Cluster analysis of psychiatric profile, its correlates, and using mental health services among the young people aged 15-34: findings from the first phase of Iranian youth cohort in Ravansar

Relationship between metabolic syndrome and depression: A study based on Rafsanjan Youth Cohort Study

BACKGROUND

Depressed people are susceptible to metabolic syndrome ression and metabolic syndrome in the Rafsanjan Youth Cohort Study in 2021.

METHODS

In this cross-sectional study, the data of 3005 young people aged 15-35 under the coverage of urban and rural health centers was investigated in the enrollment stage of the Rafsanjan Youth Cohort Study as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Data was collected using face-to-face interview and electronic questionnaires of the Rafsanjan Youth Cohort Study.

RESULTS

Age of the youth was 25.78 ± 6.06 years, 56 % (n = 1682) were female. The prevalence of metabolic syndrome (MetS) was 7.7 % (95 % CI: 6.8 %-8.8 %) and the prevalence of depression was 11.1 % (95 % CI: 10.0 %-12.3 %). Depression did not have a significant impact on the odds ratio of developing MetS in young people (P = 0.604). The odds ratio (OR) of MetS increases by 1.057 times with increasing age (95 % CI for OR: 1.020-1.094). This OR is also 1.715 times higher in married young people than in unmarried Youth (95 % CI for OR: 1.715-2.692) and 0.196 times lower in young people with medium and high MET index than in young people with low MET index (95 % CI for OR: 0.048-0.811).

LIMITATIONS

Inability to determine a causal relationship between MetS and depression.

CONCLUSION

Due to the growing trend of components of MetS among the young population, this issue needs to be addressed in future policies and planning for prevention and control as a health priority.

The sensitivity of the ICD-11 trait model to the symptoms of clinical disorders in young adults

Hierarchical psychopathology contributes to providing a broader picture of the links between emerging personality structures such as the DSM-5/ICD-11 trait models and clinical disorders. The present study aimed to predict the specific and general clinical symptoms by the less studied constructs of the ICD-11 model (negative affectivity, detachment, dissociality, disinhibition, and anankastia). Data from 642 young adults from Iran (63% female, 18-34 years) were collected by three mental symptom scales and the Personality Inventory for DSM-5 (PID-5), which was recently used to harmonize the constructs of the DSM-5 and ICD-11 trait models. Multiple linear regressions showed that the ICD-11 model significantly predicted both the specific clinical symptoms (ranging from R2 = 0.15 to 0.40) and the general factor of clinical symptoms extracted by exploratory factor analysis (R2 = 0.40, all p < 0.001). Negative affectivity was the strongest construct correlated with both the specific symptoms (ranging from β = 0.36 to 0.69) and the general symptom factor (β = 0.59, all p < 0.001). Because the ICD-11 trait model is a practical structure related to the clinical psychopathology in young adults, screening for maladaptive traits can help clinicians in case formulation for diagnosis and treatment.

Preexisting depression and COVID-19: a cohort study on the risk of susceptibility and hospitalization

BACKGROUND

Depression can have negative effects on a person's physical health. However, the available evidence on the risk of susceptibility to COVID-19 and its adverse outcomes in people with mental disorders, including depression, is limited and inconsistent. Therefore, we investigated the relationship between major depressive disorder (MDD) and the risk of susceptibility to COVID-19 infection and hospitalization. The data used in the study were obtained from the Employees' Health Cohort Study of Iran (EHCSIR).

METHODS

We conducted a cohort study that included 3355 participants who had complete data on major depressive disorder at baseline assessment and two annual telephone follow-ups between January 2020 and March 2022. Trained psychologists used the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) to identify major depressive disorders during the baseline assessment. We applied log binomial regression models to adjust for sociodemographic factors and background health conditions.

RESULTS

We found that 11.4% of participants had lifetime MDD and 7.3% had MDD in the past 12 months. During the pandemic, 26.1% of participants were infected with COVID-19, and 14.4% of those who were infected were hospitalized. The risk of susceptibility to COVID-19 infection was significantly higher among participants with lifetime MDD than among those without MDD (adjusted risk ratio (ARR) = 1.24, 95% CI: 1.06-1.47). However, lifetime MDD or 12-month MDD was not independently associated with hospitalization among COVID-19 cases.

CONCLUSIONS

Preexisting major depressive disorder may increase the risk of susceptibility to COVID-19.

