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Rimvall MK, Rask CU, Jensen JS, Olsen EM, Clemmensen L, Skovgaard AM, Verhulst F, van Os J, Jeppesen P. Exploring the interplay between psychotic experiences, functional somatic symptoms and health anxiety in childhood and adolescence - A longitudinal cohort study. Schizophr Res 2024; 267:322-329. [PMID: 38613863 DOI: 10.1016/j.schres.2024.03.028] [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: 10/04/2023] [Revised: 02/20/2024] [Accepted: 03/18/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Similarities exist between contemporary explanatory models underlying psychosis development, functional somatic symptoms, and health anxiety. The current study aimed to examine the potential interplay between psychotic experiences (and alternate measures of anomalous self-experiences and aberrant attribution of salience) and functional somatic symptoms on the outcome of health anxiety in youths. METHODS In a prospective general-population birth cohort, the Copenhagen Child Cohort 2000 (CCC2000), data from two time-points were available for 1122 individuals. We assessed the associations between psychotic experiences and functional somatic symptoms with health anxiety both cross-sectionally at ages 11- and 16-years, and longitudinally from age 11 to 16. Further, we examined if there was an interaction between these two domains on the outcome of health anxiety using the interaction contrast ratio. RESULTS Functional somatic symptoms and psychotic experiences were strongly cross-sectionally associated with health anxiety at both ages 11 and 16, even after adjustment for general psychopathology. In the longitudinal analyses, functional somatic symptoms, and psychotic experiences at age 11 were not individually associated with health anxiety at age 16 but having both functional somatic symptoms and psychotic experiences was: odds ratio 3.90, 95%CI 1.7-8.9, with suggestion of evidence for interaction beyond the additive effects. This association was attenuated after adjustment for general psychopathology: odds ratio 2.6, 95 % CI 1.0-6.4. CONCLUSION The strong associations between the domains support the idea of possible overlapping mechanisms underlying psychotic experiences, functional somatic symptoms, and health anxiety.
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Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Charlotte Ulrikka Rask
- Aarhus University Hospital Psychiatry, Department of Child and Adolescent Psychiatry, Research Unit, Aarhus, Denmark; Aarhus University, Department of Clinical Medicine, Aarhus, Denmark
| | - Jens Søndergaard Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Else Marie Olsen
- Psychiatric Center Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Clinical Research and Prevention, the Capital Region of Denmark, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center on Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - Frank Verhulst
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jim van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wienand D, Wijnen LI, Heilig D, Wippel C, Arango C, Knudsen GM, Goodwin GM, Simon J. Comorbid physical health burden of serious mental health disorders in 32 European countries. BMJ MENTAL HEALTH 2024; 27:e301021. [PMID: 38580438 PMCID: PMC11021748 DOI: 10.1136/bmjment-2024-301021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Mental health disorders (MHDs) are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed. OBJECTIVE To assess the burden of comorbid physical health conditions (PHCs) across serious MHDs in Europe. METHODS We estimated the relative prevalence risk of PHCs associated with alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD) and schizophrenia (SZ) across working-age populations of 32 European countries in 2019 based on a targeted literature review. Excess physical health burden was modelled using population-attributable fractions and country-level prevalence data. FINDINGS We screened 10 960 studies, of which 41 were deemed eligible, with a total sample size of over 18 million persons. Relative prevalence of PHCs was reported in 54%, 20%, 15%, 5% and 7% of studies, respectively, for SZ, DD, BD, AUD or mixed. Significant relative risk estimates ranged from 1.44 to 3.66 for BD, from 1.43 to 2.21 for DD, from 0.81 to 1.97 for SZ and 3.31 for AUD. Excess physical health burden ranged between 27% and 67% of the total, corresponding to 84 million (AUD), 67 million (BD), 66 million (DD) and 5 million (SZ) PHC diagnoses in Europe. A 1% reduction in excess risk assuming causal inference could result in two million fewer PHCs across investigated MHDs. CONCLUSIONS This is the first comprehensive study of the physical health burden of serious MHDs in Europe. The methods allow for updates, refinement and extension to other MHDs or geographical areas. CLINICAL IMPLICATIONS The results indicate potential population health benefits achievable through more integrated mental and physical healthcare and prevention approaches.
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Affiliation(s)
- Dennis Wienand
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Lena I Wijnen
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Daniel Heilig
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Christoph Wippel
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
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Fekih-Romdhane F, Ghrissi F, Stambouli M, Hakiri A, Loch AA, Cheour M, Hallit S. Moderating effect of alexithymia between problem gambling and psychotic experiences in university students. BMC Psychiatry 2024; 24:19. [PMID: 38172817 PMCID: PMC10765704 DOI: 10.1186/s12888-023-05472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Most of the young individuals with problem gambling (PG) or psychotic experiences (PEs) are less prone to seek medical help. Therefore, community-based studies investigating the relationship between these entities in non-clinical young people across a continuum of severity are warranted. To this end, the present study proposes to advance knowledge on the mechanisms that potentially underlie the association between PG and PEs, by examining the role of a potential moderator, i.e. alexithymia, in this relationship. METHODS A total of 399 participants enrolled in this study (mean age = 21.58 ± 3.20 years) participated in an online cross-sectional survey. The South Oaks Gambling Screen (SOGS), the Prodromal Questionnaire-Brief (PQ-B), and the Toronto alexithymia scale (TAS-20) were used. RESULTS Thirty-three (8.3%) participants had problem-gambling, whereas 13 (3.3%) were probable pathological gamblers. Moderation analysis results adjusted over confounders (age, household crowding index, marital status, personal history of mental disorder, other illegal drug use) showed that the interaction PG by alexithymia (p = .018) was significantly associated with PEs scores. At moderate (Beta = 1.93) and high (Beta = 3.38) levels of alexithymia, more PG was significantly associated with more PEs scores. CONCLUSION Findings suggest that GP may have a different impact on PEs depending on the individual's level of alexithymia. As such, both alexithymia and gambling behavior should be considered in the clinical assessment of young people who present with PEs, which can help in implementing more tailored and individualized treatment plans.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia.
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Farah Ghrissi
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Abir Hakiri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
- Psychology Department, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Kovess-Masfety V, Sabawoon A, Keyes K, Karam E. Prevalence, risk factors, and comorbidities of psychotic experiences in Afghanistan: a highly stressful environment. Soc Psychiatry Psychiatr Epidemiol 2024; 59:99-109. [PMID: 37558897 DOI: 10.1007/s00127-023-02539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/30/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To estimate the prevalence and demographic, psychiatric, and trauma-focused correlates of psychotic experiences (PEs) in the Afghan general population. METHODS Data were drawn from a cross-sectional household survey implemented in eight regions of Afghanistan (N = 4445). The CIDI structured instrument was administered to adults to assess psychiatric disorders and psychotic experiences; life events and PTSD were assessed using validated instruments. Weighted multivariate models integrated socio-demographics, regions, traumas as determinants of PE. RESULTS PEs were frequently reported in the Afghan population: 27.50% of the population reported a lifetime PE. PEs were more common among specific ethnic groups, and were associated with lower income in adjusted regression models. PEs were associated with mental health problems including major depressive disorders (OR = 3.43), PTSD (OR = 5.08), generalized anxiety (OR = 4.2); lifetime suicidal attempts (OR 6.04), lifetime suicidal thoughts (OR = 3.42), addiction (OR = 2.18); and psychological distress and impairment due to mental health (OR = 2.95 and 2.46, respectively). CONCLUSION Psychotic experiences in the Afghan general population confirm general population findings in other countries, that psychotic experiences are common and associated with economic and social marginalization, and part of a continuum of mental health problems experienced in populations. Efforts to reduce and treat psychotic experiences within a broad array of psychiatric conditions are needed.
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Affiliation(s)
- V Kovess-Masfety
- LPPS, University of Paris Cité, Paris, France.
- Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - A Sabawoon
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan
| | - K Keyes
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - E Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Faculty of Medicine, Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center University of Balamand, Beirut, Lebanon
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Cawthorpe DRL, Cohen D. Population-based affective-disorder-related biomedical/biophysical multi-hyper-morbidity across the lifespan: A 16-year population study. World J Psychiatry 2023; 13:423-434. [PMID: 37547734 PMCID: PMC10401504 DOI: 10.5498/wjp.v13.i7.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/03/2023] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND There are few if any life-span population-based studies of psychiatric disorder-associated biomedical and biophysical disorders and diseases (morbidity).
AIM To scope the present state of research regarding the biomedical and biophysical morbidity associated with affective and mental disorder in epidemiological samples, and to examine the life-span relationship between affective disorders and biomedical/biophysical disorders to illustrate a novel approach employing the odds ratio to represent the intensity of biomedical and biophysical morbidity associated in time in a population.
METHODS A repeatable systematic literature search of PubMed was represented in summary. Additionally, a regional population-based dataset was constructed and analyzed to represent the age- and sex-specific diagnoses (International Classification of Diseases Version 9, ICD-9) for those with and without affective disorder. The analysis presents a novel index of the relative age-specific frequency of life-span biomedical and biophysical diagnoses associated with affective disorder.
RESULTS The volume of biomedical and biophysical morbidity associated with mental disorder literature has increased, yet few studies measure comprehensive temporal hyper-morbidity (over-representation of diseases over time, either before or after the index diagnostic event) in populations. Further, there have been only a few population-based studies examining the morbidity associated with affective disorder and only one that examines the full diagnostic range of lifespan morbidity. Substantial differences arose between males and females with more females than males having greater frequencies of diagnoses. The age-specific distributions of the maximum proportional diagnosis frequency ratios for each sex illustrate the greatest diagnosis-specific differences when comparing the biomedical and biophysical diagnoses of those with and without affective disorder when the same diagnosis was represented in each grouping at the same age.
CONCLUSION Clinical research needs to focus on more than one or two comorbid biomedical or biophysical disorders at a time. Comprehensive population-based examination of the lifespan biomedical and biophysical multi-morbidity associated with affective disorder has the potential to directly inform clinical practice. Representing the proportional ratios of age-specific frequency of diagnoses for the full range of ICD-9 diagnoses is a novel analytical model. Diagnostic frequency appears a viable representation of a given disease state, such as affective disorder. Fortunately, the WPA has developed a global education section to better understand the biomedical and biophysical morbidity associated with all psychiatric disorders. This has been identified by the WPA as the psychiatric practice challenge of the 21st century.
