Pub Date : 2024-12-11DOI: 10.1017/S2045796024000799
H M Crowe, L Sampson, A C Purdue-Smithe, K M Rexrode, K C Koenen, J W Rich-Edwards
Aims: Migraine and post-traumatic stress disorder (PTSD) are both twice as common in women as men. Cross-sectional studies have shown associations between migraine and several psychiatric conditions, including PTSD. PTSD is disproportionally common among patients in headache clinics, and individuals with migraine and PTSD report greater disability from migraines and more frequent medication use. To further clarify the nature of the relationship between PTSD and migraine, we conducted bidirectional analyses of the association between (1) migraine and incident PTSD and (2) PTSD and incident migraine.
Methods: We used longitudinal data from 1989-2020 among the 33,327 Nurses' Health Study II respondents to the 2018 stress questionnaire. We used log-binomial models to estimate the relative risk of developing PTSD among women with migraine and the relative risk of developing migraine among individuals with PTSD, trauma-exposed individuals without PTSD, and individuals unexposed to trauma, adjusting for race, education, marital status, high blood pressure, high cholesterol, alcohol intake, smoking, and body mass index.
Results: Overall, 48% of respondents reported ever experiencing migraine, 82% reported experiencing trauma and 9% met the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for PTSD. Of those reporting migraine and trauma, 67% reported trauma before migraine onset, 2% reported trauma and migraine onset in the same year and 31% reported trauma after migraine onset. We found that migraine was associated with incident PTSD (adjusted relative risk [RR]: 1.26, 95% confidence interval [CI]: 1.14-1.39). PTSD, but not trauma without PTSD, was associated with incident migraine (adjusted RR: 1.20, 95% CI: 1.14-1.27). Findings were consistently stronger in both directions among those experiencing migraine with aura.
Conclusions: Our study provides further evidence that migraine and PTSD are strongly comorbid and found associations of similar magnitude between migraine and incident PTSD and PTSD and incident migraine.
{"title":"Bidirectional analysis of the association between migraine and post-traumatic stress disorder in Nurses' Health Study II.","authors":"H M Crowe, L Sampson, A C Purdue-Smithe, K M Rexrode, K C Koenen, J W Rich-Edwards","doi":"10.1017/S2045796024000799","DOIUrl":"10.1017/S2045796024000799","url":null,"abstract":"<p><strong>Aims: </strong>Migraine and post-traumatic stress disorder (PTSD) are both twice as common in women as men. Cross-sectional studies have shown associations between migraine and several psychiatric conditions, including PTSD. PTSD is disproportionally common among patients in headache clinics, and individuals with migraine and PTSD report greater disability from migraines and more frequent medication use. To further clarify the nature of the relationship between PTSD and migraine, we conducted bidirectional analyses of the association between (1) migraine and incident PTSD and (2) PTSD and incident migraine.</p><p><strong>Methods: </strong>We used longitudinal data from 1989-2020 among the 33,327 Nurses' Health Study II respondents to the 2018 stress questionnaire. We used log-binomial models to estimate the relative risk of developing PTSD among women with migraine and the relative risk of developing migraine among individuals with PTSD, trauma-exposed individuals without PTSD, and individuals unexposed to trauma, adjusting for race, education, marital status, high blood pressure, high cholesterol, alcohol intake, smoking, and body mass index.</p><p><strong>Results: </strong>Overall, 48% of respondents reported ever experiencing migraine, 82% reported experiencing trauma and 9% met the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for PTSD. Of those reporting migraine and trauma, 67% reported trauma before migraine onset, 2% reported trauma and migraine onset in the same year and 31% reported trauma after migraine onset. We found that migraine was associated with incident PTSD (adjusted relative risk [RR]: 1.26, 95% confidence interval [CI]: 1.14-1.39). PTSD, but not trauma without PTSD, was associated with incident migraine (adjusted RR: 1.20, 95% CI: 1.14-1.27). Findings were consistently stronger in both directions among those experiencing migraine with aura.</p><p><strong>Conclusions: </strong>Our study provides further evidence that migraine and PTSD are strongly comorbid and found associations of similar magnitude between migraine and incident PTSD and PTSD and incident migraine.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e76"},"PeriodicalIF":5.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1017/S2045796024000830
K E Miller, A Rasmussen
Aims: Fifteen years ago, we published an article in Social Science and Medicine seeking to resolve the contentious debate between advocates of two very different frameworks for understanding and addressing the mental health needs of conflict-affected populations. The two approaches, which we labelled trauma-focused and psychosocial, reflect deeply held beliefs about the causes and nature of distress in war-affected communities. Drawing on the burgeoning literature on armed conflict and mental health, the reports of mental health and psychosocial support (MHPSS) staff in the field, and on research on the psychology and psychophysiology of stress, we proposed an integrative model that drew on the strengths of both frameworks and underscored their essential complementarity. Our model includes two primary pathways by which armed conflict impacts mental health: directly, through exposure to war-related violence and loss, and indirectly, through the harsh conditions of everyday life caused or exacerbated by armed conflict. The mediated model we proposed draws attention to the effects of stressors both past (prior exposure to war-related violence and loss) and present (ongoing conflict, daily stressors), at all levels of the social ecology; for that reason, we have termed it an ecological model for understanding the mental health needs of conflict-affected populations.
