study to estimate the natural direct and indirect effects of being randomly assigned to receive a Section 8 housing voucher-the most common form of federal housing assistance-on risk developing any mood or externalizing disorder among adolescent boys, possibly operating through various school and community characteristics.
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Affiliation(s)
- Kara E Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Nicholas Williams
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Iván Díaz
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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Remmerswaal KCP, Ten Have M, de Graaf R, van Balkom AJLM, Penninx BWJH, Batelaan NM. Risk factors of chronic course of anxiety and depressive disorders: a 3-year longitudinal study in the general population. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02591-0. [PMID: 38015237 DOI: 10.1007/s00127-023-02591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Risk factors of a chronic course of anxiety and depressive disorders were previously studied using a limited definition of recovery, i.e. remission of the index disorder. However, frequently, other mental disorders are present at follow-up. Thus, the course of anxiety and depressive disorders was represented too rosy and the identified determinants may not apply when using a broader, more realistic definition. Additionally, physical health risk factors have often been ignored. METHODS Data were used from two waves of the Netherlands Mental Health Survey and Incidence Study-2 including 509 respondents with 12-month anxiety disorder (panic disorder, social phobia, agoraphobia or generalized anxiety disorder) or/and major depressive disorder at baseline. Chronic course was defined as (1) presence of index disorder; and (2) presence of any anxiety, mood or substance use disorder (overall course) during the subsequent three years. Regression models were built with sociodemographic, clinical, and lifestyle/physical health indicators. Predictive accuracy was evaluated with area under the curve (AUC). RESULTS Chronic course of the index disorder was present among 24.8% of cases, whereas 38.7% had a chronic overall course. The accuracy of prediction of chronic course of the index disorder was suboptimal (AUC = 0.68) compared to prediction of overall course (AUC = 0.75). The main risk factors were baseline number of mental disorders, neuroticism, childhood abuse, parental psychopathology and alcohol use. Lifestyle and physical health indicators were marginally relevant. CONCLUSION Transdiagnostic risk factors are important in predicting overall course of anxiety and depressive disorders but cannot accurately predict chronic course of the index disorder.
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Affiliation(s)
- Karin C P Remmerswaal
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Anton J L M van Balkom
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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109
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Altwaijri Y, Al-Habeeb A, Al-Subaie A, Bruffaerts R, Bilal L, Hyder S, Naseem MT, Alghanim AJ. Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey. Front Public Health 2023; 11:1238326. [PMID: 38089017 PMCID: PMC10715453 DOI: 10.3389/fpubh.2023.1238326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Comorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA). Methods The Saudi National Mental Health Survey, a cross-sectional household study - part of the World Mental Health (WMH) Survey Consortium - was conducted between 2013-2016 in the KSA, with 4,001 Saudi citizens aged 15-65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role. Results The prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days. Conclusion Comorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities.
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Affiliation(s)
- Yasmin Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Psychiatry, Edrak Medical Center, Riyadh, Saudi Arabia
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Petcu C, Boukhelif I, Davis V, Shamsi H, Al-Assi M, Miladi A, Khaled SM. Design and Implementation of Survey Quality Control System for Qatar's First National Mental Health Survey: Case Study. JMIR Form Res 2023; 7:e37653. [PMID: 37906213 DOI: 10.2196/37653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND All World Mental Health (WMH) Surveys apply high standards of data quality. To date, most of the published quality control (QC) procedures for these surveys were in relation to face-to-face interviews. However, owing to the social restrictions that emerged from the COVID-19 pandemic, telephone interviews are the most effective alternative for conducting complex probability-based large-scale surveys. OBJECTIVE In this paper, we present the QC system implemented in the WMH Qatar Survey, the first WMH Survey conducted during the COVID-19 pandemic in the Middle East. The objective of the QC process was to acquire high data quality through the reduction of random errors and bias in data collection. METHODS The QC design and procedures in this study were adapted to the telephone survey mode in response to the COVID-19 pandemic. We focus on the design of the QC indicator system and its implementation, including the investigation process, monitoring interviewers' performance during survey fielding and applying quality-informed interventions. RESULTS The study team investigated 11,035 flags triggered during the 2 waves of the survey data collection. The most triggered flags were related to short question administration duration and multiple visits to the same survey questions or responses. Live monitoring of the interviews helped in understanding why certain duration-related flags were triggered and the interviewing patterns of the interviewers. Corrective and preventive actions were taken against interviewers' behaviors based on the investigation of triggered flags per interviewer and live call monitoring of interviews. Although, in most cases, the interviewers required refresher training sessions and feedback to improve their performance, several interviewers discontinued work because of low productivity and a high number of triggered flags. CONCLUSIONS The specific QC procedures implemented in the course of the WMH Qatar Survey were essential for successfully meeting the target number of interviews (N=5000). The QC strategies and the new indicators customized for telephone interviews contributed to the flag investigation and verification process. The QC data presented in this study shed light on the rigorous methods and quality monitoring processes in the course of conducting a large-scale national survey on sensitive topics during the COVID-19 pandemic.
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Affiliation(s)
- Catalina Petcu
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Ikram Boukhelif
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Veena Davis
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Hamda Shamsi
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Marwa Al-Assi
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Anis Miladi
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
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111
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Smari UJ, Valdimarsdottir UA, Aspelund T, Hauksdottir A, Thordardottir EB, Hartman CA, Andell P, Larsson H, Zoega H. Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD: a population-based study. BMC Med 2023; 21:450. [PMID: 37981673 PMCID: PMC10659052 DOI: 10.1186/s12916-023-03160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Leveraging a large nationwide study of Icelandic women, we aimed to narrow the evidence gap around female attention-deficit/hyperactivity disorder (ADHD) and cardiometabolic comorbidities by determining the prevalence of obesity, hypertension, type 2 diabetes, and cardiovascular diseases among women with ADHD and examine the association between cardiometabolic conditions and co-occurring ADHD with anxiety and mood disorders, alcoholism/substance use disorder (SUD), self-harm, and suicide attempts. METHODS We conducted a cross-sectional analysis of the nationwide, all-female, population-based SAGA Cohort Study (n = 26,668). To ascertain diagnoses and symptoms, we used self-reported history of ADHD diagnoses, selected cardiometabolic conditions and psychiatric disorders, and measured current depressive, anxiety, and PTSD symptoms through appropriate questionnaires (PHQ-9, GAD-7, and PCL-5). We calculated age-adjusted prevalences of cardiometabolic conditions by women's ADHD status and estimated adjusted prevalence ratios (PR) and 95% confidence intervals (CI), using modified Poisson regression models. Similarly, we assessed the association of cardiometabolic conditions and co-occurring ADHD with current psychiatric symptoms and psychiatric disorders, using adjusted PRs and 95% CIs. RESULTS We identified 2299 (8.6%) women with a history of ADHD diagnosis. The age-adjusted prevalence of having at least one cardiometabolic condition was higher among women with ADHD (49.5%) than those without (41.7%), (PR = 1.19, 95% CI 1.14-1.25), with higher prevalence of all measured cardiometabolic conditions (myocardial infarctions (PR = 2.53, 95% CI 1.83--3.49), type 2 diabetes (PR = 2.08, 95% CI 1.66-2.61), hypertension (PR = 1.23, 95% CI 1.12-1.34), and obesity (PR = 1.18, 95% CI 1.11-1.25)). Women with cardiometabolic conditions and co-occurring ADHD had, compared with those without ADHD, substantially increased prevalence of (a) all measured mood and anxiety disorders, e.g., depression (PR = 2.38, 95% CI 2.19-2.58), bipolar disorder (PR = 4.81, 95% CI 3.65-6.35), posttraumatic stress disorder (PR = 2.78, 95% CI 2.52-3.07), social phobia (PR = 2.96, 95% CI 2.64-3.32); (b) moderate/severe depressive, anxiety, and PTSD symptoms with PR = 1.76 (95% CI 1.67-1.85), PR = 1.97 (95% CI 1.82-2.12), and PR = 2.01 (95% CI 1.88-2.15), respectively; (c) alcoholism/SUD, PR = 4.79 (95% CI 3.90-5.89); and (d) self-harm, PR = 1.47 (95% CI 1.29-1.67) and suicide attempts, PR = 2.37 (95% CI 2.05-2.73). CONCLUSIONS ADHD is overrepresented among women with cardiometabolic conditions and contributes substantially to other psychiatric comorbidities among women with cardiometabolic conditions.
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Affiliation(s)
- Unnur Jakobsdottir Smari
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland.
| | - Unnur Anna Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland
| | - Arna Hauksdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland
| | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland
- Mental Health Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulations (ICPE), Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pontus Andell
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, Heart and Vascular Division, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Helga Zoega
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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Liebschutz JM, Subramaniam GA, Stone R, Appleton N, Gelberg L, Lovejoy TI, Bunting AM, Cleland CM, Lasser KE, Beers D, Abrams C, McCormack J, Potter GE, Case A, Revoredo L, Jelstrom EM, Kline MM, Wu LT, McNeely J. Subthreshold opioid use disorder prevention (STOP) trial: a cluster randomized clinical trial: study design and methods. Addict Sci Clin Pract 2023; 18:70. [PMID: 37980494 PMCID: PMC10657560 DOI: 10.1186/s13722-023-00424-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Preventing progression to moderate or severe opioid use disorder (OUD) among people who exhibit risky opioid use behavior that does not meet criteria for treatment with opioid agonists or antagonists (subthreshold OUD) is poorly understood. The Subthreshold Opioid Use Disorder Prevention (STOP) Trial is designed to study the efficacy of a collaborative care intervention to reduce risky opioid use and to prevent progression to moderate or severe OUD in adult primary care patients with subthreshold OUD. METHODS The STOP trial is a cluster randomized controlled trial, randomized at the PCP level, conducted in 5 distinct geographic sites. STOP tests the efficacy of the STOP intervention in comparison to enhanced usual care (EUC) in adult primary care patients with risky opioid use that does not meet criteria for moderate-severe OUD. The STOP intervention consists of (1) a practice-embedded nurse care manager (NCM) who provides patient participant education and supports primary care providers (PCPs) in engaging and monitoring patient-participants; (2) brief advice, delivered to patient participants by their PCP and/or prerecorded video message, about health risks of opioid misuse; and (3) up to 6 sessions of telephone health coaching to motivate and support behavior change. EUC consists of primary care treatment as usual, plus printed overdose prevention educational materials and an educational video on cancer screening. The primary outcome measure is self-reported number of days of risky (illicit or nonmedical) opioid use over 180 days, assessed monthly via text message using items from the Addiction Severity Index and the Current Opioid Misuse Measure. Secondary outcomes assess other substance use, mental health, quality of life, and healthcare utilization as well as PCP prescribing and monitoring behaviors. A mixed effects negative binomial model with a log link will be fit to estimate the difference in means between treatment and control groups using an intent-to-treat population. DISCUSSION Given a growing interest in interventions for the management of patients with risky opioid use, and the need for primary care-based interventions, this study potentially offers a blueprint for a feasible and effective approach to improving outcomes in this population. TRIAL REGISTRATION Clinicaltrials.gov, identifier NCT04218201, January 6, 2020.
