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Macedo D, McEvoy M, Crowley T, Loughhead M, Procter N. Self-harm and suicidality among trans and gender diverse youth from culturally and linguistically diverse backgrounds-A scoping review. Int J Ment Health Nurs 2024; 33:781-796. [PMID: 38291609 DOI: 10.1111/inm.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/10/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
Rates of suicidality and self-harm are substantial among trans and gender diverse people, particularly among younger groups. The objective of this scoping review is to explore the state of the research conducted on determinants of mental distress, self-harm and suicidality among trans and gender diverse (TGD) youth from culturally and linguistically diverse (CALD) backgrounds. The Joanna Briggs Institute methodology for scoping reviews was used as a methodology guide. Inclusion criteria for study selection comprehended: publications on the intersectionality between gender non-conformity and cultural and linguistic diversity; focus on a young population (≤25 years of age); publications addressing self-harm and/or suicidality. Searches were conducted on eight databases and a public web search engine and yielded 474 results. Publications were screened and selected by two independent reviewers. Thematic analysis was used to identify key themes overarching the findings. The screening process yielded seven peer-reviewed studies and six research reports based on case studies, retrospective qualitative interviews, cross-sectional and longitudinal survey analyses. The key themes approached in the retrieved literature include: (1) precipitating factors for suicidality; (2) pathways contributing to self-harm and suicidality; and 3) barriers and facilitators for accessing services and mental health care. Practical actions to help mitigate suicidality among TGD youth from CALD backgrounds need to consider the impact of trauma and allow for the development of trust in the therapeutic relationship. Shifts in service delivery and policy formulation are necessary to reduce stigmatisation and potentialise the inclusion of different racial, ethnic, cultural, sexual and gender identity expressions in society.
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Affiliation(s)
- Davi Macedo
- Mental Health and Suicide Prevention Research and Education Group, UniSA, Adelaide, South Australia, Australia
| | - Monica McEvoy
- CAMHS CALD Team, Child and Adolescent Mental Health Service, Adelaide, South Australia, Australia
| | - Tim Crowley
- Complex Care and Trauma Mental Health, CAMHS, Adelaide, South Australia, Australia
| | - Mark Loughhead
- Mental Health and Suicide Prevention Research and Education Group, UniSA, Adelaide, South Australia, Australia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research and Education Group, UniSA, Adelaide, South Australia, Australia
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Salazar de Pablo G, Aymerich C, Guinart D, Catalan A, Alameda L, Trotta G, Armendariz A, Martinez Baringo E, Soler-Vidal J, Rubio JM, Garrido-Torres N, Gómez-Vallejo S, Kane JM, Howes O, Fusar-Poli P, Correll CU. What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med 2024; 54:652-662. [PMID: 38087871 DOI: 10.1017/s0033291723003458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6-44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6-88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8-53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0-54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0-41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0-46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9-35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0-48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0-43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8-28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Daniel Guinart
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Institut de Salut Mental, Hospital del Mar Research Institute (CIBERSAM), Barcelona, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alvaro Armendariz
- Unidad Terapéutica Centre Educatiu Els Til·lers, Parc Sanitari Sant Joan de Déu, Barcelona
- Grup MERITT: Etiopatogènia i tractament dels trastorns mentals greus
| | - Estrella Martinez Baringo
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanas Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nathalia Garrido-Torres
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Sandra Gómez-Vallejo
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Faculty of Medicine, Institute of Clinical Sciences, Imperial College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
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Wedell E, Bettergarcia JN, Thomson BR, Shrewsbury AM. Age Moderates the Association of Community Connectedness and Psychological Distress Among LGBTQ+ Youth and Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:722-740. [PMID: 36228152 DOI: 10.1080/00918369.2022.2132573] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
High levels of psychological distress present a major public health issue among LGBTQ+ youth and adults; however, research has repeatedly identified community connectedness as an important protective factor for mental health in LGBTQ+ populations. The aim of the present study was to examine whether age moderates the association of community connectedness on psychological distress in a community sample of LGBTQ+ people. In the present exploratory study, we analyzed secondary cross-sectional data from a sample of LGBTQ+ youth and adults (n = 292) in a semi-rural community in the Western United States. Participants completed a measure of community connectedness, the K6, and the PHQ-4. The results of two moderation models showed that the negative association of community connectedness on psychological distress was strongest among youth, weaker among young adults, and nonsignificant among older middle-aged adults and older adults. These results provide further evidence for the potential buffering role of community connectedness on psychological distress for LGBTQ+ youth and young adults.
