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Iacono A, Oremus M, Maxwell CJ, Tyas SL. Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:661-681. [PMID: 37350151 DOI: 10.1080/13825585.2023.2226855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [PM] = 8.0%) or clinical depression (PM = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.
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Affiliation(s)
- Anita Iacono
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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2
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Liu T, Wang YH, Ng ZLY, Zhang W, Wong SMY, Wong GHY, Lum TYS. Comparison of networks of loneliness, depressive symptoms, and anxiety symptoms in at-risk community-dwelling older adults before and during COVID-19. Sci Rep 2024; 14:14737. [PMID: 38926445 PMCID: PMC11208589 DOI: 10.1038/s41598-024-65533-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/20/2024] [Indexed: 06/28/2024] Open
Abstract
Network analysis provides an innovative approach to examining symptom-to-symptom interactions in mental health, and adverse external conditions may change the network structures. This study compared the networks of common risk factors and mental health problems (loneliness, depressive symptoms, and anxiety symptoms) in community-dwelling older people before and during COVID-19. Older adults (aged ≥ 60) at risk for depression were recruited through non-governmental organizations. Loneliness, depressive symptoms and anxiety symptoms were measured using the three-item Loneliness Scale (UCLA-3), nine-item Patient Health Questionnaire (PHQ-9), and seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Data from 2549 (before) and 3506 (during COVID-19) respondents were included using propensity score matching. Being restless (GAD-7-item5) was most central, indicated by Expected Influence, in both pre and during COVID-19 networks despite low severity (mean score). The network during COVID-19 had higher global strength and edge variability than the pre-pandemic network, suggesting easier symptom spread and potentially more complex symptom presentation. In addition, feeling isolated from others (UCLA-3-item3) had stronger connections with feeling worthless/guilty (PHQ-9-item6) and anticipatory anxiety (GAD-7-item7) during COVID-19 than before. These findings may enhance our knowledge of the symptom structure of common mental health problems and the impacts of the pandemic. Targeting central symptoms may offer novel preventive strategies for older people.
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Affiliation(s)
- Tianyin Liu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Yun-Han Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Zuna Loong Yee Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Stephanie Ming Yin Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Yat-Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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Wang C, Qiu X, Yang X, Mao J, Li Q. Factors Influencing Social Isolation among Cancer Patients: A Systematic Review. Healthcare (Basel) 2024; 12:1042. [PMID: 38786452 PMCID: PMC11120751 DOI: 10.3390/healthcare12101042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Social isolation, which has numerous adverse effects on health status, is prevalent among cancer patients. This review proposes to identify the influencing factors of social isolation among cancer patients. (2) Methods: Articles published in English or Chinese from six electronic databases before December 2023 were identified via a systematic search. A manual search was also performed. (3) Results: Twenty-eight studies were identified in this systematic review. The factors associated with social isolation can be summarized into the following categories: demographic characteristics, having cancer, health status, coping, social support and social interaction. Despite the heterogeneity, 20 factors were significantly associated with social isolation, including age, gender, comorbidity burden, education level, residence, medical insurance, occupation status, personality, race, smoking status, having children, not living alone, household income level, marital status, the role of primary caregiver, physical health status, mental health status, social health status, coping styles, and the level of social support and social interaction. (4) Conclusions: The systematic review showed that cancer patients' social isolation was influenced by their demographic characteristics, cancer-related factors, physical condition, psychological status, social health status, coping styles, and level of social support and social interaction. In addition, future group intervention could be considered to improve social isolation.
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Affiliation(s)
| | | | | | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (C.W.); (X.Q.); (X.Y.); (J.M.)
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4
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Ng IKS. The 'loneliness' epidemic: a new social determinant of health? Intern Med J 2024; 54:365-367. [PMID: 38385582 DOI: 10.1111/imj.16356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Affiliation(s)
- Isaac K S Ng
- Department of Medicine, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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5
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Coronado-Montoya S, Abdel-Baki A, Côté J, Crockford D, Dubreucq S, Fischer B, Lachance-Touchette P, Lecomte T, L'Heureux S, Ouellet-Plamondon C, Roy MA, Tatar O, Tibbo P, Villeneuve M, Wittevrongel A, Jutras-Aswad D. Evaluation of a Cannabis Harm Reduction Intervention for People With First-Episode Psychosis: Protocol for a Pilot Multicentric Randomized Trial. JMIR Res Protoc 2023; 12:e53094. [PMID: 38109196 PMCID: PMC10758938 DOI: 10.2196/53094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Cannabis use is highly prevalent in young people with first-episode psychosis (FEP). Most report cannabis use and are often diagnosed with a cannabis use disorder upon admission to specialized services for psychosis. Cannabis use in this population is associated with worse clinical and psychosocial outcomes, rendering it an important clinical target. Despite this, few cannabis-specific interventions have been developed for FEP and empirically evaluated through randomized controlled trials. Most evaluated interventions have targeted cannabis abstinence, with limited efficacy, but none have centered on harm reduction outcomes for people with FEP who use cannabis. Early intervention services (EIS), the standard of care for FEP, have not successfully addressed problematic cannabis use in people with FEP either. Clinical trials are needed to explore the potential of harm reduction strategies, although these should be preceded by robust pilot studies to establish optimal design and approaches. OBJECTIVE Recognizing the need for harm reduction strategies for individuals with FEP who use cannabis and based on research on patients' preferences supporting harm reduction interventions, we developed a mobile app-based cannabis harm reduction intervention for this population. This intervention is called Cannabis Harm-reducing Application to Manage Practices Safely (CHAMPS). Here, we describe the protocol for a multicenter, 2-arm, parallel group, randomized pilot trial evaluating the acceptability of CHAMPS for people with FEP who use cannabis and the feasibility of conducting a full-scale trial in this population using CHAMPS. The impact on key clinical outcomes will also be explored. METHODS This pilot trial aims to recruit 100 young people with FEP using cannabis from 6 Canadian EIS clinics. Participants will be randomized in a 1:1 ratio to CHAMPS+EIS or EIS-only. CHAMPS acceptability will be assessed using completion rates for the intervention arm. Trial feasibility will be assessed using a retention rate for randomized participants. Secondary outcomes will explore tendencies of change in the use of protective behavioral strategies and in motivation to change strategies. Exploratory outcomes include cannabis use-related problems, other substance use, the severity of dependence, psychotic symptoms, and health care service use. RESULTS Recruitment began in December 2021. Data collection and analysis are expected to be completed in early 2024. Study results describing CHAMPS acceptability and trial feasibility will then be submitted for publication in a peer-reviewed journal. CONCLUSIONS CHAMPS uniquely combines evidence-based approaches, patient perspectives, and mobile health technology to support harm reduction in people with FEP who use cannabis. Attaining adequate acceptability and feasibility through this trial may justify further exploration of harm reduction tools, particularly within the context of conducting a larger-scale randomized controlled trial. This pilot trial has the potential to advance knowledge for researchers and clinicians regarding a feasible and user-acceptable research design in the cannabis and early psychosis fields. TRIAL REGISTRATION ClinicalTrials.gov NCT04968275, https://clinicaltrials.gov/ct2/show/NCT04968275. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53094.
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Affiliation(s)
- Stephanie Coronado-Montoya
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - José Côté
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - David Crockford
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Simon Dubreucq
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Benedikt Fischer
- Centre for Applied Research in Addiction and Mental Health, Simon Fraser University, Vancouver, BC, Canada
- Research & Graduate Studies Division, University of the Fraser Valley, Abbotsford, BC, Canada
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- School of Population Health, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Tania Lecomte
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Sophie L'Heureux
- Clinique Notre-Dame des Victoires, Institut Universitaire en Santé Mentale, Centre Intégré Universitaire de Soins et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
- Department of Psychiatry and Neurosciences, Laval University, Québec, QC, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Laval University, Québec, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada
- Centre de Recherche CERVO, Québec, QC, Canada
| | - Ovidiu Tatar
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Phillip Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marie Villeneuve
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | - Anne Wittevrongel
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- University Institute on Addictions, Montreal, QC, Canada
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6
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Hirota M, Chiba R, Aoyama S, Hirano Y, Ichikawa K, Greiner C, Fujimoto H, Yotsumoto K, Hashimoto T. Individual Nurse-Led Active Listening Intervention for Spouses of Individuals With Depression: A Pre-/Posttest Pilot Study. J Psychosoc Nurs Ment Health Serv 2023; 61:19-25. [PMID: 37256746 DOI: 10.3928/02793695-20230524-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The current pre-/posttest pilot study investigated the impact of an individual nurse-led active listening intervention for spouses of individuals with depression (herein referred to as patients) on spouses' psychological states and patients' depressive symptoms. Sixteen couples participated in the study. Individual sessions were conducted over 10 weeks to help spouses express their thoughts and feelings. Psychological measurement scale scores did not change markedly postintervention for spouses; however, their subjective evaluations of the intervention were positive. In the qualitative analysis, spouses stated that they were able to express their thoughts and feelings and that the sessions were meaningful. Moreover, postintervention depressive scores of patients improved significantly. Findings suggest that the nurse-led intervention of active listening for spouses may provide a better environment for improving the depressive symptoms of patients. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 19-25.].
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7
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Lee S, Moon H, Ko J, Cankaya B, Caine E, You S. Social connectedness and mental health before and during the COVID-19 pandemic in a community sample in Korea. PLoS One 2023; 18:e0292219. [PMID: 37856559 PMCID: PMC10586704 DOI: 10.1371/journal.pone.0292219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
This study compared social connectedness patterns and examined the relationships between objective or subjective social connectedness and mental health before and during the COVID-19 pandemic among community dwelling adults in South Korea. An identical online survey was administered at two time points, in 2019 prior to the onset and again in 2021. Objective (network diversity and network size) and subjective (thwarted belongingness and perceived burdensomeness) social connectedness were measured along with positive and negative indices of mental health (depression, suicidal behavior, happiness, and life satisfaction). The results indicated that among social connectedness indices perceived burdensomeness were significantly higher during the COVID-19 pandemic compared to the prior period, while network size was smaller. Subjective social connectedness was associated with all aspects of mental health consequences, either positive or negative. Among objective social connectedness, only network diversity was significantly associated with increased happiness and life satisfaction, and objective social connectedness was not associated with depression and suicidal behavior. These associations did not differ across the two time periods. The findings, both before and during the pandemic, indicated that network diversity is an important factor for positive indices of mental health and that efforts to increase subjective social connectedness are needed to decrease the risk of depression and suicidal behavior.
