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Libutzki B, Neukirch B, Reif A, Hartman CA. Somatic burden of attention-deficit/hyperactivity disorder across the lifecourse. Acta Psychiatr Scand 2024; 150:105-117. [PMID: 38804256 DOI: 10.1111/acps.13694] [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: 01/26/2024] [Revised: 04/07/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE A thorough and comprehensive knowledge base on the extent of comorbidity of attention-deficit/hyperactivity disorder (ADHD) and somatic conditions is needed. METHOD We compared the prevalence of a wide range of somatic conditions in individuals with and without ADHD and described sex and lifecourse differences. Individuals with an ADHD diagnosis (N = 87,394) and age and sex-matched individuals without an ADHD diagnosis were identified from a large health claims dataset representative of the general German population, including both primary and specialized care (N = 4.874,754). Results were provided for the full sample as well as stratified for sex and age (<12 years, 13-17 years, 18-29 years, 30-59 years, ≥60 years). RESULTS The results showed that ADHD is associated with a wide variety of somatic conditions across the entire lifecourse. Specifically neurological disorders such as Parkison's disease (odds ratio [OR]: 5.21) and dementia (OR: 2.23), sleep-related disorders (OR: 2.38) and autoimmune disorders affecting the musculoskeletal, digestive, and endocrine system (fibromyalgia OR: 3.33; lupus OR: 2.17) are strongly and significantly associated with ADHD. Additionally, ADHD is associated with higher occurrence of common acute diseases typically treated by the general practitioner, hinting at an overall general lower health status. Sex differences in somatic comorbidity were not prominent. Age differences, in contrast, stood out: in particular endocrine, cardiovascular, and neurological disorders had an early onset in individuals with compared to individuals without ADHD. CONCLUSION This research underlines the high burden of disease due to somatic conditions among individuals with ADHD. The findings indicate the need for preventive measures to reduce comorbidity.
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Affiliation(s)
- Berit Libutzki
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Benno Neukirch
- Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Guo X, Hällström T, Johansson L, Najar J, Wetterberg H, Sacuiu S, Kern S, Skoog I. Midlife stress-related exhaustion and dementia incidence: a longitudinal study over 50 years in women. BMC Psychiatry 2024; 24:500. [PMID: 38992650 PMCID: PMC11238401 DOI: 10.1186/s12888-024-05868-z] [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: 01/30/2024] [Accepted: 05/27/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUNDS Cognitive problems are common symptoms among individuals with stress-related exhaustion. It is still unknown whether these individuals are at a higher risk of developing dementia later. This study aims to examine the relationship between midlife stress-related exhaustion and dementia incidence. METHODS A population sample of 777 women (aged 38, 46, 50 and 54 years) without dementia at baseline was followed over 50 years, from 1968 to 2019. Stress-related exhaustion was based on information from the psychiatric examination in 1968/69. Information on dementia incidence between 1968 and 2019 was obtained from neuropsychiatric examinations, key-informant interviews, and hospital registry. Dementia was diagnosed according to the DSM-III-R criteria. A subgroup of non-demented women (n = 284) was examined for cognitive functions by the Gottfries-Bråne-Steen scale 24 years after baseline. RESULTS Stress-related exhaustion in midlife was associated with higher risk for development of dementia before age 75 (Hazard ratio and 95% confidence interval: 2.95 and 1.35-6.44). The association remained after adjustment for age, major depression, and anxiety disorder. Mean age of dementia onset was younger for women with stress-related exhaustion than women without stress (mean ± SD, 76 ± 9 vs. 82 ± 8 . p = 0.009). Women with stress-related exhaustion in midlife still showed more cognitive impairments 24 years later compared with women without stress (Odds ratio and 95% confidence interval: 2.64 and 1.15-6.06). CONCLUSIONS We found that women with stress-related exhaustion in midlife were at a higher risk to develop dementia at relatively younger age. These women showed persistently lower cognitive functions over years even without dementia. Present study results need to be interpreted with caution due to small sample size and should be confirmed in future studies with larger sample size. Our study findings may imply the importance of long-term follow-up regarding cognitive function among individuals with stress-related exhaustion.
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Affiliation(s)
- Xinxin Guo
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of psychiatry, Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Tore Hällström
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Section Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Hanna Wetterberg
- Infection medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Simona Sacuiu
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of neuropsychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
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Šimunović Filipčić I, Jakšić N, Levaj S, Ćopo M, Vuksan-Ćusa Z, Mikulić FL, Grah M, Skočić Hanžek M, Šagud M, Filipčić I, Marčinko D. Physical multimorbidity in psychiatric patients with personality disorders: Insights within the ICD-11 framework. Gen Hosp Psychiatry 2024; 89:16-22. [PMID: 38704972 DOI: 10.1016/j.genhosppsych.2024.04.013] [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: 03/10/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Recent research has revealed poor physical health among individuals with personality disorders (PDs). We aimed to compare chronic physical illnesses (CPI) and chronic physical multimorbidity (CPM) prevalence between the general population (GEP) and PD patients, and to explore the relationship between CPM and various aspects of PD, predominantly within the ICD-11 framework. METHODS This cross-sectional study included 126 PD patients and 126 matched controls from the GEP. Patients were evaluated for the ICD-11 PD severity and maladaptive personality domains, subjective emptiness, and reflective functioning. CPI was assessed using a standardized self-report questionnaire. RESULTS PD patients had a higher mean number of CPIs (2.05 vs. 1.02) and a more frequent CPM occurrence (49.2% vs. 26.2%) compared to the matched controls (p < .001). The ICD-11 PD severity (OR = 1.143, p = .007) and maladaptive domain Negative affectivity (OR = 4.845, p = .002), and poor reflective functioning (OR = 1.694, p = .007) were significant predictors of CPM, independent of sociodemographic, clinical and lifestyle factors. Negative affectivity showed the most robust effect on CPM, while smoking did not significantly mediate these relationships. CONCLUSION Our study found increased CPM burden in PD patients and a link between CPM and various PD aspects under the ICD-11 framework, highlighting the need for more integrated healthcare.
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Affiliation(s)
- Ivona Šimunović Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia; Faculty of Dental Medicine and Health Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
| | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Sarah Levaj
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marija Ćopo
- Neuropsychiatric Hospital "Dr. Ivan Barbot", Croatia
| | | | | | - Majda Grah
- Faculty of Dental Medicine and Health Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; University Psychiatric Clinic Sveti Ivan, Zagreb, Croatia; University of Applied Health Science, Zagreb, Croatia
| | - Milena Skočić Hanžek
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marina Šagud
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Igor Filipčić
- Faculty of Dental Medicine and Health Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; University Psychiatric Clinic Sveti Ivan, Zagreb, Croatia; University of Applied Health Science, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
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Richmond-Rakerd LS, D'Souza S, Milne BJ, Andersen SH. Suicides, drug poisonings, and alcohol-related deaths cluster with health and social disadvantage in 4.1 million citizens from two nations. Psychol Med 2024; 54:1610-1619. [PMID: 38112104 DOI: 10.1017/s0033291723003495] [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] [Indexed: 12/20/2023]
Abstract
BACKGROUND Deaths from suicides, drug poisonings, and alcohol-related diseases ('deaths of despair') are well-documented among working-age Americans, and have been hypothesized to be largely specific to the U.S. However, support for this assertion-and associated policies to reduce premature mortality-requires tests concerning these deaths in other industrialized countries, with different institutional contexts. We tested whether the concentration and accumulation of health and social disadvantage forecasts deaths of despair, in New Zealand and Denmark. METHODS We used nationwide administrative data. Our observation period was 10 years (NZ = July 2006-June 2016, Denmark = January 2007-December 2016). We identified all NZ-born and Danish-born individuals aged 25-64 in the last observation year (NZ = 1 555 902, Denmark = 2 541 758). We ascertained measures of disadvantage (public-hospital stays for physical- and mental-health difficulties, social-welfare benefit-use, and criminal convictions) across the first nine years. We ascertained deaths from suicide, drugs, alcohol, and all other causes in the last year. RESULTS Deaths of despair clustered within a population segment that disproportionately experienced multiple disadvantages. In both countries, individuals in the top 5% of the population in multiple health- and social-service sectors were at elevated risk for deaths from suicide, drugs, and alcohol, and deaths from other causes. Associations were evident across sex and age. CONCLUSIONS Deaths of despair are a marker of inequalities in countries beyond the U.S. with robust social-safety nets, nationwide healthcare, and strong pharmaceutical regulations. These deaths cluster within a highly disadvantaged population segment identifiable within health- and social-service systems.
