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Berardelli I, Aguglia A, Amerio A, Sarubbi S, Rogante E, Trocchia MA, Zelletta D, Longhini L, Erbuto D, Pastorino F, Lamis DA, Innamorati M, Serafini G, Pompili M. Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns. J Psychiatr Pract 2024; 30:2-12. [PMID: 38227722 DOI: 10.1097/pra.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. METHODS We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. RESULTS Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73 d vs. 10.52±10.37 d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. CONCLUSIONS Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.
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Fu G, Xu Y, Pan M, Zhang Z, Zhang H, Zhao Y, Lin L, Ye Z, Liu J, Lan F, Luo D, Wang S, Zhu B, Liao X, Hong M, Chen J, Li Z, Yang G, Zhao Z, Liu Y, Ruan F, Yang C, Wang J. Ecological factors associated with child sexual abuse among 15- to 17-year-old adolescents in mainland China: implications for intervention. Front Public Health 2023; 11:1169669. [PMID: 37927859 PMCID: PMC10623125 DOI: 10.3389/fpubh.2023.1169669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Background Child sexual abuse is a major public health problem with adverse consequences for victims' physical, mental, and reproductive health. This cross-sectional study aimed to determine the prevalence of child sexual abuse and its associated factors among 15- to 17-year-old adolescents in mainland China. Methods From September 8, 2019 to January 17, 2020, a total of 48,660 participants were recruited by 58 colleges and universities across the whole country to complete the self-administered, structured, online questionnaire. This analysis was restricted to 3,215 adolescents aged between 15 and 17 years in mainland China. Chi-square tests and multivariate Logistic regression analyses were performed to identify individual, relationship, and community factors associated with child sexual abuse. Results The overall prevalence of child sexual abuse was 12.0%. More specifically, 13.0% of girls and 10.6% of boys reported that they were sexually abused prior to 18 years of age. At the individual level, being female, sexual minority identity, younger age, and higher levels of knowledge, skills and self-efficacy regarding condom use were significantly related to increased odds of reporting sexual abuse. At the relationship and community level, adolescents from disrupted families and those entering into a marriage, having casual sexual partners, and having first intercourse at a younger age were more likely to report sexual abuse. On the contrary, those who had never discussed sex-related topics with their family members at home and were offered school-based sexuality education later (vs. earlier) were less likely to report sexual abuse. Conclusion Multilevel prevention programs and strategies, including targeting adolescents with high-risk characteristics, educating young children and their parents about child sexual abuse prevention and optimizing the involvement of parents, school, community, society and government in comprehensive sexuality education, should be taken to reduce child sexual abuse among 15- to 17-year-old adolescents.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chunyan Yang
- Department of Preventive Medicine, Hubei University of Science and Technology, Xianning, China
| | - Junfang Wang
- Department of Preventive Medicine, Hubei University of Science and Technology, Xianning, China
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Hall RCW, Iannuzzi G. Prediction of violence: Part contagious disease, part unpredictable individual: Is a public health assessment approach an additional option and at what cost? BEHAVIORAL SCIENCES & THE LAW 2023; 41:246-261. [PMID: 36869399 DOI: 10.1002/bsl.2611] [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: 09/27/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
On a population level, violence shares many similarities with communicable disease states and other public health issues. Therefore, there has been a push to apply public health interventions to the problem of societal violence and for some to even identify violence as the product of a disease state (e.g., changed brain). This conceptualization could lead to the development of new risk violence assessment tools and approaches predicated more on the public health model rather than existing instruments that have often been based on inpatient mental health populations or incarcerated populations. In this article, we will discuss aspects of legal obligation for risk violence "prediction/stratification", the application of the public health communicable disease model to violence, as well as identify why it may not always translate to the individual with whom a clinician or forensic mental health evaluator interacts.