Methods: In the ensuing 15 years, the model has been rigorously tested in diverse populations and has found robust support. In this paper, we first summarize the development and key tenets of the model and briefly review recent empirical support for it. We then discuss the implications of an ecological framework for interventions aimed at strengthening mental health in conflict-affected populations.
Results: We present preliminary evidence suggesting there has been a gradual shift towards more ecological (i.e., multilevel, multimodal) programming in MHPSS interventions, along the lines suggested by our model as well as other conceptually related frameworks, particularly public health.
Conclusions: We reflect on several gaps in the model, most notably the absence of adverse childhood experiences. We suggest the importance of examining early adversity as both a direct influence on mental health and as a potential moderator of the impact of potentially traumatic war-related experiences of violence and loss.
{"title":"War exposure, daily stressors, and mental health 15 years on: implications of an ecological framework for addressing the mental health of conflict-affected populations.","authors":"K E Miller, A Rasmussen","doi":"10.1017/S2045796024000830","DOIUrl":"10.1017/S2045796024000830","url":null,"abstract":"<p><strong>Aims: </strong>Fifteen years ago, we published an article in <i>Social Science and Medicine</i> seeking to resolve the contentious debate between advocates of two very different frameworks for understanding and addressing the mental health needs of conflict-affected populations. The two approaches, which we labelled <i>trauma-focused</i> and <i>psychosocial</i>, reflect deeply held beliefs about the causes and nature of distress in war-affected communities. Drawing on the burgeoning literature on armed conflict and mental health, the reports of mental health and psychosocial support (MHPSS) staff in the field, and on research on the psychology and psychophysiology of stress, we proposed an integrative model that drew on the strengths of both frameworks and underscored their essential complementarity. Our model includes two primary pathways by which armed conflict impacts mental health: directly, through exposure to war-related violence and loss, and indirectly, through the harsh conditions of everyday life caused or exacerbated by armed conflict. The mediated model we proposed draws attention to the effects of stressors both past (prior exposure to war-related violence and loss) and present (ongoing conflict, daily stressors), at all levels of the social ecology; for that reason, we have termed it an ecological model for understanding the mental health needs of conflict-affected populations.</p><p><strong>Methods: </strong>In the ensuing 15 years, the model has been rigorously tested in diverse populations and has found robust support. In this paper, we first summarize the development and key tenets of the model and briefly review recent empirical support for it. We then discuss the implications of an ecological framework for interventions aimed at strengthening mental health in conflict-affected populations.</p><p><strong>Results: </strong>We present preliminary evidence suggesting there has been a gradual shift towards more ecological (i.e., multilevel, multimodal) programming in MHPSS interventions, along the lines suggested by our model as well as other conceptually related frameworks, particularly public health.</p><p><strong>Conclusions: </strong>We reflect on several gaps in the model, most notably the absence of adverse childhood experiences. We suggest the importance of examining early adversity as both a direct influence on mental health and as a potential moderator of the impact of potentially traumatic war-related experiences of violence and loss.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e78"},"PeriodicalIF":5.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1017/S2045796024000775
Zheng Tian, Nan Zhang, Yimiao Li, Yibo Wu, Lan Wang
<p><strong>Aims: </strong>Investigate the prevalence of adverse childhood experience (ACE) and intimate partner violence (IPV) using a large representative Chinese sample, explore the association mechanism between ACE and adult exposure to IPV and to examine gender differences.</p><p><strong>Methods: </strong>A total of 21,154 participants were included in this study. The ACE scale was used to assess participants' exposure to ACE before the age of 18. Participants were evaluated for IPV experienced after the age of 18 using the IPV Scale. Logistic regression model was used to analyse the association between ACE and the risk of IPV exposure in adulthood. Principal component analysis was used to extract the main patterns of ACEs in the Chinese population. Network analyses were employed to identify the most critical types of ACE and IPV, analyse the association mechanisms between ACEs and IPVs, explore gender differences in this association and compare gender differences in the severity of IPVs experienced in adulthood.</p><p><strong>Results: </strong>Participants with at least one ACE event faced a 215.5% higher risk of IPV compared to those without ACE experiences. In population-wide and gender-specific networks, The ACE and IPV nodes with the highest expected influence are 'ACE1 (Verbal abuse + physical abuse pattern)' and 'IPV5 (Partner compares me to other people and blatantly accuses me, making me feel embarrassed and unsure of myself)'. Positive correlations were found between 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' and 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', which were the three edges with the highest edge weight values in the ACE pattern and IPV edges. 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' in the male network and 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)', 'ACE3 (Substance abuse + mental illness + violent treatment of mother or stepmother pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me wit