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Affiliation(s)
| | - Stephanie D'Souza
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J Milne
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
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Luo Y, Wu Y, Su B, Chen C, Zheng X. The trends of mental disorders mortality in China over a 33-year period. Asian J Psychiatr 2024; 95:103996. [PMID: 38471415 DOI: 10.1016/j.ajp.2024.103996] [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: 04/09/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES We investigated the variations in the trends of mental disorders mortality by age, period, and cohort, over a 33-year period from 1987 to 2020, to reveal the relationship between age, period, cohort, and mental disorders mortality, as well as providing guidance for resource allocation to prevent mental disorders-related deaths in vulnerable target populations. METHODS The data of mental disorders mortality 1987-2020 were from five administrative organizations, which collected from the National Health Commission in China with national monitoring by sex and age, covering 31 provinces in China. The International Classification of Diseases (ICD), its 9th Revision (ICD-9) and its 10th Revision were used to code the mental diseases. From 1987-2002, ICD-9 was used, and ICD-10 was used from 2003 to 2020. The age standardized mortality rates (ASMRs) were calculated using the World Standard Population as the reference. We used joinpoint models to assess the trends of mental disorders mortality in China for the period 1987-2020. And the age-period-cohort models were employed to estimate the age-period-cohort effect on mental disorders mortality. RESULTS The age-standardized overall mental disorders mortality rate (ASMR) showed a downward trend from 1987 to 2020. Further, the ASMR of individuals in urban was higher than that in rural from 1987 to 2001, but, post-2002, this urban-rural disparity in ASMR showed a less clear pattern, with urban areas occasionally surpassing rural areas and vice versa. ASMR is less prevalent among females compared to males overall. The contribution of age effects to mental disorders mortality gradually increases with advancing age, the period effects of mental disorders mortality gradually decrease over time. The cohort effect's contribution to mental disorders mortality decreases in the newly born population, while in the older birth cohorts, the cohort effect's contribution to the mortality rate of mental disorders increases. CONCLUSIONS The ASMR exhibits a decreasing trend from 1987 to 2020, and these change trend showed urban-rural and sex differences. The primary factors contributing to this overall decline are period effects and cohort effects. Our results provide valuable information for shaping mental health policies, designing targeted interventions, and preparing for future changes in disease mortality rates. The focus on different demographic factors allows for a nuanced and tailored approach to mental health promotion and intervention strategies.
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Affiliation(s)
- Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Chen Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
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Piqueras JA, Falcó R, Rico-Bordera P, Canals J, Espinosa-Fernández L, Vivas-Fernández M, Garcia-Lopez LJ. Identifying Adolescents at Risk for Emotional Disorders with Latent Profile Analysis: A Personalized, Transdiagnostic Preventive Intervention. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01689-z. [PMID: 38605162 DOI: 10.1007/s10578-024-01689-z] [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] [Accepted: 02/24/2024] [Indexed: 04/13/2024]
Abstract
It can be challenging to assign patients to the appropriate intervention programs, as risk and protective factors for developing emotional disorders are multiple and shared across disorders. This study aimed to provide a theoretical and empirical approach to identify and categorise adolescents into different levels of severity. The risk of developing emotional symptoms was assessed in 1425 Spanish adolescents (M = 14.34, SD = 1.76; 59.9% women). Latent Profile Analysis (LPA) was conducted to identify subgroups based on their emotional symptom severity, risk, and resilience factors. Results revealed four profiles: at low risk (emotionally healthy), moderate risk (for selective interventions), high risk (for indicated interventions), and severe risk (for clinical referral). Older age and especially female gender were predictors of higher risk clusters, and there were differences in the levels of psychopathology and health-related quality of life across clusters. Identification of at-risk adolescents for emotional disorders by means of LPA may contribute to designing personalised and tailored prevention programs that match adolescents' specific needs.
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Affiliation(s)
- José A Piqueras
- Division of Personality, Assessment and Psychological Treatment, Department of Health Psychology, Miguel Hernández University (UMH), 03202, Elche, Spain
| | - Raquel Falcó
- Division of Personality, Assessment and Psychological Treatment, Department of Health Psychology, Miguel Hernández University (UMH), 03202, Elche, Spain
| | - Pilar Rico-Bordera
- Division of Personality, Assessment and Psychological Treatment, Department of Health Psychology, Miguel Hernández University (UMH), 03202, Elche, Spain.
| | - Josefa Canals
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
| | | | - Manuel Vivas-Fernández
- Division of Clinical Psychology, Department of Psychology, University of Jaen, Jaen, Spain
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Ettman CK, Subramanian M, Fan AY, Adam GP, Abdalla SM, Galea S, Stuart EA. Assets and depression in U.S. adults during the COVID-19 pandemic: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2024; 59:571-583. [PMID: 37838630 DOI: 10.1007/s00127-023-02565-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic. METHODS We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations. RESULTS Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups. CONCLUSION This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.
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Affiliation(s)
- Catherine K Ettman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
- Boston University School of Public Health, Boston, USA.
| | | | - Alice Y Fan
- Boston University School of Public Health, Boston, USA
| | - Gaelen P Adam
- Brown University School of Public Health, Providence, USA
| | | | - Sandro Galea
- Boston University School of Public Health, Boston, USA
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Liao CH, Chang CS, Kung PT, Chou WY, Tsai WC. Stroke and suicide among people with severe mental illnesses. Sci Rep 2024; 14:4991. [PMID: 38424228 PMCID: PMC10904760 DOI: 10.1038/s41598-024-55564-x] [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: 06/29/2023] [Accepted: 02/25/2024] [Indexed: 03/02/2024] Open
Abstract
The associations between people with severe mental illnesses (SMI) and the risks of stroke, suicide, and death remain unclear. We examined healthcare service usage among adults with and without SMI and explored the risk of stroke, suicide, and death. We divided 18-80-year-old adults with SMI into catastrophic and non-catastrophic illness groups. These groups were subjected to a 1:5:5 propensity score matching with people without SMI. Data on demographic characteristics, economic factors, environmental factors, comorbid conditions, self-injury behavior, the number of outpatients and ED visits, and hospitalization were collected. The primary outcomes were risks of stroke, suicide, and death. We included 19,570 people with catastrophic SMI, 97,850 with non-catastrophic SMI, and 97,850 controls. Patients with SMI, especially those with catastrophic illnesses, had higher stroke risk, suicide, and death than those without SMI. People with SMI used health services more frequently than those without SMI. Patients with a history of hospitalization or ED access had a higher risk of stroke, suicide, and death. Our data indicate that special attention should be given to patients with SMI, particularly those with a history of healthcare service utilization, such as through more extended hospital stays with high-intensity interventions.
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Affiliation(s)
- Chun-Hui Liao
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chen-Shu Chang
- Department of Neurology, Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Central-Taiwan University of Science and Technology, Taichung, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 406040, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 406040, Taiwan.
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D'Souza S, Milne BJ, Li C, Anns F, Gardner A, Lumley T, Morton SMB, Murphy IR, Verhagen E, Wright C, Quarrie K. Kumanu Tāngata: the aftermatch study - protocol to examine the health outcomes of high-level male rugby union players using linked administrative data. BMJ Open Sport Exerc Med 2024; 10:e001795. [PMID: 38362564 PMCID: PMC10868174 DOI: 10.1136/bmjsem-2023-001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tāngata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.
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Affiliation(s)
- Stephanie D'Souza
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J Milne
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Chao Li
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
| | - Francesca Anns
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrew Gardner
- Sydney School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Research Institute for Innovative Solutions for Well-being and Health (INSIGHT), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ian R Murphy
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Evert Verhagen
- Department of Public and Occupational Health, EMGO, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Craig Wright
- Social Wellbeing Agency, Wellington, New Zealand
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Yu B, von Soest T, Nes RB. Do Municipal Contexts Matter for Adolescent Mental Health? A Within-Municipality Analysis of Nationwide Norwegian Survey Data Across Six Years. Res Child Adolesc Psychopathol 2024; 52:169-182. [PMID: 37688765 DOI: 10.1007/s10802-023-01123-3] [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] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
Despite growing concerns about substantial socio-economic differences between districts in many developed nations, limited attention has been paid to how adolescent mental health may be shaped by district characteristics. A few studies have shown that adolescent mental health is related to contextual factors such as district socio-economic status, neighborhood disorder, and quality of infrastructure. However, prior estimates may be an artifact of unmeasured differences between districts. To address these concerns, we used data from the nationwide Norwegian Ungdata surveys (N = 278,764), conducted across the years 2014 to 2019. We applied three-level hierarchical linear models to examine within-municipality associations between municipal factors and adolescent mental health in the domains of internalizing problems (i.e., depressive symptoms), externalizing problems (i.e., behavioral problems), and well-being (i.e., self-esteem), thereby accounting for all time-invariant municipality-level confounders. Our results showed that municipal-level safety, infrastructure, and youth culture are associated with adolescent mental health problems. Further, cross-level interaction models indicated gender-specific associations, with stronger associations of municipality infrastructure and community belongingness with increased self-esteem and reduced delinquent behaviors among girls than boys. Our findings highlight that municipality-level interventions may be a feasible strategy for adolescent mental health, even in a society characterized by low inequality and high redistribution.
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Affiliation(s)
- Baeksan Yu
- Department of Education, Gwangju National University of Education, Yeonjingwan 303, 55 Pilmun-daero, Buk-gu, Gwangju, South Korea.
| | - Tilmann von Soest
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Ragnhild Bang Nes
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Lousdal ML, Plana-Ripoll O. Do epidemiologists choose the right tools to explore the impact of mental disorders over time? Eur Neuropsychopharmacol 2024; 79:1-3. [PMID: 37864953 DOI: 10.1016/j.euroneuro.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Mette Lise Lousdal
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
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12
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Guiney H, Caspi A, Ambler A, Belsky J, Kokaua J, Broadbent J, Cheyne K, Dickson N, Hancox RJ, Harrington H, Hogan S, Ramrakha S, Righarts A, Thomson WM, Moffitt TE, Poulton R. Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study. Dev Psychopathol 2024; 36:219-235. [PMID: 36562290 PMCID: PMC10287838 DOI: 10.1017/s0954579422001146] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.