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Affiliation(s)
- Emma Wedell
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
| | - Jay N Bettergarcia
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, California, USA
| | - Bonnie Rose Thomson
- Department of Psychology, State University of New York, Brockport, New York, USA
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Hoyt CR, Clifton M, Smith CR, Woods L, Taff SD. Transforming Occupational Therapy for the 21st Century PAIRE: Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity. Occup Ther Health Care 2023:1-24. [PMID: 37837307 PMCID: PMC11016132 DOI: 10.1080/07380577.2023.2265479] [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: 03/13/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
Theories, models, and frameworks provide the foundation for occupational therapy education, research, and clinical practice. While most have a systems approach focus, other factors, such as societal influences and structural inequities, also contribute to health. Using a cross-sectional design, this study identified the gaps in occupational therapy models of practice and presents a novel approach, the PAIRE (Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity) Model. PAIRE is focused on achieving occupational equity through the reciprocal and intersectional impact of the provider/team, the person/people seeking occupational therapy, and the occupation-in-context, with continuous influences of access, context, and justice. We describe the components of PAIRE and illustrate its functionality in education, research, and clinical practice contexts as well as case examples.
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Affiliation(s)
- Catherine R Hoyt
- Program in Occupational Therapy, WA University School of Medicine, St. Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Maribeth Clifton
- College of Allied Health Professions, Department of Health and Rehabilitation Sciences, Occupational Therapy Program, University of NE Medical Center, Omaha, NE, USA
| | | | | | - Steven D Taff
- Program in Occupational Therapy, WA University School of Medicine, St. Louis, MO, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Office of Education, Washington University School of Medicine, St. Louis, MO, USA
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Cotton SM, Sharmin S, Gao CX, Brown E, Menssink JM, Rickwood D, Bedi G, Hickie I, Hetrick SE, Parker AG, Herrman H, Telford N, McGorry PD, Filia KM. Prevalence and Correlates of Tobacco Use in Young People Presenting to Australian Primary Mental Health Services. Nicotine Tob Res 2023; 25:682-691. [PMID: 35665823 DOI: 10.1093/ntr/ntac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 12/20/2021] [Accepted: 02/07/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION In Australian youth primary mental health settings it is unclear as to the rates and correlates of tobacco use at service entry. AIMS AND METHODS We aimed to delineate the prevalence and correlates of recent tobacco use (eg, cigarettes, chewing tobacco, cigars, etc) in the past 3 months in young people at their first presentation to primary mental health services as a function of age. Cross-sectional self-report measures were collected using a tablet device from young people presenting to one of five Australian primary mental health (headspace) services. Logistic regression assessed correlates of past 3-month tobacco use in adolescents (12-17 years) and young adults (18-25 years). RESULTS Regular (at least monthly) tobacco use in the past 3 months was found in 23.4% (n = 247, N = 1055) of the sample. Increasing age (odds ratio [OR] =1.47 per year; 95% confidence interval [CI]: 1.15 to 1.89), male sex (OR = 1.98; 95% CI: 1.02 to 3.83), being in a relationship (OR = 1.96; 95% CI: 1.01 to 3.82), and poorer functioning (OR = 0.95 per unit Social and Occupational Functioning Assessment Scale increase; 95% CI: 0.91 to 0.99) predicted regular tobacco use in adolescents, but not in young adults. Living in a regional location (OR = 2.10; 95% CI: 1.40 to 3.13) and not studying (OR = 0.47; 95% CI: 0.31 to 0.73) predicted tobacco use in young adults. Having a diagnosed mental illness other than depression and/or anxiety predicted tobacco use in both groups (adolescents OR = 2.49; 95% CI: 1.26 to 4.94; young adults OR = 1.80; 95% CI: 1.13 to 2.89). CONCLUSIONS Nearly a quarter of young people with mental illness are using tobacco, supporting the need for early intervention approaches. Adapting treatment targets by age could improve the impact of interventions in adolescents versus young adults. Poor functioning and lack of engagement in education were associated with tobacco use in both age groups, respectively; however, more research is needed to determine the direction of these relationships. IMPLICATIONS Young people with mental illness have a high prevalence of recent tobacco use and this is evident when they first present to youth primary mental health services. Youth-oriented mental health settings may provide a unique window for tobacco use prevention and early intervention to reduce smoking in people with mental illness, a priority population. Age-specific targeted approaches might be needed in adolescents and young adults.