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Affiliation(s)
- Jane M Liebschutz
- Division of General Internal Medicine, Center for Research On Health Care, University of Pittsburgh, 200 Lothrop Street, Suite 933W, Pittsburgh, PA, 15213, USA.
| | | | - Rebecca Stone
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Noa Appleton
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lillian Gelberg
- David Geffen School of Medicine at UCLA, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Travis I Lovejoy
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Amanda M Bunting
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Charles M Cleland
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Karen E Lasser
- Section of General Internal Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- School of Public Health, Boston University, Boston, MA, USA
| | - Donna Beers
- Section of General Internal Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | | | - Gail E Potter
- The Emmes Company, LLC, Rockville, MD, USA
- Biostatistics Research Branch, NIH/NIAID, Rockville, MD, USA
| | | | | | | | | | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer McNeely
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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113
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Bates EJS, Berny LM, Ganiban JM, Natsuaki MN, Neiderhiser JM, Shaw DS, Leve LD. Examination of promotive and protective effects on early adolescent prosocial behavior through a bioecological lens. Front Psychol 2023; 14:1280346. [PMID: 38046108 PMCID: PMC10690822 DOI: 10.3389/fpsyg.2023.1280346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Prosocial behavior during childhood has been associated with numerous positive developmental and behavioral outcomes in adolescence and adulthood. Prosocial behavior, which includes cooperation and helping others, develops within a bioecological context. Considering it through such a lens enhances the understanding of the roles of different bioecological factors in its development. Methods Using data from a longitudinal study of adopted children and children reared with their biological parents, this paper examined if positive aspects of a child's bioecological system at age 7 predict prosocial behavior in early adolescence (age 11), and whether these bioecological factors could offset risk due to biological family psychopathology and/or maternal prenatal substance use. The analyses incorporated variables from different levels of Bronfenbrenner's bioecological model (the individual, microsystem, exosystem, and macrosystem) and examined the promotive, and potentially protective, effect of each contextual factor, while also considering their interplay with biological family psychopathology and prenatal substance use. Results Results from linear regression models indicated that the microsystem variable of parental warmth at age 7 had a promotive effect on age 11 prosocial behavior. Further, in addition to its main effect, parental warmth was protective against maternal substance use during pregnancy when children were raised with their biological parent (s). Household type (biological family) and biological family internalizing psychopathology were the only other significant predictors in the model, with each associated with lower prosocial behavior at age 11. Discussion Study results extend prior work on the benefits of parental warmth on child outcomes by employing a strength-based, bioecological approach to the development of prosocial behavior during early adolescence and examining "for whom" the effects of parental warmth are most protective.
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Affiliation(s)
- Elizabeth J. S. Bates
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Lauren M. Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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114
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Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
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Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
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115
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Spafford SG, Schuler Adair E, Baker S, Dedrickson D. Mental Wellbeing and Resilience in Suicide Prevention Crisis Line Volunteers. Community Ment Health J 2023; 59:1562-1567. [PMID: 37256524 PMCID: PMC10230468 DOI: 10.1007/s10597-023-01143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Abstract
Crisis line volunteers are critical to nationwide suicide prevention efforts as they provide free support services to those experiencing emotional distress or suicidality. Most crisis lines rely on volunteers for call-taking, however, the experiences of these volunteers and the impact of call-taking on their mental wellbeing remains understudied. The current study aimed to explore mental wellbeing and resilience in suicide prevention crisis line volunteers. In a longitudinal study among 20 volunteers of a suicide prevention crisis line, participants completed a series of three surveys at baseline, 3-month, and 6-month follow-up, measuring mental wellbeing, resilience, support, help-seeking, and other related personal and professional factors, including compassion satisfaction, burnout, and secondary traumatic stress. Results indicated that self-rated mental health was positively associated with willingness to seek help for an emotional problem from a doctor. Additionally, social support was negatively associated with burnout, but positively associated with compassion satisfaction. Finally, preparedness was negatively associated with secondary traumatic stress, while seeking help for an emotional problem or suicidality from a parent were both positively associated with secondary traumatic stress. Crisis line volunteers rated their mental health and compassion satisfaction highly and reported low levels of burnout and secondary traumatic stress. The role of social support and preparedness for call-taking deserve further investigation by researchers and crisis call centers as they may be critical to responders' wellbeing.
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116
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Izquierdo A, Dolz-Del-Castellar B, Miret M, Olaya B, Haro JM, Ayuso-Mateos JL, Lara E. Sex differences in the symptom network structure of depression: Findings from a nationwide sample of the Spanish adult population. J Affect Disord 2023; 340:583-591. [PMID: 37591351 DOI: 10.1016/j.jad.2023.08.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Sex differences in the prevalence and clinical features of depression have been widely described. However, some authors argue that categorical diagnostic systems do not adequately capture the complexity of depression. The aim of this study was to examine sex differences in the symptom network structure of depressive symptoms among individuals with a major depressive episode. METHODS The study sample consisted of 510 participants (age 62.17 ± 14.43, 71.96 % women) from a nationwide study of the Spanish non-institutionalised adult population (Edad con Salud). To estimate the presence of a 12-month major depressive episode according to DSM-IV criteria, participants were administered an adapted version of the Composite International Diagnostic Interview (CIDI 3.0). A network analysis was carried out to determine possible interrelationships between different depressive symptoms by sex. RESULTS Men and women showed a similar overall structure and network strength. However, sex-specific variations emerged in relation to individual symptom associations and symptom centrality. Specifically, for individual symptom associations "loss of confidence" and "suicide attempts" were more strongly related in women, and "suicidal ideation" and "impaired thinking" in men. For symptom centrality, "anxiety" played a central role in men's symptomatology, whereas "hopelessness", "loss of confidence", "distress" and "slowness of movement" were the most central symptoms in the women's group. LIMITATIONS Reliance on cross-sectional data precludes us from determining the direction and temporality of the association between different symptoms. CONCLUSIONS This study suggests that specific symptoms should be prioritised in the prevention, diagnosis assessment and treatment of depressed patients based on sex.
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Affiliation(s)
- Ana Izquierdo
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain.
| | - Blanca Dolz-Del-Castellar
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
| | - Elvira Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain; Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, Spain
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Sivertsen B, Knudsen AKS, Kirkøen B, Skogen JC, Lagerstrøm BO, Lønning KJ, Kessler RC, Reneflot A. Prevalence of mental disorders among Norwegian college and university students: a population-based cross-sectional analysis. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100732. [PMID: 37927428 PMCID: PMC10624983 DOI: 10.1016/j.lanepe.2023.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 11/07/2023]
Abstract
Background Self-report data indicate a sharp increase in mental health problems among college and university students in recent years, but accurate prevalence estimates of mental disorders are lacking. The current study used a validated psychiatric diagnostic survey, developed into a self-administered electronic version, to examine the prevalence of common mental disorders in a large national sample of college and university students in Norway. Methods Participants (aged 18-35 years) from the national Students' Health and Wellbeing (SHOT) Study in 2022 were recruited to a follow-up online survey of mental disorders from January to February 2023 (n = 10,460). Current (30-days), 12-months and lifetime prevalence of common mental disorders were examined using a newly developed self-administered electronic version of the Composite International Diagnostic Interview (CIDI 5.0). Findings The prevalence of a current mental disorder was high for both women (39.7% [2737/6886], 95% CI 38.6-40.9) and men (25.7% [751/2918], 95% CI 24.2-27.4). The most common disorders were major depressive episode (females 17.1% [1250/7329] and males 10.8% [331/3059]) and generalized anxiety disorder (females 16.0% [1157/7221] and males 8.2% [250/3032]), while 5.6% [387/6948] and 7.7% [228/2963] of the females and male students, respectively, fulfilled the criteria for an alcohol use disorder. The prevalence estimates for 12-month and lifetime were, as expected, even higher. Interpretation The findings suggest an alarmingly high prevalence of several mental disorders among Norwegian college and university students. Implications and potential methodological and contextual explanations of these findings are discussed. Funding Norwegian Ministry of Education and Research.
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Affiliation(s)
- Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse-Fonna HF, Haugesund, Norway
| | | | - Benedicte Kirkøen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Jens C. Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Bengt Oscar Lagerstrøm
- Division for Social Surveys, Department for Methodology and Data Collection, Statistics Norway, Oslo, Norway
| | - Kari-Jussie Lønning
- The Student Welfare Organization in Oslo and Akershus (SiO), Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Govender T, Yu J, Vidal-Ribas P, Gilman SE, Haynie DL. Adolescent Substance Use Patterns and Risk for Suicidal Thoughts and Behaviors in Young Adulthood. J Stud Alcohol Drugs 2023; 84:892-901. [PMID: 37589372 PMCID: PMC10765979 DOI: 10.15288/jsad.22-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/06/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE There is strong evidence that substance use is a risk factor for suicidality. Prior studies have focused on the suicide risk associated with using individual substances, even though substance users often use more than one substance. This study investigates the association between patterns of adolescent substance use and suicidality in young adulthood. METHOD Participants were U.S. adolescents (n = 2,111, 58.9% female, mean age = 16.31 years) from the NEXT Generation Health Study, which followed tenth graders for 7 years (2009/2010-2016) and collected data via yearly surveys. Longitudinal latent class analysis was used to identify high school patterns of substance use, and logistic regression was used to relate these patterns to risk of suicidality in young adulthood. RESULTS We identified two groups of adolescents: "non-/infrequent users" (71%) and "multiple substance users" (29%). Multiple substance users had higher odds of making a suicide plan or attempt in young adulthood (odds ratio [OR] = 2.41, 95% CI [1.05, 5.53]), but not suicidal ideation (OR = 1.55, 95% CI [0.80, 2.99]), than non-/infrequent users, adjusting for sociodemographic factors and depressive symptoms. Multiple substance users with suicidal ideation were not more likely to progress to a later plan or attempt (OR = 1.41, 95% CI [0.41, 4.84]) than non-/infrequent users. CONCLUSIONS Adolescents who use substances in high school are at higher risk for making a suicide plan or attempt in young adulthood. Early identification of these adolescents may help inform interventions to mitigate risk for suicidal behaviors in young adulthood.
