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Tortelli A, Perozziello A, Mercuel A, Dauriac-Le Masson V, Perquier F. Factors associated with the psychosis continuum among homeless people: Comparison between natives and migrants in the SAMENTA study. J Migr Health 2024; 10:100240. [PMID: 39040890 PMCID: PMC11261881 DOI: 10.1016/j.jmh.2024.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 08/10/2023] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Background In the last decades, there has been a documented increase in the proportion of migrants among homeless people in Europe. While homelessness is associated with psychosis, little is known about the factors associated with psychosis among migrants in this context. Methods Our study analyzed data collected in the SAMENTA cross-sectional survey conducted among 859 adult French-speaking homeless people living in the Greater Paris area. We analyzed the prevalence of psychosis and psychotic-like experiences (PLE) and associated factors by migrant status, using bivariate analysis and multivariable logistic regression models. Results Our sample comprised 280 natives and 559 migrants in France. Psychosis was significantly more prevalent among natives (21.6 %) than among migrants (7.5 %) (p = 0.003). The total prevalence of PLE was 30.8% (95 % CI: 24.3 - 38.2), and not statistically different between groups (p = 0.215) or sex (p = 0.528). Adverse events over the past year were associated with the increased odds of psychosis in both groups and with PLE among migrants. Sexual abuse during childhood was associated with both outcomes among natives. Among migrants, exposure to war or life-threatening events increased the odds of psychosis and PLE. Increased odds of psychosis were found among migrants who had been living in France for more than 10 years (OR = 3.34, 95 % CI: 1.41-7.93, p = 0.007). Conclusion Differences were found in the factors associated with the psychosis continuum by migrant status, they highlight the impact of experiences related to migration. Prospective studies are needed to better understand these underlying pathways.
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Affiliation(s)
- Andrea Tortelli
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Pôle Psychiatrie Précarité, Paris, France
- INSERM U955, Créteil, France
- INSERM UMR_S 1136, Paris, France
- Institut Convergences Migration, Paris, France
| | - Anne Perozziello
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Département d'Epidémiologie, Paris, France
| | - Alain Mercuel
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Pôle Psychiatrie Précarité, Paris, France
| | - Valérie Dauriac-Le Masson
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Département d'Information Médicale, Paris, France
| | - Florence Perquier
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Département d'Epidémiologie, Paris, France
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van der Ven E, Olino TM, Diehl K, Nuñez SM, Thayer G, Bridgwater MA, Ereshefsky S, Musket C, Lincoln SH, Rogers RT, Klaunig MJ, Soohoo E, DeVylder JE, Grattan RE, Schiffman J, Ellman LM, Niendam TA, Anglin DM. Ethnoracial Risk Variation Across the Psychosis Continuum in the US: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2024; 81:447-455. [PMID: 38381422 PMCID: PMC10882506 DOI: 10.1001/jamapsychiatry.2023.5497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/26/2023] [Indexed: 02/22/2024]
Abstract
Importance Studies suggest a higher risk of schizophrenia diagnoses in Black vs White Americans, yet a systematic investigation of disparities that include other ethnoracial groups and multiple outcomes on the psychosis continuum is lacking. Objective To identify ethnoracial risk variation in the US across 3 psychosis continuum outcomes (ie, schizophrenia and other psychotic disorders, clinical high risk for psychosis [CHR-P], and psychotic symptoms [PSs] and psychotic experiences [PEs]). Data Sources PubMed, PsycINFO and Embase were searched up to December 2022. Study Selection Observational studies on ethnoracial differences in risk of 3 psychosis outcomes. Data Extraction and Synthesis Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Using a random-effects model, estimates for ethnoracial differences in schizophrenia and PSs/PEs were pooled and moderation by sampling and setting was determined, along with the assessment of heterogeneity and risk of bias. Main Outcomes and Measures Risk of schizophrenia and other psychotic disorder, CHR-P, and conversion to psychosis among CHR-P and PSs/PEs. Results Of 64 studies in the systematic review, 47 were included in the meta-analysis comprising 54 929 people with schizophrenia and 223 097 with data on PSs/PEs. Compared with White individuals, Black individuals had increased risk of schizophrenia (pooled odds ratio [OR], 2.07; 95% CI, 1.64-2.61) and PSs/PEs (pooled standardized mean difference [SMD], 0.10; 95% CI, 0.03-0.16), Latinx individuals had higher risk of PSs/PEs (pooled SMD, 0.15; 95% CI, 0.08-0.22), and individuals classified as other ethnoracial group were at significantly higher risk of schizophrenia than White individuals (pooled OR, 1.81; 95% CI, 1.31-2.50). The results regarding CHR-P studies were mixed and inconsistent. Sensitivity analyses showed elevated odds of schizophrenia in Asian individuals in inpatient settings (pooled OR, 1.84; 95% CI, 1.19-2.84) and increased risk of PEs among Asian compared with White individuals, specifically in college samples (pooled SMD, 0.16; 95% CI, 0.02-0.29). Heterogeneity across studies was high, and there was substantial risk of bias in most studies. Conclusions and Relevance Findings of this systematic review and meta-analysis revealed widespread ethnoracial risk variation across multiple psychosis outcomes. In addition to diagnostic, measurement, and hospital bias, systemic influences such as structural racism should be considered as drivers of ethnoracial disparities in outcomes across the psychosis continuum in the US.
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Affiliation(s)
- Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Thomas M. Olino
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Katharina Diehl
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Stephanie M. Nuñez
- Department of Psychology, The City College of New York, City University of New York, New York
| | - Griffin Thayer
- Department of Psychology, The City College of New York, City University of New York, New York
| | | | - Sabrina Ereshefsky
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Christie Musket
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Sarah Hope Lincoln
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio
| | - R. Tyler Rogers
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
| | - Mallory J. Klaunig
- Department of Psychological Science, University of California, Irvine, Irvine
| | - Emily Soohoo
- Department of Biological Sciences, San Jose State University, San Jose, California
| | | | - Rebecca E. Grattan
- School of Psychology, Victoria University of Wellington–Te Herenga Waka, Wellington, New Zealand
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine
| | - Lauren M. Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Tara A. Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Deidre M. Anglin
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
- The Graduate Center, City University of New York, New York
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Tibiriçá L, Kohn J, Patapoff M, Williams AP, Palmer BW, Barrio C. Acculturation and clinical symptoms of schizophrenia among Latine adults in the United States. Schizophr Res 2024; 266:145-152. [PMID: 38402654 DOI: 10.1016/j.schres.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/05/2023] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Research on acculturation and schizophrenia spectrum disorders has yielded inconsistent findings. This study aimed to clarify the influence of acculturation on symptomatology in Latine individuals with schizophrenia in the United States. METHODS The analysis involved cross-sectional data from Latine (n = 120) and non-Latine White (n = 60) adults with schizophrenia in San Diego, California. Participants completed the Short Acculturation Scale for Hispanics (SASH), Positive and Negative Symptom Scale, and Hamilton Depression Rating Scale in their preferred language. Univariate linear regressions were implemented to identify proxy measures as predictors of acculturation scores. Analyses of variance were conducted to analyze the relationship of SASH scores and proxy measures of acculturation to symptom severity. RESULTS Latine participants presented more symptom severity than non-Latine Whites. When categorized by acculturation status (Spanish-preferring, bicultural, and English-preferring), Spanish-preferring participants presented similar psychiatric symptoms to the non-Latine group and less severe symptoms than both other Latine groups. Analyses identified study language as the strongest proxy measure for the SASH. Latine participants assessed in English had significantly worse positive and depressive symptoms than those assessed in Spanish. Nativity status moderated the relationship between study language and symptomatology. CONCLUSIONS Findings support an association between acculturation and symptom severity among Latine individuals with schizophrenia. The use of proxy measures of acculturation may be useful in settings where time is constrained. Future research should continue to explore acculturation and symptomatology in Latine communities.