{"title":"Adverse childhood experiences and subsequent experiences of intimate partner violence in adulthood: a gender perspective.","authors":"Zheng Tian, Nan Zhang, Yimiao Li, Yibo Wu, Lan Wang","doi":"10.1017/S2045796024000775","DOIUrl":"10.1017/S2045796024000775","url":null,"abstract":"<p><strong>Aims: </strong>Investigate the prevalence of adverse childhood experience (ACE) and intimate partner violence (IPV) using a large representative Chinese sample, explore the association mechanism between ACE and adult exposure to IPV and to examine gender differences.</p><p><strong>Methods: </strong>A total of 21,154 participants were included in this study. The ACE scale was used to assess participants' exposure to ACE before the age of 18. Participants were evaluated for IPV experienced after the age of 18 using the IPV Scale. Logistic regression model was used to analyse the association between ACE and the risk of IPV exposure in adulthood. Principal component analysis was used to extract the main patterns of ACEs in the Chinese population. Network analyses were employed to identify the most critical types of ACE and IPV, analyse the association mechanisms between ACEs and IPVs, explore gender differences in this association and compare gender differences in the severity of IPVs experienced in adulthood.</p><p><strong>Results: </strong>Participants with at least one ACE event faced a 215.5% higher risk of IPV compared to those without ACE experiences. In population-wide and gender-specific networks, The ACE and IPV nodes with the highest expected influence are 'ACE1 (Verbal abuse + physical abuse pattern)' and 'IPV5 (Partner compares me to other people and blatantly accuses me, making me feel embarrassed and unsure of myself)'. Positive correlations were found between 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' and 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', which were the three edges with the highest edge weight values in the ACE pattern and IPV edges. 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' in the male network and 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)', 'ACE3 (Substance abuse + mental illness + violent treatment of mother or stepmother pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me wit","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e75"},"PeriodicalIF":5.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-03DOI: 10.1017/S2045796024000763
Yanhan Shen, Kate Penrose, McKaylee Robertson, Rachael Piltch-Loeb, Sasha Fleary, Sarah Kulkarni, Chloe Teasdale, Subha Balasubramanian, Surabhi Yadav, Bai Xi Jasmine Chan, Jenna Sanborn, Josefina Nuñez Sahr, Avantika Srivastava, Denis Nash, Angela Parcesepe
Aims: The enduring impact of the COVID-19 pandemic on mental health and its implications for COVID-19 vaccine uptake necessitate comprehensive investigation. We aimed to characterize the persistence of moderate to severe anxiety and depression symptoms from July 2020 to July 2023, explore demographic associations with symptom persistence, and assess how these symptoms affected COVID-19 vaccination uptake between May 2021 and July 2023.
Methods: Participants from the national community-based CHASING COVID Cohort were enrolled between March and June 2020 and completed quarterly follow-ups until December 2023. Scores ≥10 on the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaire 8-item at 14 follow-up assessments indicated moderate to severe anxiety and depression symptoms, respectively. Missing scores were imputed. Persistent anxiety and depression were defined as experiencing moderate to severe anxiety and depression symptoms ≥7 out of 14 follow-up assessments, respectively.
Results: Among 4,851 participants, 15.9% experienced persistent anxiety symptoms and 19.3% persistent depression symptoms from July 2020 to July 2023. Demographic factors associated with symptom persistence included younger age, female or non-binary gender, Hispanic ethnicity, lower education level, household income <$100k, presence of children <18 in the household, greater healthcare barriers and comorbidities. Participants with ongoing moderate to severe anxiety and depression symptoms had 0.95 (95% CI: 0.94, 0.97) and 0.95 (95% CI: 0.93, 0.96) times rates of receiving additional COVID-19 vaccine doses between May 2021 and July 2023, respectively.
Conclusions: Customized support for individuals with mental disorders may mitigate barriers to vaccine uptake. Further investigation is warranted to validate these findings and inform targeted interventions.
{"title":"Persistence of anxiety and depression symptoms and their impact on the COVID-19 vaccine uptake.","authors":"Yanhan Shen, Kate Penrose, McKaylee Robertson, Rachael Piltch-Loeb, Sasha Fleary, Sarah Kulkarni, Chloe Teasdale, Subha Balasubramanian, Surabhi Yadav, Bai Xi Jasmine Chan, Jenna Sanborn, Josefina Nuñez Sahr, Avantika Srivastava, Denis Nash, Angela Parcesepe","doi":"10.1017/S2045796024000763","DOIUrl":"10.1017/S2045796024000763","url":null,"abstract":"<p><strong>Aims: </strong>The enduring impact of the COVID-19 pandemic on mental health and its implications for COVID-19 vaccine uptake necessitate comprehensive investigation. We aimed to characterize the persistence of moderate to severe anxiety and depression symptoms from July 2020 to July 2023, explore demographic associations with symptom persistence, and assess how these symptoms affected COVID-19 vaccination uptake between May 2021 and July 2023.</p><p><strong>Methods: </strong>Participants from the national community-based CHASING COVID Cohort were enrolled between March and June 2020 and completed quarterly follow-ups until December 2023. Scores ≥10 on the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaire 8-item at 14 follow-up assessments indicated moderate to severe anxiety and depression symptoms, respectively. Missing scores were imputed. Persistent anxiety and depression were defined as experiencing moderate to severe anxiety and depression symptoms ≥7 out of 14 follow-up assessments, respectively.</p><p><strong>Results: </strong>Among 4,851 participants, 15.9% experienced persistent anxiety symptoms and 19.3% persistent depression symptoms from July 2020 to July 2023. Demographic factors associated with symptom persistence included younger age, female or non-binary gender, Hispanic ethnicity, lower education level, household income <$100k, presence of children <18 in the household, greater healthcare barriers and comorbidities. Participants with ongoing moderate to severe anxiety and depression symptoms had 0.95 (95% CI: 0.94, 0.97) and 0.95 (95% CI: 0.93, 0.96) times rates of receiving additional COVID-19 vaccine doses between May 2021 and July 2023, respectively.</p><p><strong>Conclusions: </strong>Customized support for individuals with mental disorders may mitigate barriers to vaccine uptake. Further investigation is warranted to validate these findings and inform targeted interventions.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e74"},"PeriodicalIF":5.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-29DOI: 10.1017/S2045796024000738
S Dawadi, F Shawyer, E Callander, S Patten, B Johnson, S Rosenberg, V Lakra, E Lin, H Teede, G Meadows, J Enticott
Aims: Achieving equitable healthcare access is a global challenge. Improving whole-population mental health and reducing the global burden of mental disorders is a key recommendation of the 2018 Lancet Global Mental Health Commission, which proposed monitoring national indicators, including the proportion of people with severe mental disorders who are service-users. This study aims to derive an equity indicator from national datasets integrating need, service utilisation and socioeconomic status, and demonstrate its utility in identifying gaps in mental health service use amongst those with the greatest need, thereby guiding equitable healthcare delivery.
