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Wong CSM, Chan WC, Lo KWY, Chen EYH, Lam LCW. Environmental stress and emotional reactivity: an exploratory experience sampling method study. Front Psychiatry 2024; 15:1375735. [PMID: 38774437 PMCID: PMC11106578 DOI: 10.3389/fpsyt.2024.1375735] [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: 01/24/2024] [Accepted: 04/04/2024] [Indexed: 05/24/2024] Open
Abstract
Background Previous studies have shown a relationship between environments and mental health. However, limited studies have investigated the impact of environment stress (ES) on emotional reactivity. Our study aimed to fill this gap by examining how daily ES affects momentary emotional reactivity using experience sampling method (ESM). Methods Participants were randomly recruited from a prospective cohort study in Hong Kong to participate in a 7-day ESM study. The participants received eight electronic signals daily assessing their ES, positive affect (PA) and negative affect (NA). Participants were categorized into depressed group or control group based on Revised Clinical Interview Schedule. Psychometric properties of the ESM assessment were evaluated. Multilevel linear regression analyzes were conducted to examine the association of ES with PA, NA and the group status of the participants (cases versus controls). Results A total of 15 participants with depression and 15 healthy controls were recruited, and 1307 momentary assessments were completed with a compliance rate of 77.8%. The depressed group demonstrated a significant increase in NA in response to ES, while the control group showed a decrease in PA. In addition, the depressed group reported a lower perception of control and interaction with their environment compared to the control group. Conclusion Using ESM, a valid, reliable, and easy-to-use self-reporting tool, our findings provided valuable insights on the potential mechanisms underlying emotional responses to stressful environments.
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Affiliation(s)
- Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kristen Wing Yan Lo
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Wedyan M, Saeidi-Rizi F. Assessing the Impact of Urban Environments on Mental Health and Perception Using Deep Learning: A Review and Text Mining Analysis. J Urban Health 2024; 101:327-343. [PMID: 38466494 PMCID: PMC11052760 DOI: 10.1007/s11524-024-00830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 03/13/2024]
Abstract
Understanding how outdoor environments affect mental health outcomes is vital in today's fast-paced and urbanized society. Recently, advancements in data-gathering technologies and deep learning have facilitated the study of the relationship between the outdoor environment and human perception. In a systematic review, we investigate how deep learning techniques can shed light on a better understanding of the influence of outdoor environments on human perceptions and emotions, with an emphasis on mental health outcomes. We have systematically reviewed 40 articles published in SCOPUS and the Web of Science databases which were the published papers between 2016 and 2023. The study presents and utilizes a novel topic modeling method to identify coherent keywords. By extracting the top words of each research topic, and identifying the current topics, we indicate that current studies are classified into three areas. The first topic was "Urban Perception and Environmental Factors" where the studies aimed to evaluate perceptions and mental health outcomes. Within this topic, the studies were divided based on human emotions, mood, stress, and urban features impacts. The second topic was titled "Data Analysis and Urban Imagery in Modeling" which focused on refining deep learning techniques, data collection methods, and participants' variability to understand human perceptions more accurately. The last topic was named "Greenery and visual exposure in urban spaces" which focused on the impact of the amount and the exposure of green features on mental health and perceptions. Upon reviewing the papers, this study provides a guide for subsequent research to enhance the view of using deep learning techniques to understand how urban environments influence mental health. It also provides various suggestions that should be taken into account when planning outdoor spaces.
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Affiliation(s)
- Musab Wedyan
- School of Planning, Design and Construction, Michigan State University, East Lansing, MI, USA
| | - Fatemeh Saeidi-Rizi
- School of Planning, Design and Construction, Michigan State University, East Lansing, MI, USA.
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3
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Collins PY, Sinha M, Concepcion T, Patton G, Way T, McCay L, Mensa-Kwao A, Herrman H, de Leeuw E, Anand N, Atwoli L, Bardikoff N, Booysen C, Bustamante I, Chen Y, Davis K, Dua T, Foote N, Hughsam M, Juma D, Khanal S, Kumar M, Lefkowitz B, McDermott P, Moitra M, Ochieng Y, Omigbodun O, Queen E, Unützer J, Uribe-Restrepo JM, Wolpert M, Zeitz L. Making cities mental health friendly for adolescents and young adults. Nature 2024; 627:137-148. [PMID: 38383777 PMCID: PMC10917657 DOI: 10.1038/s41586-023-07005-4] [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: 06/15/2022] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.
