International Journal of Social Psychiatry最新文献

Background: Smoking cigarettes is highly prevalent in psychosis. However, the relationship between smoking and psychosis is still unclear.

Aims: This paper aims to investigate the probable association in a 6-year follow up of community-based population.

Methods: A general population sample were contacted at baseline (n = 4,011) and at 6-year follow-up (n = 2,185). Both at baseline and follow-up (newly developing/persistent), smoking cigarettes and psychotic experiences were assessed using the relevant sections of Composite International Diagnostic Interview 2.1. The associations between baseline smoking features and follow-up psychotic experiences were analysed using logistic regression models. To accurately assess the impact of smoking, participants were screened and controlled for alcohol and substance use. Interactions between baseline smoking features and existence of baseline psychotic experiences on the persistence of baseline psychotic experiences and its progression to psychotic disorder were analysed using interaction contrast ratios.

Results: Follow-up psychotic experiences were 1.8 (OR = 1.8; CI [1.3, 2.6]) and follow-up psychotic disorders were 5.9 times (OR = 5.9; CI [2.9, 12.0]; p < .001) more common in individuals whose first smoking age were ⩽15 years old at T₁ and who were an active regular smoker. The risk of persistence (OR = 1.5, 95% CI [1.1, 2.2]) and progression to psychotic disorder (OR = 5.3, 95% CI [1.6, 17.8]) was higher in smokers compared to non-smokers. There was a significant additive interaction between baseline psychotic experiences and smoking on persistence of psychotic experiences at follow-up (ICR = 1.8; 95% CI [0.2, 3.6]).

Conclusions: These findings suggest that early and regular cigarette smoking is associated with the persistence of psychotic experiences and increased risk of progression to psychotic disorder.

Background: Suicide has been linked to emotional disorders which, according to the transdiagnostic model, share common constructs such as positive and negative affect. This study examined the mediating role of positive and negative affect in the relationship between emotional symptoms and suicide risk.

Method: The sample included 1,014 participants (33.82% male, 66.17% female) aged 18 to 75 years (M = 33.0, SD = 15.15). Four independent mediation analyses were conducted, using depressive, anxious, somatization, and obsessive symptomatology (measured with the LSB-50) as independent variables; positive and negative affect (measured with the Positive and Negative Affect Schedule, PANAS) as mediators; and suicide risk (measured with the Risk of Suicide Scale, RS) as the dependent variable. Sociodemographic variables were controlled.

Results: Across all models, the relationship between emotional symptoms and suicide risk was positively mediated by negative affect and negatively mediated by positive affect.

Conclusions: Positive and negative affect function as transdiagnostic factors that partially mediate the relationship between emotional symptoms and suicide risk.

Background: Parenting plays a critical role not only in supporting children's healthy growth and development but also in contributing to a meaningful and fulfilling life.

Aims: This study evaluates how parents' self-compassion levels, which significantly influence their well-being, affect their parenting styles.

Methods: The research was conducted using a cross-sectional and descriptive design. Data were collected through an online form between April and October 2024, using a general information form, the Self-Compassion Scale, and the Multidimensional Parenting Styles Scale. Data analyses were performed using SPSS 25.0. Descriptive statistics, including mean, standard deviation, minimum/maximum values, frequency, and percentage, were used to summarize the findings.

Results: The effect of parents' self-compassion levels on parenting styles was analyzed using one-way analysis of variance (ANOVA). The results indicate that most parents exhibit high levels of self-compassion and positive parenting behaviors. Additionally, as self-compassion levels decrease, negative parenting behaviors tend to increase.

Conclusion: These findings suggest that self-compassion is a key factor in the parenting process, and supporting parents' self-compassion levels may contribute to developing more positive parenting behaviors. Therefore, it is recommended that psychosocial support and awareness programs be developed to enhance parents' self-compassion levels.

Background: Depression is a serious issue in the world, affecting over 350 million people. Although it may present at any age, adolescence to early adulthood is the most common age of onset, and females are affected twice as much as males. Rumination is a specific known risk factor for the onset, severity, prolongation, and relapse of depression. Relapse prevention in recurrent depression is a significant public health problem, and antidepressants are the current first-line treatment approach.

Aim: This study aims to evaluate the efficacy of mindfulness-based cognitive therapy in alleviating depressive symptoms, reducing rumination, and preventing relapse among depressive patients.

Method: This randomized controlled trial was conducted with 101 population of 101 consisting of adult patients with three or more previous episodes. Participants were randomly assigned to Mindfulness-Based Cognitive Therapy (n = 50) and Control Group (n = 51) using randomized sampling. The Mindfulness-Based Cognitive Therapy group received 8-week group training sessions including meditation exercises, psycho-education and group discussions. The assessment was done at baseline, post-treatment, and 2-month follow-up. Analysis was done using SPSS software (V 22).