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Affiliation(s)
- David R L Cawthorpe
- Community Health Sciences and Psychiatry, Cumming School of Medicine, Calgary T2N4N1, Alberta, Canada
| | - Dan Cohen
- Mental Health Organization North-Holland North, Utrecht University, Alkmaar 1811, North Holland, Netherlands
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Shoham N, Dunca D, Cooper C, Hayes JF, McQuillin A, Bass N, Lewis G, Kuchenbaecker K. Investigating the association between schizophrenia and distance visual acuity: Mendelian randomisation study. BJPsych Open 2023; 9:e33. [PMID: 36746515 PMCID: PMC9970182 DOI: 10.1192/bjo.2023.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Increased rates of visual impairment are observed in people with schizophrenia. AIMS We assessed whether genetically predicted poor distance acuity is causally associated with schizophrenia, and whether genetically predicted schizophrenia is causally associated with poorer visual acuity. METHOD We used bidirectional, two-sample Mendelian randomisation to assess the effect of poor distance acuity on schizophrenia risk, poorer visual acuity on schizophrenia risk and schizophrenia on visual acuity, in European and East Asian ancestry samples ranging from approximately 14 000 to 500 000 participants. Genetic instrumental variables were obtained from the largest available summary statistics: for schizophrenia, from the Psychiatric Genomics Consortium; for visual acuity, from the UK Biobank; and for poor distance acuity, from a meta-analysis of case-control samples. We used the inverse variance-weighted method and sensitivity analyses to test validity of results. RESULTS We found little evidence that poor distance acuity was causally associated with schizophrenia (odds ratio 1.00, 95% CI 0.91-1.10). Genetically predicted schizophrenia was associated with poorer visual acuity (mean difference in logMAR score: 0.024, 95% CI 0.014-0.033) in European ancestry samples, with a similar but less precise effect that in smaller East Asian ancestry samples (mean difference: 0.186, 95% CI -0.008 to 0.379). CONCLUSIONS Genetic evidence supports schizophrenia being a causal risk factor for poorer visual acuity, but not the converse. This highlights the importance of visual care for people with psychosis and refutes previous hypotheses that visual impairment is a potential target for prevention of schizophrenia.
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Affiliation(s)
- Natalie Shoham
- Division of Psychiatry, University College London, UK; and Islington Early Intervention Service, Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
- Correspondence: Natalie Shoham.
| | - Diana Dunca
- UCL Genetics Institute, University College London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK; and Tower Hamlets Memory Service, East London NHS Foundation Trust, London, UK
| | - Joseph F. Hayes
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | | | - Nick Bass
- Division of Psychiatry, University College London, UK; and Tower Hamlets Memory Service, East London NHS Foundation Trust, London, UK
| | - Gemma Lewis
- Division of Psychiatry, University College London, UK
| | - Karoline Kuchenbaecker
- Division of Psychiatry, University College London, UK; and UCL Genetics Institute, University College London, UK
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Psychotic-like experiences are associated with physical disorders in general population: A cross-sectional study from the NESARC II. J Psychosom Res 2023; 165:111128. [PMID: 36608509 DOI: 10.1016/j.jpsychores.2022.111128] [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: 09/16/2022] [Revised: 12/04/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) constitute subthreshold symptoms of psychotic disorders, and belong to five distinct dimensions: Positive, Negative, Depressive, Mania and Disorganization. PLEs are associated with various psychiatric disorders. However, few studies examined their association with physical disorders. OBJECTIVE Our aims were (1) to assess the associations between various physical disorders and PLEs in a U.S. representative sample, and (2) to examine these associations according to the five dimensions of PLEs. METHOD We used data from the wave II (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II), a large national sample representative of the US population (N = 34,653). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule 4. Twenty-two PLEs were examined. Lifetime prevalence and adjusted Odds-Ratio (aOR) reflecting the association of sixteen physical disorders (including notably metabolic conditions and heart diseases) with PLEs were calculated. RESULTS All studied physical disorders were associated with the presence of PLEs. Particularly the presence of any physical condition, any heart disease and diabetes were more frequent in participants with at least one PLE compared with the group without any PLE (aOR = 1.74, 95% CI = 1.62-1.87, aOR = 1.44, 95% CI = 1.33-1.55 and aOR = 1.38, 95% CI = 1.24-1.54, respectively). Almost all physical disorders were associated with the five dimensions of PLEs. CONCLUSIONS PLEs were associated with a large range of physical disorders, with a gradual dose effect. To assess PLEs in the general population could help with the screening of subjects with physical disorders.
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Behavioral Health Emergencies. PHYSICIAN ASSISTANT CLINICS 2023. [DOI: 10.1016/j.cpha.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Simon J, Wienand D, Park AL, Wippel C, Mayer S, Heilig D, Laszewska A, Stelzer I, Goodwin GM, McDaid D. Excess resource use and costs of physical comorbidities in individuals with mental health disorders: A systematic literature review and meta-analysis. Eur Neuropsychopharmacol 2023; 66:14-27. [PMID: 36345094 DOI: 10.1016/j.euroneuro.2022.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
Individuals with mental health disorders (MHDs) have worse physical health than the general population, utilise healthcare resources more frequently and intensively, incurring higher costs. We provide a first comprehensive overview and quantitative synthesis of literature on the magnitude of excess resource use and costs for those with MHDs and comorbid physical health conditions (PHCs). This systematic review (PROSPERO CRD42017075319) searched studies comparing resource use or costs of individuals with MHDs and comorbid PHCs versus individuals without comorbid conditions published between 2007 and 2021. We conducted narrative and quantitative syntheses, using random-effects meta-analyses to explore ranges of excess resource use and costs across care segments, comparing to MHD only, PHC only, or general population controls (GPC). Of 20,075 records, 228 and 100 were eligible for narrative and quantitative syntheses, respectively. Most studies were from the US, covered depression or schizophrenia, reporting endocrine/metabolic or circulatory comorbidities. Frequently investigated healthcare segments were inpatient, outpatient, emergency care and medications. Evidence on lost productivity, long-term and informal care was rare. Substantial differences exist between MHDs, with depressive disorder tending towards lower average excess resource use and cost estimates, while excess resource use ranges between +6% to +320% and excess costs between +14% to +614%. PHCs are major drivers of resource use and costs for individuals with MHDs, affecting care segments differently. Significant physical health gains and cost savings are potentially achievable through prevention, earlier identification, management and treatment, using more integrated care approaches. Current international evidence, however, is heterogeneous with limited geographical representativeness and comparability.
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Affiliation(s)
- Judit Simon
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
| | - Dennis Wienand
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Christoph Wippel
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Mayer
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Daniel Heilig
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Agata Laszewska
- Department of Health Economics, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Ines Stelzer
- Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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Bórquez-Infante I, Vasquez J, Dupré S, Undurraga EA, Crossley NA, Undurraga J. Childhood adversity increases risk of psychotic experiences in patients with substance use disorder. Psychiatry Res 2022; 316:114733. [PMID: 35907276 DOI: 10.1016/j.psychres.2022.114733] [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: 01/13/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) increase the risk of psychotic experiences (PE), but little is known about heterogeneities of this association in different developmental stages, dimensions, or whether they are affected by substance use disorder (SUD). This study examines the association between different types of ACEs at various developmental stages and lifetime PE in patients with SUD in Chile. METHODS We included 399 consenting adults in outpatient or residential SUD treatment programs. Sociodemographic data and information about PE and ACEs were obtained by trained clinical psychologists. RESULTS Patients reporting PE experienced more ACEs compared to patients without PE (4.2 versus 3.4). They also experienced more complex adversities (41.8% versus 25.1%), had more psychiatric comorbidities (85% versus 70.4%), and reported using more substances (mean 4.5 versus 3.9). Adjusted association between ACEs and PE showed the highest OR for arrests (1.88), sexual abuse (1.81), alcohol abuse by parents (1.48), school exclusion (1.39), foster or residential care (18.3). CONCLUSION Early exposure to ACEs is a risk factor for later PE among patients with SUD. Type of ACE and the period when they occurred is important, suggesting the existence of critical periods where the individual is more susceptible to adverse environmental stimuli.
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Affiliation(s)
- Ignacio Bórquez-Infante
- Centre for Studies on Justice and Society, Institute of Sociology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Vasquez
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile; Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sofía Dupré
- Centre for Studies on Justice and Society, Institute of Sociology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo A Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile; Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile; CIFAR Azrieli Global Scholars program, CIFAR, Toronto, Canada
| | - Nicolás A Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile; Department of Neurology and Psychiatry, Clinica Alemana Universidad Del Desarrollo, Santiago, Chile.
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Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D, Cannon M. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med 2022; 52:1-12. [PMID: 36004805 PMCID: PMC9772919 DOI: 10.1017/s0033291722002550] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/31/2022]
Abstract
Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College, Dublin 4, Ireland
- Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin 6, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
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12
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Kurokawa Y, Watanabe S, Miyabe S, Ishibashi K, Yamamoto S, Goto M, Hasegawa S, Miyachi H, Kohei F, Nagao T. Oral hygiene status and factors related to oral health in hospitalized patients with schizophrenia. Int J Dent Hyg 2022; 20:658-663. [PMID: 35920084 DOI: 10.1111/idh.12605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/17/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to elucidate the oral hygiene status and the factors associated with poor oral hygiene among patients with schizophrenia. METHODS The relationships of oral hygiene status (calculus index [CI], debris index [DI]), the mean number of decayed-missing-filled teeth (mean DMFT), and Revised Oral Assessment Guide (ROAG) with related factors (hospitalization, chlorpromazine equivalents [CPZE], age, Barthel Index [BI], frequency of cleaning teeth, and self-oral hygiene ability) among 249 hospitalized schizophrenic patients were investigated. RESULTS The results for oral hygiene status were as follows: median (range); CI 0.5 (0-6.0), DI 1.7 (0-6.0), ROAG 10.0 (7.0-15.0); and mean DMFT 21.7±7.3. The average CPZE was 524.4±353.6 mg (mean ± SD), and the BI was 76.4±30.7. There was a negative correlation between BI and DI (r = -0.34) and a positive correlation between age and mean DMFT (r=0.57). Male patients tended to have worse oral conditions (ROAG) than females. The least-squares multiple regression analysis revealed that BI for DI, age for mean DMFT, sex for ROAG, and self-oral hygiene ability for CI, DI, and mean DMFT were factors related to oral health status. CONCLUSION Patients with schizophrenia tended to have poor oral hygiene. BI, being male, and low activities of daily living were associated with poor oral hygiene. Furthermore, advanced age was associated with an increased risk of dental caries.