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Affiliation(s)
- Hayley Guiney
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Antony Ambler
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Jay Belsky
- Robert M. and Natalie Reid Dorn Professor, Department of Human Ecology, University of California, Davis, CA, USA
| | - Jesse Kokaua
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
- Centre for Pacific Health, Va’a O Tautai, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | | | - Kirsten Cheyne
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Nigel Dickson
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | - Robert J. Hancox
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Antoinette Righarts
- Department of Preventive and Social Medicine, Otago Medical School, University of Otago, New Zealand
| | | | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, London, UK
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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13
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Diniz BS, Seitz-Holland J, Sehgal R, Kasamoto J, Higgins-Chen AT, Lenze E. Geroscience-Centric Perspective for Geriatric Psychiatry: Integrating Aging Biology With Geriatric Mental Health Research. Am J Geriatr Psychiatry 2024; 32:1-16. [PMID: 37845116 PMCID: PMC10841054 DOI: 10.1016/j.jagp.2023.09.014] [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: 07/20/2023] [Revised: 08/30/2023] [Accepted: 09/14/2023] [Indexed: 10/18/2023]
Abstract
The geroscience hypothesis asserts that physiological aging is caused by a small number of biological pathways. Despite the explosion of geroscience research over the past couple of decades, the research on how serious mental illnesses (SMI) affects the biological aging processes is still in its infancy. In this review, we aim to provide a critical appraisal of the emerging literature focusing on how we measure biological aging systematically, and in the brain and how SMIs affect biological aging measures in older adults. We will also review recent developments in the field of cellular senescence and potential targets for interventions for SMIs in older adults, based on the geroscience hypothesis.
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Affiliation(s)
- Breno S Diniz
- UConn Center on Aging & Department of Psychiatry (BSD), School of Medicine, University of Connecticut Health Center, Farmington, CT.
| | - Johanna Seitz-Holland
- Department of Psychiatry (JSH), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry (JSH), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Raghav Sehgal
- Program in Computational Biology and Bioinformatics (RS, JK), Yale University, New Haven, CT
| | - Jessica Kasamoto
- Program in Computational Biology and Bioinformatics (RS, JK), Yale University, New Haven, CT
| | - Albert T Higgins-Chen
- Department of Psychiatry (ATHC), Yale University School of Medicine, New Haven, CT; Department of Pathology (ATHC), Yale University School of Medicine, New Haven, CT
| | - Eric Lenze
- Department of Psychiatry (EL), School of Medicine, Washington University at St. Louis, St. Louis, MO
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14
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Brennan GM, Moffitt TE, Ambler A, Harrington H, Hogan S, Houts RM, Mani R, Poulton R, Ramrakha S, Caspi A. Tracing the origins of midlife despair: association of psychopathology during adolescence with a syndrome of despair-related maladies at midlife. Psychol Med 2023; 53:7569-7580. [PMID: 37161676 PMCID: PMC10636241 DOI: 10.1017/s0033291723001320] [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: 11/29/2022] [Revised: 02/13/2023] [Accepted: 04/19/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Midlife adults are experiencing a crisis of deaths of despair (i.e. deaths from suicide, drug overdose, and alcohol-related liver disease). We tested the hypothesis that a syndrome of despair-related maladies at midlife is preceded by psychopathology during adolescence. METHODS Participants are members of a representative cohort of 1037 individuals born in Dunedin, New Zealand in 1972-73 and followed to age 45 years, with 94% retention. Adolescent mental disorders were assessed in three diagnostic assessments at ages 11, 13, and 15 years. Indicators of despair-related maladies across four domains - suicidality, substance misuse, sleep problems, and pain - were assessed at age 45 using multi-modal measures including self-report, informant-report, and national register data. RESULTS We identified and validated a syndrome of despair-related maladies at midlife involving suicidality, substance misuse, sleep problems, and pain. Adults who exhibited a more severe syndrome of despair-related maladies at midlife tended to have had early-onset emotional and behavioral disorders [β = 0.23, 95% CI (0.16-0.30), p < 0.001], even after adjusting for sex, childhood SES, and childhood IQ. A more pronounced midlife despair syndrome was observed among adults who, as adolescents, were diagnosed with a greater number of mental disorders [β = 0.26, 95% CI (0.19-0.33), p < 0.001]. Tests of diagnostic specificity revealed that associations generalized across different adolescent mental disorders. CONCLUSIONS Midlife adults who exhibited a more severe syndrome of despair-related maladies tended to have had psychopathology as adolescents. Prevention and treatment of adolescent psychopathology may mitigate despair-related maladies at midlife and ultimately reduce deaths of despair.
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Affiliation(s)
- Grace M. Brennan
- Duke Aging Center, Duke University School of Medicine, Durham, NC, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Terrie E. Moffitt
- Duke Aging Center, Duke University School of Medicine, Durham, NC, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for the Study of Population Health and Aging, Duke University Population Research Institute, Durham, NC, USA
- Institute of Psychiatry, King's College London, London, UK
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
- Promenta, University of Oslo, Oslo, Norway
| | - Antony Ambler
- Institute of Psychiatry, King's College London, London, UK
| | - HonaLee Harrington
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Sean Hogan
- Department of Psychology and Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Renate M. Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | | | - Richie Poulton
- Department of Psychology and Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology and Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Duke Aging Center, Duke University School of Medicine, Durham, NC, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for the Study of Population Health and Aging, Duke University Population Research Institute, Durham, NC, USA
- Institute of Psychiatry, King's College London, London, UK
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
- Promenta, University of Oslo, Oslo, Norway
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15
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van Namen DM, Knapen V, van Staa A, de Vries H, Hilberink SR, Nagelhout GE. Stress and strain: a qualitative study into the impact of having relatives with addiction problems on students' health and daily lives. Int J Qual Stud Health Well-being 2023; 18:2223864. [PMID: 37422698 DOI: 10.1080/17482631.2023.2223864] [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: 02/10/2022] [Accepted: 06/08/2023] [Indexed: 07/10/2023] Open
Abstract
PURPOSE To explore the impact of having relatives with addiction problems on students' health, substance use, social life, and cognitive functioning, and to establish possible contributions of the participants' gender, type of relationship, and type of addiction of the relative(s). METHODS A qualitative, cross-sectional study of semi-structured interviews with thirty students from a University of Applied Sciences in the Netherlands who had relatives with addiction problems. RESULTS Nine major themes were identified: (1) violence; (2) death, illness, and accidents of relatives; (3) informal care; (4) perception of addiction; (5) ill health, use of alcohol and illegal drugs; (6) financial problems; (7) pressured social life; (8) affected cognitive functioning, and(9) disclosure. CONCLUSIONS Having relatives with addiction problems severely affected the life and health of participants. Women were more likely to be informal carers, to experience physical violence, and to choose a partner with addiction problems than men. Conversely, men more often struggled with their own substance use. Participants who did not share their experiences reported more severe health complaints. It was impossible to make comparisons based on the type of relationship or type of addiction because participants had more than one relative or addiction in the family.
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Affiliation(s)
- Dorine M van Namen
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Vera Knapen
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - AnneLoes van Staa
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Sander R Hilberink
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Gera E Nagelhout
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- IVO Research Institute, The Hague, The Netherlands
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16
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Cunningham R, Imlach F, Every-Palmer S, Haitana T, Peterson D. Dealing With Discrimination in Physical Health Care Services: Strategies of People With Mental Health and Substance Use Conditions. J Patient Exp 2023; 10:23743735231211778. [PMID: 37928962 PMCID: PMC10623936 DOI: 10.1177/23743735231211778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Discrimination against people with mental health and substance use conditions (MHSUC) by health professionals contributes to the poor physical health outcomes this group experiences. We surveyed people with MHSUC in Aotearoa New Zealand to explore how they experienced and responded to discrimination from physical health services. Participants identified 6 strategies used to avoid or minimize the impact of discrimination. Avoidance strategies included not seeking help, not disclosing MHSUC diagnoses and changing or seeking out health professionals who did not behave in discriminatory ways. Minimizing strategies were being a "model patient," taking a support person to consultations or advocating for what they needed, even in the face of discrimination. Physical health services must focus on providing non-discriminatory care to reduce the need for compensatory strategies and improve care of physical illness for people with MHSUC.
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Affiliation(s)
- Ruth Cunningham
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Fiona Imlach
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Tracy Haitana
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Debbie Peterson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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17
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Ruffieux Y, Wettstein A, Maartens G, Folb N, Mesa-Vieira C, Didden C, Tlali M, Williams C, Cornell M, Schomaker M, Johnson LF, Joska JA, Egger M, Haas AD. Life years lost associated with mental illness: A cohort study of beneficiaries of a South African medical insurance scheme. J Affect Disord 2023; 340:204-212. [PMID: 37544483 PMCID: PMC10924225 DOI: 10.1016/j.jad.2023.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND People with mental illness have a reduced life expectancy, but the extent of the mortality gap and the contribution of natural and unnatural causes to excess mortality among people with mental illness in South Africa are unknown. METHODS We analysed reimbursement claims from South African medical insurance scheme beneficiaries aged 15-85 years. We estimated excess life years lost (LYL) associated with organic, substance use, psychotic, mood, anxiety, eating, personality, developmental or any mental disorders. RESULTS We followed 1,070,183 beneficiaries for a median of three years, of whom 282,926 (26.4 %) received mental health diagnoses. Men with a mental health diagnosis lost 3.83 life years (95 % CI 3.58-4.10) compared to men without. Women with a mental health diagnosis lost 2.19 life years (1.97-2.41) compared to women without. Excess mortality varied by sex and diagnosis, from 11.50 LYL (95 % CI 9.79-13.07) among men with alcohol use disorder to 0.87 LYL (0.40-1.43) among women with generalised anxiety disorder. Most LYL were attributable to natural causes (men: 3.42, women: 1.94). A considerable number of LYL were attributable to unnatural causes among men with bipolar (1.52) or substance use (2.45) disorder. LIMITATIONS Mental diagnoses are based on reimbursement claims. CONCLUSIONS Premature mortality among South African individuals with mental disorders is high. Our findings support interventions for the prevention, early detection, and treatment of physical comorbidities in this population. Targeted programs for suicide prevention and substance use treatment, particularly among men, can help reduce excess mortality from unnatural causes.