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Affiliation(s)
- Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Psychology, University of Illinois Urbana–Champaign, Champaign, Illinois
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Denise L. Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Campbell-Sills L, Kautz JD, Ray C, Lester PB, Choi KW, Naifeh JA, Aliaga PA, Kessler RC, Stein MB, Ursano RJ, Bliese PD. Associations of active-duty mental health trajectories with post-military adjustment: Results from the STARRS Longitudinal Study. J Affect Disord 2023; 340:535-541. [PMID: 37553016 PMCID: PMC11271821 DOI: 10.1016/j.jad.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Many servicemembers experience difficulties transitioning from military to civilian life. We examined whether changes in mental health observed during active duty were associated with indices of post-military adjustment. METHODS Survey data from the multi-wave Army STARRS Pre/Post Deployment Study (PPDS; conducted 2012-2014) were linked to follow-up data from wave 1 of the STARRS Longitudinal Study (STARRS-LS1; conducted 2016-2018). Empirical Bayes estimates of intercepts and slopes of posttraumatic stress, problematic anger, and depressive symptoms during the PPDS were extracted from mixed-effects growth models and evaluated as predictors of life stress among 1080 participants who had separated or retired from the Army at STARRS-LS1; and of job satisfaction among 586 veterans who were employed at STARRS-LS1. RESULTS Higher average levels and larger increases in posttraumatic stress, anger, and depression over the deployment period were each associated with increased stress and (in the case of anger and depression) reduced job satisfaction. Posttraumatic stress and anger slopes were associated with overall stress (b = 5.60, p < 0.01 and b = 15.64, p = 0.04, respectively) and relationship stress (b = 5.50, p = 0.01 and b = 22.86, p = 0.01, respectively) beyond the average levels of those symptoms. LIMITATIONS Some transition-related difficulties may have resolved before outcome assessment; some measures were not previously validated. CONCLUSIONS Larger increases in posttraumatic stress and anger over a deployment period were associated with increased stress after leaving the Army, even after controlling for average symptom levels during the same period. Monitoring changes in mental health during active duty may help identify personnel who need additional support to facilitate the military-to-civilian transition.
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Affiliation(s)
- Laura Campbell-Sills
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Jason D Kautz
- Department of Organizations, Strategy, and International Management, University of Texas at Dallas, Dallas, TX, USA
| | - Caitlin Ray
- School of Industrial and Labor Relations, Cornell University, Ithaca, NY, USA
| | - Paul B Lester
- Graduate School of Defense Management, Naval Postgraduate School, Monterey, CA, USA
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - James A Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Pablo A Aliaga
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Paul D Bliese
- Department of Management, Darla Moore School of Business, University of South Carolina, Columbia, SC, USA
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Cai Y, Schrack JA, Agrawal Y, Armstrong NM, Wanigatunga AA, Kitner-Triolo M, Moghekar A, Ferrucci L, Simonsick EM, Resnick SM, Gross AL. Application and validation of an algorithmic classification of early impairment in cognitive performance. Aging Ment Health 2023; 27:2187-2192. [PMID: 37354067 PMCID: PMC10592406 DOI: 10.1080/13607863.2023.2227118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/09/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE Due to the long prodromal period for dementia pathology, approaches are needed to detect cases before clinically recognizable symptoms are apparent, by which time it is likely too late to intervene. This study contrasted two theoretically-based algorithms for classifying early cognitive impairment (ECI) in adults aged ≥50 enrolled in the Baltimore Longitudinal Study of Aging. METHOD Two ECI algorithms were defined as poor performance (1 standard deviation [SD] below age-, sex-, race-, and education-specific means) in: (1) Card Rotations or California Verbal Learning Test (CVLT) immediate recall and (2) ≥1 (out of 2) memory or ≥3 (out of 6) non-memory tests. We evaluated concurrent criterion validity against consensus diagnoses of mild cognitive impairment (MCI) or dementia and global cognitive scores using receiver operating characteristic (ROC) curve analysis. Predictive criterion validity was evaluated using Cox proportional hazards models to examine the associations between algorithmic status and future adjudicated MCI/dementia. RESULTS Among 1,851 participants (mean age = 65.2 ± 11.8 years, 50% women, 74% white), the two ECI algorithms yielded comparably moderate concurrent criterion validity with adjudicated MCI/dementia. For predictive criterion validity, the algorithm based on impairment in Card Rotations or CVLT immediate recall was the better predictor of MCI/dementia (HR = 3.53, 95%CI: 1.59-7.84) over 12.3 follow-up years. CONCLUSIONS Impairment in visuospatial ability or memory may be capable of detecting early cognitive changes in the preclinical phase among cognitively normal individuals.
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Affiliation(s)
- Yurun Cai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yuri Agrawal
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Nicole M. Armstrong
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Abhay Moghekar
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | | | - Susan M. Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Hosseini FA, Shaygan M, Jahandideh Z. Positive imagery in depressive suicidal patients: A randomized controlled trial of the effect of viewing loved ones' photos on mood states and suicidal ideation. Heliyon 2023; 9:e22312. [PMID: 38058624 PMCID: PMC10695982 DOI: 10.1016/j.heliyon.2023.e22312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
According to research, it has been suggested that individuals who are affected by depression could potentially engage in the creation and experience emotional advantages relating to positive events directed towards the past or future, with the condition that they are provided with suitable mental imagery techniques. The main aim of this study was to assess the impact of utilizing positive imagery, specifically through the utilization of photographs featuring loved ones, on mood states and suicidal ideation among individuals diagnosed with depression and exhibiting suicidal tendencies. This randomized, double-blind, controlled crossover trial was conducted among 78 hospitalized depressive patients at three psychiatric services between April and August 2019. The patients participated in four individual picture-viewing sessions on four consecutive days. The four categories of pictures were included: loved ones, neutral faces of strangers, natural landscapes, and optical illusions. Directly prior to and immediately following the observation of the visual stimuli (photographs), the Brunel Mood Scale (BRUMS) and the Beck Scale for Suicide Ideation (BSSI) were completed by the patients. Repeated measures ANOVAs conducted in this study revealed a significant main effect of time on ratings of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). Additionally, statistically significant interactions were identified between picture category and time in relation to the variables of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). The analysis did not reveal a significant main effect of time on ratings of anger, confusion, and suicidal ideation (P values > 0.05). Likewise, the interaction between picture category and time did not yield significant results for the variables of anger, confusion, and suicidal ideation (P values > 0.05). The positive imagery procedure using the presentation of loved ones' photos showed beneficial effects on the mood states of depressed patients. The findings of this study suggest that incorporating a greater emphasis on positive imagery within the context of clinical depression may offer potential advantages. This highlights the potential for novel opportunities in the treatment of depression. Trial registration The study has been registered in the Iranian Registry of Clinical Trials (registration number: IRCT20180808040744N1; first registration date: December 22, 2018; website: https://en.irct.ir/trial/33186).
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Affiliation(s)
- Fahimeh Alsadat Hosseini
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Jahandideh
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Pai M, Muhammad T. Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators. BMC Geriatr 2023; 23:685. [PMID: 37872470 PMCID: PMC10591391 DOI: 10.1186/s12877-023-04380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND While functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one's social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression. METHODS Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent's overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects. RESULTS 39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments. CONCLUSIONS That SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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Descarpentrie A, Poquet D, Brugailleres P, Sauvegrain P, Frenoy P, Richard E, Bernard JY, de Lauzon-Guillain B, Vandentorren S, Lioret S. Is breastfeeding duration related to the health of migrant mother-child dyads experiencing homelessness? The ENFAMS cross-sectional survey. Eur J Public Health 2023; 33:796-802. [PMID: 37339520 PMCID: PMC10567129 DOI: 10.1093/eurpub/ckad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Literature from the general population shows a consensus about the health benefits associated with breastfeeding for both mothers and children. However, studies investigating these issues in the context of homelessness and migration are rare. This research aimed to examine the relations of any breastfeeding duration with health outcomes among migrant mother-child dyads experiencing homelessness. METHODS Data were collected among sheltered and mainly foreign-born mothers experiencing homelessness, and their children aged 6 months to 5 years, from the ENFAMS cross-sectional survey (n = 481, 2013-Great Paris area). Any breastfeeding duration, along with various health outcomes of both the mother and her child, was ascertained by face-to-face questionnaires administered by trained interviewers to mothers (perceived physical and emotional health and maternal depression) or by trained psychologists to children (adaptive behaviours). Nurses measured weight and height [thus allowing them to calculate body mass index (BMI)] and haemoglobin concentration (mother-child dyad) and maternal blood pressure. Multivariable linear and modified Poisson regression analyses were performed to examine outcome-wide associations between any breastfeeding duration ≥6 months and the various mother-child outcomes. RESULTS Any breastfeeding ≥6 months was associated with lower systolic blood pressure in mothers (B = -0.40, 95% confidence interval = -0.68 to -0.12). No association was observed with the other outcomes. CONCLUSIONS The relevance of supporting breastfeeding to improve mothers' physical health holds true in the context of migration and homelessness. It is therefore important to support breastfeeding in these settings. Moreover, given the documented social complexity of breastfeeding practices, interventions should take mothers' socio-cultural heritage and the structural barriers they face into account.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Delphine Poquet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Priscille Sauvegrain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Sorbonne Université, Midwifery Unit, Paris, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
| | - Pauline Frenoy
- Université Paris Saclay, UVSQ, Université Paris-Sud, Inserm, Gustave Roussy, “Exposome and Heredity” Team, CESP, Villejuif, France
| | - Elodie Richard
- CIFRE Fnasat, Université Bordeaux, Inserm, UMR1219, Bordeaux, France
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Stéphanie Vandentorren
- Université Bordeaux, Inserm, UMR1219, PHARes Team, Bordeaux, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Kim HS, McGrath DS, Hodgins DC. Addiction substitution and concurrent recovery in gambling disorder: Who substitutes and why? J Behav Addict 2023; 12:682-696. [PMID: 37578867 PMCID: PMC10562828 DOI: 10.1556/2006.2023.00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/06/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023] Open
Abstract
Objectives When individuals recover from gambling disorder, their involvement in other potentially addictive substances and behaviors may also subsequently increase (substitution) or decrease (concurrent recovery). The objectives of this study were to identify and compare recovery processes associated with substitution and concurrent recovery in gambling disorder. Methods A mixed-method study was conducted with 185 people who were recovered from gambling disorder. Semi-structured interviews were used to: (i) establish onset and recovery of gambling disorder as well as other substance and behavioral addictions; and (ii) assess processes (e.g., reasons, emotional state, helpfulness) associated with addiction substitution and concurrent recovery. Participants also completed a survey assessing demographic characteristics, gambling behaviors, and psychological characteristics to compare demographic and clinical differences between participants who engaged in addiction substitution, concurrent recovery, or neither (controls). Results The most frequently reported reason for engaging in addiction substitution was as a substitute coping mechanism. The most reported reason for engaging in concurrent recovery was due to the addictions being mutually influenced. Negative emotional states were common when engaging in both addiction substitution and concurrent recovery. Although the three groups did not differ on gambling characteristics, addiction substitution was associated with greater underlying vulnerabilities including childhood adversity, impulsivity, emotion dysregulation, and, maladaptive coping skills. Conclusion Transdiagnostic treatments that target the underlying mechanisms of addictions may reduce the likelihood of engaging in addiction substitution.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- University of Ottawa, Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Daniel S. McGrath
- University of Ottawa, Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Hotham J, Cannings-John R, Moore L, Hawkins J, Bonell C, Hickman M, Zammit S, Hines LA, Adara L, Townson J, White J. Association of cannabis, cannabidiol and synthetic cannabinoid use with mental health in UK adolescents. Br J Psychiatry 2023; 223:478-484. [PMID: 37485911 PMCID: PMC10866672 DOI: 10.1192/bjp.2023.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Cannabis has been associated with poorer mental health, but little is known of the effect of synthetic cannabinoids or cannabidiol (often referred to as CBD). AIMS To investigate associations of cannabis, synthetic cannabinoids and cannabidiol with mental health in adolescence. METHOD We conducted a cross-sectional analysis with 13- to 14-year-old adolescents across England and Wales in 2019-2020. Multilevel logistic regression was used to examine the association of lifetime use of cannabis, synthetic cannabinoids and cannabidiol with self-reported symptoms of probable depression, anxiety, conduct disorder and auditory hallucinations. RESULTS Of the 6672 adolescents who participated, 5.2% reported using of cannabis, 1.9% reported using cannabidiol and 0.6% reported using synthetic cannabinoids. After correction for multiple testing, adolescents who had used these substances were significantly more likely to report a probable depressive, anxiety or conduct disorder, as well as auditory hallucinations, than those who had not. Adjustment for socioeconomic disadvantage had little effect on associations, but weekly tobacco use resulted in marked attenuation of associations. The association of cannabis use with probable anxiety and depressive disorders was weaker in those who reported using cannabidiol than those who did not. There was little evidence of an interaction between synthetic cannabinoids and cannabidiol. CONCLUSIONS To our knowledge, this study provides the first general population evidence that synthetic cannabinoids and cannabidiol are associated with probable mental health disorders in adolescence. These associations require replication, ideally with prospective cohorts and stronger study designs.
