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Bidirectional analysis of the association between migraine and post-traumatic stress disorder in Nurses' Health Study II. 护士健康研究II中偏头痛与创伤后应激障碍相关性的双向分析
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-12-11 DOI: 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.

目的:偏头痛和创伤后应激障碍(PTSD)在女性中的发病率都是男性的两倍。横断面研究显示偏头痛与包括创伤后应激障碍在内的几种精神疾病之间存在关联。创伤后应激障碍在头痛诊所的病人中是不成比例的常见,偏头痛和创伤后应激障碍患者报告偏头痛导致更大的残疾和更频繁的药物使用。为了进一步明确PTSD与偏头痛之间关系的本质,我们对(1)偏头痛与PTSD的关系以及(2)PTSD与偏头痛的关系进行了双向分析。方法:我们使用1989-2020年的纵向数据,对33,327名参加2018年护士健康研究II压力问卷的受访者进行调查。我们使用对数二项模型来估计患有偏头痛的女性患PTSD的相对风险,以及患有PTSD的个体、没有PTSD的创伤暴露个体和没有创伤暴露的个体患偏头痛的相对风险,并对种族、教育、婚姻状况、高血压、高胆固醇、饮酒、吸烟和体重指数进行调整。结果:总体而言,48%的受访者报告曾经经历过偏头痛,82%报告经历过创伤,9%符合精神疾病诊断和统计手册- PTSD的5个标准。在报告偏头痛和创伤的患者中,67%在偏头痛发作前报告有创伤,2%在同年报告有创伤和偏头痛发作,31%在偏头痛发作后报告有创伤。我们发现偏头痛与PTSD事件相关(校正相对危险度[RR]: 1.26, 95%可信区间[CI]: 1.14-1.39)。创伤后应激障碍(PTSD)与偏头痛发作相关,而非无创伤后应激障碍(PTSD)(调整后RR: 1.20, 95% CI: 1.14-1.27)。在有先兆的偏头痛患者中,这两个方向的结果都一致。结论:我们的研究提供了进一步的证据,证明偏头痛和创伤后应激障碍是强烈的共病,并且发现偏头痛和创伤后应激障碍以及创伤后应激障碍和偏头痛之间存在类似程度的关联。
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引用次数: 0
War exposure, daily stressors, and mental health 15 years on: implications of an ecological framework for addressing the mental health of conflict-affected populations. 战争暴露、日常压力源和心理健康15年来:生态框架对解决受冲突影响人群心理健康的影响。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-12-11 DOI: 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.