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Affiliation(s)
- Lize Tibiriçá
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Jordan Kohn
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Molly Patapoff
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Allison P Williams
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA, USA
| | - Concepcion Barrio
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
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Oh H, Verdugo JL, Karcher NR, van der Ven E, Koyanagi A, Smith L, DeVylder JE. Ethno-racial variation in psychotic experiences in the United States: Findings from the National Latino and Asian American Survey and the National Survey of American Life. Schizophr Res 2023; 262:55-59. [PMID: 37925751 DOI: 10.1016/j.schres.2023.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/26/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Ethno-racial differences in psychosis risk are documented; however, there is less research on whether these differences extend to sub-threshold psychotic experiences, and whether there is significant variation within ethno-racial categories. METHODS We analyzed data from the National Latino and Asian American Survey (NLAAS) and the National Survey of American Life (NSAL). Using multivariable logistic regression, we examined the association between race/ethnicity and lifetime psychotic experiences among Latino, Asian, and Black adults in the general population, adjusting for gender, age, nativity, education level, income level, employment status, and everyday discrimination. RESULTS Puerto Ricans, Cubans, and other Hispanics had greater odds of lifetime psychotic experiences when compared with Mexicans, though differences diminished when adjusting for covariates. Filipino and other Asians had greater odds of lifetime psychotic experiences when compared with Chinese, though again, differences diminished when adjusting for covariates. Among Black Americans, there were no significant ethnic subgroup differences. CONCLUSION Ethno-racial differences extend across the psychosis continuum. There are nuanced health profiles across and within ethno-racial categories. Differences may be attributable to differences in experiences living in the US, underscoring the need for community-specific interventions.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, United States.
| | | | - Nicole R Karcher
- Washington University in St. Louis School of Medicine, Department of Psychiatry, United States
| | - Els van der Ven
- Dept of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Netherlands
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jordan E DeVylder
- Silver School of Social Work, New York University, New York, United States
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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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Hong S, Walton B, Kim HW, Rhee TG. Predicting the Behavioral Health Needs of Asian Americans in Public Mental Health Treatment: A Classification Tree Approach. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:630-643. [PMID: 36988832 PMCID: PMC10052246 DOI: 10.1007/s10488-023-01266-x] [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] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
Given the fact that experiencing pandemic-related hardship and racial discrimination worsen Asian Americans' mental health, this study aimed to identify unique characteristics of behavioral health needs among Asian Americans (N = 544) compared to White Americans (N = 78,704) and Black Americans (N = 11,252) who received publicly funded behavioral health services in Indiana before and during the COVID-19 pandemic. We used 2019-2020 Adults Needs and Strengths Assessment (ANSA) data for adults eligible for Medicaid or funding from the state behavioral health agency. Chi-squared automatic interaction detection (CHAID) was used to detect race-specific differences among demographic variables, the pandemic status, and ANSA items. Results indicated that, regardless of age, gender, or pandemic status, Asian Americans who received behavioral health services, struggled more with cultural-related factors compared to White and Black individuals. Within this context, intersections among behavioral/emotional needs (psychosis), life functioning needs (involvement in recovery, residential stability, decision making, medical/physical health), and strengths (job history, interpersonal, and spiritual) further differentiated the mental health functioning of Asian from White and Black Americans. Classification tree algorithms offer a promising approach to detecting complex behavioral health challenges and strengths of populations based on race, ethnicity, or other characteristics.
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Affiliation(s)
- Saahoon Hong
- Indiana University School of Social Work, Indianapolis, IN, USA.
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA.
| | - Betty Walton
- Indiana University School of Social Work, Indianapolis, IN, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA
| | - Hea-Won Kim
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Taeho Greg Rhee
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
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Verdaguer S, Ramya R, Hernández M, Flórez KR. Examining the Independent Association Between Acculturative Stress and Psychological Distress Among Mexican Immigrants in New York City: An Exploratory Study. Health Equity 2023; 7:197-205. [PMID: 36974196 PMCID: PMC10039280 DOI: 10.1089/heq.2022.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/29/2023] Open
Abstract
Objective This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population. Design Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants. Results A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress. Conclusion The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.
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Affiliation(s)
- Sandra Verdaguer
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
- Address correspondence to: Sandra Verdaguer, MPH, Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th Street, New York, NY 10027, USA.
| | - Rachita Ramya
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - María Hernández
- El Instituto: Institute of Latina/o, Caribbean and Latin America Studies of College of Liberal Arts and Science, University of Connecticut, Storrs, CT, USA
| | - Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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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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Barton A, Novoa O, Sanchez M, Romano E, Cano M. Impact of pre-migration assets and pre-migration trauma on acculturative stress among recent Latinx immigrant young adults. ETHNICITY & HEALTH 2022; 27:1410-1427. [PMID: 33550826 PMCID: PMC10616781 DOI: 10.1080/13557858.2021.1881766] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Pre-migration trauma is associated with adverse mental health outcomes among Latinx immigrants. Pre-migration assets like family cohesion and social support may promote positive mental health outcomes in this population. The current study aims to identify the cumulative and interaction effects of pre-migration trauma, social support, and family cohesion on acculturative stress among recent Latinx immigrants (RLIs). METHOD The current study utilizes baseline data from an on-going longitudinal study following 540 RLIs during their initial 3 years in the U.S. Simple main effects of the predictor variables on acculturative stress were estimated using hierarchical multiple regression (HMR). Predictor variables were entered into the HMR model as follows: (1) demographic variables were entered in the first block, (2) family cohesion and social support in the second block and (3) pre-migration trauma in the third block. Interaction effects between family cohesion and social support on the association between pre-migration trauma and acculturative stress were examined. RESULTS Results showed that 20.6% of the variance of acculturative stress was explained by the predictor variables entered into the HMR model. The first predictor block included demographic variables and explained 13.5% of the variability in acculturative stress, R2 = 13.5, F(6, 521) = 13.55, p < .001. The second block added family cohesion and social support to the HMR model and showed an ΔR2 of 4.5%, R2 = 18.0, F(8, 519) = 14.22, p < .001. The third block added pre- migration trauma to the HMR model and showed an ΔR2 change of 2.6%, R2 = 20.6, F(9, 518) = 14.93, p < .001. Significant interaction effects were found for family cohesion among documented RLIs. Social support was not a significant moderator. CONCLUSION Study findings suggest pre-migration resources such as family cohesion and social support may ameliorate post-immigration acculturative stress among RLI, while pre-migration trauma, may exacerbate acculturative stress.
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Affiliation(s)
- Alexa Barton
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Osmari Novoa
- Robert Stempel College of College of Public Health & Social Work, Florida International University
| | - Mariana Sanchez
- Robert Stempel College of College of Public Health & Social Work, Florida International University
| | | | - Miguel Cano
- Robert Stempel College of College of Public Health & Social Work, Florida International University
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Hayakawa T, Terahara M, Fujito NT, Matsunaga T, Teshima KM, Hane M, Kitajima K, Sato C, Takahata N, Satta Y. Lower promoter activity of the ST8SIA2 gene has been favored in evolving human collective brains. PLoS One 2021; 16:e0259897. [PMID: 34914745 PMCID: PMC8675693 DOI: 10.1371/journal.pone.0259897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022] Open
Abstract
ST8SIA2 is an important molecule regulating expression of the phenotype involved in schizophrenia. Lowered promoter activity of the ST8SIA2 gene is considered to be protective against schizophrenia by conferring tolerance to psychosocial stress. Here, we examined the promoter-type composition of anatomically modern humans (AMHs) and archaic humans (AHs; Neanderthals and Denisovans), and compared the promoter activity at the population level (population promoter activity; PPA) between them. In AMHs, the TCT-type, showing the second lowest promoter activity, was most prevalent in the ancestral population of non-Africans. However, the detection of only the CGT-type from AH samples and recombination tracts in AH sequences showed that the CGT- and TGT-types, exhibiting the two highest promoter activities, were common in AH populations. Furthermore, interspecies gene flow occurred into AMHs from AHs and into Denisovans from Neanderthals, influencing promoter-type compositions independently in both AMHs and AHs. The difference of promoter-type composition makes PPA unique in each population. East and Southeast Asian populations show the lowest PPA. This results from the selective increase of the CGC-type, showing the lowest promoter activity, in these populations. Every non-African population shows significantly lower PPA than African populations, resulting from the TCT-type having the highest prevalence in the ancestral population of non-Africans. In addition, PPA reduction is also found among subpopulations within Africa via a slight increase of the TCT-type. These findings indicate a trend toward lower PPA in the spread of AMHs, interpreted as a continuous adaptation to psychosocial stress arising in migration. This trend is considered as genetic tuning for the evolution of collective brains. The inferred promoter-type composition of AHs differed markedly from that of AMHs, resulting in higher PPA in AHs than in AMHs. This suggests that the trend toward lower PPA is a unique feature in AMH spread.