Methods: We present a case study of a universal health insurance scheme (Medicare) in Australia. We developed the equity indicator using three national datasets. Geographic areas were linked to an area-based socioeconomic deprivation quintile (Census 2016). Per geographic area, we estimated the number with a mental healthcare need using scores ≥30 on the Kessler-10 (Australian National Health Surveys 2015 and 2018), and obtained the number of services used, defined as mental health-related contacts with general practitioners and mental health professionals (Medicare administrative data 2015-2019). We divided the number of services by the population with an estimated mental healthcare need and averaged these use-rates across each socioeconomic deprivation quintile. The equity indicator is the ratio of the use-rates in the least versus most deprived quintiles.
Results: Those estimated to have the greatest need for mental healthcare in 2019 ranged between 8.2% in the most disadvantaged area quintile (Q1) and 2.4% in the least (Q5), corresponding to a proportional increase of 27.7% in Q1 and 19.5% in Q5 since 2015. Equity-indicator-adjusted service rates of 4.2 (3.8-4.6) and 23.9 (22.4-25.4) showed that individuals with the highest need for care residing in Q1 areas received a stark 6 times fewer services compared to their Q5 counterparts, producing an equity indicator of 6.
Conclusions: As the global prevalence of common mental disorders may be increasing, it is crucial to calculate robust indicators evaluating the equity of mental health service use. In this Australian case study, we developed an equity indicator enabling the direct comparison of geographic areas with different need profiles. The results revealed striking inequities that persisted despite publicly-funded universal healthcare, recent service reforms and being a high-income country. This study demonstrates the importance and feasibility of generating such an indicator to inform and empower communities, healthcare providers and policymakers to pursue equitable service provision.
{"title":"An equity indicator for assessing mental healthcare access: a national population case study.","authors":"S Dawadi, F Shawyer, E Callander, S Patten, B Johnson, S Rosenberg, V Lakra, E Lin, H Teede, G Meadows, J Enticott","doi":"10.1017/S2045796024000738","DOIUrl":"10.1017/S2045796024000738","url":null,"abstract":"<p><strong>Aims: </strong>Achieving equitable healthcare access is a global challenge. Improving whole-population mental health and reducing the global burden of mental disorders is a key recommendation of the 2018 Lancet Global Mental Health Commission, which proposed monitoring national indicators, including the proportion of people with severe mental disorders who are service-users. This study aims to derive an equity indicator from national datasets integrating need, service utilisation and socioeconomic status, and demonstrate its utility in identifying gaps in mental health service use amongst those with the greatest need, thereby guiding equitable healthcare delivery.</p><p><strong>Methods: </strong>We present a case study of a universal health insurance scheme (Medicare) in Australia. We developed the equity indicator using three national datasets. Geographic areas were linked to an area-based socioeconomic deprivation quintile (Census 2016). Per geographic area, we estimated the number with a mental healthcare need using scores ≥30 on the Kessler-10 (Australian National Health Surveys 2015 and 2018), and obtained the number of services used, defined as mental health-related contacts with general practitioners and mental health professionals (Medicare administrative data 2015-2019). We divided the number of services by the population with an estimated mental healthcare need and averaged these use-rates across each socioeconomic deprivation quintile. The equity indicator is the ratio of the use-rates in the least versus most deprived quintiles.</p><p><strong>Results: </strong>Those estimated to have the greatest need for mental healthcare in 2019 ranged between 8.2% in the most disadvantaged area quintile (Q1) and 2.4% in the least (Q5), corresponding to a proportional increase of 27.7% in Q1 and 19.5% in Q5 since 2015. Equity-indicator-adjusted service rates of 4.2 (3.8-4.6) and 23.9 (22.4-25.4) showed that individuals with the highest need for care residing in Q1 areas received a stark 6 times fewer services compared to their Q5 counterparts, producing an equity indicator of 6.</p><p><strong>Conclusions: </strong>As the global prevalence of common mental disorders may be increasing, it is crucial to calculate robust indicators evaluating the equity of mental health service use. In this Australian case study, we developed an equity indicator enabling the direct comparison of geographic areas with different need profiles. The results revealed striking inequities that persisted despite publicly-funded universal healthcare, recent service reforms and being a high-income country. This study demonstrates the importance and feasibility of generating such an indicator to inform and empower communities, healthcare providers and policymakers to pursue equitable service provision.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e70"},"PeriodicalIF":5.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-28DOI: 10.1017/S2045796024000507
C Sculco, B Bano, G Piumatti, R Amati, C Barbui, L Crivelli, M Purgato, E Albanese
Aims: It is widely recognized that the COVID-19 pandemic exerted an impact on the mental health of the general population, but epidemiological evidence is surprisingly sparse. We aimed to explore the association between serologically confirmed SARS-CoV-2 infection and psychological distress - assessed by symptoms of depression, anxiety and stress - in the general adult population in southern Switzerland, a region widely affected by the pandemic. We also investigated whether this association varied over time and between pandemic waves from late 2020 through 2021.