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Affiliation(s)
- James Hotham
- Old Age Psychiatry, Penn Hospital, Black Country Healthcare NHS Foundation Trust, UK
| | | | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Jemma Hawkins
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, UK
| | - Chris Bonell
- Department of Public Health, Environment and Society, London School of Hygiene & Tropical Medicine, UK
| | - Matthew Hickman
- Department of Population Health Sciences, University of Bristol, UK
| | - Stanley Zammit
- Department of Population Health Sciences, University of Bristol, UK; and MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Lindsey A. Hines
- Department of Population Health Sciences, University of Bristol, UK
| | - Linda Adara
- Centre for Trials Research, School of Medicine, Cardiff University, UK
| | - Julia Townson
- Centre for Trials Research, School of Medicine, Cardiff University, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, UK; and Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, UK
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Fico G, Oliva V, De Prisco M, Fortea L, Fortea A, Giménez-Palomo A, Anmella G, Hidalgo-Mazzei D, Vazquez M, Gomez-Ramiro M, Carreras B, Murru A, Radua J, Mortier P, Vilagut G, Amigo F, Ferrer M, García-Mieres H, Vieta E, Alonso J. Anxiety and depression played a central role in the COVID-19 mental distress: A network analysis. J Affect Disord 2023; 338:384-392. [PMID: 37336249 PMCID: PMC10276655 DOI: 10.1016/j.jad.2023.06.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Psychological, socio-demographics, and clinical factors play an important role in patients with COVID-19, but their relationship is complex. The network approach might be used to disentangle complex interactions in different systems. Using data from a multicentre, cross-sectional, survey among patients with COVID-19 in Spain (July-November 2020), we investigated the network structure of mental disorders symptoms, social support, and psychological resilience, and changes in network structures according to the presence of a pre-existing mental disorder or hospitalization for COVID-19. METHODS Subjects completed a survey to evaluate sociodemographic characteristics, COVID-19 infection status, resilience, social support, and symptoms of depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder. 2084 patients with COVID-19 were included in the analysis. Network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between COVID-19 patients with and without a history of lifetime mental disorder, and between hospitalized and non-hospitalized patients. LIMITATIONS Generalization of our findings may be difficult since differences in network connectivity may exist in different populations or samples. RESULTS Anxiety and depression showed high centrality in patients with COVID-19 and anxiety showed the highest bridge influence in the network. Resilience and social support showed a low influence on mental disorder symptoms. Global network estimations show no statistically significant changes between patients with and without pre-existing mental disorders or between hospitalized and non-hospitalized patients. CONCLUSIONS Anxiety might be a key treatment target in patients with COVID-19 since its treatment might prevent other mental health adverse outcomes.
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Affiliation(s)
- Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Lydia Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain
| | - Adriana Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Giménez-Palomo
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Mireia Vazquez
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Gomez-Ramiro
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Alvaro Cunqueiro, SERGAS, Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain
| | - Bernat Carreras
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain
| | - Andrea Murru
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Helena García-Mieres
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Kiekens G, Claes L, Hasking P, Mortier P, Bootsma E, Boyes M, Myin-Germeys I, Demyttenaere K, Cuijpers P, Kessler RC, Nock MK, Bruffaerts R. A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period. Psychol Med 2023; 53:6011-6026. [PMID: 36325723 DOI: 10.1017/s0033291722003178] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). METHODS Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. RESULTS Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10-20% at the highest predicted risk could effectively reach 34.9-56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8-93.4, AUC = 0.88-0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. CONCLUSIONS Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Penelope Hasking
- Curtin enAble Institute & School of Population Health, Curtin University, Perth, Australia
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Erik Bootsma
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- The KU Leuven - VIB Center for Microbiology, Leuven, Belgium
| | - Mark Boyes
- Curtin enAble Institute & School of Population Health, Curtin University, Perth, Australia
| | | | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA
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Hussain MA, Watson CWM, Morgan EE, Heaton RK, Letendre SL, Jeste DV, Moore DJ, Iudicello JE. Combined effects of loneliness and inflammation on depression in people with HIV. J Neurovirol 2023; 29:538-554. [PMID: 37651083 PMCID: PMC10645641 DOI: 10.1007/s13365-023-01145-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Loneliness is prevalent in people with HIV (PWH) and associated with adverse health-related consequences, including depression. Chronic inflammation has been linked to depression in PWH, though its association with loneliness is less well established. Simultaneous examination of inflammation, loneliness and depression is needed to clarify these relationships. This study investigated the relationship between loneliness and inflammation, and the effects of loneliness and inflammation on depression in PWH. METHODS 82 PWH who were on suppressive ART (mean age [SD] = 53.2 [9.0]) completed the UCLA Loneliness Scale-Version 3 and the Center for Epidemiologic Studies Depression Scale as part of a comprehensive evaluation. Biomarkers of systemic inflammation (CRP, IL-6, CCL2/MCP-1, sCD14) and coagulation (D-dimer) were measured in blood using commercial immunoassays. RESULTS Multivariable linear regression analyses revealed that higher D-dimer, CCL2/MCP-1, and sCD14 were significant predictors of loneliness (ps < .05) while accounting for relevant covariates. Stepwise multiple linear regression models that included loneliness, biomarkers, and their interactions as predictors of depressive symptoms revealed significant main effects of loneliness and CCL2/MCP-1 levels (ps < .05), and a significant loneliness by D-dimer interaction (p < .05) whereby higher D-dimer was associated with increased depressive symptoms only at higher levels of loneliness. CONCLUSIONS Increased coagulation activity is associated with loneliness, and in the context of loneliness, may increase risk for depression. Increased inflammation was associated with depression suggesting potentially dissociable underlying biological processes. To the extent that these processes are modifiable, such findings could have important implications in the treatment of loneliness and depression in PWH.
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Affiliation(s)
- Mariam A Hussain
- San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, USA.
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA.
| | - C Wei-Ming Watson
- San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
| | - Erin E Morgan
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
| | - Scott L Letendre
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- Department of Neurosciences, University of California San Diego, La Jolla, USA
- Sam and Rose Stein Institute for Research On Aging, University of California San Diego, La Jolla, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
| | - Jennifer E Iudicello
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, USA
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Rogers AM, Youssef GJ, Teague S, Sunderland M, Le Bas G, Macdonald JA, Mattick RP, Allsop S, Elliott EJ, Olsson CA, Hutchinson D. Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study. J Affect Disord 2023; 338:278-288. [PMID: 37302506 DOI: 10.1016/j.jad.2023.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Maternal and paternal perinatal depression and anxiety are theorised to adversely impact infant development. Yet, few studies have assessed both mental health symptoms and clinical diagnoses within the one study. Moreover, research on fathers is limited. This study therefore aimed to examine the association between symptoms and diagnoses of maternal and paternal perinatal depression and anxiety with infant development. METHOD Data were from the Triple B Pregnancy Cohort Study. Participants included 1539 mothers and 793 partners. Depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale and Depression Anxiety Stress Scales. Major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia were assessed using the Composite International Diagnostic Interview in trimester three. Infant development was assessed at 12-months using the Bayley Scales of Infant and Toddler Development. RESULTS Antepartum, maternal depressive and anxiety symptoms were associated with poorer infant social-emotional (d = -0.11, p = .025) and language development (d = -0.16, p = .001). At 8-weeks postpartum, maternal anxiety symptoms were associated with poorer overall development (d = -0.11, p = .030). No association was observed for clinical diagnoses in mothers, nor paternal depressive and anxiety symptoms or clinical diagnoses; albeit risk estimates were largely in the expected direction of adverse effects on infant development. CONCLUSIONS Evidence suggests that maternal perinatal depression and anxiety symptoms may adversely impact infant development. Effects were small but findings underscore the importance of prevention, early screening and intervention, alongside consideration of other risk factors during early critical periods.
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Affiliation(s)
- Alana M Rogers
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Samantha Teague
- Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
| | - Matthew Sunderland
- University of Sydney, Matilda Centre for Research in Mental Health and Substance Use, New South Wales, Australia.
| | - Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Richard P Mattick
- The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia.
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Western Australia, Australia.
| | - Elizabeth J Elliott
- University of Sydney, Faculty of Medicine and Health, Discipline of Child and Adolescence, New South Wales, Australia; Sydney Children's Hospitals Network, Westmead, Sydney, Australia.