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Affiliation(s)
- Toshiyuki Hayakawa
- Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Masahiro Terahara
- Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
| | - Naoko T. Fujito
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Takumi Matsunaga
- Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
| | | | - Masaya Hane
- Bioscience and Biotechnology Center, Nagoya University, Nagoya, Aichi, Japan
| | - Ken Kitajima
- Institute for Glyco-core Research (iGCORE), Nagoya University, Nagoya, Aichi, Japan
| | - Chihiro Sato
- Institute for Glyco-core Research (iGCORE), Nagoya University, Nagoya, Aichi, Japan
| | - Naoyuki Takahata
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Yoko Satta
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
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11
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Tortelli A, Simon P, Lehouelleur S, Skurnik N, Richard JR, Baudin G, Ferchiou A, Leboyer M, Schürhoff F, Szöke A. Characteristics associated with the risk of psychosis among immigrants and their descendants in France. Brain Behav 2021; 11:e02096. [PMID: 33835727 PMCID: PMC8119809 DOI: 10.1002/brb3.2096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/11/2021] [Accepted: 02/15/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To explore the sociodemographic characteristics that might explain the increased incidence of psychosis among immigrants and their descendants in France. METHODS Data were collected for all subjects with first contact for psychosis aged between 18 and 64 years, in two catchment areas in the Paris region. Incidence rates (IR) and incidence rate ratios (IRR) were adjusted for gender and age. RESULTS During 805,396 persons-year at risk, we identified 321 cases of first-episode psychosis, of which 129 were immigrants and 78 descendants of immigrants. We found that the geographic origin was associated with the risk of psychosis although generation has little impact. Sub-Saharan African immigrants and their descendants showed the highest risk (IRR = 3.1 and IRR = 2.9, respectively). We observed that living in deprived areas increased the incidence of psychosis (IRR = 1.3, 95CI%: 1.0-1.6), particularly among immigrants (IRR = 1.6; 95% CI: 1.1-2.5). Finally, our study showed that subjects having unstable housing (a proxy for "hard to count population") could inflate the incidence rates among immigrants. CONCLUSION The current study shows that the increased risk of psychosis in groups with an immigration background in France is associated with their origin and highlights the importance of socioeconomic factors in modulating this risk.
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Affiliation(s)
- Andrea Tortelli
- INSERM U955 Translational Neuropsychiatry, Créteil, France.,Pôle GHU Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Paris, France.,Institut Convergences Migrations, Aubervilliers, France
| | - Patrick Simon
- Institut Convergences Migrations, Aubervilliers, France.,Institut National d'Etudes Démographiques, Aubervilliers, France
| | | | - Norbert Skurnik
- Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Paris, France
| | | | - Grégoire Baudin
- Laboratoire de Psychopathologie et Processus de Santé, Université de Paris, EA 4057, Boulogne-Billancourt, France
| | - Aziz Ferchiou
- INSERM U955 Translational Neuropsychiatry, Créteil, France.,AP-HP, DMU IMPACT, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Marion Leboyer
- INSERM U955 Translational Neuropsychiatry, Créteil, France.,AP-HP, DMU IMPACT, Hôpitaux Universitaires Henri-Mondor, Créteil, France.,Fondation FondaMental, Créteil, France.,UPEC, University Paris-Est, Créteil, France
| | - Franck Schürhoff
- INSERM U955 Translational Neuropsychiatry, Créteil, France.,AP-HP, DMU IMPACT, Hôpitaux Universitaires Henri-Mondor, Créteil, France.,Fondation FondaMental, Créteil, France.,UPEC, University Paris-Est, Créteil, France
| | - Andrei Szöke
- INSERM U955 Translational Neuropsychiatry, Créteil, France.,AP-HP, DMU IMPACT, Hôpitaux Universitaires Henri-Mondor, Créteil, France.,Fondation FondaMental, Créteil, France
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12
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Kim MJ, Gorman BK. Acculturation and Self-rated Health Among Asian Immigrants: The Role of Gender and Age. POPULATION RESEARCH AND POLICY REVIEW 2021. [DOI: 10.1007/s11113-021-09642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractUsing the 2002–2003 National Latino and Asian American Study (NLAAS), we examine the relationship between acculturation and poor-to-fair self-rated health (SRH) among Asian immigrants (N = 1639). Using latent class analysis, we construct a multidimensional measure of acculturation that considers dimensions of involvement in U.S. culture as well as attachment to Asian ethnic cultures and identify three classes of Asian immigrants: the assimilated, who most strongly adhere to U.S. culture; the integrated, who align with both U.S. and Asian ethnic cultures; and the separated, who are almost exclusively attached to Asian ethnic cultures. Logistic regression results revealed that among the pooled sample of Asian immigrant adults, the separated are significantly more likely to report poor-to-fair SRH than the assimilated. We then tested for gender and age differences in the acculturation–SRH relationship, and found that stratifying by gender yields noticeably different patterns. Among Asian immigrant women, the probability of reporting poor-to-fair SRH increases with age for the separated and the integrated, while it declines with age for the assimilated. Conversely, among Asian immigrant men, the probability of reporting poor-to-fair SRH increases most steeply with age for the assimilated, while it is shallower for the separated and the integrated. Future research should continue to develop a dynamic understanding of acculturation and examine its association with other health outcomes, including how these relationships differ across subsets of immigrant groups.
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13
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Gómez JM. Does Gender Matter? An Exploratory Study of Cultural Betrayal Trauma and Hallucinations in Latino Undergraduates at a Predominantly White University. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP1375-1390NP. [PMID: 29295025 DOI: 10.1177/0886260517746942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Violence victimization, such as physical, sexual, and emotional abuse, has been linked with hallucinations. How abuse-related distress manifests is dependent on a host of factors, including gender, ethnicity, and societal inequality. Cultural betrayal trauma theory may provide insight into hallucinatory experiences for Latinos in the United States, as it is a contextualized framework that identifies societal trauma (e.g., discrimination) as a contributor to the harm of within-group interpersonal violence victimization in minority populations. Though men may experience higher rates of hallucinations, there is little work on gender differences in the predictive power of violence victimization on hallucinations, particularly in Latino populations. Therefore, with cultural betrayal trauma theory as a guide, the purpose of the current exploratory study is to examine gender differences in the association of ethno-cultural betrayal trauma (within-group violence victimization) on tactile, visual, and auditory hallucinations in a sample of Latino undergraduate students at a predominantly White university in the United States. Participants (N = 80) completed online self-report measures on ethno-cultural betrayal trauma and hallucinatory experiences. Sizable proportions of the sample reported experiencing ethno-cultural betrayal trauma and tactile, visual, and auditory hallucinations. Controlling for between-group trauma, the link between ethno-cultural betrayal trauma and tactile, visual, and auditory hallucinations was moderated by male gender. With cultural betrayal trauma theory as its framework, these preliminary results suggest that gender differences in hallucinatory experiences may be affected by the way trauma-related distress is expressed in Latino undergraduate students in the United States.