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Affiliation(s)
- Yoshiya Kurokawa
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Satoshi Watanabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Satoru Miyabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Kenichiro Ishibashi
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan.,Department of Maxillofacial Surgery, Ogaki Municipal Hospital, Gifu, Japan
| | - Satoshi Yamamoto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan.,Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, Division of Surgical Pathology, University of Fukui Hospital, Fukui, Japan
| | - Mitsuo Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Hitoshi Miyachi
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Fujita Kohei
- Hinaga General Center for Mental Care, Mie, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
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Abstract
AIMS Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have an increased risk of multiple long-term conditions (MLTC; multimorbidity). However, there is limited research regarding ethnic inequities in multimorbidity in people with psychosis. This study investigates ethnic inequities in physical health multimorbidity in a cohort of people with psychosis. METHODS In this retrospective cohort study, using the Clinical Records Interactive Search (CRIS) system, we identified service-users of the South London and Maudsley NHS Trust with a schizophrenia spectrum disorder, and then additional diagnoses of diabetes, hypertension, low blood pressure, overweight or obesity and rheumatoid arthritis. Logistic and multinomial logistic regressions were used to investigate ethnic inequities in odds of multimorbidity (psychosis plus one physical health condition), and multimorbidity severity (having one or two physical health conditions, or three or more conditions), compared with no additional health conditions (no multimorbidity), respectively. The regression models adjusted for age and duration of care and investigated the influence of gender and area-level deprivation. RESULTS On a sample of 20 800 service-users with psychosis, aged 13-65, ethnic differences were observed in the odds for multimorbidity. Controlling for sociodemographic factors and duration of care, compared to White British people, higher odds of multimorbidity were found for people of Black African [adjusted Odds Ratio = 1.41, 95% Confidence Intervals (1.23-1.56)], Black Caribbean [aOR = 1.79, 95% CI (1.58-2.03)] and Black British [aOR = 1.64, 95% CI (1.49-1.81)] ethnicity. Reduced odds were observed among people of Chinese [aOR = 0.61, 95% CI (0.43-0.88)] and Other ethnic [aOR = 0.67, 95% CI (0.59-0.76)] backgrounds. Increased odds of severe multimorbidity (three or more physical health conditions) were also observed for people of any Black background. CONCLUSIONS Ethnic inequities are observed for multimorbidity among people with psychosis. Further research is needed to understand the aetiology and impact of these inequities. These findings support the provision of integrated health care interventions and public health preventive policies and actions.
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Rodrigues M, Stranges S, Ryan BL, Anderson KK. The prevalence of physical multimorbidity among people with non-affective psychotic disorders 10 years after first diagnosis: a matched retrospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:495-503. [PMID: 34357406 DOI: 10.1007/s00127-021-02157-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/30/2021] [Indexed: 12/31/2022]
Abstract
AIMS The higher prevalence of chronic physical health conditions among people with psychotic disorders may result in a reduced life expectancy as compared to the general population. More research is needed on the risk of multiple co-occurring chronic health conditions, known as multimorbidity, for people with psychotic disorders. METHODS We conducted a matched retrospective cohort study to quantify the prevalence of multimorbidity and associated factors among people with psychotic disorders over the 10-year period following first diagnosis, relative to those without psychosis. Data from an early psychosis intervention program in London, Canada were linked to population-based health administrative data to identify patients with first-episode psychosis (n = 439), and a comparison group from the general population (n = 1759) matched on age, sex, and postal code. We followed the cohort for 10 years to ascertain the prevalence of multimorbidity. We compared people with and without psychosis using modified Poisson regression models, and explored risk factors for multimorbidity among those with psychotic disorders. RESULTS People with psychotic disorders may have a 26% higher prevalence of multimorbidity 10 years following first diagnosis, although our findings include the possibility of a null effect (PR = 1.26, 95% CI 0.96-1.66). People with psychosis living in areas with the highest levels of material deprivation had a threefold higher prevalence of multimorbidity as compared to those in the lowest areas of material deprivation (PR = 3.09, 95% CI 1.21-7.90). CONCLUSION Multimorbidity is prevalent among those with psychosis, and assessment for chronic health conditions should be integrated into clinical care for younger populations with psychotic illness.
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Affiliation(s)
- Myanca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Canada.,Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Canada.,Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Bridget L Ryan
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Canada.,Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Canada. .,Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada.
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Oh H, DeVylder JE, Koyanagi A. Psychotic experiences as a health indicator: A provisional framework. Int J Soc Psychiatry 2022; 68:244-252. [PMID: 33554709 DOI: 10.1177/0020764021992809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
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16
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Lieberman A, Rogers ML, Graham A, Joiner TE. Examining Correlates of Suicidal Ideation between those with and without Psychosis in a Psychiatric Inpatient Sample. J Affect Disord 2021; 294:254-260. [PMID: 34303305 DOI: 10.1016/j.jad.2021.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The present study explored group differences in suicide-related variables between those with and without psychosis within the context of a psychiatric inpatient sample that included a range of affective disorder diagnoses. METHODS 54 individuals with psychosis and 103 individuals without psychosis (but experiencing other severe and acute mental health issues) were compared, and analyses of indirect effects were conducted to test specificity of thwarted belongingness, perceived burdensomeness, capability for suicide, agitation, and insomnia as accounting for group differences in suicidal ideation. RESULTS Patients without psychosis experienced higher levels of suicidal ideation, perceived burdensomeness, thwarted belongingness, agitation, and insomnia than patients with psychosis. Additionally, perceived burdensomeness and agitation emerged as robust explanatory factors for the relationship between psychosis status and suicidal ideation. LIMITATIONS Future work should include longitudinal analyses to understand temporal relationships between study variables. Additionally, stability of patients' psychotic symptoms was required and therefore may not reflect those at greatest acuity. CONCLUSIONS Although several studies have investigated suicide-related variables among those with psychosis as compared to the general population, the present study is novel in that the severity of these symptoms in those with psychosis is compared to that of those in other acutely ill populations (e.g., major depression, substance use).
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Affiliation(s)
- Amy Lieberman
- Department of Psychology, Florida State University, United States.
| | | | - Adam Graham
- Mental Health Cooperative, Nashville, TN, United States
| | - Thomas E Joiner
- Department of Psychology, Florida State University, United States
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Aker AM, Vigod SN, Dennis CL, Kaster T, Brown HK. The association between asthma and perinatal mental illness: a population-based cohort study. Int J Epidemiol 2021; 51:964-973. [PMID: 34379748 DOI: 10.1093/ije/dyab160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Asthma is a risk factor for mental illness, but few studies have explored this association around the time of pregnancy. We studied the association between asthma and perinatal mental illness and explored the modifying effects of social and medical complexities. METHODS In a population-based cohort of 846 155 women in Ontario, Canada, with a singleton live birth in 2005-2015 and no recent history of mental illness, modified Poisson regression models were constructed to examine the association between asthma diagnosed before pregnancy and perinatal mental illness, controlling for socio-demographics and medical history. We explored the modifying effects of social and medical complexities using relative excess risk due to interaction. Additional analyses examined the association between asthma and perinatal mental illness by timing and type of mental illness. RESULTS Women with asthma were more likely than those without asthma to have perinatal mental illness [adjusted relative risk (aRR) 1.14; 95% (confidence interval) CI: 1.13, 1.16]. Asthma was associated with increased risk of diagnosis of mental illness prenatally (aRR 1.11; 95% CI: 1.08, 1.13) and post-partum (aRR 1.17; 95% CI: 1.15, 1.19) and specifically diagnoses of mood and anxiety disorders (aRR 1.14; 95% CI: 1.13, 1.16), psychotic disorders (aRR 1.20; 95% CI: 1.10, 1.31) and substance- or alcohol-use disorders (aRR 1.24; 95% CI: 1.14, 1.36). There was no effect modification related to social or medical complexity for these outcomes. CONCLUSIONS Women with asthma predating pregnancy are at slightly increased risk of mental illness in pregnancy and post-partum. A multidisciplinary management strategy may be required to ensure timely identification and treatment.
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Affiliation(s)
- Amira M Aker
- Department of Health & Society, University of Toronto Scarborough, Toronto, Canada.,ICES, Toronto, Canada
| | - Simone N Vigod
- ICES, Toronto, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Tyler Kaster
- ICES, Toronto, Canada.,Centre for Addiction & Mental Health, Toronto, Canada
| | - Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, Canada.,ICES, Toronto, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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18
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Hüfner K, Caramazza F, Stawinoga AE, Pircher Nöckler ER, Fusar-Poli P, Bhandari SS, Basnyat B, Brodmann Maeder M, Strapazzon G, Tomazin I, Sperner-Unterweger B, Brugger H. Assessment of Psychotic Symptoms in Individuals Exposed to Very High or Extreme Altitude: A Field Study. High Alt Med Biol 2021; 22:369-378. [PMID: 34324390 PMCID: PMC8742264 DOI: 10.1089/ham.2020.0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hüfner, Katharina, Fabio Caramazza, Agnieszka E. Stawinoga, Evelyn R. Pircher Nöckler, Paolo Fusar-Poli, Sanjeeb S. Bhandari, Buddha Basnyat, Monika Brodmann Maeder, Giacomo Strapazzon, Iztok Tomazin, Barbara Sperner-Unterweger, and Hermann Brugger. Assessment of psychotic symptoms in individuals exposed to very high or extreme altitude: A field study. High Alt Med Biol. xx:xxx-xxx, 2021. Background: Symptoms of psychosis such as hallucinations can occur at high or extreme altitude and have been linked to accidents on the mountain. No data are available on how to assess such symptoms in the field and what their prevalence or predisposing factors might be. Methods: In this field study at Everest Base Camp (5,365 m) in Nepal, 99 participants of organized expeditions underwent 279 assessments: The High Altitude Psychosis Questionnaire (HAPSY-Q), the Prodromal Questionnaire, 16-items (PQ-16), and the Mini International Neuropsychiatric Interview (M.I.N.I., psychosis section) were collected together with further clinical data. Statistical analysis was done for each phase, that is, altitude range of the climb, and overall data. Results: One of 97 climbers fulfilled the M.I.N.I. diagnostic criteria for psychosis during one acclimatization climb. At least one endorsed item on the HAPSY-Q and the PQ-16, indicating the presence of symptoms of psychosis in the absence of a psychotic disorders, were identified in 10/97 (10.3%) and 18/87 (20.7%) participants respectively. The scores of the HAPSY-Q and the PQ-16 were correlated (r = 0.268, p < 0.001). Odds ratio analysis identified an increased risk for accidents in individuals with endorsed items on the HAPSY-Q. Conclusions: The diagnosis of high altitude psychosis is rare in climbers during organized expeditions. Nevertheless, subdiagnostic symptoms of psychosis occurred in a significant proportion of climbers. Future research is needed to validate these pilot findings.
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Affiliation(s)
- Katharina Hüfner
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Fabio Caramazza
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria.,Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | | | - Evelyn R Pircher Nöckler
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Buddha Basnyat
- Mountain Medicine Society of Nepal, Kathmandu, Nepal.,Oxford University Clinical Research Unit, Patan Academy of Health Science, Nepal International, Kathmandu, Nepal
| | - Monika Brodmann Maeder
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,Department of Emergency Medicine, University Hospital Bern and Bern University, Bern, Switzerland
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Iztok Tomazin
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Mountain Rescue Association of Slovenia, Kranj, Slovenia
| | - Barbara Sperner-Unterweger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Shoham N, Eskinazi M, Hayes JF, Lewis G, Theodorsson M, Cooper C. Associations between psychosis and visual acuity impairment: A systematic review and meta-analysis. Acta Psychiatr Scand 2021; 144:6-27. [PMID: 34028803 PMCID: PMC8504204 DOI: 10.1111/acps.13330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Several theories propose that visual acuity impairment is associated with psychosis. Visual impairment could lead to psychosis or the converse, or they may share underlying pathology or risk factors. In the first evidence synthesis in this area for over 25 years, we collated studies measuring the association between visual acuity impairment and psychosis. METHODS We searched the MEDLINE, EMBASE, PsycINFO, and Web of Science databases for studies published from 1992 to 2020, using the Newcastle Ottawa Scale to assess risk of bias. We narratively synthesized findings and meta-analyzed sufficiently homogenous results. RESULTS We included 40 papers, which reported on 31 studies. Evidence from seven cohort studies was inconsistent, which precluded meta-analysis of this study design. These contradictory results also made it difficult to draw conclusions regarding a temporal association. We found evidence for an association from eight cross-sectional studies treating visual acuity impairment as the exposure and psychosis as the outcome [pooled odds ratio (OR) =1.76, 95% confidence interval (CI): 1.34-2.31], and four with the reverse exposure and outcome (OR: 1.85, 95% CI: 1.17-2.92). Seven case-control studies with mixed findings were found, but only two primarily addressed our research question, and these findings were mixed. CONCLUSIONS Although evidence supports a cross-sectional association between visual acuity impairment and psychosis, further research is needed to clarify the temporal direction, given the mixed findings in cohort studies. Understanding the association may give insights into prevention strategies for people at risk of visual acuity impairment and psychosis.