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Affiliation(s)
- Ryan C W Hall
- Psychiatry Department, University of Central Florida College of Medicine, Orlando, Florida, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
- Adjunct Faculty Member Barry University, Dwayne O. Andreas School of Law, Orlando, Florida, USA
| | - Gregory Iannuzzi
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
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Yousefi F, Talib MA. Predictors of personality disorders in prisoners. J Med Life 2022; 15:454-461. [PMID: 35646191 PMCID: PMC9126463 DOI: 10.25122/jml-2021-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
Personality disorders can lead to difficult social or occupational functional processes rooted in chronic maladaptive thoughts, feelings, and behaviors. This study aimed to investigate factors of personality disorder in prisoners from the central prison of Sanandaj, Iran. We conducted a cross-sectional study, which included all prisoners in the central prison of Sanandaj, Iran. The study sample includes 343 prisoners, of which 329 were male, and 14 were female, selected by randomized multistage sampling method. Participants filled in Millon's multi-axis clinical questionnaire. The data were analyzed using Chi-square, multiple logistic regression, and bootstrap analysis. There were 183 participants without personality disorders (53.4%) and 99 participants (28.9%) with cluster B personality disorders (narcissistic, histrionic, anti-social, and borderline). Male gender (OR=0.07) and elementary education level (OR=0.18) have a significant relationship with cluster A personality disorders (paranoid, schizoid, schizotypal). Cluster B has a significant relationship only with the elementary education level (OR=0.27). Cluster C (avoidant, dependent, obsessive-compulsive personality disorder) has a significant relationship with male gender (OR=0.20), elementary education level (OR=0.30), unemployment (OR=2.64), theft crime types (OR=0.38) and disputes and assaults (OR=0.18). Based on these results, psychological and psychiatric interventions in prisoners are suggested.
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Affiliation(s)
- Fayegh Yousefi
- Department of Psychiatry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran,Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mansor Abu Talib
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, Malaysia,Corresponding Author: Mansor Abu Talib, Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, Malaysia. E-mail:
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Ahmadabadi Z, Najman JM, Williams GM, Clavarino AM, d'Abbs P. Gender Differences in Intimate Partner Violence in Current and Prior Relationships. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:915-937. [PMID: 29294920 DOI: 10.1177/0886260517730563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although much available research indicates that intimate partner violence (IPV) is male perpetrated, growing recent evidence suggests a gender symmetry model of family violence. This article examines gender differences in IPV in current and prior relationships reported by young adults. Data comprised 2,060 young adults (62.1% females) who participated in the 30-year follow-up of the Mater Hospital and University of Queensland Study of Pregnancy (MUSP) in Brisbane, Australia. The Composite Abuse Scale was used to measure IPV during the last 12 months in the respondents' most recent relationship. Similar proportions of males and females reported leaving their prior relationships. Both males and females who were not currently in a relationship reported experiencing much higher rates of IPV than those who were in a relationship. There were no differences in the past experience of IPV between males and females who were not currently in a relationship, but males in a current relationship reported they experienced most forms of IPV more often than did females. IPV typically involves both male and female perpetrators and victims. It does appear that the majority of relationships involving higher rates of IPV were dissolved. IPV was more likely to have occurred in relationships that ended than in relationships that persisted. Males more often remain in an abusive relationship and report experiencing higher rates of IPV in their current relationships compared with females.
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Affiliation(s)
- Zohre Ahmadabadi
- School of Public Health, University of Queensland, Herston, Australia
| | - Jackob M Najman
- School of Public Health, University of Queensland, Herston, Australia
- School of Social Sciences, University of Queensland, St Lucia, Australia
| | - Gail M Williams
- School of Public Health, University of Queensland, Herston, Australia
| | | | - Peter d'Abbs
- School of Public Health, University of Queensland, Herston, Australia
- Menzies School of Health Research, Spring Hill, Queensland, Australia
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Talevi D, Collazzoni A, Rossi A, Stratta P, Mazza M, Pacitti F, Costa M, Crescini C, Rossi R. Cues for different diagnostic patterns of interpersonal violence in a psychiatric sample: an observational study. BMC Psychiatry 2020; 20:196. [PMID: 32357860 PMCID: PMC7193401 DOI: 10.1186/s12888-020-02594-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 04/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Interpersonal violence has increased as a health concern, especially in psychiatry practice, over the last decades. Nevertheless, most patients with stable mental disorders do not present an increased risk of violence, and mental disorder is not a necessary or sufficient cause of violent behaviours. People with mental disorders endorse more often a number of risk factors for violence that could confound this association, such as young age and male gender. The aim of this study was to investigate the effect of age, gender, and diagnosis on reported levels of interpersonal violence in a sample of people with severe mental illness. METHODS The sample was composed of 160 inpatients: 73 with a psychosis within the schizophrenia spectrum, 53 with a mood disorder and 34 with a personality disorder. All patients enrolled in the study were assessed for experiences of victimization and perpetration of interpersonal violence using the Karolinska Interpersonal Violence Scale interview. Demographic variables were also collected. RESULTS Both violence perpetration and victimization negatively correlated with age. Compared to males, females were exposed to higher degree of victimization in childhood and adulthood, whereas males were more involved in the perpetration of violence in childhood. Personality disorders were associated with higher levels of interpersonal violence, both perpetration and victimization; an interaction effect of gender and diagnosis was also observed for violence perpetration in adulthood. Distinct patterns of interpersonal violence did emerge for the diagnostic groups with mood disorder showing a victimization pattern, personality disorders a perpetration pattern and psychoses less defined patterns. CONCLUSIONS The main finding is that psychotic disorders, mood disorders and personality disorders have different patterns of violent experiences interacting with age and gender. This study offers a better understanding of how gender and age could affect violent behaviours. Moreover, study findings may increase the comprehension of the reason why some mental disorders, compared to others, are more associated with the risk of victimization or perpetration of violence. These patterns could have pathophysiological or pathoplastic meaning addressing clinical and diagnostic trajectories and they could interact with other intervening risk factors.