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14
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Cariello AN, Perrin PB, Derlan CL, Espinoza GA, Morlett-Paredes A, Moreno OA, Trujillo MA. Moderating influence of enculturation on the relations between minority stressors and physical health via anxiety in Latinx immigrants. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:356-366. [PMID: 31556631 PMCID: PMC8153969 DOI: 10.1037/cdp0000308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The Latinx population in the United States has grown rapidly, now standing at over 56 million people. Discrimination and acculturative stress have been found to affect the mental and physical health of Latinx immigrants, yet enculturation has been identified as an important cultural strength for this population. The purpose of this study was to examine the relations among minority stressors, anxiety, and physical health in a sample of Latinx immigrants living in the United States. A secondary aim was to examine whether the direct and indirect effects among these variables were moderated by enculturation (i.e., moderated mediation). METHOD A community sample of 202 Latinx immigrants completed questionnaires measuring these constructs. RESULTS Both acculturative stress (b = -1.68, p < .001) and discrimination (b = -1.69, p < .001) yielded direct effects on physical health, as well as indirect effects (b = -.10, 95% confidence interval [-.23, -.01]; b = -.21, 95% confidence interval [-.40, -.08], respectively) through anxiety. CONCLUSIONS Psychologists and allied health care providers are recommended to assess for the impact of minority stressors on anxiety and physical health when providing care to Latinx immigrants. Future intervention research targeting Latinx mental and physical health can consider ways to include innate cultural strengths like enculturation and partner with Latinx cultural centers, churches, and local communities to make enculturation more salient. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Annahir N. Cariello
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Chelsea L. Derlan
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - G. Antonio Espinoza
- Department of History, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Oswaldo A. Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael A. Trujillo
- Department of Psychiatry, University of California, San Francisco, San Francisco, USA
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15
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DeLuca JS, Andorko ND, Chibani D, Jay SY, Rakhshan Rouhakhtar PJ, Petti E, Klaunig MJ, Thompson EC, Millman ZB, Connors KM, Akouri-Shan L, Fitzgerald J, Redman SL, Roemer C, Bridgwater MA, DeVylder JE, King CA, Pitts SC, Reinblatt SP, Wehring HJ, Bussell KL, Solomon N, Edwards SM, Reeves GM, Buchanan RW, Schiffman J. Telepsychotherapy with Youth at Clinical High Risk for Psychosis: Clinical Issues and Best Practices during the COVID-19 Pandemic. JOURNAL OF PSYCHOTHERAPY INTEGRATION 2020; 30:304-331. [PMID: 34305369 PMCID: PMC8297958 DOI: 10.1037/int0000211] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Early detection and prevention of psychosis has become an international priority. Much of this work has focused on youth presenting with attenuated symptoms of psychosis-those at Clinical High Risk for psychosis (CHR)-given their elevated probability of developing the full disorder in subsequent years. Individuals at CHR may be prone to exacerbated psychological distress during the COVID-19 pandemic and its subsequent physical isolation measures, due to heightened stress sensitivity and comorbid mental health problems. Telepsychotherapy holds promise for reaching this population, especially during the current COVID-19 outbreak. However, there are limited evidence-based guidelines or interventions for use of telepsychotherapy with this population. In this paper, we review common clinical issues for individuals at CHR and how they might be exacerbated by the COVID-19 pandemic; best practices for treatment and adaptations for telepsychotherapy for individuals at CHR; and highlight real clinical issues that we are currently experiencing in a United States-based specialized CHR clinic as we conduct telepsychotherapy via videoconferencing. We conclude with questions for those in the field to contemplate, as well as potential challenges and benefits in using telepsychotherapy with individuals at CHR and their families.
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Affiliation(s)
- Joseph S. DeLuca
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Nicole D. Andorko
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Doha Chibani
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Samantha Y. Jay
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | | | - Emily Petti
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Mallory J. Klaunig
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Elizabeth C. Thompson
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI
| | | | - Kathleen M. Connors
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - LeeAnn Akouri-Shan
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - John Fitzgerald
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Samantha L. Redman
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Caroline Roemer
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | | | | | - Cheryl A. King
- University of Michigan, Departments of Psychiatry and Psychology, Ann Arbor, MI
| | - Steven C. Pitts
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
| | - Shauna P. Reinblatt
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Heidi J. Wehring
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | | | - Natalee Solomon
- Maryland Department of Health, Behavioral Health Administration, Transition-Aged Youth and Young Adult Services, Baltimore, MD
| | - Sarah M. Edwards
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Gloria M. Reeves
- University of Maryland School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, MD
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Jason Schiffman
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD
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16
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Narita Z, Knowles K, Fedina L, Oh H, Stickley A, Kelleher I, DeVylder J. Neighborhood change and psychotic experiences in a general population sample. Schizophr Res 2020; 216:316-321. [PMID: 31791815 DOI: 10.1016/j.schres.2019.11.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 08/23/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
Social stress caused by the neighborhood environment may be a risk factor for psychotic experiences (PEs). However, little information is available on the effect of the perception of the neighborhood in relation to PEs. In a general population study in the United States (N = 974), we examined the relationship between PEs and neighborhood disruption/gentrification. When adjusted for age, sex, race, income, nativity, city, marital status, and common mental disorders, higher disruption scores were significantly associated with higher odds for any PE (odds ratio = 1.09, 95% CI = 1.05-1.12). The same pattern of associations was observed for individual PEs including delusional mood, delusion of reference and persecution, delusion of control, and hallucination. This study suggests that subjectively perceived neighborhood change may be a factor contributing to the occurrence of PEs. There was no significant relationship between PE and gentrification. Having a low income and racial minority status did not modify this association. Future studies can employ comparative longitudinal analyses of individuals/neighborhoods/cities, geographical information systems, and ethnography, to examine the impact of neighborhood change on mental health.
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Affiliation(s)
- Zui Narita
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States.
| | - Kandra Knowles
- Graduate School of Social Service, Fordham University, 113 W 60th St, New York, NY 10023, United States
| | - Lisa Fedina
- School of Social Work, University of Michigan, 1080 S University Ave, Ann Arbor, MI 48109, United States.
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, 669 W 34th St, Los Angeles, CA 90089, United States
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, 123 St Stephen's Green, Dublin D02 YN77, Ireland.
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, 113 W 60th St, New York, NY 10023, United States.
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17
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Acculturative stress, disability, and health treatment utilization among Asian and Latin American immigrants in the United States. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1275-1284. [PMID: 30895354 DOI: 10.1007/s00127-019-01691-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Empirical research has largely ignored the potential links between immigration-related stress and disability as well as immigration-related stress and health service utilization despite increasing scholarship on the association between acculturative stress and health. This study examined the associations between acculturative stress, disability, and health treatment utilization among Asian and Latin American immigrants in the United States. METHODS Data were from the National Latino and Asian American Study (NLAAS), a nationally representative survey of Asians and Latinos living in the United States. The analytic sample contained 2653 immigrants. We utilized multivariable logistic regression and negative binomial regression analyses to examine the associations between acculturative stress and disability domains. We also examined the association between acculturative stress and treatment utilization, as this may have implications for how to best intervene to address any functional disability related to acculturative stress. RESULTS Acculturative stress was significantly associated with self-reported disability across five domains: self-care, cognition, mobility, time out of role, and social interaction. Additionally, acculturative stress was significantly associated with a greater frequency of disability domains. Acculturative stress was not significantly associated with utilization of services from mental health or general health sectors, but was significantly and positively associated with utilization of non-health care services. The findings were robust regarding the inclusion of everyday discrimination as well as demographic and socioeconomic covariates. CONCLUSIONS Acculturative stress may be an important yet overlooked correlate of disability among immigrants in the United States. Non-health care services may provide an effective pathway for intervening for these individuals.
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18
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Shuhama R, Carmo LDSRD, Busatto Filho G, Santos JLF, Del-Ben CM, Scazufca M, Menezes PR. From where we came: Absence of internal migration effect on psychosis in two case-control Brazilian samples. Schizophr Res 2019; 212:241-242. [PMID: 31402080 DOI: 10.1016/j.schres.2019.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 07/22/2019] [Accepted: 07/27/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Rosana Shuhama
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Geraldo Busatto Filho
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo city, São Paulo, Brazil
| | - Jair Lício Ferreira Santos
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcia Scazufca
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo city, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo city, São Paulo, Brazil
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19
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Waldman K, Wang JSH, Oh H. Psychiatric problems among returned migrants in Mexico: updated findings from the Mexican Migration Project. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1285-1294. [PMID: 30918977 DOI: 10.1007/s00127-019-01699-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Migration is often a stressful process that can have deleterious effects on health. We study the potential mental health consequences of migration by comparing Mexican migrants to the United States who have since returned to Mexico with Mexicans who have never migrated. METHODS Data from the Mexican Migration Project were used to compare returned migrants and non-migrants in Mexico for the years 2007-2016 (N = 7716). Random intercept logistic regression models were used to estimate the associations between characteristics of migration and psychiatric problems. Coarsened exact matching was implemented to account for the selection bias inherent to migration. RESULTS Relatively healthier Mexicans were more likely to migrate to the United States, regardless of their documentation status. Returned migrants in Mexico who traveled to the United States while undocumented were significantly more likely to report that they experienced psychiatric problems when compared with non-migrant Mexicans, even after adjusting for demographic, socioeconomic, pre-migration health, and community-level factors. CONCLUSIONS Undocumented return migrants in Mexico are at-risk of developing psychiatric problems, despite evidence that suggests migrants tend to be healthier than non-migrants before they travel to the United States. Mental health services should encompass strategies for migrants on both sides of the border.
