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Caroppo E, Calabrese C, Mazza M, Rinaldi A, Coluzzi D, Napoli P, Sapienza M, Porfiri M, De Lellis P. Migrants' mental health recovery in Italian reception facilities. COMMUNICATIONS MEDICINE 2023; 3:162. [PMID: 37993495 PMCID: PMC10665420 DOI: 10.1038/s43856-023-00385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Forced migration leaves deep marks on the psychological well-being of migrants, with post-traumatic stress disorder (PTSD) and other psychological conditions being prevalent among them. While research has clarified the extent to which pre-migration trauma is a predictor of mental health outcomes, the role of post-migration stressors in the settlement environment are yet to be fully characterized. METHODS We monitored mental health of a cohort of 100 asylum-seekers during their 14-day COVID-19-related quarantine in reception facilities in Rome, Italy, through the administration of six questionnaires (a demographic survey, the WHO-5 well-being index, the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), the Harvard Trauma Questionnaire, the Trauma and Loss Spectrum-Self Report, and the LiMEs-Italian version). Through the combination of statistical analysis and supervised learning, we studied the impact of the first contact with the reception system on asylum-seekers' mental health and sought for possible risk and shielding factors for PTSD. RESULTS We find that sheltering in refugee centers has a positive impact on migrants' mental health; asylum-seekers with PTSD reported more traumatic events and personality characteristics related to loss and trauma; life events are predictors of PTSD in asylum-seekers. CONCLUSIONS We identify past traumatic experiences as predictors of PTSD, and establish the positive role the immediate post-migration environment can play on migrants' psychological well-being. We recommend for host countries to implement reception models that provide effective protection and integration of asylum-seekers, similar to those in the Italian system.
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Affiliation(s)
- Emanuele Caroppo
- Department of Mental Health, Local Health Authority Roma 2, Rome, Italy.
| | - Carmela Calabrese
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
- Institut de Neurosciences des Systémes (INS), Aix Marseille Université, 13, Marseille, France
| | - Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Daniele Coluzzi
- Migrant Health Unit, Local Health Authority Roma 2, Rome, Italy
| | | | - Martina Sapienza
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Porfiri
- Center for Urban Science and Progress, Department of Mechanical and Aerospace Engineering, and Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA.
| | - Pietro De Lellis
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy.
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Kirchebner J, Lau S, Machetanz L. Offenders and non-offenders with schizophrenia spectrum disorders: Do they really differ in known risk factors for aggression? Front Psychiatry 2023; 14:1145644. [PMID: 37139319 PMCID: PMC10150953 DOI: 10.3389/fpsyt.2023.1145644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Individuals with schizophrenia spectrum disorders (SSD) have an elevated risk for aggressive behavior, and several factors contributing to this risk have been identified, e. g. comorbid substance use disorders. From this knowledge, it could be inferred that offender patients show a higher expression of said risk factors than non-offender patients. Yet, there is a lack of comparative studies between those two groups, and findings gathered from one of the two are not directly applicable to the other due to numerous structural differences. The aim of this study therefore was to identify key differences in offender patients and non-offender patients regarding aggressive behavior through application of supervised machine learning, and to quantify the performance of the model. Methods For this purpose, we applied seven different (ML) algorithms on a dataset comprising 370 offender patients and a comparison group of 370 non-offender patients, both with a schizophrenia spectrum disorder. Results With a balanced accuracy of 79.9%, an AUC of 0.87, a sensitivity of 77.3% and a specificity of 82.5%, gradient boosting emerged as best performing model and was able to correctly identify offender patients in over 4/5 the cases. Out of 69 possible predictor variables, the following emerged as the ones with the most indicative power in distinguishing between the two groups: olanzapine equivalent dose at the time of discharge from the referenced hospitalization, failures during temporary leave, being born outside of Switzerland, lack of compulsory school graduation, out- and inpatient treatment(s) prior to the referenced hospitalization, physical or neurological illness as well as medication compliance. Discussion Interestingly, both factors related to psychopathology and to the frequency and expression of aggression itself did not yield a high indicative power in the interplay of variables, thus suggesting that while they individually contribute to aggression as a negative outcome, they are compensable through certain interventions. The findings contribute to our understanding of differences between offenders and non-offenders with SSD, showing that previously described risk factors of aggression may be counteracted through sufficient treatment and integration in the mental health care system.
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Malaspina D. What social determinants can tell us about schizophrenia. Schizophr Res 2022:S0920-9964(22)00400-5. [PMID: 36528441 DOI: 10.1016/j.schres.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/05/2022] [Accepted: 10/30/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Dolores Malaspina
- Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Aytac HM, Oyaci Y, Pehlivan M, Pehlivan S. DNA Methylation Pattern of Gene Promoters of MB-COMT, DRD2, and NR3C1 in Turkish Patients Diagnosed with Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:685-693. [PMID: 36263643 PMCID: PMC9606422 DOI: 10.9758/cpn.2022.20.4.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We aim to evaluate the methylation status of membrane-bound catechol-O-methyltransferase (MB-COMT) promotor, dopamine receptor D2 (DRD2), and nuclear receptor subfamily 3 group C member 1 (NR3C1) gene in pa- tients with SCZ by comparing healthy controls. METHODS A sample of 110 patients with SCZ and 100 age- and sex-matched healthy volunteers was included in the study. The interview was started by filling out data forms that included sociodemographic and clinical information. The Structured Clinical Interview for DSM-IV Axis I Disorders was used to confirming the diagnosis according to DSM-IV-TR criteria. Then the patients were evaluated with the Positive and Negative Symptoms Scale in terms of symp- tom severity. Methylation-specific polymerase chain reaction was used to determine the methylation status of MB-COMT promotor, DRD2 , and NR3C1 gene from DNA material. RESULTS When we compared the percentages of MB-COMT promotor, DRD2, and NR3C1 gene methylation status in SCZ patients with the healthy control group, the percentages of MB-COMT promotor (OR: 0.466; 95% CI: 0.268- 0.809; p = 0.006), DRD2 (OR: 0.439; 95% CI: 0.375-0.514; p < 0.001), and NR3C1 (OR: 0.003; 95% CI: 0.001- 0.011; p < 0.001) gene methylation status of SCZ was found to be significantly different from the control group. Whereas unmethylation of MB-COMT promotor and NR3C1 genes were associated with SCZ, the partial methylation of the DRD2 gene was related to the SCZ. CONCLUSION The MB-COMT promotor, DRD2, and NR3C1 gene methylation status may be associated with the SCZ in the Turkish population.
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Affiliation(s)
- Hasan Mervan Aytac
- Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey,Address for correspondence: Hasan Mervan Aytac Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, G-434 Street, No: 2L, Basaksehir, Istanbul 34944, Turkey, E-mail: , ORCID: https://orcid.org/0000-0002-1053-6808
| | - Yasemin Oyaci
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Eger G, Reuven Y, Dreiher J, Shvartzman P, Weiser M, Aizenberg D, Weizman A, Lev-Ran S. Effects of country of origin and wave of immigration on prevalence of schizophrenia among first and second-generation immigrants: A 30-year retrospective study. Schizophr Res 2022; 243:247-253. [PMID: 32229262 DOI: 10.1016/j.schres.2020.03.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/18/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare the rates of schizophrenia among 1st and 2nd generation immigrants from two distinct backgrounds and across sequential periods of immigration. METHODS A 30-years retrospective cohort study (187,184 individuals) of 1st and 2nd generation East-African immigrants (EAIs) and former Soviet-Union immigrants (FSUIs) who migrated to Israel between 1980 and 2012. EAIs were further divided according to waves of immigration. Period prevalence was calculated between the years 2002-2012. Multivariate logistic regression models were used to examine the association between immigration-related factors and prevalence of schizophrenia (Native-Born Israelis serving as reference group). RESULTS The prevalence of schizophrenia in 1st generation EAIs and FSUIs was 1.8% and 1.2%, respectively, compared to 1.0% among NBIs (p<0.001). The prevalence of schizophrenia among 2nd generation EAIs and FSUIs was 1.3% and 0.8%, respectively, compared to 0.6% among NBIs (p<0.001). Adjusted odds ratios for developing schizophrenia compared to NBIs were 1.6 (95%CI:1.4-1.8) and 2.1 (95%CI:1.6-2.7), among 1st and 2nd generation EAIs and 1.1 (95%CI:0.9-1.2) and 1.3 (95%CI:1.0-1.8) among 1st and 2nd generation FSUIs respectively. Among EAIs, we observed the highest rate of schizophrenia in the pioneer wave of immigrants with gradual decline across subsequent waves: 2.4%, 1.9% and 1.0% for the 1st, 2nd and 3rd waves of immigration, respectively (p<0.001). CONCLUSIONS The increased risk for developing schizophrenia among 2nd generation immigrants and among pioneer groups of immigrants emphasizes the importance of persistent investment in acculturation. Further studies elucidating the impact of country of origin and ethnic density on the risk for developing schizophrenia are warranted.
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Affiliation(s)
- G Eger
- Geha Mental Health Center, Israel.
| | - Y Reuven
- Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - J Dreiher
- Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
| | - P Shvartzman
- Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
| | - M Weiser
- Psychiatry division, "Sheba" Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | | | | | - S Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Lev-Hasharon Mental Health Center, Israel
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Vanova M, Aldridge-Waddon L, Jennings B, Elbers L, Puzzo I, Kumari V. Clarifying the roles of schizotypy and psychopathic traits in lexical decision performance. Schizophr Res Cogn 2022; 27:100224. [PMID: 34824994 PMCID: PMC8605281 DOI: 10.1016/j.scog.2021.100224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Some studies suggest that lexical recognition is impaired in people with schizophrenia, psychopathy and/or antisocial personality disorders, but not affective disorders. We examined the extent to which various traits dimensionally linked to one or more of these disorders are associated with lexical recognition performance in the general population. METHODS Seventy-eight healthy English-speaking participants completed self-report measures of schizotypy, psychopathy, impulsivity, depression, anxiety and stress. All participants were assessed on a one-choice variant of a lexical decision task (LDT). RESULTS Meanness and Boldness traits of psychopathy (Triarchic Psychopathy Measure), and positive schizotypy (Unusual Experiences, Oxford-Liverpool Inventory of Feelings and Experiences) were associated with poor word-nonword accuracy, and predicted a significant amount of unique variance (Meanness, 12%; Boldness, 4.8%; Positive Schizotypy, 4.4%; total 21%) in performance. Higher motor impulsivity predicted 30% of the variance in low-frequency words recognition accuracy, but only in non-native English speakers. Affective traits were not associated with LDT performance. CONCLUSION Psychopathic traits show stronger negative associations with lexical recognition performance than schizotypal traits, and impulsivity may differently influence lexical decision performance in native and non-native speakers. Further studies are needed to replicate these findings, especially the influence of language familiarity in the impulsivity-performance relationship, and to clarify the influence of corresponding symptom dimensions in lexical recognition abilities, taking language familiarity, migration status, and comorbidity into account, in people with schizophrenia, psychopathy, and/or antisocial personality disorders.