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Affiliation(s)
- Sue M Cotton
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sonia Sharmin
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- Research and Evaluation, Take Two Berry Street, Melbourne, VIC, Australia
- Department of Occupational Therapy and Social Work and Social Policy, La Trobe University, Melbourne, VIC, Australia
| | - Caroline X Gao
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ellie Brown
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Jana M Menssink
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Debra Rickwood
- headspace National Youth Mental Health Foundation Ltd., Melbourne, VIC, Australia
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ian Hickie
- Brain and Mind, University of Sydney, Camperdown, NSW, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Alexandra G Parker
- Orygen, Parkville, VIC, Australia
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Helen Herrman
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Nic Telford
- headspace National Youth Mental Health Foundation Ltd., Melbourne, VIC, Australia
| | - Patrick D McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Kate M Filia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
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Ranganath P, Hjetland GJ, Finserås TR, Brunborg GS, Hesse M, Skogen JC. Negative experiences, social exclusion and unwanted attention on social media: exploring the association with adolescent alcohol use. BMC Public Health 2022; 22:2361. [PMID: 36527010 PMCID: PMC9756586 DOI: 10.1186/s12889-022-14679-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents' presence on Social Media (SoMe) facilitates peer connections making them susceptible to peer-influences and approval. Negative experiences on SoMe can affect adolescent stress and wellbeing, impelling their use of alcohol. This paper provides a novel understanding of the relationship between negative experiences on SoMe and key indicators of alcohol use in adolescents. METHODS Data was collected from upper secondary school students (n = 3528, ages 16-19, 45% boys) in Bergen (Norway) using a web-based questionnaire during school-hours in 2020 and 2021. Dependent variables were alcohol consumption, binge drinking and scoring ≥ 2 points on the CRAFFT instrument screening for substance use problems in adolescents. Independent variables were two scales indicating "negative acts and exclusion" and "unwanted attention from others". Covariates included age, gender, country of birth and subjective socioeconomic status. Results are presented as relative risk ratios (RRR), odds ratios (OR) and incidence rate ratios (IRR) with 95% confidence intervals. RESULTS Using multinomial logistic regression models, "negative acts and exclusion" and "unwanted attention" were positively associated with trying alcohol (OR: 1.50 (95% CI 1.28-1.76) and 1.86 (95% CI 1.66-2.09) respectively, both p ≤ 0.001), with frequency and amount of alcohol consumed. Findings from logistic regression models indicated that "negative acts and exclusion" and "unwanted attention" were positively associated with i. CRAFFT-caseness (OR: 2.13 and 1.86) and ii. frequent binge drinking (OR: 1.55 and 1.89). CONCLUSION Both exclusion and unwanted attention on SoMe were associated with indicators of problematic drinking, including frequency, quantity, and consequences related to alcohol.
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Affiliation(s)
- Priya Ranganath
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Gunnhild Johnsen Hjetland
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Turi Reiten Finserås
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Geir Scott Brunborg
- grid.418193.60000 0001 1541 4204Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway ,grid.4714.60000 0004 1937 0626 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Jens Christoffer Skogen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway ,grid.412835.90000 0004 0627 2891Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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Barbato M, Liu L, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone W, Tsuang MT, Walker EF, Woods SW, Cannon TD, Addington J. Migrant status, clinical symptoms and functional outcome in youth at clinical high risk for psychosis: findings from the NAPLS-3 study. Soc Psychiatry Psychiatr Epidemiol 2022; 58:559-568. [PMID: 36348056 DOI: 10.1007/s00127-022-02383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Migrant status is a known risk factor for psychosis, but the underlying causes of this vulnerability are poorly understood. Recently, studies have begun to explore whether migrant status predicts transition to psychosis in individuals at clinical high risk (CHR) for psychosis. Results, however, have been inconclusive. The present study assessed the impact of migrant status on clinical symptoms and functional outcome in individuals at CHR for psychosis who took part in the NAPLS-3 study. METHODS Participants' migrant status was classified as native-born, first-generation, or second-generation migrant. Clinical symptoms were assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS); functional outcome was measured using the Global Functioning Scales:Social and Role (GF:S; GF:R). Assessments were conducted at baseline, 12-months, 18-months, and 24-months follow-up. Generalized linear mixed models for repeated measures were used to examine changes over time and differences between groups. RESULTS The overall sample included 710 individuals at CHR for psychosis (54.2% males; Age: M = 18.19; SD = 4.04). A mixed model analysis was conducted, and no significant differences between groups in symptoms or functioning were observed at any time point. Over time, significant improvement in symptoms and functioning was observed within each group. Transition rates did not differ across groups. CONCLUSION We discuss potential factors that might explain the lack of group differences. Overall, migrants are a heterogeneous population. Discerning the impact of migration from that of neighborhood ethnic density, social disadvantage or socio-economic status of different ethnic groups could help better understand vulnerability and resilience to psychosis.