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Affiliation(s)
- Sojung Lee
- Department of Psychology, Chungbuk National University, Cheongju, South Korea
| | - Hyejoo Moon
- Department of Psychology, Chungbuk National University, Cheongju, South Korea
| | - Jisu Ko
- Department of Psychology, Chungbuk National University, Cheongju, South Korea
| | - Banu Cankaya
- Department of Psychology, MEF University, Istanbul, Turkey
| | - Eric Caine
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Cheongju, South Korea
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8
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Stefanidou T, Ambler G, Bartl G, Barber N, Billings J, Bogatsu T, Carroll R, Chipp B, Conneely M, Downey AM, Evlat G, Hunter R, Le Novere M, Lewis G, Mackay T, Marwaha S, Matin Z, Naughton G, Nekitsing C, O'Sullivan M, Pinfold V, Pan S, Sobers A, Thompson KJ, Vasikaran J, Webber M, Johnson S, Lloyd-Evans B. Randomised controlled trial of the Community Navigator programme to reduce loneliness and depression for adults with treatment-resistant depression in secondary community mental health services: trial protocol. Trials 2023; 24:652. [PMID: 37803385 PMCID: PMC10559405 DOI: 10.1186/s13063-023-07684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND New treatments are needed for people with treatment-resistant depression (TRD), who do not benefit from anti-depressants and many of whom do not recover fully with psychological treatments. The Community Navigator programme was co-produced with service users and practitioners. It is a novel social intervention which aims to reduce loneliness and thus improve health outcomes for people with TRD. Participants receive up to 10 individual meetings with a Community Navigator, who helps them to map their social world and set and enact goals to enhance their social connections and reduce loneliness. Participants may also access group meet-ups with others in the programme every 2 months, and may be offered modest financial support to enable activities to support social connections. METHODS A researcher-blind, multi-site, 1:1 randomised controlled trial with N = 306 participants will test the effectiveness of the Community Navigator programme for people with TRD in secondary community mental health teams (CMHTs). Our primary hypothesis is that people who are offered the Community Navigator programme as an addition to usual CMHT care will be less depressed, assessed using the PHQ-9 self-report measure, at 8-month, end-of-treatment follow-up, compared to a control group receiving usual CMHT care and a booklet with information about local social groups and activities. We will follow participants up at end-of-treatment and at 14 months, 6 months after end-of-treatment follow-up. Secondary outcomes include the following: loneliness, anxiety, personal recovery, self-efficacy, social network, social identities. We will collect data about health-related quality of life and service use to investigate the cost-effectiveness of the Community Navigator programme. DISCUSSION This trial will provide definitive evidence about the effectiveness and cost-effectiveness of the Community Navigator programme and whether it can be recommended for use in practice. The trial is due to finish in August 2025. TRIAL REGISTRATION Prospectively registered on 8th July 2022 at: ISRCTN13205972.
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Affiliation(s)
- Theodora Stefanidou
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Gareth Ambler
- Department of Statistical Sciences, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| | - Gergely Bartl
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Nick Barber
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- The McPin Foundation, London, UK
| | - Jo Billings
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Tumelo Bogatsu
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | | | - Beverley Chipp
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- The McPin Foundation, London, UK
| | - Maev Conneely
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | | | - Gamze Evlat
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Rachael Hunter
- Priment Clinical Trials Unit, University College London, London, UK
- Department of Primary Care and Population Health, University College London, London, UK
| | - Marie Le Novere
- Priment Clinical Trials Unit, University College London, London, UK
- Department of Primary Care and Population Health, University College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Priment Clinical Trials Unit, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | | | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Zubair Matin
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | | | | | - Millie O'Sullivan
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | | | - Shengning Pan
- Department of Statistical Sciences, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| | - Angela Sobers
- Barnet, Enfield and Haringey, NHS Mental Health Trust, London, UK
| | - Keith J Thompson
- The McPin Foundation, London, UK
- Tees, Esk and Wear Valley, NHS Foundation Trust, Durham, UK
| | - Jerusaa Vasikaran
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Martin Webber
- School for Business and Society, University of York, York, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
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9
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Valeri L, Rahimi-Eichi H, Liebenthal E, Rauch SL, Schutt RK, Öngür D, Dixon LB, Onnela JP, Baker JT. Intensive longitudinal assessment of mobility, social activity and loneliness in individuals with severe mental illness during COVID-19. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:62. [PMID: 37730830 PMCID: PMC10511540 DOI: 10.1038/s41537-023-00383-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/20/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Linda Valeri
- Department of Biostatistics, Columbia University, New York, NY, USA.
| | | | - Einat Liebenthal
- Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Scott L Rauch
- Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Russell K Schutt
- University Of Massachusetts, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dost Öngür
- Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Lisa B Dixon
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Justin T Baker
- Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
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10
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Cleary M, West S, Kornhaber R, Hungerford C. Autism, Discrimination and Masking: Disrupting a Recipe for Trauma. Issues Ment Health Nurs 2023; 44:799-808. [PMID: 37616302 DOI: 10.1080/01612840.2023.2239916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Outcomes of discrimination for autistic people include masking, social isolation and exclusion, trauma, and mental health problems. This discursive paper discusses the discrimination experienced by autistic people in health, education, employment, and media settings; and considers how to reduce the impact of discrimination. Addressing the impact of discrimination requires an improved understanding of the lived experience of the autistic person, the embedding of inclusive practices in communities, developing the person's life skills and supports, and enabling the person to work through their psychological trauma. Further research can aid in minimizing and preventing discrimination against people with autism.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Rachel Kornhaber
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
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11
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Swinkels LTA, Hoeve M, Ter Harmsel JF, Schoonmade LJ, Dekker JJM, Popma A, van der Pol TM. The effectiveness of social network interventions for psychiatric patients: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102321. [PMID: 37499318 DOI: 10.1016/j.cpr.2023.102321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen's d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care. PROSPERO ID: CRD42019131959.
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Affiliation(s)
- L T A Swinkels
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - M Hoeve
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, Netherlands
| | - J F Ter Harmsel
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - J J M Dekker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - T M van der Pol
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
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12
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Fallavollita WL, Lyons MD. Social acceptance from peers and youth mentoring: Implications for addressing loneliness and social isolation. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2065-2082. [PMID: 36696683 DOI: 10.1002/jcop.23002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/21/2022] [Accepted: 01/14/2023] [Indexed: 06/14/2023]
Abstract
Youth mentoring may be able to support lonely and socially isolated youth. This study examined the association between participating in youth mentoring programs and mentee perception of social acceptance from peers. Regression models considered the association between mentoring and peer social acceptance in terms of demographics, program features, and baseline peer relationship quality for 693 youth from 27 mentoring programs. The construct validity of a social acceptance scale was explored. The scale suggested two factors of peer social acceptance. No significant changes in peer social acceptance were observed before and after participating in mentoring programs. Trends in social acceptance indicated that positive/negative feelings in the mentor-mentee relationship were associated with positive/negative indicators of peer social acceptance. Mentoring programs may be able to help prevent loneliness and social isolation through positive aspects of the mentor-mentee relationships, but additional intervention activities are likely necessary to support lonely and socially isolated youth.
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Affiliation(s)
| | - Michael D Lyons
- School of Education and Human Development, University of Virginia, Virginia, USA
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13
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Zainal NH, Newman MG. A cross-lagged prospective network analysis of depression and anxiety and cognitive functioning components in midlife community adult women. Psychol Med 2023; 53:4160-4171. [PMID: 35534458 PMCID: PMC9646930 DOI: 10.1017/s0033291722000848] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Scar theory proposes that heightened depression and anxiety precede and predict worse cognitive functioning outcomes, whereas the vulnerability theory posits the opposite pathway. However, most investigations on this topic have been cross-sectional, precluding causal inferences. Thus, we used cross-lagged prospective network analyses to facilitate causal inferences in understanding the relations between psychopathology and cognitive functioning components. METHODS Racially-diverse midlife women (n = 1816) participated in the Study of Women's Health Across the Nation at two time-points, spanning one year apart. Five psychopathology (anxiety severity, depressed mood, somatic symptoms, positive affect, interpersonal problems) and four cognitive functioning nodes (working memory (WM), processing speed (PS), facial recognition (FCR), and verbal memory (VRM)) were assessed. All analyses adjusted for age, menopausal status, estradiol, and follicle-stimulating hormones. RESULTS Contemporaneous networks yielded notable inverse between-node relations (edges) between interpersonal problems and reduced FCR and PS, and between depressed mood and lower FCR, VRM, or PS. Nodes that had the highest likelihood to bridge other constructs were positive affect, anxiety severity, WM, and VRM. Temporal networks produced edges consistent with the scar (v. vulnerability) hypotheses. Higher somatic symptoms were related to reduced PS and WM, and greater depressed mood was correlated with lower future PS and WM. Also, higher anxiety severity coincided with decreased future PS and WM. Greater positive affect was associated with stronger future PS, FCR, and WM. Also, positive affect had the strongest relations with other nodes. CONCLUSIONS Findings suggest the importance of targeting symptoms and cognitive functioning simultaneously.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States
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14
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Schmidt P. On Experiential Loneliness. TOPOI : AN INTERNATIONAL REVIEW OF PHILOSOPHY 2023:1-16. [PMID: 37361722 PMCID: PMC10262127 DOI: 10.1007/s11245-023-09936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/28/2023]
Abstract
Presumably, everyone has, at some point in their lives, felt lonely. Loneliness is, in that particular sense, omnipresent. What it feels like to be lonely can, however, vary significantly. Loneliness is far from being a homogeneous phenomenon. Different kinds of loneliness need to be distinguished, considering its causes, contexts, a person's capacities to cope with it, and many other factors. This paper introduces the notion of a specific kind of loneliness: experiential loneliness. Experiential loneliness, it will be argued, consists in particular ways of experiencing the world, oneself, and others. Although feelings of being lonely in one way or another can emanate from one's experience of the world being structured in a particular manner, such kinds of loneliness need not-at least, not always and the whole time-lead to emotional feelings that are concerned with one's loneliness or the lack of meaningful social relationship. Loneliness can give rise to quite different emotional feelings that sometimes even cover up their provenience from underlying experiential loneliness. The notion of experiential loneliness, it is suggested, helps to tie back certain styles of thinking, desires, feelings, and behaviors to contexts of loneliness. Moreover, it will be argued that the notion can also elucidate the development of feelings of being lonely in contexts in which others are not only around but also available. To develop and enrich the notion of experiential loneliness as well as to exemplify its usefulness, a closer look will be taken at the case of borderline personality disorder, a condition in which sufferers are often plagued by loneliness.
