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The mediating role of depression and disability in the association between widowhood and cognitive function among elderly Chinese individuals. 抑郁和残疾在中国老年人丧偶与认知功能之间关系中的中介作用。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-14 DOI: 10.1016/j.jpsychires.2024.11.026
Chuanlei Zheng, Yanhong Liu, Sisi Xie, Shaobo Zeng, Qingfeng Wu

Objective: The incidence of mild cognitive impairment among the elderly in China was increasing. Widowhood, depression, and disability were significant factors that impacted cognitive function. Yet, there was currently no research, both domestically and internationally, that comprehensively examines all these factors together. Therefore, in order to achieve successful aging, the objective of this study is to investigate the impact and pathway of depression and disability on the association between widowhood and cognitive function in the elderly population of China, with the aim of establishing a robust foundation for developing evidence-based strategies to prevent and manage cognitive impairment among older adults in China.

Methods: The 2018 Chinese Longitudinal Healthy Longevity Survey data was utilized to assess cognitive function, depression level, and disability status using the Mini-Mental State Examination, The Center for Epidemiological Studies Depression-10 scale, and the Katz scale. The mediating role of depression and disability in the association widowhood and cognitive function were tested by the bruceR package in R Studio.

Results: A total of 7973 elderly individuals aged over 65 were included in the study, with nearly 50% being widowed. Widowhood was identified as a significant risk factor for cognitive impairment in the elderly population. The results from the analysis of mediating effects indicated that both depression and disability independently mediated this relationship, while also contributing to a chain-mediated effect on the association between widowhood and cognitive function in the population.

Conclusion: We recommend that greater attention be dedicated to this population, and measures be implemented to enhance their mental well-being and disability management, thereby improving cognitive function.

