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van der Wal JM, Huth KBS, Lok A, Bockting CL, Stronks K, Nicolaou M. Exploring the mechanisms underlying increased risk of depressive disorder in ethnic minority populations in Europe: A causal loop diagram. Soc Sci Med 2024; 351:116977. [PMID: 38788426 DOI: 10.1016/j.socscimed.2024.116977] [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: 12/28/2023] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Multiple ethnic minority populations in Europe show high risk of major depressive disorder (MDD), with ethnic discrimination and low socioeconomic position (SEP) as established risk factors. How this risk is shaped by the interactions between these, and other social factors, remains to be elucidated. We aimed to develop a causal-loop diagram (CLD) to gain a better understanding of how factors at the intersection of ethnic discrimination and SEP dynamically interact to drive MDD risk. METHODS We iteratively mapped the interactions and feedback loops between factors at the intersection of ethnic discrimination and SEP, drawing input from (i) a series of two interviews with a range of MDD domain experts, (ii) an existing CLD mapping the onset of MDD across psychological, biological, and social dimensions at the level of the individual, and (iii) other relevant literature. RESULTS Through tracing the feedback loops in the resulting CLD, we identified ten driving mechanisms for MDD onset in ethnic minorities (two related to ethnic discrimination, SEP, social network and support, and acculturation, as well as one relating to the living environment and self-stigma towards MDD); and four factors that modulate these mechanisms (recent migration, religious affiliation, neighborhood social environment, and public stigma towards MDD). The intersecting nature of ethnic discrimination and SEP, combined with the reinforcing dynamics of the identified driving mechanisms across time- and spatial scales, underscores the excess exposure to circumstances that increase MDD risk in ethnic minorities. CONCLUSIONS While this CLD requires validation through future studies, the intersecting and reinforcing nature of the identified driving mechanisms highlights that tackling the high risk of MDD in ethnic minorities may require intervening at multiple targets, from the individual (e.g., psychological interventions targeting negative beliefs or reducing stress) to the societal level (e.g., addressing labor market discrimination).
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Affiliation(s)
- J M van der Wal
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.
| | - K B S Huth
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands; University of Amsterdam, Department of Psychological Methods, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands
| | - A Lok
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - C L Bockting
- Amsterdam UMC, location AMC, Department of Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - K Stronks
- Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - M Nicolaou
- Amsterdam UMC, location VUmc, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
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Studer S, Kleinstäuber M, von Lersner U, Weise C. Increasing transcultural competence in clinical psychologists through a web-based training: study protocol for a randomized controlled trial. Trials 2024; 25:71. [PMID: 38243285 PMCID: PMC10799352 DOI: 10.1186/s13063-023-07878-w] [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: 07/11/2023] [Accepted: 12/15/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND In mental health care, the number of patients with diverse cultural backgrounds is growing. Nevertheless, evaluated training programs for transcultural competence are missing. Barriers for engaging in transcultural therapy can be identified in patients as well as in therapists. Besides language barriers, clinical psychologists report insecurities, for example, fear of additional expenses when involving a language mediator, ethical concerns such as power imbalances, or fear of lack of knowledge or incorrect handling when working with patients from other cultures. Divergent values and concepts of disease, prejudices, and stereotyping are also among the issues discussed as barriers to optimal psychotherapy care. The planned study aims to empower clinical psychologists to handle both their own as well as patients' barriers through a web-based training on transcultural competence. METHODS The training includes 6 modules, which are unlocked weekly. A total of N = 174 clinical psychologists are randomly assigned to two groups: the training group (TG) works through the complete training over 6 weeks, which includes a variety of practical exercises and self-reflections. In addition, participants receive weekly written feedback from a trained psychologist. The waitlist control group (WL) completes the training after the end of the waiting period (2 months after the end of the TG's training). The primary outcome is transcultural competence. Secondary outcomes consist of experiences in treating people from other cultures (number of patients, satisfaction and experience of competence in treatment, etc.). Data will be collected before and after the training as well as 2 and 6 months after the end of the training. DISCUSSION This randomized controlled trial tests the efficacy of and satisfaction with a web-based training on transcultural competence for German-speaking clinical psychologists. If validated successfully, the training can represent a time- and place-flexible training opportunity that could be integrated into the continuing education of clinical psychologists in the long term. TRIAL REGISTRATION DRKS00031105. Registered on 21 February 2023.
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Affiliation(s)
- Selina Studer
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
| | - Maria Kleinstäuber
- Department of Psychology, Emma Eccles Jones College of Education and Human Services, Utah State University, 6405 Old Main Hill, Logan, UT, 84321, USA
| | | | - Cornelia Weise
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Smyth E, Steel C, Ellett L. The prevalence of non-affective psychosis in refugee populations: A systematic review. Schizophr Res 2023; 260:99-112. [PMID: 37634388 DOI: 10.1016/j.schres.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 06/27/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND As we face the largest refugee crisis since World War Two, research is increasingly examining the impact of forced displacement. The risk of non-affective psychosis in refugees is evidenced to be significantly greater than non-refugees, and the role of pre-, peri- and post-migratory trauma and dissociation is increasingly implicated. AIMS To determine the prevalence of non-affective psychosis in refugee populations. METHOD PRISMA guidelines were followed. Three key databases (PubMed, PsychINFO and Web of Science), Google scholar and study references were searched. The full-text of 62 studies were screened and 23 studies were eligible for inclusion. A narrative synthesis was undertaken and the Quality Assessment Tool for Quantitative Studies was used to assess methodological quality. (PROSPERO registration CRD42019152170). RESULTS The results were widely heterogeneous. The combined weighted average prevalence of non-affective psychosis in refugee populations was 0.9 %. Psychosis prevalence for individual psychotic symptoms was 28.4 %; 0.5 % for schizophrenia; 1.0 % for psychosis; 0.6 % for mixed psychotic disorders and 2.9 % for psychotic episodes. CONCLUSIONS Variations in examined populations, diagnostic and prevalence classifications, and study designs and methodologies likely contributed to heterogeneity across the data. The findings highlight a greater need to provide more specialist mental health services and trauma-focused interventions, as well as transculturally sensitive assessment and treatment to address refugee vulnerability to psychosis. Future research should examine psychosis prevalence longitudinally and in refugees-only, address methodological bias and further examine the role of trauma and dissociation in refugee psychosis prevalence.
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Affiliation(s)
- Emily Smyth
- Psychology Department, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK.
| | - Craig Steel
- The Oxford Institute of Clinical Psychology Training and Research, The Oxford Centre for Psychological Health, University of Oxford, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, UK.
| | - Lyn Ellett
- School of Psychology, University of Southampton, UK.
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4
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Falgas-Bague I, Cruz-Gonzalez M, Zhen-Duan J, Nagendra A, Alvarez K, Canino G, Duarte CS, Bird H, M. De-Salazar P, Alegría M. Association of sociocultural stressors with bipolar disorder onset in Puerto Rican youth growing up as members of a minoritized ethnic group: results from the Boricua Youth Longitudinal Study. LANCET REGIONAL HEALTH. AMERICAS 2023; 24:100549. [PMID: 37485018 PMCID: PMC10362791 DOI: 10.1016/j.lana.2023.100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/29/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023]
Abstract
Background The development of bipolar disorder is currently explained by a complex interaction of genetic and environmental factors. Less is known regarding the influence of sociocultural factors. This study aims to evaluate the incidence and impact of sociocultural factors on bipolar disorder onset in two comparable samples of youth growing up in different social settings. Methods We leveraged data from two urban population-based cohorts representative of Puerto Rican children growing up in either San Juan (Puerto Rico) or the South Bronx (NYC) and followed up for 17 years. Bipolar disorder diagnoses were based on retrospective self-reports on the World Health Organization Composite International Diagnostic Interview. We used a causal inference approach to estimate associations of sociocultural factors with bipolar disorder onset after adjusting for potential confounders. Findings We found that South Bronx children, who grew up as a minoritized group, had twice the risk of bipolar disorder onset as young adults, with an incidence rate of 2.22 new cases per 1000 person-years compared to 1.08 new cases in San Juan (incidence rate difference, 1.13; 95% CI, 0.09-1.20). After adjusting for potential confounders, South Bronx children had the same lifetime hazard of bipolar disorder onset compared to San Juan children. However, our analysis demonstrated that caregivers' exposure to societal cultural stress partially explained the increased risk of bipolar disorder onset in the South Bronx, in addition to the potential contribution of genetics. Interpretation Our results provide evidence that societal cultural stress can increase the risk of lifetime bipolar disorder onset in youth growing up as a minoritized group. Addressing stress in minoritized groups might reduce the risk of bipolar disorder onset. Funding The Boricua Youth Study has been supported by the National Institutes of HealthMH56401, MH098374, DA033172, and AA020191. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.