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Affiliation(s)
- Philipp Schmidt
- Institut für Philosophie, Julius-Maximilians-Universität Würzburg, Ehrenhof Südflügel, Residenzplatz 2, 97070 Würzburg, Germany
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15
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Popa E. Loneliness as Cause. TOPOI : AN INTERNATIONAL REVIEW OF PHILOSOPHY 2023:1-10. [PMID: 37361721 PMCID: PMC10233518 DOI: 10.1007/s11245-023-09933-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
While loneliness has been linked to various mental and physical health problems, the sense in which loneliness is a cause of these conditions has so far attracted little philosophical attention. This paper aims to fill this gap by analyzing research on health effects of loneliness and therapeutic interventions through current approaches to causality. To deal with the problem of causality between psychological, social, and biological variables, the paper endorses a biopsychosocial model of health and disease. I will investigate how three main approaches to causality used in psychiatry and public health apply to loneliness: interventionism, mechanisms, and dispositional theories. Interventionism can specify whether loneliness causes specific effects, or whether a treatment works, incorporating results from randomized controlled trials. Mechanisms help explain how loneliness brings about negative health effects, spelling out psychological processes involved in lonely social cognition. Dispositional approaches help stress particular features of loneliness connected to negative social interactions, such as defensiveness. I will conclude by showing that previous research alongside emerging approaches to health effects of loneliness lend themselves to analysis in terms of the causal models under discussion.
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Affiliation(s)
- Elena Popa
- Interdisciplinary Centre for Ethics, Jagiellonian University, Ul. Grodzka 52, 31-044 Kraków, Poland
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16
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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17
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HaGani N, Surkalim DL, Clare PJ, Merom D, Smith BJ, Ding D. Health Care Utilization Following Interventions to Improve Social Well-Being: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e2321019. [PMID: 37382954 PMCID: PMC10311391 DOI: 10.1001/jamanetworkopen.2023.21019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/16/2023] [Indexed: 06/30/2023] Open
Abstract
Importance It has been suggested that interventions that aim to improve social well-being may contribute to decreased health care use; however, such evidence has not been fully systematically synthesized. Objective To systematically review and meta-analyze available evidence on the associations between psychosocial interventions and health care utilization. Data Sources Medline, Embase, PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, Scopus, Google Scholar, and reference lists of systematic reviews were searched from inception until November 31, 2022. Study Selection Included studies were randomized clinical trials reporting on both health care utilization and social well-being outcomes. Data Extraction and Synthesis The reporting of the systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Full-text and quality assessments were conducted by 2 reviewers independently. Multilevel random-effects meta-analyses were used to synthesize the data. Subgroup analyses were conducted to examine the characteristics associated with decreased health care use. Main Outcomes and Measures The outcome of interest was health care utilization, including primary, emergency, inpatient, and outpatient care services. Social well-being was measured as social support, social participation, social relationships, community support, social integration, or loneliness. Results A total of 41 studies were retrieved from 18 969 citations; 37 studies were eligible for meta-analysis. Data were analyzed for 7842 participants, including 2745 older adults, 1579 young women considered to be at risk of social and mental health disadvantages, 1118 people with chronic illnesses, 1597 people with mental illnesses, and 803 caregivers. The odds ratio (OR) random-effects model showed an overall reduction in health care use (OR, 0.75; 95% CI, 0.59 to 0.97), but the standardized mean difference (SMD) random effect model showed no association. An improvement in health care utilization was observed in association with social support interventions (SMD, 0.25; 95% CI, 0.04 to 0.45) but not in loneliness interventions. Subgroup analysis indicated a reduced length of inpatient visits (SMD, -0.35; 95% CI, -0.61 to -0.09) and number of emergency care visits (OR, 0.64; 95% CI, 0.43 to 0.96) following the intervention. However, an increase in outpatient care associated with psychosocial interventions was observed (SMD, 0.34; 95% CI, 0.05 to 0.62). The largest reductions in health care use were associated with interventions among caregivers (OR, 0.23; 95% CI, 0.07 to 0.71) and individuals with mental illnesses (OR, 0.31; 95% CI, 0.13 to 0.74). Conclusions These findings suggest that psychosocial interventions were associated with most measures of health care utilization. As the association differed by participant and intervention delivery characteristics, these characteristics should be considered in the design of future interventions.
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Affiliation(s)
- Neta HaGani
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Daniel L. Surkalim
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Philip J. Clare
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Ben J. Smith
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
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18
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Krueger J, Osler L, Roberts T. Loneliness and Absence in Psychopathology. TOPOI : AN INTERNATIONAL REVIEW OF PHILOSOPHY 2023:1-16. [PMID: 37361724 PMCID: PMC10129314 DOI: 10.1007/s11245-023-09916-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 06/28/2023]
Abstract
Loneliness is a near-universal experience. It is particularly common for individuals with (so-called) psychopathological conditions or disorders. In this paper, we explore the experiential character of loneliness, with a specific emphasis on how social goods are experienced as absent in ways that involve a diminished sense of agency and recognition. We explore the role and experience of loneliness in three case studies: depression, anorexia nervosa, and autism. We demonstrate that even though experiences of loneliness might be common to many psychopathologies, these experiences nevertheless have distinctive profiles. Specifically, we suggest that: (i) loneliness is often a core characteristic of depressive experience; (ii) loneliness can drive, and even cement, disordered eating practices and anorectic identity in anorexia nervosa; iii) loneliness is neither a core characteristic of autism nor a driver but is rather commonly experienced as stemming from social worlds, environments, and norms that fail to accommodate autistic bodies and their distinctive forms of life. We aim to do justice to the pervasiveness of loneliness in many - if not all - psychopathologies, while also highlighting the need to attend to psychopathology-specific experiences of loneliness, agency, and (non-)recognition.
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Affiliation(s)
- Joel Krueger
- Department of Social and Political Sciences, Philosophy, and Anthropology, University of Exeter Amory, Rennes Drive, EX4 4RJ Exeter, UK
| | - Lucy Osler
- School of English, Communication and Philosophy, Cardiff University, John Perceival Building, Cardiff, CF10 3EU Cardiff, UK
| | - Tom Roberts
- Department of Social and Political Sciences, Philosophy, and Anthropology, University of Exeter Amory, Rennes Drive, EX4 4RJ Exeter, UK
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19
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Lawn S, Kaine C, Stafrace S, Backman-Hoyle D, Lavranos E, Jefferies B, Byrne S, Kaur M, Giordani G, Matthews L, Mathews S. Why talking about loneliness matters to the mental health of consumers and to the work of the psychiatrist. Aust N Z J Psychiatry 2023; 57:469-471. [PMID: 36949578 DOI: 10.1177/00048674231159622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- Sharon Lawn
- Lived Experience Australia Ltd., Oaklands Park, SA, Australia
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Christine Kaine
- Lived Experience Australia Ltd., Oaklands Park, SA, Australia
| | - Simon Stafrace
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - De Backman-Hoyle
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Eileen Lavranos
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Bronte Jefferies
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Simon Byrne
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Manjit Kaur
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Gina Giordani
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Lyndy Matthews
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Sarah Mathews
- Community Collaboration Committee, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
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20
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Lay-Yee R, Matthews T, Moffitt T, Poulton R, Caspi A, Milne B. Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes. Soc Psychiatry Psychiatr Epidemiol 2023; 58:373-382. [PMID: 36456781 PMCID: PMC9715405 DOI: 10.1007/s00127-022-02389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood. METHODS We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors. RESULTS Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation. CONCLUSION Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand.
| | - Timothy Matthews
- Department of Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Barry Milne
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
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21
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Adlington K, Vasquez C, Pearce E, Wilson CA, Nowland R, Taylor BL, Spring S, Johnson S. 'Just snap out of it' - the experience of loneliness in women with perinatal depression: a Meta-synthesis of qualitative studies. BMC Psychiatry 2023; 23:110. [PMID: 36849948 PMCID: PMC9970854 DOI: 10.1186/s12888-023-04532-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pregnancy and the arrival of a new baby is a time of great transition and upheaval. Women often experience social isolation and loneliness at this time and may develop depression, particularly in the postnatal period. Qualitative studies have reported that loneliness is also a feature of perinatal depression. However, until now there has been no attempt to synthesise research exploring the links between loneliness and perinatal depression. This study's aim was to explore existing qualitative evidence to answer two research questions: What are the experiences of loneliness for women with perinatal depression? What helps and what makes loneliness worse for women with perinatal depression? METHODS A qualitative meta-synthesis retrieved primary qualitative studies relevant to the research questions. Four electronic databases were systematically searched (Ovid MEDLINE®; PsycINFO; Embase; Web of Science). Papers were screened according to pre-defined inclusion criteria and assigned a quality score. Thematic analysis was used to identify major overarching themes in the literature. RESULTS Twenty-seven relevant qualitative studies were included. Themes relating to the interaction between perinatal depression and loneliness included self-isolation and hiding symptoms due to stigma of perinatal depression and fear of judgement as a 'bad mother'; a sudden sense of emotional disconnection after birth; and a mismatch between expected and actual support provided by partner, family and community. There was also a double burden of loneliness for women from disadvantaged communities, due to increased stigma and decreased social support. Validation and understanding from healthcare professionals, peer support from other mothers with experience of perinatal depression, and practical and emotional family support were all important factors that could ameliorate loneliness. CONCLUSIONS Loneliness appears to play a central role in the experience of perinatal depression based on the frequency with which it emerged in women's accounts. The findings provide a foundation for the development of further theories about the role of loneliness in perinatal depression and evidence in which future psychological and social intervention design processes can be rooted. Addressing stigma and offering culturally appropriate professional and peer support are potential targets for interventions that could help women with perinatal depression, particularly in disadvantaged communities, feel less lonely. TRIAL REGISTRATION Prospero registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID = 251,936.