Methods: We used data from 305 adults who participated in the Corona Immunitas Ticino prospective seroprevalence study in southern Switzerland, including results of the serological tests of SARS-CoV-2 infection collected in June 2021, and explored associations with depression, anxiety and stress scores as measured by the 21-item Depression, Anxiety and Stress Scale at three time points between December 2020 and August 2021, accounting for socio-demographic and health characteristics.
Results: In our sample, 84.3% of the participants (mean age of 51.30 years, SD = ±.93) were seronegative at baseline. Seropositive (i.e., infected) participants had a decreasing probability of being depressed and anxious through the COVID-19 pandemic waves compared to the seronegative (non-infected) participants. Further, seropositivity at baseline was also associated with more rapid decline in depressive, anxiety and stress symptomatology, and younger age and the presence of chronic diseases were independently associated with mild anxiety (OR = .97; P = 0.013; 95% CI = 0.95, 0.99; OR = 3.47; P = 0.001; 95% CI = 1.71, 7.04) and stress (OR = .96; P = 0.003; 95% CI = .94, .99; OR = 2.56; P = 0.010; 95% CI = 1.25, 5.22).
Conclusions: Our results suggest that the MH consequences of the pandemic may not be due to the SARS-CoV-2 infection per se, but to fears associated with the risk of infection, and to the pandemic uncertainties.
目的:人们普遍认为 COVID-19 大流行对普通人群的心理健康产生了影响,但流行病学证据却少得令人吃惊。我们的目的是探讨瑞士南部(受大流行病广泛影响的地区)经血清学确诊的 SARS-CoV-2 感染与心理困扰(通过抑郁、焦虑和压力症状评估)之间的关联。我们还研究了这种关联是否会随着时间的推移而变化,以及从 2020 年末到 2021 年的不同疫情波次之间的关联:我们使用了参加瑞士南部 Corona Immunitas Ticino 前瞻性血清流行病学研究的 305 名成年人的数据,包括 2021 年 6 月收集的 SARS-CoV-2 感染血清学检测结果,并在 2020 年 12 月至 2021 年 8 月期间的三个时间点,在考虑社会人口学和健康特征的情况下,探讨了与 21 项抑郁、焦虑和压力量表测量的抑郁、焦虑和压力得分之间的关联:在我们的样本中,84.3% 的参与者(平均年龄 51.30 岁,SD = ±.93)在基线时血清阴性。与血清阴性(未感染)的参与者相比,血清阳性(即已感染)的参与者在 COVID-19 大流行期间抑郁和焦虑的概率有所下降。此外,基线血清阳性也与抑郁、焦虑和压力症状的下降速度更快有关,而年龄较小和患有慢性疾病则与轻度焦虑有独立的关联(OR = .97; P = 0.013; 95% CI = 0.95, 0.99; OR = 3.47; P = 0.001; 95% CI = 1.71, 7.04)和压力(OR = .96; P = 0.003; 95% CI = .94, .99; OR = 2.56; P = 0.010; 95% CI = 1.25, 5.22)独立相关:我们的研究结果表明,大流行造成的心理健康后果可能不是因为 SARS-CoV-2 感染本身,而是因为与感染风险相关的恐惧以及大流行的不确定性。
{"title":"(Fear of) SARS-CoV-2 infection and psychological distress: a population-based cohort study in southern Switzerland.","authors":"C Sculco, B Bano, G Piumatti, R Amati, C Barbui, L Crivelli, M Purgato, E Albanese","doi":"10.1017/S2045796024000507","DOIUrl":"10.1017/S2045796024000507","url":null,"abstract":"<p><strong>Aims: </strong>It is widely recognized that the COVID-19 pandemic exerted an impact on the mental health of the general population, but epidemiological evidence is surprisingly sparse. We aimed to explore the association between serologically confirmed SARS-CoV-2 infection and psychological distress - assessed by symptoms of depression, anxiety and stress - in the general adult population in southern Switzerland, a region widely affected by the pandemic. We also investigated whether this association varied over time and between pandemic waves from late 2020 through 2021.</p><p><strong>Methods: </strong>We used data from 305 adults who participated in the Corona Immunitas Ticino prospective seroprevalence study in southern Switzerland, including results of the serological tests of SARS-CoV-2 infection collected in June 2021, and explored associations with depression, anxiety and stress scores as measured by the 21-item Depression, Anxiety and Stress Scale at three time points between December 2020 and August 2021, accounting for socio-demographic and health characteristics.</p><p><strong>Results: </strong>In our sample, 84.3% of the participants (mean age of 51.30 years, SD = ±.93) were seronegative at baseline. Seropositive (i.e., infected) participants had a decreasing probability of being depressed and anxious through the COVID-19 pandemic waves compared to the seronegative (non-infected) participants. Further, seropositivity at baseline was also associated with more rapid decline in depressive, anxiety and stress symptomatology, and younger age and the presence of chronic diseases were independently associated with mild anxiety (OR = .97; <i>P</i> = 0.013; 95% CI = 0.95, 0.99; OR = 3.47; <i>P</i> = 0.001; 95% CI = 1.71, 7.04) and stress (OR = .96; <i>P</i> = 0.003; 95% CI = .94, .99; OR = 2.56; <i>P</i> = 0.010; 95% CI = 1.25, 5.22).</p><p><strong>Conclusions: </strong>Our results suggest that the MH consequences of the pandemic may not be due to the SARS-CoV-2 infection per se, but to fears associated with the risk of infection, and to the pandemic uncertainties.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e73"},"PeriodicalIF":5.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-28DOI: 10.1017/S2045796024000672