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Affiliation(s)
- Martina Vanova
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Luke Aldridge-Waddon
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Ben Jennings
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Leonie Elbers
- Department of Psychology, University of Wuppertal, Germany
| | - Ignazio Puzzo
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - Veena Kumari
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
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He Y, Gu Y, Wang S, Li Y, Li G, Hu Z. Migration, Schizophrenia, and Crime: A Study From a Forensic Psychiatric Sample. Front Psychiatry 2022; 13:869978. [PMID: 35599762 PMCID: PMC9120637 DOI: 10.3389/fpsyt.2022.869978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The association between mental health problems and crime in immigrants has attracted recent academic interest, with results suggesting that there were possible interactions between immigration, schizophrenia, and criminal behavior. However, very few studies have examined these interactions, especially in developing countries that have mass internal immigration. Therefore, this study sought to identify the associations between the sociodemographic, clinical, and criminal factors in migrants and non-migrants with schizophrenia who had been involved in criminal activities in China. METHODS Forensic archives of suspects who had been referred for criminal responsibility assessments in the Sichuan West China Forensic Center from January 2015 to December 2019 were reviewed. The sociodemographic, and criminal activity information of the suspects were extracted, while the clinical and social function were measured by the Brief Psychiatric Rating Scale (BPRS) and Social Disability Screening Schedule (SDSS) based on the archives. A Chi-squared test, a T-test, a Mann-Whitney U test, and Multinomial logistic regression were employed for the statistical analysis. RESULTS A total of 552 patients were reviewed and evaluated, 17.2% (n = 95) of which were migrants. The migrant patient group was younger than the non-migrant patient group. The BPRS and SDSS scores for the migrant patient group were lower than for the non-migrant patient group. The migrant patient group had more work experience and more had been employed at the time of the crime than the non-migrant patient group. The unemployed migrant patients were more likely to commit a property-related crime. CONCLUSIONS Compared to the non-migrant schizophrenia patient group, the migrant patient group had less severe psychiatric symptoms and less social function impairments. Employment was an important factor in preventing criminality in patients with schizophrenia, especially for migrant patients. Vocational rehabilitation focuses on developing appropriate employment that can significantly assist in schizophrenia patient recovery, which in turn could reduce their chances of committing crime. Besides, reducing other obstacles to stigma, housing and health insurance would also be beneficial to crime reduction.
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Affiliation(s)
- Yong He
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, China
| | - Yan Gu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, China
| | - Shujian Wang
- Shanghai Key Laboratory of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Yan Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, China
| | - Gangqin Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, China
| | - Zeqing Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, China
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Jahan S, Wraith D, Dunne MP, Naish S. Assessing evidence for seasonality of hospital admissions for schizophrenia in Queensland, Australia: a time series observational study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:2025-2035. [PMID: 34110485 DOI: 10.1007/s00484-021-02160-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 05/06/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
Most evidence on seasonal admission patterns for schizophrenia derives from the Northern Hemisphere with results from the Southern Hemisphere less documented. This study examines seasonal patterns in hospital admissions due to schizophrenia in Queensland, Australia, a large area that has a range of different climatic features. Daily hospital admissions data for people with the primary diagnosis of schizophrenia were collected from Queensland Health Department for the period from January 1996 to December 2015. A generalised linear regression model with Quasi-Poisson distribution was used to assess seasonal admission patterns across different climatic regions. The evidence for seasonality was also explored in subgroups that had different socio-demographic characteristics or history of prior hospitalisation for psychiatric disorders. Overall, a significant winter pattern (RR 1.05, 95%CI 1.01-1.13) was found with a peak in August (RR 1.08, 95%CI 1.03-1.17) in temperate Southeast Queensland. However, the hot humid North and Far North Queensland showed a peak in October (RR 1.10, 95%CI 1.02-1.22). Males (RR 1.11, 95%CI 1.07-1.14), people aged 40-59 years old (RR 1.10, 95%CI 1.05-1.15) and those who had never married (RR 1.09, 95%CI 1.06-1.12), were Australian by birth (RR 1.07, 95%CI 1.04-1.10) or were unemployed (RR 1.13, 95%CI 1.09-1.18) had significantly higher risk for hospital admissions, particularly during the winter months. The seasonal admission pattern for schizophrenia did not change significantly according to admission status and history of outpatient or community psychiatric treatment. The study found some evidence for seasonality of hospital admissions for schizophrenia that differed from northern tropical to southern temperate regions of Queensland.
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Affiliation(s)
- Shafkat Jahan
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.
| | - Darren Wraith
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Suchithra Naish
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia
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Abstract
Ethnic differences may significantly influence the outcome of psychopharmacological treatment, in terms of prescription, adherence, clinical response, emergence of side effects, as well as pharmacokinetics and pharmacodynamics. The purpose of this review was to explore the available literature in order to provide general suggestions to help clinicians in choosing the best therapeutic option for patients, taking into account ethnicity. Although findings are sometimes controversial, the overall published studies suggest that ethnicities other than Caucasians tend to show a lower response to antidepressants and a reduced compliance. Africans tend to be more prescribed with antipsychotics, probably due to cultural stereotypes, except with clozapine, probably for their chronic benign neutropenia. Asians usually require less antipsychotic dosages than Caucasians. The differential response and side effect profile of antidepressants and antipsychotics have been related to individual intrinsic factors, to genetic make-up, but also to cultural and contextual variables. Interestingly, albeit limited data suggest ethnic-related genetic heterogeneity at the level of the serotonin transporters, the cytochromes and some neuroreceptors. Taken together, no conclusive findings are available about the role and impact of ethnicity in psychopharmacology. One of the main problems is that the majority of the studies in psychopharmacology have been conducted on Caucasians, so that there is an urgent need to have data in other populations. Furthermore, in the era of precision medicine, the role of ethnicity may be also supported by genetic analysis.
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Schmengler H, Cohen D, Tordjman S, Melchior M. Autism Spectrum and Other Neurodevelopmental Disorders in Children of Immigrants: A Brief Review of Current Evidence and Implications for Clinical Practice. Front Psychiatry 2021; 12:566368. [PMID: 33815159 PMCID: PMC8012490 DOI: 10.3389/fpsyt.2021.566368] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Children of immigrants may have higher neurodevelopmental risks than those of non-immigrant populations. Yet, some evidence suggests that this group may receive late diagnosis, and therefore miss beneficial early interventions. Clinicians may misattribute symptoms of disorders to other social, behavioral or language problems. Likewise, there might be cultural differences in parents' likelihood of perceiving or reporting first developmental concerns to clinicians. Population-based standardized screening may play an important role in addressing ethnic inequalities in the age at diagnosis, although further research focusing on cross-cultural use is necessary. Once children are diagnosed, clinicians may rely on culturally sensitive procedures (translation services, cultural mediators) to increase the accessibility of interventions and improve adherence among immigrant families. In this brief review, we provide an overview about what is currently known about the epidemiology and risk factors of neurodevelopmental disorders, paying special attention to autism spectrum disorder (ASD), in children of immigrants and suggest the necessity of population-based screening and culturally sensitive care.
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Affiliation(s)
- Heiko Schmengler
- INSERM U1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France.,École des Hautes Études en Santé Publique, Rennes, France.,Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.,Institute for Intelligent Systems and Robotics, CNRS UMR 7222, Sorbonne Université, Paris, France
| | - Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Université de Rennes 1 and Centre Hospitalier Guillaume-Régnier, Rennes, France.,Integrative Neuroscience and Cognition Center, CNRS UMR 8002 and University of Paris, Paris, France
| | - Maria Melchior
- INSERM U1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
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Neill E, Tan EJ, Toh WL, Selvendra A, Morgan VA, Rossell SL, Castle DJ. Examining which factors influence age of onset in males and females with schizophrenia. Schizophr Res 2020; 223:265-270. [PMID: 32883558 DOI: 10.1016/j.schres.2020.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Data from the 2010 Australian National Survey of High Impact Psychosis (SHIP) was used to examine (1) what variables influence age of onset (AOO) for males and females, and (2) whether influencing variables were different between the sexes. METHOD Data from 622 schizophrenia patients in the SHIP sample was used. These included early life factors, encompassing family psychiatric history, childhood development, trauma and parental loss. Factors occurring within 12 months of diagnosis were also used, including drug/alcohol abuse and premorbid work and social adjustment. Based on the recognised differences in symptom profiles and AOO between the sexes, these factors were regressed separately for males and females. RESULTS Stepwise linear regressions showed that a family history of psychiatric disorders was significantly associated with earlier AOO in both sexes. Other variables differed between males and females. Specifically, for females, an earlier AOO was associated with poor premorbid social adjustment and the loss of a family member in childhood. Older AOO was associated with immigrant status. For males, a younger AOO was associated with unemployment at onset, poor premorbid work adjustment, parental divorce in childhood, and lifetime cannabis use. A higher premorbid IQ was associated with an older AOO. CONCLUSION Familial predisposition to psychiatric illness is related to earlier AOO of schizophrenia independent of sex. Males appear to have more individual-based predictive factors while females seem to have more community/social-based influences. Future directions for research in schizophrenia are suggested.
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Affiliation(s)
- Erica Neill
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Eric J Tan
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Ajit Selvendra
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, WA, Australia; Centre for Clinical Research in Neuropsychiatry, Medical School, University of Western Australia, Perth, WA, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J Castle
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
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Mørup MF, Kymes SM, Oudin Åström D. A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States. PLoS One 2020; 15:e0234121. [PMID: 32497106 PMCID: PMC7272089 DOI: 10.1371/journal.pone.0234121] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/19/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Schizophrenia is a condition that places a significant burden on individuals with the condition, their family, and society. A large proportion of those treated for schizophrenia do not experience treatment response and are referred to as having "treatment-resistant schizophrenia" (TRS). Expert opinion has long held that the prevalence of TRS among individuals with schizophrenia is 30%, but the basis of this estimate is unclear. This article presents a model developed for estimating the prevalence of TRS in the United States 2014. METHODS An incidence-prevalence-mortality model was developed to estimate the prevalence of TRS in the United States. The model was populated with data from public health agencies and published literature. Prevalence in 2014 was modelled using a Markov cohort simulation for each birth cohort between 1930 to 2014. RESULTS Using different scenarios for baseline incidence, relative risks of mortality, it was estimated that approximately 22% of individuals with schizophrenia would be considered treatment-resistant in 2014. DISCUSSION The results suggests that prevalence of TRS may be somewhat lower than the 30% often reported, however this is highly dependent on the definition of treatment resistance. Methods such as this may help answer epidemiological and health policy questions as well as test the influence of key underlying assumptions.