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Affiliation(s)
- Irene Falgas-Bague
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 2 Kreutzstrasse, 4123, Allschwil, Switzerland
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA
| | - Arundati Nagendra
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Schizophrenia and Psychosis Action Alliance, Alexandria, VA 22301, USA
| | - Kiara Alvarez
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico Medical School, Office A928 9th Floor, Rio Piedras, 00935, Puerto Rico
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Hector Bird
- New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Pablo M. De-Salazar
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 2 Kreutzstrasse, 4123, Allschwil, Switzerland
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Suite 506, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215, USA
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Elisa DF, Claudio B, Vincenzo V, Paola R. Compulsory admission: are there differences between migrants and natives? Data from a psychiatric emergency service of an Italian metropolitan area. Heliyon 2023; 9:e14406. [PMID: 36938435 PMCID: PMC10018564 DOI: 10.1016/j.heliyon.2023.e14406] [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: 10/18/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Background As compared to natives, higher rates of involuntary admission were found among migrants in most European countries. A possible strategy to reduce this phenomenon is to develop preventive strategies targeting risk and protective factors of compulsory admission specific to the migrant population. Aims The first aim of the present study was to evaluate compulsory admission rates in the migrant population as compared to natives admitted for an acute mental disorder. The second aim was investigate whether sociodemographic, clinical, and care-related variables associated with compulsory admission differed between migrants and natives. Moreover, in the whole sample we assessed whether migrant status affected the risk of compulsory admission. Methods Retrospective single-center study on patients hospitalized in the period between January 1, 2018 and December 31, 2020 in a large metropolitan academic hospital. We compared sociodemographic, clinical, and care-related variables between migrants and natives, voluntary or compulsory admitted. We investigated the association between compulsory admission and the variables collected in the whole sample and in the migrants' and natives' groups with a correlation analysis followed by hierarchical logistic regression models. Results The sample included 185 migrant patients and 933 native patients. The prevalence of compulsory admission was significantly higher in the migrants' group. Male gender, lower education, non-comprehension of the local language, a diagnosis of a schizophrenia spectrum disorder, and aggressive behavior were associated with compulsory admission in the migrants' sample, partially differing from the natives. Conclusion Our study highlighted how migrant status is associated with a higher risk for compulsory admission. Inclusion policies or the presence of cultural mediators in emergency settings might be preventive strategies in this context.
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Affiliation(s)
- Del Favero Elisa
- Dipartimento di Neuroscienze “Rita Levi Montalcini”, Università degli Studi di Torino, Via Cherasco 11, Turin, Italy
- Corresponding author.
| | - Brasso Claudio
- Dipartimento di Neuroscienze “Rita Levi Montalcini”, Università degli Studi di Torino, Via Cherasco 11, Turin, Italy
| | - Villari Vincenzo
- Dipartimento di Neuroscienze e Salute Mentale-, A.O.U. Città della Salute e della Scienza, Via Cherasco 11, Turin, Italy
| | - Rocca Paola
- Dipartimento di Neuroscienze “Rita Levi Montalcini”, Università degli Studi di Torino, Via Cherasco 11, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale-, A.O.U. Città della Salute e della Scienza, Via Cherasco 11, Turin, Italy
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Beltran G. Les besoins en santé mentale des personnes migrantes LGBTI : entre orientation généraliste. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 34:251-260. [PMID: 37336741 DOI: 10.3917/spub.hs2.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
INTRODUCTION In France, there are no studies on the mental health of lesbian, gay, bi, trans and intersex (LGBTI) migrants. In North America however, some data show high prevalence for mental issues in this population. PURPOSE OF RESEARCH This study analyze mental health needs of LGBTI migrants and document the care and support for those needs in two French cities, with a socio-anthropological approach. RESULTS LGBTI migrants suffer from numerous mental issues linked with their migration and their sexual orientation, gender identity and expression (SOGIE). Those sources of violence are imbricated and fuel each other. It is mainly as migrants that LGBTI are taken care of by State services devoted to precarious people, even though some LGBTI associations propose a different kind of community support. CONCLUSIONS LGBTI migrants deal with the same deficits in mental health services than other migrants, but have also specific difficulties. The development of support group for this minority helps with those difficulties and ultimately questions the strengths and limits of community-based approach to mental health.
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Fovet T, Pignon B, Wathelet M, Benradia I, Roelandt JL, Jardri R, Thomas P, D'Hondt F, Amad A. Admission to jail and psychotic symptoms: a study of the psychotic continuum in a sample of recently incarcerated men. Soc Psychiatry Psychiatr Epidemiol 2023; 58:25-34. [PMID: 35859058 DOI: 10.1007/s00127-022-02339-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/08/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE We sought to measure the prevalence of psychotic symptoms (PSs) and psychotic disorders (PDs) in a sample of men entering jail and to compare these prevalences with those observed in the general population. We also aimed to explore the sociodemographic and clinical factors associated with PSs and PDs. METHODS The Mental Health in the Prison Population (MHPP) survey interviewed 630 incarcerated men upon admission to jail, using the Mini International Neuropsychiatric Interview. We looked for associations between sociodemographic and clinical characteristics and the presence of lifetime PSs and PDs in the MHPP and Mental Health in the General Population (MHGP) surveys, which used the same methodology to collect data from the jail and general populations of the same geographical area. RESULTS A higher proportion of PSs without PDs was found in the MHGP group (25.3% vs. 17.8%, p < 0.001), whereas a higher prevalence of PDs was found in the MHPP group (7.0% vs. 2.6%, p < 0.001). The multivariable model indicated that subjects who were single or separated/divorced/widowed and had a history of trauma exposure were at joint risk of PSs and PDs, whereas entering jail was not associated with either PSs or PDs after adjustment for all covariates. CONCLUSION The present study shows that PDs, but not PSs, are more prevalent in men entering jail than in the general population. This overrepresentation could be further explained by the exposure to vulnerability factors found in this population rather than by any specificity related to entering jail.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France. .,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France.
| | - Baptiste Pignon
- Université Paris Est Créteil (UPEC), INSERM, IMRB, AP-HP, Hôpitaux Universitaires « Henri Mondor », DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Dpt. & CURE Research Platform, Lille, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
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Pavarin RM, Fioritti A, Fabbri C, Sanchini S, De Ronchi D. Comparison of Mortality Rates between Italian and Foreign-born Patients with Alcohol Use Disorders. J Psychoactive Drugs 2022; 54:471-481. [PMID: 34963415 DOI: 10.1080/02791072.2021.2014082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Italy, although the number of foreign-born residents has grown exponentially, there are no data on mortality risk among migrants who have alcohol use disorders (AUDs). We examined the mortality risk and causes of death for natives and non-natives in a cohort of individuals treated for AUDs in Northern Italy in the period from 01/01/1975 to 31/12/2016. We highlight important characteristics of non-natives compared to Italians: 1) a younger age and a higher proportion of females; 2) a better health status; 3) a better social capital 4) a lower risk of death. We found differences in mortality between the various areas of origin, with a higher risk among participants born in Asia and African countries other than Mediterranean. The excess mortality compared to the reference population (SMRs) was at least three times for Italians and two times for migrants. While the non-native patients with AUDs have in general better health than Italians with AUDs, our results highlighted higher percentage of dropouts from treatment and lower access to Mental Health Services, suggesting that barriers to the access and completion of therapeutic programs still exist.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italian Society of Substance Abuse (SITD), Italy
| | - Angelo Fioritti
- Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italy
| | - Chiara Fabbri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Samantha Sanchini
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Forli, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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van de Beek MH, Landman E, Veling W, Schoevers RA, van der Krieke L. Discussing the unspoken: A qualitative analysis of online forum discussions on mental health problems in young Moroccan-Dutch migrants. Transcult Psychiatry 2022; 60:86-98. [PMID: 35939051 DOI: 10.1177/13634615221105118] [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] [Indexed: 11/16/2022]
Abstract
Migrants and their offspring are at increased risk of developing mental disorders. Previous research has shown associations between adverse social factors (e.g., discrimination, lack of social support) and mental health problems in migrants, but it is unknown how these associations are understood by migrants themselves. In this study, we aimed to gain explorative insight into the way young Moroccan-Dutch people experience their social environment, and how they relate this social environment to the development of mental health problems. At www.marokko.nl, the largest online discussion platform for young Moroccan-Dutch people, contributors discuss a broad variety of subjects, including societal, cultural, religious, and mental health issues. Combining deductive and inductive approaches to qualitative data analysis, we analysed 22 forum discussions at marokko.nl about mental health problems, after which data saturation was reached. Contributors described feeling isolated and experiencing discrimination in their social environment. Contributor comments identified social challenges arising from Dutch society, Dutch culture (e.g., being too individualistic), Moroccan culture (e.g., strict parenting style), and living between these two cultures. These social challenges are perceived to be associated with mental health problems. Furthermore, we created a model describing the different types of explanations contributors used for mental health problems, being: religious (e.g., possession); medical (i.e., a bio-psycho-social cause); or a combination of both. This model can help clinicians in delivering culturally sensitive mental health care. Lastly, this study shows the taboo on mental health problems in the Moroccan-Dutch population and the opportunity to open up in the online environment.