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Affiliation(s)
- Yann Ruffieux
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Anja Wettstein
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Cristina Mesa-Vieira
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Christiane Didden
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Sociology, Ludwig-Maximilians-Universität München, Germany
| | - Mpho Tlali
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | | | - Morna Cornell
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Michael Schomaker
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa; Department of Statistics, Ludwig-Maximilians-Universität München, Germany
| | - Leigh F Johnson
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - John A Joska
- HIV Mental Health Research Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Division of Neuropsychiatry, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andreas D Haas
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
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18
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Conway CC, Kotov R, Krueger RF, Caspi A. Translating the hierarchical taxonomy of psychopathology (HiTOP) from potential to practice: Ten research questions. AMERICAN PSYCHOLOGIST 2023; 78:873-885. [PMID: 36227328 PMCID: PMC10097839 DOI: 10.1037/amp0001046] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a novel diagnostic system grounded in empirical research into the architecture of mental illness. Its basic units are continuous dimensions-as opposed to categories-that are organized into a hierarchy according to patterns of symptom co-occurrence observed in quantitative studies. Previous HiTOP discussions have focused on existing evidence regarding the model's structure and ability to account for neurobiological, social, cultural, and clinical variation. The present article looks ahead to the next decade of applied research and clinical practice using the HiTOP rubric. We highlight 10 topics where HiTOP has the potential to make significant breakthroughs. Research areas include genetic influences, environmental contributions, neural mechanisms, real-time dynamics, and lifespan development of psychopathology. We also discuss development of novel assessments, forecasting methods, and treatments. Finally, we consider implications for clinicians and educators. For each of these domains, we propose directions for future research and venture hypotheses as to what HiTOP will reveal about psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Roman Kotov
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert F. Krueger
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic, and Developmental Psychiatry Research Centre, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
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19
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McCarter R, Rosato M, Thampi A, Barr R, Leavey G. Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland. Eur Psychiatry 2023; 66:e70. [PMID: 37578131 PMCID: PMC10594365 DOI: 10.1192/j.eurpsy.2023.2441] [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: 05/02/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND People with severe mental illness (SMI) die prematurely, mostly due to preventable causes. OBJECTIVE To examine multimorbidity and mortality in people living with SMI using linked administrative datasets. METHOD Analysis of linked electronically captured routine hospital administrative data from Northern Ireland (2010-2021). We derived sex-specific age-standardised rates for seven chronic life-limiting physical conditions (chronic kidney disease, malignant neoplasms, diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, myocardial infarction, and stroke) and used logistic regression to examine the relationship between SMI, socio-demographic indicators, and comorbid conditions; survival models quantified the relationship between all-cause mortality and SMI. RESULTS Analysis was based on 929,412 hospital patients aged 20 years and above, of whom 10,965 (1.3%) recorded a diagnosis of SMI. Higher likelihoods of an SMI diagnosis were associated with living in socially deprived circumstances, urbanicity. SMI patients were more likely to have more comorbid physical conditions than non-SMI patients, and younger at referral to hospital for each condition, than non-SMI patients. Finally, in fully adjusted models, SMI patients had a twofold excess all-cause mortality. CONCLUSION Multiple morbidities associated with SMI can drive excess mortality. While SMI patients are younger at referral to treatment for these life-limiting conditions, their relatively premature death suggests that these conditions are also quite advanced. There is a need for a more aggressive approach to improving the physical health of this population.
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Affiliation(s)
- Rachel McCarter
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research – Northern Ireland (ADR-NI), Ulster University, Coleraine, UK
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research – Northern Ireland (ADR-NI), Ulster University, Coleraine, UK
| | | | | | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research – Northern Ireland (ADR-NI), Ulster University, Coleraine, UK
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20
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Wang J, Wei Z, Yao N, Li C, Sun L. Association Between Sunlight Exposure and Mental Health: Evidence from a Special Population Without Sunlight in Work. Risk Manag Healthc Policy 2023; 16:1049-1057. [PMID: 37337544 PMCID: PMC10277019 DOI: 10.2147/rmhp.s420018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/10/2023] [Indexed: 06/21/2023] Open
Abstract
Purpose In recent years, mental health problems have become the most serious social problems worldwide. Past studies have proposed that some links exist between sunlight and mental health; however, relevant studies examining low-dose sunlight exposure populations are lacking. We conducted a study among a group of operating room nurses (ORNs) who work long hours in operating rooms and have limited sunlight exposure. We aim to add to and refine previous researches on the association between mental health and sunlight exposure in community population. Patients and Methods A total of 787 ORNs were interviewed and analyzed. Mental health, sunlight exposure duration, sociodemographic and work-related variables, and chronic diseases were evaluated. The Kessler 10 scale (K10) was used to assess participants' mental health status, and their sunlight exposure duration was assessed using their self-reports. Multiple linear regression analysis was adopted to examine the association between sunlight exposure and mental health. Results The average K10 score of ORNs was 25.41. ORNs exhibit poorer mental health than other populations. Poor mental health was negatively associated with greater sunlight exposure hours per day (β=-0.378) and sleep regularity (β=-3.341). Poor mental health was positively associated with chronic disease (β=3.514). Conclusion This study indicated that the positive association between sunlight exposure and mental health existed. Appropriate enhancement of sunlight exposure will be beneficial to mental health. Hospitals, related organizations and individuals should pay greater attention to ORNs' mental health and sunlight exposure conditions. More policy recommendations as well as building structure recommendations should be proposed.
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Affiliation(s)
- Jie Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China
| | - Nan Yao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China
| | - Caifeng Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China
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21
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Hoffmann MS, Evans-Lacko S, Collishaw S, Knapp M, Pickles A, Shearer C, Maughan B. Parent- and teacher-reported associations from adolescent bifactor models of psychopathology: an outcome-wide association study of 26 outcomes in mid-life. J Child Psychol Psychiatry 2023; 64:397-407. [PMID: 36151972 DOI: 10.1111/jcpp.13707] [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] [Accepted: 08/31/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent mental health problems have lasting impacts on health and social functioning later in life. Evidence to date mostly comes from studies of specific diagnostic categories/dimensions, but hierarchical models can elucidate associations with general as well as specific dimensions of psychopathology. We provide evidence on long-term outcomes of general and specific dimensions of adolescent psychopathology using both parent and teacher reports. METHODS Parents and teachers from the Isle of Wight study completed Rutter behaviour scales when participants were 14-15 years old (n = 2,275), assessing conduct, emotional and hyperactivity problems. Metric-invariant bifactor models for parents and teachers were used to test domain-specific and domain-general associations with 26 self-reported psychosocial outcomes at mid-life (age 44-45 years, n = 1,423). Analyses examined the individual and joint contributions of parent and teacher reports of adolescent psychopathology. All analyses were adjusted for covariates (gender, IQ and family social class) and weighted to adjust for the probability of nonresponse. RESULTS Parent- and teacher-reported general factors of psychopathology (GFP) were associated with 15 and 12 outcomes, respectively, across the socioeconomic, relationship, health and personality domains, along with an index of social exclusion. Nine outcomes were associated with both parent- and teacher-reported GFP, with no differences in the strength of the associations across reporters. Teacher-reported specific factors (conduct, emotional and hyperactivity) were associated with 21 outcomes, and parent-reported specific factors were associated with seven. Five outcomes were associated with the same specific factors from both reporters; only one showed reporter differences in the strength of the associations. CONCLUSIONS These findings confirm the relevance of the GFP and the utility of teacher as well as parent reports of adolescent mental health in predicting psychosocial outcomes later in the life course.
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Affiliation(s)
- Mauricio Scopel Hoffmann
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.,Department of Neuropsychiatry, Universidade Federal de Santa Maria, Santa Maria, Brazil.,Graduation program in Psychiatry and Behavioural Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christina Shearer
- Child and Adolescent Mental Health Service, South West London and St George's Mental Health NHS Trust, London, UK
| | - Barbara Maughan
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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22
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Lewis J, Weich S, O'Keeffe C, Stone T, Hulin J, Bell N, Doyle M, Lucock M, Mason S. Use of urgent, emergency and acute care by mental health service users: A record-level cohort study. PLoS One 2023; 18:e0281667. [PMID: 36780483 PMCID: PMC9925080 DOI: 10.1371/journal.pone.0281667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND People with serious mental illness experience worse physical health and greater mortality than the general population. Crude rates of A&E attendance and acute hospital admission are higher in people with serious mental illness than other hospital users. We aimed to further these findings by undertaking a standardised comparison of urgent and emergency care pathway use among users of mental health services and the general population. METHODS Retrospective cohort analysis using routine data from 2013-2016 from the CUREd dataset for urgent and emergency care contacts (NHS 111, ambulance, A&E and acute admissions) and linked mental health trust data for Sheffield, England. We compared annual age- and sex-standardised usage rates for each urgent and emergency care service between users of mental health services and those without a recent history of mental health service use. RESULTS We found marked differences in usage rates for all four urgent and emergency care services between the general population and users of mental health services. Usage rates and the proportion of users were 5-6 times and 3-4 times higher in users of mental health services, respectively, for all urgent and emergency care services. Users of mental health services were often more likely to experience the highest or lowest acuity usage characteristics. CONCLUSIONS Current users of mental health services were heavily over-represented among urgent and emergency care users, and they made more contacts per-person. Higher service use among users of mental health services could be addressed by improved community care, more integrated physical and mental health support, and more proactive primary care. A complex pattern of service use among users of mental health services suggests this will need careful targeting to reduce avoidable contacts and optimise patient outcomes.