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Affiliation(s)
- Pamela Y Collins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Tessa Concepcion
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - George Patton
- Centre for Adolescent Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Thaisa Way
- Dumbarton Oaks, Harvard University, Washington, DC, USA
| | - Layla McCay
- Centre for Urban Design and Mental Health, London, UK
| | - Augustina Mensa-Kwao
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helen Herrman
- Orygen, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Evelyne de Leeuw
- Ecole de Sante Publique, Universite de Montreal, Montreal, Quebec, Canada
| | - Nalini Anand
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | - Yajun Chen
- Sun Yat Sen University, Guangzhou, China
| | | | - Tarun Dua
- World Health Organization, Geneva, Switzerland
| | | | | | - Damian Juma
- Healthy Brains Global Initiative, Nairobi, Kenya
| | | | - Manasi Kumar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- University of Nairobi, Nairobi, Kenya
| | - Bina Lefkowitz
- Sacramento County Board of Education, Sacramento, CA, USA
- Lefkowitz Consulting, Sacramento, CA, USA
| | | | - Modhurima Moitra
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - Emily Queen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jürgen Unützer
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - Lian Zeitz
- Climate Mental Health Network, Annapolis, MD, USA
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4
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Hannon E, Anselimus SM, Bardikoff N, Bulc B, Germann S, Gonsalves PP, Melendez-Torres GJ, Ospina-Pinillos L, Sinha M, Wanjiru M. Why cities matter for adolescent mental health and wellbeing. Lancet 2024; 403:708-710. [PMID: 37827186 DOI: 10.1016/s0140-6736(23)02238-9] [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: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Affiliation(s)
| | - Sweetbert M Anselimus
- Tanzania's Psychosocial Welfare Organization, and University of Dar es Salaam, Iringa, Tanzania
| | - Nicole Bardikoff
- Global Mental Health at Grand Challenges Canada, Toronto, ON, Canada
| | - Barbara Bulc
- Global Development and SDG CoLab, Geneva, Switzerland
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5
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Motoc I, Hoogendijk EO, Timmermans EJ, Deeg D, Penninx BWJH, Huisman M. Social and physical neighbourhood characteristics and 10-year incidence of depression and anxiety in older adults: Results from the Longitudinal Aging Study Amsterdam. Soc Sci Med 2023; 327:115963. [PMID: 37207380 DOI: 10.1016/j.socscimed.2023.115963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE A growing literature suggests that neighbourhood characteristics are associated with mental health outcomes, but the evidence in older adults is inconsistent. We investigated the association of neighbourhood characteristics, pertaining to demographic, socio-economic, social and physical environment domains, with the subsequent 10-year incidence of depression and anxiety, in Dutch older adults. METHODS In the Longitudinal Aging Study Amsterdam depressive and anxiety symptoms were assessed four times between 2005/2006 and 2015/2016, using the Center for Epidemiological Studies Depression Scale (n = 1365) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (n = 1420). Neighbourhood-level data on urban density, percent population over 65 years of age, percent immigrants, average house price, average income, percent low-income earners, social security beneficiaries, social cohesion, safety, proximity to retail facilities, housing quality, percent green space, percent water coverage, air pollution (particulate matter (PM2.5)), and traffic noise, were obtained for study baseline years 2005/2006. Cox proportional hazard regression models, clustered within neighbourhood, were used to estimate the association between each neighbourhood-level characteristic and the incidence of depression and anxiety. RESULTS The incidence of depression and anxiety was 19.9 and 13.2 per 1000 person-years, respectively. Neighbourhood characteristics were not associated with the incidence of depression. However, various neighbourhood characteristics were associated with an increased incidence of anxiety, including: higher urban density level, higher percent immigrants, greater proximity to retail facilities, lower housing quality score, lower safety score, higher PM2.5 levels and less green space. CONCLUSION Our results indicate that several neighbourhood characteristics are associated with anxiety but not with depression incidence in older age. Several of these characteristics have the potential to be modifiable and thus could serve as a target for interventions at the neighbourhood-level in improving anxiety, provided that future studies replicate our findings and provide further evidence for a causal effect.