目的:15年前,我们在《社会科学与医学》上发表了一篇文章,试图解决两种截然不同的框架的倡导者之间的争论,这些框架旨在理解和解决受冲突影响人群的心理健康需求。我们将这两种方法分别称为创伤导向和社会心理导向,它们反映了人们对受战争影响社区痛苦的原因和性质的根深蒂固的信念。根据关于武装冲突和心理健康的新兴文献、实地心理健康和社会心理支持工作人员的报告,以及关于压力的心理学和心理生理学研究,我们提出了一个综合模型,该模型利用了两个框架的优势,并强调了它们的基本互补性。我们的模型包括武装冲突影响心理健康的两种主要途径:直接的,通过暴露于与战争有关的暴力和损失;间接的,通过武装冲突造成或加剧的日常生活的恶劣条件。我们提出的中介模型将注意力集中在过去(先前暴露于与战争有关的暴力和损失)和现在(持续冲突,日常压力源)在社会生态各个层面的压力源的影响上;因此,我们将其称为理解受冲突影响人群心理健康需求的生态模型。方法:在随后的15年中,该模型在不同的人群中进行了严格的测试,并找到了强有力的支持。在本文中,我们首先总结了该模型的发展和关键原则,并简要回顾了最近对该模型的实证支持。然后,我们讨论了旨在加强受冲突影响人群心理健康的干预措施的生态框架的含义。结果:我们提出的初步证据表明,在MHPSS干预措施中,沿着我们的模型以及其他概念相关框架,特别是公共卫生所建议的路线,已经逐渐转向更生态(即多层次、多模式)的规划。结论:我们反映了模型中的几个差距,最明显的是缺乏不良的童年经历。我们建议研究早期逆境的重要性,因为它既是对心理健康的直接影响,也是对与战争有关的暴力和损失的潜在创伤性经历的影响的潜在调节。
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引用次数: 0
Adverse childhood experiences and subsequent experiences of intimate partner violence in adulthood: a gender perspective. 童年的不良经历与成年后遭受亲密伴侣暴力的经历:性别视角。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-12-10 DOI: 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
目的:调查中国儿童不良童年经历(ACE)和亲密伴侣暴力(IPV)的患病率,探讨ACE与成人亲密伴侣暴力暴露之间的关联机制,并检验性别差异。方法:本研究共纳入21,154名受试者。ACE量表用于评估参与者在18岁之前接触ACE的情况。使用IPV量表评估参与者18岁以后的IPV经历。采用Logistic回归模型分析ACE与成年期IPV暴露风险之间的关系。采用主成分分析提取中国人群ace的主要模式。采用网络分析方法识别ACE和IPV的最关键类型,分析ACE和IPV之间的关联机制,探讨这种关联的性别差异,并比较成年期IPV严重程度的性别差异。结果:至少有一次ACE事件的参与者与没有ACE经历的参与者相比,IPV的风险高215.5%。在人群和性别网络中,期望影响最大的ACE和IPV节点是“ACE1(言语虐待+身体虐待模式)”和“IPV5(伴侣将我与其他人比较并公然指责我,使我感到尴尬和不确定自己)”。之间的正相关性被发现“傻乎乎(辱骂+身体虐待模式)”——“IPV3(合作伙伴不关心我当我在糟糕(不舒服或心情不好))”,“ACE4(暴力对待母亲或继母+犯罪行为在家庭模式)”——“IPV1(合伙人曾经直接攻击或伤害我的乐器)”和“ACE2(接触性侵犯模式)”——“IPV2(伴侣身体或性接触我违背我的意愿)”,即ACE模式和IPV模式中边权值最高的3条边。“ACE1(言语虐待+身体虐待模式)”—“IPV3(伴侣在我状态不好时不关心我[感觉不舒服或心情不好])”,“ACE2(暴露于性侵犯模式)”—“IPV2(伴侣违背我的意愿与我发生身体或性接触)”,男性网络中的“ACE4(暴力对待母亲或继母+家庭模式中的犯罪行为)”-“IPV1(伴侣曾用工具直接攻击或伤害过我)”和“ACE1(言语虐待+身体虐待模式)”-“IPV3(伴侣在我状态不好时不关心我[感觉不舒服或心情不好])”。ACE4(暴力对待母亲在家庭或继母+犯罪行为模式)”——“IPV1(合伙人曾经直接攻击或伤害我的乐器)”,“ACE3(滥用药物+心理疾病+暴力对待母亲或继母模式)”——“IPV1(合伙人曾经直接攻击或伤害我的乐器)的女性网络中最高的三条边边在ACE和IPV在网络边缘,分别都显示出正相关。“IPV3(当我状态不好[感觉不舒服或心情不好]时,伴侣不关心我)”的强度在男性网络中高于女性(男性= 0.821,女性= 0.755,p = 0.002)。“ACE3(药物滥用+精神疾病+母亲或继母暴力治疗模式)”-“IPV1(伴侣曾直接使用工具攻击或伤害我)”(P = 0.043)和“ACE4(母亲或继母暴力治疗+家庭犯罪行为模式)”-“IPV1(伴侣曾使用工具直接攻击或伤害我)”(P = 0.032)的边缘权重值女性大于男性。结论:中国人群中最常见的ACE类型是言语暴力结合肢体暴力,而IPV的主要类型是言语暴力。与女性相比,男性更容易受到伴侣的情感忽视。童年时期目睹身体暴力与成年后遭受伴侣身体暴力之间的关联在女性中比在男性中更强。ACE和IPV之间的同型连续体是理解代际家庭暴力的重要机制。提高经济和教育水平,推广正确的养育观念,减少虐待儿童,建立对亲密关系的正确认识,消除对暴力的羞耻,并进一步促进性别平等。这些努力对于减少IPV流行率和打破受害者生活中的暴力循环至关重要。
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引用次数: 0
Persistence of anxiety and depression symptoms and their impact on the COVID-19 vaccine uptake. 焦虑和抑郁症状的持续存在及其对COVID-19疫苗摄取的影响
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-12-03 DOI: 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.