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Affiliation(s)
- Natalie Shoham
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Michelle Eskinazi
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Joseph F. Hayes
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Gemma Lewis
- Division of PsychiatryUniversity College LondonLondonUK
| | | | - Claudia Cooper
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
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Bai B, Yin H, Guo L, Ma H, Wang H, Liu F, Liang Y, Liu A, Geng Q. Comorbidity of depression and anxiety leads to a poor prognosis following angina pectoris patients: a prospective study. BMC Psychiatry 2021; 21:202. [PMID: 33879109 PMCID: PMC8056494 DOI: 10.1186/s12888-021-03202-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Depression and anxiety are two common mood problems among patients with cardiovascular disease (CVD) and are associated with poor cardiac prognoses. The comorbidity of depression and anxiety is considered to be a more severe psychological status than non-comorbid mood disorders. However, little is known about the relationship between depression or anxiety and noncardiac readmission. We conducted a prospective study on the prognostic impact of depression, anxiety, and the comorbidity of the two among angina pectoris (AP) patients. METHOD In this prospective study, 443 patients with AP were included in the analysis. Follow-up assessments were performed 1 year, and 2 years after patient discharges. Clinical outcomes of interest included noncardiac readmission, major adverse cardiovascular events (MACEs), and composite events. Depression and anxiety symptom scores derived from the patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7) questionnaire were used to assess mood symptoms at baseline. Participants with symptom scores of ≥10 on both the depression and anxiety questionnaires formed the clinical comorbidity subgroup. We used multivariable Cox proportional hazards models to evaluate the impact of individual mood symptom and comorbidity on clinical outcomes. RESULTS Among all the AP patients, 172 (38. 9%) were determined to have depression symptoms, 127 (28.7%) patients had anxiety symptoms and 71 (16.0%) patients suffered from their comorbidity. After controlling covariates, we found that patients who endured clinical depression (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.06-5.33, p = 0.035) and anxiety ([HR] 2.85, 95% [CI] 1.10-7.45, p = 0.032) had a high risk of noncardiac readmission. Compared to participants with no mood symptoms, those with clinical comorbidity of depression and anxiety presented a greater risk of noncardiac readmission ([HR] 2.91, 95% [CI] 1.03-8.18, p = 0.043) MACEs ([HR] 2.38, 95% [CI] 1.11-5.10, p = 0.025) and composite event ([HR] 2.52, 95% [CI] 1.35-4.69, p = 0.004). CONCLUSION Depression and anxiety were found to have predictive value for noncardiac readmission among patients with AP. Furthermore, prognoses were found to be worse for patients with comorbidity of depression and anxiety than those with single mood symptom. Additional attention needs to be focused on the initial identification and long-term monitoring of mood symptom comorbidity.
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Affiliation(s)
- Bingqing Bai
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Han Yin
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Lan Guo
- Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Huan Ma
- Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Haochen Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Fengyao Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Yanting Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Anbang Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Qingshan Geng
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
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Galderisi S, De Hert M, Del Prato S, Fagiolini A, Gorwood P, Leucht S, Maggioni AP, Mucci A, Arango C. Identification and management of cardiometabolic risk in subjects with schizophrenia spectrum disorders: A Delphi expert consensus study. Eur Psychiatry 2021; 64:e7. [PMID: 33413701 PMCID: PMC8057390 DOI: 10.1192/j.eurpsy.2020.115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with schizophrenia spectrum disorders (SSD) have worse physical health and reduced life expectancy compared to the general population. In 2009, the European Psychiatric Association, the European Society of Cardiology and the European Association for the Study of Diabetes published a position paper aimed to improve cardiovascular and diabetes care in patients with severe mental illnesses. However, the initiative did not produce the expected results. Experts in SSD or in cardiovascular and metabolic diseases convened to identify main issues relevant to management of cardiometabolic risk factors in schizophrenia patients and to seek consensus through the Delphi method. METHODS The steering committee identified four topics: 1) cardiometabolic risk factors in schizophrenia patients; 2) cardiometabolic risk factors related to antipsychotic treatment; 3) differences in antipsychotic cardiometabolic profiles; 4) management of cardiometabolic risk. Twelve key statements were included in a Delphi questionnaire delivered to a panel of expert European psychiatrists. RESULTS Consensus was reached for all statements with positive agreement higher than 85% in the first round. European psychiatrists agreed on: 1) high cardiometabolic risk in patients with SSD, 2) importance of correct risk management of cardiometabolic diseases, from lifestyle modification to treatment of risk factors, including the choice of antipsychotic drugs with a favourable cardiometabolic profile. The expert panel identified the psychiatrist as the central coordinating figure of management, possibly assisted by other specialists and general practitioners. CONCLUSIONS This study demonstrates high level of agreement among European psychiatrists regarding the importance of cardiovascular risk assessment and management in subjects with SSD.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marc De Hert
- University Psychiatric Centre—KU Leuven, Kortenberg, Belgium
- Department of Neuroscience, KU Leuven, Kortenberg, Belgium
- Antwerp Health Law and Ethics Chair, AHLEC University Antwerpen, Antwerp, Belgium
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Pisa, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, Division of Psychiatry, University of Siena, Siena, Italy
| | - Philip Gorwood
- INSERM U1266, Institute of Psychiatry and Neurosciences of Paris (IPNP) & GHU Paris Psychiatrie et Neurosciences (CMME, Sainte-Anne Hospital), Université de Paris, Paris, France
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Technische Universität München, Munich, Germany
| | | | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
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Jacob L, Smith L, McDermott D, Haro JM, Stickley A, Koyanagi A. Relationship between sexual orientation and psychotic experiences in the general population in England. Psychol Med 2021; 51:138-146. [PMID: 31694728 DOI: 10.1017/s003329171900309x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Non-heterosexual individuals are at high risk for a variety of factors associated with the emergence of psychotic experiences (PEs) (e.g. common mental disorders, substance use, and stress). However, there is a scarcity of data on the association between sexual orientation and PEs. Therefore, the aim of this study was to examine the sexual orientation-PE relationship, and to identify potential mediators in this relationship. METHODS This study used nationally representative cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. Sexual orientation was dichotomized into heterosexual and non-heterosexual. Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Regression and mediation analyses were conducted to analyze the association between sexual orientation and PEs, and to identify potential mediators involved in this relationship. RESULTS The final sample consisted of 7275 individuals aged ⩾16 years. The prevalence of non-heterosexual orientation and any PE was 7.1% and 5.5%, respectively. After adjusting for sex, age, and ethnicity, non-heterosexual orientation was positively associated with any PE (odds ratio 1.99, 95% confidence interval 1.34-2.93). The strongest mediators involved in this relationship were borderline personality disorder (BPD) traits (mediated percentage = 33.5%), loneliness (29.1%), and stressful life events (25.4%). CONCLUSIONS These findings suggest that there is a positive relationship between sexual orientation and PEs in the general population in England, and that underlying mechanisms may involve BPD traits, loneliness, and stressful life events. Future studies with a longitudinal design are warranted to shed more light on how these factors are implicated in the association between sexual orientation and PEs.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux78180, France
- Research and development unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona08830, Spain
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Daragh McDermott
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Josep Maria Haro
- Research and development unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona08830, Spain
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ai Koyanagi
- Research and development unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona08830, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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23
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Comorbid physical illnesses in adult outpatients with psychotic disorders: risk factors, psychological functioning, and quality of life outcomes. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1633-1643. [PMID: 33616692 PMCID: PMC8429359 DOI: 10.1007/s00127-021-02034-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/29/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE In contrast to global research, where physical comorbidity in psychotic disorders is established, only a few studies have been conducted in Southeast Asia. With a concerning trend of chronic physical illnesses emerging in adults below the age of 65, an investigation into comorbid chronic physical illnesses in adults diagnosed with psychotic disorders is necessary. This study aims to explore the risk factors, psychological functioning, and quality of life outcomes associated with comorbidity in adults below the age of 65, diagnosed with psychotic disorders, in a multi-ethnic non-Western setting. METHODS Electronic medical records of 364 patients with psychotic disorders who had provided written consent to participate were screened for co-occurring physical conditions. The majority of participants were female (53.7%), Chinese (69%), single (74.5%), and had tertiary and above education (43%). They were approximately 35 years old on average and the mean age of onset for psychosis was 26.7 years old. RESULTS Comorbid physical illnesses were present in approximately a third of adults with psychotic disorders (28%). They typically reported cardiovascular-related diseases, respiratory, and skin conditions. Comorbidity was significantly related to lower physical quality of life. As compared to other types of psychotic disorders, schizophrenia was significantly related to a greater frequency of comorbid physical conditions. Multinomial regression analyses revealed that age, age of onset, Malay and Indian ethnicities were significant factors. CONCLUSION Physical comorbidity in adults below the age of 65 is common, signifying an emerging need to place greater attention into the screening and emphasis on the physical care needs of this age group. Finally, more research is needed to understand the impact of common co-occurring acute and chronic cardiovascular, skin, and respiratory diseases locally.
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Bhavsar V, Dorrington S, Morgan C, Hatch SL, McGuire P, Fusar-Poli P, Mills J, MacCabe JH, Hotopf M. Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London. Psychol Med 2021; 51:147-157. [PMID: 31713511 PMCID: PMC7116680 DOI: 10.1017/s0033291719003106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Co-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health. METHODS We linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions. RESULTS In all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49-3.27] and 3.46 (95% CI 1.52-7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15-1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22-20.44) among those with PTSD with psychotic experiences. CONCLUSIONS Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.
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Affiliation(s)
- Vishal Bhavsar
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sarah Dorrington
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Stephani L. Hatch
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - John Mills
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - James H. MacCabe
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
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25
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Stickley A, Sumiyoshi T, Narita Z, Oh H, DeVylder JE, Jacob L, Koyanagi A. Physical injury and psychotic experiences in 48 low- and middle-income countries. Psychol Med 2020; 50:2751-2758. [PMID: 31637996 DOI: 10.1017/s0033291719002897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- and middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs. METHOD Cross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002-2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression. RESULTS In fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85-2.31], traffic injury (OR 1.84, 95% CI 1.53-2.21) and other injury (OR 2.09, 95% CI 1.84-2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22-2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle). CONCLUSIONS Different types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.