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Affiliation(s)
- Irina Motoc
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life and Mental Health Programs, Amsterdam, the Netherlands.
| | - Emiel O Hoogendijk
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life and Mental Health Programs, Amsterdam, the Netherlands
| | - Erik J Timmermans
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Dorly Deeg
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life and Mental Health Programs, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam Public Health, Aging & Later Life and Mental Health Programs, Amsterdam, the Netherlands; Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Martijn Huisman
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life and Mental Health Programs, Amsterdam, the Netherlands; Department of Sociology, VU University, Amsterdam, the Netherlands
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6
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Report of the intergovernmental panel on climate change: implications for the mental health policy of children and adolescents in Europe-a scoping review. Eur Child Adolesc Psychiatry 2022; 31:701-713. [PMID: 32845381 PMCID: PMC9142437 DOI: 10.1007/s00787-020-01615-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Climate change is a worldwide challenge. Its consequences do encompass severe threats not only for the existence and somatic health, but also for the mental health of children and adolescents. Mental health can be impaired by three types of consequences. Direct consequences of climate change, such as natural disasters and indirect consequences, such as loss of land, flight and migration, exposure to violence, change of social, ecological, economic or cultural environment. Moreover, the increasing awareness of the existential dimension of climate change in children and adolescents can influence their well-being or challenge their mental health. Consequences of climate change for somatic health may interact with mental health or have psychological sequelae in children and adolescents. Based on the estimates by the United Nations Intergovernmental Panel on Climate Change, we have summarized current data on these differential pathways as to how climate change affects the mental health of children worldwide through selective literature research on Pubmed. Mental health sequelae of direct and indirect consequences of climate change, increased awareness and physical health problems caused by climate change are presented. We give insights into special vulnerabilities of children and adolescents and identify high-risk groups. As the "Fridays for Future" movement has been initiated in northern Europe, we will discuss these results with a focus on children and adolescents in Europe. The results indicate that climate change is a serious threat to children and adolescent mental health. Children´s rights, mental health and climate change should not continue to be seen as separate points; instead, they need to be brought together to address this major challenge determining the future of our children and their descendants.
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7
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van der Wal JM, van Borkulo CD, Deserno MK, Breedvelt JJF, Lees M, Lokman JC, Borsboom D, Denys D, van Holst RJ, Smidt MP, Stronks K, Lucassen PJ, van Weert JCM, Sloot PMA, Bockting CL, Wiers RW. Advancing urban mental health research: from complexity science to actionable targets for intervention. Lancet Psychiatry 2021; 8:991-1000. [PMID: 34627532 DOI: 10.1016/s2215-0366(21)00047-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/30/2022]
Abstract
Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.
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Affiliation(s)
- Junus M van der Wal
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands; Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Claudia D van Borkulo
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Marie K Deserno
- Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands; Centre for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Josefien J F Breedvelt
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; National Centre for Social Research, London, UK; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mike Lees
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - John C Lokman
- Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Denny Borsboom
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Damiaan Denys
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ruth J van Holst
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Marten P Smidt
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Karien Stronks
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Paul J Lucassen
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Julia C M van Weert
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, Netherlands
| | - Peter M A Sloot
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Institute for Advanced Study, University of Amsterdam, Amsterdam, Netherlands; National Centre for Cognitive Science, ITMO University, St Petersburg, Russia
| | - Claudi L Bockting
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands.
| | - Reinout W Wiers
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
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Krabbendam L, van Vugt M, Conus P, Söderström O, Abrahamyan Empson L, van Os J, Fett AKJ. Understanding urbanicity: how interdisciplinary methods help to unravel the effects of the city on mental health. Psychol Med 2021; 51:1099-1110. [PMID: 32156322 DOI: 10.1017/s0033291720000355] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-first century urbanization poses increasing challenges for mental health. Epidemiological studies have shown that mental health problems often accumulate in urban areas, compared to rural areas, and suggested possible underlying causes associated with the social and physical urban environments. Emerging work indicates complex urban effects that depend on many individual and contextual factors at the neighbourhood and country level and novel experimental work is starting to dissect potential underlying mechanisms. This review summarizes findings from epidemiology and population-based studies, neuroscience, experimental and experience-based research and illustrates how a combined approach can move the field towards an increased understanding of the urbanicity-mental health nexus.