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Affiliation(s)
- Dalila Talevi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.
| | - Alberto Collazzoni
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health, ASL 1 Avezzano Sulmona L'Aquila, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Manuela Costa
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Claudio Crescini
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Li W, Yang Y, Hong L, An FR, Ungvari GS, Ng CH, Xiang YT. Prevalence of aggression in patients with schizophrenia: A systematic review and meta-analysis of observational studies. Asian J Psychiatr 2020; 47:101846. [PMID: 31715468 DOI: 10.1016/j.ajp.2019.101846] [Citation(s) in RCA: 13] [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: 07/23/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Aggression is common in patients with schizophrenia and is clinically significant, but its prevalence is inconsistent across studies. This is a meta-analysis of the prevalence of aggression and its associated factors in patients with schizophrenia. METHODS PubMed, EMBASE, PsycINFO, the Cochrane Library, Medline and Web of Science databases were systematically searched. Studies that reported the prevalence of aggression in patients with schizophrenia using the Modified Overt Aggression Scale (MOAS) were included and analyzed using the random-effects model. RESULTS Fifteen studies with 4855 patients were initially included; of these, 13 studies with 3929 patients were pooled in the final meta-analysis. The pooled prevalence of aggression was 33.3% (95%CI: 21.5%-47.7%); specifically, the estimated prevalence of verbal, property-oriented, auto and physical aggression were 42.6% (95%CI: 17.0%-72.9%), 23.8% (95%CI: 10.1%-46.4%), 23.5% (95%CI: 6.5%-57.7%), and 23.7% (95%CI: 10.4%-45.3%), respectively. Subgroup analyses revealed that different MOAS cut-off values (P < 0.001) and source of patients (inpatients vs. community-dwelling patients) significantly moderated the results (P < 0.001). Meta-regression analyses found that studies published recently reported higher aggression rate, while higher quality assessment score was associated with lower aggression rate (both P < 0.01). CONCLUSIONS This meta-analysis confirmed that aggression is common in schizophrenia patients. Considering the significant clinical risk issues, appropriate treatments and effective management of aggression in this population need to be developed.
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Affiliation(s)
- Wen Li
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China; Department of Psychiatry and Psychology, Southern Medical University Nanfang Hospital, Guangdong, China
| | - Liu Hong
- Department of Psychiatry, WuZhongpei Memorial Hospital, Guangdong province, China; Graduate School of Guangdong Medical University, Guangdong province, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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Britt JY, Patton CL, Remaker DN, Prell L, Vitacco MJ. Predicting violence risk and recidivism in female parolees: A state-wide sample. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 66:101471. [PMID: 31706405 DOI: 10.1016/j.ijlp.2019.101471] [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: 01/21/2019] [Revised: 06/07/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
Historically, research on violence risk assessments has primarily focused on male psychiatric patients and/or inmates, with minimal attention given to female patients and/or inmates-two populations likely to differ with regard to violence risk conceptualization. To date, there is no known measure of violence risk specifically tailored to predicting risk for this population that is accurate, brief, and cost-effective. As such, the current study exclusively focused on the predictive ability of the Iowa Violence and Victimization Instrument (IVVI) for female parolees over a 30-month follow-up period. Results indicated not only was the IVVI comparable across genders, its predictive power was comparable to more established measures (i.e., Violence Risk Appraisal Guide-Revised, HCR-20 V3). Results also found the IVVI may have greater usefulness with prediction of violent and felony property offenses, but limited usefulness for predicting misdemeanor property and drug offenses. Taken together, findings gathered from the current study suggest while women are reoffending at lower rates than men, yet there are fewer gender differences in risk factors for engaging in violence than expected.
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Affiliation(s)
- Jessica Y Britt
- Department of Psychiatry and Health Behavior, Augusta University, United States of America.
| | - Christina L Patton
- Court Services, Colorado Mental Health Institute -Pueblo, United States of America
| | | | | | - Michael J Vitacco
- Department of Psychiatry and Health Behavior, Augusta University, United States of America
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