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Affiliation(s)
- A Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - T Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Z Narita
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - H Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - J E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - L Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux78180, France
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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26
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Francesconi M, Minichino A, Khandaker GM, Midouhas E, Lewis G, Flouri E. Reprint of: Internalising symptoms mediate the longitudinal association between childhood inflammation and psychotic-like experiences in adulthood. Schizophr Res 2020; 226:24-29. [PMID: 33341190 DOI: 10.1016/j.schres.2020.11.009] [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: 12/01/2018] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 10/22/2022]
Abstract
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adolescence. To test this hypothesis, we used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated a subsample of 4525 individuals from this cohort with data on interleukin 6 (IL-6) and C-reactive protein (CRP) in childhood (age 9 years). We measured PLEs at age 18 years, and we used latent growth curve modelling to estimate longitudinal trajectories of internalising and externalising symptoms from ages 9 to 16 years. The individual predicted values of the intercept (set at baseline, 9 years) and the slope (rate of annual change) were then used in the mediation analysis. There was evidence for full mediation by the intercept of internalising symptoms. Our findings suggest that inflammation during childhood may be relevant for the future onset of PLEs via its association with a high level of internalising symptoms. These findings, although obtained from a non-clinical population, provide an additional step in advancing knowledge on the relationship between inflammation and symptoms of the psychosis continuum.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | | | | | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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Šimunović Filipčić I, Ivezić E, Jakšić N, Mayer N, Grah M, Rojnić Kuzman M, Bajić Z, Svab V, Herceg M, Filipčić I. Gender differences in early onset of chronic physical multimorbidities in schizophrenia spectrum disorder: Do women suffer more? Early Interv Psychiatry 2020; 14:418-427. [PMID: 31414567 DOI: 10.1111/eip.12867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/07/2019] [Accepted: 07/14/2019] [Indexed: 12/11/2022]
Abstract
AIM The association between various physical illnesses and schizophrenia spectrum disorder (SSD) is well-established. However, the role of gender remains unclear. The present study explored the gender-based differences in the prevalence and early onset of chronic physical multimorbidities (CPM) in patients with SSD and the general population (GEP). METHODS We recruited 329 SSD patients and 837 GEP controls in this nested cross-sectional study. The primary outcome was the prevalence of the chronic physical multimorbidities, especially in the youngest age group (<35 years). RESULTS Women with SSD had more than double the odds for having CPM than men (OR = 2.47; 95% CI 1.35-4.50), while the gender-related burden of chronic diseases in controls was nearly the same (OR = 0.89; 95% CI 0.65-1.22). Furthermore, the prevalence of chronic disease in younger women patients was significantly higher than in controls (P = .002), while younger men did not seem to experience this increased comorbidity burden. CONCLUSIONS This study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Tailored and individualized treatment plans must consider this, aiming to deliver holistic care and effective treatment outcomes.
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Affiliation(s)
- Ivona Šimunović Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ena Ivezić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Nina Mayer
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Majda Grah
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Martina Rojnić Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zarko Bajić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Vesna Svab
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Miroslav Herceg
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department for psychotic disorders, Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - Igor Filipčić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Stevens M, Ratheesh A, Watson A, Filia K, Donoghue BO, Cotton SM. Rates, types and associations of sexual risk behaviours and sexually transmitted infections in those with severe mental illness: a scoping review. Psychiatry Res 2020; 290:112946. [PMID: 32450411 DOI: 10.1016/j.psychres.2020.112946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022]
Abstract
The aim of this scoping review was to: (i) determine rates and types of sexual risk behaviours and sexually-transmitted infections (STIs) in those with severe mental illness (SMI); and (ii) delineate correlates of poor sexual health outcome. The online databases OVID MedLine and PsycINFO were searched from databases inception to February 2018 for any literature with a focus on sexual risk behaviours (inconsistent condom use, multiple sexual partners, substance use and transactional sexual acts) or STIs in SMI populations. Fourteen studies were identified; the quality of these studies ranged from poor to moderate. Outcome definitions were heterogeneous, precluding meta-analysis. We found rates of sexual risk behaviours and STIs to be more common among those with SMI than the rates in the general Australian population. Current studies do not acknowledge the relationship of sexual risk behaviours and STI risk and hence do not provide a full model of sexual health outcomes in those with SMI. In order to improve sexual health outcomes in SMI populations, further research is required of greater methodological rigor, with consensus in the definition of sexual risk behaviours, clarifying causal relationships and where in the course of SMI that these outcomes emerge.
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Affiliation(s)
- Meg Stevens
- Melbourne Medical School, The University of Melbourne, VIC, Australia
| | - Aswin Ratheesh
- Centre for Youth Mental Health, The University of Melbourne, VIC, Parkville, Australia; Orygen, Parkville, VIC, Australia; Orygen Youth Health, Parkville, VIC
| | - Amity Watson
- Centre for Youth Mental Health, The University of Melbourne, VIC, Parkville, Australia; Orygen, Parkville, VIC, Australia
| | - Kate Filia
- Centre for Youth Mental Health, The University of Melbourne, VIC, Parkville, Australia; Orygen, Parkville, VIC, Australia
| | - Brian O Donoghue
- Centre for Youth Mental Health, The University of Melbourne, VIC, Parkville, Australia; Orygen, Parkville, VIC, Australia; Orygen Youth Health, Parkville, VIC
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, VIC, Parkville, Australia; Orygen, Parkville, VIC, Australia.
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Oh H, Koyanagi A, DeVylder JE, Leiderman EA. Psychotic experiences and psychiatric treatment utilization in Buenos Aires. Int J Soc Psychiatry 2020; 66:344-348. [PMID: 32114863 DOI: 10.1177/0020764020907628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Psychotic experiences are associated with psychiatric treatment utilization, though findings have not been entirely consistent. Furthermore, it is unclear how psychotic experiences relate to specific types of psychiatric treatment, and whether mental illness moderates these associations. METHODS In total, 1,036 adult residents of Buenos Aires were recruited through convenience sampling in public places. Multivariable logistic regression models examined the associations between psychotic experiences and psychiatric treatment, adjusted for age, sex and education. Analyses were then stratified by diagnosis of mental illness. RESULTS Approximately 17.95% (N = 186) of the sample reported at least one psychotic experience over the past week, about 22.39% (N = 232) of the sample was receiving some psychiatric or psychological treatment and 8.59% (N = 89) was receiving psychopharmacological treatment. In the total sample, psychotic experiences were associated with greater odds of being in psychiatric/psychological treatment (adjusted odds ratio (AOR): 1.52; 95% confidence interval (CI): 1.05-2.21) and psychopharmacological treatment (AOR: 2.49; 95% CI: 1.52-4.09), adjusted for age, sex and education. Mental illness did not moderate the association between psychotic experiences and psychiatric/psychological treatment, but did moderate the association between psychotic experiences and psychopharmacological treatment. Among people with mental disorders, psychotic experiences were associated with greater odds of receiving psychopharmacological treatment (AOR: 14.63; 95% CI: 1.73-123.45) versus people without mental disorders (AOR: 1.75; 95% CI: 0.98-3.15). CONCLUSION Psychotic experiences are associated with psychiatric treatment utilization, particularly psychopharmacological treatment among people with a co-occurring mental illnesses. Translational research should explore the utility of psychosis screens in assessing need for medication or clinical responsiveness to medications.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Eduardo A Leiderman
- Centro de Investigación en Neurociencia y Neuropsicología, Facultad de Humanidades y Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina
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Quirk SE, Stuart AL, Brennan-Olsen SL, Pasco JA, Berk M, Chanen AM, Koivumaa-Honkanen H, Kotowicz MA, Lukkala PS, Williams LJ. Physical health comorbidities in women with personality disorder: Data from the Geelong Osteoporosis Study. Eur Psychiatry 2020; 34:29-35. [PMID: 26928343 DOI: 10.1016/j.eurpsy.2015.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 01/31/2023] Open
Abstract
AbstractBackgroundAssociations between common psychiatric disorders, psychotic disorders and physical health comorbidities are frequently investigated. The complex relationship between personality disorders (PDs) and physical health is less understood, and findings to date are varied. This study aims to investigate associations between PDs with a number of prevalent physical health conditions.MethodsThis study examined data collected from women (n = 765; ≥ 25 years) participating in a population-based study located in south-eastern Australia. Lifetime history of psychiatric disorders was assessed using the semi-structured clinical interviews (SCID-I/NP and SCID-II). The presence of physical health conditions (lifetime) were identified via a combination of self-report, medical records, medication use and clinical data. Socioeconomic status, and information regarding medication use, lifestyle behaviors, and sociodemographic information was collected via questionnaires. Logistic regression models were used to investigate associations.ResultsAfter adjustment for sociodemographic variables (age, socioeconomic status) and health-related factors (body mass index, physical activity, smoking, psychotropic medication use), PDs were consistently associated with a range of physical health conditions. Novel associations were observed between Cluster A PDs and gastro-oesophageal reflux disease (GORD); Cluster B PDs with syncope and seizures, as well as arthritis; and Cluster C PDs with GORD and recurrent headaches.ConclusionsPDs were associated with physical comorbidity. The current data contribute to a growing evidence base demonstrating associations between PDs and a number of physical health conditions independent of psychiatric comorbidity, sociodemographic and lifestyle factors. Longitudinal studies are now required to investigate causal pathways, as are studies determining pathological mechanisms.
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31
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Shoham N, Lewis G, Hayes J, McManus S, Kiani R, Brugha T, Bebbington P, Cooper C. Psychotic symptoms and sensory impairment: Findings from the 2014 adult psychiatric morbidity survey. Schizophr Res 2020; 215:357-364. [PMID: 31481335 PMCID: PMC7613093 DOI: 10.1016/j.schres.2019.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/07/2019] [Accepted: 08/26/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Hearing and visual impairment have been associated with psychosis. Mechanisms behind this are poorly understood. We tested whether i) self-reported hearing and visual impairments are associated with psychotic symptoms in the 2014 UK Adult Psychiatric Morbidity Survey; ii) the odds of having psychotic symptoms vary with self-perceived degree of impairments; and iii) reduced social functioning partially explains these associations. METHODS We analysed cross-sectional data using logistic regression. Hearing and visual impairment were the exposures, and screening positive on the Psychosis Screening Questionnaire was the outcome. We used structural equation modelling to assess mediation by social functioning, measured by the Social Functioning Questionnaire. RESULTS Psychotic symptoms were strongly associated with visual impairment (Adjusted Odds Ratio (AOR) 1.81, 95% Confidence Intervals (CI) 1.33 to 2.44), especially moderate visual impairment (AOR 2.75, 95% CI 1.78 to 4.24, p < .001). Psychotic symptoms were associated with a severe degree of hearing impairment (AOR 4.94, 95% CI 1.66 to 14.67, p = .004), and weakly associated with hearing impairment overall (AOR 1.50, 95% CI 1.10 to 2.04, p = .010). Social functioning accounted for approximately 50% of associations with both types of sensory impairment, but the confidence intervals around these estimates were broad. CONCLUSIONS Our findings suggest an association between psychosis and visual impairment, with the strongest evidence for moderate visual impairment; the findings also support a linear relationship between psychosis and degree of hearing impairment. Social functioning may mediate these relationships and be a potential target for intervention, alongside sensory correction. These should be investigated longitudinally.