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Affiliation(s)
- Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
| | - Mark van Vugt
- Department of Experimental and Applied Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Ola Söderström
- Institut de Géographie, Université de Neuchâtel, Espace Louis-Agassiz, 2000, Neuchâtel, Switzerland
| | - Lilith Abrahamyan Empson
- Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Clinique de Cery, Prilly, Switzerland
| | - Jim van Os
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne-Kathrin J Fett
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, LondonSE5 8AF, UK
- Department of Psychology, City, University of London, Northampton Square, LondonEC1V 0HB, UK
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9
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Adjaye-Gbewonyo D, Rebok GW, Gallo JJ, Gross AL, Underwood CR. Urbanicity of residence and depression among adults 50 years and older in Ghana and South Africa: an analysis of the WHO Study on Global AGEing and Adult Health (SAGE). Aging Ment Health 2019; 23:660-669. [PMID: 29634295 PMCID: PMC6188817 DOI: 10.1080/13607863.2018.1450839] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES As the primary cause of disability worldwide, depression is a significant contributor to global morbidity and mortality and often disproportionately affects older adults. Several studies have demonstrated a link between urban residence and depression, but few studies have examined this association among older adult populations, and even fewer have studied it within an African context. Given that African societies are aging and urbanizing at rapid rates, this study aimed to assess the relationship between urbanicity and depression within older adult populations in two African countries. METHOD Data were drawn from the Ghana and South Africa samples of the World Health Organization Study on Global AGEing and Adult Health (SAGE) wave 1 (2007-2008). Depression over the past 12 months was measured using self-reported treatment and depressive symptoms based on ICD-10 criteria in 4209 Ghanaian and 3148 South African adults aged 50 years and older residing in their current location for over one year. RESULTS The 12-month prevalence of depression was 7.5% and 4.0% in Ghana and South Africa, respectively; 41.1% and 65.6%, respectively, lived in urban areas. Comparing urban to rural residents, the adjusted odds ratio (OR) for depression in multivariable analysis was 1.13 (95% CI: 0.71-1.79) in South Africa and 0.85 (95% CI: 0.55-1.31) in Ghana. CONCLUSION Results do not support a significant urban-rural difference in 12-month depression among Ghanaian or South African SAGE participants. Mental health resources in rural areas should therefore be enhanced in these countries for more equitable distributions between the two settings given similar need.
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Affiliation(s)
- Dzifa Adjaye-Gbewonyo
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205,
| | - George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center on Aging and Health, 624 North Broadway, Baltimore, MD 21205,
| | - Joseph J. Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205,
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center on Aging and Health, 2024 E. Monument Street, Baltimore, MD 21205,
| | - Carol R. Underwood
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Communications Programs, 111 Market Place, Suite 310, Baltimore, MD 21202,
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Ventimiglia I, Seedat S. Current evidence on urbanicity and the impact of neighbourhoods on anxiety and stress-related disorders. Curr Opin Psychiatry 2019; 32:248-253. [PMID: 30920971 DOI: 10.1097/yco.0000000000000496] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW To synthesize recent knowledge on the association of urbanization (and neighbourhood factors) and anxiety and stress-related disorders. RECENT FINDINGS The quality of urban neighbourhoods and neighbourhood factors - physical (e.g. green space), social (e.g. social cohesion) and biological (e.g. stress response) factors - are directly linked to the presence and severity of anxiety disorders, although data on posttraumatic stress disorder (PTSD) are pauce. Preliminary data indicate that architectural and space design elements in PTSD can either increase anxiety and lead to trauma triggers or relieve symptoms and reinforce safety. In addition, there is emerging evidence that being raised in urban environments with a wide range of microbial exposure dampens the immune response to psychosocial stressors. SUMMARY Evidence points to a higher prevalence of anxiety disorders and PTSD in urban environments. Current research is focused on the role of neighbourhood factors in prevention and treatment. Few studies have assessed comprehensive treatment models in urban populations and the potential moderating role of these factors on treatment outcomes. Several lines of inquiry are starting to address how urban living impacts on biological stress regulation pathways. As urbanization continues, improved understanding of urban mental health is central to informing mental health promotion policies.