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Affiliation(s)
- Michael Frank Mørup
- Health Economics & Epidemiology Statistics, Department of Data Science, H Lundbeck A/S, Valby, Denmark
| | - Steven M. Kymes
- H Lundbeck Deerfield, Deerfield, IL, United States of America
| | - Daniel Oudin Åström
- Health Economics & Epidemiology Statistics, Department of Data Science, H Lundbeck A/S, Valby, Denmark
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Schultze-Lutter F, Ruhrmann S, Klosterkötter J. Early detection of psychosis – Establishing a service for persons at risk. Eur Psychiatry 2020; 24:1-10. [DOI: 10.1016/j.eurpsy.2008.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 07/08/2008] [Accepted: 08/08/2008] [Indexed: 10/21/2022] Open
Abstract
AbstractPurposeThe establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system.MethodAcross the first six years (1998–2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied.ResultsRising steadily in number across the first three years, 872 persons, predominately of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services.ConclusionSupported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.
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14
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Antonucci LA, Pergola G, Pigoni A, Dwyer D, Kambeitz-Ilankovic L, Penzel N, Romano R, Gelao B, Torretta S, Rampino A, Trojano M, Caforio G, Falkai P, Blasi G, Koutsouleris N, Bertolino A. A Pattern of Cognitive Deficits Stratified for Genetic and Environmental Risk Reliably Classifies Patients With Schizophrenia From Healthy Control Subjects. Biol Psychiatry 2020; 87:697-707. [PMID: 31948640 DOI: 10.1016/j.biopsych.2019.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Schizophrenia risk is associated with both genetic and environmental risk factors. Furthermore, cognitive abnormalities are established core characteristics of schizophrenia. We aim to assess whether a classification approach encompassing risk factors, cognition, and their associations can discriminate patients with schizophrenia (SCZs) from healthy control subjects (HCs). We hypothesized that cognition would demonstrate greater HC-SCZ classification accuracy and that combined gene-environment stratification would improve the discrimination performance of cognition. METHODS Genome-wide association study-based genetic, environmental, and neurocognitive classifiers were trained to separate 337 HCs from 103 SCZs using support vector classification and repeated nested cross-validation. We validated classifiers on independent datasets using within-diagnostic (SCZ) and cross-diagnostic (clinically isolated syndrome for multiple sclerosis, another condition with cognitive abnormalities) approaches. Then, we tested whether gene-environment multivariate stratification modulated the discrimination performance of the cognitive classifier in iterative subsamples. RESULTS The cognitive classifier discriminated SCZs from HCs with a balanced accuracy (BAC) of 88.7%, followed by environmental (BAC = 65.1%) and genetic (BAC = 55.5%) classifiers. Similar classification performance was measured in the within-diagnosis validation sample (HC-SCZ BACs, cognition = 70.5%; environment = 65.8%; genetics = 49.9%). The cognitive classifier was relatively specific to schizophrenia (HC-clinically isolated syndrome for multiple sclerosis BAC = 56.7%). Combined gene-environment stratification allowed cognitive features to classify HCs from SCZs with 89.4% BAC. CONCLUSIONS Consistent with cognitive deficits being core features of the phenotype of SCZs, our results suggest that cognitive features alone bear the greatest amount of information for classification of SCZs. Consistent with genes and environment being risk factors, gene-environment stratification modulates HC-SCZ classification performance of cognition, perhaps providing another target for refining early identification and intervention strategies.
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Affiliation(s)
- Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy.
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland
| | - Alessandro Pigoni
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | | | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Raffaella Romano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Barbara Gelao
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Silvia Torretta
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Grazia Caforio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Bari University Hospital, Bari, Italy.
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Cruz I, Serna C, Rué M, Real J, Galván L, Pifarré J. Comparative exposure to antipsychotic medications in immigrant and native-born populations of a Spanish health region. Eur Psychiatry 2020; 27:477-82. [DOI: 10.1016/j.eurpsy.2011.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 02/01/2011] [Accepted: 02/05/2011] [Indexed: 10/18/2022] Open
Abstract
AbstractBackgroundRaised rates of psychoses among ethnic minorities have been reported. Exposure to antipsychotic medications can give information on mental illness management and ethnic-related differences.ObjectiveTo compare exposure to antipsychotic medications in immigrant and native-born populations in Spain.MethodDescriptive cross-sectional study of the dispensation of antipsychotic medications to the population aged 15 to 64 years, in a Spanish Health Region during 2008.Results1.9% of the native-born population was exposed to antipsychotic medications as compared to 0.4% of the immigrant population. Native-born women were exposed from 1.8 to 5.3 times more and native-born men from 3.6 to 6.3 times more than immigrants of the same gender. The least exposed were persons from Eastern Europe and men from sub-Saharan Africa. Active ingredients prescribed were similar between the two groups. Of the immigrant group, 15.7% were admitted to a psychiatric ward as compared to 6.4% of the native-born population. In the former, non-specific diagnoses were predominant.ConclusionsAll immigrant groups had lower exposure to antipsychotic medications, were admitted to inpatient care more often and had less specific diagnoses. Both diagnostic processes and adherence to treatment need improvement in the regional immigrant population.
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Guo Q, Wang L, Yuan W, Li L, Zhang J, Hou W, Yang Y, Zhang X, Cai W, Ma H, Xun Y, Jia R, He Z, Tai F. Different effects of chronic social defeat on social behavior and the brain CRF system in adult male C57 mice with different susceptibilities. Behav Brain Res 2020; 384:112553. [PMID: 32057826 DOI: 10.1016/j.bbr.2020.112553] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/16/2022]
Abstract
Chronic social defeat stress (CSDS) has been found to produce different impacts on anxiety-like behaviors, spatial cognitive function and memory in rodents with different susceptibilities. However, the impacts of chronic social defeat on social behaviors in adult male mice with different susceptibilities to social defeat and the underlying mechanisms in the brain remain unclear. In the present study, we found that ten days of social defeat reduced the tendency of susceptible adult male C57 mice to approach an unfamiliar individual and increased their avoidance of an unfamiliar CD-1 mouse but had no effects on resilient individuals. In addition, CSDS enhanced anxiety-like behavior in susceptible animals, but produced no effects in the resilient group. Meanwhile, CSDS increased the number of corticotropin-releasing factor (CRF)-positive neurons in the paraventricular nucleus of the hypothalamus and CRF-R2-positive neurons in the accumbens nucleus shell in both resilient and susceptible animals. CSDS increased the number of CRF-R1-positive neurons and CRF-R1 mRNA expression in the prelimbic cortex (PrL) and the number of CRF-R2-positive neurons in the basolateral amygdala, but reduced the number of CRF-R2-positive neurons and mRNA expression in the PrL in susceptible animals. Therefore, the different effects of CSDS on sociability and anxiety-like behavior in mice with different susceptibilities may be associated with region- and type-specific alterations in CRF receptor levels. These findings help us understand the underlying mechanism by which social stress affects emotion and social behavior and provides an important basis for the treatment of disorders of social and emotional behavior caused by social stress.
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Affiliation(s)
- Qianqian Guo
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Limin Wang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Wei Yuan
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Laifu Li
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Jing Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Wenjuan Hou
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Yang Yang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Xueni Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Wenqi Cai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Huan Ma
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - YuFeng Xun
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Rui Jia
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China
| | - Zhixiong He
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China.
| | - Fadao Tai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, 710062, China; Cognition Neuroscience and Learning Division, Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, 710062, China.
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Lurie I, Barnea Y, Caspi Y, Olmer L, Baruch Y. Patterns of psychiatric hospitalizations among migrant workers and asylum-seekers in Israel: a single hospital archive study, 2005-2011. Nord J Psychiatry 2020; 74:115-122. [PMID: 31621452 DOI: 10.1080/08039488.2019.1677770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: Migrants have increased risk for psychiatric hospitalizations. Over the last decades Israel has become a destination for migration of migrant workers and asylum-seekers.Methods: The current retrospective study retrieved socio-demographic, clinical and migration-related chart data for 117 migrants admitted to a major Israeli psychiatric hospital between 2005-2011, to delineate characteristics and risk-factors for psychiatric hospitalizations. Multivariate logistic regression analyses were performed to predict re-hospitalization.Results: Of the study sample, 61% were single men, 20% had been exposed to trauma, 15% had prior psychiatric hospitalizations and 24% had attempted suicide. Approximately, 76% were involuntarily hospitalized and diagnosed with psychosis. None were diagnosed with PTSD. Approximately, 20% were re-hospitalized. Factors significantly associated with re-hospitalization were male gender (OR = 15.2, 95%, CI 1.8-126.9, p = 0.012), prior psychiatric hospitalization (OR = 15.4, 95% CI 2.1-111.9, p < 0.01), being single (OR = 5.96, 95% CI1.14-31.07, p = 0.03) and traumatic exposure (OR = 4.75, 95% CI: 1.17-19.36, p= 0.03). Shorter duration in Israel, unemployment, asylum-seekers, no temporary-visa and use of restraints were more prevalent among those re-hospitalized.Conclusion: Identification of migrants at risk and trauma-informed, culturally relevant services can reduce hospitalizations.