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Affiliation(s)
- Madelien H van de Beek
- Dimence Institute for Mental Health, Dimence Group, Deventer, the Netherlands.,University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erwin Landman
- Dimence Institute for Mental Health, Dimence Group, Deventer, the Netherlands.,Department of Development Psychology, University of Tilburg, Tilburg, Netherlands
| | - Wim Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert A Schoevers
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Benradia I, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. Trauma exposure and PTSD among men entering jail: A comparative study with the general population. J Psychiatr Res 2021; 145:205-212. [PMID: 34929470 DOI: 10.1016/j.jpsychires.2021.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/27/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
Research has consistently shown high levels of post-traumatic stress disorder (PTSD) in correctional settings. We aimed to compare the prevalences of trauma exposure, subthreshold PTSD, and full PTSD in incarcerated people with those observed in the general population. We used the Mini-International Neuropsychiatric Interview to screen for psychiatric disorders among men upon admission to jail (N = 630) and non-incarcerated men living in the same geographic area (the northern district of France; N = 5793). We utilized a multinomial regression model to assess the association between admission to jail and the prevalences of trauma exposure, subthreshold PTSD, and full PTSD. We employed logistic regression models to verify the interaction between admission to jail and PTSD status on the presence of psychiatric comorbidities. Full PTSD was overrepresented among men in jail after adjustment for all covariates (OR [95% CI] = 3.49 [1.55-7.85], p = 0.002). The association between PTSD status and the presence of at least one psychiatric comorbidity was also more important upon admission to jail than in the general population. Admission to jail was not associated with a higher prevalence of trauma exposure (OR [95% CI] = 1.12 [0.85-1.46], p = 0.419) or subthreshold PTSD (OR [95% CI] = 1.17 [0.81-1.68], p = 0.413). These results suggest higher prevalence rates of full PTSD and psychiatric comorbidities associated with PTSD symptoms in incarcerated people than in the general population. The provision of trauma-focused interventions tailored to these clinical specificities should be considered for the jail population.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France; ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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11
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Brito MA, Amad A, Rolland B, Geoffroy PA, Peyre H, Roelandt JL, Benradia I, Thomas P, Vaiva G, Schürhoff F, Pignon B. Religiosity and prevalence of suicide, psychiatric disorders and psychotic symptoms in the French general population. Eur Arch Psychiatry Clin Neurosci 2021; 271:1547-1557. [PMID: 33566159 DOI: 10.1007/s00406-021-01233-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 01/23/2021] [Indexed: 02/07/2023]
Abstract
We aimed to examine the association between religious beliefs and observance and the prevalence of psychiatric disorders, psychotic symptoms and history of suicide attempts in the French general population. The cross-sectional survey interviewed 38,694 subjects between 1999 and 2003, using the MINI. Current religious beliefs and observance were identified by means of two questions: "are you a believer?" and "are you religiously observant?". We studied the association between religiosity and psychiatric outcomes using a multivariable logistic regression model adjusted for sociodemographic characteristics, including migrant status. Religious beliefs were positively associated with psychotic symptoms and disorders [OR = 1.37, 95% CI (1.30-1.45) and OR = 1.38, 95% CI (1.20-1.58)], unipolar depressive disorder [OR = 1.15, 95% CI (1.06-1.23)] and generalized anxiety disorder [OR = 1.13, 95% CI (1.06-1.21)], but negatively associated with bipolar disorder [OR = 0.83, 95% CI (0.69-0.98)], alcohol use disorders [OR = 0.69, 95% CI (0.62-0.77)], substance use disorders [OR = 0.60, 95% CI (0.52-0.69)] and suicide attempts [OR = 0.90, 95% CI (0.82-0.99)]. Religious observance was positively associated with psychotic symptoms and disorders [OR = 1.38, 95% CI (1.20-1.58) and OR = 1.25, 95% CI (1.07-1.45)], but negatively associated with social anxiety disorder [OR = 0.87, 95% CI (0.76-0.99)], alcohol use disorders [OR = 0.60, 95% CI (0.51-0.70)], substance use disorders [OR = 0.48, 95% CI (0.38-0.60)] and suicide attempts [OR = 0.80, 95% CI (0.70-0.90)]. Among believers, religious observance was not associated with psychotic outcomes. Religiosity appears to be a complex and bidirectional determinant of psychiatric symptoms and disorders. In this respect, religiosity should be more thoroughly assessed in epidemiological psychiatric studies, as well as in clinical practice.
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Affiliation(s)
- Maria Alice Brito
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France.,Paris University, Paris, France
| | - Ali Amad
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, 59000, Lille, France.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London, UK
| | - Benjamin Rolland
- Service Universitaire D'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron France , CRNL, Inserm U1028-CNRS UMR5292, UCBL, Université de Lyon, Lyon, France
| | - Pierre A Geoffroy
- Paris University, Paris, France.,Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018, Paris, France.,Université de Paris, NeuroDiderot, Inserm, 75019, Paris, France.,Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France
| | - Hugo Peyre
- Paris University, Paris, France.,Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Paris, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Pierre Thomas
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, 59000, Lille, France
| | - Guillaume Vaiva
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France.,Centre National de Ressources Et Résilience Pour Les Psychotraumatismes (Cn2r), Lille Paris, France
| | - Franck Schürhoff
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France.,Laboratoire Neuro-Psychiatrie Translationnelle, Inserm, U955, Institut Mondor de Recherche Biomédicale, 94000, Créteil, France.,Fondation FondaMental, 94000, Créteil, France.,Faculté de Médecine, UPEC, Université Paris Est Créteil, 94000, Créteil, France
| | - Baptiste Pignon
- Département Médico-Universitaires de Psychiatrie Et D'addictologie Des Hôpitaux Universitaires Henri-Mondor, Hôpital Albert Chenevier, Groupe Hospitaliers Henri-Mondor, CHU de Créteil Assistance Publique-Hôpitaux de Paris (AP-HP), DMU IMPACT, 40 rue de Mesly, 94 000, Créteil, France. .,Laboratoire Neuro-Psychiatrie Translationnelle, Inserm, U955, Institut Mondor de Recherche Biomédicale, 94000, Créteil, France. .,Fondation FondaMental, 94000, Créteil, France. .,Faculté de Médecine, UPEC, Université Paris Est Créteil, 94000, Créteil, France.
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12
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The Prevalence of Cannabis Use Disorder Comorbidity in Individuals With Bipolar Disorder: A Systematic Review and Meta-Analysis. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Osooli M, Ohlsson H, Sundquist J, Sundquist K. Major depressive disorders in young immigrants: A cohort study from primary healthcare settings in Sweden. Scand J Public Health 2021:14034948211019796. [PMID: 34120516 DOI: 10.1177/14034948211019796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS Previous studies on major depressive disorder (MDD) among immigrants have reported mixed results. Using data from primary healthcare settings in Sweden, we compared the incidence of MDD among first- and second-generation immigrants aged 15-39 years with natives. METHODS This was a retrospective nationwide open cohort study. Eligible individuals were born 1965-1983, aged 15-39 years at baseline, and resided in Sweden for at least one year during the study period 2000-2015. We identified MDD cases through the Primary Care Registry (PCR). The follow-up for each individual started when they met the inclusion criteria and were registered in the PCR and ended at MDD diagnosis, death, emigration, moving to a county without PCR coverage, or the end of the study period, whichever came first. Results: The final sample included 1,341,676 natives and 785,860 immigrants. The MDD incidence rate per 1000 person-years ranged from 6.1 (95% confidence intervals: 6.1, 6.2) to 16.6 (95% confidence intervals: 16.2, 17.0) in native males and second-generation female immigrants with a foreign-born father, respectively. After adjusting for income, the MDD risk did not differ substantially between first-generation male and female immigrants and natives. However, male and female second-generation immigrants had a 16-29% higher adjusted risk of MDD than natives. CONCLUSIONS This cohort study using primary healthcare data in Sweden, albeit incomplete, indicated that second-generation immigrants seem to be at a particularly high risk of MDDs. The underlying mechanisms need further investigation.