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Affiliation(s)
- Ilaria Ventimiglia
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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11
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Purtle J, Nelson KL, Yang Y, Langellier B, Stankov I, Diez Roux AV. Urban-Rural Differences in Older Adult Depression: A Systematic Review and Meta-analysis of Comparative Studies. Am J Prev Med 2019; 56:603-613. [PMID: 30777704 DOI: 10.1016/j.amepre.2018.11.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 12/15/2022]
Abstract
CONTEXT Depression among older adults (aged 60 years or older) is a problem that could be exacerbated by global trends in urbanization and population aging. The study purpose was to assess whether urban, relative to rural, residence is associated with depression among older adults and whether associations differ in countries with developed versus developing economies. EVIDENCE ACQUISITION In 2017, the authors identified and extracted information from comparative studies of urban-rural depression prevalence among older adults. Studies were identified in PubMed, PsychINFO, and Web of Science and limited to English language articles published after 1985. Eighteen studies met inclusion criteria. Random effects meta-analysis was conducted to produce weighted pooled ORs estimating the association between urban-rural residence and depression for all study participants (N=31,598) and sub-analyses were conducted for developed (n=12,728) and developing (n=18,870) countries. EVIDENCE SYNTHESIS Depression prevalence was significantly higher among urban residents in ten studies and significantly higher among rural residents in three studies (all three conducted in China). Associations between urban-rural residence and depression generally remained significant after adjusting for covariates. In developed countries, the odds of depression were significantly higher among urban than rural residents (pooled OR=1.44, 95% CI=1.10, 1.88). However, in developing countries, this association was not observed (pooled OR=0.91, 95% CI=0.46, 1.77). CONCLUSIONS Converging trends of urbanization and population aging could increase the global burden of depression among older adults. The pathways through which urban-rural residence influences depression risk among older adults might differ by country context. Future research should focus on measuring variation in these contexts.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Yong Yang
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Brent Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Bakolis I, Hammoud R, Smythe M, Gibbons J, Davidson N, Tognin S, Mechelli A. Urban Mind: Using Smartphone Technologies to Investigate the Impact of Nature on Mental Well-Being in Real Time. Bioscience 2018; 68:134-145. [PMID: 29599549 PMCID: PMC5862247 DOI: 10.1093/biosci/bix149] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Existing evidence on the beneficial effects of nature on mental health comes from studies using cross-sectional designs. We developed a smartphone-based tool (Urban Mind; www.urbanmind.info) to examine how exposure to natural features within the built environment affects mental well-being in real time. The tool was used to monitor 108 individuals who completed 3013 assessments over a 1-week period. Significant immediate and lagged associations with mental well-being were found for several natural features. These associations were stronger in people with higher trait impulsivity, a psychological measure of one's tendency to behave with little forethought or consideration of the consequences, which is indicative of a higher risk of developing mental-health issues. Our investigation suggests that the benefits of nature on mental well-being are time-lasting and interact with an individual's vulnerability to mental illness. These findings have potential implications from the perspectives of global mental health as well as urban planning and design.
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Affiliation(s)
- Ioannis Bakolis
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Ryan Hammoud
- PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Michael Smythe
- Artist and action-based researcher at Nomad Projects (https://nomadprojects.org) in London, United Kingdom
| | - Johanna Gibbons
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Neil Davidson
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Stefania Tognin
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Andrea Mechelli
- Reader, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
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Fitzgerald D, Rose N, Singh I. Revitalizing sociology: urban life and mental illness between history and the present. THE BRITISH JOURNAL OF SOCIOLOGY 2016; 67:138-160. [PMID: 26898388 DOI: 10.1111/1468-4446.12188] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper proposes a re-thinking of the relationship between sociology and the biological sciences. Tracing lines of connection between the history of sociology and the contemporary landscape of biology, the paper argues for a reconfiguration of this relationship beyond popular rhetorics of 'biologization' or 'medicalization'. At the heart of the paper is a claim that, today, there are some potent new frames for re-imagining the traffic between sociological and biological research - even for 'revitalizing' the sociological enterprise as such. The paper threads this argument through one empirical case: the relationship between urban life and mental illness. In its first section, it shows how this relationship enlivened both early psychiatric epidemiology, and some forms of the new discipline of sociology; it then traces the historical division of these sciences, as the sociological investment in psychiatric questions waned, and 'the social' become marginalized within an increasingly 'biological' psychiatry. In its third section, however, the paper shows how this relationship has lately been revivified, but now by a nuanced epigenetic and neurobiological attention to the links between mental health and urban life. What role can sociology play here? In its final section, the paper shows how this older sociology, with its lively interest in the psychiatric and neurobiological vicissitudes of urban social life, can be our guide in helping to identify intersections between sociological and biological attention. With a new century now underway, the paper concludes by suggesting that the relationship between urban life and mental illness may prove a core testing-ground for a 'revitalized' sociology.