目的中国老年人轻度认知障碍的发病率正在上升。丧偶、抑郁和残疾是影响认知功能的重要因素。然而,目前国内外还没有研究对所有这些因素进行综合研究。因此,为了实现成功老龄化,本研究旨在调查抑郁和失能对中国老年人群丧偶与认知功能相关性的影响和路径,旨在为制定循证策略预防和管理中国老年人认知障碍奠定坚实的基础:利用2018年中国健康长寿纵向调查数据,采用小型精神状态检查、流行病学研究中心抑郁-10量表和卡茨量表评估认知功能、抑郁水平和残疾状况。抑郁和残疾在鳏寡与认知功能关系中的中介作用由 R Studio 中的 bruceR 软件包进行检验:研究共纳入了 7973 名 65 岁以上的老年人,其中近 50%为丧偶。丧偶被认为是老年人认知障碍的一个重要风险因素。中介效应分析的结果表明,抑郁和残疾独立地中介了这一关系,同时也对鳏寡与人群认知功能之间的关联产生了连锁中介效应:我们建议对这一人群给予更多关注,并采取措施加强他们的心理健康和残疾管理,从而改善认知功能。
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引用次数: 0
Non-attendance in randomized remote mental health clinical trial during the COVID-19 pandemic 在 COVID-19 大流行期间未参加随机远程心理健康临床试验。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-13 DOI: 10.1016/j.jpsychires.2024.11.024
Dayane Santos Martins , Natan Pereira Gosmann , Carolina Blaya Dreher , Giovanni Abrahão Salum , Gisele Gus Manfro
During the COVID-19 pandemic, a significant increase in psychiatric symptoms was found among essential service professionals (professionals or interns from the health and educational sector) who were exposed to high-risk contamination areas. These symptoms impair functionality, impacting quality of life, work, autonomy, and relationships. Recent data show that brief interventions are effective; however, between 20 and 30% of those individuals often do not attend their scheduled appointments. This study aimed to identify variables related to non-attendance for remote telepsychotherapy among participants with COVID-19-related emotional distress compared to those who initiated treatment. We included 2097 essential service professionals with PROMIS (Patient-Reported Outcomes Measurement Information System) T-scores ≥70 for anxiety, depression, or irritability who scheduled a remote mental health appointment. Participants completed clinical and sociodemographic data, mental health risk and protective factors, and PROMIS subscales. We conducted a binary logistic regression, using attendance vs. non-attendance as the dependent variable and these demographic and clinical characteristics as independent variables. Of the 2097 participants, 230 (11%) did not attend the first session despite three rescheduling attempts. Non-attendance was associated with the presence of irritability and seeking treatment during the second COVID-19 wave. In contrast, anxious symptoms, older age, and coping mechanisms that typically include intellectual and reading activities were associated with attendance. Our findings shed light on non-attendance patterns in mental health services, revealing that personal characteristics and environmental factors significantly contribute to missed appointments. Understanding these dynamics can improve patient engagement and adherence to mental health treatments, particularly in the context of telepsychotherapy during the COVID-19 pandemic.
在 COVID-19 大流行期间,发现暴露在高风险污染区的基本服务专业人员(卫生和教育部门的专业人员或实习生)的精神症状明显增加。这些症状损害了功能,影响了生活质量、工作、自主性和人际关系。最近的数据显示,简短的干预措施是有效的;但是,这些人中有 20% 到 30% 的人经常不按时赴约。本研究旨在确定与开始治疗的人相比,患有 COVID-19 相关情绪困扰的参与者不参加远程心理治疗的相关变量。我们纳入了 2097 名基本服务专业人员,他们的焦虑、抑郁或易怒症状的 PROMIS(患者报告结果测量信息系统)T 值≥70,并预约了远程心理健康预约。参与者填写了临床和社会人口学数据、心理健康风险和保护因素以及 PROMIS 分量表。我们使用出席与不出席作为因变量,这些人口统计学和临床特征作为自变量,进行了二元逻辑回归。在 2097 名参与者中,有 230 人(占 11%)尽管尝试了三次重新安排时间,但仍未参加第一次治疗。在 COVID-19 第二波中,未参加治疗与易怒和寻求治疗有关。相比之下,焦虑症状、年龄较大以及通常包括智力和阅读活动在内的应对机制则与出席率有关。我们的研究结果揭示了心理健康服务中的失访模式,揭示了个人特征和环境因素对失访的重要影响。了解这些动态因素可以提高患者对心理健康治疗的参与度和依从性,尤其是在 COVID-19 大流行期间的远程心理治疗中。
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引用次数: 0
Clinical and lifestyle predictors of loneliness: A two-year longitudinal study 孤独感的临床和生活方式预测因素:一项为期两年的纵向研究
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-10 DOI: 10.1016/j.jpsychires.2024.11.025
Thyago Antonelli-Salgado , Bruno Braga Montezano , Thiago Henrique Roza , Vitória Bouvier , Aline Zimerman , Lucas Tavares Noronha , Grasiela Marcon , Maurício Scopel Hoffmann , André Russowsky Brunoni , Ives Cavalcante Passos

Background

While loneliness is a global public health problem, the literature lacks studies assessing loneliness predictors in low- and middle-income countries. Therefore, we aimed to analyze clinical and lifestyle predictors of loneliness.

Methods

We conducted a 2-year longitudinal study in Brazil based on a snowball sample and online surveys (baseline: May 6 to June 6, 2020). We assessed clinical and lifestyle predictors of loneliness using multiple regression models. The analyses were adjusted for several sociodemographic variables and weighted for attrition and sampling procedures.

Results

The study included a nationwide sample of 473 participants (18–75 years; 87.1% females). After adjusting for sociodemographic factors, we identified as risk factors: depressive symptoms (RR: 1.214; 95%CI: 1.08–1.36; p = 0.001), anxiety symptoms (RR:1.191; 95%CI: 1.04–1.35; p = 0.007), alcohol abuse (RR: 1.579; 95%CI: 1.32–1.88; p < 0.001), and cannabis use (RR: 1.750; 95%CI: 1.25–2.39; p < 0.001). More than 150 min/week of physical activity (RR: 0.177; 95%CI: 0.07–0.34; p < 0.001) and good/excellent quality of family relationships (RR: 0.73; 95%CI: 0.60–0.87; p < 0.001) and sleep (RR: 0.483; 95%CI: 0.39–0.59; p < 0.001) were protective factors.