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Affiliation(s)
- Jen Lewis
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Colin O'Keeffe
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Tony Stone
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Joe Hulin
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Nicholas Bell
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Mike Doyle
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
- University of Huddersfield, Huddersfield, United Kingdom
| | - Mike Lucock
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
- University of Huddersfield, Huddersfield, United Kingdom
| | - Suzanne Mason
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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23
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Libutzki B, Neukirch B, Kittel-Schneider S, Reif A, Hartman CA. Risk of accidents and unintentional injuries in men and women with attention deficit hyperactivity disorder across the adult lifespan. Acta Psychiatr Scand 2023; 147:145-154. [PMID: 36464800 PMCID: PMC10107297 DOI: 10.1111/acps.13524] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is associated with risk-taking behavior, leading to accidents and unintentional injuries (summarized here as incidents). Main aim of this study is to determine if men and women with and without ADHD differ in the risk of mild (treated outpatient) and severe (treated inpatient) incidents across the adult lifespan (age groups: 18-29; 30-59, and ≥60 years). Secondary aim: investigate the role of comorbid mental disorders and drugs for the treatment of these comorbidities, and ADHD-medication. METHODS Using anonymized German claims data (N = 4,575,027), adults with ADHD diagnosis during 2016-2019 (N = 17,041) were compared with a 1:4 age and sex-matched group without ADHD diagnosis. Regression analyses statistically tested group differences. RESULTS Incidents occur in a U-shaped form across the adult lifespan. Individuals with ADHD show the same pattern but at a substantially increased risk of both mild and severe incidents throughout the lifespan. Women without ADHD are at lower risk in young adulthood than men but at higher risk in older adulthood. Women with ADHD show the same pattern for severe incidents, but for mild incidents they have the highest risk throughout the lifespan. Co-occurring anxiety disorder and the use of psycholeptics and ADHD-medication decreased the incident risk. CONCLUSION We extend available knowledge which has hitherto focused on young adult males and traffic accidents. ADHD is associated with increased incidents across the adult lifespan, with distinct patterns regarding age, sex, and incident severity. An accurate diagnosis of ADHD in adulthood provides the first step towards prevention of accidents and unintentional injuries.
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Affiliation(s)
- Berit Libutzki
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Benno Neukirch
- Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Lorenzo EC, Kuchel GA, Kuo CL, Moffitt TE, Diniz BS. Major depression and the biological hallmarks of aging. Ageing Res Rev 2023; 83:101805. [PMID: 36410621 PMCID: PMC9772222 DOI: 10.1016/j.arr.2022.101805] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Major depressive disorder (MDD) is characterized by psychological and physiological manifestations contributing to the disease severity and outcome. In recent years, several lines of evidence have suggested that individuals with MDD have an elevated risk of age-related adverse outcomes across the lifespan. This review provided evidence of a significant overlap between the biological abnormalities in MDD and biological changes commonly observed during the aging process (i.e., hallmarks of biological aging). Based on such evidence, we formulate a mechanistic model showing how abnormalities in the hallmarks of biological aging can be a common denominator and mediate the elevated risk of age-related health outcomes commonly observed in MDD. Finally, we proposed a roadmap for novel studies to investigate the intersection between the biology of aging and MDD, including the use of geroscience-guided interventions, such as senolytics, to delay or improve major depression by targeting biological aging.
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Affiliation(s)
- Erica C Lorenzo
- UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Chia-Ling Kuo
- Department of Public Health Sciences, University of Connecticut Health Center, Farmington, CT, USA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA; Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, United Kingdom; PROMENTA Center, University of Oslo, Oslo, Norway
| | - Breno S Diniz
- UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA.
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Polygenic Liability to Depression Is Associated With Multiple Medical Conditions in the Electronic Health Record: Phenome-wide Association Study of 46,782 Individuals. Biol Psychiatry 2022; 92:923-931. [PMID: 35965108 DOI: 10.1016/j.biopsych.2022.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/01/2022] [Accepted: 06/02/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of disease-associated disability, with much of the increased burden due to psychiatric and medical comorbidity. This comorbidity partly reflects common genetic influences across conditions. Integrating molecular-genetic tools with health records enables tests of association with the broad range of physiological and clinical phenotypes. However, standard phenome-wide association studies analyze associations with individual genetic variants. For polygenic traits such as MDD, aggregate measures of genetic risk may yield greater insight into associations across the clinical phenome. METHODS We tested for associations between a genome-wide polygenic risk score for MDD and medical and psychiatric traits in a phenome-wide association study of 46,782 unrelated, European-ancestry participants from the Michigan Genomics Initiative. RESULTS The MDD polygenic risk score was associated with 211 traits from 15 medical and psychiatric disease categories at the phenome-wide significance threshold. After excluding patients with depression, continued associations were observed with respiratory, digestive, neurological, and genitourinary conditions; neoplasms; and mental disorders. Associations with tobacco use disorder, respiratory conditions, and genitourinary conditions persisted after accounting for genetic overlap between depression and other psychiatric traits. Temporal analyses of time-at-first-diagnosis indicated that depression disproportionately preceded chronic pain and substance-related disorders, while asthma disproportionately preceded depression. CONCLUSIONS The present results can inform the biological links between depression and both mental and systemic diseases. Although MDD polygenic risk scores cannot currently forecast health outcomes with precision at the individual level, as molecular-genetic discoveries for depression increase, these tools may augment risk prediction for medical and psychiatric conditions.
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Milne BJ, D'Souza S, Andersen SH, Richmond-Rakerd LS. Use of Population-Level Administrative Data in Developmental Science. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2022; 4:447-468. [PMID: 37284522 PMCID: PMC10241456 DOI: 10.1146/annurev-devpsych-120920-023709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Population-level administrative data-data on individuals' interactions with administrative systems (e.g., health, criminal justice, and education)-have substantially advanced our understanding of life-course development. In this review, we focus on five areas where research using these data has made significant contributions to developmental science: (a) understanding small or difficult-to-study populations, (b) evaluating intergenerational and family influences, (c) enabling estimation of causal effects through natural experiments and regional comparisons, (d) identifying individuals at risk for negative developmental outcomes, and (e) assessing neighborhood and environmental influences. Further advances will be made by linking prospective surveys to administrative data to expand the range of developmental questions that can be tested; supporting efforts to establish new linked administrative data resources, including in developing countries; and conducting cross-national comparisons to test findings' generalizability. New administrative data initiatives should involve consultation with population subgroups including vulnerable groups, efforts to obtain social license, and strong ethical oversight and governance arrangements.
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Affiliation(s)
- Barry J Milne
- School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Stephanie D'Souza
- School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
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Psychiatric Symptoms and Frequency of Eating out among Commuters in Beijing: A Bidirectional Association? Nutrients 2022; 14:nu14204221. [PMID: 36296905 PMCID: PMC9609142 DOI: 10.3390/nu14204221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Mental illness places as a distant first in global burdens, exceeding both cardiovascular and circulatory diseases, in terms of the years lived with the disability. The emergence of the new and burgeoning area of “Nutrition Psychiatry” offers promise in improving mental health with diet. Mental health and well-being are critical to commuters but rarely recieve the attention they need. This study aimed to examine the bidirectional relationship between the frequency of eating out and depression, anxiety, and stress symptoms in a sample of Beijing commuters. Methods: A total of 3337 commuters (mean (SD) age, 38.78 (10.41); 74.74% males) from the cohort study CHCN-BTH were included. The psychiatric symptoms were evaluated using a 21-item self-reported depression–anxiety–stress scale (DASS-21). A Cochran–Armitage trend chi-square test, restricted cubic spline, multiple logistic regression, multinomial logit models, and E-values were performed to estimate the associations between eating out and psychiatric symptoms in both directions. Results: A daily rate of eating out more than 50% had a higher risk for depression (OR, 95% CI: 1.68, 1.184–2.393), anxiety (1.73, 1.259–2.369), and stress (1.99, 1.191–3.329) than the individuals eating at home. A higher frequency of eating out for lunch was significantly associated with an increased risk of depression (1.78, 1.28–2.46), anxiety (1.67, 1.26–2.23), and stress (2.05, 1.31–3.22). Similar results were found when eating out for dinner with increased risks for depression 2.20 (1.59, 3.06), anxiety 1.91 (1.42, 2.59), and stress 2.61 (1.68, 4.05). There is limited evidence supporting the effects of psychiatric symptoms on the frequency of eating out in the reverse analyses. Conclusions: The frequency of eating out is positively associated with an increased risk of psychiatric symptoms, especially when eating out for lunch and dinner. People eating at home have the lowest risk of suffering psychiatric symptoms, followed by those eating in the workplace canteen. Eating at home should be considered for future recommendations for the prevention of psychiatric symptoms.
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Weye N, Momen NC, Whiteford HA, Christensen MK, Iburg KM, Santomauro DF, Agerbo E, Mortensen PB, Pedersen CB, McGrath JJ, Plana-Ripoll O. The contribution of general medical conditions to the non-fatal burden of mental disorders: register-based cohort study in Denmark. BJPsych Open 2022; 8:e180. [PMID: 36205020 PMCID: PMC9634585 DOI: 10.1192/bjo.2022.583] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND General medical conditions (GMCs) often co-occur with mental and substance use disorders (MSDs). AIMS To explore the contribution of GMCs to the burden of disease in people with MSDs, and investigate how this varied by age. METHOD A population-based cohort of 6 988 507 persons living in Denmark during 2000-2015 followed for up to 16 years. Danish health registers were used to identify people with MSDs and GMCs. For each MSD, years lived with disability and health loss proportion (HeLP) were estimated for comorbid MSDs and GMCs, using a multiplicative model for disability weights. RESULTS Those with any MSD lost the equivalent of 43% of healthy life (HeLP = 0.43, 95% CI 0.40-0.44) after including information on GMCs, which was an increase from 25% before including GMCs (HeLP = 0.25, 95% CI 0.23-0.27). Schizophrenia was associated with the highest burden of disease (HeLP = 0.77, 95% CI 0.68-0.85). However, within each disorder, the relative contribution of MSDs and GMCs varied. For example, in those diagnosed with schizophrenia, MSDs and GMCs accounted for 86% and 14% of the total health loss; in contrast, in those with anxiety disorders, the same proportions were 59% and 41%. In general, HeLP increased with age, and was mainly associated with increasing rates of pulmonary, musculoskeletal and circulatory diseases. CONCLUSIONS In those with mental disorders, the relative contribution of comorbid GMCs to the non-fatal burden of disease increases with age. GMCs contribute substantially to the non-fatal burden of disease in those with MSDs.