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Affiliation(s)
- Kyle Waldman
- Sol Price School of Public Policy, University of Southern California, 650 Childs Way, Los Angeles, CA, 90089-0411, USA
| | - Julia Shu-Huah Wang
- Department of Social Work and Social Administration, The University of Hong Kong (HKU), Hong Kong, China
| | - Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th St., Los Angeles, CA, 90089-0411, USA.
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20
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Woollen J, Scott R, Lucero R, Bakken S. A semi-automated approach for analyzing collages to inform the design of a family health information management system for Hispanic dementia caregivers. J Biomed Inform 2019; 95:103225. [PMID: 31195101 PMCID: PMC6624078 DOI: 10.1016/j.jbi.2019.103225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 06/01/2019] [Accepted: 06/09/2019] [Indexed: 11/19/2022]
Abstract
Culturally- and linguistically-tailored health communication is needed for vulnerable populations to manage their health and the health of their families. This presents a significant design challenge. The use of collages is an increasingly popular technique with the flexibility to capture the needs and experiences of individuals with various cultural and language preferences. Collage analysis has typically remained qualitative in nature. We introduce a novel, objective, semi-automated approach that enhances collage analysis to elucidate pattern differences that may not be detectable by natural perception. We present a case scenario of collage analysis based on the expressed experience and self-management needs of Hispanic dementia caregivers (n = 24). We demonstrate how our innovative approach may reveal cultural differences between language groups that could have otherwise been missed using traditional techniques.
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Affiliation(s)
- Janet Woollen
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
| | - Robert Scott
- Columbia University Libraries, New York, NY, United States
| | - Robert Lucero
- College of Nursing, University of Florida, Gainesville, FL, United States
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, NY, United States; School of Nursing, Columbia University, New York, NY, United States.
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21
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Azami M, YektaKooshali MH, Shohani M, Khorshidi A, Mahmudi L. Epidemiology of multiple sclerosis in Iran: A systematic review and meta-analysis. PLoS One 2019; 14:e0214738. [PMID: 30964886 PMCID: PMC6456231 DOI: 10.1371/journal.pone.0214738] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis. METHOD A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491. RESULTS According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001). CONCLUSIONS The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.
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Affiliation(s)
- Milad Azami
- Student Research Committee, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Hossein YektaKooshali
- Student Research Committee, School of Nursing, Midwifery and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoumeh Shohani
- Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Khorshidi
- Department of Epidemiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Leily Mahmudi
- Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran
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Psychoses sans Frontieres: towards an interdisciplinary understanding of psychosis risk amongst migrants and their descendants. Epidemiol Psychiatr Sci 2019; 28:146-152. [PMID: 30208980 PMCID: PMC6330066 DOI: 10.1017/s2045796018000501] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Understanding the excess risk of psychotic disorders in migrant and ethnic minority groups has long been an important research focus in psychiatric epidemiology and public mental health. Heterogeneity between migrant groups based on the region of origin, minority status and other socioeconomic factors may provide clues as to the underlying aetiological mechanisms explaining this risk, as well as informing our general understanding of psychotic disorders. Nonetheless, disentangling the mechanisms underlying this association has been the focus of more speculation and theory to date than empirical research. Now more than ever, we need to move beyond studies which demonstrate excess rates in migrant and ethnic minority groups to novel population-based studies which identify the determinants and mechanisms through which this risk is shaped. In this paper, we review the main hypotheses proposed to explain these disparities and the current level of support for them. We then highlight recent evidence from epidemiology and neuroscience which provides important new clues in our understanding of the aetiology of psychotic disorders. We concluded with suggestions for future interdisciplinary research to prevent this public mental health inequality within a generation.
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Leaune E, Dealberto MJ, Luck D, Grot S, Zeroug-Vial H, Poulet E, Brunelin J. Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: a meta-analysis. Psychol Med 2019; 49:545-558. [PMID: 30178719 DOI: 10.1017/s0033291718002271] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Psychotic symptoms (PS) are experienced by a substantial proportion of the general population. When not reaching a threshold of clinical relevance, these symptoms are defined as psychotic experiences (PEs) and may exist on a continuum with psychotic disorders. Unfavorable socio-environmental conditions, such as ethnic minority position (EMP) and migrant status (MS), may increase the risk of developing PS and PEs. We conducted an electronic systematic review and a meta-analysis assessing the role of EMP and MS for the development and persistence of PS in the general population. Sub-group analyses were performed investigating the influence of ethnic groups, host countries, age, types of PS, and scales. Twenty-four studies met our inclusion criteria. EMP was a relevant risk factor for reporting PS [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.22-1.70) and PEs (OR 1.36, 95% CI 1.16-1.60). The greatest risk was observed in people from the Maghreb and the Middle East ethnic groups in Europe (OR 3.30, 95% CI 2.09-5.21), in Hispanic in the USA (OR 1.98, 95% CI 1.43-2.73), and in the Black populations (OR 1.85, 95% CI 1.39-2.47). We found a significant association between MS and delusional symptoms (OR 1.47, 95% CI 1.33-1.62). We found no association between EMP and persistence of PEs.EMP was associated with increased risk of reporting PS and PEs, and the risk was higher in ethnic groups facing deprivation and discrimination. We found an association between MS and delusional symptoms. These results raise questions about the precise role of socio-environmental factors along the psychosis continuum.
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Affiliation(s)
| | | | - David Luck
- Centre de recherche, Institut Universitaire en Santé Mentale de Montréal,Canada
| | - Stéphanie Grot
- Centre de recherche, Institut Universitaire en Santé Mentale de Montréal,Canada
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Tortelli A, Nakamura A, Suprani F, Schürhoff F, Van der Waerden J, Szöke A, Tarricone I, Pignon B. Subclinical psychosis in adult migrants and ethnic minorities: systematic review and meta-analysis. BJPsych Open 2018; 4:510-518. [PMID: 30564447 PMCID: PMC6293451 DOI: 10.1192/bjo.2018.68] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It is well established that migration and ethnic minority status are risk factors for psychotic disorders. Recent studies have aimed to determine if they are also associated with subclinical psychosis (psychotic-like experiences and schizotypal traits). AIMS We aimed to determine to what extent migrant and ethnic minority groups are associated with higher risk of subclinical psychosis. METHOD We conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and examined findings by ethnicity, migrant status, outcomes of subclinical psychosis and host country. A meta-analysis was carried out with robust variance estimation where possible, to handle statistically dependent effect size estimates. RESULTS We included 28 studies (19 studies on psychotic-like experiences and 9 studies on schizotypal traits) and found that ethnicity, but not migrant status, was associated with current and lifetime psychotic-like experiences. In the narrative analysis, we observed the effect of psychosocial risk factors on this association: Black ethnicity groups showed consistent increased prevalence of current and lifetime psychotic-like experiences compared with the reference population across countries. CONCLUSIONS More generalisable and standardised cohort studies of psychotic-like experiences and schizotypal traits in relation to migration/ethnicity are necessary to examine the effects of exposures and outcomes in different contexts, and to understand the underlying mechanisms of the association between subclinical psychosis and migrant and ethnic minority status. DECLARATION OF INTEREST None.