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Affiliation(s)
- Natalie Shoham
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland.
| | - Gemma Lewis
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Joseph Hayes
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Sally McManus
- NatCen Social Research, 35 Northampton Square, London EC1V 0AX, United Kingdom of Great Britain and Northern Ireland
| | - Reza Kiani
- University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, United Kingdom of Great Britain and Northern Ireland
| | - Traolach Brugha
- University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, United Kingdom of Great Britain and Northern Ireland
| | - Paul Bebbington
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Claudia Cooper
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
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Oh H, Smith L, Koyanagi A. Health Conditions and Psychotic Experiences: Cross-Sectional Findings From the American Life Panel. Front Psychiatry 2020; 11:612084. [PMID: 33519553 PMCID: PMC7839662 DOI: 10.3389/fpsyt.2020.612084] [Citation(s) in RCA: 4] [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: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Background: People with psychotic disorders have poor health, but studies have shown that people who have a milder and more prevalent form of psychosis (psychotic experiences) are also at risk for health problems. More research is needed to examine a broad range of health conditions to discover new relations with psychotic experiences. Methods: We analyzed cross-sectional data from the American Life Panel, a nationally representative sample of the United States adult population. Using multivariable logistic regression, we examined the associations between health conditions (categories of conditions, specific conditions, count of conditions) and lifetime psychotic experiences. Results: Approximately 71% of the weighted sample reported at least one health condition, and around 18% reported a lifetime psychotic experience. Using multivariable logistic regression, we found that several health conditions were associated with psychotic experiences, including pain due to other causes, neck pain, other injury, any gastrointestinal/kidney problem, liver diseases/cirrhosis, any nervous/sensory problem, migraine, nerve problem causing numbness/pain, any other disorder, specifically sleep disorder, chronic fatigue syndrome, and chronic pain. Further, the count of specific health conditions and the count of categories were associated with greater odds of psychotic experiences. Conclusion: We found that numerous health conditions were associated with psychotic experiences.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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Francesconi M, Minichino A, Khandaker GM, Midouhas E, Lewis G, Flouri E. Internalising symptoms mediate the longitudinal association between childhood inflammation and psychotic-like experiences in adulthood. Schizophr Res 2020; 215:424-429. [PMID: 31387824 DOI: 10.1016/j.schres.2019.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 01/18/2023]
Abstract
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adolescence. To test this hypothesis, we used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated a subsample of 4525 individuals from this cohort with data on interleukin 6 (IL-6) and C-reactive protein (CRP) in childhood (age 9 years). We measured PLEs at age 18 years, and we used latent growth curve modelling to estimate longitudinal trajectories of internalising and externalising symptoms from ages 9 to 16 years. The individual predicted values of the intercept (set at baseline, 9 years) and the slope (rate of annual change) were then used in the mediation analysis. There was evidence for full mediation by the intercept of internalising symptoms. Our findings suggest that inflammation during childhood may be relevant for the future onset of PLEs via its association with a high level of internalising symptoms. These findings, although obtained from a non-clinical population, provide an additional step in advancing knowledge on the relationship between inflammation and symptoms of the psychosis continuum.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | | | | | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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Stickley A, Waldman K, Koyanagi A, DeVylder JE, Narita Z, Sumiyoshi T, Jacob L, Oh H. Psychotic experiences and accidents, injuries, and poisonings among adults in the United States. Psychiatry Res 2019; 282:112610. [PMID: 31655406 DOI: 10.1016/j.psychres.2019.112610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 01/25/2023]
Abstract
Psychotic experiences (PEs) have been linked to an increased risk for accidents and injuries. However, this association remains little researched in many countries. To address this research gap, the current study used cross-sectional data from the United States to examine the association between PEs and accidents, injuries, and poisoning in a general population sample. Data were analyzed from 2274 individuals who completed the psychosis screen as part of the National Comorbidity Survey Replication (NCS-R). Information was obtained on PEs (hallucinations and delusions) and the experience of past 12-month accidents, injuries, and poisoning. Logistic regression analysis was used to examine the association while adjusting for demographic variables and common mental disorders (CMDs). In a fully adjusted model past 12-month PEs were associated with almost three times higher odds for reporting accidents, injuries, and poisoning (odds ratio [OR]: 2.97, 95% confidence interval [CI]: 1.13-7.74). The results of this study indicate that PEs are associated with higher odds for accidents and injuries among adults in the United States. Research is now needed to determine the direction of this association and the factors linked to it.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, CA, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Zui Narita
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Hans Oh
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, CA, USA
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Carr DC, Taylor MG, Gee NR, Sachs-Ericsson NJ. Typologies of older adult companion animal owners and non-owners: moving beyond the dichotomy. Aging Ment Health 2019; 23:1452-1466. [PMID: 30380913 DOI: 10.1080/13607863.2018.1503999] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: Research on the influence of companion animals (CA) on the health of older adults has yielded contradictory results. Selection factors, leading to heterogeneity both between and within groups of CA owners and non-owners, likely bias results. We conduct analyses to identify typologies of owners and non-owners. Methods: Using data on older adults (60+) from the 2012 Health and Retirement Study (HRS), and the HRS companion animal module, (owners = 478) and (non-owners = 624), we conducted latent class analyses (LCA). We used key demographic, health, daily engagement, and pet characteristic variables to complete our analyses. Results: Analyses revealed five clusters of CA owners and four clusters of non-owners. Health and CA related characteristics distinguishing clusters suggest important sources of variability and reflect qualitatively different profiles of owners and non-owners. We also found CA owners were more likely than non-owners to be high on neuroticism and to be less extroverted than non-owners-but again there was considerable within group variability. Implications: Factors that select people into pet ownership not only work individually to characterize ownership, they create distinct typologies of CA owners and non-owners that likely contribute to subsequent health outcomes. In order to determine if having a CA is beneficial to health in later life and for whom, future research should consider selection factors like those identified in the typologies. Statistical analyses, such as LCA, that can adequately account for these selection factors is necessary to avoid biases in the interpretation of results.
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Affiliation(s)
- Dawn C Carr
- Department of Sociology, Florida State University , Tallahassee , FL , USA
| | - Miles G Taylor
- Department of Sociology, Florida State University , Tallahassee , FL , USA
| | - Nancy R Gee
- Department of Psychology, State University of New York , Fredonia , NY , USA.,WALTHAM Centre for Pet Nutrition , Leicestershire, UK
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Associations of psychosis-risk symptoms with quality of life and self-rated health in the Community. Eur Psychiatry 2019; 62:116-123. [PMID: 31586798 DOI: 10.1016/j.eurpsy.2019.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/12/2019] [Accepted: 08/26/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Understanding factors related to poor quality of life (QoL) and self-rated health (SRH) in clinical high-risk (CHR) for psychosis is important for both research and clinical applications. We investigated the associations of both constructs with CHR symptoms, axis-I disorders, and sociodemographic variables in a community sample. METHODS In total, 2683 (baseline) and 829 (3-year follow-up) individuals of the Swiss Canton of Bern (age-at-baseline: 16-40 years) were interviewed by telephone regarding CHR symptoms, using the Schizophrenia Proneness Instrument for basic symptoms, the Structured Interview for Psychosis-Risk Syndromes for ultra-high risk (UHR) symptoms, the Mini-International Neuropsychiatric Interview for current axis-I disorders, the Brief Multidimensional Life Satisfaction Scale for QoL, and the 3-level EQ-5D for SRH. RESULTS In cross-sectional structural equation modelling, lower SRH was exclusively significantly associated with higher age, male gender, lower education, and somatoform disorders. Poor QoL was exclusively associated only with eating disorders. In addition, both strongly interrelated constructs were each associated with affective, and anxiety disorders, UHR and, more strongly, basic symptoms. Prospectively, lower SRH was predicted by lower education and anxiety disorders at baseline, while poorer QoL was predicted by affective disorders at baseline. CONCLUSIONS When present, CHR, in particular basic symptoms are already distressful for individuals of the community and associated with poorer subjective QoL and health. Therefore, the symptoms are clinically relevant by themselves, even when criteria for a CHR state are not fulfilled. Yet, unlike affective and anxiety disorders, CHR symptoms seem to have no long-term influence on QoL and SRH.
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Stickley A, Oh H, Sumiyoshi T, Narita Z, DeVylder JE, Jacob L, Waldman K, Koyanagi A. Perceived discrimination and psychotic experiences in the English general population. Eur Psychiatry 2019; 62:50-57. [PMID: 31527013 DOI: 10.1016/j.eurpsy.2019.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/07/2019] [Accepted: 08/26/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population. METHODS Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations. RESULTS In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75-3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40-3.35) for strange experience to 3.36 (95%CI: 1.47-7.76) for auditory hallucination. CONCLUSION Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
| | - Hans Oh
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, CA, USA
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Zui Narita
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, CA, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Jeleč V, Bajić Ž, Šimunović Filipčić I, Portolan Pajić I, Šentija Knežević M, Miloloža I, Radić-Krišto D, Benjak T, Jakšić N, Šagud M, Wang W, Filipčić I. Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population. BMC Psychiatry 2019; 19:203. [PMID: 31253196 PMCID: PMC6599369 DOI: 10.1186/s12888-019-2190-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 06/23/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Utilization of somatic healthcare services is highly predictive of the development of chronic physical illnesses and increased mortality risks. The objective of this study was to assess the differences in healthcare utilization among patients with schizophrenia spectrum disorders (SSD), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and the general population in Croatia. METHODS We enrolled 566 Croatian participants from the general population, 282 with SSD, 178 with MDD, and 86 with PTSD. The primary outcome was a self-reported specialist consultation for non-psychiatric (e.g., somatic) causes within the previous 12 months. RESULTS Although SSD patients with chronic physical illnesses were significantly more often hospitalized for physical illness than the general population, the proportion of patients who had a specialist consultation were equal in SSD and the general population. MDD and PTSD patients had significantly higher adjusted odds for specialist consultation than the general population and SSD patients (MDD compared to SSD: OR = 2.14; 95% CI 1.27-3.59; PTSD compared to SSD: OR = 2.03; 95% CI 1.00-4.10). CONCLUSIONS SSD patients' utilization of somatic healthcare is equal to the general population, despite their increased healthcare needs. However, their utilization is lower than in MDD and PTSD patients and, therefore, probably not adequate. TRIAL REGISTRATION The study protocol was registered at ClinicalTrials.gov ( NCT02773108 ) on May 16, 2016.