Conclusion

Several clinical factors (depression, anxiety, alcohol, and cannabis) have been identified as risk factors for loneliness, while lifestyle factors (physical activity, better quality of sleep, and family relationships) have been associated with a lower incidence of loneliness. Addressing clinical and lifestyle factors may therefore be essential to preventing loneliness.
背景:尽管孤独是一个全球性的公共健康问题,但文献中缺乏对中低收入国家孤独感预测因素的评估研究。因此,我们旨在分析孤独感的临床和生活方式预测因素:我们在巴西开展了一项为期两年的纵向研究,研究基于滚雪球抽样和在线调查(基线:2020 年 5 月 6 日至 6 月 6 日)。我们使用多元回归模型评估了孤独感的临床和生活方式预测因素。分析根据几个社会人口变量进行了调整,并根据自然减员和抽样程序进行了加权:该研究在全国范围内抽取了 473 名参与者(18-75 岁;87.1% 为女性)。在对社会人口学因素进行调整后,我们确定了以下风险因素:抑郁症状(RR:1.214;95%CI:1.08-1.36;P = 0.001)、焦虑症状(RR:1.191;95%CI:1.04-1.35;P = 0.007)、酗酒(RR:1.579;95%CI:1.32-1.88;P 结论:该研究发现了一些临床因素(抑郁、焦虑、酗酒):一些临床因素(抑郁、焦虑、酒精和大麻)已被确定为孤独的风险因素,而生活方式因素(体育锻炼、更好的睡眠质量和家庭关系)则与降低孤独发生率有关。因此,解决临床和生活方式因素可能是预防孤独的关键。
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引用次数: 0
Parental mental disorders and ages of onset of severe mental disorders in offspring: A nationwide family-link study 父母的精神障碍与后代严重精神障碍的发病年龄:一项全国性的家庭联系研究。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-09 DOI: 10.1016/j.jpsychires.2024.11.018
Pao-Yuan Ching , Tien-Wei Hsu , Shih-Jen Tsai , Ya-Mei Bai , Chih-Ming Cheng , Tung-Ping Su , Tzeng-Ji Chen , Chih-Sung Liang , Mu-Hong Chen

Objective

The current study used a retrospective study design to investigate the association between age of onset of severe mental disorders in offspring and the likelihood of diagnoses of parental mental disorder.

Method

We enrolled 212,333 people with severe mental disorder, including schizophrenia, bipolar disorder (BD), or major depressive disorder (MDD) and 2,123,329 controls matched for age, sex, and demographics from the National Health Insurance Database of Taiwan. Poisson regression models were used to examine the likelihood of diagnoses of five mental disorders in their parents compared to the parents of the controls (reported as odds ratio (OR) with 95% confidence interval), including schizophrenia, BD, MDD, alcohol use disorder (AUD), and substance use disorder (SUD). The study cohort was classified into child-onset, adolescent-onset, and adult-onset groups according to the onset of severe mental disorders in the offspring.

Result

The parents of people with child-, adolescent-, and adult-onset schizophrenia (OR range: 1.73–9.08, all p < 0.05) or BD (OR range: 1.97–8.17, all p < 0.05) were more likely to be diagnosed with schizophrenia, BD, MDD, AUD, and substance use disorder (SUD) than controls except for AUD in the child-onset group. However, the parents of people with child-, adolescent-, and adult-onset depressive disorder were more likely to be diagnosed with schizophrenia, BD, MDD, AUD, and SUD (OR range: 1.82–4.76, all p < 0.05) than controls. Sub-analyses stratified by sex showed different patterns of associations between parental mental disorders and offspring mental disorders.