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Affiliation(s)
- Mehdi Osooli
- Center for Primary Health Care Research, Lund University, Sweden
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Sweden.,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, USA.,Department of Functional Pathology, Shimane University, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Sweden.,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, USA.,Department of Functional Pathology, Shimane University, Japan
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14
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Tortelli A, Perquier F, Melchior M, Lair F, Encatassamy F, Masson C, K’ourio H, Gourevitch R, Mercuel A. Mental Health and Service Use of Migrants in Contact with the Public Psychiatry System in Paris. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249397. [PMID: 33333905 PMCID: PMC7765309 DOI: 10.3390/ijerph17249397] [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: 11/23/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Migrants, and particularly asylum seekers, are at increased risk of psychiatric disorders in comparison with natives. At the same time, inequalities in access to mental health care are observed. METHODS In order to evaluate whether the Parisian public psychiatric system is optimally structured to meet the needs of this population, we examined data on mental health and service use considering three different levels: the global system treatment level, a psychiatric reception center, and mobile teams specializing in access to psychiatric care for asylum seekers. RESULTS We found higher treatment rates among migrants than among natives (p < 0.001) but inequalities in pathways to care: more mandatory admissions (OR = 1.36, 95% CI: 1.02-1.80) and fewer specialized consultations (OR = 0.56, 95% CI: 0.38-0.81). We observed a mismatch between increased need and provision of care among migrants without stable housing or seeking asylum. CONCLUSIONS Inequalities in the provision of care for migrants are observed in the Parisian public psychiatric system, particularly for those experiencing poor social and economic conditions. There is a need to facilitate access to mental health care and develop more tailored interventions to reduce discontinuity of care.
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Affiliation(s)
- Andrea Tortelli
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
- Pierre Louis Institute for Epidemiology and Public Health (IPLESP/INSERM UMR_S 1136), 75012 Paris, France;
- Institut des Migrations, 75013 Paris, France
- Correspondence:
| | - Florence Perquier
- Departement d’Epidémiologie, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France;
| | - Maria Melchior
- Pierre Louis Institute for Epidemiology and Public Health (IPLESP/INSERM UMR_S 1136), 75012 Paris, France;
- Institut des Migrations, 75013 Paris, France
| | - François Lair
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
| | - Fabien Encatassamy
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Chloé Masson
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
| | - Hélène K’ourio
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Raphaël Gourevitch
- CPOA: Centre Psychiatrique d’Orientation et d’Accueil, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences-1, rue Cabanis, F-75014 Paris, France; (F.E.); (H.K.); (R.G.)
| | - Alain Mercuel
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, 75014 Paris, France; (F.L.); (C.M.); (A.M.)
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15
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Abstract
Bipolar spectrum disorders encompass heterogeneous clinical manifestations and comorbidities. A latent class analysis (LCA) was performed in 1846 subjects who experienced an episode of abnormally elevated or irritable mood to identify homogeneous groups of subjects, based on the distribution of 11 manic and 7 psychotic symptoms. LCA identified five classes: 1) two classes with irritability and with low and high level of psychosis (respectively "irritable," 29.1% of the sample, and "irritable-psychotic," 16.2%); 2) a class with expansive mood and hyperactivity ("expansive-hyperactive," 12.7%); and 3) two classes with manic symptoms and high and low level of psychosis ("manic-psychotic," 15.0%, and "manic," 27.2%). "Irritable" displayed lower rates of depressive episode, panic, and substance use disorders. Manic-psychotic displayed higher rates of depressive episode, panic, generalized anxiety, and substance use disorders. Use of mental health treatment more frequent in manic-psychotic and manic classes. Five classes of bipolar spectrum disorders were characterized by different sociodemographic and clinical patterns.
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16
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Higher prevalence of depressed mood in immigrants' offspring reflects their social conditions in the host country: The HELIUS study. PLoS One 2020; 15:e0234006. [PMID: 32497057 PMCID: PMC7272005 DOI: 10.1371/journal.pone.0234006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/15/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immigrants from low- and middle-income countries who have settled in high-income countries show higher risks of depression in comparison with host populations. The risks are associated with adverse social conditions. Indecisive results have been reported on the depression risks of the offspring of immigrant populations. OBJECTIVE To assess the prevalence of depressed mood in immigrant offspring relative to the host population and to analyse whether that risk is explained by social conditions. METHODS Cross-sectional data from the Dutch HELIUS study were analysed, involving 19,904 men and women of Dutch, South-Asian Surinamese, African Surinamese, Turkish or Moroccan ethnic descent aged 18 to 70. Depressive symptomatology was assessed using the Patient Health Questionnaire-9 (PHQ-9). Indicators of social conditions were socioeconomic position (educational level, occupational level, employment status), perceived ethnic discrimination and sociocultural integration (ethnic identity, cultural orientation, social network). We used logistic regression to assess the risk of depressed mood (PHQ-9 sum score ≥10) in immigrants' offspring, as well as in first generation immigrants, relative to the risk in the host population. Social indicators were stepwise added to the model. RESULTS The prevalence of depressed mood was 13% to 20% among immigrant offspring, with the lowest level for those of African Surinamese descent; prevalence in the Dutch origin population was 7%. Relative risk of depressed mood, expressed as average marginal effects (AMEs), decreased substantially in all offspring groups after adjustment for socioeconomic indicators and discrimination. E.g. the AME of Turkish vs. Dutch decreased from 0.11 (0.08-0.13) to 0.05 (0.03-0.08). Patterns resembled those in first generation immigrants. CONCLUSIONS Results suggest that the observed higher prevalence of depressed mood in immigrants' offspring will decline to the level of the host population as the various populations grow closer in terms of socioeconomic position and as immigrant offspring cease to experience discrimination.
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17
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Fovet T, Plancke L, Amariei A, Benradia I, Carton F, Sy A, Kyheng M, Tasniere G, Amad A, Danel T, Thomas P, Roelandt JL. Mental disorders on admission to jail: A study of prevalence and a comparison with a community sample in the north of France. Eur Psychiatry 2020; 63:e43. [PMID: 32336297 PMCID: PMC7355167 DOI: 10.1192/j.eurpsy.2020.38] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background. The aim of the present study was to estimate prevalence rates of psychiatric and substance use disorders in male and female prisoners on admission to prison in the north of France and compare the frequency of these disorders to the general population. Methods. This cross-sectional survey on Mental Health in the Prison Population (MHPP), conducted between March 2014 and April 2017, interviewed 653 randomly selected men and women who had recently been committed to the French general population prison system in the Nord and Pas-de-Calais departments. For each subject, the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric interview, was used to screen for psychiatric and substance use disorders. The prevalence rates were then compared with data from the Mental Health in the General Population (MHGP) survey, a general population survey that used the same assessment methodology as MHPP in the Nord and Pas-de-Calais departments. A control sample was taken from the MHGP survey with a ratio of one case (MHPP) to three controls (MHGP) matching on age and sex. Results. The sample was primarily composed of French men, most of them single with low educational levels at the time of imprisonment. The mean age was 31.7 (standard deviation = 9.9; min = 18; max = 67). Most of the subjects included were first-time prisoners. The prevalence of affective disorders among newly incarcerated individuals was 31.2% with higher rates for major depressive disorder (27.2%). The prevalence of anxiety disorders was 44.4% with higher rates for generalized anxiety disorder (25.2%). The prevalence of psychotic syndromes was 6.9%. The prevalence of substance use disorders was 53.5% and a suicide risk was identified in 31.4% of the prisoners interviewed. Higher prevalence rates were found in the MHPP when compared with the MHGP for all psychiatric and substance use disorders assessed except for dysthymia and current isolated psychotic syndrome. Conclusions. Our study shows very high levels of prevalence for psychiatric and substance use disorders in recently committed French prisoners.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, U1172-Lille Neuroscience & Cognition-Equipe Plasticity & SubjectivitY, F-59000 Lille, France.,CHU Lille, Pôle de Psychiatrie, F-59000 Lille, France
| | - Laurent Plancke
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-Lez-Lille, France.,Univ. Lille, CNRS, UMR 8019 - CLERSE - Centre Lillois d'Études et de Recherches sociologiques et Économiques, F-59000 Lille, France
| | - Alina Amariei
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-Lez-Lille, France
| | - Imane Benradia
- EPSM Lille-Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Fanny Carton
- CHU Lille, Pôle de Psychiatrie, F-59000 Lille, France
| | - Aminata Sy
- EPSM Lille-Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale, Lille, France
| | - Maeva Kyheng
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.,CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | | | - Ali Amad
- Univ. Lille, Inserm, U1172-Lille Neuroscience & Cognition-Equipe Plasticity & SubjectivitY, F-59000 Lille, France.,CHU Lille, Pôle de Psychiatrie, F-59000 Lille, France
| | - Thierry Danel
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-Lez-Lille, France
| | - Pierre Thomas
- Univ. Lille, Inserm, U1172-Lille Neuroscience & Cognition-Equipe Plasticity & SubjectivitY, F-59000 Lille, France.,CHU Lille, Pôle de Psychiatrie, F-59000 Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille-Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
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18
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Pignon B, Sescousse G, Amad A, Benradia I, Vaiva G, Thomas P, Geoffroy PA, Roelandt JL, Rolland B. Alcohol Use Disorder Is Differently Associated With Psychotic Symptoms According To Underlying Psychiatric Disorders: A General Population Study. Alcohol Alcohol 2019; 55:112-120. [DOI: 10.1093/alcalc/agz077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/09/2019] [Accepted: 08/21/2019] [Indexed: 01/09/2023] Open
Abstract
Abstract
Aims
Psychotic symptoms can occur in the general population, and alcohol use disorder (AUD) is an identified vulnerability factor. However, it remains unclear how AUD is associated with psychotic symptoms, depending on the underlying psychiatric condition.