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Affiliation(s)
- Ido Lurie
- Shalvata Mental Health Center, Hod Hasharon, Israel.,Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Barnea
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Abarbanel Mental Health Center, Bat-Yam, Israel
| | - Yael Caspi
- Veterans' Outpatient Psychiatric Clinic, Department of Psychiatry, Rambam Medical Health Care Center, Haifa, Israel
| | - Liraz Olmer
- Gertner Institute for Health Policy and Epidemiology, Tel HaShomer, Israel
| | - Yehuda Baruch
- Health Administration Department, Israel Academic College, Ramat Gan, Israel
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Oduola S, Craig TKJ, Das-Munshi J, Bourque F, Gayer-Anderson C, Morgan C. Compulsory admission at first presentation to services for psychosis: does ethnicity still matter? Findings from two population-based studies of first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:871-881. [PMID: 30895353 PMCID: PMC6656788 DOI: 10.1007/s00127-019-01685-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/04/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Compared with the majority population, those from minority ethnic groups in the UK are more likely to be admitted compulsorily during a first episode of psychosis (FEP). We investigated whether these disparities in pathways in to care continue. METHODS We analysed data from two first episode psychosis studies, conducted in the same geographical area in south London 15 years apart: the Aetiology and Ethnicity in Schizophrenia and Other Psychosis (AESOP) and the Clinical Record Interactive Search-First Episode Psychosis (CRIS-FEP) studies. The inclusion/exclusion criteria for case ascertainment for first episode psychosis were identical across the two studies. We performed multivariable logistic regression to estimate odds of compulsory admission by ethnic group, controlling for confounders. PARTICIPANTS Two hundred sixty-six patients with first episode psychosis, aged 18-64 years, who presented to mental health services in south London in 1997-1999 and 446 with FEP who presented in 2010-2012. RESULTS When the two samples were compared, ethnic differences in compulsory admission appear to have remained the same for black African patients, i.e. three times higher than white British in both samples: AESOP (adj. OR = 3.96; 95% CI = 1.80-8.71) vs. CRIS-FEP (adj. OR = 3.12; 95% CI = 1.52-6.35). Black Caribbean patients were three times more likely to be compulsorily admitted in AESOP (adj. OR = 3.20; 95% CI = 1.56-6.54). This was lower in the CRIS-FEP sample (adj. OR = 1.68; 95% CI = 0.71-3.98) and did not meet conventional levels for statistical significance. CONCLUSION Ethnicity is strongly associated with compulsory admissions at first presentation for psychosis with evidence of heterogeneity across groups, which deserves further research.
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Affiliation(s)
- Sherifat Oduola
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
- South London & Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.
| | - Tom K J Craig
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Jayati Das-Munshi
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- South London & Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Francois Bourque
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- Division of Social and Cultural Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, H4H 1R3, Canada
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
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Stouten LH, Veling W, Laan W, Van der Gaag M. Psychopathology, cognition and outcome in Dutch and immigrant first-episode psychosis patients. Early Interv Psychiatry 2019; 13:646-656. [PMID: 29603625 DOI: 10.1111/eip.12561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 10/29/2017] [Accepted: 02/04/2018] [Indexed: 11/27/2022]
Abstract
AIM The primary aim was to examine differences in baseline symptom expression, neurocognition, social cognition and psychosocial functioning between Dutch, first-generation immigrants and second-generation immigrants with a first-episode psychosis (FEP). The secondary aim was to examine functional and symptomatic change and between-group differences at 12-months follow-up. Associations between migration, baseline characteristics and outcome were explored. METHODS Forty-six Dutch, 56 second-generation- and 60 first-generation immigrant patients completed baseline measures for 6 symptom dimensions (positive symptoms, negative symptoms, neurocognitive functioning, social cognitive functioning, excitement and emotional distress) and 5 domains of psychosocial functioning (general functioning, work and study, relationships, self-care and disturbing behaviour). Functioning and psychotic symptoms were assessed at baseline and 12-months follow-up. ANCOVA and t tests were used to assess between-group differences. General linear models were used to explore within-group differences. Backward-regression was used to explore predictors of outcome. RESULTS Levels of positive symptoms, excitement and emotional distress did not differ between groups at baseline or follow-up. Dutch patients had lower levels of negative symptoms than both immigrant groups at follow-up. On neurocognition and social cognition, Dutch performed better than second-generation immigrants, who in turn performed better than first-generation immigrants. Psychosocial functioning across all domains at baseline and at 12-months follow-up was similar across groups. Baseline levels of general psychosocial functioning and income were the strongest predictors of outcome at follow-up. CONCLUSIONS Psychosocial functioning and symptom profiles are comparable between Dutch, first-generation immigrant and second-generation immigrant FEP patients, excluding neurocognitive and social cognitive deficits. A range of baseline characteristics predicted outcome.
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Affiliation(s)
- Luyken H Stouten
- Parnassia Psychiatric Institute, Centre for Early Psychosis, The Hague, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Winfried Laan
- Parnassia Psychiatric Institute, Centre for Early Psychosis, The Hague, The Netherlands
| | - Mark Van der Gaag
- Parnassia Psychiatric Institute, Centre for Early Psychosis, The Hague, The Netherlands.,Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Fett AKJ, Lemmers-Jansen IL, Krabbendam L. Psychosis and urbanicity: a review of the recent literature from epidemiology to neurourbanism. Curr Opin Psychiatry 2019; 32:232-241. [PMID: 30724751 PMCID: PMC6493678 DOI: 10.1097/yco.0000000000000486] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Epidemiological studies associate city living with an elevated psychosis risk. Urban (social/economic) stress and exposure to environmental toxins, pollution or disease agents have been proposed to underlie this association. This review provides an update on the recent evidence (May 2017 - November 2018). RECENT FINDINGS Of 647 screened studies, 17 on: urbanicity-psychosis associations in worldwide high, middle and low-income countries; explanatory mechanisms, including nature exposure, social and economic stressors and genetic risk; urbanicity effects on the brain and coping; and urbanicity and resources, were included. The reviewed evidence revealed complex patterns of urbanicity-psychosis associations with considerable international variation within Europe and between low, middle and high-income countries worldwide. Social and economic stressors (e.g. migration, ethnic density and economic deprivation), nature exposure and access to resources could only explain part of the urbanicity effects. Risk factors differed between countries and between affective and non-affective psychosis. SUMMARY Urbanicity-psychosis associations are heterogeneous and driven by multiple risk and protective factors that seem to act differently in different ethnic groups and countries. Interdisciplinary research combining approaches, for example from experimental neuroscience and epidemiology, are needed to unravel specific urban mechanisms that increase or decrease psychosis risk.
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Affiliation(s)
- Anne-Kathrin J. Fett
- Department of Psychology, City, University of London, London, UK
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Imke L.J. Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Luderowski A, Boden ZV. Love and incomprehensibility: The hermeneutic labour of caring for and understanding a loved one with psychosis. Health (London) 2019; 24:737-754. [PMID: 30935237 DOI: 10.1177/1363459319829189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers' perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one's psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers' effortful quest to understand their loved one's experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic 'mooring points', making sense of their loved one's unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful - it is hermeneutic labour - done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems.
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Neumann B, Ross T, Opitz-Welke A. Foreign National Patients in German Prison Psychiatry. Front Psychiatry 2019; 10:988. [PMID: 32116816 PMCID: PMC7033612 DOI: 10.3389/fpsyt.2019.00988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/12/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Over the past few years, the share of foreign national prisoners in the European and American justice systems has increased at a disproportionately high rate, yet studies on mental health issues among this diverse group are rare. Recent research suggests a range of factors leading to mental health vulnerability in foreign national prisoners, including language barriers, isolation, cultural misunderstanding, and legal standing. Relevant findings of topic-related studies indicate that under-referral to mental health services due to missed or misinterpreted symptoms is a major risk for foreign national prisoners. AIMS We aimed to investigate the disparities regarding the percentage of foreign national patients who were treated in high-security hospitals compared to the psychiatric ward of prison hospitals-after adjusting for diagnosis, age, marital status, and substance abuse. We hypothesized that foreign national patients were underrepresented in compulsory, high-security mental health care. We also aimed to explore citizenship-related institutional disparities concerning diagnoses and self-harmful behavior. METHOD From 2010 to 2015, data collected from high-security hospitals in the federal state of Baden-Wurttemberg and the psychiatric ward of a Berlin prison hospital was evaluated by comparing nationality, diagnosis, and self-harm using Fisher's exact test and χ²-test. The odds ratios for citizenship-related differences in diagnosis and institution of treatment were evaluated by using logistic regression. RESULTS Mentally ill foreign national patients were significantly less likely to be treated in high-security hospitals rather than prison hospital psychiatry (adjusted for diagnosis, age at admission, marital status, and substance abuse; adjusted OR = 0.5). Foreign nationals and Germans in prison hospital psychiatry showed no significant disparities in diagnosis; however, in high-security hospitals, foreign nationals were more likely to have been diagnosed with schizophrenia/psychotic or neurotic/stress-related disorders and were less likely to have been diagnosed with personality disorders than German patients. Additionally, foreign nationals were more likely to commit self-harm than Germans in prison hospital psychiatry, but significant citizenship-related differences could not be verified in high-security hospital patients. CONCLUSION Treatment conditions of foreign national patients in prison psychiatry must be improved. To achieve this, the psychiatric assessment and (mental) health-related aspects of these patients should be further investigated.
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Affiliation(s)
- Britta Neumann
- Institute of Forensic Psychiatry, Charité University of Medicine Berlin, Berlin, Germany
| | - Thomas Ross
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center and University of Ulm, Ulm, Germany
| | - Annette Opitz-Welke
- Institute of Forensic Psychiatry, Charité University of Medicine Berlin, Berlin, Germany
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Fountoulakis KN, Gonda X, Siamouli M, Panagiotidis P, Moutou K, Nimatoudis I, Kasper S. Paternal and maternal age as risk factors for schizophrenia: a case-control study. Int J Psychiatry Clin Pract 2018; 22:170-176. [PMID: 29069946 DOI: 10.1080/13651501.2017.1391292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Advanced parental age might constitute a generic risk factor for mental and somatic disorders. The current study tested whether this concerns also patients with schizophrenia. METHODS A total of 231 schizophrenic, 56 other severe mental disorders patients and 204 controls were diagnosed according to DSM-IV-TR. Data were tested with ANOVA models including relative risk and odds ratios. RESULTS Patients with schizophrenia manifested higher paternal (32.55 ± 6.35 vs. 29.42 ± 6.07, p < .001) and maternal age (27.66 ± 5.57 vs. 25.46 ± 4.52, p < .001). Patients with other mental disorders had higher paternal (33.29 ± 8.35; p = .001) but not maternal age (26.69 ± 5.89; p = .296) compared to controls. There was no difference between the two patient groups concerning either paternal or maternal age (p > .05). There seems to be a higher risk for the development of schizophrenia in offspring with paternal age above 25 years and maternal age above 22 years at delivery. CONCLUSIONS The current study provides further support for the suggestion that advanced paternal age constitutes a risk factor (in a non-dose dependent and gender-independent way) for the development of schizophrenia but also for other mental disorders. In contrast, advanced maternal age characterises schizophrenia specifically. The higher risk is evident after 25 years of paternal and 22 years of maternal age, respectively.