Conclusion

No matter when the severe mental disorder of the offsprings occurred at different onset stages, their parents had a higher likelihood of being diagnosed with schizophrenia, BD, MDD, AUD, and SUD.
研究目的本研究采用回顾性研究设计,调查后代严重精神障碍发病年龄与父母精神障碍诊断可能性之间的关系:我们从台湾国民健康保险数据库中选取了212,333名严重精神障碍患者,包括精神分裂症、双相情感障碍(BD)或重度抑郁障碍(MDD)患者,以及2,123,329名年龄、性别和人口统计学特征匹配的对照者。与对照组的父母相比,研究人员使用泊松回归模型检测了他们的父母诊断出五种精神障碍的可能性(以几率比(OR)和 95% 的置信区间报告),包括精神分裂症、BD、MDD、酒精使用障碍(AUD)和药物使用障碍(SUD)。研究队列根据后代严重精神障碍的发病情况分为儿童发病组、青少年发病组和成人发病组:结果:儿童、青少年和成人精神分裂症患者的父母(OR 范围为 1.73-9.08,均为儿童、青少年和成人发病组)均有严重精神障碍:1.73-9.08,均为 p 结论:无论儿童、青少年和成人精神分裂症患者的严重精神障碍发生于何时,他们的后代都可能患有严重精神障碍:在不同的发病阶段,无论后代的严重精神障碍发生在何时,其父母被诊断为精神分裂症、BD、MDD、AUD 和 SUD 的可能性都较高。
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引用次数: 0
Corrigendum to “German translation and psychometric evaluation of the Mental Health Literacy Scale (MHLS-GER) in a general population sample and in patients with acute myocardial infarction” [J. Psychiat. Res. 178 (2024) 201–209] 对 "心理健康素养量表(MHLS-GER)在普通人群样本和急性心肌梗死患者中的德文翻译和心理测量学评估 "的更正[J. Psychiat. Res. 178 (2024) 201-209]。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-09 DOI: 10.1016/j.jpsychires.2024.11.001
Simone Fischer , Timo Schmitz , Christine Meisinger , Jakob Linseisen , Inge Kirchberger
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引用次数: 0
Changes in hoarding-related beliefs and associated neural changes during a simulated discarding task after cognitive-behavioral treatment for hoarding disorder 囤积症认知行为治疗后,在模拟丢弃任务中囤积相关信念的变化及相关神经变化。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-09 DOI: 10.1016/j.jpsychires.2024.11.017
Kelly A. Knowles , Michael C. Stevens , Hannah C. Levy , David F. Tolin
Hoarding disorder (HD) is maintained by maladaptive beliefs about possessions, and recent research has demonstrated that changes in these beliefs partially mediate improvement in cognitive-behavioral therapy (CBT) for hoarding. It is not yet known whether changes in neural activity, particularly when discarding possessions, are associated with cognitive change during CBT for HD. Adults who completed group CBT for HD (N = 58) participated in a simulated discarding task before and after CBT. Neural activity was measured using functional magnetic resonance imaging (fMRI) as participants made simulated discarding decisions. At baseline, activity in the left middle insula and left anterior cingulate cortex was significantly associated with hoarding-related beliefs. After receiving CBT for HD, decreases in maladaptive hoarding-related beliefs were significantly associated with increased activity compared to baseline in the right anterior ventral insula, along the left middle frontal gyrus and bilateral inferior temporal lobe, and in visuospatial areas. These results demonstrate that maladaptive beliefs in HD are associated with activation of specific neural regions during discarding decisions and that reduction in beliefs over a course of CBT for HD is associated with specific changes in neural activity.
囤积症(HD)是由对财物的不适应性信念所维持的,最近的研究表明,这些信念的改变在一定程度上促进了囤积症认知行为疗法(CBT)的改善。目前还不清楚神经活动的变化,尤其是丢弃财物时的神经活动变化,是否与囤积症认知行为疗法期间的认知变化有关。完成囤积症团体 CBT 治疗的成人(58 人)在 CBT 治疗前后参加了一项模拟丢弃任务。在参与者做出模拟丢弃决定时,使用功能磁共振成像(fMRI)测量了他们的神经活动。基线时,左侧中脑岛和左侧前扣带回皮层的活动与囤积相关信念有显著关联。与基线相比,在接受囤积相关信念的CBT治疗后,适应不良的囤积相关信念的减少与右侧腹侧前脑岛、左侧额叶中回和双侧颞叶下部以及视觉空间区域活动的增加有明显关联。这些结果表明,在做出丢弃决定的过程中,HD患者的不良信念与特定神经区域的激活有关,而在对HD患者进行CBT治疗的过程中,信念的减少与神经活动的特定变化有关。