We aimed to compare the prevalence of psychotic symptoms among subjects with different types of psychiatric disorders, i.e. unipolar or bipolar disorders, anxiety disorders, psychotic disorders or no psychiatric disorder, depending on whether or not there was an underlying AUD.
Methods
In a 38,694-subject general population study, we compared the likelihood of occurrence of seven types of psychotic symptoms, depending on the AUD status and the underlying psychiatric disorders, after adjustment for age, sex, marital status, education and income levels.
Results
In unipolar depression and anxiety disorders, almost all types of psychotic symptoms were found associated with AUD (odds ratios (ORs) between 1.98 and 2.19). In contrast, in bipolar disorder, only auditory hallucinations were associated with AUD (OR = 2.50). In psychotic disorders, only thought broadcasting was more frequent among subjects with AUD (OR = 1.78).
Conclusion
Our findings in depression and anxiety disorders are in line with the ‘dual diagnosis’ concept, which posits that comorbid psychiatric/addictive disorders form distinctive entities that are more frequently associated with non-specific severity factors, here psychotic symptoms. The co-occurrence of AUD in bipolar/psychotic disorders was not associated with a generalized increased occurrence of psychotic symptoms but altered their manifestations with an increased risk of auditory hallucinations for bipolar disorder and thought broadcasting for psychotic disorders.
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Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie; Inserm, U955, Team 15; Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, 51 avenue du Maréchal Delattre de Tassigny, 94000 Paris, France
| | - Guillaume Sescousse
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier; Univ Lyon, UCBL, Inserm U1028, CNRS UMR5292, CRNL, PSYR2, 95 Bd Pinel, Bron F-69500, France
| | - Ali Amad
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Camberwell, London, UK
| | - Imane Benradia
- EPSM Lille Métropole; Centre Collaborateur de l’Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale; Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, F-59 260 Hellemmes, France
| | - Guillaume Vaiva
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
| | - Pierre Thomas
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale (F2RSM) Hauts-de-France, rue André Verhaeghe, Lille F-59000, France
| | - Pierre A Geoffroy
- Inserm, U1144, F-75006; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, F-75013; AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 200 Rue du Faubourg Saint-Denis, F-75475, Paris cedex 10 75475 and Fondation FondaMental, Créteil 94000, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole; Centre Collaborateur de l’Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale; Équipe Eceve Inserm UMR 1123, 211 rue Roger Salengro, F-59 260 Hellemmes, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier; Univ Lyon, UCBL, Inserm U1028, CNRS UMR5292, CRNL, PSYR2, 95 Bd Pinel, Bron F-69500, France
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Dykxhoorn J, Hollander AC, Lewis G, Magnusson C, Dalman C, Kirkbride JB. Risk of schizophrenia, schizoaffective, and bipolar disorders by migrant status, region of origin, and age-at-migration: a national cohort study of 1.8 million people. Psychol Med 2019; 49:2354-2363. [PMID: 30514409 PMCID: PMC6763532 DOI: 10.1017/s0033291718003227] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 09/17/2018] [Accepted: 10/09/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND We assessed whether the risk of various psychotic disorders and non-psychotic bipolar disorder (including mania) varied by migrant status, a region of origin, or age-at-migration, hypothesizing that risk would only be elevated for psychotic disorders. METHODS We established a prospective cohort of 1 796 257 Swedish residents born between 1982 and 1996, followed from their 15th birthday, or immigration to Sweden after age 15, until diagnosis, emigration, death, or end of 2011. Cox proportional hazards models were used to model hazard ratios by migration-related factors, adjusted for covariates. RESULTS All psychotic disorders were elevated among migrants and their children compared with Swedish-born individuals, including schizophrenia and schizoaffective disorder (adjusted hazard ratio [aHR]migrants: 2.20, 95% CI 1.96-2.47; aHRchildren : 2.00, 95% CI 1.79-2.25), affective psychotic disorders (aHRmigrant1.42, 95% CI 1.25-1.63; aHRchildren: 1.22 95% CI 1.07-1.40), and other non-affective psychotic disorders (aHRmigrant: 1.97, 95% CI 1.81-2.14; aHRchildren: 1.68, 95% CI 1.54-1.83). For all psychotic disorders, risks were generally highest in migrants from Africa (i.e. aHRschizophrenia: 5.24, 95% CI 4.26-6.45) and elevated at most ages-of-migration. By contrast, risk of non-psychotic bipolar disorders was lower for migrants (aHR: 0.58, 95% CI 0.52-0.64) overall, and across all ages-of-migration except infancy (aHR: 1.20; 95% CI 1.01-1.42), while risk for their children was similar to the Swedish-born population (aHR: 1.00, 95% CI 0.93-1.08). CONCLUSIONS Increased risk of psychiatric disorders associated with migration and minority status may be specific to psychotic disorders, with exact risk dependent on the region of origin.
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Affiliation(s)
| | | | | | - Cecelia Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Christina Dalman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
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Pignon B, Geoffroy PA, Thomas P, Roelandt JL, Amad A. Environment risk factors have different impact on bipolar and psychotic disorders: an analysis of MHGP survey. Psychol Med 2019; 49:1229-1232. [PMID: 30782237 DOI: 10.1017/s0033291719000229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie,Créteil 94000,France
| | - Pierre A Geoffroy
- Paris Diderot Université - Paris VII,5 Rue Thomas Mann, 75013 Paris,France
| | - Pierre Thomas
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE,F-59000 Lille,France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole; Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale;Équipe Eceve Inserm UMR 1123,Lille,France
| | - Ali Amad
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE,F-59000 Lille,France
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21
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Pignon B, Amad A, Pelissolo A, Fovet T, Thomas P, Vaiva G, Roelandt JL, Benradia I, Rolland B, Geoffroy PA. Increased prevalence of anxiety disorders in third-generation migrants in comparison to natives and to first-generation migrants. J Psychiatr Res 2018; 102:38-43. [PMID: 29597072 DOI: 10.1016/j.jpsychires.2018.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 02/26/2018] [Accepted: 03/19/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION We sought to examine the prevalence of anxiety disorders associated with migration in the first-, second- and third-generation. METHODS The French Mental Health in the General Population cross-sectional survey interviewed 38,694 individuals using the MINI. The prevalence of lifetime anxiety disorders, and comorbidities was compared between migrants and non-migrants and by generation. All analyses were adjusted for age, sex, and income and education levels. RESULTS In comparison to natives, pooled anxiety disorders were more common among migrants (25.3% vs. 20.7%, OR = 1.24) and among the three studied generations of migrants. Moreover, the prevalence rate of the pooled anxiety disorders was significantly higher in third-generation migrants, in comparison to first-generation (26.7% vs. 22.6%, OR = 1.14). Prevalence rates were higher in migrants for panic disorder (6.6% vs. 5.3%, OR = 1.20), general anxiety disorder (15.0% vs. 12.0%, OR = 1.24), posttraumatic stress disorder (1.0% vs. 0.6%, OR = 1.51), but not for social anxiety disorder. In comparison to natives, migrants with anxiety disorders had higher prevalence rates of suicide attempts (14.0% vs. 12.8% for natives), psychotic disorders (8.3% vs. 5.7%), unipolar depressive disorder (29.5% vs. 25.4%), bipolar disorder (5.0% vs. 4.0%), and addictive disorders (9.6% vs. 6.2% for alcohol use disorder, 8.2% vs. 4.1% for substance use disorders). CONCLUSION Migration was associated with a higher prevalence of all anxiety disorders, in the first, second and third generation, and associated with more psychiatric comorbidities. Moreover, the prevalence increased across generations, and was significantly higher among third-generation migrants, in comparison to first-generation.