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Affiliation(s)
- Konstantinos N Fountoulakis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Xenia Gonda
- b Department of Psychiatry and Psychotherapy , Semmelweis University , Budapest , Hungary.,c MTA-SE Neuropsychopharmacology and Neurochemistry Research Group , Hungarian Academy of Sciences, Semmelweis University , Budapest , Hungary
| | - Melina Siamouli
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Panagiotis Panagiotidis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Ioannis Nimatoudis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Siegfried Kasper
- e Universitätsklinik für Psychiatrie und Psychotherapie , Medizinische Universität , Vienna , Austria
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Zhu Y, Hu X, Yang B, Wu G, Wang Z, Xue Z, Shi J, Ouyang X, Liu Z, Rosenheck R. Association between migrant worker experience, limitations on insurance coverage, and hospitalization for schizophrenia in Hunan Province, China. Schizophr Res 2018; 197:93-97. [PMID: 29195746 DOI: 10.1016/j.schres.2017.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 11/07/2017] [Accepted: 11/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND While transnational migration has been shown to be a risk factor for schizophrenia, studies have not examined whether massive internal rural-to-urban migration in China in recent years has increased the risk of hospitalization for schizophrenia, or schizophrenia symptom severity among migrants. METHOD In a sample of patients acutely hospitalized with schizophrenia in Changsha, Hunan Province, China (N=334), the proportion of past migrant workers among patients was compared to the proportion of past migrant workers in the general adult population of Hunan. Past migrants were also compared to non-migrants on age of onset, and on symptom severity using the Positive and Negative Syndrome Scale (PANSS). The risk ratio for being a migrant among those hospitalized for schizophrenia was stratified by age and gender subgroups. Multiple regression analysis was used to evaluate group differences in age of onset and symptoms. RESULTS Of 334 patients diagnosed with schizophrenia hospitalized for <180days, 150 (44.9%) were identified as having been migrant workers compared to 31.0% in the general adult population of Hunan for a risk ratio of 1.45, a risk that was higher for women (2.19) than for men (1.09). Migrant workers also had higher scores than others on total PANSS symptoms. CONCLUSION Migrant workers appear to be at greater risk of hospitalization for schizophrenia than other residents of Hunan and showed more severe psychopathology. These findings may reflect specific lack of health insurance coverage for workers migrating to non-native provinces in China, thereby delaying access to treatment.
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Affiliation(s)
- Yifan Zhu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Xinran Hu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China.
| | - Bo Yang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Guowei Wu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Zheng Wang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Zhimin Xue
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Jincheng Shi
- Xiangya School of Public Health, Central South University, Changsha, PR China
| | - Xuan Ouyang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China.
| | - Zhening Liu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China; The State Key Laboratory of Medical Genetics, Central South University, PR China.
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Pignon B, Peyre H, Szöke A, Geoffroy PA, Rolland B, Jardri R, Thomas P, Vaiva G, Roelandt JL, Benradia I, Behal H, Schürhoff F, Amad A. A latent class analysis of psychotic symptoms in the general population. Aust N Z J Psychiatry 2018; 52:573-584. [PMID: 29232967 DOI: 10.1177/0004867417744255] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Individuals with psychotic symptoms may actually correspond to various subgroups, characterized by different patterns of psychotic symptoms as well as specific sociodemographic and clinical correlates. We aimed to identify groups of individuals from the general population with specific patterns of psychotic symptoms. METHODS In a 38,694-subject survey, a latent class analysis was performed to identify subgroups based on the distribution of seven psychotic symptoms taken from the Mini International Neuropsychiatric Interview. The different classes were subsequently compared according to sociodemographic and clinical correlates. RESULTS The best fit was obtained with a four-class solution, including the following: (1) a class with a low prevalence of all psychotic symptoms ('LOW', 85.9%); (2) a class with a high prevalence of all psychotic symptoms ('HAL + DEL', 1.7%); and classes with a high prevalence of (3) hallucinations ('HAL', 4.5%) or (4) delusions ('DEL', 7.9%). The HAL + DEL class displayed higher rates of history of trauma, social deprivation and migrant status, while the HAL and DEL classes displayed intermediate rates between HAL + DEL and LOW. HAL + DEL displayed the highest rates of psychotic and non-psychotic disorders and the use of mental health treatment, while HAL and DEL displayed intermediate rates of these disorders between HAL + DEL and LOW. In comparison to the HAL class, psychotic and substance use disorders were more frequent in the DEL class, while anxiety and mood disorders were less frequent. CONCLUSION These findings support the hypothesis of a continuum model relating the level of psychotic symptoms to the level of global psychopathology.
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Affiliation(s)
- Baptiste Pignon
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Hugo Peyre
- 2 Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department and Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Andrei Szöke
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Pierre A Geoffroy
- 3 Inserm, U1144 and Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, and AP-HP, GH Saint-Louis-Lariboisière-F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Fondation FondaMental, Créteil, France
| | - Benjamin Rolland
- 4 Service Universitaire d'Addictologie, Pôle UP-MOPHA, CH Le Vinatier, Univ. Lyon and CRNL Inserm U1028/CNRS UMR5292-CH Le Vinatier, Bron, France
| | - Renaud Jardri
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France
| | - Pierre Thomas
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Guillaume Vaiva
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Jean-Luc Roelandt
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Imane Benradia
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Hélène Behal
- 8 Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Department of biostatistics, Lille, France
| | - Franck Schürhoff
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Ali Amad
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France.,9 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lund C, Brooke-Sumner C, Baingana F, Baron EC, Breuer E, Chandra P, Haushofer J, Herrman H, Jordans M, Kieling C, Medina-Mora ME, Morgan E, Omigbodun O, Tol W, Patel V, Saxena S. Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Lancet Psychiatry 2018; 5:357-369. [PMID: 29580610 DOI: 10.1016/s2215-0366(18)30060-9] [Citation(s) in RCA: 450] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 01/08/2023]
Abstract
Mental health has been included in the UN Sustainable Development Goals. However, uncertainty exists about the extent to which the major social determinants of mental disorders are addressed by these goals. The aim of this study was to develop a conceptual framework for the social determinants of mental disorders that is aligned with the Sustainable Development Goals, to use this framework to systematically review evidence regarding these social determinants, and to identify potential mechanisms and targets for interventions. We did a systematic review of reviews using a conceptual framework comprising demographic, economic, neighbourhood, environmental events, and social and culture domains. We included 289 articles in the final Review. This study sheds new light on how the Sustainable Development Goals are relevant for addressing the social determinants of mental disorders, and how these goals could be optimised to prevent mental disorders.
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Affiliation(s)
- Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Carrie Brooke-Sumner
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council of South Africa, Cape Town, South Africa
| | - Florence Baingana
- World Health Organization Sierra Leone Country Office, Freetown, Sierra Leone
| | - Emily Claire Baron
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Erica Breuer
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Johannes Haushofer
- Princeton University, Princeton, NJ, USA; Busara Center for Behavioral Economics, Nairobi, Kenya
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mark Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Research and Development Department, War Child, Amsterdam, Netherlands
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - Olayinka Omigbodun
- Centre for Child and Adolescent Mental Health and Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Wietse Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Peter C Alderman Foundation, Bedford, NY, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA; London School of Hygiene & Tropical Medicine, London, UK; Sangath, Porvorim, Goa, India; Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Delhi, India
| | - Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Abdel-Baki A, Ouellet-Plamondon C, Medrano S, Nicole L, Rousseau C. Immigrants' outcome after a first-episode psychosis. Early Interv Psychiatry 2018; 12:193-201. [PMID: 26616492 DOI: 10.1111/eip.12302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 10/22/2015] [Indexed: 12/11/2022]
Abstract
AIM Immigration is a risk factor for psychosis emergence, and previous studies show that immigrants are less likely to engage in treatment for psychosis. However, the literature on outcome is scant and heterogeneous. This study was designed to compare first-generation (FGI) and second-generation immigrants (SGI) to non-immigrants' symptomatic and functional outcomes 2 years after a first-episode psychosis (FEP). METHODS A 2-year prospective longitudinal study of 223 FEP patients between 18 and 30 years took place in two early intervention services (EIS) in Montreal, Canada. RESULTS Forty-two per cent of the sample were immigrants (FGI (n = 56), SGI (n = 38)). Compared with non-immigrants, immigrants had similar symptomatic and functioning profiles at baseline, 1 and 2 years, except that fewer SGI had a history of homelessness and more were living with their families. FGI were less likely to have a substance use disorder but more likely to pursue their studies and to present depressive symptoms. CONCLUSIONS Even if immigrants are known to be at greater risk of developing psychosis, probably secondary to stress related to immigration, their symptomatic and functional outcomes, once engaged in EIS treatment, are similar to or sometimes better than non-immigrants' outcomes. Because immigrants tend to be less engaged in their follow-up, understanding why they disengage from treatment is crucial to develop better therapeutic approaches to better engage them as EIS treatment can improve their outcomes effectively.
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Affiliation(s)
- Amal Abdel-Baki
- Department of Psychiatry, Clinique JAP, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry, Clinique JAP, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
| | | | - Luc Nicole
- Institut en Santé Mentale de l'Université de Montréal, Montreal, Quebec, Canada
| | - Cécile Rousseau
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Caqueo-Urízar A, Alessandrini M, Boyer L. Calidad de vida en pacientes con esquizofrenia de origen Aymara en la zona Centro-Sur de los Andes. UNIVERSITAS PSYCHOLOGICA 2018. [DOI: 10.11144/javeriana.upsy16-5.qlap] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
El objetivo de este estudio consistió en comparar la calidad de vida (CV) de pacientes con esquizofrenia pertenecientes al grupo étnico aymara de los Andes Centro-Sur, con pacientes no Aymara. En este estudio transversal participaron 253 pacientes de tres clínicas de salud mental en Chile, Perú y Bolivia. Se recogieron datos sociodemográficos y características clínicas. La calidad de vida se evaluó utilizando el Cuestionario S-QoL18. Los análisis comparativos exploraron las diferencias de QoL entre los pacientes Aymara y no Aymara. Los participantes de origen Aymara tuvieron puntuaciones de CV más bajos en comparación con los pacientes no Aymara para el Índice total, las relaciones familiares y la dimensión de vida sentimental. Los ingresos familiares mensuales y la duración del trastorno fueron significativamente más bajos en los pacientes Aymara. Nuestro estudio soporta la hipótesis de una peor CV en pacientes aymaras con esquizofrenia.