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Affiliation(s)
- Andrea Tortelli
- U955-15, INSERM, Créteil and Pôle GHT Psychiatrie Précarité, Paris, France
| | - Aurélie Nakamura
- UMR_S 1136, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, France
| | - Federico Suprani
- Department of Medical and Surgical Sciences, Bologna University, Italy
| | - Franck Schürhoff
- U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental Scientific Cooperation Foundation, F-94010 Creteil and Faculté de médecine, University Paris-Est Créteil, France
| | - Judith Van der Waerden
- UMR_S 1136, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, l'université Pierre et Marie Curie, France
| | - Andrei Szöke
- U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental, France
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna University, Italy
| | - Baptiste Pignon
- U955-15, INSERM and Pôle de Psychiatrie et d'Addictologie, DHU PePSY, Hôpitaux universitaires Henri-Mondor, AP-HP and Fondation FondaMental and Faculté de médecine, University Paris-Est Créteil, France
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Fujito NT, Satta Y, Hane M, Matsui A, Yashima K, Kitajima K, Sato C, Takahata N, Hayakawa T. Positive selection on schizophrenia-associated ST8SIA2 gene in post-glacial Asia. PLoS One 2018; 13:e0200278. [PMID: 30044798 PMCID: PMC6059407 DOI: 10.1371/journal.pone.0200278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/23/2018] [Indexed: 11/19/2022] Open
Abstract
A number of loci are associated with highly heritable schizophrenia and the prevalence of this mental illness has had considerable negative fitness effects on human populations. Here we focused on one particular schizophrenia-associated gene that encodes a sialyltransferase (ST8SIA2) and is expressed preferentially in the brain with the level being largely determined by three SNPs in the promoter region. It is suggested that the expression level of the ST8SIA2 gene is a genetic determinant of schizophrenia risk, and we found that a geographically differentiated non-risk SNP type (CGC-type) has significantly reduced promoter activity. A newly developed method for detecting ongoing positive selection was applied to the ST8SIA2 genomic region with the identification of an unambiguous sweep signal in a rather restricted region of 18 kb length surrounding the promoter. We also found that while the CGC-type emerged in anatomically modern humans in Africa over 100 thousand years ago, it has increased its frequency in Asia only during the past 20-30 thousand years. These findings support that the positive selection is driven by psychosocial stress due to changing social environments since around the last glacial maximum, and raise a possibility that schizophrenia extensively emerged during the Upper Paleolithic and Neolithic era.
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Affiliation(s)
- Naoko T. Fujito
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Yoko Satta
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Masaya Hane
- Bioscience and Biotechnology Center, Nagoya University, Aichi, Japan
| | - Atsushi Matsui
- Primate Research Institute, Kyoto University, Aichi, Japan
| | - Kenta Yashima
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Ken Kitajima
- Bioscience and Biotechnology Center, Nagoya University, Aichi, Japan
| | - Chihiro Sato
- Bioscience and Biotechnology Center, Nagoya University, Aichi, Japan
| | - Naoyuki Takahata
- School of Advanced Sciences, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - Toshiyuki Hayakawa
- Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
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26
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Acculturative stress in Korean Americans. Appl Nurs Res 2017; 38:70-75. [PMID: 29241523 DOI: 10.1016/j.apnr.2017.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/12/2017] [Accepted: 09/23/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Acculturative stress is known to contribute to chronic diseases among many immigrants and yet this association in Korean Americans remains unclear. AIM The study purpose was to examine the level of acculturative stress in Korean Americans and to determine if correlations existed with personal and physiological factors. METHODS An exploratory, cross-sectional, descriptive study was conducted in a sample of 107 Korean American adults. Data on acculturative stress and personal factors were collected using a survey questionnaire in addition to a direct measure of physiological factors (i.e., body mass index and blood pressure). RESULTS All 107 participants were first-generation Koreans. Most participants were women (66.4%), with a mean age of 53.9±10.7, married (88.8%), and with a college education (84.2%). Acculturative stress was associated with a number of personal factors (i.e., arrival age, years of U.S education, years of U.S. residency, English proficiency), and the personal factors of gender, age, employment status, and years of U.S. residency were associated with the physiological factors. No statistically significant associations were found between acculturative stress and physiological factors. CONCLUSIONS The mean acculturative stress score in this study was higher than findings from prior studies of Korean immigrants in the United States or Canada, with the rates of obesity and hypertension higher than prior reports of Korean Americans or Koreans residing in Korea. Future study is necessary with a larger sample from a variety of different geographic areas of the United States to examine further the impact of acculturative stress on physiological factors during the process of acculturation.
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DeVylder JE, Cogburn C, Oh HY, Anglin D, Smith ME, Sharpe T, Jun HJ, Schiffman J, Lukens E, Link B. Psychotic Experiences in the Context of Police Victimization: Data From the Survey of Police-Public Encounters. Schizophr Bull 2017; 43:993-1001. [PMID: 28369639 PMCID: PMC5581896 DOI: 10.1093/schbul/sbx038] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social defeat has been proposed as the common mechanism underlying several well-replicated risk factors for sub-threshold psychotic experiences (PEs) identified in epidemiological research. Victimization by the police may likewise be socially defeating among vulnerable individuals and, therefore, may be associated with elevated risk for PEs. However, no prior studies have examined the relation between police victimization and PEs. We tested the hypothesis that exposure to police victimization (ie, physical, sexual, psychological, and neglect) would be associated with increased odds for PEs in the Survey of Police-Public Encounters data (N = 1615), a general population sample of adults from 4 US cities. Respondents who reported each type of police victimization were more likely to report PEs in logistic regression analyses (all P < .01), most of which were significant even when adjusting for demographic variables, psychological distress, and self-reported crime involvement (adjusted OR range: 1.30 to 7.16). Furthermore, the prevalence of PEs increased with greater exposure to police victimization in a linear dose-response relation, OR (95% CI) = 1.44 (1.24-1.66). These findings suggest that police victimization is a clinically important and previously unreported risk factor for PEs in the urban US population. These findings support the need for community-based outreach efforts and greater police training to reduce the prevalence of this exposure, particularly in socially disadvantaged urban communities.
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Affiliation(s)
- Jordan E DeVylder
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD;,To whom correspondence should be addressed; School of Social Work, University of Maryland, Baltimore, 525 W Redwood Street, Baltimore, MD 21201, US; tel: 410-706-6234, fax: 410-706-6046, e-mail:
| | | | - Hans Y Oh
- University of California Berkeley, School of Public Health, Berkeley, CA
| | - Deidre Anglin
- Department of Psychology, The City College of New York, New York, NY
| | | | - Tanya Sharpe
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Hyun-Jin Jun
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Jason Schiffman
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD
| | - Ellen Lukens
- School of Social Work, Columbia University, New York, NY
| | - Bruce Link
- School of Public Policy, University of California Riverside, Riverside, CA
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Cicero DC, Krieg A, Martin EA. Measurement Invariance of the Prodromal Questionnaire-Brief Among White, Asian, Hispanic, and Multiracial Populations. Assessment 2017; 26:294-304. [PMID: 28092988 DOI: 10.1177/1073191116687391] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Prodromal Questionnaire-Brief is a scale that is used to screen individuals for risk for the development of psychosis. It has promising psychometric properties in clinical and nonclinical populations, including undergraduates. However, the measurement invariance of the scale has not been examined in Asian, White, Hispanic, and Multiracial samples. A total of 2,767 undergraduates at two large public U.S. universities completed the Prodromal Questionnaire-Brief. The Total scores had configural and scalar invariance, while the Distress scores displayed configural, metric, and partial scalar invariance. Follow-up analyses revealed that three items were responsible for the lack of complete scalar invariance for the Distress scores. This suggests that the Total and Distress scores are measuring the same construct across groups and mean scores represent the same level of latent prodromal traits across groups. Mean comparisons for the Distress Scale across ethnicity should be interpreted with caution because it lacks complete scalar invariance. White and Hispanic participants had lower Total scores that Multiracial and Asian participants, and this pattern emerged for 13 items. For the distress items that were scalar invariant, the Asian group reported more distress than the White and Hispanic groups, while the Multiracial group reported more distress than the White group.