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Affiliation(s)
| | - Nikolas Rose
- Department of Social Science, Health and Medicine, King's College London
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre for Practical Ethics, University of Oxford
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Fujise N, Abe Y, Fukunaga R, Nakagawa Y, Nishi Y, Koyama A, Ikeda M. Comparisons of prevalence and related factors of depression in middle-aged adults between urban and rural populations in Japan. J Affect Disord 2016; 190:772-776. [PMID: 26618770 DOI: 10.1016/j.jad.2015.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/29/2015] [Accepted: 11/15/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Findings of urban-rural differences in the prevalence of depression have been controversial, and few reports have directly compared the related factors of depression between urban and rural areas. The present study aimed to investigate differences between urban and rural areas in Japan with regards to the prevalence of and related factors of depression in middle-aged adults, in order to further understanding of the features of depression in this demographic. METHODS We used a multistage, random sampling procedure and mailing method. In total, 5000 participants were recruited from urban and rural areas in Kumamoto Prefecture (2500 in each area). Participants were aged from 40 to 64 years. Depression was assessed using the Center for Epidemiologic Studies Depression scale (CES-D). RESULTS The prevalence of middle-aged depression was not different between the urban and rural areas. Logistic regression analysis found that being female, living alone, and having a chronic illness were significantly associated with depression in urban-dwelling middle-aged adults. Younger age, sleep disturbance, and financial strain were significantly associated with depression in both urban and rural areas. LIMITATIONS The definition of depression was based on CES-D scores, without corroborating clinical evaluation. CONCLUSIONS We found no marked differences in the prevalence of middle-aged depression between the urban and rural areas. Some related factors of depression in middle-aged adults differed between urban and rural areas in Japan. Effective intervention programs for middle-aged adults with depression should consider regional differences.
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Affiliation(s)
- Noboru Fujise
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Yasuhisa Abe
- Yatsushiro Kousei Hospital, 1705 furushiromachi, Yatsushiro, Kumamoto, 866-0043, Japan
| | - Ryuta Fukunaga
- Yatsushiro Kousei Hospital, 1705 furushiromachi, Yatsushiro, Kumamoto, 866-0043, Japan
| | - Youichi Nakagawa
- Kumamoto Prefectural Government, 6-18-1 Suizenji, Chuo-ku, Kumamoto, 862-8570, Japan
| | - Yoshitomo Nishi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Asuka Koyama
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Manabu Ikeda
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Lambert KG, Nelson RJ, Jovanovic T, Cerdá M. Brains in the city: Neurobiological effects of urbanization. Neurosci Biobehav Rev 2015; 58:107-22. [PMID: 25936504 PMCID: PMC4774049 DOI: 10.1016/j.neubiorev.2015.04.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/27/2015] [Accepted: 04/22/2015] [Indexed: 12/11/2022]
Abstract
With a majority of humans now living in cities, strategic research is necessary to elucidate the impact of this evolutionarily unfamiliar habitat on neural functions and well-being. In this review, both rodent and human models are considered in the evaluation of the changing physical and social landscapes associated with urban dwellings. Animal models assessing increased exposure to artificial physical elements characteristic of urban settings, as well as exposure to unnatural sources of light for extended durations, are reviewed. In both cases, increased biomarkers of mental illnesses such as major depression have been observed. Additionally, applied human research emphasizing the emotional impact of environmental threats associated with urban habitats is considered. Subjects evaluated in an inner-city hospital reveal the impact of combined specific genetic vulnerabilities and heightened stress responses in the expression of posttraumatic stress disorder. Finally, algorithm-based models of cities have been developed utilizing population-level analyses to identify risk factors for psychiatric illness. Although complex, the use of multiple research approaches, as described herein, results in an enhanced understanding of urbanization and its far-reaching effects--confirming the importance of continued research directed toward the identification of putative risk factors associated with psychiatric illness in urban settings.