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引用次数: 0
Health-care utilisation and associated economic burden in major depressive disorder and treatment-resistant depression in a longitudinal population-based cohort study of 110.000 patients 一项针对 11 万名患者的纵向人群队列研究显示,重度抑郁症和耐药性抑郁症患者的医疗利用率和相关经济负担。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-09 DOI: 10.1016/j.jpsychires.2024.11.022
Sofia Pappa , Moulesh Shah , Sophie Young , Tazneem Anwar , Timothy Ming
Major depressive disorder (MDD), and particularly treatment-resistant depression (TRD), lead to high levels of health-care use and disease burden. The aim of this study was to evaluate and compare the health-care resource utilisation and associated costs in these patient groups. It was a population-wide, retrospective analysis of NHS health-care electronic records in northwest London using the Discover-NOW platform, one of the largest interlinked datasets in Europe hosted by Imperial College Health Partners, which contains coded emergency and routine, primary and secondary, physical and mental health data, covering a population of more than 2.5 million. Eligible patients were adults with a diagnosis of MDD who had been prescribed at least one antidepressant between 2015 and 2020. A total of 110,406 patients were included, 101,333 [92%] with MDD and 9073 [8%] with TRD. Mean duration of depression was 52.8 (SD 41.7) months for MDD and 70.8 (SD 37.8) months for TRD (p < 0.0001). Patients with TRD had significantly higher risks of both psychiatric and somatic comorbidities such as anxiety, asthma, and alcohol misuse (all p < 0.0001). They also demonstrated increased primary care and emergency attendance rates, more frequent and longer hospitalizations, and on average 1.5 times greater total healthcare costs compared to MDD patients. Primary care visits represented the largest proportion overall (TRD mean 162 [SD 96] vs. MDD 108 [90] visits per patient, p < 0.0001; cost per patient £17,348 [SD £33,040] vs. £12,011 [£25,588], p < 0.0001) during the study period. In secondary care, accident and emergency visits accounted for the highest use (TRD mean 5.5 [10.6] vs. MDD 3.54 [SD 6.0] visits per patient, p < 0.0001) while non-elective hospitalisations incurred the highest costs (mean £2518 [£8064] vs. £1909 [SD £6807], p < 0.0001). Demand increased with the duration of depression and the number of lines of treatment. The study highlights the substantial clinical and economic burden associated with MDD and especially TRD across different care settings.
重度抑郁障碍(MDD),尤其是治疗耐受性抑郁(TRD),导致高水平的医疗使用和疾病负担。本研究旨在评估和比较这些患者群体的医疗资源使用情况和相关成本。该平台是欧洲最大的互联数据集之一,由帝国理工学院健康合作伙伴托管,其中包含编码的急诊和常规、初级和中级、身体和精神健康数据,覆盖人口超过 250 万。符合条件的患者是在 2015 年至 2020 年期间诊断出患有 MDD 并至少服用过一种抗抑郁药的成年人。共纳入 110406 名患者,其中 101333 人[92%]患有 MDD,9073 人[8%]患有 TRD。MDD患者的平均抑郁持续时间为52.8个月(标准差为41.7个月),TRD患者的平均抑郁持续时间为70.8个月(标准差为37.8个月)(p
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引用次数: 0
Association of precarious employment with depressive symptoms and insomnia: Findings from the Korean Working Conditions Survey. 不稳定就业与抑郁症状和失眠的关系:韩国工作条件调查的结果。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-07 DOI: 10.1016/j.jpsychires.2024.11.021
Seong-Uk Baek, Jin-Ha Yoon