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Affiliation(s)
- Katherine Adlington
- Division of Psychiatry, University College London, London, UK. .,Section of Women's Mental Health, King's College London, London, UK. .,East London NHS Foundation Trust, London, UK.
| | | | - Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Rebecca Nowland
- School of Health and Midwifery, University of Central Lancashire, Preston, UK
| | | | | | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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22
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Birken M, Chipp B, Shah P, Olive RR, Nyikavaranda P, Hardy J, Chhapia A, Barber N, Lee S, Pearce E, Lloyd-Evans B, Perkins R, McDaid D, Stefanidou T, Shafran R, Pitman A, Johnson S. Exploring the experiences of loneliness in adults with mental health problems: A participatory qualitative interview study. PLoS One 2023; 18:e0280946. [PMID: 36881570 PMCID: PMC9990944 DOI: 10.1371/journal.pone.0280946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 01/11/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Loneliness is associated with many mental health conditions, as both a potential causal and an exacerbating factor. Richer evidence about how people with mental health problems experience loneliness, and about what makes it more or less severe, is needed to underpin research on strategies to help address loneliness. METHODS Our aim was to explore experiences of loneliness, as well as what helps address it, among a diverse sample of adults living with mental health problems in the UK. We recruited purposively via online networks and community organisations, with most interviews conducted during the COVID-19 pandemic. Qualitative semi-structured interviews were conducted with 59 consenting participants face-to-face, by video call or telephone. Researchers with relevant lived experience were involved at all stages, including design, data collection, analysis and writing up of results. FINDINGS Analysis led to identification of four overarching themes: 1. What the word "lonely" meant to participants, 2. Connections between loneliness and mental health, 3. Contributory factors to continuing loneliness, 4. Ways of reducing loneliness. Central aspects of loneliness were lack of meaningful connections with others and lack of a sense of belonging to valued groups and communities. Some drivers of loneliness, such as losses and transitions, were universal, but specific links were also made between living with mental health problems and being lonely. These included direct effects of mental health symptoms, the need to withdraw to cope with mental health problems, and impacts of stigma and poverty. CONCLUSIONS The multiplicity of contributors to loneliness that we identified, and of potential strategies for reducing it, suggest that a variety of approaches are relevant to reducing loneliness among people with mental health problems, including peer support and supported self-help, psychological and social interventions, and strategies to facilitate change at community and societal levels. The views and experiences of adults living with mental health problems are a rich source for understanding why loneliness is frequent in this context and what may address it. Co-produced approaches to developing and testing approaches to loneliness interventions can draw on this experiential knowledge.
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Affiliation(s)
- Mary Birken
- Division of Psychiatry, University College London, London, United Kingdom
- * E-mail:
| | - Beverley Chipp
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Patrick Nyikavaranda
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Jackie Hardy
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Anjie Chhapia
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Nick Barber
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Stephen Lee
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Eiluned Pearce
- Division of Psychiatry, University College London, London, United Kingdom
| | | | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, United Kingdom
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | | | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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23
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Abstract
PURPOSE OF REVIEW People with persistent depressive disorders and with bipolar disorder are more likely to feel lonely than people in the general population. This evidence update focused on studies in the last 2 years, characterized by the COVID-19 pandemic and consequent social distancing directives. RECENT FINDINGS Longitudinal studies identified that people who feel lonely are more likely to become depressed or to experience relapse of mood disorders. There is emerging evidence that feelings of loneliness or mandatory social isolation can precede manic episodes. Hence the relationship between loneliness and mood disorders is complex and bidirectional. Interventions were developed to reduce loneliness in people with mental health problems, including depressive disorders, through cognitive modification and/or supported socialisation. No loneliness-focused interventions have been specifically tailored to people with bipolar disorder. SUMMARY Studies carried out before and during the COVID-19 pandemic found that feelings of loneliness can be both consequences and precursors of persistent depression and bipolar disorder. Mood symptoms and loneliness have a cumulative negative effect on physical and mental health outcomes. Conceptual overlaps and relations between loneliness and mood symptoms should be clarified in qualitative studies. Theory-driven intervention models should be developed and tested in methodologically robust studies.
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24
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Cao Q(K, Dabelko-Schoeny H, Warren K, Lee MY. The Loneliness of Low-Income Older Adults in a Federal Volunteering Program: A Network Perspective. Gerontol Geriatr Med 2023; 9:23337214231219097. [PMID: 38143874 PMCID: PMC10748629 DOI: 10.1177/23337214231219097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Volunteering has been associated with increased social interactions and reduced feelings of loneliness among older adults. However, a growing number of social network analyses (SNA) conducted in the general population outside of volunteering contexts suggest that lonely individuals tended to interact with other lonely individuals in the network, reinforcing loneliness through peer associations. To better understand the psychosocial impact of peer interactions among older adults within volunteer programs, this study examines how older adults' loneliness is correlated with their peers' loneliness within the Senior Companions Program (SCP). This study collected information on the social networks within an SCP in a Midwest Metropolitan and feelings of loneliness among low-income Russian, Khmer, Somali, Nepali, and English-speaking older volunteers (N = 41). A linear network autocorrelation model (LNAM) was constructed to quantify how volunteers' loneliness is correlated with their peers' loneliness within SCP. The LNAM results indicated that less lonely volunteers tended to make friends with lonelier volunteers (ρ = -.06, p < .05) in SCP even when accounting for statistical controls. The finding that more and less lonely individuals connect indicates an altruistic tendency for less lonely individuals to interact with those who are lonelier. This may be an important pathway by which volunteering addresses loneliness.
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Affiliation(s)
| | | | - Keith Warren
- The Ohio State University College of Social Work, Columbus, OH, USA
| | - Mo Yee Lee
- The Ohio State University College of Social Work, Columbus, OH, USA
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25
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Primary and secondary negative symptoms severity and the use of psychiatric care resources in schizophrenia spectrum disorders: A 3-year follow-up longitudinal retrospective study. Schizophr Res 2022; 250:31-38. [PMID: 36252294 DOI: 10.1016/j.schres.2022.10.002] [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: 04/11/2022] [Revised: 07/18/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
Negative symptoms represent one of the core features of schizophrenia spectrum disorders (SSD), strongly correlated with low remission rates, poor real-world functioning, and worse quality of life. Despite the body of evidence attesting the role of negative symptoms in determining worse outcomes in SSD, few studies have directly investigated their impact on the use of psychiatric services and even fewer research have examined the differential impact between primary versus secondary negative symptoms. The present study aims to investigate whether SSD subjects with high levels of primary and of secondary negative symptoms at an index hospitalization show a different use of psychiatric services in the subsequent 3 years. A total of 429 subjects were included in the study. Results show that SSD patients with high levels of negative symptoms are characterized by an overall greater use of high-cost resources, with more admissions in the hospital acute care psychiatric ward and in high intensity residential inpatient services. Moreover, while primary negative symptoms appear to play a role in determining a greater use of psychiatric services, high levels of secondary negative symptoms are associated with an increased use of most psychiatric resources, especially of high-cost ones. In conclusion, negative symptoms have a relevant impact on the pattern of psychiatric resources utilization in SSD patients. While scientific research continues to look for effective treatments for primary negative symptoms, clinicians should pay particular attention to secondary negative symptoms, as these also have important consequences but may benefit from appropriate treatment.
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26
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Southward MW, Terrill DR, Sauer‐Zavala S. The effects of the Unified Protocol and Unified Protocol skills on loneliness in the COVID-19 pandemic. Depress Anxiety 2022; 39:913-921. [PMID: 36372958 PMCID: PMC9877890 DOI: 10.1002/da.23297] [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: 06/29/2022] [Revised: 10/23/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Loneliness is a significant public health concern with no established first-line intervention although modular, transdiagnostic, cognitive-behavioral interventions, such as the Unified Protocol (UP), are promising candidates. The UP contains skill modules to target anxiety, depression, and related conditions, although it is unclear if the UP can reduce loneliness and if UP skill use contributes to these reductions. METHODS Using data from the first-stage randomization of a sequential multiple assignment randomized trial, we tested whether the UP led to reductions in loneliness and whether specific dimensions of UP skill use predicted session-to-session changes in loneliness. Participants (N = 70; Mage = 33.74, 67% female, 74% white) completed six sessions of core UP modules, reporting how frequently they felt lonely and used UP skills before each session. Using hierarchical linear modeling, we examined the trajectory of change in loneliness and disaggregated between- from within-person variability to test session-to-session effects of skill use. RESULTS Loneliness significantly decreased during treatment with the UP. Using more UP skills than one's personal average, but not frequency of skill use, predicted session-to-session decreases in loneliness. CONCLUSIONS Therapists may be encouraged to guide patients toward using a large quantity of different skills to specifically address loneliness.
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27
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Iamtrakul P, Chayphong S. Exploring the Influencing Factors on Living Alone and Social Isolation among Older Adults in Rural Areas of Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114572. [PMID: 36361450 PMCID: PMC9655045 DOI: 10.3390/ijerph192114572] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/25/2022] [Accepted: 11/04/2022] [Indexed: 06/12/2023]
Abstract
Older adults living alone present a vulnerable physical and mental health group with public health and service needs. This situation has risen and is therefore expected to increase calls for urgent attention from concerned authorities. This article focuses on the study of factors related to different living arrangements of older adults and also examines the extent to which baseline variables explained the association between living alone and social isolation characteristics. A questionnaire survey restricted to respondents aged 60 years and over, living in Ban Phaeo, Samutsakhon, Thailand, was scoped for data collection. Older adults living alone and in co-residence (living together) constitute a total of 1162 samples. The binary logistic regression model was applied to examine the association between living alone and social isolation characteristics. The result found that factors relating to older adults' different living arrangements are marital status, household members numbers, level of dependency, and type of caregivers. An association was found between the characteristics of living alone and social isolation in three relative variables, which are age, activities of daily living (ADLs), and type of caregivers. In conclusion, household living arrangements have different related factors like marital status, where a single or divorced person is more likely to live alone. Furthermore, it is also influenced by the need for caregiving on the part of the older adult or family members; particularly, their children typically emerge as the unpaid assistance from families. When only a sample of older adults living alone with social isolation is considered, it was discovered that with the advancing age of older adults living alone, whether single or married, encountered problems with the activities of daily living (ADLs). This set of people rarely goes out to perform activities outside their home and seldom attend social and physical activities. This could lead to a risk of social isolation with a greater risk of physical and mental health problems, including the well-being of older adults living alone in later life. Thus, family caregivers play a key role as a primary source of support to prevent older adults from being socially isolated, which has become an integral part of our healthcare system in promoting physical, mental, and functional health among older adults in a positive way.
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28
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Hawn SE, Hawrilenko M, McDowell Y, Campbell S, Garcia NM, Simpson TL. An in-depth look at latent classes of DSM-5 psychiatric comorbidity among individuals with PTSD: Clinical indicators and treatment utilization. J Clin Psychol 2022; 78:2214-2244. [PMID: 35973077 PMCID: PMC9561047 DOI: 10.1002/jclp.23429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 04/25/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is associated with high comorbidity rates across the full range of psychiatric disorders. However, little is known about how psychiatric comorbidity manifests among people with PTSD, particularly with regard to concurrent diagnoses. METHOD Latent class analysis (LCA) was used to characterize discrete classes of PTSD comorbidity using past year DSM-5 diagnostic standards among a large nationally representative epidemiologic sample of U.S. adults. Follow-up analyses compared participant characteristics across latent classes. RESULTS The LCA was best characterized by five classes: low comorbidity, distress-fear, distress-externalizing, mania-fear-externalizing, and mania-externalizing. Excluding the low comorbidity class, proportions of borderline and schizotypal personality disorder were high across classes. CONCLUSION Participant characteristics across classes of past year PTSD comorbidity are explored through the lens of case conceptualization and treatment planning utility.