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Affiliation(s)
- Vjekoslav Jeleč
- 0000 0004 0631 385Xgrid.412095.bDepartment of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia ,City Office for Health, Zagreb, Croatia
| | - Žarko Bajić
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
| | | | | | | | - Ivan Miloloža
- 0000 0001 1015 399Xgrid.412680.9Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Delfa Radić-Krišto
- 0000 0004 0367 1520grid.411045.5Division of Hematology, Merkur University Hospital, Zagreb, Croatia ,0000 0001 1015 399Xgrid.412680.9Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tomislav Benjak
- 0000 0000 8878 5439grid.413299.4Croatian Institute of Public Health, Zagreb, Croatia
| | - Nenad Jakšić
- 0000 0004 0397 9648grid.412688.1Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marina Šagud
- 0000 0004 0397 9648grid.412688.1Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia ,0000 0001 0657 4636grid.4808.4School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Wei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry, Zhejiang University College of Medicine, Hangzhou, China
| | - Igor Filipčić
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia ,0000 0001 1015 399Xgrid.412680.9Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia ,0000 0001 0657 4636grid.4808.4School of Medicine, University of Zagreb, Zagreb, Croatia
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Oh H, Waldman K, Stickley A, DeVylder JE, Koyanagi A. Psychotic experiences and physical health conditions in the United States. Compr Psychiatry 2019; 90:1-6. [PMID: 30639892 DOI: 10.1016/j.comppsych.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/08/2018] [Accepted: 12/15/2018] [Indexed: 01/23/2023] Open
Abstract
AIMS Psychotic experiences are associated with physical health conditions, though the associations have not always been consistent in the literature. The current study examines the associations between psychotic experiences and several physical health conditions across four racial groups in the United States. METHODS We analyzed data from the Collaborative Psychiatric Epidemiology Surveys to examine the associations between psychotic experiences and physical health conditions across four racial groups (White, Black, Asian, Latino). We used multivariable logistic regression to calculated adjusted odds ratios and 95% Confidence Intervals. RESULTS Psychotic experiences were significantly associated with several physical health conditions depending on the condition and the racial group being examined. Further, the number of physical health conditions was associated with increasingly greater risk for psychotic experiences in a linear fashion. CONCLUSIONS Psychotic experiences may serve as useful markers for physical health conditions and overall physical health status. Future studies should examine the underlying mechanisms between psychotic experiences and health, and explore the clinical utility of psychotic experiences for preventive interventions.
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Affiliation(s)
- H Oh
- University of Southern California, School of Social Work, 669 W. 34th St., University of Southern California, Los Angeles, CA 90089 - 0411, United States of America.
| | - K Waldman
- University of Southern California, School of Social Work, 669 W. 34th St., University of Southern California, Los Angeles, CA 90089 - 0411, United States of America
| | - A Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
| | - J E DeVylder
- Fordham University, Graduate School of Social Service, 113 W 60th Street, New York, NY 10023, United States of America.
| | - A Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
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Oh H, Waldman K, Stubbs B, Koyanagi A. Psychotic experiences in the context of mood and anxiety disorders and their associations with health outcomes among people of color in the United States. J Psychosom Res 2019; 118:27-33. [PMID: 30782351 DOI: 10.1016/j.jpsychores.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Psychotic experiences appear to increase risk for health outcomes above and beyond mood/anxiety disorders. However, existing studies that have found this association were conducted mostly in low- and middle-income countries, calling for more studies to explore the association in other contexts, such as the U.S., where people of color face considerable health disparities. MATERIALS/METHODS Data from the National Latino and Asian American Survey, and the National Survey of American Life were analyzed. After restricting the analytic sample to individuals with at least one mood or anxiety disorder (N = 2929), multivariable logistic regression was used to examine the associations between psychotic experiences and health outcomes, disabilities, and help-seeking behaviors, adjusting for socio-demographic characteristics and psychiatric disorders. RESULTS Among people of color with mood/anxiety disorders, 16.58% (n = 519) of the weighted analytic sample reported psychotic experiences. Psychotic experiences were associated with 1.75 times greater odds (95% CI: 1.24-2.47) for reporting a lifetime health condition, with varying odds depending on the specific conditions (e.g. arthritis, heart disease, ulcers, and asthma), and specific disabilities (e.g. cognition, mobility, social interaction, and time out of role). Psychotic experiences were associated with 1.66 times the odds of seeking any treatment (95% CI: 1.20-2.29), and the perceived need for help among people who did not seek treatment (e.g. feeling the need for treatment, being encouraged to seek treatment by others). CONCLUSIONS Mental health practitioners serving people of color who have mood/anxiety disorders should routinely screen for psychotic experiences, which may suggest health problems and disabilities that warrant integrated healthcare.
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Affiliation(s)
- Hans Oh
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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Chee GL, Wynaden D, Heslop K. The physical health of young people experiencing first-episode psychosis: Mental health consumers' experiences. Int J Ment Health Nurs 2019; 28:330-338. [PMID: 30175885 DOI: 10.1111/inm.12538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
Abstract
Young people experiencing first-episode psychosis taking antipsychotic medications often develop comorbidities such as obesity and cardiometabolic abnormalities at an earlier age than young people in the general population. Therefore, it is important to explore the healthcare needs and experiences of this group of consumers. This paper reports research conducted to obtain an informed understanding of young people's health literacy, physical healthcare needs, and interest and knowledge about their physical health. Grounded theory methodology was used to guide the research. Semistructured interviews were conducted with 24 young consumers aged between 18 and 35 years who were case managed by one metropolitan community mental health service. The results describe the journey of young people from the time of diagnosis, to when they developed an awareness of the need to improve their physical health and the impact of physical health issues on their overall health and well-being. Six categories emerged from the data: (i) initial responses when diagnosed with first-episode psychosis; (ii) focus of care on treating first-episode psychosis; (iii) lack of education on antipsychotic medications; (iv) adverse effects from taking antipsychotic medication; (v) increased awareness of the need for good physical health; and 6) importance of social support in the community. The findings highlight the importance for health professionals improving young people's health literacy and addressing physical health and well-being as part of first-episode psychosis programmes. Young people require improved health education on the importance of maintaining healthy lifestyle in relation to their overall health and well-being.
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Affiliation(s)
- Gin-Liang Chee
- Community Mental Health Nursing, South Metropolitan Health Service, Perth, Western Australia
| | - Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia
| | - Karen Heslop
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia
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Nakanishi M, Tanaka S, Kurokawa G, Ando S, Yamasaki S, Fukuda M, Takahashi K, Kojima T, Nishida A. Inhibited autonomy for promoting physical health: qualitative analysis of narratives from persons living with severe mental illness. BJPsych Open 2019; 5:e10. [PMID: 30762505 PMCID: PMC6343122 DOI: 10.1192/bjo.2018.77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Autonomy is a key factor in the reduction of inequitable physical healthcare among people with severe mental illness compared with the general population.AimsTo clarify the critical mechanism underlying autonomy in physical health promotion based on the perspectives of people with severe mental illness. METHOD We employed a conventional content analysis of narrative data from the Healthy Active Lives in Japan (HeAL Japan) workshop meetings. RESULTS 'Inhibited autonomy' was extracted as a central component and shaped by the users' experiences, both in a healthcare setting and in real life. This component emerged based on the lack of an empowerment mechanism in psychiatric services. CONCLUSIONS A barrier to the encouragement of autonomy in physical health promotion was found in current psychiatric services. An effective strategy should be explored to foster an empowerment mechanism in psychiatric and mental health services.Declaration of interestNone.
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Affiliation(s)
- Miharu Nakanishi
- Chief Researcher, Mental Health and Nursing Research Team,Mental Health Promotion Project,Tokyo Metropolitan Institute of Medical Science,Japan
| | - Shintaro Tanaka
- Research Assistant, Mental Health Promotion Project,Tokyo Metropolitan Institute of Medical Science,Japan
| | | | - Shuntaro Ando
- Lecturer, Department of Neuropsychiatry,Graduate School of Medicine,The University of Tokyo,Japan
| | - Syudo Yamasaki
- Chief Researcher, Mental Health Promotion Project,Tokyo Metropolitan Institute of Medical Science,Japan
| | - Masato Fukuda
- Professor, Department of Psychiatry and Neuroscience,Gunma University Graduate School of Medicine,Japan
| | | | | | - Atsushi Nishida
- Project Leader, Mental Health Promotion Project,Tokyo Metropolitan Institute of Medical Science,Japan
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Psychotic experiences as indicators of risk for cardiovascular disease. Schizophr Res 2018; 202:281-283. [PMID: 29880454 DOI: 10.1016/j.schres.2018.05.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/29/2018] [Indexed: 11/23/2022]
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Scott KM, Saha S, Lim CC, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Benjet C, Bromet EJ, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, de Jonge P, Degenhardt L, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Kovess-Masfety V, Lee S, Lepine JP, Mneimneh Z, Navarro-Mateu F, Piazza M, Posada-Villa J, Sampson NA, Stagnaro JC, Kessler RC, McGrath JJ. Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys. Psychol Med 2018; 48:2730-2739. [PMID: 29478433 PMCID: PMC6109618 DOI: 10.1017/s0033291718000363] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders. METHODS In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments. RESULTS After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1-1.5] to 1.9 (95% CI 1.4-2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2-1.9) to 1.7 (95% CI 1.2-2.4). CONCLUSIONS PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.