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Affiliation(s)
- Kelly G Lambert
- Department of Psychology, Randolph-Macon College, Ashland, VA 23005, USA.
| | - Randy J Nelson
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Magdalena Cerdá
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
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Breslau J, Marshall GN, Pincus HA, Brown RA. Are mental disorders more common in urban than rural areas of the United States? J Psychiatr Res 2014; 56:50-5. [PMID: 24857610 DOI: 10.1016/j.jpsychires.2014.05.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/02/2014] [Accepted: 05/02/2014] [Indexed: 11/30/2022]
Abstract
Urban vs. rural residence is commonly cited as a risk factor for depression and other mental disorders, but epidemiological evidence for this relationship in the US is inconclusive. We examined three consecutive annual samples (2009-2011) of adolescents (age 12-17, N = 55,583) and adults (age 18 and over, N = 116,459) from the National Survey of Drug Use and Health (NSDUH) to compare the prevalence of major depression and other serious mental illness across four categories of urbanicity: (1) large metropolitan areas, (2) small metropolitan areas, (3) semi-rural areas, and (4) rural areas, with and without adjustment for other demographic risk factors. For adolescents, no association was observed between urbanicity and the prevalence of major depression, with or without statistical adjustments. For adults, no differences were found in the prevalence of major depression or serious mental illness between large metropolitan areas and rural areas, but the prevalence of both was slightly higher in the two intermediate urbanicity categories than in large metropolitan areas, with statistically significant odds ratios after adjustment ranging from 1.12 to 1.19. Contrary to expectations, the prevalence of mental disorders was not higher in the most urban compared with the most rural areas, suggesting that the move to identify mechanistic explanations for risk associated with the urban environment is premature. Evidence of slightly higher prevalence in small urban and semi-rural areas relative to large urban areas, reported for the first time, requires additional investigation.
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Affiliation(s)
- Joshua Breslau
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, 15213 PA, USA.
| | | | - Harold A Pincus
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, 15213 PA, USA
| | - Ryan A Brown
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, 15213 PA, USA
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Neighborhood disadvantage in context: the influence of urbanicity on the association between neighborhood disadvantage and adolescent emotional disorders. Soc Psychiatry Psychiatr Epidemiol 2014; 49:467-75. [PMID: 23754682 PMCID: PMC6438365 DOI: 10.1007/s00127-013-0725-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 05/27/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Inconsistent evidence of a relationship between neighborhood disadvantage and adolescent mental health may be, in part, attributable to heterogeneity based on urban or rural residence. Using the largest nationally representative survey of US adolescent mental health available, we estimated the association between neighborhood disadvantage and adolescent emotional disorders and the extent to which urbanicity modified this association. METHODS The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) sampled adolescents aged 13-17 years (N = 10,123). Households were geocoded to Census tracts. Using a propensity score approach that addresses bias from non-random selection of individuals into neighborhoods, logistic regression models were used to estimate the relative odds of having a DSM-IV emotional disorder (any past-year anxiety disorder, major depressive disorder or dysthymia) comparing similar adolescents living in disadvantaged versus non-disadvantaged neighborhoods in urban center, urban fringe, and non-urban areas. RESULTS The association between neighborhood disadvantage and emotional disorder was more than twice as large for adolescents living in urban centers versus non-urban areas. In urban centers, living in a disadvantaged neighborhood was associated with 59% (95% confidence interval 25-103) increased adjusted odds of emotional disorder. CONCLUSIONS Urbanicity modifies the relationship between neighborhood disadvantage and emotional disorder in adolescents. This effect modification may explain why evidence of a relationship between neighborhood disadvantage and adolescent mental health has been inconsistent. Recognizing the joint influence of neighborhood socioeconomic context and urbanicity may improve specificity in identifying relevant neighborhood processes.
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Alegría M, Molina KM, Chen CN. Neighborhood characteristics and differential risk for depressive and anxiety disorders across racial/ethnic groups in the United States. Depress Anxiety 2014; 31:27-37. [PMID: 24123668 PMCID: PMC5737710 DOI: 10.1002/da.22197] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 08/31/2013] [Accepted: 09/08/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The prevalence of psychiatric disorders varies depending on the person's neighborhood context, their racial/ethnic group, and the specific diagnoses being examined. Less is known about specific neighborhood features that represent differential risk for depressive and anxiety disorders (DAD) across racial/ethnic groups in the United States. This study examines whether neighborhood etiologic factors are associated with DAD, above and beyond individual-level characteristics, and whether these associations are moderated by race/ethnicity. METHODS We utilized nationally representative data (N = 13,837) from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file). Separate weighted multilevel logistic regression models were fitted for any past-year depressive and/or anxiety disorder, any depressive disorder only, and any anxiety disorder only. RESULTS After adjusting for individual-level characteristics, African Americans living in a neighborhood with greater affluence and Afro-Caribbeans residing in more residentially unstable neighborhoods were at increased risk for any past-year depressive disorder as compared to their non-Latino white counterparts. Further, Latinos residing in neighborhoods with greater levels of Latino/immigrant concentration were at increased risk of any past-year anxiety disorder. Lastly, Asians living in neighborhoods with higher levels of economic disadvantage were at decreased risk of any past-year depressive and/or anxiety disorders compared to non-Latino whites, independent of individual-level factors. Differences across subethnic groups are also evident. CONCLUSIONS Results suggest neighborhood characteristics operate differently on risk for DAD across racial/ethnic groups. Our findings have important implications for designing and targeting interventions to address DAD risk among racial/ethnic minorities.