A Kip, S Valencia, E Glunz, S R Lowe, K-P Tam, N Morina
Aims: Although natural hazards (e.g., tropical cyclones, earthquakes) disproportionately affect developing countries, most research on their mental health impact has been conducted in high-income countries. We aimed to summarize prevalences of mental disorders in Global South populations (classified according to the United Nations Human Development Index) affected by natural hazards.
Methods: To identify eligible studies for this meta-analysis, we searched MEDLINE, PsycINFO and Web of Science up to February 13, 2024, for observational studies with a cross-sectional or longitudinal design that reported on at least 100 adult survivors of natural hazards in a Global South population and assessed mental disorders with a validated instrument at least 1 month after onset of the hazard. Main outcomes were the short- and long-term prevalence estimates of mental disorders. The project was registered on the International Prospective Register of Systematic Reviews (CRD42023396622).
Results: We included 77 reports of 75 cross-sectional studies (six included a non-exposed control group) comprising 82,400 individuals. We found high prevalence estimates for post-traumatic stress disorder (PTSD) in the general population (26.0% [95% CI 18.5-36.3]; I2 = 99.0%) and depression (21.7% [95% CI 10.5-39.6]; I2 = 99.2%) during the first year following the event, with similar prevalences observed thereafter (i.e., 26.0% and 23.4%, respectively). Results were similar for regions with vs. without recent armed conflict. In displaced samples, the estimated prevalence for PTSD was 46.5% (95% CI 39.0-54.2; k = 6; I2 = 93.3). We furthermore found higher symptom severity in exposed, versus unexposed, individuals. Data on other disorders were scarce, apart from short-term prevalence estimates of generalised anxiety disorder (15.9% [95% CI 4.7-42.0]; I2 = 99.4).
Conclusions: Global South populations exposed to natural hazards report a substantial burden of mental disease. These findings require further attention and action in terms of implementation of mental health policies and low-threshold interventions in the Global South in the aftermath of natural hazards. However, to accurately quantify the true extent of this public health challenge, we need more rigorous, well-designed epidemiological studies across diverse regions. This will enable informed decision making and resource allocation for those in need.
目的:尽管自然灾害(如热带气旋、地震)对发展中国家的影响尤为严重,但有关其对心理健康影响的研究大多在高收入国家进行。我们旨在总结受自然灾害影响的全球南部人口(根据联合国人类发展指数分类)的精神障碍患病率:为了确定符合荟萃分析条件的研究,我们检索了 MEDLINE、PsycINFO 和 Web of Science(截止到 2024 年 2 月 13 日),寻找横断面或纵向设计的观察性研究,这些研究报告了全球南部人口中至少 100 名自然灾害成年幸存者的情况,并在灾害发生后至少 1 个月使用有效工具对精神障碍进行了评估。主要结果是精神障碍的短期和长期患病率估计值。该项目已在系统综述国际前瞻性注册中心注册(CRD42023396622):结果:我们纳入了 75 项横断面研究的 77 份报告(其中 6 项研究包括非暴露对照组),涉及 8.24 万人。我们发现,在事件发生后的第一年,一般人群中创伤后应激障碍(PTSD)和抑郁症的患病率较高(分别为 26.0% [95% CI 18.5-36.3];I2 = 99.0%),分别为 21.7% [95% CI 10.5-39.6];I2 = 99.2%),此后观察到的患病率相似(分别为 26.0% 和 23.4%)。最近发生武装冲突的地区与未发生武装冲突的地区的结果相似。在流离失所的样本中,创伤后应激障碍的患病率估计为 46.5%(95% CI 39.0-54.2;k = 6;I2 = 93.3)。此外,我们还发现,与未接触创伤后应激障碍的人相比,接触过创伤后应激障碍的人症状严重程度更高。除了广泛性焦虑症的短期患病率估计值(15.9% [95% CI 4.7-42.0];I2 = 99.4)之外,有关其他疾病的数据很少:结论:暴露于自然灾害的全球南方人口报告了精神疾病的巨大负担。这些发现需要我们进一步关注并采取行动,在自然灾害发生后的全球南部地区实施心理健康政策和低门槛干预措施。然而,为了准确量化这一公共卫生挑战的真实程度,我们需要在不同地区开展更加严格、设计良好的流行病学研究。这将有助于做出明智的决策,并为有需要的人分配资源。
{"title":"Prevalence of mental disorders in adult populations from the Global South following exposure to natural hazards: a meta-analysis.","authors":"A Kip, S Valencia, E Glunz, S R Lowe, K-P Tam, N Morina","doi":"10.1017/S2045796024000672","DOIUrl":"10.1017/S2045796024000672","url":null,"abstract":"<p><strong>Aims: </strong>Although natural hazards (e.g., tropical cyclones, earthquakes) disproportionately affect developing countries, most research on their mental health impact has been conducted in high-income countries. We aimed to summarize prevalences of mental disorders in Global South populations (classified according to the United Nations Human Development Index) affected by natural hazards.