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Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Inserm, U955, Team 15, UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France; Fondation FondaMental, Créteil, 94000, France.
| | - Ali Amad
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France; Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, F-59000, Lille, France
| | - Antoine Pelissolo
- AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie, Inserm, U955, Team 15, UPEC, Université Paris-Est, Faculté de médecine, Créteil, 94000, France; Fondation FondaMental, Créteil, 94000, France
| | - Thomas Fovet
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Pierre Thomas
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Guillaume Vaiva
- Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, CHU Lille, Pôle de Psychiatrie, Unité CURE, F-59000, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Equipe Eceve Inserm UMR 1123, Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Equipe Eceve Inserm UMR 1123, Lille, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie, Pôle UP-MOPHA, CH Le Vinatier, Univ. Lyon, 69500, Bron, France; CRNL Inserm U1028/CNRS UMR5292, CH Le Vinatier, 69678, Bron Cedex, France
| | - Pierre A Geoffroy
- Inserm, U1144, Paris, F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, F-75013, France; AP-HP, GH Saint-Louis, Lariboisière, F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475, Paris Cedex 10, France; Fondation FondaMental, Créteil, 94000, France
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Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: A general population-based study. Drug Alcohol Depend 2018; 187:40-47. [PMID: 29626745 DOI: 10.1016/j.drugalcdep.2018.02.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND To compare the symptom patterns of major depressive disorder (MDD) among subjects with MDD and 1) no alcohol use disorder (AUD), 2) alcohol abuse and 3) alcohol dependence, respectively. METHODS In a general population survey of 38,694 French individuals, MDD and AUDs were assessed using the Mini International Neuropsychiatric Interview 5.0.0 (MINI). A total of 4339 subjects (11.2%) in the sample met the criteria for MDD. Among them, 413 (9.5%) AUD subjects were identified: 138 (3.2%) for alcohol abuse and 275 (6.3%) for alcohol dependence. The associations of each of the ten MDD criteria of the MINI and psychiatric clinical features were compared among the three groups. The relative profiles of 'MDD + AUD' vs. 'MDD alone' were determined using a multivariable stepwise regression model. RESULTS With the noAUD group as the reference, sadness (OR = 0.46; 95%CI, 0.29-0.74) and anhedonia (OR = 1.66; 95%CI, 1.06-2.73) were only associated with alcohol abuse. Sleep disorders (OR = 2.07; 95%CI, 1.51-2.88), feelings of guilt (OR = 1.41; 95%CI, 1.05-1.90), diminished concentration/indecisiveness (OR = 1.52; 95%CI, 1.12-2.07) and thoughts of death (OR = 1.95; 95%CI 1.49-2.55) were only associated with alcohol dependence. Weight or appetite variations were both associated with alcohol abuse (OR = 1.7; 95%CI, 1.15-2.53) and dependence (OR = 1.41; 95%CI, 1.06-1.88). Bipolar disorder and PTSD were only associated with alcohol dependence. Psychotic features, previous suicide attempts, and panic disorder were more frequent in the MDD-AUD group. CONCLUSION MDD-AUD subjects displayed a more severe profile with specific symptomatology and comorbidity profiles compared to MDD-only subjects.
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23
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Pignon B, Peyre H, Szöke A, Geoffroy PA, Rolland B, Jardri R, Thomas P, Vaiva G, Roelandt JL, Benradia I, Behal H, Schürhoff F, Amad A. A latent class analysis of psychotic symptoms in the general population. Aust N Z J Psychiatry 2018; 52:573-584. [PMID: 29232967 DOI: 10.1177/0004867417744255] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Individuals with psychotic symptoms may actually correspond to various subgroups, characterized by different patterns of psychotic symptoms as well as specific sociodemographic and clinical correlates. We aimed to identify groups of individuals from the general population with specific patterns of psychotic symptoms. METHODS In a 38,694-subject survey, a latent class analysis was performed to identify subgroups based on the distribution of seven psychotic symptoms taken from the Mini International Neuropsychiatric Interview. The different classes were subsequently compared according to sociodemographic and clinical correlates. RESULTS The best fit was obtained with a four-class solution, including the following: (1) a class with a low prevalence of all psychotic symptoms ('LOW', 85.9%); (2) a class with a high prevalence of all psychotic symptoms ('HAL + DEL', 1.7%); and classes with a high prevalence of (3) hallucinations ('HAL', 4.5%) or (4) delusions ('DEL', 7.9%). The HAL + DEL class displayed higher rates of history of trauma, social deprivation and migrant status, while the HAL and DEL classes displayed intermediate rates between HAL + DEL and LOW. HAL + DEL displayed the highest rates of psychotic and non-psychotic disorders and the use of mental health treatment, while HAL and DEL displayed intermediate rates of these disorders between HAL + DEL and LOW. In comparison to the HAL class, psychotic and substance use disorders were more frequent in the DEL class, while anxiety and mood disorders were less frequent. CONCLUSION These findings support the hypothesis of a continuum model relating the level of psychotic symptoms to the level of global psychopathology.
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Affiliation(s)
- Baptiste Pignon
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Hugo Peyre
- 2 Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department and Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Andrei Szöke
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Pierre A Geoffroy
- 3 Inserm, U1144 and Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, and AP-HP, GH Saint-Louis-Lariboisière-F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Fondation FondaMental, Créteil, France
| | - Benjamin Rolland
- 4 Service Universitaire d'Addictologie, Pôle UP-MOPHA, CH Le Vinatier, Univ. Lyon and CRNL Inserm U1028/CNRS UMR5292-CH Le Vinatier, Bron, France
| | - Renaud Jardri
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France
| | - Pierre Thomas
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Guillaume Vaiva
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Jean-Luc Roelandt
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Imane Benradia
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Hélène Behal
- 8 Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Department of biostatistics, Lille, France
| | - Franck Schürhoff
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Ali Amad
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France.,9 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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24
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Font H, Roelandt JL, Behal H, Geoffroy PA, Pignon B, Amad A, Simioni N, Vaiva G, Thomas P, Duhamel A, Benradia I, Rolland B. Prevalence and predictors of no lifetime utilization of mental health treatment among people with mental disorders in France: findings from the 'Mental Health in General Population' (MHGP) survey. Soc Psychiatry Psychiatr Epidemiol 2018; 53:567-576. [PMID: 29619580 DOI: 10.1007/s00127-018-1507-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/28/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE No lifetime utilization of mental health treatment (NUMT) is an indicator of the treatment gap among people in need of treatment. Until now, the overall prevalence and predictors of NUMT have never been explored in France. METHODS In a 39,617-respondent survey, participants were assessed for NUMT, i.e., no lifetime psychotherapy, psychopharmacotherapy, or psychiatric hospitalization. Mental disorders were investigated using the Mini International Neuropsychiatric Interview (MINI 5.0.0). MINI diagnoses were grouped into five categories: mood disorders (MDs); anxiety disorders (ADs); alcohol use disorders (AUDs); substance use disorders (SUDs); and psychotic disorders (PDs). Using multivariable logistic regression models, we explored the factors associated with NUMT among the MINI-positive respondents. The odds ratio and 95% confidence interval were calculated for each factor. RESULTS In total, 12,818 (32.4%) respondents were MINI-positive, 46.5% of them reported NUMT (35.6% for MDs, 39.7% for PDs, 42.8% for ADs, 56.0% for AUDs, and 56.7% for SUDs). NUMT was positively associated with being male [OR 1.75 (1.59-1.91)] and practising religion [OR 1.13 (1.02-1.25)] and negatively associated with ageing [per 10-year increase: OR 0.88 (0.85-0.91)], being single [OR 0.74 (0.66-0.84)], being a French native [OR 0.67 (0.60-0.75)], and experiencing MDs [OR 0.39 (0.36-0.43)], ADs [OR 0.47 (0.43-0.52)], AUDs [OR 0.83 (0.73-0.96)], SUDs [OR 0.77 (0.65-0.91)], or PDs [OR 0.50 (0.43-0.59)]. CONCLUSIONS In France, NUMT rates were the highest for AUDs and SUDs. Additionally, suffering from MDs or ADs increased the lifetime treatment utilization for people having any other mental disorder. This finding emphasizes the need to better screen AUDs and SUDs among people treated for MDs or ADs.