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Bulla J, Hoffmann K, Querengässer J, Ross T. Socioeconomic disadvantage and schizophrenia in migrants under mental health detention orders. Int J Soc Psychiatry 2017; 63:550-558. [PMID: 28658994 DOI: 10.1177/0020764017716696] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia. AIMS This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders. METHOD Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI). RESULTS For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses. CONCLUSION Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.
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Affiliation(s)
- Jan Bulla
- Department of Forensic Psychiatry and Psychotherapy, Centre of Psychiatry Reichenau, Reichenau, Germany
| | - Klaus Hoffmann
- Department of Forensic Psychiatry and Psychotherapy, Centre of Psychiatry Reichenau, Reichenau, Germany
| | - Jan Querengässer
- Department of Forensic Psychiatry and Psychotherapy, Centre of Psychiatry Reichenau, Reichenau, Germany
| | - Thomas Ross
- Department of Forensic Psychiatry and Psychotherapy, Centre of Psychiatry Reichenau, Reichenau, Germany
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30
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Huang TL, Lo LH, Shiea J, Su H. Rapid and simple analysis of disease-associated biomarkers of Taiwanese patients with schizophrenia using matrix-assisted laser desorption ionization mass spectrometry. Clin Chim Acta 2017; 473:75-81. [PMID: 28807542 DOI: 10.1016/j.cca.2017.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Matrix-assisted laser desorption ionization/time-of-flight mass spectrometry (MALDI-TOF MS) is an extremely sensitive analytical tool for characterizing biological compounds in bio samples. In this study, we applied MALDI-TOF MS to assess potential protein biomarkers in the peripheral blood mononuclear cells (PBMCs) of patients with schizophrenia in the acute phase, recovery phase and healthy controls in Taiwan. METHODS We recruited 40 participants, including 20 pairs of patients diagnosed with schizophrenia in the acute phase, after four-week treatment with drug in the recovery phase, and 20 healthy controls. The schizophrenic patients were diagnosed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID), and severity was assessed by a positive and negative symptom scale at baseline and at endpoint following four-week treatment with drug. The patients' PBMCs biomarkers were rapidly measured using a technique that combines MALDI-TOF MS and principle component analysis. A receiver operating characteristic curve was created for the evaluated biomarker. RESULTS Significant differences in α-defensins 1-3 were found between the patients in acute phase with schizophrenia and the healthy controls, but not between the schizophrenic patients in recovery phase and healthy controls or between the schizophrenic patients in acute phase and in recovery phase. CONCLUSIONS α-Defensins can be biomarkers of Taiwanese patients with schizophrenia, thus supporting the hypothesis that the inflammatory response and immunity system is correlated with the pathophysiology of schizophrenia. Moreover, the result also implies that α-defensins may be related in schizophrenia-associated disease not in efficacy of drug-treatment.
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Affiliation(s)
- Tiao-Lai Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Genomic and Proteomic Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
| | - Li-Hua Lo
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
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31
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Mustelin L, Hedman AM, Thornton LM, Kuja-Halkola R, Keski-Rahkonen A, Cantor-Graae E, Almqvist C, Birgegård A, Lichtenstein P, Mortensen PB, Pedersen CB, Bulik CM. Risk of eating disorders in immigrant populations. Acta Psychiatr Scand 2017; 136:156-165. [PMID: 28542783 DOI: 10.1111/acps.12750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. METHOD All individuals born 1984-2002 (Danish cohort) and 1989-1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. RESULTS The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. CONCLUSION The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care.
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Affiliation(s)
- L Mustelin
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - A M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - L M Thornton
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - R Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Keski-Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - E Cantor-Graae
- Social Medicine and Global Health, Lund University, Malmö, Sweden
| | - C Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Birgegård
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - P B Mortensen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - C B Pedersen
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - C M Bulik
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Akdeniz C, Schäfer A, Streit F, Haller L, Wüst S, Kirsch P, Tost H, Meyer-Lindenberg A. Sex-Dependent Association of Perigenual Anterior Cingulate Cortex Volume and Migration Background, an Environmental Risk Factor for Schizophrenia. Schizophr Bull 2017; 43:925-934. [PMID: 28969352 PMCID: PMC5472165 DOI: 10.1093/schbul/sbw138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Migration status is one of the best-established risk factors for schizophrenia. An increase in risk is observed in both first- and second-generation immigrants, with a varying magnitude depending on the ethnic background of the individuals. The underlying mechanisms for the increased risk are only recently coming into focus. A causal role for social stress has been widely proposed, and recent work indicated altered neural stress processing in the perigenual anterior cingulate cortex (pACC) in migrants. Since previous work shows that social stress may lead to enduring changes in the gray matter volume of vulnerable brain regions, we investigated the impact of migration background on brain structure. We studied healthy young adults (N = 124), native Germans and second-generation migrants, using whole-brain structural magnetic resonance imaging. Groups were matched for a broad range of sociodemographic characteristics including age, gender, urban exposure, and education. We found a significant group by sex interaction effect in pACC gray matter volume, which was reduced in males with migration background only. This mirrors previous findings in urban upbringing, another risk factor for schizophrenia. Our results provide convergent evidence for an impact of environmental risk factors linked to schizophrenia on gray matter volume and extend prior data by highlighting the possibility that the pACC structure may be particularly sensitive to the convergent risk factors linked to schizophrenia.
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Affiliation(s)
- Ceren Akdeniz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany,These authors contributed equally
| | - Axel Schäfer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany,These authors contributed equally
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Leila Haller
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Stefan Wüst
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany,Present address: Institute of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
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Vitale AM, Matigian NA, Cristino AS, Nones K, Ravishankar S, Bellette B, Fan Y, Wood SA, Wolvetang E, Mackay-Sim A. DNA methylation in schizophrenia in different patient-derived cell types. NPJ SCHIZOPHRENIA 2017; 3:6. [PMID: 28560252 PMCID: PMC5441549 DOI: 10.1038/s41537-016-0006-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/11/2016] [Accepted: 12/02/2016] [Indexed: 12/21/2022]
Abstract
DNA methylation of gene promoter regions represses transcription and is a mechanism via which environmental risk factors could affect cells during development in individuals at risk for schizophrenia. We investigated DNA methylation in patient-derived cells that might shed light on early development in schizophrenia. Induced pluripotent stem cells may reflect a “ground state” upon which developmental and environmental influences would be minimal. Olfactory neurosphere-derived cells are an adult-derived neuro-ectodermal stem cell modified by developmental and environmental influences. Fibroblasts provide a non-neural control for life-long developmental and environmental influences. Genome-wide profiling of DNA methylation and gene expression was done in these three cell types from the same individuals. All cell types had distinct, statistically significant schizophrenia-associated differences in DNA methylation and linked gene expression, with Gene Ontology analysis showing that the differentially affected genes clustered in networks associated with cell growth, proliferation, and movement, functions known to be affected in schizophrenia patient-derived cells. Only five gene loci were differentially methylated in all three cell types. Understanding the role of epigenetics in cell function in the brain in schizophrenia is likely to be complicated by similar cell type differences in intrinsic and environmentally induced epigenetic regulation. Schizophrenia-associated differences in the DNA methylation status of patient-derived cells suggest it could affect early brain development. Mechanisms that control gene expression without altering the genetic code, such as DNA methylation, could explain how environmental risk factors contribute to schizophrenia in genetically susceptible individuals. Alan Mackay-Sim and colleagues from Griffith University, Australia, carried out genome-wide comparisons of DNA methylation in induced pluripotent stem (iPS) cells, olfactory neurosphere-derived cells and fibroblasts from patients and controls. Differences in the DNA methylation pattern between patient and control iPS cells, which could reflect what happens in the embryo, suggest a disease-associated effect very early on in development. Only five genes were differentially methylated in all three patient-derived cell types compared to controls. None of these genes has previously been associated with schizophrenia and may represent new targets for future research.
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Affiliation(s)
- Alejandra M Vitale
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia.,Instituto de Biologia y Medicina Experimental-IBYME-CONICET, Buenos Aires, Argentina
| | - Nicholas A Matigian
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia.,The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, QLD Australia
| | - Alexandre S Cristino
- The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, QLD Australia
| | - Katia Nones
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, QLD Australia
| | - Sugandha Ravishankar
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia
| | - Bernadette Bellette
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia
| | - Yongjun Fan
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia
| | - Stephen A Wood
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia
| | - Ernst Wolvetang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD Australia
| | - Alan Mackay-Sim
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD Australia
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Severance EG, Yolken RH, Eaton WW. Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res 2016; 176:23-35. [PMID: 25034760 PMCID: PMC4294997 DOI: 10.1016/j.schres.2014.06.027] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/17/2014] [Accepted: 06/19/2014] [Indexed: 12/12/2022]
Abstract
Autoimmunity, gastrointestinal (GI) disorders and schizophrenia have been associated with one another for a long time. This paper reviews these connections and provides a context by which multiple risk factors for schizophrenia may be related. Epidemiological studies strongly link schizophrenia with autoimmune disorders including enteropathic celiac disease. Exposure to wheat gluten and bovine milk casein also contribute to non-celiac food sensitivities in susceptible individuals. Co-morbid GI inflammation accompanies humoral immunity to food antigens, occurs early during the course of schizophrenia and appears to be independent from antipsychotic-generated motility effects. This inflammation impacts endothelial barrier permeability and can precipitate translocation of gut bacteria into systemic circulation. Infection by the neurotropic gut pathogen, Toxoplasma gondii, will elicit an inflammatory GI environment. Such processes trigger innate immunity, including activation of complement C1q, which also functions at synapses in the brain. The emerging field of microbiome research lies at the center of these interactions with evidence that the abundance and diversity of resident gut microbiota contribute to digestion, inflammation, gut permeability and behavior. Dietary modifications of core bacterial compositions may explain inefficient gluten digestion and how immigrant status in certain situations is a risk factor for schizophrenia. Gut microbiome research in schizophrenia is in its infancy, but data in related fields suggest disease-associated altered phylogenetic compositions. In summary, this review surveys associative and experimental data linking autoimmunity, GI activity and schizophrenia, and proposes that understanding of disrupted biological pathways outside of the brain can lend valuable information regarding pathogeneses of complex, polygenic brain disorders.