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
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Hasen AA, Seid AA, Mohammed AA. Poor sleep quality and suicidal ideation among pregnant women during COVID-19 in Ethiopia: systematic review and meta-analysis. PeerJ 2023; 11:e16038. [PMID: 37790617 PMCID: PMC10544305 DOI: 10.7717/peerj.16038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction COVID-19 has profoundly impacted the mental health and well-being of pregnant women worldwide. In Ethiopia, the poor sleep quality and suicidal ideation among pregnant women has increased due to the COVID-19 pandemic. This study aimed to provide comprehensive evidence on the prevalence and associated factors of poor sleep quality and suicidal ideation among pregnant women during COVID-19 in Ethiopia. Materials and Methods This study is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendation. Data were searched from PubMed, Google Scholar, and African Journals Online from the occurrence of the COVID-19 pandemic to February 2023. Two researchers extracted the data and performed the methodological quality assessment independently. Random-effect model was used to estimate the pooled effect size and I2was used to check heterogeneity. Stata 14.0 (StataCorp, Collage Station, Texas, USA) was used for statistical analysis. Results From six studies the pooled prevalence of poor sleep quality was 55% (95% CI [0.42-0.69], I2 = 98.1%, p < 0.001). Age ≥ 30 years pooled AOR = 1.95, 95% CI (0.85, 3.06), 3rd trimester pooled AOR = 3.20, 95% CI (1.82, 4.58), substance use pooled AOR = 2.51, 95% CI (0.99, 4.04), depression pooled AOR = 2.97, 95% CI (0.92, 5.02) and stress pooled AOR 2.14, 95% CI (0.24, 4.03) were associated factors of poor sleep quality. Three studies reported about suicidal ideation and pooled prevalence was 11% (95% CI: 0.09, 0.13, I2 = 48.2%, p = 0.145). Depression pooled AOR = 3.19, 95% CI (1.68, 4.71) was the only associated factor of suicidal ideation. Conclusion Due to COVID-19 pregnant women in Ethiopia were affected by poor sleep quality and suicidal ideation. Thus, suitable and well designed programs proposing awareness of COVID-19, mental health counseling and involvement should be designed to improve the general mental health of pregnant women. Trial registration PROSPERO registration number CRD42023389896.
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Affiliation(s)
- Aragaw Asfaw Hasen
- Department of Statistics, College of Natural and Computational Sciences, Samara University, Semera, Afar, Ethiopia
| | - Abubeker Alebachew Seid
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, Afar, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Semera, Afar, Ethiopia
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Karageorgiou V, Casanova F, O'Loughlin J, Green H, McKinley TJ, Bowden J, Tyrrell J. Body mass index and inflammation in depression and treatment-resistant depression: a Mendelian randomisation study. BMC Med 2023; 21:355. [PMID: 37710313 PMCID: PMC10502981 DOI: 10.1186/s12916-023-03001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/24/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) has a significant impact on global burden of disease. Complications in clinical management can occur when response to pharmacological modalities is considered inadequate and symptoms persist (treatment-resistant depression (TRD)). We aim to investigate inflammation, proxied by C-reactive protein (CRP) levels, and body mass index (BMI) as putative causal risk factors for depression and subsequent treatment resistance, leveraging genetic information to avoid confounding via Mendelian randomisation (MR). METHODS We used the European UK Biobank subcohort ([Formula: see text]), the mental health questionnaire (MHQ) and clinical records. For treatment resistance, a previously curated phenotype based on general practitioner (GP) records and prescription data was employed. We applied univariable and multivariable MR models to genetically predict the exposures and assess their causal contribution to a range of depression outcomes. We used a range of univariable, multivariable and mediation MR models techniques to address our research question with maximum rigour. In addition, we developed a novel statistical procedure to apply pleiotropy-robust multivariable MR to one sample data and employed a Bayesian bootstrap procedure to accurately quantify estimate uncertainty in mediation analysis which outperforms standard approaches in sparse binary outcomes. Given the flexibility of the one-sample design, we evaluated age and sex as moderators of the effects. RESULTS In univariable MR models, genetically predicted BMI was positively associated with depression outcomes, including MDD ([Formula: see text] ([Formula: see text] CI): 0.133(0.072, 0.205)) and TRD (0.347(0.002, 0.682)), with a larger magnitude in females and with age acting as a moderator of the effect of BMI on severity of depression (0.22(0.050, 0.389)). Multivariable MR analyses suggested an independent causal effect of BMI on TRD not through CRP (0.395(0.004, 0.732)). Our mediation analyses suggested that the effect of CRP on severity of depression was partly mediated by BMI. Individuals with TRD ([Formula: see text]) observationally had higher CRP and BMI compared with individuals with MDD alone and healthy controls. DISCUSSION Our work supports the assertion that BMI exerts a causal effect on a range of clinical and questionnaire-based depression phenotypes, with the effect being stronger in females and in younger individuals. We show that this effect is independent of inflammation proxied by CRP levels as the effects of CRP do not persist when jointly estimated with BMI. This is consistent with previous evidence suggesting that overweight contributed to depression even in the absence of any metabolic consequences. It appears that BMI exerts an effect on TRD that persists when we account for BMI influencing MDD.
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Affiliation(s)
| | | | | | - Harry Green
- College of Medicine & Health, University of Exeter, Exeter, UK
| | | | - Jack Bowden
- College of Medicine & Health, University of Exeter, Exeter, UK
- Genetics Department, Novo Nordisk Research Centre Oxford, Oxford, UK
| | - Jessica Tyrrell
- College of Medicine & Health, University of Exeter, Exeter, UK
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Birkenæs V, Refsum Bakken N, Frei E, Jaholkowski P, Smeland OB, Tesfaye M, Agartz I, Susser E, Bresnahan M, Røysamb E, Nordbø Jørgensen K, Nesvåg R, Havdahl A, Andreassen OA, Elken Sønderby I. Psychometric Properties and Diagnostic Associations of the Short-Form Community Assessment of Psychic Experiences in a Population-Based Sample of 29 021 Adult Men. Schizophr Bull 2023; 49:1229-1238. [PMID: 37262330 PMCID: PMC10483447 DOI: 10.1093/schbul/sbad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND HYPOTHESIS Around 5%-7% of the adult population are estimated to have lifetime psychotic experiences (PEs), which are associated with psychosis risk. PEs assessed with Community Assessment of Psychic Experiences (CAPE) are associated with psychosis but also non-psychotic disorders, which could be partly explained by CAPE indirectly capturing emotional symptoms. We investigated the psychometric properties of a shorter version, CAPE-9, and whether CAPE-9 scores are associated with lifetime psychotic or non-psychotic mental disorders after controlling for current anxiety and depressive symptoms. DESIGN CAPE-9 questionnaire data were obtained from 29 021 men (42.4 ± 5.6 yrs.) from the Norwegian Mother, Father, and Child Cohort Study. We investigated CAPE-9 reliability and factor structure. Logistic regression was used to test effects of current anxiety and depressive symptoms (SCL-12) on associations between CAPE-9 scores and psychiatric diagnoses. RESULTS CAPE-9 fit a previously reported 3-factor structure and showed good reliability. Twenty-six percent reported at least one lifetime PE. CAPE-9 scores were significantly associated with most psychiatric disorders (schizophrenia, depression, bipolar disorder, substance abuse, anxiety, trauma-related disorders, and ADHD). After controlling for concurrent emotional symptoms, only associations with schizophrenia (OR = 1.29; 95% CI = 1.18-1.38) and trauma-related disorders (OR = 1.09; CI = 1.02-1.15) remained significant. CONCLUSIONS CAPE-9 showed good psychometric properties in this large population-based adult male sample, and PEs were more clearly associated with psychotic disorders after controlling for current emotional symptoms. These results support the use of the short CAPE-9 as a cost-effective tool for informing public health initiatives and advancing our understanding of the dimensionality of psychosis.
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Affiliation(s)
- Viktoria Birkenæs
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nora Refsum Bakken
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Evgeniia Frei
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Piotr Jaholkowski
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Markos Tesfaye
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakohjemmet Hospital, Oslo, Norway
| | - Ezra Susser
- Mailman School of Public Health, Department of Epidemiology and Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Michaeline Bresnahan
- Mailman School of Public Health, Department of Epidemiology and Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Espen Røysamb
- Faculty of Social Sciences, Department of Psychology, Oslo University Hospital, Oslo, Norway
| | - Kjetil Nordbø Jørgensen
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ida Elken Sønderby
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
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Castillo-Navarrete JL, Vicente B, Schmidt K, Moraga-Escobar E, Rojas-Ponce R, Lagos P, Macaya X, Guzman-Castillo A. Interaction of Val66Met BDNF and 5-HTTLPR polymorphisms with prevalence of post-earthquake 27-F PTSD in Chilean population. PeerJ 2023; 11:e15870. [PMID: 37692110 PMCID: PMC10484206 DOI: 10.7717/peerj.15870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/18/2023] [Indexed: 09/12/2023] Open
Abstract
Post-traumatic stress (PTSD) disorder is a mental health condition that can occur after experiencing or witnessing a traumatic event. The 27-F earthquake that struck Chile in 2010 was one such event that had a significant impact on the mental health of the population. A study was conducted to investigate the prevalence of PTSD and its associated factors among survivors of this earthquake. The study was a longitudinal design, involving a sample of 913 patients aged 18 to 75 years who attended 10 Primary Care Centers in Concepción, Chile. The Composite International Diagnostic Interview (CIDI) was used to assess both depressive episodes (DE) and PTSD before and after the earthquake. The study also involved genotyping studies using saliva samples from the participants, specifically focusing on the Val66Met and 5-HTTLPR polymorphisms. Statistical analysis was performed to examine the association between different variables and the presence of PTSD. These variables included demographic factors, family history of psychiatric disorders, DE, childhood maltreatment experiences, and critical traumatic events related to the earthquake. The results showed that the incidence of post-earthquake PTSD was 11.06%. No significant differences were found between the groups of participants who developed post-earthquake PTSD regarding the Val66Met or 5-HTTLPR polymorphisms. However, a significant association was found between the concomitant diagnosis of DE and the development of post-earthquake PTSD. The presence of DE doubled the risk of developing post-earthquake PTSD. The number of traumatic events experienced also had a statistically significant association with an increased risk of developing post-earthquake PTSD. The study's limitations include the potential interference of different DE subtypes, the complexity of quantifying the degree of earthquake exposure experienced by each individual, and events entailing social disruption, such as looting, that can profoundly influence distress. In conclusion, the study found that PTSD following the 27-F earthquake in Chile was associated with a concomitant diagnosis of DE and the number of traumatic events experienced. The study did not find a significant association between PTSD and the Val66Met or 5-HTTLPR polymorphisms. The researchers recommend that mental health professionals should prioritize the detection and treatment of concomitant depressive episodes and exposure to critical traumatic events in survivors of disasters. They also suggest that further research is needed to better understand the relationship between genetic factors and post-disaster PTSD.