目的:COVID-19大流行对心理健康的持续影响及其对COVID-19疫苗接种的影响有必要进行全面调查。我们的目的是表征2020年7月至2023年7月期间中度至重度焦虑和抑郁症状的持续性,探索与症状持续性的人口统计学关联,并评估这些症状如何影响2021年5月至2023年7月期间的COVID-19疫苗接种。方法:于2020年3月至6月招募来自全国社区的CHASING COVID队列的参与者,并完成季度随访,直至2023年12月。在14项随访评估中,广泛性焦虑障碍7项和患者健康问卷8项得分≥10分分别提示中度至重度焦虑和抑郁症状。缺失的分数被计算在内。持续焦虑和抑郁被定义为分别经历中度至重度焦虑和抑郁症状≥7 / 14的随访评估。结果:在4851名参与者中,15.9%的人在2020年7月至2023年7月期间出现了持续的焦虑症状,19.3%的人出现了持续的抑郁症状。与症状持续相关的人口统计学因素包括年龄较小、女性或非二元性别、西班牙裔、教育程度较低、家庭收入。结论:针对精神障碍患者的个性化支持可能减轻疫苗接种障碍。有必要进一步调查以验证这些发现并为有针对性的干预措施提供信息。
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引用次数: 0
An equity indicator for assessing mental healthcare access: a national population case study. 评估获得精神保健的公平指标:一项全国人口案例研究。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-29 DOI: 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.

目标:实现公平获得医疗保健是一项全球性挑战。2018年《柳叶刀》全球精神卫生委员会提出了一项重要建议,即改善全体人口的精神健康和减轻精神障碍的全球负担。该委员会提议监测国家指标,包括严重精神障碍患者使用服务的比例。本研究旨在从综合需求、服务利用和社会经济地位的国家数据集中得出一个公平指标,并证明其在确定最需要的人在精神卫生服务使用方面的差距方面的效用,从而指导公平的医疗保健提供。方法:我们提出了一个澳大利亚全民健康保险计划(Medicare)的案例研究。我们利用三个国家的数据集开发了公平指标。地理区域与基于区域的社会经济剥夺五分之一有关(2016年人口普查)。每个地理区域,我们使用Kessler-10(2015年和2018年澳大利亚国家健康调查)得分≥30来估计有精神卫生保健需求的人数,并获得使用的服务数量,定义为与全科医生和精神卫生专业人员进行精神卫生相关接触(2015-2019年医疗保险行政数据)。我们将服务的数量除以估计有精神保健需求的人口,并在每个社会经济剥夺五分之一中平均这些使用率。公平指标是最贫困五分之一与最贫困五分之一的使用率之比。结果:2019年最贫困地区五分位数(第一季度)和最贫困地区五分位数(第五季度)估计最需要精神卫生保健的人数分别为8.2%和2.4%,与2015年相比,第一季度和第五季度分别增长27.7%和19.5%。权益指标调整后的服务率分别为4.2(3.8-4.6)和23.9(22.4-25.4),表明居住在Q1地区的最高护理需求的个人获得的服务比Q5地区少了6倍,产生的权益指标为6。结论:由于常见精神障碍的全球患病率可能正在增加,因此计算评估精神卫生服务使用公平性的可靠指标至关重要。在这个澳大利亚案例研究中,我们开发了一个公平指标,可以直接比较具有不同需求概况的地理区域。调查结果显示,尽管有公共资金支持的全民医疗保健、最近的服务改革以及作为一个高收入国家,严重的不平等现象依然存在。这项研究表明,制定这样一个指标的重要性和可行性,为社区、医疗保健提供者和政策制定者提供信息和授权,以追求公平的服务提供。
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引用次数: 0
(Fear of) SARS-CoV-2 infection and psychological distress: a population-based cohort study in southern Switzerland. (对)SARS-CoV-2 感染的恐惧和心理困扰:瑞士南部一项基于人群的队列研究。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-28 DOI: 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。
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引用次数: 0
Prevalence of mental disorders in adult populations from the Global South following exposure to natural hazards: a meta-analysis. 全球南部成人遭受自然灾害后精神失常的发生率:荟萃分析。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-28 DOI: 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}
引用次数: 0
Michaela Polacek. 'I had to eat myself up on the left, now I'm only on the right'. 米凯拉-波拉切克我不得不在左边把自己吃掉,现在我只在右边"。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-27 DOI: 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}
引用次数: 0
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. 一项关于儿童虐待和精神障碍的出生队列纵向研究,使用的是 1983 年至 2014 年期间全州 83,050 名昆士兰居民的儿童保护和行政健康数据。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-20 DOI: 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.