Result: The results showed that there were no significant differences between the groups on depression relapse (χ² = 0.002; p = 0.99). However, there is a statistically significant reduction in depressive symptoms mean score level in the MBCT group [F(2, 37) = 6.878, p = .003]. Moreover, there is a statistically significant reduction in rumination score in the MBCT group [F (2,37) = 36.021; p = 0.02].

Conclusion: The findings showed that MBCT appears efficacious in reducing depressive symptoms and rumination. However, MBCT did not further reduce their risk for relapse/recurrence.

Background: Previous studies showed that posttraumatic stress disorder (PTSD) and dissociation are common trauma-related mental health problems.

Aims: This study examined their prevalence, long-term persistence, and association with depression among adolescents in the general population.

Methods: We assessed trauma exposure, PTSD, dissociation, and depression in a sample of 1,359 secondary school students in China at two timepoints 1 year apart.

Results: Of all participants, 19.0% had either or both probable PTSD and dissociative symptoms at baseline; 52.1% of participants with probable depression presented with co-occurring trauma-related symptoms. The 1-year persistence rate for probable PTSD and dissociative symptoms was 47% and 36.1%, respectively. After controlling for demographic variables and baseline depressive symptoms, baseline PTSD symptoms significantly predicted depressive symptoms at follow-up (β = .208, p < .001).

Conclusions: This study contributes to the limited literature on PTSD and dissociative symptoms in general samples of adolescents, providing important data regarding their prevalence, persistence, and association with depressive symptoms. The results also support the demoralization model. Trauma-related symptoms are prevalent among young people and are associated with more depressive symptoms over time. Early identification of PTSD and dissociation is important.

Objectives: Scarce data exist on the association between social network connectivity (family and friends) and depression among single parents in low-and middle-income countries (LMICs), and the mechanisms explaining the association are largely unknown. This study investigates the extent to which anxiety mediates the association between social network connectivity and depression among single parents in Ghana.

Methods: Data from 627 single parents were collected using a multi-stage stratified sampling technique. Social network connectivity was measured using the Lubben Social Network Scale-6 Item Version (LSNS-6), and depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D-10). Multivariable OLS models and bootstrapping mediation analyses were performed.

Results: The mean age (SD) was 45.0 (14.7) years, and 67.3% were females. After full adjustment, social network connectivity (B = -.060, SE = .021, 95% CI = -.100 to -.019, p < .005) was independently associated with lower levels of depression and anxiety (B = -.166, SE = .022, 95% CI = -.209 to -.122, p < .001), while anxiety (B = .597, SE = .035, 95% CI = .528 to .667, p < .001) is associated with higher levels of depression. Moreover, the social network connectivity-depression link was mediated by anxiety (indirect effect B = -.1000, 95% bootCI = -.1302 to -.0684), yielding 71.1% of the total effect. The sex-based mediation analysis indicated that anxiety explained a larger degree in males than in females.

Conclusions: Anxiety mediates the association between social network connectivity and depression among single parents in Ghana. Building resilient social network connectivity may provide a safety net in dealing with psychological problems among single parents.

Background: In recent years, a pattern has emerged in healthcare systems where clinicians and organisations are publicly blamed and punished following tragic events such as suicides or homicides. These responses often reflect more than institutional accountability, they reveal unconscious cultural mechanisms of scapegoating rooted in collective anxiety, grief, and the intolerability of uncertainty.

Aims: This paper explores scapegoating in healthcare not merely as an ethical or organisational failure, but as a deep-seated psychological and sociocultural process. It aims to illuminate how blame is mobilised as a primitive defence against psychic pain and systemic dysfunction, and to consider the implications for clinical practice, regulation, and public trust.

Methodological approach: This article employs an interpretive narrative approach, synthesising psychoanalytic and sociological theory to illuminate scapegoating in healthcare. It draws on the work of Freud, Bion, Menzies-Lyth, Douglas, and Girard, and integrates contemporary case material from international healthcare refined through peer discussion to illustrate and develop the theoretical analysis.Key Arguments:Scapegoating functions as a symbolic ritual of emotional discharge that obstructs learning and distorts justice. Organisational investigations and media narratives often collapse systemic complexity into linear blame, serving retributive rather than restorative purposes. Those targeted are frequently among the most vulnerable, socially, professionally, or structurally. The paper argues that only by recognising and resisting these unconscious group dynamics can healthcare systems foster genuine accountability, psychological safety, and real learning.