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Affiliation(s)
- Juan-Luis Castillo-Navarrete
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Benjamin Vicente
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Kristin Schmidt
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Esteban Moraga-Escobar
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
| | - Romina Rojas-Ponce
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Paola Lagos
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Ximena Macaya
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Facultad de Odontología, Universidad de Concepción, Concepción, Chile
| | - Alejandra Guzman-Castillo
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Ciencias Básicas y Morfología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
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Ferro MA, Elgie M, Dol M, Basque D. Measurement invariance of the 12-item self-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 across early and late adolescents in Canada. Disabil Rehabil 2023; 45:3118-3124. [PMID: 36082846 DOI: 10.1080/09638288.2022.2118867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/11/2022] [Accepted: 08/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study examined whether the 12-item self-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 demonstrated measurement invariance between young adolescents aged 10-16 years with a physical illness and older adolescents aged 15-19 years from the general population. MATERIALS AND METHODS Young adolescent data come from the baseline wave of the Multimorbidity in Youth across the Life-course study (n = 117) and older adolescent data come from the Canadian Community Health Survey-Mental Health (n = 1851). Multiple-group confirmatory factor analysis was used to test measurement invariance. WHODAS 2.0 scores were compared across morbidity subgroups using multiple regression. RESULTS Measurement invariance of the WHODAS 2.0 was demonstrated: (χ2=635.2(144), p<.001; RMSEA = 0.059 (0.054, 0.064); CFI = 0.967; TLI = 0.970; and, SRMR = 0.068). Adjusting for data source, sex, race, immigrant status, and household income, WHODAS 2.0 scores were associated with morbidity status in a dose-response manner: physical illness only (B = 1.50, p<.001), mental illness only (B = 2.92, p<.001), and physical-mental comorbidity (B = 4.44, p<.001). CONCLUSIONS Measurement invariance of the WHODAS 2.0 suggests that young adolescents interpret the items and disability construct similarly to older adolescents - a group that previously demonstrated measurement invariance with an adult sample. The 12-item self-administered WHODAS 2.0 may be used to measure disability across the life-course. IMPLICATIONS FOR REHABILITATIONThe 12-item self-administered WHODAS 2.0 is one of the most widely used measures of disability and functioning.Measurement invariance of the WHODAS 2.0 suggests that young adolescents interpret the items and disability construct similarly to older adolescents and adults in Canada.Researchers and health professionals can be confident that differences in 12-item self-administered WHODAS 2.0 scores are real and meaningful.The 12-item self-administered WHODAS 2.0 may be used to measure disability across the life-course.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Melissa Elgie
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Megan Dol
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Dominique Basque
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Esie P, Bates LM. Dismantling the monolith: ethnic origin, racial identity, and major depression among US-born Black Americans. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1293-1304. [PMID: 36592179 DOI: 10.1007/s00127-022-02412-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/12/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Numerous investigations have sought to understand why Black Americans have a lower prevalence of major depressive disorder (MDD) than white Americans, yet fewer have explored within-racial group variation or its causes. Limited extant evidence indicates that US-born Caribbeans have higher levels of MDD relative to African Americans. Among African Americans, racial identity is considered protective against depression, yet it is unclear how it functions among Black Americans with recent immigrant origins. We examined the extent to which differential effects of racial identity on MDD by ethnic origin explain the elevated prevalence among US-born Caribbeans relative to all other US-born Black Americans. METHODS With data from the largest nationally representative study of Black mental health, log-binomial models assessed effect modification of ethnic origin (Caribbean, non-Caribbean) on the relationship between racial identity and MDD. Separate models evaluated four indicators of racial identity-"closeness to Black people," "importance of race to one's identity," "belief that one's fate is shared with other Black people," and "Black group evaluation." RESULTS Belief in "shared fate" was positively associated with MDD for US-born Caribbeans alone (PR = 3.43, 95% CI 1.87, 6.27). Models suggested that "importance of race" and "Black group evaluation" were detrimental for Caribbeans, yet protective for non-Caribbeans. "Closeness" appeared protective for both groups. CONCLUSION Findings suggest that the protective effect of racial identity against MDD among US-born Black Americans may depend on both ethnic origin and the operationalization of racial identity. Results provide new insight into the role of racial identity on depression and suggest promising directions for future research.
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Affiliation(s)
- Precious Esie
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.
| | - Lisa M Bates
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
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Amro I, Ali A, Hassan MHMO, Al Shawwaf M, Alhassan A, Al Bahari D, El Fakki H, Hijawi Z, Aly S, Amin A, Mohammed R, Nofal M, Abdelkader M, Salman S, Currie J, Alabdulla M, Sampson NA, First M, Kessler RC, Woodruff PW, Khaled SM. Design and field procedures for the clinical reappraisal of the Composite International Diagnostic Interview version 3.3 in Qatar's national mental health study. Int J Methods Psychiatr Res 2023; 32:e1958. [PMID: 36654500 PMCID: PMC10485330 DOI: 10.1002/mpr.1958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/22/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The Composite International Diagnostic Interview (CIDI) has been clinically reappraised in several studies conducted mainly in the US and Europe. This report describes the methodology used to conduct one of the Middle East's largest clinical reappraisal studies. The study was carried out in conjunction with the World Mental Health Qatar-the first national psychiatric epidemiological study of common mental disorders in the country. This study aimed to evaluate the diagnostic consistency of core modules of the newly translated and adapted Arabic version of the CIDI 5.0 against the independent clinical diagnoses based on the Structured Clinical Interview for DSM-5 (SCID-5). METHODS Telephone follow-up interviews were administered by trained clinicians using the latest research edition of the SCID for DSM-5. Telephone administered interviews were key in the data collection, as the study took place during the COVID-19 pandemic. RESULTS Overall, within 12 months, 485 interviews were completed. The response rate was 52%. Quality control monitoring documented excellent adherence of clinical interviews to the rating protocol. CONCLUSIONS The overall methods used in this study proved to be efficient and effective. For future research, instrument cultural adaptation within the cultural context is highly recommended.
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Affiliation(s)
- Iman Amro
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Amal Ali
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Michael First
- Columbia University Department of PsychiatryNew YorkNew YorkUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Salma M. Khaled
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
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137
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Ichiki T, Koyama A, Imai M, Nishi Y, Abe Y, Fukunaga R, Murakami R, Nagaoka M, Takebayashi M, Fujise N. The trajectory of non-depressed suicidal ideation in community-dwelling older people in a rural area in Japan: a prospective longitudinal study with a 3-year follow-up. Psychogeriatrics 2023; 23:831-837. [PMID: 37448176 DOI: 10.1111/psyg.13006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Suicidal ideation is closely related to severe suicidal behaviour and is an important predictor of suicide attempt and completion, including in older people. Older people tend to have many opportunities to be conscious of death, and may have vague suicidal ideation because of various loss experiences, even if they are not depressed. We hypothesised that suicidal ideation among older people might be a risk factor for later transition to depression. The present study aimed to clarify risk factors that predict the incidence of depression in older people 3 years post-baseline in a rural area of Japan, and to examine the subsequent course of depression among non-depressed older people with suicidal ideation. METHODS In 2015 and 2018, survey questionnaires were mailed to residents aged 65 years and over living in a rural area in Japan. Participants were divided into a depression group and a non-depression group using 15-item Geriatric Depression Scale scores 3 years post-baseline. Logistic regression analysis was used to identify predictive factors of late-life depression 3 years post-baseline. RESULTS We received 597 valid responses, with a 3-year follow-up rate of 78.8%. Regarding suicidal ideation, 6.7% of non-depressed older people exhibited suicidal ideation at baseline. Of these, 9.8% exhibited depression after 3 years post-baseline. Logistic regression analysis indicated that development of late-life depression is significantly associated with suicidal ideation, being female, and poor health-related quality of life (HRQOL). CONCLUSIONS The results revealed that suicidal ideation, being female, and poor HRQOL were predictive factors of the development of late-life depression 3 years post-baseline in a rural area of Japan. These findings provide novel information regarding the transition to depression among community-dwelling older people who are not depressed but have suicidal ideation. Whereas suicidal ideation is considered to be a symptom of depression, the current results suggest that suicidal ideation may precede depression in some older people.
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Affiliation(s)
- Takahiro Ichiki
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
- Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Asuka Koyama
- Faculty of Social Welfare, Kumamoto Gakuen University, Kumamoto, Japan
| | - Masaki Imai
- Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
- Kumamoto Mental Health Hospital, Kumamoto, Japan
| | | | | | | | | | - Maiko Nagaoka
- Health Care Center, Kumamoto University, Kumamoto, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University, Kumamoto, Japan
| | - Noboru Fujise
- Health Care Center, Kumamoto University, Kumamoto, Japan
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138
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Bedregal P, Lermanda V, Sierra R, Viviani P. Risk factors associated with higher scores in internalizing and externalizing behaviors in Chilean preschoolers. Infant Ment Health J 2023; 44:663-678. [PMID: 37608475 DOI: 10.1002/imhj.22082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/02/2023] [Accepted: 05/21/2023] [Indexed: 08/24/2023]
Abstract
Early detection of behavioral disorders in children is necessary for intervention. Available data show a high prevalence of child and adolescent psychiatric disorders in Chile (22.5%), but behavioral problems in younger children have not been evaluated. This work assesses behavioral disorders in preschoolers and their association with sociodemographic variables of the family and the child. The data was collected during the impact assessment of the Biopsychosocial Development Support Program "Chile Crece Contigo", using a multistage and representative random sample of 1377 preschoolers, aged between 30 and 48 months, who attended public health services. Homes were visited to apply a questionnaire and the Child Behavior Checklist (CBCL, 1.5-5 years). Results: Multivariable regression model for total raw scores shows that child's age, the number of chronic diseases in the child, and history of exposure to mother's alcohol consumption in pregnancy, remain significant when adjusted for all variables included (R2 of 17.8% and η2 of .19 (95% CI: .14-.22)). In externalizing and internalizing explanatory models, child's chronic diseases and a higher score of authoritarian beliefs about parenting show the two largest effect sizes. These results add to the evidence of urgent problems in preschool mental health.
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Affiliation(s)
- Paula Bedregal
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Victoria Lermanda
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Sierra
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Santiago, Chile
| | - Paola Viviani
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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139
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Ghimire DJ, Cole F, Hermosilla S, Axinn WG, Benjet C. Alcohol use and internal migration in Nepal: a cross-sectional study. J Epidemiol Community Health 2023; 77:587-593. [PMID: 37407031 PMCID: PMC10498928 DOI: 10.1136/jech-2022-220030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/05/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Alcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country. METHODS A representative sample of 7435 individuals, aged 15-59 from Nepal were interviewed in 2016-2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes. RESULTS Net of individual sociodemographic characteristics, internal migration was associated with increased odds of opportunity to drink (OR 1.32, 95% CI 1.14 to 1.53), onset of regular alcohol use given lifetime use (OR 1.29, 95% CI 1.13 to 1.48) and AUD given lifetime use (OR 1.24, 95% CI 0.99 to 1.57). The statistically significant association between internal migration and opportunity to drink was specific to females, whereas the associations between migration and regular use and disorder were statistically significant for males. CONCLUSIONS Despite high rates of internal migration worldwide, most research studying migration and alcohol use focuses on international migrants. Findings suggest that internal migrants are at increased risk to transition into alcohol use and disorders. Support services for internal migrants could prevent problematic alcohol use among this underserved population.