</p><p><strong>Methods: </strong>To identify eligible studies for this meta-analysis, we searched MEDLINE, PsycINFO and Web of Science up to February 13, 2024, for observational studies with a cross-sectional or longitudinal design that reported on at least 100 adult survivors of natural hazards in a Global South population and assessed mental disorders with a validated instrument at least 1 month after onset of the hazard. Main outcomes were the short- and long-term prevalence estimates of mental disorders. The project was registered on the International Prospective Register of Systematic Reviews (CRD42023396622).</p><p><strong>Results: </strong>We included 77 reports of 75 cross-sectional studies (six included a non-exposed control group) comprising 82,400 individuals. We found high prevalence estimates for post-traumatic stress disorder (PTSD) in the general population (26.0% [95% CI 18.5-36.3]; <i>I</i><sup>2</sup> = 99.0%) and depression (21.7% [95% CI 10.5-39.6]; <i>I</i><sup>2</sup> = 99.2%) during the first year following the event, with similar prevalences observed thereafter (i.e., 26.0% and 23.4%, respectively). Results were similar for regions with vs. without recent armed conflict. In displaced samples, the estimated prevalence for PTSD was 46.5% (95% CI 39.0-54.2; <i>k</i> = 6; <i>I</i><sup>2</sup> = 93.3). We furthermore found higher symptom severity in exposed, versus unexposed, individuals. Data on other disorders were scarce, apart from short-term prevalence estimates of generalised anxiety disorder (15.9% [95% CI 4.7-42.0]; <i>I</i><sup>2</sup> = 99.4).</p><p><strong>Conclusions: </strong>Global South populations exposed to natural hazards report a substantial burden of mental disease. These findings require further attention and action in terms of implementation of mental health policies and low-threshold interventions in the Global South in the aftermath of natural hazards. However, to accurately quantify the true extent of this public health challenge, we need more rigorous, well-designed epidemiological studies across diverse regions. This will enable informed decision making and resource allocation for those in need.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e68"},"PeriodicalIF":5.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1017/S2045796024000714
Florian Reese
{"title":"Michaela Polacek. 'I had to eat myself up on the left, now I'm only on the right'.","authors":"Florian Reese","doi":"10.1017/S2045796024000714","DOIUrl":"10.1017/S2045796024000714","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e72"},"PeriodicalIF":5.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1017/S204579602400074X
Steve Kisely, Stuart Leske, James Ogilvie, Carleen Thompson, Dan Siskind, Troy Allard
Aims: Most information about the association between childhood maltreatment (CM) and subsequent psychiatric morbidity is based on retrospective self-reports. Findings from longitudinal studies using prospective reports to statutory agencies may be subject to attrition. We therefore compared the prevalence to age 30 of inpatient psychiatric diagnoses in those who experienced agency-reported CM with those of the rest of the cohort using administrative data to minimise loss to follow-up.
Methods: We used linked administrative data for two birth cohorts of all individuals born in Queensland, Australia in 1983 and 1984 (N = 83,050) and followed to age 30 years. This was the entire cohort aside from 312 people who died. Information on CM came from statewide child protection data and psychiatric diagnoses from all public and private hospital admissions in Queensland.
Results: On adjusted analyses, the 4,703 participants (5.7%) who had been notified to the statewide child protection authority had three to eight times the odds of being admitted for any of the following psychiatric diagnoses by age 30 years old: schizophrenia-spectrum disorders, bipolar affective disorders, depression, anxiety and post-traumatic stress disorders (PTSD). There were similar findings for all the CM subtypes. Associations were especially strong for PTSD with between a seven - and nine-fold increase in the odds of admission.
Conclusions: This is one of the largest studies of the long-term effects of CM, covering an entire jurisdiction. All types of maltreatment are significantly related to a range of psychiatric disorders requiring hospitalisation. Early identification, intervention and providing appropriate support to individuals who have experienced CM may help mitigate the long-term consequences and reduce the risk of subsequent mental health problems.