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Affiliation(s)
- Sage E. Hawn
- National Center for PTSD, Boston VA Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Matthew Hawrilenko
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | | | - Sarah Campbell
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | | | - Tracy L. Simpson
- VA Puget Sound Healthcare System, Seattle, WA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
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29
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Umagami K, Remington A, Lloyd-Evans B, Davies J, Crane L. Loneliness in autistic adults: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2117-2135. [PMID: 35257592 PMCID: PMC9597154 DOI: 10.1177/13623613221077721] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
LAY ABSTRACT Recently, researchers have been interested in how autistic people experience loneliness. Yet, most of this research has focused on loneliness in autistic children and young people. We present the results of a systematic review on loneliness in autistic adults. A systematic review is a rigorous way of searching for all existing research on a topic and summarizing the findings about specific questions. We searched for all research published on this topic until 9 April 2021. We found 34 articles that investigated loneliness in autistic adults. This research showed that (1) there is fairly little research that has involved directly asking autistic adults about their first-hand experiences of loneliness (e.g. what loneliness feels like for them); (2) few research studies have used loneliness questionnaires specifically developed for autistic adults (this was attempted in just one research study); (3) collective loneliness (i.e. loneliness associated with how much an autistic person feels they 'fit in' to society) seems important to autistic adults but has not been investigated as commonly as other aspects of loneliness (e.g. loneliness associated with romantic relationships or friendships); (4) things that might increase loneliness in autistic adults include anxiety and depression, and a lack of autism understanding and acceptance, for example; and (5) things that might reduce loneliness in autistic adults include having relationships and self-acceptance, for example. In our article, we discuss the kinds of future research on loneliness in autistic adults that might be useful.
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30
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The effects of social isolation stress and discrimination on mental health. Transl Psychiatry 2022; 12:398. [PMID: 36130935 PMCID: PMC9490697 DOI: 10.1038/s41398-022-02178-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Social isolation and discrimination are growing public health concerns associated with poor physical and mental health. They are risk factors for increased morbidity and mortality and reduced quality of life. Despite their detrimental effects on health, there is a lack of knowledge regarding translation across the domains of experimental research, clinical studies, and real-life applications. Here, we review and synthesize evidence from basic research in animals and humans to clinical translation and interventions. Animal models indicate that social separation stress, particularly in early life, activates the hypothalamic-pituitary-adrenal axis and interacts with monoaminergic, glutamatergic, and GABAergic neurotransmitter systems, inducing long-lasting reductions in serotonin turnover and alterations in dopamine receptor sensitivity. These findings are of particular importance for human social isolation stress, as effects of social isolation stress on the same neurotransmitter systems have been implicated in addictive, psychotic, and affective disorders. Children may be particularly vulnerable due to lasting effects of social isolation and discrimination stress on the developing brain. The effects of social isolation and loneliness are pronounced in the context of social exclusion due to discrimination and racism, during widespread infectious disease related containment strategies such as quarantine, and in older persons due to sociodemographic changes. This highlights the importance of new strategies for social inclusion and outreach, including gender, culture, and socially sensitive telemedicine and digital interventions for mental health care.
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31
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Hasha W, Igland J, Fadnes LT, Kumar BN, Heltne UM, Diaz E. Effect of a self-help group intervention using Teaching Recovery Techniques to improve mental health among Syrian refugees in Norway: a randomized controlled trial. Int J Ment Health Syst 2022; 16:47. [PMID: 36068576 PMCID: PMC9450394 DOI: 10.1186/s13033-022-00557-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mental health symptoms among refugees are common, often related to chronic pain disorders, and their management is usually challenging. Studies evaluating the effect of group therapies among adult refugees to improve mental health symptoms are scarce. Aims To assess the effect of Teaching Recovery Techniques (TRT) on mental health and to reduce pain disorder among adult Syrian refugees. Method A randomized controlled trial was designed to study the effect of a self-help group intervention using TRT. The outcomes, mental health symptoms measured by Impact of Event Scale-Revised (IES-R) and General Health Questionnaire (GHQ-12) and chronic pain measured by Brief Pain Inventory (BPI), were reported as regression coefficients (B) with 95% confidence intervals. Results Seventy-six adults participated: 38 in the intervention and 38 in the control groups. Intention-to-treat analyses showed a significant effect on general mental health as measured by GHQ-12 with B (95% CI) of -3.8 (-7.2, -0.4). There was no effect of TRT on mental health when assessed by IES-R (-1.3 (-8.7, 6.2)) or on pain levels assessed by BPI (-0.04 (-4.0, 3.9)). Conclusions This self-help group intervention significantly improved general mental health symptoms among adult refugees but had no effect on trauma symptoms or chronic pain. Higher participation rates might be necessary to achieve the full potential of TRT. Trial registration: The trial was registered with Clinical Trials.gov at https://clinicaltrials.gov/ct2/show/NCT03951909. To include user participation in the design of the interventions, the study was retrospectively registered on 19 February 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00557-4.
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Affiliation(s)
- Wegdan Hasha
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Bernadette N Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, 222 Skøyen, 0213, Oslo, Norway
| | - Unni M Heltne
- Centre for Crisis Psychology, Møllendalsbakken 9, 5020, Bergen, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Unit for Migration and Health, Norwegian Institute of Public Health, 222 Skøyen, 0213, Oslo, Norway
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32
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Mikocka-Walus A, Skvarc D, de Acosta MB, Evertsz FB, Bernstein CN, Burisch J, Ferreira N, Gearry RB, Graff LA, Jedel S, Mokrowiecka A, Stengel A, Trindade IA, van Tilburg MAL, Knowles SR. Exploring the Relationship Between Self-Isolation and Distress Among People with Gastrointestinal Disorders During the COVID-19 Pandemic. J Clin Psychol Med Settings 2022; 29:654-665. [PMID: 34494184 PMCID: PMC8423336 DOI: 10.1007/s10880-021-09818-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/17/2022]
Abstract
This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May-September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p < .001). GI symptoms moderated the association between isolation and distress (B = .047, t = 2.47, p = .015). Interventions targeting these factors may help to reduce distress in people with GI disorders at the time of major stressors such as the COVID-19 pandemic.
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Affiliation(s)
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Manuel Barreiro de Acosta
- Department of Gastroenterology, IBD Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Floor Bennebroek Evertsz
- Department of Medical Psychology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | | | - Johan Burisch
- Medical Division, Hvidovre Hospital, University of Copenhagen, GastrounitHvidovre, Denmark
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Lesley A Graff
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sharon Jedel
- Division of Digestive Diseases, Rush University Medical Center, Chicago, IL, USA
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - Inês A Trindade
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miranda A L van Tilburg
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, USA
- Division of Gastroenterology, University of North Carolina, Chapel Hill, NC, USA
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Simon R Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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33
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Bandyopadhyay S, Boylan CT, Baho YG, Casey A, Asif A, Khalil H, Badwi N, Patel R. Ethnicity-related stereotypes and their impacts on medical students: A critical narrative review of health professions education literature. MEDICAL TEACHER 2022; 44:986-996. [PMID: 35311604 DOI: 10.1080/0142159x.2022.2051464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Stereotypes are oversimplified beliefs about groups of people. Social psychology concepts and theories describing ethnicity-related stereotypes are well reported in non-medical educational settings. In contrast, the full impact of stereotyping on medical students, and the extent to which they were represented in health professions education (HPE) is less well-described. Using the lens of social psychological theory, this review aimed to describe ethnicity-related stereotypes about medical students portrayed in HPE literature and the impacts of those stereotypes. METHODS A critical narrative approach was undertaken. Social psychology concepts and theories were used as a framework through which to review the impacts of ethnicity-related stereotypes on medical students as described in HPE literature. A database search of Ovid MEDLINE, JSTOR, Project Muse, and PsychINFO was conducted to identify both theoretical and empirical articles relating to this topic in the HPE literature. Data was synthesised using thematic analysis, giving particular care to appraise the evidence from perspectives in social psychology. FINDINGS In HPE, the experiences and impact of stereotyping on learners from minority ethnic groups was explained by social psychology concepts such as stereotype threat, stereotype reactance, attributional ambiguity, self-fulfilling prophecy, stereotype boost, stereotype lift, and stereotype masking. Stereotype boost and stereotype lift were particularly described among students who identified as White, whereas stereotype threat was described more commonly among students from minority ethnics groups. The impact of stereotyping is not just on assessment, but may be across all teaching and learning activities at medical school. INTERPRETATION Social psychology concepts and theories can be used to describe the experience and impact of ethnicity-related stereotypes in HPE. Educators can better support learners from minority ethnic groups by self-reflecting over assumptions about individuals from minority ethnic groups, as well as minimise the impact of stereotyping and bias to create more inclusive learning environments.
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Affiliation(s)
- Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Conor T Boylan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Yousif G Baho
- Hull York Medical School, University of Hull, Kingston Upon Hull, UK & University of York, York, UK
| | - Anna Casey
- Brighton and Sussex Medical School, Brighton, UK
| | - Aqua Asif
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Halimah Khalil
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Nermin Badwi
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rakesh Patel
- Medical Education Centre, School of Medicine, University of Nottingham, Nottingham, UK
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34
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Antecedents of Subjective Health among Korean Senior Citizens Using Archival Data. Behav Sci (Basel) 2022; 12:bs12090315. [PMID: 36135119 PMCID: PMC9496000 DOI: 10.3390/bs12090315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the determinants of subjective health among South Korean senior citizens. Secondary data for the year 2018 was used from the Senior Citizen Research Panel data collected by the Korea Employment Information Service. A total of 3822 valid observations were analyzed. The dependent variable was subjective health, and the independent variables were religion participation, social gathering participation, economic activity, food expenditure, leisure expenditure, travel frequency, and art watching frequency. Descriptive analysis, correlation matrix, and independent t-test were carried out for data analysis. Multiple linear regression analysis was employed using assets, age, and gender as control variables to test the research hypotheses. The results indicate that all the proposed attributes have a significant positive impact on the subjective health of Korean senior citizens, with implications for policy making.