Co-occurrence of Aggression and Suicide Attempt Among Young People and Related Factors: Findings from Iranian Youth Cohort Study in Ravansar

BACKGROUND

Aggression and suicide attempt are behaviors that affect public health. To better understand the nature of these behaviors, the present study was conducted to investigate the concurrence of suicide attempt and aggression in young people. This study sought to identify those factors which contribute to the co-occurrence of suicide attempt and aggression in young people.

METHODS

The present study was part of the recruitment phase of Ravansar youth cohort study (a branch of the PERSIAN Cohort) with a sample of 2991 people from Ravansar in western Iran. Registration and data collection were done between October 2014 and January 2017. Data were collected using structured interviews and standard questionnaires, and analyzed using multi-nominal logistic regression analysis.

RESULTS

The results showed that the variables of age and education were significant correlates of concurrence of suicide attempt and aggression. Also, among the mental disorders, only major depressive disorder (MDD) (OR=8.34, P=0.001) predicted the concurrence of suicide attempt and aggression in the past 12 month. In contrast, the variables of generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), dysthymia, and substance use disorder were not significant in predicting the concurrence of attempted suicide and aggression.

CONCLUSION

The occurrence of aggression and suicide in young people is a complex phenomenon, and more research should be done to better understand this phenomenon.

Physical Activity Patterns, Circadian Rhythms, and Aggressive and Suicidal Behavior among a Larger Sample of the General Population Aged 15 to 34 Years

BACKGROUND

From a psychological perspective, aggressive behavior, non-suicidal self-injury and suicidal behavior could be considered dysfunctional coping strategies. Poor sleep patterns may further increase such dysfunctional coping. In contrast, regular physical activity may have the power to counteract such dysfunctional coping. Given this background, the aim of the present study was to combine categories of circadian rhythms as a proxy of normative sleep patterns and categories of physical activity patterns, and to associate these categories with aggressive behavior, non-suicidal self-injury and suicidal behavior among a larger sample of adolescents and young adults, aged 15 to 34 years.

METHOD

A total of 2991 (55.6% females) individuals aged 15 to 34 years of the so-called Ravansar non-communicable disease cohort study (RaNCD) took part in this study. Participants completed self-rating questionnaires covering circadian-related sleep patterns, regular physical activity, socio-demographic information and dimensions of aggression, non-suicidal self-injury and suicidal behavior.

RESULTS

In a first step, both sleep patterns (circadian rhythm disorder: yes vs. no) and physical activity patterns (high vs. low) were dichotomized. Next, participants were assigned to one of four prototypical clusters: No circadian sleep disorders and high physical activity ("Hi-Sleep-Hi-PA"); no circadian sleep disorders and low physical activity ("Hi-Sleep-Lo-PA"); circadian sleep disorders and high physical activity ("Lo-Sleep-Hi-PA"); circadian sleep disorders and low physical activity ("Lo-Sleep-Lo-PA"). Projecting these four clusters on dimensions of aggressive behavior, non-suicidal self-injury and suicidal behavior, the following findings were observed: Participants of the "Hi-Sleep-Hi-PA" reported the lowest scores for aggressive behavior, self-injury and suicidal behavior, compared to participants of the "Lo-Sleep-Lo-PA" cluster. No differences for aggressive behavior, self-injury and suicidal behavior were observed among participants of the "Hi-Sleep-Lo-PA" and the "Lo-Sleep-Hi-PA" clusters.

CONCLUSIONS

It appeared that the combination of favorable circadian sleep patterns and high physical activity patterns was associated with lower aggressive behavior, lower self-injury and suicidal behavior as proxies of favorable psychological functioning. In contrast, persons reporting high circadian sleep disorders and low physical activity patterns appeared to demand particular attention and counseling for both their lifestyle issues (sleep and physical activity) and their dysfunctional coping strategies.

Access to Care for Mental Health Problems in Afghanistan: A National Challenge

BACKGROUND

This paper describes the access to care for mental health problems in Afghanistan, according to the nature of the mental health problems and the service provider. Following the Andersen model, it evaluates the respective roles in access to care of "predisposing," "needs," "enabling" factors, and other "environmental" factors such as exposure to traumatic events and level of danger of the place of residence.

METHODS

Trans-sectional probability survey in general population by multistage sampling in 16 provinces, nationally representative: N=4445 (15 years or older), participation rate of 81%. Face to face interviews using standardized measures of mental health (CIDI, Composite International Diagnostic Interview). Different logistic regression models are presented.