{"title":"A longitudinal birth cohort study of child maltreatment and mental disorders using linked statewide child protection and administrative health data for 83,050 Queensland residents from 1983 to 2014.","authors":"Steve Kisely, Stuart Leske, James Ogilvie, Carleen Thompson, Dan Siskind, Troy Allard","doi":"10.1017/S204579602400074X","DOIUrl":"10.1017/S204579602400074X","url":null,"abstract":"<p><strong>Aims: </strong>Most information about the association between childhood maltreatment (CM) and subsequent psychiatric morbidity is based on retrospective self-reports. Findings from longitudinal studies using prospective reports to statutory agencies may be subject to attrition. We therefore compared the prevalence to age 30 of inpatient psychiatric diagnoses in those who experienced agency-reported CM with those of the rest of the cohort using administrative data to minimise loss to follow-up.</p><p><strong>Methods: </strong>We used linked administrative data for two birth cohorts of all individuals born in Queensland, Australia in 1983 and 1984 (<i>N</i> = 83,050) and followed to age 30 years. This was the entire cohort aside from 312 people who died. Information on CM came from statewide child protection data and psychiatric diagnoses from all public and private hospital admissions in Queensland.</p><p><strong>Results: </strong>On adjusted analyses, the 4,703 participants (5.7%) who had been notified to the statewide child protection authority had three to eight times the odds of being admitted for any of the following psychiatric diagnoses by age 30 years old: schizophrenia-spectrum disorders, bipolar affective disorders, depression, anxiety and post-traumatic stress disorders (PTSD). There were similar findings for all the CM subtypes. Associations were especially strong for PTSD with between a seven - and nine-fold increase in the odds of admission.</p><p><strong>Conclusions: </strong>This is one of the largest studies of the long-term effects of CM, covering an entire jurisdiction. All types of maltreatment are significantly related to a range of psychiatric disorders requiring hospitalisation. Early identification, intervention and providing appropriate support to individuals who have experienced CM may help mitigate the long-term consequences and reduce the risk of subsequent mental health problems.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e69"},"PeriodicalIF":5.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Psychotic-like experiences (PLEs), especially for persistent PLEs, are highly predictive of subsequent mental health problems. Hence, it is crucial to explore the psychopathological associations underlying the occurrence and persistence of PLEs. This study aimed to explore the above issues through a longitudinal dynamic network approach among PLEs and psychological and psychosocial factors.
Methods: A total of 3,358 college students completed two waves of online survey (from Oct 2021 to Oct 2022). Socio-demographic information was collected at baseline, and PLEs, depressive and anxiety symptoms, and adverse life events were assessed in both waves. Cross-lagged panel network analyses were used to establish networks among individuals with baseline PLEs as well as those without.
Results: At baseline, 455(13.5%) students were screened positive for PLEs. Distinct dynamic network structures were revealed among participants with baseline PLEs and those without. While 'psychomotor disturbance' had the strongest connection with PLEs in participants with baseline PLEs, 'suicide/self-harm' was most associated with PLEs in those without. Among all three subtypes of PLEs, bizarre experiences and persecutory ideation were the most affected nodes by other constructs in participants with baseline PLEs and those without, respectively. Additionally, wide interconnections within the PLEs construct existed only among participants without baseline PLEs.
Conclusions: The study provides time-variant associations between PLEs and depressive symptoms, anxiety symptoms, and adverse life events using network structures. These findings help to reveal the crucial markers of the occurrence and persistence of PLEs, and shed high light on future intervention aimed to prevent and relieve PLEs.
{"title":"A longitudinal network of psychotic-like experiences, depressive and anxiety symptoms, and adverse life events: a cohort study of 3,358 college students.","authors":"Meng Sun, Heng Sun, Zijuan Ma, Shaoling Zhong, Xinhu Yang, Yue Li, Hongling Zhou, Liang Zhou","doi":"10.1017/S2045796024000726","DOIUrl":"10.1017/S2045796024000726","url":null,"abstract":"<p><strong>Aims: </strong>Psychotic-like experiences (PLEs), especially for persistent PLEs, are highly predictive of subsequent mental health problems. Hence, it is crucial to explore the psychopathological associations underlying the occurrence and persistence of PLEs. This study aimed to explore the above issues through a longitudinal dynamic network approach among PLEs and psychological and psychosocial factors.</p><p><strong>Methods: </strong>A total of 3,358 college students completed two waves of online survey (from Oct 2021 to Oct 2022). Socio-demographic information was collected at baseline, and PLEs, depressive and anxiety symptoms, and adverse life events were assessed in both waves. Cross-lagged panel network analyses were used to establish networks among individuals with baseline PLEs as well as those without.</p><p><strong>Results: </strong>At baseline, 455(13.5%) students were screened positive for PLEs. Distinct dynamic network structures were revealed among participants with baseline PLEs and those without. While 'psychomotor disturbance' had the strongest connection with PLEs in participants with baseline PLEs, 'suicide/self-harm' was most associated with PLEs in those without. Among all three subtypes of PLEs, bizarre experiences and persecutory ideation were the most affected nodes by other constructs in participants with baseline PLEs and those without, respectively. Additionally, wide interconnections within the PLEs construct existed only among participants without baseline PLEs.</p><p><strong>Conclusions: </strong>The study provides time-variant associations between PLEs and depressive symptoms, anxiety symptoms, and adverse life events using network structures. These findings help to reveal the crucial markers of the occurrence and persistence of PLEs, and shed high light on future intervention aimed to prevent and relieve PLEs.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e64"},"PeriodicalIF":5.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}