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Affiliation(s)
- Dirgha J Ghimire
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Faith Cole
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sabrina Hermosilla
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - William G Axinn
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Corina Benjet
- Epidemiology and Psychosocial Research, National Institute for Psychiatry Ramon de la Fuente Muniz, Ciudad de Mexico, Mexico
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Rezaei Z, Mohammadi S, Aghaei A, Pouragha H, Latifi A, Keshavarz-Mohammadi N. Assessment of risk factors for suicidal behavior: results from the Tehran University of Medical Sciences Employees' Cohort study. Front Public Health 2023; 11:1180250. [PMID: 37674684 PMCID: PMC10478100 DOI: 10.3389/fpubh.2023.1180250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/19/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Suicide is a major issue of concern for public health. It is estimated that suicide accounts for 700,000 deaths every year. A personal history of one or more suicide attempts is the most important determinant of suicide among the general population. This study aimed to assess the major risk factors associated with suicidal behaviors among Iranian employees in a medical setting. Methods In this study, 3,913 employees of Tehran University of Medical Sciences who participated in the employees' cohort study conducted by the university were recruited. Suicidal behaviors (SBs) and their associated risk factors were evaluated using the World Mental Health Composite International Diagnostic Interview (CIDI) Version 3.0. Univariate and multivariate logistic regressions were performed to identify the determinants of SBs among the participants, and crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated. Results Overall, 49.6% of respondents (n = 1,939) reported that they were tired of life and thinking about death. The lifetime prevalence rate of suicidal ideation (SI) was 8.1% (n = 317), that of suicide planning (SP) was 7.3% (n = 287), and that of suicide attempts (SA) was 3.1% (n = 122). Being female (OR: 1.87, CI: 1.64-2.12), being divorced (OR: 3.13, CI: 1.88-5.22), having a low level of education (OR: 1.57, CI: 1.15-2.14), and working in clinical and medical services (OR: 1.25, CI: 1.09-1.43) were associated with being tired of life and thinking about death. These factors were also associated with SI, SP, and SA. Discussion These findings highlight the need to prioritize mental health for suicide prevention, especially for high-risk groups, in workplace mental health promotion programs and policies.
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Affiliation(s)
- Zahed Rezaei
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
- Asadabad School of Medical Sciences, Asadabad, Iran
| | - Samira Mohammadi
- Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Abbas Aghaei
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamidreza Pouragha
- Center for Research on Occupational Disease, Tehran University of Medical Sciences, Tehran, Iran
- Department of Environmental Engineering, Mehralborz University (MAU), Tehran, Iran
| | - Arman Latifi
- Department of Public Health, School of Public Health, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Nastaran Keshavarz-Mohammadi
- Department of Public Health, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Otieno P, Asiki G, Wilunda C, Wami W, Agyemang C. Cardiometabolic multimorbidity and associated patterns of healthcare utilization and quality of life: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002215. [PMID: 37585386 PMCID: PMC10431646 DOI: 10.1371/journal.pgph.0002215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023]
Abstract
Understanding the patterns of multimorbidity, defined as the co-occurrence of more than one chronic condition, is important for planning health system capacity and response. This study assessed the association of different cardiometabolic multimorbidity combinations with healthcare utilization and quality of life (QoL). Data were from the World Health Organization (WHO) study on global AGEing and adult health Wave 2 (2015) conducted in Ghana. We analysed the clustering of cardiometabolic diseases including angina, stroke, type 2 diabetes, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataract and depression. The clusters of adults with cardiometabolic multimorbidity were identified using latent class analysis and agglomerative hierarchical clustering algorithms. We used negative binomial regression to determine the association of multimorbidity combinations with outpatient visits. The association of multimorbidity clusters with hospitalization and QoL were assessed using multivariable logistic and linear regressions. Data from 3,128 adults aged over 50 years were analysed. We identified four distinct classes of multimorbidity: relatively "healthy class" with no multimorbidity (47.9%): abdominal obesity only (40.7%): cardiometabolic and arthritis class comprising participants with hypertension, type 2 diabetes, stroke, abdominal and general obesity, arthritis and cataract (5.7%); and cardiopulmonary and depression class including participants with angina, chronic lung disease, asthma, and depression (5.7%). Relative to the class with no multimorbidity, the cardiopulmonary and depression class was associated with a higher frequency of outpatient visits [β = 0.3; 95% CI 0.1 to 0.6] and higher odds of hospitalization [aOR = 1.9; 95% CI 1.0 to 3.7]. However, cardiometabolic and arthritis class was associated with a higher frequency of outpatient visits [β = 0.8; 95% CI 0.3 to 1.2] and not hospitalization [aOR = 1.1; 95% CI 0.5 to 2.9]. The mean QoL scores was lowest among participants in the cardiopulmonary and depression class [β = -4.8; 95% CI -7.3 to -2.3] followed by the cardiometabolic and arthritis class [β = -3.9; 95% CI -6.4 to -1.4]. Our findings show that cardiometabolic multimorbidity among older persons in Ghana cluster together in distinct patterns that differ in healthcare utilization. This evidence may be used in healthcare planning to optimize treatment and care.
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Affiliation(s)
- Peter Otieno
- African Population and Health Research Center, Nairobi, Kenya
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Welcome Wami
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Tripathi A, Samanta T. Leisure as social engagement: does it moderate the association between subjective wellbeing and depression in later life? FRONTIERS IN SOCIOLOGY 2023; 8:1185794. [PMID: 37649638 PMCID: PMC10465305 DOI: 10.3389/fsoc.2023.1185794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/27/2023] [Indexed: 09/01/2023]
Abstract
Objectives To investigate the role of leisure (as social engagement) in moderating the association between subjective wellbeing and depressive symptoms among older Indians. Methods The sample included data from 39,538 older adults (aged 55-80) from the Longitudinal Aging Study in India (LASI, Wave-1), 2017-2018. Individual level questionnaire was used to examine the relationship among social engagement, subjective wellbeing, and depressive symptoms. Moderating effects of leisure activities were estimated through interaction analysis and linear multivariable modeling. Results Low participation in social engagement activities (or leisure) was associated with greater likelihood of depressive symptoms. Leisure activities positively and significantly moderated the subjective wellbeing among older adults with depressive symptoms. Results suggest a significant wealth gradient where affluent older Indians having a clear advantage in heightened levels of social engagement and subsequently lower likelihood of depressive symptoms. Additionally, being in an urban area, co-residence in a "joint" household and belonging to the dominant social groups in terms of caste and religious categories are associated with gains in wellbeing. Discussion The direct and indirect effects of social engagement suggest that depressive symptoms can be mitigated while enhancing overall wellbeing of older adults. This holds promise for social policy in redirecting efforts to develop age-friendly initiatives and social infrastructure that enhance the link between engagement and wellbeing.
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Affiliation(s)
- Ashwin Tripathi
- Indian Institute of Technology Gandhinagar, Gandhinagar, India
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Felez-Nobrega M, Koyanagi A. Health status and quality of life in comorbid physical multimorbidity and depression among adults aged ⩾50 years from low- and middle-income countries. Int J Soc Psychiatry 2023; 69:1250-1259. [PMID: 36825661 DOI: 10.1177/00207640231157253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Data on the clinical and functional significance of comorbid depression in physical multimorbidity in middle-aged and older adults and from low- and middle-income countries (LMICs) are lacking. AIMS This study aims to determine the association of comorbid depression in physical multimorbidity with health outcomes and quality of life among adults aged ⩾50 years from six LMICs. METHODS Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. DSM-IV Depression was based on past 12-month symptoms. Eleven chronic physical conditions were assessed. Health status was based on scales ranging from 0 (best) to 100 (worse). The quality of life (8-item WHO Quality of Life) scale ranged from 0 (worse) to 100 (best). Multivariable linear regression analyses were conducted. RESULTS Data on 34,129 individuals aged ⩾50 years [mean (SD) age 62.4 (16.0) years; 52.1% females] were analyzed. Among people with physical multimorbidity, having comorbid depression was associated with significantly worse health status in terms of sleep/energy (β = 14.71: 95% CI [12.23, 17.20]), self-care (13.23: [8.66, 17.82]), pain/discomfort (13.03: [9.59, 16.47]), mobility (11.06: [6.91, 15.21]), cognition (10.41: [7.31, 13.50]), perceived stress (8.35: [4.71, 11.99]), interpersonal activities (7.81: [3.71, 11.91]), and lower quality of life (-8.81: [-10.74, -6.88]). CONCLUSIONS Comorbid depression in physical multimorbidity was associated with lower quality of life and poorer scores in multiple domains of health status. Treatment of depression in people with physical multimorbidity may potentially lead to better clinical outcomes, but future studies are needed to determine the most effective intervention to address this comorbidity in LMICs.
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Affiliation(s)
- Mireia Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), ISCIII, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), ISCIII, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Joo JH, Davey-Rothwell M, Choi N, Gallo J, Mace RA, Xie A. Increasing the Repertoire for Depression Care: Methods and Challenges of a Randomized Controlled Trial of Peer Support for Vulnerable Older Adults. Am J Geriatr Psychiatry 2023; 31:586-595. [PMID: 36842891 PMCID: PMC10329981 DOI: 10.1016/j.jagp.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Low-income White and older adults of color face barriers to depression care. Our purpose is to describe the methods and challenges encountered during the implementation of a randomized controlled trial to test the effectiveness of a peer support depression care intervention for low-income White and older adults of color during the COVID-19 pandemic. METHODS Peer Enhanced Depression Care (Peers) is an 8-week community-based intervention that uses peer mentors who are trained and supervised to provide social support and self-care skills to depressed older adults. The effectiveness of the intervention in reducing depression will be evaluated by following a sample of older adults recruited in the community over a 12-month period. Target enrollment is 160 older adults. We hypothesize that participants randomized to the Peer Enhanced Depression Care intervention will experience greater decrease in depressive symptoms compared to participants randomized to the social interaction control. We provide lessons learned regarding the recruitment of BIPOC and White low-income older adults and peer mentors during the COVID-19 pandemic. RESULTS Recruitment challenges occurred in primary care clinics that were unable to accommodate recruitment efforts during the pandemic. This led to focused outreach to community-based organizations serving older adults. Challenges to participant recruitment have included barriers related to stigma, distrust, as well as unfamiliarity with research. Peer mentor recruitment was facilitated by existing government-supported resources. CONCLUSIONS This study will provide knowledge regarding the effectiveness, mechanism, and processes of delivering an informal psychosocial intervention such as peer support to a vulnerable older adult population.