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Affiliation(s)
- Hélène Font
- Centre Collaborateur de l'Organisation Mondiale de la Santé, 211 rue Roger Salengro, 59 260, Hellemmes, France.
| | - Jean-Luc Roelandt
- Centre Collaborateur de l'Organisation Mondiale de la Santé, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Hélène Behal
- Département de Biostatistiques, Univ. Lille, CHU Lille, EA 2694, Santé publique: épidémiologie et qualité des soins, Lille, France
| | - Pierre-Alexis Geoffroy
- AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Pôle Neurosciences, Paris, France
- Université Paris Diderot, UMR-S 1144, Paris, France
| | - Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri Mondor, Pôle Psychiatrie Addictologie, Créteil, France
- INSERM, U955, équipe 15, Créteil, France
- Fondation FondaMental, Créteil, France
- UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Ali Amad
- Pôle de Psychiatrie et Addictologie, CHRU de Lille, Lille, France
- UMR9193-PsychiC-SCALab, Department of Psychiatry, Univ. Lille, CNRS, CHU de Lille, Lille, France
| | - Nicolas Simioni
- Fondation Phénix, Centre Phénix Plainpalais, Geneva, Switzerland
| | - Guillaume Vaiva
- Pôle de Psychiatrie et Addictologie, CHRU de Lille, Lille, France
- UMR9193-PsychiC-SCALab, Department of Psychiatry, Univ. Lille, CNRS, CHU de Lille, Lille, France
| | - Pierre Thomas
- Pôle de Psychiatrie et Addictologie, CHRU de Lille, Lille, France
- UMR9193-PsychiC-SCALab, Department of Psychiatry, Univ. Lille, CNRS, CHU de Lille, Lille, France
| | - Alain Duhamel
- Département de Biostatistiques, Univ. Lille, CHU Lille, EA 2694, Santé publique: épidémiologie et qualité des soins, Lille, France
| | - Imane Benradia
- Centre Collaborateur de l'Organisation Mondiale de la Santé, 211 rue Roger Salengro, 59 260, Hellemmes, France
| | - Benjamin Rolland
- Pôle de Psychiatrie et Addictologie, CHRU de Lille, Lille, France
- INSERM U1171, Univ Lille, Lille, France
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Université de Lyon, UCBL, Lyon, France
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25
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Michels S, Wöhr M, Schwarting RK, Culmsee C. Psychiatric risk gene Cacna1c determines mitochondrial resilience against oxidative stress in neurons. Cell Death Dis 2018; 9:645. [PMID: 29844355 PMCID: PMC5974319 DOI: 10.1038/s41419-018-0676-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Susanne Michels
- Institute of Pharmacology and Clinical Pharmacy, University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Markus Wöhr
- Department of Experimental and Biological Psychology, University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Rainer Kw Schwarting
- Department of Experimental and Biological Psychology, University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Carsten Culmsee
- Institute of Pharmacology and Clinical Pharmacy, University of Marburg, Marburg, Germany. .,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany.
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26
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Michels S, Ganjam GK, Martins H, Schratt GM, Wöhr M, Schwarting RKW, Culmsee C. Downregulation of the psychiatric susceptibility gene Cacna1c promotes mitochondrial resilience to oxidative stress in neuronal cells. Cell Death Discov 2018; 4:54. [PMID: 29760952 PMCID: PMC5945680 DOI: 10.1038/s41420-018-0061-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/03/2018] [Indexed: 12/21/2022] Open
Abstract
Affective disorders such as major depression and bipolar disorder are among the most prevalent forms of mental illness and their etiologies involve complex interactions between genetic and environmental risk factors. Over the past ten years, several genome wide association studies (GWAS) have identified CACNA1C as one of the strongest genetic risk factors for the development of affective disorders. However, its role in disease pathogenesis is still largely unknown. Vulnerability to affective disorders also involves diverse environmental risk factors such as perinatal insults, childhood maltreatment, and other adverse pathophysiological or psychosocial life events. At the cellular level, such environmental influences may activate oxidative stress pathways, thereby altering neuronal plasticity and function. Mitochondria are the key organelles of energy metabolism and, further, highly important for the adaptation to oxidative stress. Accordingly, multiple lines of evidence including post-mortem brain and neuro-imaging studies suggest that psychiatric disorders are accompanied by mitochondrial dysfunction. In this study, we investigated the effects of Cacna1c downregulation in combination with glutamate-induced oxidative stress on mitochondrial function, Ca2+ homeostasis, and cell viability in mouse hippocampal HT22 cells. We found that the siRNA-mediated knockdown of Cacna1c preserved mitochondrial morphology, mitochondrial membrane potential, and ATP levels after glutamate treatment. Further, Cacna1c silencing inhibited excessive mitochondrial reactive oxygen species formation and calcium influx, and protected the HT22 cells from oxidative cell death. Overall, our findings suggest that the GWAS-confirmed psychiatric risk gene CACNA1C plays a major role in oxidative stress pathways with particular impact on mitochondrial integrity and function.
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Affiliation(s)
- Susanne Michels
- 1Institute of Pharmacology and Clinical Pharmacy, Philipps-University, Marburg, Germany.,2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany
| | - Goutham K Ganjam
- 1Institute of Pharmacology and Clinical Pharmacy, Philipps-University, Marburg, Germany.,2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany
| | - Helena Martins
- 2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany.,3Department of Health Sciences and Technology, Systems Neuroscience, ETH Zurich, Zurich, Switzerland
| | - Gerhard M Schratt
- 2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany.,3Department of Health Sciences and Technology, Systems Neuroscience, ETH Zurich, Zurich, Switzerland
| | - Markus Wöhr
- 2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany.,4Department of Experimental and Biological Psychology, Behavioral Neuroscience, Philipps-University, Marburg, Germany
| | - Rainer K W Schwarting
- 2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany.,4Department of Experimental and Biological Psychology, Behavioral Neuroscience, Philipps-University, Marburg, Germany
| | - Carsten Culmsee
- 1Institute of Pharmacology and Clinical Pharmacy, Philipps-University, Marburg, Germany.,2Center for Mind, Brain and Behavior, Philipps-University, Marburg, Germany
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Abstract
PURPOSE OF REVIEW Arguably, the strongest evidence of an environmental contribution to the cause of psychosis is the increased risk for certain groups of migrants and ethnic minorities. This article summarizes findings published since 2016. RECENT FINDINGS Two studies suggested that migration or minority status are proxies for exposure to an inferior social status. A study from Bologna, Italy, showed that the psychosis risk for internal migrants from Southern Italy was as much increased as that for international migrants. A report from New Zealand reported a higher risk for Maoris than for the remainder of the population.Furthermore, a Danish investigation showed that own-group ethnic density of the neighbourhood at age 15 strongly modified the psychosis risk at adult age. This rules out differential mobility during the prodromal phase as an explanation for the ethnic density effect. Preliminary evidence suggests that the psychotogenic effect of migration may be mediated by elevated dopamine in the striatum. SUMMARY An increasing body of evidence suggests that the higher psychosis risk for certain migrant or ethnic minority groups is due to an inferior social status. Neuroimaging of the dopamine system appears to be a promising avenue for research into pathogenesis.
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Pignon B, Schürhoff F, Szöke A, Geoffroy PA, Jardri R, Roelandt JL, Rolland B, Thomas P, Vaiva G, Amad A. Sociodemographic and clinical correlates of psychotic symptoms in the general population: Findings from the MHGP survey. Schizophr Res 2018; 193:336-342. [PMID: 28689754 DOI: 10.1016/j.schres.2017.06.053] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We aimed to explore the sociodemographic and psychiatric correlates of psychotic symptoms in a large general population sample. METHODS The French Mental Health in the General Population cross-sectional survey interviewed 38,694 individuals using the Mini International Neuropsychiatric Interview. We looked for associations between the presence of lifetime psychotic symptoms, sociodemographic characteristics (including migrant status over three generations) and clinical characteristics. We then looked for associations regarding only hallucinations, delusional symptoms, and the co-occurrence of both hallucinations and delusional symptoms. To test the psychosis continuum hypothesis, associations with sociodemographic characteristics were compared with the characterized psychotic disorders' associations. RESULTS We found that 22.3% of the population declared psychotic symptoms without psychotic disorders, including 5.7% who declared hallucinations, 20.5% delusional symptoms, 4.0% both hallucinations and delusional symptoms, and 2.8% characterized psychotic disorders. The presence of psychotic symptoms was associated with young age, migrant status (over three generations), secondary education level, low-income level and never-married and separated marital status. Hallucinations, delusional symptoms and the co-occurrence of both hallucinations and delusional symptoms showed the same correlates, and hallucinations were also associated with elementary education level. Characterized psychotic disorders showed the same correlates. Concerning clinical outcomes, the presence of psychotic symptoms, hallucinations and delusional symptoms was associated with all non-psychotic disorders, i.e., bipolar, depressive, alcohol use, generalized anxiety, social phobia, panic and post-traumatic stress disorders and dysthymia (except dysthymia, which was not associated with hallucinations). CONCLUSIONS Our results indicate that psychotic symptoms are associated with broad psychopathologies and support the continuum model of psychosis.