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29
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Termorshuizen F, Selten JP, Heerdink ER. Dispensing of psychotropic medication among 400,000 immigrants in The Netherlands. Soc Psychiatry Psychiatr Epidemiol 2017; 52:963-977. [PMID: 28616632 PMCID: PMC5534199 DOI: 10.1007/s00127-017-1405-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/03/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE Previously, a high prevalence of certain psychiatric disorders was shown among non-Western immigrants. This study explores whether this results in more prescriptions for psychotropic medication. METHODS Data on dispensing of medication among adults living in the four largest Dutch cities in 2013 were linked to demographic data from Statistics Netherlands. Incident (i.e., following no dispensing in 2010-2012) and prevalent dispensing among immigrants was compared to that among native Dutch (N = 1,043,732) and analyzed using multivariable Poisson and logistic regression. RESULTS High adjusted Odds Ratios (ORadj) of prevalent and high Incidence Rate Ratios (IRRadj) of incident dispensing of antipsychotics were found among Moroccan (N = 115,455) and Turkish individuals (N = 105,460), especially among young Moroccan males (ORadj = 3.22 [2.99-3.47]). Among Surinamese (N = 147,123) and Antillean individuals (N = 41,430), slightly higher rates of dispensed antipsychotics were found and the estimates decreased after adjustment. The estimates for antipsychotic dispensing among the Moroccan and Turkish increased, following adjustment for household composition. Rates for antidepressant dispensing among Turkish and Moroccan subjects were high (Moroccans: ORadj = 1.74 [1.70-1.78]). Among Surinamese and Antillean subjects, the rates for antidepressant dispensing were low and the ORadj lagged behind the IRRadj (Surinamese: 0.69 [0.67-0.71] vs. 1.06 [1.00-1.13]). Similar results were found for anxiolytics. For ADHD medication, lower dispensing rates were found among all migrant groups. CONCLUSIONS The findings agree with earlier reports of more mental health problems among Moroccan and Turkish individuals. Surinamese/Antillean individuals did not use psychotropic drugs at excess and discontinued antidepressants and anxiolytics earlier. The data strongly suggest under-treatment for ADHD in all ethnic minority groups.
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Affiliation(s)
- Fabian Termorshuizen
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands. .,Rivierduinen, Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ, Leiden, The Netherlands.
| | - Jean-Paul Selten
- Rivierduinen, Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands ,0000 0001 0481 6099grid.5012.6Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | - Eibert R. Heerdink
- 0000000120346234grid.5477.1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, P.O. Box 80082, 3508 TB Utrecht, The Netherlands ,0000000090126352grid.7692.aDepartment of Clinical Pharmacy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Abstract
OBJECTIVE We investigated the role of biological and psychosocial risk factors in the development of psychotic disorders with regards to immigrant status. Our hypothesis was that biological risk factors are more predictive of psychosis in non-immigrants, whereas psychosocial risk factors play a bigger role in immigrants. METHOD A retrospective audit of admissions between December 2013 and June 2014 in an Australian adult inpatient unit was conducted, focussing on patients with psychotic disorders. We analysed the association between immigrant status, and biological and psychosocial variables. RESULTS For biological risk factors, non-immigrants had significantly more family history of psychotic disorders (p = 0.021), illicit drug use (p = < 0.001) and alcohol use (p = < 0.001). For psychosocial risk factors, immigrants were more likely to have experienced a traumatic event (p = 0.022). With regards to age of index presentation, age at onset of psychotic disorder, proportion of males and dysfunctional family background, there was no significant difference. CONCLUSION Retrospective data in this report suggests that the development of psychotic disorders in immigrants and non-immigrants may be different.
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Affiliation(s)
- Grace Yx Lim
- Medical Student, School of Psychology and Psychiatry, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Michael Th Wong
- Adjunct Clinical Associate Professor of Psychiatry, School of Psychology and Psychiatry, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
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DeVylder JE, Koyanagi A, Unick J, Oh H, Nam B, Stickley A. Stress Sensitivity and Psychotic Experiences in 39 Low- and Middle-Income Countries. Schizophr Bull 2016; 42:1353-1362. [PMID: 27109925 PMCID: PMC5049526 DOI: 10.1093/schbul/sbw044] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Stress has a central role in most theories of psychosis etiology, but the relation between stress and psychosis has rarely been examined in large population-level data sets, particularly in low- and middle-income countries. We used data from 39 countries in the World Health Survey (n = 176 934) to test the hypothesis that stress sensitivity would be associated with psychotic experiences, using logistic regression analyses. Respondents in low-income countries reported higher stress sensitivity (P < .001) and prevalence of psychotic experiences (P < .001), compared to individuals in middle-income countries. Greater stress sensitivity was associated with increased odds for psychotic experiences, even when adjusted for co-occurring anxiety and depressive symptoms: adjusted odds ratio (95% CI) = 1.17 (1.15-1.19) per unit increase in stress sensitivity (range 2-10). This association was consistent and significant across nearly every country studied, and translated into a difference in psychotic experience prevalence ranging from 6.4% among those with the lowest levels of stress sensitivity up to 22.2% among those with the highest levels. These findings highlight the generalizability of the association between psychosis and stress sensitivity in the largest and most globally representative community-level sample to date, and support the targeting of stress sensitivity as a potential component of individual- and population-level interventions for psychosis.
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Affiliation(s)
- Jordan E. DeVylder
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD;,*To whom correspondence should be addressed; School of Social Work, University of Maryland, Baltimore, 525 W Redwood St, Baltimore, MD 21201, US; tel: 410-706-6234, fax: 410-706-6046, e-mail:
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain;,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Jay Unick
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Hans Oh
- School of Public Health, University of California Berkeley, Berkeley, CA;,Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA
| | - Boyoung Nam
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Stockholm, Sweden
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Nasr Z, Majed M, Rostami A, Sahraian MA, Minagar A, Amini A, McGee JC, Etemadifar M. Prevalence of multiple sclerosis in Iranian emigrants: review of the evidence. Neurol Sci 2016; 37:1759-1763. [PMID: 27351545 DOI: 10.1007/s10072-016-2641-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 06/17/2016] [Indexed: 12/21/2022]
Abstract
Iran has the highest prevalence of multiple sclerosis (MS) in the Middle East and Asia. Rate of emigration has been significantly raised among Iranians and though, multiple studies have been published on prevalence of MS among Iranian emigrants. Here we systematically reviewed these publications. We performed a comprehensive literature search was performed on April 30, 2015 in data bases of MEDLINE, EMBASE, Scopus and Google Scholar for the terms 'multiple sclerosis', 'incidence', 'prevalence', 'epidemiology', 'migration', 'emigrant', 'immigrant', 'Iran', 'Parsis' and 'Persian'. Study location, prevalence day or period, and age of at disease onset were recorded for all the included publications. Nine publications from Sweden, Canada, Norway, UK, and India were included. Only three reported age-adjusted prevalence and six reported age of disease onset. MS prevalence among Iranian emigrants varied from 21 per 100,000 people in Bombay, India in 1985 to 433 per 100,000 people in British Columbia, Canada in 2012. Five studies reported the prevalence in the region of interest, ranging from 1.33 in Bombay, India to 240 in British Columbia, Canada. Five studies also reported the prevalence of MS in the population of the destination country, and in all of them, the prevalence of MS was higher in Iranian immigrants compared to native people. Prevalence studies performed in Iran and also on Iranian emigrants indicate roles for both genetic and environmental factors in MS susceptibility. Data might indicate that living in a high-risk area increases the susceptibility to MS.
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Affiliation(s)
- Zahra Nasr
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran. .,Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoud Majed
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Mohamad Ali Sahraian
- Department of Neurology and MS Research Center, Neuroscience Institute, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Minagar
- Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71130, USA
| | - Arman Amini
- Department of Neuroscience, Physiology and Pharmacology, Faculty of Life Sciences, University College London, London, UK
| | - Jeanine C McGee
- Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71130, USA
| | - Masoud Etemadifar
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran
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Seeman MV. Gendering psychosis: the illness of Zelda Fitzgerald. MEDICAL HUMANITIES 2016; 42:65-69. [PMID: 26392268 DOI: 10.1136/medhum-2015-010734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 06/05/2023]
Abstract
Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance.
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Fighting with Spirits: Migration Trauma, Acculturative Stress, and New Sibling Transition-A Clinical Case Study of an 8-Year-Old Girl with Absence Epilepsy. Cult Med Psychiatry 2015; 39:698-724. [PMID: 25670159 DOI: 10.1007/s11013-015-9438-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article, we discuss the impact of migration and acculturation processes on the cultural, personal identity, and mental health of children who immigrate to a Western, multicultural environment, and the challenges clinicians in such environments face, when confronted with non-Western idioms of distress and healing practices. We do that by presenting a challenging clinical case of an 8-year-old girl who presented with very disorganized behavior, which matches a culturally accepted construct of spirit possession, in the context of migration trauma, acculturative stress, and new sibling transition. We identify cultural conflict in school and bullying as major mediators between acculturative stress and mental distress. We also aim at identifying vulnerability, risk and protective factors, and the importance of cultural coping resources. We explore in depth the patient's cultural background and the family's belief system and culturally shaped narratives, in order to arrive at a cultural formulation, which focuses on the significance of idioms of distress in shaping psychopathology and influencing the personal and interpersonal course of trauma- and stress-related disorders. We also call attention to the finding that in children, idioms of distress may manifest themselves in a somatic manner. We argue, together with other researchers, that spirit possession deserves more interest as an idiom of distress and a culture-specific response to traumatizing events. We finally emphasize the importance of an anti-reductionist clinical stance, that is able to use different levels of understanding processes of distress and healing, and seeks to reconciliate cultural divides and integrate different explanatory frameworks and help-seeking practices.