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Affiliation(s)
- Margarita Alegría
- Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4 Floor, Somerville, MA 02143
| | - Kristine M. Molina
- Behavioral Medicine Research Center, Clinical Research Building, #1516, Miller School of Medicine, University of Miami, 1120 N.W. 14 Street, Miami, FL 33136
| | - Chih-Nan Chen
- Department of Economics, National Taipei University, 67, Sec. 3, Ming-shen E. Rd. Taipei, Taiwan 10478
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Gene-environment interactions in common mental disorders: an update and strategy for a genome-wide search. Soc Psychiatry Psychiatr Epidemiol 2014; 49:3-14. [PMID: 24323294 DOI: 10.1007/s00127-013-0801-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 11/19/2013] [Indexed: 02/05/2023]
Abstract
A decade of research has demonstrated the explanatory potential of interplay between genetic variants and environmental factors in the development of common mental disorders. Initial findings have undergone tests of replicability and specificity. Some gene-environment interactions have been confirmed, some have not replicated and yet other turned out to be more specific than initially thought. Specific and complementary roles of genetic factors have been delineated: a common functional length polymorphism in the serotonin transporter gene (5-HTTLPR) moderated the effect of childhood maltreatment on chronic depression in adulthood, but did not substantially influence the effects of adult stressful life events on the onset of new depressive episodes; in contrast, a common functional polymorphism in the brain-derived neurotrophic factor gene (BDNF) moderated the effect of stressful life events in adulthood in triggering new depressive episodes, but did not influence the effects of childhood maltreatment. Molecular mechanisms underlying gene-environment interactions are being uncovered, including DNA methylation and other epigenetic modifications. New gene-environment interactions continue to be reported, still largely from hypothesis-driven research. Statistical and biological prioritization strategies are proposed to facilitate a systematic discovery of novel gene-environment interactions in genome-wide analyses.
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de Dios C, González-Pinto A, Montes JM, Goikolea JM, Saiz-Ruiz J, Prieto E, Vieta E. Predictors of recurrence in bipolar disorders in Spain (PREBIS study data). J Affect Disord 2012; 141:406-14. [PMID: 22608052 DOI: 10.1016/j.jad.2012.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 03/01/2012] [Accepted: 03/01/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate demographic, psychosocial and clinical predictors of mood recurrences in bipolar disorder (BD) euthymic outpatients followed-up for 12 months in a naturalistic setting. METHODS The study included 595 consecutive BD patients, diagnosed according to DSM-IV-TR criteria, in clinical remission at baseline. Quarterly assessments were scheduled. Clinical evaluation as well as mood and functioning psychometric evaluations were performed. We applied logistic regression analysis to determine predictors of presenting an affective recurrence, and Cox regression analysis to examine the association between individual predictors and time to affective recurrence. RESULTS Of the 593 patients finally included (60% women, 84.5% BD I), 141 (23.78%) had at least a recurrence during the 12 months follow-up. Time until 25% of the patients experienced a recurrence was 12 months (95% CI: 9.14-undetermined). In multivariate analysis, factors significantly related to relapse were living setting (p=0.002) and total number of previous episodes (p=0.01). Residents in mixed urban/rural catchment areas had 57% more risk than dwellers of cities with more than 100,000 people, and a higher number of previous episodes also increased the relapse risk. A shorter time to relapse was related to job status (p=0.004) and to living setting (p=0.002). CONCLUSION In our sample, living in environments of less than 100,000 inhabitants and having more previous affective episodes were related to an increased relapse risk in BD, and job status and living setting were related to a shorter time to relapse. LIMITATIONS No specific contemporary practice guidelines were used. Drug treatment and plasma levels, although measured, were not registered.
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Affiliation(s)
- Consuelo de Dios
- Department of Psychiatry, University Hospital La Paz, IDIPAZ, Madrid, Spain.
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