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Pires de Oliveira Padilha P, Bertulies-Esposito B, L'Heureux S, Olivier D, Lal S, Abdel-Baki A. COVID-19 pandemic's effects and telehealth in Early Psychosis Services of Quebec, Canada: Will changes last? Early Interv Psychiatry 2022; 16:862-867. [PMID: 34626091 PMCID: PMC8653188 DOI: 10.1111/eip.13227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/06/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
AIM To explore the impacts of the COVID-19 pandemic first wave in Quebec, Canada on practices in early intervention services (EIS) for first-episode psychosis, including reorganization of clinical and administrative practices and teleconsultation use. METHODS Adopting a cross-sectional descriptive study design, a 41 questions online survey was sent to the team leaders of all the 33 Quebec EIS, of which 100% responded. Data were collected from 18 May to 4 June 2020 and analysed using descriptive statistics and content analysis. Programmes were categorized as urban/non-urban and results were compared between these. RESULTS All 33 existing Quebec EIS (16 urban and 17 non-urban) completed the survey. Among them, 85% did not experience redeployment of EIS team staff and 58% reported stable frequency of patient interactions, either in-person or through telemedicine. During the studied period, 64% of programmes reported that all professionals used teleconsultation at least occasionally. However, 73% of programmes, mostly in non-urban areas, reported some limitations regarding clinicians' degree of ease with teleconferencing platforms and half of EIS could not access technical support to use them. The majority of EIS (94%) expressed interest to participate in a training program about the use of technologies for teleconsultations. Many smaller clinics reported interest in offering multiregional/multiclinics group teletherapy, therefore merging their pool of patients and clinical staff workforce. CONCLUSIONS Further studies are warranted to improve access to and use of technology-mediated treatment, which seems to be a promising alternative to provide high-quality mental healthcare during the COVID-19 pandemic and beyond.
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Affiliation(s)
| | - Bastian Bertulies-Esposito
- CHUM Research Centre, Axe Neurosciences, Montreal, Quebec, Canada.,Department of Psychiatry and addictology, University of Montreal, Montreal, Quebec, Canada.,Department of Psychiatry, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Sophie L'Heureux
- Department of Psychiatry and Neurosciences, Laval University, Quebec City, Quebec, Canada.,Clinique Notre-Dame des Victoires, IUSMQ, Quebec City, Quebec, Canada
| | - David Olivier
- Department of Psychiatry and addictology, University of Montreal, Montreal, Quebec, Canada.,Program Oxy-Jeunes, CIUSSS MCQ, Shawinigan, Quebec, Canada
| | - Shalini Lal
- School of Rehabilitation, University of Montreal, Montreal, Quebec, Canada.,Youth Mental Health and Technology Lab, CHUM Research Centre, Montreal, Quebec, Canada.,PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Amal Abdel-Baki
- CHUM Research Centre, Axe Neurosciences, Montreal, Quebec, Canada.,Department of Psychiatry and addictology, University of Montreal, Montreal, Quebec, Canada.,Youth Mental Health Service, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
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36
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Farina EA, Assaf M, Corbera S, Chen CM. Factors Related to Passive Social Withdrawal and Active Social Avoidance in Schizophrenia. J Nerv Ment Dis 2022; 210:490-496. [PMID: 35766542 PMCID: PMC9243431 DOI: 10.1097/nmd.0000000000001502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Social withdrawal in schizophrenia may be a result of "passive" motivation (reduced drive to engage) or "active" motivation (increased drive to avoid). We conducted a cross-sectional, between-subjects study using self-report measures and social cognition tasks to evaluate the relationships between motivational subtypes, social abilities, and social functioning in schizophrenia spectrum (n = 52, ages 19-34). Regression models showed significant differences in passive and active withdrawal. Passive, but not active, motivation predicted social functioning as measured by a clinical interview. This suggests that motivation, especially passive type, plays an important role in social withdrawal in schizophrenia. However, on a self-report measure of social functioning, neither passive nor active motivation predicted outcomes, suggesting a potential disconnect between observer versus self-report measures when assessing social motivation. Furthermore, performance on tasks of social abilities did not predict motivation, which supports the idea that motivation is distinct from social ability and should be specifically addressed in treatment.
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Affiliation(s)
- Emily A. Farina
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, USA
- Olin Neuropsychiatry Research Center, Hartford Hospital, 400 Washington Street, Hartford, CT, USA
| | - Michal Assaf
- Olin Neuropsychiatry Research Center, Hartford Hospital, 400 Washington Street, Hartford, CT, USA
| | - Silvia Corbera
- Department of Psychological Science, Central Connecticut State University, New Britain, CT, USA
| | - Chi-Ming Chen
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, USA
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Abstract
AIMS Current information about the prevalence of various mental health disorders in the general adult population of the Republic of Ireland is lacking. In this study, we examined the prevalence of 12 common mental disorders, the proportion of adults who screened positive for any disorder, the sociodemographic factors associated with meeting criteria for a disorder and the associations between each disorder and history of attempted suicide. METHODS A non-probability nationally representative sample (N = 1110) of adults living in Ireland completed self-report measures of 12 mental health disorders. Effect sizes were calculated using odds ratios from logistic regression models, and population attributable risk fractions (PAFs) were estimated to quantify the associations between each disorder and attempted suicide. RESULTS Prevalence rates ranged from 15.0% (insomnia disorder) to 1.7% (histrionic personality disorder). Overall, 42.5% of the sample met criteria for a mental health disorder, and 11.1% had a lifetime history of attempted suicide. Younger age, being a shift worker and trauma exposure were independently associated with a higher likelihood of having a mental health disorder, while being in university was associated with a lower likelihood of having a disorder. ICD-11 complex posttraumatic stress disorder, borderline personality disorder and insomnia disorder had the highest PAFs for attempted suicide. CONCLUSIONS Mental health disorder prevalence in Ireland is relatively high compared to international estimates. The findings are discussed in relation to important mental health policy implications.
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Thompson KN, Odgers CL, Bryan BT, Danese A, Milne BJ, Strange L, Matthews T, Arseneault L. Trajectories of childhood social isolation in a nationally representative cohort: Associations with antecedents and early adulthood outcomes. JCPP ADVANCES 2022; 2:e12073. [PMID: 37431453 PMCID: PMC10242821 DOI: 10.1002/jcv2.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background This study examined early life antecedents of childhood social isolation, whether these factors accounted for poor outcomes of isolated children, and how these associations varied according to patterns of stability and change in childhood isolation. Methods Participants included 2232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. We conducted growth mixture modelling (GMM) on combined parent and teacher reports of children's social isolation when children were 5, 7, 10 and 12 years, and we assessed associations with age-5 antecedents and age-18 outcomes using regression analyses. Results We identified three linear developmental trajectories of increasing (4.75%), decreasing (5.25%) and low stable (90.00%) social isolation. Age-5 attention deficit hyperactivity disorder (ADHD) symptoms, emotional problems, prosocial behaviours, maternal personality (openness) and size of school were associated with the decreasing trajectory of social isolation. When controlling for these antecedents, increasingly isolated children were still more likely to experience ADHD symptoms, loneliness, lower job optimism and lower physical activity at age 18. Conclusions Isolated children follow distinct patterns of change over childhood and isolation seems most detrimental to health at the time it is experienced. Social isolation can be a valuable indicator of co-occurring problems and provide targets for mental health intervention in young people.
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Affiliation(s)
- Katherine N. Thompson
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Candice L. Odgers
- Social Science Research InstituteDuke UniversityDurhamNorth CarolinaUSA
- Department of Psychological ScienceUniversity of California IrvineIrvineCaliforniaUSA
| | - Bridget T. Bryan
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
- Department of Child & Adolescent PsychiatryInstitute of PsychiatryPsychology & NeuroscienceKing's College LondonLondonUK
- National and Specialist CAMHS Trauma, Anxiety, and Depression ClinicSouth London and Maudsley NHS Foundation TrustLondonUK
| | - Barry J. Milne
- Faculty of ArtsCentre of Methods and Policy Application in the Social SciencesUniversity of AucklandAucklandNew Zealand
- Faculty of ScienceDepartment of StatisticsUniversity of AucklandAucklandNew Zealand
| | - Lily Strange
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Timothy Matthews
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
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39
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Giacco D. Tackling social isolation in people with psychosis: promising developments but need for conceptual clarity. J Ment Health 2022; 31:297-301. [PMID: 35599584 DOI: 10.1080/09638237.2022.2069725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Domenico Giacco
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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40
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Toh G, Pearce E, Vines J, Ikhtabi S, Birken M, Pitman A, Johnson S. Digital interventions for subjective and objective social isolation among individuals with mental health conditions: a scoping review. BMC Psychiatry 2022; 22:331. [PMID: 35549899 PMCID: PMC9098213 DOI: 10.1186/s12888-022-03889-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design. METHODS We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi: https://doi.org/10.17605/OSF.IO/CNX8A ). RESULTS Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions. CONCLUSION Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field.
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Affiliation(s)
- Gigi Toh
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK.
| | - Eiluned Pearce
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK
| | - John Vines
- School of Informatics, University of Edinburgh, Crichton St, Newington, Edinburgh, UK
| | - Sarah Ikhtabi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK
| | - Mary Birken
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK
| | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK
- Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK.
- Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK.
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41
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Zagic D, Wuthrich VM, Rapee RM, Wolters N. Interventions to improve social connections: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:885-906. [PMID: 34796368 DOI: 10.1007/s00127-021-02191-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/31/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote 'objective social contact' and the 'quality of social connections'; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials. METHODS A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0. RESULTS Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges' g = 0.43) and perceived quality of social connections (Hedges' g = - 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges' g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges' g = - 0.53). CONCLUSION In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress.
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Affiliation(s)
- Dino Zagic
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia. .,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia.
| | - Viviana M Wuthrich
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nine Wolters
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Faculty of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Barnett P, Steare T, Dedat Z, Pilling S, McCrone P, Knapp M, Cooke E, Lamirel D, Dawson S, Goldblatt P, Hatch S, Henderson C, Jenkins R, K T, Machin K, Simpson A, Shah P, Stevens M, Webber M, Johnson S, Lloyd-Evans B. Interventions to improve social circumstances of people with mental health conditions: a rapid evidence synthesis. BMC Psychiatry 2022; 22:302. [PMID: 35484521 PMCID: PMC9047264 DOI: 10.1186/s12888-022-03864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/16/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Poor social circumstances can induce, exacerbate and prolong symptoms of mental health conditions, while having a mental health condition can also lead to worse social outcomes. Many people with mental health conditions prioritise improvement in social and functional outcomes over reduction in clinical symptoms. Interventions that improve social circumstances in this population should thus be considered a priority for research and policy. METHODS This rapid evidence synthesis reports on randomised controlled trials of interventions to improve social circumstances across eight social domains (Housing and homelessness; money and basic needs; work and education; social isolation and connectedness; family, intimate and caring relationships; victimisation and exploitation; offending; and rights, inclusion and citizenship) in people with mental health conditions. Economic evaluations were also identified. A comprehensive, stepped search approach of the Cochrane library, MEDLINE, Embase, PsycINFO, Web of Science and Scopus was conducted. RESULTS One systematic review and 102 randomised controlled trials were included. We did not find RCT evidence for interventions to improve family, intimate and caring relationships and only one or two trials for each of improving money and basic needs, victimisation and exploitation, and rights, inclusion and citizenship. Evidence from successful interventions in improving homelessness (Housing First) and employment (Individual Placement and Support) suggests that high-intensity interventions which focus on the desired social outcome and provide comprehensive multidisciplinary support could influence positive change in social circumstances of people with mental health conditions. Objective social isolation could be improved using a range of approaches such as supported socialisation and social skills training but interventions to reduce offending showed few benefits. Studies with cost and cost-effectiveness components were generally supportive of interventions to improve housing and vocational outcomes. More research is needed to ensure that social circumstances accompanied by high risks of further exacerbation of mental health conditions are adequately addressed. CONCLUSIONS Although there is a large body of literature examining how to support some aspects of life for people with mental health conditions, more high-quality evidence is required in other social domains. Integration into mental health services of interventions targeting social circumstances could significantly improve a number of social outcomes.