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Affiliation(s)
- Baptiste Pignon
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil 94000, France; INSERM, U955, team 15, Créteil 94000, France; Fondation FondaMental, Créteil 94000, France; UPEC, Université Paris-Est, Faculté de Médecine, Créteil 94000, France.
| | - Franck Schürhoff
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil 94000, France; INSERM, U955, team 15, Créteil 94000, France; Fondation FondaMental, Créteil 94000, France; UPEC, Université Paris-Est, Faculté de Médecine, Créteil 94000, France
| | - Andrei Szöke
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, Créteil 94000, France; INSERM, U955, team 15, Créteil 94000, France; Fondation FondaMental, Créteil 94000, France; UPEC, Université Paris-Est, Faculté de Médecine, Créteil 94000, France
| | - Pierre A Geoffroy
- Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France
| | - Renaud Jardri
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; Univ Lille, CNRS UMR-9193 (SCA-Lab) & CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la Recherche et la Formation en Santé Mentale, Equipe Eceve Inserm UMR 1123, Lille, France
| | - Benjamin Rolland
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; Univ Lyon 1, CRNL, Inserm U1028 / CNRS UMR5292, CH Le Vinatier, Bron, F-69500, France
| | - Pierre Thomas
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; Univ Lille, CNRS UMR-9193 (SCA-Lab) & CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France; Fédération Régionale de Recherche en Santé Mentale (F2RSM) Nord - Pas-de-Calais, F-59000 Lille, France
| | - Guillaume Vaiva
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; Univ Lille, CNRS UMR-9193 (SCA-Lab) & CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France; Fédération Régionale de Recherche en Santé Mentale (F2RSM) Nord - Pas-de-Calais, F-59000 Lille, France
| | - Ali Amad
- CHRU de Lille, Pôle de psychiatrie, Hôpital Fontan, Lille 59000, France; Univ Lille, CNRS UMR-9193 (SCA-Lab) & CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France; Fédération Régionale de Recherche en Santé Mentale (F2RSM) Nord - Pas-de-Calais, F-59000 Lille, France
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Tebeka S, Pignon B, Amad A, Le Strat Y, Brichant-Petitjean C, Thomas P, Vaiva G, Roelandt JL, Benradia I, Etain B, Rolland B, Dubertret C, Geoffroy PA. A study in the general population about sadness to disentangle the continuum from well-being to depressive disorders. J Affect Disord 2018; 226:66-71. [PMID: 28963866 DOI: 10.1016/j.jad.2017.08.085] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/23/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sadness is both a common experience in general population and one of the main criteria of major depressive disorder (MDD). We tested the hypothesis of a depressive continuum using sadness as an intermediate experience between well-being and disorder. METHODS A French cross-sectional Mental Health survey in General Population interviewed 38,694 individuals. We examined prevalences and compared sociodemographic correlates and psychiatric disorders of individuals in 3 independent groups 1) MDD, 2) sadness without MDD, and 3) controls. RESULTS The prevalence of sadness was of 29.8% in the whole sample and of 93% in subjects suffering from MDD (n = 4976). The "sadness" group shared the same sociodemographic patterns as the "MDD" group. All psychiatric disorders assessed (i.e. bipolar disorder, anxiety disorder, alcohol use disorder, psychotic disorder and suicide attempts) were significantly associated with both "sadness" and "MDD" groups compared to "controls". Individuals with sadness, compared to those with MDD, were significantly less likely to meet the criteria for all psychiatric disorders. MDD's sensitivity of sadness was 94,2%. LIMITATIONS Even though we used a quota sampling method, the sample was not strictly representative of the general population. CONCLUSION Sadness validates the depressive continuum hypothesis, since it is more frequent in the general population than MDD itself and at the same time shares with MDD the same sociodemographic and clinical correlates. A gradual association from controls to MDD was observed for psychiatric comorbidities. Finally, the high sensitivity of sadness may suggest its use to screen at-risk individuals converting from well-being to full psychiatric disorders.
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Affiliation(s)
- Sarah Tebeka
- APHP, Louis Mourier, Department of Psychiatry, Colombes, France; Centre for Psychiatry and Neurosciences, Inserm (French National Institute of Health and Medical Research) U894, Paris, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France.
| | - Baptiste Pignon
- Inserm (French National Institute of Health and Medical Research), U955, team 15, Créteil, France; AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie et d'Addictologie, Créteil, France; Fondation FondaMental, Créteil, France; UPEC, University Paris-Est, Faculté de médecine, Créteil, France
| | - Ali Amad
- Univ Lille, CNRS UMR-9193 (SCA-Lab), France; CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France
| | - Yann Le Strat
- APHP, Louis Mourier, Department of Psychiatry, Colombes, France; Centre for Psychiatry and Neurosciences, Inserm (French National Institute of Health and Medical Research) U894, Paris, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France
| | | | - Pierre Thomas
- Univ Lille, CNRS UMR-9193 (SCA-Lab), France; CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France; Fédération régionale de recherche en santé mentale (F2RSM) Nord - Pas-de-Calais, F-59000 Lille, France
| | - Guillaume Vaiva
- Univ Lille, CNRS UMR-9193 (SCA-Lab), France; CHU Lille, Hôpital Fontan (CURE), F-59000 Lille, France; Fédération régionale de recherche en santé mentale (F2RSM) Nord - Pas-de-Calais, F-59000 Lille, France
| | - Jean-Luc Roelandt
- Inserm, UMRS 1123, ECEVE - University Paris Diderot, Site Villemin 10 avenue de Verdun, Paris F-75010, France; WHO Collaborating Centre for Research and Training in Mental Health, EPSM LilleMétropole, 211 Rue Roger Salengro, 59260 Hellemmes-Lille France
| | - Imane Benradia
- Inserm, UMRS 1123, ECEVE - University Paris Diderot, Site Villemin 10 avenue de Verdun, Paris F-75010, France; WHO Collaborating Centre for Research and Training in Mental Health, EPSM LilleMétropole, 211 Rue Roger Salengro, 59260 Hellemmes-Lille France
| | - Bruno Etain
- University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France; Fondation FondaMental, Créteil, France; Inserm, U1144, Paris F-75006, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris cedex 10, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France
| | - Benjamin Rolland
- PSYR2, CNRL, Inserm U1028 / CNRS UMR5292, Université Lyon 1, Bron, France; Pôle UP-MOPHA, CH le Vinatier, Bron, France
| | - Caroline Dubertret
- APHP, Louis Mourier, Department of Psychiatry, Colombes, France; Centre for Psychiatry and Neurosciences, Inserm (French National Institute of Health and Medical Research) U894, Paris, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France
| | - Pierre A Geoffroy
- University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France; Fondation FondaMental, Créteil, France; Inserm, U1144, Paris F-75006, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris cedex 10, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France
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Tebeka S, Le Strat Y, Dubertret C. Is parity status associated with bipolar disorder clinical features, severity or evolution? J Affect Disord 2018; 225:201-206. [PMID: 28837954 DOI: 10.1016/j.jad.2017.08.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/29/2017] [Accepted: 08/14/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess prospectively the association of the number of past pregnancies on the evolution of bipolar disorder (BD). METHODS Data were drawn from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population of 34,653 participants. All women diagnosed with BD were included. The number of children and BD's characteristics, i.e. BD type, age of onset, hospitalization and suicide attempt, and lifetime psychiatrics comorbidity were assessed at wave 1. Mood episode and BD's characteristics were also assessed at wave 2. RESULTS In the sample of 1190 women with BD, 27% had no child, 17% had one, 25% had two 31% had three children or more. Women with at least two children were more likely to have BD I, to report hypomania and suicide attempt during the follow-up than women without child. Parity was not associated with other characteristics of BD, nor with the severity and course of the illness. LIMITATIONS Not provide information on pregnancies not ending to a delivery. CONCLUSION Parity is associated with a higher incidence of hypomania and suicide attempt during a 3-years follow-up in women with BD.
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Affiliation(s)
- Sarah Tebeka
- AP-HP, Department of Psychiatry, Louis-Mourier Hospital, Colombes, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France; INSERM U894, Centre for Psychiatry and Neurosciences, 2 ter rue d'Alesia, 75014 Paris, France
| | - Yann Le Strat
- AP-HP, Department of Psychiatry, Louis-Mourier Hospital, Colombes, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France; INSERM U894, Centre for Psychiatry and Neurosciences, 2 ter rue d'Alesia, 75014 Paris, France
| | - Caroline Dubertret
- AP-HP, Department of Psychiatry, Louis-Mourier Hospital, Colombes, France; University Paris 7 Denis Diderot, Faculty of Medicine, Paris, France; INSERM U894, Centre for Psychiatry and Neurosciences, 2 ter rue d'Alesia, 75014 Paris, France
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