RESULTS

The 12-month rate of mental health help-seeking was 6.56% with substantial regional variation (2.35% to 12.65%). Providers were mainly from the health sector; the non-health sector (religious and healers) was also prevalent. Most consultations were held in private clinics (non-governmental organisation, NGO). The severity of mental health disorders as well as the perceived impairment due to mental health were independently very important: odds ratio (OR) = 6.04 for severe disorder, OR=3.79 for perceived impairment. Living in a dangerous area decreased access to care: for high level of danger and for very high level: OR=0.22. Gender, education and ethnicity were not associated with mental health help-seeking after controlling for exposure to trauma.

CONCLUSION

Access to care for mental health problems depended mainly on the needs as defined as disorder severity level and impairment, and on environmental factors such as exposure to traumatic events. The system seems equitable; however, this is counterbalanced by a very challenging environment. This survey is a testimony to the hardship experienced by the Afghan population and by health professionals, and to the efforts to deliver organized mental healthcare in a challenging situation. This research may inform and support policy-makers and NGOs in other countries undergoing similar challenges.

Cluster analysis of risky behaviors among the youth in Western Iran: Determining correlates and comparing clusters based on severity of disability and attitude toward mental health help-seeking

BACKGROUND AND AIMS

The objectives of the study were (i) cluster analysis of risky behaviors; (ii) determining correlates; and (iii) comparing clusters with regard to the attitude toward mental health help seeking.

METHODS

The current cross-sectional study is a part of the first phase of the Persian Youth Cohort. From October 2014 to January 2017, 2990 individuals from Ravansar City in western Iran completed structured interviews and national and international standard questionnaires. The obtained data were analyzed using two-stage cluster analysis, multinomial logistic regression analysis, and Chi-square test.

RESULTS

This model provided three distinct clusters: (i) low-risk group with mild distress, (ii) high-risk group with high distress, and (iii) violent group with medium distress. Some sociodemographic and lifetime psychiatric disorders were the correlates of unhealthy clusters (P < 0.05). Compared to the reference cluster, a higher number of members in unhealthy clusters were suffering from medium to severe disability. Nevertheless, the participants in these clusters were less inclined to mental health help seeking.

CONCLUSIONS

More than half of the youth were suffering from suicidal and violent behaviors. Since high-risk participants are less inclined to mental health help seeking, the health policymakers can successfully utilize the results in planning general health programs.

The Prevalence of Depression and Anxiety and Their Lifestyle Determinants in a Large Sample of Iranian Adults: Results from a Population Based Cross-Sectional Study

Association of lifestyle-related factors and mental health has been less studied in Middle Eastern countries. This study aimed to examine the prevalence of two common mental health problems, i.e., depression and anxiety, and their lifestyle determinants in a large sample of Iranian population.

This study was conducted within the framework of SEPAHAN population based cross-sectional study (N=4763(. The General Practice Physical Activity Questionnaire (GPPAQ) was used to assess physical activity and the Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. Logistic regression was used as the main statistical method for data analysis by SPSS version 16.0. A P-value <0.05 was considered to be statistically significant.

The risk of anxiety and depression was 2.5 (OR=2.56,95% CI: 1.97-3.33) and 2.21(1.83-2.67) times higher in women than men, respectively. With every one-year increase in the age, the risk of anxiety decreased by 2% (OR=0.98,95% CI:0.97-0.99). Individuals with higher education had 56% lower risk of anxiety (OR=0.44,95% CI: 0.36-0.55) and 46% depression (OR=0.54,95% CI: 0.46-0.64) than the undergraduate group, and the risk of depression in the inactive (less than one hour of activity per week) group was 27% higher than the active group (OR=1.27,95% CI: 1.06-1.51). The risk of anxiety in the non-smoker group was 65% (OR=0.35,95% CI: 0.20-0.59) and depression was 64% lower than among smokers (OR=0.34,95% CI:0.22-0.53). In the ex-smoker group, the risk of anxiety was 60% (OR=0.40,95% CI:0.19-0.85) and depression was 59% lower than for the smoker group (OR=0.41,95% CI: 0.24-0.73).

This current study’s results demonstrated significant associations between unhealthy lifestyle factors and increased risk of anxiety and depression. Hence, special attention must be paid to preventive intervention programmes aiming to enhance healthy lifestyle among at-risk populations.