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Affiliation(s)
- Kate M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Sukanta Saha
- Queensland Centre for Mental Health Research and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - Carmen C.W. Lim
- Queensland Centre for Mental Health Research and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, NL
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Jean-Pierre Lepine
- Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris; Universités Paris Descartes-Paris Diderot; INSERM UMR-S 1144, Paris, France
| | - Zeina Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - Marina Piazza
- Universidad Cayetano Heredia, Lima, Peru; National Institute of Health, Lima, Peru
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - John J. McGrath
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; and National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
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Salagre E, Arango C, Artigas F, Ayuso-Mateos JL, Bernardo M, Castro-Fornieles J, Bobes J, Desco M, Fañanás L, González-Pinto A, Haro JM, Leza JC, Mckenna PJ, Meana JJ, Menchón JM, Micó JA, Palomo T, Pazos Á, Pérez V, Saiz-Ruiz J, Sanjuán J, Tabarés-Seisdedos R, Crespo-Facorro B, Casas M, Vilella E, Palao D, Olivares JM, Rodriguez-Jimenez R, Vieta E. CIBERSAM: Ten years of collaborative translational research in mental disorders. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 12:1-8. [PMID: 30416047 DOI: 10.1016/j.rpsm.2018.10.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Estela Salagre
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Celso Arango
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Francesc Artigas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Neuroquímica y Neurofarmacología, Institut d'Investigacions Biomèdiques de Barcelona IIBB-CSIC, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, España
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Unidad Esquizofrenia Clínic, Institut Clínic de Neurociencias, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología Infantil y Juvenil, Institut Clínic de Neurociencias, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, España
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Asturias, España
| | - Manuel Desco
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, España
| | - Lourdes Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Secció Zoologia i Antropologia Biològica, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, España
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital Universitario Araba, Instituto de Investigación Sanitaria Bioaraba; Universidad del País Vasco, Vitoria, España
| | - Josep María Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, España
| | - Juan Carlos Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Farmacología, Facultad de Medicina, Universidad Complutense de Madrid, Instituto Universitario de Investigación en Neuroquímica UCM, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, España
| | - Peter J Mckenna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, España
| | - José Javier Meana
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Farmacología, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Barakaldo, Bizkaia, España
| | - José Manuel Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Departamento de Ciencias Clínicas, Universitat de Barcelona, Barcelona, España
| | - Juan Antonio Micó
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Grupo de Investigación en Neuropsicofarmacología y Psicobiología,, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Tomás Palomo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital 12 de Octubre, Madrid, España
| | - Ángel Pazos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Fisiología y Farmacología, Facultad de Medicina, Universidad de Cantabria, Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC-SODERCAN, Santander, Cantabria, España
| | - Víctor Pérez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Universitat Autònoma de Barcelona, Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, España
| | - Jerónimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España
| | - Julio Sanjuán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; INCLIVA, Universidad de Valencia, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Rafael Tabarés-Seisdedos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Medicina, INCLIVA, Universidad de Valencia, Valencia, España
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, España
| | - Miquel Casas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España
| | - Elisabet Vilella
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Tarragona, España
| | - Diego Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servei de Salut Mental, Parc Taulí Hospital Universitari, Institut de Recerca i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - Jose Manuel Olivares
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Unidad de Psiquiatría, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Instituto Biomédico Galicia Sur, Vigo, Pontevedra, España
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, España
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España; Servicio de Psiquiatría y Psicología, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
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Filipčić I, Šimunović Filipčić I, Grošić V, Bakija I, Šago D, Benjak T, Uglešić B, Bajić Ž, Sartorius N. Patterns of chronic physical multimorbidity in psychiatric and general population. J Psychosom Res 2018; 114:72-80. [PMID: 30314582 DOI: 10.1016/j.jpsychores.2018.09.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A growing body of evidence has demonstrated the high prevalence and complexity of chronic physical multimorbidity defined as ≥2 chronic physical illness in people with psychiatric disorders. The present study aimed to assess differences in the prevalence and patterns of self-reported chronic physical illness and multimorbidity in the general and psychiatric populations. METHODS We performed a latent class analysis of 15 self-reported chronic physical illnesses on a sample of 1060 psychiatric patients and 837 participants from the general population. RESULTS Self-reported chronic physical illness and multimorbidity were significantly more prevalent in the population of psychiatric patients than in the general population (P < .001). Psychiatric patients had 27% (CI95% 24% - 30%) higher age-standardized relative risk for chronic physical illness and a 31% (CI95% 28% - 34%) higher for multimorbidity (P < .001). The number of chronic physical illnesses combinations was 52% higher in the psychiatric than in general population (255 vs 161 combinations respectively; P < .001). We identified four distinct latent classes: "Relatively healthy", "Musculoskeletal", "Hypertension and obesity", and "Complex multimorbidity" with no significant differences in the nature of multimorbidity latent classes patterns. The class "Relatively healthy" was significantly less (ARI = -25% (CI95% -30% -21%), and the class "Hypertension and obesity" was significantly more prevalent in the population of psychiatric patients (ARI = 20% (CI95% 17% - 23%). CONCLUSIONS These findings indicate that mental disorders are associated with an increased risk of a wide range of chronic physical illnesses and multimorbidity. There is an urgent need for the development of the guidelines regarding the physical healthcare of all individuals with mental disorders with multimorbidity in focus.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | | | | | - Ivana Bakija
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | | | - Boran Uglešić
- Department of Psychiatry, University Hospital Center Split, Split, Croatia
| | - Žarko Bajić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Koyanagi A, Oh H, Stickley A, Stubbs B, Veronese N, Vancampfort D, Haro JM, DeVylder JE. Sibship size, birth order and psychotic experiences: Evidence from 43 low- and middle-income countries. Schizophr Res 2018; 201:406-412. [PMID: 29929772 DOI: 10.1016/j.schres.2018.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/08/2018] [Accepted: 06/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sibship size and birth order may be contributing factors to the multifactorial etiology of psychosis. Specifically, several studies have shown that sibship size and birth order are associated with schizophrenia. However, there are no studies on their association with psychotic experiences (PE). METHODS Cross-sectional, community-based data from 43 low- and middle-income countries which participated in the World Health Survey were analyzed. The Composite International Diagnostic Interview was used to identify four types of past 12-month PE. The association of sibship size and birth order with PE was assessed with multivariable logistic regression. RESULTS The final sample consisted of 212,920 adults [mean (SD) age 38.1 (16.0) years; 50.7% females]. In the multivariable analysis, compared to individuals with no siblings, the OR increased linearly from 1.26 (95%CI = 1.01-1.56) to 1.72 (95%CI = 1.41-2.09) among those with 1 and ≥ 9 siblings, respectively. Compared to the first-born, middle-born individuals were more likely to have PE when having a very high number of siblings (i.e. ≥9). CONCLUSIONS Future studies should examine the environmental and biological factors underlying the association between sibship size/birth order and PE. Specifically, it may be important to examine the unmeasured factors, such as childhood infections and adversities that may be related to both family structure and PE.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Hans Oh
- University of Southern California, School of Social Work, CA, USA
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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48
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Psychotic experiences and religiosity: Findings from the collaborative psychiatric epidemiological surveys. Schizophr Res 2018; 201:435-436. [PMID: 29880451 DOI: 10.1016/j.schres.2018.05.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/11/2018] [Accepted: 05/25/2018] [Indexed: 11/20/2022]
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Alonso J, Saha S, Lim CCW, Aguilar-Gaxiola S, Al-Hamzawi A, Benjet C, Bromet EJ, Degenhardt L, de Girolamo G, Esan O, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Karam G, Kovess-Masfety V, Lepine JP, Lee S, Mneimneh Z, Navarro-Mateu F, Posada-Villa J, Sampson NA, Scott KM, Stagnaro JC, Ten Have M, Viana MC, Kessler RC, McGrath JJ. The association between psychotic experiences and health-related quality of life: a cross-national analysis based on World Mental Health Surveys. Schizophr Res 2018; 201:46-53. [PMID: 29778294 PMCID: PMC6371397 DOI: 10.1016/j.schres.2018.04.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 02/06/2023]
Abstract
Psychotic experiences (PEs) are associated with a range of mental and physical disorders, and disability, but little is known about the association between PEs and aspects of health-related quality of life (HRQoL). We aimed to investigate the association between PEs and five HRQoL indicators with various adjustments. Using data from the WHO World Mental Health surveys (n = 33,370 adult respondents from 19 countries), we assessed for PEs and five HRQoL indicators (self-rated physical or mental health, perceived level of stigma (embarrassment and discrimination), and social network burden). Logistic regression models that adjusted for socio-demographic characteristics, 21 DSM-IV mental disorders, and 14 general medical conditions were used to investigate the associations between the variables of interest. We also investigated dose-response relationships between PE-related metrics (number of types and frequency of episodes) and the HRQoL indicators. Those with a history of PEs had increased odds of poor perceived mental (OR = 1.5, 95% CI = 1.2-1.9) and physical health (OR = 1.3, 95% CI = 1.0-1.7) after adjustment for the presence of any mental or general medical conditions. Higher levels of perceived stigma and social network burden were also associated with PEs in the adjusted models. Dose-response associations between PE type and frequency metrics and subjective physical and mental health were non-significant, except those with more PE types had increased odds of reporting higher discrimination (OR = 2.2, 95% CI = 1.3-3.5). Our findings provide novel insights into how those with PEs perceive their health status.
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Affiliation(s)
- Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, University of Queensland, St. Lucia, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia
| | - Carmen C W Lim
- Queensland Centre for Mental Health Research, University of Queensland, St. Lucia, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia
| | | | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya Governorate, Iraq
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muniz, Mexico City, Mexico
| | - Evelyn J Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
| | - Oluyomi Esan
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Josep M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris, France
| | - Jean-Pierre Lepine
- Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris; Universités Paris Descartes-Paris Diderot; INSERM UMR-S 1144, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Zeina Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - Jose Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Margreet Ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - John J McGrath
- Queensland Centre for Mental Health Research, University of Queensland, St. Lucia, Queensland, Australia; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark..
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Osborn DP, Petersen I, Beckley N, Walters K, Nazareth I, Hayes J. Weight change over two years in people prescribed olanzapine, quetiapine and risperidone in UK primary care: Cohort study in THIN, a UK primary care database. J Psychopharmacol 2018; 32:1098-1103. [PMID: 29938561 DOI: 10.1177/0269881118780011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Follow-up studies of weight gain related to antipsychotic treatment beyond a year are limited in number. We compared weight change in the three most commonly prescribed antipsychotics in a representative UK General Practice database. METHOD We conducted a cohort study in United Kingdom primary care records of people newly prescribed olanzapine, quetiapine or risperidone. The primary outcome was weight in each six month period for two years after treatment initiation. Weight changes were compared using linear regression, adjusted for age, baseline weight and diagnosis. RESULTS N = 6338 people received olanzapine, 12,984 quetiapine and 6556 risperidone. Baseline weight was lowest for men treated with olanzapine (80.8 kg versus 83.5 kg quetiapine, 82.0 kg risperidone) and women treated with olanzapine (67.7 kg versus 71.5 kg quetiapine 68.4 kg risperidone. Weight gain occurred during treatment with all three drugs. Compared with risperidone mean weight gain was higher with olanzapine (adjusted co-efficient +1.24 kg (95% confidence interval: 0.69-1.79 kg per six months) for men and +0.77 kg (95% confidence interval: 0.29-1.24 kg) for women). Weight gain with quetiapine was lower in unadjusted models compared with risperidone, but this difference was not significant after adjustment. CONCLUSION Olanzapine is more commonly prescribed to people with lower weight. However, after accounting for baseline weight, age, sex and diagnosis, olanzapine is still associated with greater weight gain over two years than risperidone or quetiapine. Baseline weight does not ameliorate the risks of weight gain associated with antipsychotic medication. Weight gain should be assertively discussed and managed for people prescribed antipsychotics, especially olanzapine.
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Affiliation(s)
- David Pj Osborn
- 1 UCL Division of Psychiatry, University College London, UK.,2 Camden and Islington NHS Foundation Trust, London, UK
| | - Irene Petersen
- 3 Department of Primary Care and Population Health, University College London, UK
| | - Nick Beckley
- 3 Department of Primary Care and Population Health, University College London, UK
| | - Kate Walters
- 3 Department of Primary Care and Population Health, University College London, UK
| | - Irwin Nazareth
- 3 Department of Primary Care and Population Health, University College London, UK
| | - Joseph Hayes
- 1 UCL Division of Psychiatry, University College London, UK.,2 Camden and Islington NHS Foundation Trust, London, UK
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