Background: Gamification, the strategic application of game design elements in non-game environments, has become increasingly prominent in digital mental health. It aims to enhance user engagement, motivation, and adherence through mechanisms such as points, feedback systems, rewards, and narrative frameworks. While it shows promise in promoting therapeutic engagement, the empirical foundation of its use in psychiatric treatment remains limited.

Aims: This section aims to explore the current state of evidence supporting gamification in psychiatric care, identify gaps in research, and highlight its potential role in improving treatment outcomes and user experience within digital mental health interventions.

Method: We performed a comprehensive search of the PubMed database, covering articles published between January 1, 2014, and May 31, 2025. The search included only empirical studies that employed gamified interventions in mental health contexts. Articles were screened and selected following PRISMA guidelines. Quality assessment was conducted using the GRADE framework, while risk of bias in randomized controlled trials (RCTs) was assessed using the Cochrane RoB 2.0 tool. Due to heterogeneity in study designs and outcome measures, findings were synthesized narratively.

Results: The review identified 7 eligible studies from an initial 109, all of which were randomized controlled trials (RCTs). These studies primarily used mobile or app-based platforms featuring gamified elements such as badges, levels, storylines, and points. The participants were largely adolescents and young adults experiencing mental health conditions, including depression, anxiety, and eating disorders. The studies reported positive effects on user engagement, adherence to therapeutic exercises, and symptom reduction.

Conclusions: Gamification appears to be a viable and potentially effective adjunctive strategy for psychiatric and mental health interventions. Despite encouraging initial evidence, further research is needed to solidify its clinical relevance and optimize its theoretical integration.

Background: While many studies have examined the relationships between the Big Five traits, and Internet Gaming Disorder (IGD) and Social Media Addiction (SMA), limited studies have considered the Big Five facets (i.e., narrowly defined traits).

Aims: The current study aims to contribute to the literature by examining the relationships between the Big Five traits and facets, and IGD and SMA among adults in the general population.

Method: Participants were a convenience sample of 246 gamers and/or social media users. Their age ranged from 18 to 88 (M = 25.21, SD = 8.38). They completed instruments that assess the Big Five traits and facets, IGD, and SMA.

Results: At the trait level, the results showed that conscientiousness and negative emotionality were protective and risk factors for IGD and SMA, respectively. Furthermore, agreeableness was a protective factor for IGD whereas extraversion was a risk factor for SMA. At the facet level, trust, respectfulness, and responsibility were protective factors for IGD whereas emotional volatility and depression were the main risk factors for SMA.

Conclusions: The results highlighted the advantages of using facets as predictors and have implications for both research and clinical practice. Limitations include the unreliability of two facets and the cross-sectional design of the study. Future research directions include using better instruments to assess the Big Five traits and facets and conducting longitudinal studies to assess the direction of causality.

Background: Asylum seekers and refugees (ASR) are at high risk of mental health disorders including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and anxiety. However, prevalence rates vary significantly due to methodological differences and the diverse socio-demographic characteristics of these populations. Access to mental health care is further complicated by language barriers, cultural differences, and systemic discrimination. The STAR-MH (Screening Tool for Asylum-seeker and Refugee Mental Health) was developed in the original version as a brief, easy-to-administer tool for early detection of MDD and PTSD in this vulnerable group.

Objective: To standardise the Italian version of the STAR-MH for use in non-clinical contexts, such as migrant reception centres.

Methods: The English version of the STAR-MH was back-translated into Italian following WHO guidelines; the resulting tool was then tested on a sample of 122 adult ASR in Northern Italy residing in migrant reception centres. Psychometric evaluations included internal consistency (Cronbach's α), factorial validity (PCA analysis), and construct validity (correlations with standardised psychiatric assessment tools such as the HSCL-25, HTQ-5, and MINI). ROC analyses were run to test its diagnostic properties and derive its cut-off score.

Results: The Italian version of the STAR-MH showed sufficient, albeit sub-optimal, internal consistency (Cronbach's α = .68) and a mono-component structure. While it was not sufficiently sensitive to MDD (which may be attributed to content- and culture-related biases), it demonstrated strong convergent validity with established psychiatric assessment tools and high diagnostic accuracy for PTSD (AUC = 0.82, sensitivity = 80%, and specificity = 76.7%).

Conclusion: The Italian version of the STAR-MH is a clinimetrically sound instrument to screen for PTSD among ASR, although modifications may be needed to improve its ability to capture MDD in different ASR populations. As it is, the STAR-MH can be a valuable resource for non healthcare providers, such as frontline workers, to facilitate timely mental health interventions.