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Affiliation(s)
- Nanna Weye
- National Centre for Register-based Research, Aarhus University, Denmark
| | - Natalie C Momen
- National Centre for Register-based Research, Aarhus University, Denmark
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Australia; and Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia
| | - Maria Klitgaard Christensen
- National Centre for Register-based Research, Aarhus University, Denmark; and Department of Public Health, Aarhus University, Denmark
| | | | - Damian F Santomauro
- School of Public Health, The University of Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia; and Institute for Health Metrics and Evaluation, University of Washington, USA
| | - Esben Agerbo
- National Centre for Register-based Research, Aarhus University, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark; and Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus University, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark; and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
| | - Carsten Bøcker Pedersen
- National Centre for Register-based Research, Aarhus University, Denmark; and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Denmark; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Australia; and Queensland Brain Institute, The University of Queensland, Australia
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Aarhus University, Denmark; and Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Denmark
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Charoenmakpol N, Chiddaycha M, Wainipitapong S. The Arizona Sexual Experiences Scale-the Thai Translation (ASEX-Thai): Reliability and validity in Thai patients with mental disorders. F1000Res 2022; 11:503. [PMID: 36226038 PMCID: PMC9525992 DOI: 10.12688/f1000research.111051.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Sexual dysfunction is common among patients with mental disorders but receives less clinical attention, especially in Thailand and other Asian countries. The Arizona Sexual Experiences Scale-the Thai Translation (ASEX-Thai), a self-rated, brief, questionnaire is a potential tool for screening for sexual dysfunction in this population. Our study aimed to assess the reliability and validity of ASEX-Thai in Thai patients with mental disorders. Methods: We enrolled 202 patients from an outpatient psychiatric department at a tertiary hospital in Bangkok, Thailand. Demographic data, clinical data, and diagnosis of sexual dysfunction were assessed. ASEX-Thai was done, and we analyzed the test’s psychometric properties. Results: Most participants were diagnosed with major depressive disorder (48%). There was a positive correlation between the ASEX-Thai and sexual dysfunction diagnosis (r = 0.402, p < 0.001). The KMO coefficient was 0.77 and Barlett’s sphericity test was significant (χ
2 = 409.76, p<0.001). A score of ≥ 17 points of the ASEX-Thai was the most suitable for sexual dysfunction screening (sensitivity 77.23 %, and specificity 58.42 %). For reliability, the Cronbach’s alpha coefficient (0.831) showed good internal consistency. Conclusions: The ASEX-Thai is a valid and reliable self-rated questionnaire for screening for sexual dysfunction among Thai patients with mental disorders. The test could help clinicians to evaluate this undetected condition and deliver proper interventions.
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Affiliation(s)
- Natthaphon Charoenmakpol
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Mayteewat Chiddaycha
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Sorawit Wainipitapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- Center of Excellence in Transgender Health (CETH), Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Brown RT, Evans JL, Valle K, Guzman D, Chen YH, Kushel MB. Factors Associated With Mortality Among Homeless Older Adults in California: The HOPE HOME Study. JAMA Intern Med 2022; 182:1052-1060. [PMID: 36036902 PMCID: PMC9425284 DOI: 10.1001/jamainternmed.2022.3697] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/02/2022] [Indexed: 11/14/2022]
Abstract
Importance The population of homeless older adults is growing and experiences premature mortality. Little is known about factors associated with mortality among homeless older adults. Objective To identify the prevalence and factors associated with mortality in a cohort of homeless adults 50 years and older. Design, Setting, and Participants In this prospective cohort study (Health Outcomes in People Experiencing Homelessness in Older Middle Age [HOPE HOME]), 450 adults 50 years and older who were homeless at baseline were recruited via venue-based sampling in Oakland, California. Enrollment occurred in 2 phases, from July 2013 to June 2014 and from August 2017 to July 2018, and participants were interviewed at 6-month intervals. Exposures Baseline and time-varying characteristics, including sociodemographic factors, social support, housing status, incarceration history, chronic medical conditions, substance use, and mental health problems. Main Outcomes and Measures Mortality through December 31, 2021, based on state and local vital records information from contacts and death certificates. All-cause mortality rates were compared with those in the general population from 2014 to 2019 using age-specific standardized mortality ratios with 95% CIs. Results Of the 450 included participants, median (IQR) age at baseline was 58.1 (54.5-61.6) years, 107 (24%) were women, and 360 (80%) were Black. Over a median (IQR) follow-up of 55 (38-93) months, 117 (26%) participants died. Median (IQR) age at death was 64.6 (60.3-67.5) years. In multivariable analyses, characteristics associated with mortality included a first episode of homelessness at 50 years and older (adjusted hazard ratio [aHR], 1.62; 95% CI, 1.13-2.32), homelessness (aHR, 1.82; 95% CI, 1.23-2.68) or institutionalization (aHR, 6.36; 95% CI, 3.42-11.82) at any follow-up compared with being housed, fair or poor self-rated health (aHR, 1.64; 95% CI, 1.13-2.40), and diabetes (aHR, 1.55; 95% CI, 1.06-2.26). Demographic characteristics, substance use problems, and mental health problems were not independently associated. All-cause standardized mortality was 3.5 times higher (95% CI, 2.5-4.4) compared with adults in Oakland. The most common causes of death were heart disease (n = 17 [14.5%]), cancer (n = 17 [14.5%]), and drug overdose (n = 14 [12.0%]). Conclusions and Relevance The cohort study found that premature mortality was common among homeless older adults and associated factors included late-life homelessness and ongoing homelessness. There is an urgent need for policy approaches to prevent and end homelessness among older adults in the US.
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Affiliation(s)
- Rebecca T. Brown
- Division of Geriatrics, Department of Medicine, University of California, San Francisco
- Division of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Geriatrics and Extended Care, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Jennifer L. Evans
- Benioff Homelessness and Housing Initiative, University of California, San Francisco
| | - Karen Valle
- Benioff Homelessness and Housing Initiative, University of California, San Francisco
- Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco
| | - David Guzman
- Benioff Homelessness and Housing Initiative, University of California, San Francisco
- Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco
| | - Yea-Hung Chen
- Institute for Global Health Sciences, University of California, San Francisco
| | - Margot B. Kushel
- Benioff Homelessness and Housing Initiative, University of California, San Francisco
- Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco
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Castro-de-Araujo LFS, Cortes F, de Siqueira Filha NT, Rodrigues EDS, Machado DB, de Araujo JAP, Lewis G, Denaxas S, Barreto ML. Patterns of multimorbidity and some psychiatric disorders: A systematic review of the literature. Front Psychol 2022; 13:940978. [PMID: 36186392 PMCID: PMC9524392 DOI: 10.3389/fpsyg.2022.940978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The presence of two or more chronic diseases results in worse clinical outcomes than expected by a simple combination of diseases. This synergistic effect is expected to be higher when combined with some conditions, depending on the number and severity of diseases. Multimorbidity is a relatively new term, with the first fundamental definitions appearing in 2015. Studies usually define it as the presence of at least two chronic medical illnesses. However, little is known regarding the relationship between mental disorders and other non-psychiatric chronic diseases. This review aims at investigating the association between some mental disorders and non-psychiatric diseases, and their pattern of association. Methods We performed a systematic approach to selecting papers that studied relationships between chronic conditions that included one mental disorder from 2015 to 2021. These were processed using Covidence, including quality assessment. Results This resulted in the inclusion of 26 papers in this study. It was found that there are strong associations between depression, psychosis, and multimorbidity, but recent studies that evaluated patterns of association of diseases (usually using clustering methods) had heterogeneous results. Quality assessment of the papers generally revealed low quality among the included studies. Conclusions There is evidence of an association between depressive disorders, anxiety disorders, and psychosis with multimorbidity. Studies that tried to examine the patterns of association between diseases did not find stable results. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021216101, identifier: CRD42021216101.