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Oh H, Abe J, Negi N, DeVylder J. Immigration and psychotic experiences in the United States: Another example of the epidemiological paradox? Psychiatry Res 2015; 229:784-90. [PMID: 26282227 DOI: 10.1016/j.psychres.2015.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 07/14/2015] [Accepted: 08/01/2015] [Indexed: 10/23/2022]
Abstract
In Europe, it is widely established that immigration increases risk for psychotic disorder. However, research has yet to confirm this association in the United States, where immigrants paradoxically report better health status than their native-born counterparts. Further, few studies have examined this topic with respect to sub-threshold psychotic experiences, which are more common than psychotic disorders in the general population. This study analyzes the (1) National Comorbidity Survey-Replication, (2) the National Latino and Asian American Survey, and (3) the National Survey of American Life, in order to determine whether generation status had any impact on risk for lifetime and 12-month PE, and whether these associations vary across racial/ethnic groups, adjusting for demographic variables and socioeconomic status. We found an absence of an immigration effect on PE across various ethnic groups and across various geographic areas, and found that immigration is actually protective among Latinos, supporting the idea that the epidemiological paradox extends to the psychosis phenotype.
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Affiliation(s)
- Hans Oh
- Columbia School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027, USA.
| | - Jennifer Abe
- Loyola Marymount University, School University Hall Suite 4600, 1 LMU Drive, Los Angeles, CA 90045, USA
| | - Nalini Negi
- University of Maryland, School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA
| | - Jordan DeVylder
- University of Maryland, School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA
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Psychotic experiences in the population: Association with functioning and mental distress. Schizophr Res 2015; 165:9-14. [PMID: 25868930 DOI: 10.1016/j.schres.2015.03.020] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 03/03/2015] [Accepted: 03/22/2015] [Indexed: 11/23/2022]
Abstract
Psychotic experiences are far more common in the population than psychotic disorder. They are associated with a number of adverse outcomes but there has been little research on associations with functioning and distress. We wished to investigate functioning and distress in a community sample of adolescents with psychotic experiences. Two hundred and twelve school-going adolescents were assessed for psychotic experiences, mental distress associated with these experiences, global (social/occupational) functioning on the Children's Global Assessment Scale, and a number of candidate mediator variables, including psychopathology, suicidality, trauma (physical and sexual abuse and exposure to domestic violence) and neurocognitive functioning. Seventy five percent of participants who reported psychotic experiences reported that they found these experiences distressing (mean score for severity of distress was 6.9 out of maximum 10). Participants who reported psychotic experiences had poorer functioning than participants who did not report psychotic experiences (respective means: 68.6, 81.9; OR=0.25, 95% CI=0.14-0.44). Similarly, participants with an Axis-1 psychiatric disorder who reported psychotic experiences had poorer functioning than participants with a disorder who did not report psychotic experiences (respective means: 61.8, 74.5; OR=0.28, 95% CI=0.12-0.63). Candidate mediator variables explained some but not all of the relationship between psychotic experiences and functioning (OR=0.48, 95% CI=0.22-1.05, P<0.07). Young people with psychotic experiences have poorer global functioning than those who do not, even when compared with other young people with psychopathology (but who do not report psychotic experiences). A disclosure of psychotic experiences should alert treating clinicians that the individual may have significantly more functional disability than suggested by the psychopathological diagnosis alone.
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Mamah D, Owoso A, Sheffield JM, Bayer C. The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden. Compr Psychiatry 2014; 55:1757-71. [PMID: 25128205 DOI: 10.1016/j.comppsych.2014.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. METHODS Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. RESULTS Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated significantly with scores on the aWERCAP (R=0.88), pWERCAP (R=0.62) and total cognition (R=-0.44). CONCLUSIONS Our results show that the WERCAP Screen and the WERC Stress Screen are easy to administer and derived scores are related to cognitive and clinical traits. This suggests that their use could have particular benefits for epidemiologic studies and in busy clinical settings. Longitudinal studies would be required to evaluate clinical outcomes with high questionnaire scores.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University, St. Louis, Missouri.
| | - Akinkunle Owoso
- Department of Psychiatry, Washington University, St. Louis, Missouri
| | - Julia M Sheffield
- Department of Psychology, Washington University, St. Louis, Missouri
| | - Chelsea Bayer
- Department of Psychiatry, Washington University, St. Louis, Missouri
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Perceived discrimination and psychotic experiences across multiple ethnic groups in the United States. Schizophr Res 2014; 157:259-65. [PMID: 24856412 DOI: 10.1016/j.schres.2014.04.036] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/18/2014] [Accepted: 04/23/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationship between perceived discrimination and psychotic experiences (PE) using validated measures of discrimination and a racially/ethnically diverse population-level sample. METHODS Data were drawn from two population-level surveys (The National Latino and Asian American Survey and The National Survey of American Life), which were analyzed together using survey weights and stratification variables. The analytic sample (N=8990) consisted of Latino, Asian, African-American, and Afro-Caribbean adults living in the United States. Separate unadjusted and adjusted multivariable logistic regression models were used, first to examine the crude bivariate relationship between perceived discrimination and PE, and second to examine the relationship adjusting for demographic variables. Adjusted logistic regression models were also used to examine the relationships between perceived discrimination and specific sub-types of PE (auditory and visual hallucinatory experiences, and delusional ideation). RESULTS When compared to individuals who did not report any discrimination, those who reported the highest levels of discrimination were significantly more likely to report both 12-month PE (Adjusted OR=4.590, p<0.001) and lifetime PE (adjusted OR=4.270, p<0.001). This held true for visual hallucinatory experiences (adjusted OR=3.745, p<0.001), auditory hallucinatory experiences (adjusted OR=5.649, p<0.001), and delusional ideation (adjusted OR=7.208, p<0.001). CONCLUSION Perceived discrimination is associated with the increased probability of reporting psychotic experiences in a linear Fashion in the US general population.
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Park SC, Lee HY, Sakong JK, Jun TY, Lee MS, Kim JM, Kim JB, Yim HW, Park YC. Distinctive Clinical Correlates of Psychotic Major Depression: The CRESCEND Study. Psychiatry Investig 2014; 11:281-9. [PMID: 25110501 PMCID: PMC4124187 DOI: 10.4306/pi.2014.11.3.281] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/14/2013] [Accepted: 09/20/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD). METHODS We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and χ(2) tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD. RESULTS PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD. CONCLUSION Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
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Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Yong-In Mental Hospital, Yongin, Republic of Korea
- Institute of Mental Health, Hanyang University, Seoul, Republic of Korea
| | - Hwa-Young Lee
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Asan, Republic of Korea
| | - Jeong-Kyu Sakong
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Tae-Youn Jun
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min-Soo Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, School of Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Jung-Bum Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Hyeon-Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong Chon Park
- Institute of Mental Health, Hanyang University, Seoul, Republic of Korea
- Department of Psychiatry, College of Medicine, Hanyang University, Seoul, Republic of Korea
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Abstract
The DSM-5 lists 13 psychotic disorders and introduces modest but significant changes in their diagnosis. Asian Americans bring unique issues to the assessment, diagnosis and treatment of these disorders. They may exhibit greater prevalence of culturally influenced psychosis-like experiences that may or may not constitute a pathological condition such as psychosis risk syndrome or attenuated psychosis. Acute psychotic disorders with good prognosis may be more prevalent in Asians and may sometimes be misdiagnosed as schizophrenia or schizoaffective disorder. Catatonic disorders are also more prevalent in Asians, and are likely to receive more appropriate labeling with DSM-5. The expanded cultural formulation in DSM-5 is a progressive step but its benefits might be limited by lack of culturally trained clinicians and/or limited time for assessment. There is a dearth of systematic data on psychotic disorders in Asian Americans and it is hoped that the DSM-5 will stimulate this much needed research.
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