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Affiliation(s)
- Jin Hui Joo
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Melissa Davey-Rothwell
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Namkee Choi
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Joseph Gallo
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ryan A Mace
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Alice Xie
- Department of Psychiatry (JHJ, AX), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Health, Society and Behavior, Bloomberg School of Public Health (MDR), Johns Hopkins University, Baltimore, MD; The University of Texas at Austin (NC), Steve Hicks School of Social Work, Austin, TX; Department of Mental Health, School of Public Health (JG), Johns Hopkins University, Baltimore, MD; Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (RAM), Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Kidd JD, Tettamanti NA, Kaczmarkiewicz R, Corbeil TE, Dworkin JD, Jackman KB, Hughes TL, Bockting WO, Meyer IH. Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample. Psychiatry Res 2023; 326:115339. [PMID: 37429172 PMCID: PMC10528335 DOI: 10.1016/j.psychres.2023.115339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023]
Abstract
Transgender individuals experience numerous health disparities relative to cisgender individuals. However, most transgender-health studies have focused on convenience samples with limited generalizability. This study utilized data from the 2016-2018 TransPop Study, the first national probability sample of transgender adults (n=274) with a cisgender comparison sample (n=1162). Using multivariable logistic regression, adjusted for demographics, we compared the prevalence of hazardous drinking, problematic drug use, serious psychological distress, suicidality, and non-suicidal self-injury between transgender and cisgender individuals and among transgender men (n=78), transgender women (n=120), and transgender nonbinary individuals (n=76). Among transgender individuals, 28.2% (95%CI 21.2-35.2) and 31.2% (95%CI 23.8-38.7) reported hazardous drinking and problematic drug use, respectively; 44.4% (95% CI 35.8-53.0) reported recent suicidal ideation, 6.9% (95% CI 2.3-11.5) reported a recent suicide attempt, and 21.4% (95% CI 14.5%-28.4%) reported recent non-suicidal self-injury. In their lifetime, 81.3% (95%CI 75.1-87.5) of transgender respondents had suicidal ideation, 42.0% (95%CI 34.2-49.8) had attempted suicide, and 56.0% (95% CI 48.2-63.8) reported non-suicidal self-injury. Most (81.5%; 95%CI 75.5-87.5) had utilized formal mental health care and 25.5% (95%CI 18.5-32.4) had sought informal mental health support. There were no differences in alcohol or drug-use outcomes between transgender and cisgender adults. Compared to cisgender adults, transgender adults had higher odds of serious psychological distress (aOR=3.1; 95%CI 1.7-5.7), suicidal ideation (recent: aOR=5.1, 95%CI 2.7-9.6); lifetime: aOR=6.7, 95%CI 3.8-11.7), lifetime suicide attempts (aOR=4.4, 95%CI 2.4-8.0), and non-suicidal self-injury (recent: aOR=13.0, 95%CI 4.8-35.1); lifetime: aOR=7.6, 95%CI 4.1-14.3). Transgender nonbinary adults had the highest odds for all outcomes, including substance use outcomes. Findings from these national probability samples support those of earlier convenience-sample studies showing mental health disparities among transgender adults relative to cisgender adults, with nonbinary individuals at highest risk. These findings also highlight variations in risk across sub-groups of transgender individuals.
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Affiliation(s)
- Jeremy D Kidd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
| | | | | | | | - Jordan D Dworkin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, New York, NY, USA; New York Presbyterian Hospital, New York, NY, USA
| | - Tonda L Hughes
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Columbia University School of Nursing, New York, NY, USA
| | - Walter O Bockting
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Columbia University School of Nursing, New York, NY, USA
| | - Ilan H Meyer
- Williams Institute for Sexual Orientation Law and Public Policy, University of California - Los Angeles, Los Angeles, CA, USA
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Domènech-Abella J, Gabarrell-Pascuet A, García-Mieres H, Mortier P, Felez-Nobrega M, Cristóbal-Narváez P, Vilagut G, Olaya B, Alonso J, Haro JM. Loneliness during the last phase of the COVID-19 pandemic in Spain: A longitudinal study of group-based trajectories, risk factors, and consequences in mental health. Psychiatry Res 2023; 326:115327. [PMID: 37413806 DOI: 10.1016/j.psychres.2023.115327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION The present study aims to investigate the courses of loneliness following a national state of emergency including a curfew due to a rise in COVID-19 cases, associated risk factors, and the effect of loneliness on symptoms of depression and anxiety. METHODS Data of 2,000 adults in Spain which were interviewed by telephone at the first follow-up of the MINDCOVID project (February-March 2021) and of whom 953 were interviewed nine months later (November-December 2021) were analyzed. Group-based trajectories and mixed models were constructed. RESULTS Three courses of loneliness were detected: (1) invariant low loneliness (42.6%), (2) decreasing medium loneliness (51.5%), and (3) fairly invariant high loneliness (5.9%). Loneliness courses were associated with the severity and variability of symptoms of depression and anxiety. In contrast to the majority of pre-pandemic studies, younger adults more frequently reported loneliness compared to middle-aged and, particularly, older individuals. Other risk factors for loneliness were being female, being unmarried, and, notably, having pre-pandemic mental disorders. CONCLUSIONS Future studies should validate whether the newly observed loneliness patterns across age groups persist and assess the evolution of loneliness courses and their impact on mental health, with particular attention given to young adults and individuals with pre-existing mental disorders.
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Affiliation(s)
- Joan Domènech-Abella
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Aina Gabarrell-Pascuet
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Helena García-Mieres
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mireia Felez-Nobrega
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Paula Cristóbal-Narváez
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Olaya
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josep Maria Haro
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
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148
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Altwaijri YA, Al-Subaie AS, Al-Habeeb A, Galea S, Akkad M, Naseem MT, Bilal L. Urbanization and mental health: A perspective from Riyadh City, Kingdom of Saudi Arabia. Int J Soc Psychiatry 2023; 69:1121-1133. [PMID: 36825615 DOI: 10.1177/00207640231152202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND While global studies demonstrated that features of urban living are associated with the risk of developing mental disorders, there remains a significant knowledge gap surrounding this topic in the Middle East and North Africa region. AIMS This study aims to assess the prevalence, severity, correlates, and treatment of mental disorders in Riyadh City by examining certain aspects of urban living such as exposure to traumatic events, early exposure to urbanization, and seeking treatment. METHODS The Saudi National Mental Health Survey is a community epidemiological survey in a nationally representative sample of citizens aged 15 to 65 in KSA. The World Health Organization Composite International Diagnostic Interview (CIDI 3·0) was used to estimate the 12-month prevalence of common mental disorders. RESULTS The prevalence of any mental disorder in Riyadh City was 29.2%. The most common disorders were anxiety disorders and mood disorders. Female, young, and previously married respondents were at higher risk for developing mental disorders. Exposure to traumatic events was associated with all types of mental disorders. Only 2.9% of those with any mental disorder sought mental health treatments. CONCLUSIONS We found a high prevalence of mental disorders in Riyadh City that could be attributed to certain features of urban living. These results may point to potential interventions in urban areas that can mitigate the adverse consequences of urban living and promote the salutogenic aspects of cities.
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Affiliation(s)
- Yasmin A Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah S Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - AbdulHameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh Saudi Arabia
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Marya Akkad
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
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149
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Falgas-Bague I, Cruz-Gonzalez M, Zhen-Duan J, Nagendra A, Alvarez K, Canino G, Duarte CS, Bird H, M. De-Salazar P, Alegría M. Association of sociocultural stressors with bipolar disorder onset in Puerto Rican youth growing up as members of a minoritized ethnic group: results from the Boricua Youth Longitudinal Study. LANCET REGIONAL HEALTH. AMERICAS 2023; 24:100549. [PMID: 37485018 PMCID: PMC10362791 DOI: 10.1016/j.lana.2023.100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/29/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023]
Abstract
Background The development of bipolar disorder is currently explained by a complex interaction of genetic and environmental factors. Less is known regarding the influence of sociocultural factors. This study aims to evaluate the incidence and impact of sociocultural factors on bipolar disorder onset in two comparable samples of youth growing up in different social settings. Methods We leveraged data from two urban population-based cohorts representative of Puerto Rican children growing up in either San Juan (Puerto Rico) or the South Bronx (NYC) and followed up for 17 years. Bipolar disorder diagnoses were based on retrospective self-reports on the World Health Organization Composite International Diagnostic Interview. We used a causal inference approach to estimate associations of sociocultural factors with bipolar disorder onset after adjusting for potential confounders. Findings We found that South Bronx children, who grew up as a minoritized group, had twice the risk of bipolar disorder onset as young adults, with an incidence rate of 2.22 new cases per 1000 person-years compared to 1.08 new cases in San Juan (incidence rate difference, 1.13; 95% CI, 0.09-1.20). After adjusting for potential confounders, South Bronx children had the same lifetime hazard of bipolar disorder onset compared to San Juan children. However, our analysis demonstrated that caregivers' exposure to societal cultural stress partially explained the increased risk of bipolar disorder onset in the South Bronx, in addition to the potential contribution of genetics. Interpretation Our results provide evidence that societal cultural stress can increase the risk of lifetime bipolar disorder onset in youth growing up as a minoritized group. Addressing stress in minoritized groups might reduce the risk of bipolar disorder onset. Funding The Boricua Youth Study has been supported by the National Institutes of HealthMH56401, MH098374, DA033172, and AA020191. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.
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Affiliation(s)
- Irene Falgas-Bague
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 2 Kreutzstrasse, 4123, Allschwil, Switzerland
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA
| | - Arundati Nagendra
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Schizophrenia and Psychosis Action Alliance, Alexandria, VA 22301, USA
| | - Kiara Alvarez
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico Medical School, Office A928 9th Floor, Rio Piedras, 00935, Puerto Rico
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Hector Bird
- New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Pablo M. De-Salazar
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 2 Kreutzstrasse, 4123, Allschwil, Switzerland
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Suite 506, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA
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150
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Lee H, An JH, Chang H, Jun JY, Hong JP. A Three-Year Longitudinal Study of Risk Factors for Suicidality in North Korean Defectors. J Korean Med Sci 2023; 38:e218. [PMID: 37463689 DOI: 10.3346/jkms.2023.38.e218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/26/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea. METHODS The subjects were 300 NKDs registered with a regional adaptation center (the Hana Center) in South Korea. Face-to-face interviews were conducted using the North Korean version of the World Health Organization's Composite International Diagnostic Interview to diagnose mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were also asked about sociodemographic and clinical factors at baseline. At follow-up after three years, the NKDs (n = 172 respondents) were asked to participate in an online survey, responding to self-questionnaires about suicidality. Logistic regression analyses were used to explore associations between baseline variables and future suicidality among NKDs. RESULTS Thirty (17.4%) of the 172 survey respondents reported suicidality at follow-up. The presence of health problems over the past year, any prior suicidality at baseline, a higher score on a trauma-related scale, and a lower score on a resilience scale at baseline were associated with greater odds of suicidality at follow-up after adjusting for age, sex, and educational level. Of all mental disorder categories, major depressive disorder, dysthymia, agoraphobia, and social phobia were also associated with significantly increased odds of suicidality at follow-up after adjusting for age, sex, educational level, and prior suicidality at baseline. CONCLUSION Resilience, a previous history of suicidality, and the presence of lifetime depressive disorder and anxiety disorder should be given consideration in mental health support and suicide prevention in NKDs.
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Affiliation(s)
- Hyerin Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyun An
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyein Chang
- Department of Psychology, Sungkyunkwan University, Seoul, Korea
| | - Jin Yong Jun
- Department of Psychiatry, National Center for Mental Health, Seoul, Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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