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Affiliation(s)
- Luis Fernando Silva Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Psychiatry, Austin Health, The University of Melbourne, Parkville, VIC, Australia
| | - Fanny Cortes
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
| | - Noêmia Teixeira de Siqueira Filha
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Health Sciences, University of York, York, United Kingdom
| | - Elisângela da Silva Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Federal University of Ceará, Ceará, Brazil
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Jacyra Azevedo Paiva de Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- *Correspondence: Jacyra Azevedo Paiva de Araujo
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, United Kingdom
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
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Schwarz T, Schmidt AE, Bobek J, Ladurner J. Barriers to accessing health care for people with chronic conditions: a qualitative interview study. BMC Health Serv Res 2022; 22:1037. [PMID: 35964086 PMCID: PMC9375930 DOI: 10.1186/s12913-022-08426-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 08/05/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is a growing interest in redesigning healthcare systems to increase access to and coordination across care settings for people with chronic conditions. We aim to gain a better understanding of the barriers faced by (1) children with chronic bronchial asthma, (2) adults with non-specific chronic back pain, and (3) older people with pre-existing mental illness/es in Austria's fragmented social health insurance system. METHODS Using a qualitative design, we conducted semi-structured interviews face-to-face and by telephone with health service providers, researchers, experts by experience (persons with lived/ personal experience, i.e., service users, patient advocates or family members/carers), and employees in public health administration between July and October 2019. The analysis and interpretation of data were guided by Levesque's model of access, a conceptual framework used to evaluate access broadly according to different dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability, and appropriateness. RESULTS The findings from the 25 expert interviews were organised within Levesque's conceptual framework. They highlight a lack of coordination and defined patient pathways, particularly at the onset of the condition, when seeking a diagnosis, and throughout the care process. On the supply side, patterns of poor patient-provider communication, lack of a holistic therapeutic approach, an urban-rural divide, strict separation between social care and the healthcare system and limited consultation time were among the barriers identified. On the demand side, patients' ability to perceive a need and to subsequently seek and reach healthcare services was an important barrier, closely linked to a patient's socio-economic status, health literacy and ability to pay. CONCLUSIONS While studies on unmet needs suggest a very low level of barriers to accessing health care in the Austrian context, our study highlights potential 'invisible' barriers. Barriers to healthcare access are of concern for patients with chronic conditions, underlining existing findings about the need to improve health services according to patients' specific needs. Research on how to structure timely and integrated care independent of social and economic resources, continuity of care, and significant improvements in patient-centred communication and coordination of care would be paramount.
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Affiliation(s)
- Tanja Schwarz
- Austrian National Public Health Institute, Addiction Competence Centre, Stubenring 6, 1010, Vienna, Austria
| | - Andrea E Schmidt
- Austrian National Public Health Institute, Competence Centre on Climate and Health, Stubenring 6, 1010, Vienna, Austria.
| | - Julia Bobek
- Austrian National Public Health Institute, Health Economics and Health Systems Analysis, Stubenring 6, 1010, Vienna, Austria
| | - Joy Ladurner
- Austrian National Public Health Institute, Psychosocial Health, Stubenring 6, 1010, Vienna, Austria
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O'Gallagher K, Teo JTH, Shah AM, Gaughran F. Interaction Between Race, Ethnicity, Severe Mental Illness, and Cardiovascular Disease. J Am Heart Assoc 2022; 11:e025621. [PMID: 35699192 PMCID: PMC9238657 DOI: 10.1161/jaha.121.025621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Severe mental illnesses, such as schizophrenia or bipolar disorder, affect ≈1% of the population who, as a group, experience significant disadvantage in terms of physical health and reduced life expectancy. In this review, we explore the interaction between race, ethnicity, severe mental illness, and cardiovascular disease, with a focus on cardiovascular care pathways. Finally, we discuss strategies to investigate and address disparities in cardiovascular care for patients with severe mental illness.
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Affiliation(s)
- Kevin O'Gallagher
- British Heart Foundation Centre of Research ExcellenceKing’s College LondonLondonUnited Kingdom
- King’s College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - James TH. Teo
- King’s College Hospital NHS Foundation TrustLondonUnited Kingdom
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
| | - Ajay M. Shah
- British Heart Foundation Centre of Research ExcellenceKing’s College LondonLondonUnited Kingdom
- King’s College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUnited Kingdom
- South London and Maudsley NHS Foundation TrustLondonUnited Kingdom
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Social Inequalities in the Association between Social Infrastructure and Mental Health: An Observational Cross-Sectional Analysis of Children and Adolescents in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116760. [PMID: 35682343 PMCID: PMC9180519 DOI: 10.3390/ijerph19116760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023]
Abstract
The mental health (MH) of especially children and adolescents with low socioeconomic status (SES) benefits from access to greenspaces. This study aimed at investigating social inequalities in the association between several types of social infrastructure (SI) and MH in children and adolescents. The sample comprised 12,624 children and adolescents of the KiGGS Wave 2 study (2014–2017). KiGGS provided information on SI (access to playgrounds, sports fields, swimming pools, parks) for all children and the environmental module (GerES V) within KiGGS on the walking time to SI for a subsample. Social inequality was measured by parental SES and the German Index of Socioeconomic deprivation and MH by the Strengths and Difficulties Questionnaire. Ordinal logistic regression analyses showed that access to fewer SI places was associated with higher odds of MH problems. Children and adolescents experiencing high (but not medium or low) socioeconomic deprivation at the municipal level were more likely to have MH problems when having less access to SI places. At the individual level, MH problems in high- and low-SES, but not medium-SES children and adolescents were associated with no access to SI places. Children and adolescents from high socioeconomically deprived areas and with low and high SES might benefit from high-availability SI.
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Milne BJ. Longitudinal research in Aotearoa New Zealand using the Integrated Data Infrastructure: a review. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2072905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Barry J. Milne
- Centre of Methods and Policy Application in the Social Sciences, and School of Social Sciences, University of Auckland, Auckland, New Zealand
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36
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Momen NC, Plana-Ripoll O, Agerbo E, Christensen MK, Iburg KM, Laursen TM, Mortensen PB, Pedersen CB, Prior A, Weye N, McGrath JJ. Mortality Associated With Mental Disorders and Comorbid General Medical Conditions. JAMA Psychiatry 2022; 79:444-453. [PMID: 35353141 PMCID: PMC8968685 DOI: 10.1001/jamapsychiatry.2022.0347] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Premature mortality has been observed among people with mental disorders. Comorbid general medical conditions contribute substantially to this reduction in life expectancy. OBJECTIVE To provide an analysis of mortality associated with comorbidity between a broad range of mental disorders and general medical conditions. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study of 5 946 800 individuals born in Denmark from 1900 to 2015 and residing in the country at the start of follow-up (January 1, 2000, or their date of birth, whichever occurred later). EXPOSURES Danish health registers were used to identify people with mental disorders and general medical conditions. MAIN OUTCOMES AND MEASURES Considering pairs of mental disorders and general medical conditions, we calculated mortality rate ratios (MRRs) and differences in life expectancy (ie, life-years lost) to assess the association of mortality with both disorders of interest compared with the mental disorder of interest, the general medical condition of interest, and neither disorder of interest. RESULTS The study population comprised 2 961 397 males and 2 985 403 females, with a median (IQR) age of 32.0 years (7.3-52.9) at start of follow-up and 48.9 years (42.5-68.8) at the end. Based on all pairs of comorbid mental disorders and general medical conditions, the mean MRR compared with people without these conditions was 5.90 (median, 4.94; IQR, 3.80-7.30), and the mean reduction of life expectancy compared with the general population was 11.35 years (median, 11.08; range, 5.27-23.53; IQR, 8.22-13.72). The association with general medical condition comorbidity in those with mental disorders varied by general medical condition; for example, the addition of a neurological condition for each of the mental disorders was associated with a mean MRR of 1.22, whereas for cancer, the mean MRR for all mental disorders was 4.07. CONCLUSIONS AND RELEVANCE In this study, shorter life expectancy was associated with comorbid mental disorders and general medical conditions compared with the entire population and also when compared with patients who had either mental disorders only or general medical conditions only. Prevention and early detection of comorbidities could reduce premature mortality in patients with mental disorders.
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Affiliation(s)
- Natalie C. Momen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Esben Agerbo
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU – Centre for Integrated Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Maria K. Christensen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Thomas Munk Laursen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Preben B. Mortensen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU – Centre for Integrated Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Carsten B. Pedersen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU – Centre for Integrated Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Anders Prior
- Department of Public Health, Aarhus University, Aarhus, Denmark,Research Unit for General Practice, Aarhus, Denmark
| | - Nanna Weye
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - John J. McGrath
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
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Richmond-Rakerd LS, D’Souza S, Milne BJ, Caspi A, Moffitt TE. Longitudinal Associations of Mental Disorders With Dementia: 30-Year Analysis of 1.7 Million New Zealand Citizens. JAMA Psychiatry 2022; 79:333-340. [PMID: 35171209 PMCID: PMC8851362 DOI: 10.1001/jamapsychiatry.2021.4377] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Mental disorders are an underappreciated category of modifiable risk factors for dementia. Developing an evidence base about the link between mental disorders and dementia risk requires studies that use large, representative samples, consider the full range of psychiatric conditions, ascertain mental disorders from early life, use long follow-ups, and distinguish between Alzheimer disease and related dementias. OBJECTIVE To test whether mental disorders antedate dementia across 3 decades of observation. DESIGN, SETTING, AND PARTICIPANTS This population-based administrative register study of mental disorders and Alzheimer disease and related dementias included all individuals born in New Zealand between 1928 and 1967 who resided in the country for any time during the 30-year observation period between July 1988 and June 2018. Data were from the New Zealand Integrated Data Infrastructure, a collection of whole-of-population administrative data sources linked at the individual level. Data were analyzed from October 2020 to November 2021. EXPOSURES Diagnoses of mental disorders were ascertained from public-hospital records. MAIN OUTCOMES AND MEASURES Diagnoses of dementia were ascertained from public-hospital records, mortality records, and pharmaceutical records. RESULTS Of 1 711 386 included individuals, 866 301 (50.6%) were male, and individuals were aged 21 to 60 years at baseline. Relative to individuals without a mental disorder, those with a mental disorder were at increased risk of developing subsequent dementia (relative risk [RR], 4.24; 95% CI, 4.07-4.42; hazard ratio, 6.49; 95% CI, 6.25-6.73). Among individuals with dementia, those with a mental disorder developed dementia a mean of 5.60 years (95% CI, 5.31-5.90) earlier than those without a mental disorder. Associations held across sex and age and after accounting for preexisting chronic physical diseases and socioeconomic deprivation. Associations were present across different types of mental disorders and self-harm behavior (RRs ranged from 2.93 [95% CI, 2.66-3.21] for neurotic disorders to 6.20 [95% CI, 5.67-6.78] for psychotic disorders), and were evident for Alzheimer disease (RR, 2.76; 95% CI, 2.45-3.11) and all other dementias (RR, 5.85; 95% CI, 5.58-6.13). CONCLUSIONS AND RELEVANCE In this study, mental disorders were associated with the onset of dementia in the population. Ameliorating mental disorders in early life might also ameliorate neurodegenerative conditions and extend quality of life in old age.