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Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. .,Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK.
| | - Thomas Steare
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK
| | - Zainab Dedat
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK
| | - Stephen Pilling
- grid.83440.3b0000000121901201Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK ,grid.452735.20000 0004 0496 9767National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
| | - Paul McCrone
- grid.36316.310000 0001 0806 5472Institute of Lifecourse Development, University of Greenwich, London, UK
| | - Martin Knapp
- grid.13063.370000 0001 0789 5319Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Eleanor Cooke
- grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust and MH Policy Research Unit, London, UK
| | - Daphne Lamirel
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK
| | - Sarah Dawson
- grid.5337.20000 0004 1936 7603Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Peter Goldblatt
- grid.83440.3b0000000121901201Department of Epidemiology & Public Health, Institute of Health Equity, University College London, London, UK
| | - Stephani Hatch
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Kings College London, London, UK ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, Kings College London, London, UK
| | - Claire Henderson
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research Department, Kings College London, London, UK ,grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | - Rachel Jenkins
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neurology, Kings College London, London, UK
| | - T K
- grid.83440.3b0000000121901201Mental Health Policy Research Unit Lived Experience Working Group, Department of Psychiatry, University College London, London, UK
| | - Karen Machin
- grid.83440.3b0000000121901201Mental Health Policy Research Unit Lived Experience Working Group, Department of Psychiatry, University College London, London, UK
| | - Alan Simpson
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research Department, Kings College London, London, UK ,grid.13097.3c0000 0001 2322 6764Florence Nightingale Faculty of Nursing, Kings College London, Midwifery & Palliative care, London, UK
| | - Prisha Shah
- grid.83440.3b0000000121901201Mental Health Policy Research Unit Lived Experience Working Group, Department of Psychiatry, University College London, London, UK
| | - Martin Stevens
- grid.13097.3c0000 0001 2322 6764NIHR Policy Research Unit On Health and Social Care Workforce Research Unit, King’s College London, London, UK
| | - Martin Webber
- grid.5685.e0000 0004 1936 9668International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York, England
| | - Sonia Johnson
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
| | - Brynmor Lloyd-Evans
- grid.83440.3b0000000121901201Department of Psychiatry, Mental Health Policy Research Unit, University College London, London, UK
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Mikhaylova O, Dokuka S. Anorexia and Young Womens' Personal Networks: Size, Structure, and Kinship. Front Psychol 2022; 13:848774. [PMID: 35519652 PMCID: PMC9063839 DOI: 10.3389/fpsyg.2022.848774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Anorexia is a serious threat to young women's wellbeing worldwide. The effectiveness of mental health intervention and treatment is often evaluated on the basis of changes in the personal networks; however, the development of such measures for young women with anorexia is constrained due to the lack of quantitative descriptions of their social networks. We aim to fill this substantial gap. In this paper, we identify the basic properties of these women's personal networks such as size, structure, and proportion of kin connections. The empirical analysis, using a concentric circles methodology, is based on 50 ego networks constructed on data drawn from interviews with Russian-speaking bloggers who have been diagnosed with anorexia and write about this condition. We conclude that young women with anorexia tend to support a limited number of social ties; they are prone to select women as alters, but do not have a preference to connect to their relatives. Further research is needed to elucidate whether these personal network characteristics are similar among women with anorexia who belong to different age, ethnic, cultural, and income groups.
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Affiliation(s)
| | - Sofia Dokuka
- Institute of Education, HSE University, Moscow, Russia
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44
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Burke L, Littlewood E, Gascoyne S, McMillan D, Chew-Graham CA, Bailey D, Sloan C, Fairhurst C, Baird K, Hewitt C, Henry A, Ryde E, Shearsmith L, Coventry P, Crosland S, Newbronner E, Traviss-Turner G, Woodhouse R, Clegg A, Gentry T, Hill A, Lovell K, Dexter Smith S, Webster J, Ekers D, Gilbody S. Behavioural Activation for Social IsoLation (BASIL+) trial (Behavioural activation to mitigate depression and loneliness among older people with long-term conditions): Protocol for a fully-powered pragmatic randomised controlled trial. PLoS One 2022; 17:e0263856. [PMID: 35324908 PMCID: PMC8947398 DOI: 10.1371/journal.pone.0263856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Depression is a leading mental health problem worldwide. People with long-term conditions are at increased risk of experiencing depression. The COVID-19 pandemic led to strict social restrictions being imposed across the UK population. Social isolation can have negative consequences on the physical and mental wellbeing of older adults. In the Behavioural Activation in Social IsoLation (BASIL+) trial we will test whether a brief psychological intervention (based on Behavioural Activation), delivered remotely, can mitigate depression and loneliness in older adults with long-term conditions during isolation. Methods We will conduct a two-arm, parallel-group, randomised controlled trial across several research sites, to evaluate the clinical and cost-effectiveness of the BASIL+ intervention. Participants will be recruited via participating general practices across England and Wales. Participants must be aged ≥65 with two or more long-term conditions, or a condition that may indicate they are within a ‘clinically extremely vulnerable’ group in relation to COVID-19, and have scored ≥5 on the Patient Health Questionnaire (PHQ9), to be eligible for inclusion. Randomisation will be 1:1, stratified by research site. Intervention participants will receive up to eight intervention sessions delivered remotely by trained BASIL+ Support Workers and supported by a self-help booklet. Control participants will receive usual care, with additional signposting to reputable sources of self-help and information, including advice on keeping mentally and physically well. A qualitative process evaluation will also be undertaken to explore the acceptability of the BASIL+ intervention, as well as barriers and enablers to integrating the intervention into participants’ existing health and care support, and the impact of the intervention on participants’ mood and general wellbeing in the context of the COVID-19 restrictions. Semi-structured interviews will be conducted with intervention participants, participant’s caregivers/supportive others and BASIL+ Support Workers. Outcome data will be collected at one, three, and 12 months post-randomisation. Clinical and cost-effectiveness will be evaluated. The primary outcome is depressive symptoms at the three-month follow up, measured by the PHQ9. Secondary outcomes include loneliness, social isolation, anxiety, quality of life, and a bespoke health services use questionnaire. Discussion This study is the first large-scale trial evaluating a brief Behavioural Activation intervention in this population, and builds upon the results of a successful external pilot trial. Trial registration ClinicalTrials.Gov identifier ISRCTN63034289, registered on 5th February 2021.
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Affiliation(s)
- Lauren Burke
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Samantha Gascoyne
- Department of Health Sciences, University of York, York, United Kingdom
| | - Dean McMillan
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
| | | | - Della Bailey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Claire Sloan
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Kalpita Baird
- Department of Health Sciences, University of York, York, United Kingdom
| | - Catherine Hewitt
- Department of Health Sciences, University of York, York, United Kingdom
| | - Andrew Henry
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | - Eloise Ryde
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | - Leanne Shearsmith
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Peter Coventry
- Department of Health Sciences, University of York, York, United Kingdom
| | - Suzanne Crosland
- Department of Health Sciences, University of York, York, United Kingdom
| | | | | | - Rebecca Woodhouse
- Department of Health Sciences, University of York, York, United Kingdom
| | - Andrew Clegg
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Tom Gentry
- Age UK, Tavis House, 1–6 Tavistock Square, London United Kingdom
| | - Andrew Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Karina Lovell
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Sarah Dexter Smith
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | | | - David Ekers
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
- * E-mail:
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Seewer N, Skoko A, Käll A, Andersson G, Luhmann M, Berger T, Krieger T. Evaluation of the Efficacy of Two Internet-based Self-help Interventions for Chronic Loneliness: Study Protocol for a Three-arm Randomized Controlled Trial (Preprint). JMIR Res Protoc 2022; 11:e36358. [PMID: 35867403 PMCID: PMC9356337 DOI: 10.2196/36358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Loneliness, or perceived social isolation, is prevalent in both the general population and clinical practice. Although loneliness has repeatedly been associated with mental and physical health, research on interventions that reduce loneliness effectively is still rather scarce. Objective This study aims to evaluate the efficacy of a guided and an unguided version of the same internet-based cognitive behavioral self-help program for loneliness (SOLUS-D) for adults. Methods A total of 250 participants will be randomly assigned to 1 of 2 intervention groups (SOLUS-D with guidance or SOLUS-D without guidance) or a wait-list control group (2:2:1 allocation ratio). Adult participants experiencing high levels of loneliness will be recruited from the general population. Individuals currently experiencing at least moderately severe depressive symptoms, an ongoing severe substance use disorder, previous or current bipolar or psychotic disorder, or acute suicidality will be excluded from the trial. Assessments will take place at baseline, 5 weeks (midassessment), and 10 weeks (postassessment). The primary outcome is loneliness assessed using the 9-item University of California, Los Angeles Loneliness Scale at the posttreatment time point. Secondary outcomes include depressive symptoms, symptoms of social anxiety, satisfaction with life, social network size, and variables assessing cognitive bias and social behavior. The maintenance of potentially achieved gains will be assessed and compared at 6 and 12 months after randomization in the 2 active conditions. Potential moderators and mediators will be tested exploratorily. Data will be analyzed on an intention-to-treat basis. Results Recruitment and data collection started in May 2021 and are expected to be completed by 2022, with the 12-month follow-up to be completed by 2023. As of the time of submission of the manuscript, 134 participants were randomized. Conclusions This 3-arm randomized controlled trial will add to the existing research on the efficacy of loneliness interventions. Furthermore, it will shed light on the role of human guidance in internet-based treatments for individuals with increased levels of loneliness and the possible mechanisms of change. If SOLUS-D proves effective, it could provide a low-threshold, cost-efficient method of helping and supporting individuals with increased levels of loneliness. Trial Registration ClinicalTrials.gov NCT04655196; https://clinicaltrials.gov/ct2/show/NCT04655196 International Registered Report Identifier (IRRID) DERR1-10.2196/36358
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Affiliation(s)
- Noëmi Seewer
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrej Skoko
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anton Käll
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Maike Luhmann
- Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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Tsai TY, Chiu CJ, Wang TY, Tseng HH, Chen KC, Chen PS, Yang YK. Loneliness and isolated living status in middle-aged and older adults in Taiwan: exploration on stress-related biomarkers, depressive symptoms, and disability. BMC Psychiatry 2022; 22:177. [PMID: 35279110 PMCID: PMC8917755 DOI: 10.1186/s12888-022-03824-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Loneliness is a subjective feeling by which an individual perceives a lack of closeness in interpersonal relationships. An isolated living status is linked with higher odds of risky health behavior. The conflicting impacts of loneliness and isolated living status on stress-related biomarkers, depressive symptoms, and disability remain unexplained. METHODS Six hundred twenty-nine participants aged 66.0 (SD=7.3) separated into four groups: "Lonely and Isolated," "Not Lonely, but Isolated," "Lonely, but Not Isolated," and "Neither Lonely, nor Isolated," were retrieved from the Social Environment and Biomarkers of Aging Study conducted in 2000. Follow-up health indicators in 2006 included three stress-related biomarkers, depressive symptoms, and two physical disability indicators. A hierarchical regression was performed for the analysis. RESULTS Firstly, compared to the "Neither Lonely nor Isolated" group, only the "Lonely, but Not Isolated" participants at baseline retained positive associations with the stress-related biomarkers levels 6 years later (urine cortisol level (B=9.25, 95% CI=3.24-15.27), serum Interleukin-6 level (B=2.76, 95% CI=0.72-4.79) and the serum high sensitivity C-reactive protein (hsCRP) level (B=0.40, 95% CI=0.17-0.62)). However, such associations were not observed in the "Lonely and Isolated" participants. Secondly, only "Lonely and Isolated" participants at baseline were positively associated with depressive symptoms 6 years later (B=1.70, 95% CI=0.11-3.30). Finally, the associations between combinations of loneliness and isolated living status and physical disability were eliminated after adjusting the covariables. CONCLUSION Four combinations of loneliness and isolated living status were associated with different impacts on stress-related biomarkers, depressive symptoms, and physical disability. Further dynamic investigations are warranted.