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Affiliation(s)
- Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, USA
- Institute of Genomic Medicine, University of California, La Jolla, CA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Mathison Centre for Mental Health Research & Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Argyriadis A, Patelarou E, Paoullis P, Patelarou A, Dimitrakopoulos I, Zisi V, Northway R, Gourni M, Asimakopoulou E, Katsarou D, Argyriadi A. Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811282. [PMID: 36141554 PMCID: PMC9517303 DOI: 10.3390/ijerph191811282] [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] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 05/06/2023]
Abstract
Current research often refers to cultural competence to improve health care delivery. In addition, it focuses on the cultural uniqueness of each health service user for optimal personalized care. This study aimed to collect self-assessment data from health professionals regarding their cultural competence and to identify their development needs. A mixed methods design was adopted using the Cultural Competence Self-assessment Checklist of the Central Vancouver Island Multicultural Society. This was translated into Greek, validated, and then shared with health professionals in Cyprus. Subsequently, a semi-structured interview guide was designed and utilized. This was structured in exactly the same question categories as the questionnaire. Data collection took place between October 2021 and May 2022, and convenience sampling was used to recruit 499 health scientists in Cyprus. The sample comprised doctors, nurses, psychologists, midwives, social workers, and physiotherapists. Subsequently, 62 interviews were conducted with participants from the same specialties. The results showed that (compared to other health professionals) nurses and psychologists are more sensitive to issues of cultural competence. It would appear that the more socially oriented sciences had better-prepared healthcare staff to manage diversity in context. However, there is a gap between knowledge and skills when comparing doctors to nurses; they seem to be more skilled and willing to intervene actively in cases of racist behavior or problem-solving. In conclusion, participants identified the importance of their cultural competence; they also realized the importance of optimal planning of personalized health care. There is a significant need for continuous and specialized cultural competence training for all health professions.
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Affiliation(s)
- Alexandros Argyriadis
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
- Correspondence: ; Tel.: +357-22394394
| | - Evridiki Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Athina Patelarou
- School of Health Sciences, Hellenic Mediterranean University, 714 10 Iraklio, Greece
| | | | - Vasiliki Zisi
- Department of Physical Education and Sport Science, University of Thessaly, 382 21 Volos, Greece
| | - Ruth Northway
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK
| | - Maritsa Gourni
- School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
| | | | - Dimitra Katsarou
- Department of Pre-School Education and Educational Design, University of the Aegean, 811 00 Mitilini, Greece
| | - Agathi Argyriadi
- School of Education and Social Sciences, Frederick University, Limassol 3080, Cyprus
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Psychometric properties of a brief, self-report measure of social inclusion: the F-SIM16. Epidemiol Psychiatr Sci 2022; 31:e8. [PMID: 35060845 PMCID: PMC8786614 DOI: 10.1017/s2045796021000755] [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] [Indexed: 11/07/2022] Open
Abstract
AIMS A disproportionate number of people with mental ill-health experience social exclusion. Appropriate measurement tools are required to progress opportunities to improve social inclusion. We have developed a novel measure, the Filia Social Inclusion Measure (F-SIM). Here we aimed to present a more concise, easy-to-use form, while retaining its measurement integrity by (i) refining the F-SIM using traditional and contemporary item-reduction techniques; and (ii) testing the psychometric properties of the reduced measure. METHODS Five hundred and six participants completed the F-SIM, younger and older groups of people with serious mental illness (including psychosis, mood, anxiety disorders) and same-aged community counterparts. The F-SIM was completed at baseline and 2-week follow-up, alongside other measures (including social inclusion, loneliness). The F-SIM was refined using multidimensional scaling network analysis, confirmatory factor analysis and item response theory. The psychometric evaluation included assessment of dimensionality, internal consistency, test-retest reliability, discriminant ability and construct validity. RESULTS The F-SIM was reduced from 135-items to 16; with 4-items in each domain of housing and neighbourhood, finances, employment and education and social participation and relationships. Psychometric properties were sound, including strong internal consistency within domains (all α > 0.85) and excellent overall (α = 0.92). Test-retest reliability was also high (γ = 0.90). Differences between groups were observed; clinical subgroups consistently reported lower levels of social inclusion compared to community counterparts. CONCLUSIONS The F-SIM16 is a sound, reliable, brief self-report measure of social inclusion suitable for use in clinical and research settings. It has the potential to evaluate the effectiveness of interventions, and aid in fostering targeted and personalised needs-based care.
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Deschênes JM, Roy L, Girard N, Abdel-Baki A. Comment aider les jeunes atteints de psychose à éviter l’itinérance ? SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088183ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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