目的:有关儿童虐待(CM)与后续精神病发病率之间关系的大多数信息都是基于回顾性自我报告。使用向法定机构提交的前瞻性报告进行的纵向研究的结果可能会受到自然减员的影响。因此,我们使用行政数据,比较了那些经历过机构报告的CM患者与其他队列中的患者到30岁时的住院精神病诊断流行率,以尽量减少随访损失:我们使用了两个出生队列的关联管理数据,这两个出生队列包括 1983 年和 1984 年在澳大利亚昆士兰出生的所有个人(N = 83,050 人),并跟踪随访至 30 岁。这是除 312 名死亡者之外的整个队列。有关精神病学的信息来自全州儿童保护数据,精神病学诊断则来自昆士兰州所有公立和私立医院的住院病例:经调整分析,4703 名曾向全州儿童保护机构报告的参与者(5.7%)在 30 岁之前因以下任何一种精神病诊断入院的几率是前者的三到八倍:精神分裂症谱系障碍、双相情感障碍、抑郁症、焦虑症和创伤后应激障碍(PTSD)。所有 CM 亚型都有类似的发现。创伤后应激障碍的相关性尤其强,入院几率增加了 7 到 9 倍:这是关于儿童疾病长期影响的最大规模研究之一,涵盖了整个辖区。所有类型的虐待都与一系列需要入院治疗的精神疾病密切相关。及早识别、干预并为遭受过虐待的个人提供适当的支持,可能有助于减轻长期后果并降低随后出现精神健康问题的风险。
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引用次数: 0
A longitudinal network of psychotic-like experiences, depressive and anxiety symptoms, and adverse life events: a cohort study of 3,358 college students. 类似精神病的经历、抑郁和焦虑症状以及不良生活事件的纵向网络:一项针对 3,358 名大学生的队列研究。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-18 DOI: 10.1017/S2045796024000726
Meng Sun, Heng Sun, Zijuan Ma, Shaoling Zhong, Xinhu Yang, Yue Li, Hongling Zhou, Liang Zhou

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.

目的:类似精神病的经历(PLEs),尤其是持续性类似精神病的经历,对随后的心理健康问题有很高的预测性。因此,探索类精神病经历的发生和持续背后的精神病理学关联至关重要。本研究旨在通过纵向动态网络法探讨 PLEs 与心理和社会心理因素之间的上述问题:共有 3 358 名大学生完成了两波在线调查(2021 年 10 月至 2022 年 10 月)。基线调查收集了社会人口学信息,两次调查都对PLEs、抑郁症状、焦虑症状和不良生活事件进行了评估。交叉滞后面板网络分析用于在基线 PLEs 和非 PLEs 患者之间建立网络:结果:基线时,455 名(13.5%)学生的 PLEs 筛查呈阳性。基线 PLEs 患者和非 PLEs 患者的动态网络结构截然不同。在基线 PLEs 患者中,"精神运动障碍 "与 PLEs 的关系最为密切,而在无 PLEs 患者中,"自杀/自残 "与 PLEs 的关系最为密切。在 PLEs 的所有三个亚型中,离奇经历和迫害性意念分别是基线 PLEs 参与者和非 PLEs 参与者中受其他构念影响最大的节点。此外,只有无基线 PLEs 的参与者才会在 PLEs 结构中存在广泛的相互联系:本研究利用网络结构提供了 PLEs 与抑郁症状、焦虑症状和不良生活事件之间的时变关联。这些发现有助于揭示 PLEs 发生和持续的关键标志,并为未来旨在预防和缓解 PLEs 的干预措施提供了重要启示。
{"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}
引用次数: 0
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Epidemiology and Psychiatric Sciences
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