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Affiliation(s)
- Emily G. Severance
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 1105, Baltimore, MD 21287-4933 U.S.A
| | - Robert H. Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 1105, Baltimore, MD 21287-4933 U.S.A
| | - William W. Eaton
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, U.S.A
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Social Stress and Psychosis Risk: Common Neurochemical Substrates? Neuropsychopharmacology 2016; 41:666-74. [PMID: 26346639 PMCID: PMC4707841 DOI: 10.1038/npp.2015.274] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 08/25/2015] [Accepted: 08/26/2015] [Indexed: 12/19/2022]
Abstract
Environmental risk factors have been implicated in the etiology of psychotic disorders, with growing evidence showing the adverse effects of migration, social marginalization, urbanicity, childhood trauma, social defeat, and other adverse experiences on mental health in vulnerable populations. Collectively, social stress may be one mechanism that could link these environmental risk factors. The exact mechanism(s) by which social stress can affect brain function, and in particular the molecular targets involved in psychosis (such as the dopaminergic (DA) system), is (are) not fully understood. In this review, we will discuss the interplay between social environmental risk factors and molecular changes in the human brain; in particular, we will highlight the impact of social stress on three specific neurochemical systems: DA, neuroinflammation/immune, and endocannabinoid (eCB) signaling. We have chosen the latter two molecular pathways based on emerging evidence linking schizophrenia to altered neuroinflammatory processes and cannabis use. We further identify key developmental periods in which social stress interacts with these pathways, suggesting window(s) of opportunities for novel interventions. Taken together, we suggest that they may have a key role in the pathogenesis and disease progression, possibly provide novel treatment options for schizophrenia, and perhaps even prevent it.
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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: 20] [Impact Index Per Article: 2.2] [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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Laurens KR, Luo L, Matheson SL, Carr VJ, Raudino A, Harris F, Green MJ. Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry 2015; 15:205. [PMID: 26302744 PMCID: PMC4548447 DOI: 10.1186/s12888-015-0562-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/14/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Identifying the unique and shared premorbid indicators of risk for the schizophrenia spectrum disorders (SSD) and affective psychoses (AP) may refine aetiological hypotheses and inform the delivery of universal versus targeted preventive interventions. This systematic review synthesises the available evidence concerning developmental risk factors and antecedents of SSD and AP to identify those with the most robust support, and to highlight remaining evidence gaps. METHODS A systematic search of prospective birth, population, high-risk, and case-control cohorts was conducted in Medline and supplemented by hand searching, incorporating published studies in English with full text available. Inclusion/exclusion decisions and data extraction were completed in duplicate. Exposures included three categories of risk factors and four categories of antecedents, with case and comparison groups defined by adult psychiatric diagnosis. Effect sizes and prevalence rates were extracted, where available, and the strength of evidence synthesised and evaluated qualitatively across the study designs. RESULTS Of 1775 studies identified by the search, 127 provided data to the review. Individuals who develop SSD experience a diversity of subtle premorbid developmental deficits and risk exposures, spanning the prenatal period through early adolescence. Those of greatest magnitude (or observed most consistently) included obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions. Relatively less evidence has accumulated to implicate this diversity of exposures in AP, and many yet remain unexamined, with the most consistent or strongest evidence to date being for obstetric complications, psychopathology, cognitive indicators and motor dysfunction. Among the few investigations affording direct comparison between SSD and AP, larger effect sizes and a greater number of significant associations are commonly reported for SSD relative to AP. CONCLUSIONS Shared risk factors for SSD and AP may include obstetric complications, childhood psychopathology, cognitive markers and motor dysfunction, but the capacity to distinguish common versus distinct risk factors/antecedents for SSD and AP is limited by the scant availability of prospective data for AP, and inconsistency in replication. Further studies considering both diagnoses concurrently are needed. Nonetheless, the prevalence of the risk factors/antecedents observed in cases and controls helps demarcate potential targets for preventative interventions for these disorders.
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Affiliation(s)
- Kristin R. Laurens
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Luming Luo
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Sandra L. Matheson
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia
| | - Vaughan J. Carr
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Alessandra Raudino
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Felicity Harris
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Melissa J. Green
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia ,Neuroscience Research Australia, Sydney, Australia
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Werbeloff N, Dohrenwend BP, Yoffe R, van Os J, Davidson M, Weiser M. The association between negative symptoms, psychotic experiences and later schizophrenia: a population-based longitudinal study. PLoS One 2015; 10:e0119852. [PMID: 25748557 PMCID: PMC4351950 DOI: 10.1371/journal.pone.0119852] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 01/16/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychotic experiences are common in the general population, and predict later psychotic illness. Much less is known about negative symptoms in the general population. METHOD This study utilized a sample of 4,914 Israel-born individuals aged 25-34 years who were screened for psychopathology in the 1980's. Though not designed to specifically assess negative symptoms, data were available on 9 self-report items representing avolition and social withdrawal, and on 5 interviewer-rated items assessing speech deficits, flat affect and poor hygiene. Psychotic experiences were assessed using the False Beliefs and Perceptions subscale of the Psychiatric Epidemiology Research Interview. Psychiatric hospitalization was ascertained 24 years later using a nation-wide psychiatric hospitalization registry. RESULTS After removing subjects with diagnosable psychotic disorders at baseline, 20.2% had at least one negative symptom. Negative symptoms were associated with increased risk of later schizophrenia only in the presence of strong (frequent) psychotic experiences (OR = 13.0, 9% CI: 2.1-79.4). CONCLUSIONS Negative symptoms are common in the general population, though the majority of people with negative symptoms do not manifest a clinically diagnosed psychiatric disorder. Negative symptoms and psychotic experiences critically depend on each other's co-occurrence in increasing risk for later schizophrenia.
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Affiliation(s)
- Nomi Werbeloff
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
| | - Bruce P. Dohrenwend
- Department of Psychiatry and Mailman School of Public Health, Columbia University, New York, New York, United States of America; New York State Psychiatric Institute, New York, New York, United States of America
| | - Rinat Yoffe
- Division of Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, London, United Kingdom
| | - Michael Davidson
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
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Abnormal immune system development and function in schizophrenia helps reconcile diverse findings and suggests new treatment and prevention strategies. Brain Res 2015; 1617:93-112. [PMID: 25736181 DOI: 10.1016/j.brainres.2015.02.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 12/20/2022]
Abstract
Extensive research implicates disturbed immune function and development in the etiology and pathology of schizophrenia. In addition to reviewing evidence for immunological factors in schizophrenia, this paper discusses how an emerging model of atypical immune function and development helps explain a wide variety of well-established - but puzzling - findings about schizophrenia. A number of theorists have presented hypotheses that early immune system programming, disrupted by pre- and perinatal adversity, often combines with abnormal brain development to produce schizophrenia. The present paper focuses on the hypothesis that disruption of early immune system development produces a latent immune vulnerability that manifests more fully after puberty, when changes in immune function and the thymus leave individuals more susceptible to infections and immune dysfunctions that contribute to schizophrenia. Complementing neurodevelopmental models, this hypothesis integrates findings on many contributing factors to schizophrenia, including prenatal adversity, genes, climate, migration, infections, and stress, among others. It helps explain, for example, why (a) schizophrenia onset is typically delayed until years after prenatal adversity, (b) individual risk factors alone often do not lead to schizophrenia, and (c) schizophrenia prevalence rates actually tend to be higher in economically advantaged countries. Here we discuss how the hypothesis explains 10 key findings, and suggests new, potentially highly cost-effective, strategies for treatment and prevention of schizophrenia. Moreover, while most human research linking immune factors to schizophrenia has been correlational, these strategies provide ethical ways to experimentally test in humans theories about immune function and schizophrenia. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.
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Kira IA, Lewandowski L, Ashby JS, Omidy AZ. Development and Piloting the MMMM Ecological Interactive Open Systems Model: A Prospective One-Year Treatment Outcome of Children of Tortured Refugees. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/psych.2015.610125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Ethnic minority groups across the world face a complex set of adverse social and psychological challenges linked to their minority status, often involving racial discrimination. Racial discrimination is increasingly recognized as an important contributing factor to health disparities among non-dominant ethnic minorities. A growing body of literature has recognized these health disparities and has investigated the relationship between racial discrimination and poor health outcomes. Chronically elevated cortisol levels and a dysregulated hypothalamic-pituitary-adrenal (HPA) axis appear to mediate effects of racial discrimination on allostatic load and disease. Racial discrimination seems to converge on the anterior cingulate cortex (ACC) and may impair the function of the prefrontal cortex (PFC), hence showing substantial similarities to chronic social stress. This review provides a summary of recent literature on hormonal and neural effects of racial discrimination and a synthesis of potential neurobiological pathways by which discrimination affects mental health.
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Differences in Psychopathology Between Immigrant and Native Adolescents Admitted to a Psychiatric Inpatient Unit. J Immigr Minor Health 2014; 17:1715-22. [DOI: 10.1007/s10903-014-0143-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Padhy SK, Sarkar S, Davuluri T, Patra BN. Urban living and psychosis--an overview. Asian J Psychiatr 2014; 12:17-22. [PMID: 25446903 DOI: 10.1016/j.ajp.2014.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/12/2014] [Accepted: 09/19/2014] [Indexed: 01/08/2023]
Abstract
Since more than half a century, the association of urbanicity with psychosis has been explored. The research interest initially stemmed from the finding of a higher proportion of cases of psychotic disorder coming for treatment from the inner parts of cities. Subsequently, interest in the relationship of urbanicity and schizophrenia expanded and various facets of this association were explored. This narrative review provides an overview of the relationship between urbanicity and psychosis, and evaluates the link from the standpoint of causality. The review further delves into the possible risk factors and mechanisms explaining this association; both biological ones like genetic vulnerability and infections, as well as environmental ones like pollution. Since the literature has primarily emerged from the developed western countries, the review draws attention to the caveats while extrapolating the results to a developing country scenario.
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Affiliation(s)
- Susanta K Padhy
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
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Jensen NK, Johansen KS, Kastrup M, Krasnik A, Norredam M. Patient experienced continuity of care in the psychiatric healthcare system-a study including immigrants, refugees and ethnic danes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9739-59. [PMID: 25233017 PMCID: PMC4199047 DOI: 10.3390/ijerph110909739] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/29/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups.
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Affiliation(s)
- Natasja Koitzsch Jensen
- The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen 1014, Denmark.
| | - Katrine Schepelern Johansen
- KORA, The Danish Institute for Local and Regional Government Research, Købmagergade 22, Copenhagen 1150, Denmark.
| | - Marianne Kastrup
- Competence Center for Transcultural Psychiatry, Psychiatric Center Ballerup, Niels Andersens Vej 65, Hellerup 2900, Denmark.
| | - Allan Krasnik
- The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen 1014, Denmark.
| | - Marie Norredam
- The Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, Copenhagen 1014, Denmark.