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Affiliation(s)
| | - Stephanie D’Souza
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J. Milne
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, England
- Promenta Center, University of Oslo, Oslo, Norway
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, England
- Promenta Center, University of Oslo, Oslo, Norway
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Ettman CK, Adam GP, Clark MA, Wilson IB, Vivier PM, Galea S. Wealth and depression: A scoping review. Brain Behav 2022; 12:e2486. [PMID: 35134277 PMCID: PMC8933775 DOI: 10.1002/brb3.2486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/16/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The inverse relation between income and depression is well established. Less is understood about the relation between wealth and depression. We therefore conducted a scoping review to answer the question: What is known from the existing literature about the relation between wealth and depression? METHODS We searched for studies and articles in Medline (via PubMed), Embase, PsycINFO, PsycArticles, EconLit, and SocINDEX from inception through July 19, 2020. Ninety-six articles were included in our review. Key article characteristics were year of publication, sample size, country, study design, definition of depression, definition of wealth, and association between wealth and depression. Thirty-two longitudinal articles were included in a detailed charted review. RESULTS Depression was defined in a relatively standard manner across articles. In contrast, definitions and measurements of wealth varied greatly. The majority of studies in the full review (n = 56, 58%) and half of the studies in the longitudinal charted review (n = 16, 50%) reported an inverse relation between wealth and depression. The longitudinal charted review showed that (1) macro-economic events influenced depression, (2) wealth status influenced depression across the lifecourse, (3) wealth protected against depression in the face of stressors such as job loss, (4) subjective or psychosocial factors such as perception of wealth, relative comparison, and social status modified the relation between wealth and depression, and (5) savings interventions were successful in reducing depression and varied by context. CONCLUSION These findings suggest that wealth should be included in our consideration of the forces that shape mental health.
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Affiliation(s)
- Catherine K Ettman
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA.,Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Gaelen P Adam
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Melissa A Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Ira B Wilson
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Patrick M Vivier
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Providence, Rhode Island, USA
| | - Sandro Galea
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA
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Klopack ET, Crimmins EM, Cole SW, Seeman TE, Carroll JE. Accelerated epigenetic aging mediates link between adverse childhood experiences and depressive symptoms in older adults: Results from the Health and Retirement Study. SSM Popul Health 2022; 17:101071. [PMID: 35313610 PMCID: PMC8933834 DOI: 10.1016/j.ssmph.2022.101071] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 12/31/2022] Open
Abstract
Adverse childhood experiences (ACEs) increase risk for depression at subsequent ages and have been linked to accelerated biological aging. We hypothesize that accelerated epigenetic aging may partially mediate the link between ACEs and depression. This study examines 3 three second-generation epigenetic aging measures (viz., GrimAge, PhenoAge, and DunedinPoAm38) as mediators of the link between ACEs and depressive symptoms in older adulthood. We utilize structural equation modeling to assess mediation in the Health and Retirement Study (N = 2672). Experiencing ACEs is significantly associated with an older GrimAge and a faster pace of aging via the DunedinPoAm38. Having an older GrimAge and faster DunedinPoAm38 pace of aging were also significantly associated with more depressive symptoms. PhenoAge was not significantly associated with depressive symptoms and was only associated with experiencing three ACEs. These associations were reduced by socioeconomic and lifestyle factors, including obesity and substance use. GrimAge explained between 9 and 14% of the association between ACEs and adult depressive symptoms, and DunedinPoAm38 explained between 2 and 7% of the association between ACEs and adult depressive symptoms. Findings indicate accelerated aging, as measured by GrimAge and DunedinPoAm38, is associated with ACEs and with depressive symptoms in older Americans. Findings also show these epigenetic aging measures mediate a portion of the association between ACEs and adult depressive symptoms. Epigenetic aging may represent a physiological mechanism underlying the link between early life adversity and adult depression. Weight maintenance and substance use are potentially important areas for intervention.
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Affiliation(s)
| | | | - Steve W Cole
- University of California, Los Angeles, United States
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McGorry PD, Mei C, Chanen A, Hodges C, Alvarez-Jimenez M, Killackey E. Designing and scaling up integrated youth mental health care. World Psychiatry 2022; 21:61-76. [PMID: 35015367 PMCID: PMC8751571 DOI: 10.1002/wps.20938] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mental ill-health represents the main threat to the health, survival and future potential of young people around the world. There are indications that this is a rising tide of vulnerability and need for care, a trend that has been augmented by the COVID-19 pandemic. It represents a global public health crisis, which not only demands a deep and sophisticated understanding of possible targets for prevention, but also urgent reform and investment in the provision of developmentally appropriate clinical care. Despite having the greatest level of need, and potential to benefit, adolescents and emerging adults have the worst access to timely and quality mental health care. How is this global crisis to be addressed? Since the start of the century, a range of co-designed youth mental health strategies and innovations have emerged. These range from digital platforms, through to new models of primary care to new services for potentially severe mental illness, which must be locally adapted according to the availability of resources, workforce, cultural factors and health financing patterns. The fulcrum of this progress is the advent of broad-spectrum, integrated primary youth mental health care services. They represent a blueprint and beach-head for an overdue global system reform. While resources will vary across settings, the mental health needs of young people are largely universal, and underpin a set of fundamental principles and design features. These include establishing an accessible, "soft entry" youth primary care platform with digital support, where young people are valued and essential partners in the design, operation, management and evaluation of the service. Global progress achieved to date in implementing integrated youth mental health care has highlighted that these services are being accessed by young people with genuine and substantial mental health needs, that they are benefiting from them, and that both these young people and their families are highly satisfied with the services they receive. However, we are still at base camp and these primary care platforms need to be scaled up across the globe, complemented by prevention, digital platforms and, crucially, more specialized care for complex and persistent conditions, aligned to this transitional age range (from approximately 12 to 25 years). The rising tide of mental ill-health in young people globally demands that this focus be elevated to a top priority in global health.
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Affiliation(s)
- Patrick D McGorry
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Cristina Mei
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Craig Hodges
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Mario Alvarez-Jimenez
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Tan XW, Lee ES, Toh MPHS, Lum AWM, Seah DEJ, Leong KP, Chan CYW, Fung DSS, Tor PC. Comparison of mental-physical comorbidity, risk of death and mortality among patients with mental disorders - A retrospective cohort study. J Psychiatr Res 2021; 142:48-53. [PMID: 34320455 DOI: 10.1016/j.jpsychires.2021.07.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/27/2022]
Abstract
AIM To compare the risk of death, the prevalence of comorbid chronic physical illness and mortality among an Asian population of patients with mental disorders. METHODS This was a retrospective data analysing of medical records of patients with schizophrenia, depression, anxiety, bipolar disorder, alcohol use disorder (AUD) or substance use disorder and the comorbid chronic physical illnesses. The hazard risk of death was calculated with Cox regression and compared between patients with and without comorbid chronic physical illness(es). Odds ratios of specific comorbid chronic physical illness were calculated with logistic regression and mean crude death rate was calculated for patients with different mental disorders. RESULTS A total of 56,447 patients with mental disorders were included in the analysis. Compared to patients without comorbid physical illness, patients with mental-physical comorbidity were associated with a higher risk of death [2.36 (2.22-2.52); hazard ratio (95% CI)] and less estimated survival days [2157 (2142-2172) vs 2508 (2504-2513)]. Compared to other mental disorders, those with AUD had the highest prevalence of two or more comorbid chronic physical illnesses and associated with the highest odds of comorbid hypertension, diabetes mellitus, stroke, nephritis, chronic kidney disease, and cancer. The highest one-year crude death rate was similarly observed in patients with AUD. CONCLUSIONS Mental-physical comorbidity was associated with a higher risk of death compared to patients with mental disorders only. The highest prevalence of mental-physical comorbidity and mortality were observed in patients with AUD. More attention and resources may be needed to tackle the burden of AUD.
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Affiliation(s)
- Xiao Wei Tan
- Department of Mood Disorder and Anxiety, Institute of Mental Health, 539747, Singapore.
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, 138543, Singapore; Lee Kong Chian School of Medicine, Nanyang Technology University of Singapore, 308232, Singapore
| | - Matthias Paul Han Sim Toh
- National Public Health & Epidemiology Unit, National Centre for Infectious Diseases, 308442, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, 539747, Singapore
| | | | - Darren Ee Jin Seah
- Clinical Research Unit, National Healthcare Group Polyclinics, 138543, Singapore
| | | | | | - Daniel Shuen Sheng Fung
- Lee Kong Chian School of Medicine, Nanyang Technology University of Singapore, 308232, Singapore; Department of Child Psychiatry, Institute of Mental Health, Singapore, 539747
| | - Phern Chern Tor
- Department of Mood Disorder and Anxiety, Institute of Mental Health, 539747, Singapore; Lee Kong Chian School of Medicine, Nanyang Technology University of Singapore, 308232, Singapore; Duke-NUS Graduate Medical School, Singapore, 169857
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