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Affiliation(s)
- Tsung-Yu Tsai
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.410770.50000 0004 0639 1057Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan.
| | - Tzu-Yun Wang
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kao-Chin Chen
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-See Chen
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Kuang Yang
- grid.64523.360000 0004 0532 3255Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.410770.50000 0004 0639 1057Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Ikhtabi S, Pitman A, Toh G, Birken M, Pearce E, Johnson S. The experience of loneliness among people with a "personality disorder" diagnosis or traits: a qualitative meta-synthesis. BMC Psychiatry 2022; 22:130. [PMID: 35177022 PMCID: PMC8855579 DOI: 10.1186/s12888-022-03767-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/08/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Loneliness is prevalent among people with a "personality disorder" diagnosis or who have related personality traits, but the experience of loneliness among people with "personality disorder" diagnoses/traits has not been well described. A qualitative approach has potential to help understand the experience of loneliness among people with "personality disorder" diagnoses/traits, and to develop interventions that promote recovery. We therefore aimed to synthesise the qualitative literature relevant to this topic. METHOD We conducted a meta-synthesis of qualitative studies exploring the subjective experience of loneliness as reported by people with "personality disorder" diagnoses/traits. We searched four databases using pre-formulated search terms, selected eligible articles, appraised the quality of each, and analyzed data from eligible studies using thematic synthesis. RESULT We identified 39 articles that described the experience of loneliness in people with "personality disorder" diagnoses/traits. From extracted data, we identified seven themes: (1) disconnection and emptiness: a "haunting alienation", (2) alienation arising from childhood experiences, (3) thwarted desire for closeness and connection, (4) paradox: for both closeness and distance, (5) experiences of existential loneliness, (6) recovery, embedded in a social world, and (7) group therapy: a setback. Our results suggest that for our sample early alienating and traumatic experiences may pave the way for experiences of loneliness, which further exacerbate "personality disorder" symptoms and distress. CONCLUSION Despite describing a need to belong and efforts to cope with unmet social needs, people with "personality disorder" diagnoses/traits (particularly "emotionally unstable personality disorder") report experiencing an intense disconnection from other people. This seems rooted in early adversities, reinforced by later traumatic experiences. Given the apparent salience of loneliness to people with "personality disorder" diagnoses/traits, interventions focused on helping people connect with others, which may include both psychological and social components, have potential to be beneficial in reducing loneliness and promoting recovery.
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Affiliation(s)
| | - Alexandra Pitman
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
| | - Gigi Toh
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Mary Birken
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Eiluned Pearce
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK
| | - Sonia Johnson
- grid.83440.3b0000000121901201UCL Division of Psychiatry, London, UK ,grid.450564.60000 0000 8609 9937Camden and Islington NHS Foundation Trust, London, UK
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The Psychological Structure of Loneliness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031061. [PMID: 35162085 PMCID: PMC8833983 DOI: 10.3390/ijerph19031061] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/30/2021] [Accepted: 01/13/2022] [Indexed: 12/04/2022]
Abstract
Despite the current surge of interest in loneliness, its health consequences, and possible remedies, the concept itself remains poorly understood. This paper seeks to contribute to a more fully worked out account of what loneliness consists in. It does this by stressing that loneliness always has an experiential component and by introducing a simple psychological structure to analyze the experience. On this basis, it suggests that we can distinguish between three ways of thinking about the phenomenal dimension of loneliness. There are objectivist views that seek to understand loneliness by a description of its intentional object, subjectivist views that consider its holistic relation to other aspects of the sufferer’s psyche, and embodied and enacted views that focus on the relation between the lonely person’s mental life and her social environment. The aim is not to adjudicate between these views or to suggest that they are mutually exclusive. Rather, this paper recommends a pluralistic framework on which all three approaches have something to contribute to a fuller understanding of the condition and may be of use in devising measures aimed at improving sufferers’ health.
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Giacco D, Kirkbride JB, Ermakova AO, Webber M, Xanthopoulou P, Priebe S. Neighbourhood characteristics and social isolation of people with psychosis: a multi-site cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1907-1915. [PMID: 34791516 PMCID: PMC9375739 DOI: 10.1007/s00127-021-02190-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE People with psychosis are vulnerable to social isolation, which is associated with worse clinical outcomes. In general populations, people living in areas with higher population density have more social contacts, while those living in more socially deprived and fragmented areas are less satisfied with their relationships. We assessed whether and how neighbourhood factors are associated with social contacts and satisfaction with friendships for people with psychosis. METHODS We carried out a cross-sectional study including people with psychosis aged 18-65 years in urban and rural sites in England. Population density and social deprivation and fragmentation indexes were described within Lower Level Super Output Areas (LSOA). Their associations with participants' social contacts and satisfaction with friendships were tested with negative binomial and ordinal regression models, respectively. RESULTS We surveyed 511 participants with psychotic disorders. They had a median of two social contacts in the previous week (interquartile range [IQR] = 1-4), and rated satisfaction with friendships as 5 out of 7 (Manchester Short Assessment of Quality of Life; IQR = 4-6). Higher population density was associated with fewer social contacts (Z-standardised relative risk [RR] = 0.88; 95% CI = 0.79-0.99, p = 0.03), but not with satisfaction with friendships (RR = 1.08; 95% CI = 0.93-1.26, p = 0.31). No associations were found for social contacts or satisfaction with friendships with social deprivation or fragmentation indexes. CONCLUSIONS Clinicians in urban areas should be aware that their patients with psychosis are more socially isolated when more people live around them, and this could impact their clinical outcomes. These findings may inform housing programmes.
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Affiliation(s)
- Domenico Giacco
- Division of Health Sciences, Warwick Medical School, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, England.
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Service Development), Barts and the London School of Medicine, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, England.
- Coventry and Warwickshire Partnership NHS Trust, Coventry, England.
| | - James B Kirkbride
- Division of Psychiatry, University College London, London, W1T 7BN, England
| | - Anna O Ermakova
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Service Development), Barts and the London School of Medicine, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, England
- Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, Silwood Park, Buckhurst Road, Ascot, Berks, SL5 7PY, England
| | - Martin Webber
- Department of Social Policy and Social Work, University of York, Heslington, YO10 5DD, York, UK
| | - Penny Xanthopoulou
- College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, EX2 4TH, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Service Development), Barts and the London School of Medicine, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, England
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50
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Taylor BL, Nath S, Sokolova AY, Lewis G, Howard LM, Johnson S, Sweeney A. The relationship between social support in pregnancy and postnatal depression. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1435-1444. [PMID: 35451605 PMCID: PMC9246777 DOI: 10.1007/s00127-022-02269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 03/08/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE Lack of social support is considered a potential risk factor for postnatal depression but limited longitudinal evidence is available. Pregnancy, when women have increased contact with healthcare services, may be an opportune time to intervene and help strengthen women's social networks to prevent feelings of depression postnatally, particularly for those at greatest risk. Our study examined the longitudinal relationship between social support in pregnancy and postnatal depression, and whether this is moderated by age or relationship status. METHODS We analysed data collected from 525 women from a diverse inner-city maternity population in England who were interviewed in pregnancy and again three months postnatally. Women provided sociodemographic information and completed self-report measures of depression (Edinburgh Postnatal Depression Scale) and social support (Social Provisions Scale). RESULTS Less social support in pregnancy was associated with postnatal depression, after adjusting for sociodemographic confounders and antenatal depression (Coef. = - 0.05; 95% CI - 0.10 to - 0.01; p = 0.02). There was weak evidence of a moderating effect of relationship status. Subgroup analysis showed a stronger relationship between social support in pregnancy and postnatal depression for women who were not living with a partner (Coef. = - 0.11; 95% CI - 0.21 to - 0.01; p = 0.03) than for those who were (Coef. = - 0.03; 95% CI - 0.09 to 0.02; p = 0.28). Sensitivity analysis using multiple imputations to account for missing data confirmed the main results. CONCLUSIONS Interventions that target social support in pregnancy have the potential to reduce depression postnatally. Future research should explore in greater detail which women would benefit most from which type of social support.
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Affiliation(s)
- Billie Lever Taylor
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Selina Nath
- grid.83440.3b0000000121901201Present Address: Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK ,grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Antoaneta Y. Sokolova
- grid.83440.3b0000000121901201Lived Experience Advisory Group, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Gemma Lewis
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Louise M. Howard
- grid.13097.3c0000 0001 2322 6764Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - Sonia Johnson
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Angela Sweeney
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, UK.
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