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45
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Lasalvia A, Bonetto C, Tosato S, Zanatta G, Cristofalo D, Salazzari D, Lazzarotto L, Bertani M, Bissoli S, De Santi K, Cremonese C, De Rossi M, Gardellin F, Ramon L, Zucchetto M, Amaddeo F, Tansella M, Ruggeri M. First-contact incidence of psychosis in north-eastern Italy: influence of age, gender, immigration and socioeconomic deprivation. Br J Psychiatry 2014; 205:127-34. [PMID: 24723631 DOI: 10.1192/bjp.bp.113.134445] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Considerable variations in the incidence of psychosis have been observed across countries, in terms of age, gender, immigration status, urbanicity and socioeconomic deprivation. AIMS To evaluate the incidence rate of first-episode psychosis in a large area of north-eastern Italy and the distribution of the above-mentioned risk factors in individuals with psychoses. METHOD Epidemiologically based survey. Over a 3-year period individuals with psychosis on first contact with services were identified and diagnosed according to ICD-10 criteria. RESULTS In total, 558 individuals with first-episode psychosis were identified during 3,077,555 person-years at risk. The annual incidence rate per 100,000 was 18.1 for all psychoses, 14.3 for non-affective psychoses and 3.8 for affective psychoses. The rate for all psychoses was higher in young people aged 20-29 (incidence rate ratio (IRR) = 4.18, 95% CI 2.77-6.30), immigrants (IRR = 2.26, 95% CI 1.85-2.75) and those living in the most deprived areas (IRR = 2.09, 95% CI 1.54-2.85). CONCLUSIONS The incidence rate in our study area was lower than that found in other European and North American studies and provides new insights into the factors that may increase and/or decrease risk for developing psychosis.
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Affiliation(s)
- Antonio Lasalvia
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Sarah Tosato
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gioia Zanatta
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Doriana Cristofalo
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Damiano Salazzari
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Lorenza Lazzarotto
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Mariaelena Bertani
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Sarah Bissoli
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Katia De Santi
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Carla Cremonese
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Moreno De Rossi
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Francesco Gardellin
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Luana Ramon
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Maria Zucchetto
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele Tansella
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - Mirella Ruggeri
- Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
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Mölsä M, Punamäki RL, Saarni SI, Tiilikainen M, Kuittinen S, Honkasalo ML. Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland. Transcult Psychiatry 2014; 51:499-525. [PMID: 24648488 DOI: 10.1177/1363461514526630] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50-80 years of age were selected from the Somali older adult population living in the Helsinki area (N = 307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations.
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Zahreddine N, Hady RT, Chammai R, Kazour F, Hachem D, Richa S. Psychiatric morbidity, phenomenology and management in hospitalized female foreign domestic workers in Lebanon. Community Ment Health J 2014; 50:619-28. [PMID: 24370752 DOI: 10.1007/s10597-013-9682-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 12/03/2013] [Indexed: 11/26/2022]
Abstract
40 million female domestic workers worldwide experience the inhumane conditions associated with this unregulated occupation, a situation that induces psychiatric morbidities in many. The case in Lebanon is not any better where it is estimated that one foreign domestic worker (FDW) commits suicide weekly. 33 female FDW and 14 female Lebanese (control group, CG) were enrolled. Brief Psychotic Rating Scale (BPRS) and Clinical Global Impression (CGI) scales were administered on admission and discharge and socio-demographic, living conditions, mental health care data and phenomenological observations were collected. Sexual, physical, and verbal abuses were detected in FDW (12.5, 37.5, and 50.0 %. respectively). 66.7 % of them were diagnosed with brief psychotic episode. The mean duration of hospital stay (13.1 days) was significantly lower in the FDW group. The mean cumulative antipsychotic dose of the FDW was 337.1 mg of chlorpromazine equivalent and the mean BPRS total pre-score of FDW was 66.4 with a much improved state on the CGI global improvement scale, all of which were nonsignificantly different from the CG. Striking phenomenological findings among FDW were acute anorexia (39.4 %), nudity (30.3 %), catatonic features (21.2 %), and delusion of pregnancy (12.1 %). Inpatient FDW are more diagnosed with psychotic than affective disorders and receive approximately similar treatment as controls in spite of the trend to rapidly discharge and deport the worker to limit the costs. Both groups presented with similar severity, although the FDW had peculiar phenomenological observations.
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Affiliation(s)
- Nada Zahreddine
- Department of Psychiatry, Saint-Joseph University, Beirut, Lebanon,
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Saradalekshmi KR, Neetha NV, Sathyan S, Nair IV, Nair CM, Banerjee M. DNA methyl transferase (DNMT) gene polymorphisms could be a primary event in epigenetic susceptibility to schizophrenia. PLoS One 2014; 9:e98182. [PMID: 24859147 PMCID: PMC4032286 DOI: 10.1371/journal.pone.0098182] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 04/28/2014] [Indexed: 11/22/2022] Open
Abstract
DNA methylation has been implicated in the etiopathology of various complex disorders. DNA methyltransferases are involved in maintaining and establishing new methylation patterns. The aim of the present study was to investigate the inherent genetic variations within DNA methyltransferase genes in predisposing to susceptibility to schizophrenia. We screened for polymorphisms in DNA methyltransferases, DNMT1, DNMT3A, DNMT3B and DNMT3L in 330 schizophrenia patients and 302 healthy controls for association with Schizophrenia in south Indian population. These polymorphisms were also tested for subgroup analysis with patient's gender, age of onset and family history. DNMT1 rs2114724 (genotype P = .004, allele P = 0.022) and rs2228611 (genotype P = 0.004, allele P = 0.022) were found to be significantly associated at genotypic and allelic level with Schizophrenia in South Indian population. DNMT3B rs2424932 genotype (P = 0.023) and allele (P = 0.0063) increased the risk of developing schizophrenia in males but not in females. DNMT3B rs1569686 (genotype P = 0.027, allele P = 0.033) was found to be associated with early onset of schizophrenia and also with family history and early onset (genotype P = 0.009). DNMT3L rs2070565 (genotype P = 0.007, allele P = 0.0026) confers an increased risk of developing schizophrenia at an early age in individuals with family history. In-silico prediction indicated functional relevance of these SNPs in regulating the gene. These observations might be crucial in addressing and understanding the genetic control of methylation level differences from ethnic viewpoint. Functional significance of genotype variations within the DNMTs indeed suggest that the genetic nature of methyltransferases should be considered while addressing epigenetic events mediated by methylation in Schizophrenia.
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Affiliation(s)
| | - Nanoth Vellichiramal Neetha
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - Sanish Sathyan
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - Indu V. Nair
- Mental Health Centre, Thiruvananthapuram, Kerala, India
| | | | - Moinak Banerjee
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
- * E-mail:
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Mundt A, Kliewe T, Yayla S, Ignatyev Y, Busch MA, Heimann H, Heinz A, Rapp MA, Schouler-Ocak M, Ströhle A, Aichberger MC. Social characteristics of psychological distress in disadvantaged areas of Berlin. Int J Soc Psychiatry 2014; 60:75-82. [PMID: 23117825 DOI: 10.1177/0020764012464017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Living in disadvantaged urban areas is associated with poor mental health. The purpose of this study was to assess which social characteristics were associated with psychological distress within a disadvantaged, multi-ethnic neighbourhood of Berlin. METHODS The study was conducted in an area of Berlin with the highest rates of unemployment and highest density of migrants. A total of 143 participants aged 18-57 years were included from a random sample. The social characteristics educational level, employment status, marital status, living alone, per-capita income and background of migration were collected. Psychological distress was assessed using the General Health Questionnaire GHQ-28; scores ≥ 5 indicated psychological distress corresponding to psychiatric caseness. RESULTS Psychological distress was found in 40.6% (n = 58) of the sample. Psychological distress was associated with younger age (OR = 0.95, 95% CI = 0.92-0.98, p = .004), female gender (OR = 3.51, 95% CI = 1.55-7.92, p = .003) and living alone (OR = 3.88, 95% CI = 1.58-9.52, p = .003), but not with background of migration, low educational level or with unemployment. CONCLUSIONS Young age and female gender may predispose for psychological distress in disadvantaged areas. Living alone could be a social indicator of poor mental health within disadvantaged urban areas. The directionality of the association is unclear. BACKGROUND of migration, low income and educational level do not seem to be associated with poor mental health within those areas.
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Affiliation(s)
- Adrian Mundt
- 1Unit for Social & Community Psychiatry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, UK
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DeVylder JE, Oh HY, Yang LH, Cabassa LJ, Chen FP, Lukens EP. Acculturative stress and psychotic-like experiences among Asian and Latino immigrants to the United States. Schizophr Res 2013; 150:223-8. [PMID: 23932446 PMCID: PMC3896050 DOI: 10.1016/j.schres.2013.07.040] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 11/24/2022]
Abstract
Previous studies have shown variation in the prevalence and incidence of psychosis across immigrant groups, but the underlying mechanisms are not fully understood. Stress related to acculturation may increase risk for psychosis among immigrant groups. In this study we examine the association between acculturative stress and psychotic-like experiences in a sample of Latino- and Asian-American immigrants to the United States in the National Latino and Asian American Study (n=2434). Acculturative stress was associated with visual and auditory hallucinations among Asians, but only with hearing voices among Latinos. Increased risk for psychotic-like experiences among Latinos was primarily associated with younger age of immigration. Acculturative stress appears to be a promising candidate mechanism explaining the relationship between immigration and psychosis, particularly among Asian Americans. Ethnic differences may reflect variability between groups that integrate more readily into the host culture and those that are subject to greater discrimination and environmental adversity.
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Affiliation(s)
- Jordan E. DeVylder
- Columbia University School of Social Work, United States,New York State Psychiatric Institute, Columbia University, United States,Corresponding author at: Columbia University School of Social Work, 1255 Amsterdam Avenue, 9th floor, New York, NY 10027, United States. Tel.: +1 917 628 6569; fax: +1 212 851 2389. (J.E. DeVylder)
| | - Hans Y. Oh
- Columbia University School of Social Work, United States
| | - Lawrence H. Yang
- New York State Psychiatric Institute, Columbia University, United States,Mailman School of Public Health, Columbia University, United States
| | - Leopoldo J. Cabassa
- Columbia University School of Social Work, United States,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, United States
| | - Fang-pei Chen
- Columbia University School of Social Work, United States
| | - Ellen P. Lukens
- Columbia University School of Social Work, United States,New York State Psychiatric Institute, Columbia University, United States
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