Precarious employment (PE) is an important occupational health concern. This study aims to examine the relations between PE and depressive symptoms and insomnia in Korean workers. This study included a nationally representative sample of 49,420 adult workers. A modified version of the Employment Precariousness Scale (EPRES), which comprises six dimensions (temporariness, disempowerment, vulnerability, exercise of rights, uncertain work schedules, and wages), was used to quantify PE levels on a scale ranging from 0 to 100. PE levels were categorized into four groups based on quartile values. Depressive symptoms were assessed using the World Health Organization-5 Well-Being Index, and insomnia was assessed using the Minimal Insomnia Symptom Scale. Logistic regressions were performed, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. The prevalence rates of depressive symptoms and insomnia were 10.7% and 8.4%, respectively. Compared with the lowest PE level, the highest PE levels were associated with both depressive symptoms (OR: 2.86, 95% CI: 2.61-3.14) and insomnia (OR: 1.33, 95% CI: 1.21-1.47). An interquartile range increase in the EPRES score was associated with a 1.84-fold (95% CI: 1.76-1.92) and 1.23-fold (95% CI: 1.17-1.29) increase in the odds of depressive symptoms and insomnia, respectively. All six individual dimensions were positively associated with depressive symptoms, whereas three dimensions-vulnerability, uncertain work schedules, and wages-were associated with insomnia. PE is a risk factor for depressive symptoms and insomnia. Policy interventions are required to safeguard mental health of precarious workers.

不稳定就业(PE)是一个重要的职业健康问题。本研究旨在探讨韩国工人的不稳定就业与抑郁症状和失眠之间的关系。这项研究包括一个具有全国代表性的 49 420 名成年工人样本。该量表包括六个维度(临时性、丧失权力、脆弱性、行使权利、不确定的工作时间安排和工资)。根据四分位值将 PE 水平分为四组。抑郁症状采用世界卫生组织-5 Well-Being 指数进行评估,失眠则采用失眠症状量表(Minimal Insomptom Scale)进行评估。进行了逻辑回归,并估算了几率比(OR)和 95% 的置信区间(CI)。抑郁症状和失眠的患病率分别为 10.7% 和 8.4%。与最低 PE 水平相比,最高 PE 水平与抑郁症状(OR:2.86,95% CI:2.61-3.14)和失眠(OR:1.33,95% CI:1.21-1.47)相关。EPRES 分数在四分位数之间的增加分别与抑郁症状和失眠几率增加 1.84 倍(95% CI:1.76-1.92)和 1.23 倍(95% CI:1.17-1.29)有关。所有六个个体维度都与抑郁症状呈正相关,而三个维度--脆弱性、不确定的工作时间安排和工资--则与失眠相关。PE 是抑郁症状和失眠的风险因素。需要采取政策干预措施来保障不稳定工人的心理健康。
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引用次数: 0
Social connection and suicidal thoughts and behaviors in the Million Veteran Program cohort 百万退伍军人计划队列中的社会联系与自杀想法和行为。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-07 DOI: 10.1016/j.jpsychires.2024.11.008
Kyle J. Bourassa , Paul A. Dennis , Pujan Patel , Xue J. Qin , David A. Sbarra , Elizabeth R. Hauser , Allison E. Ashley-Koch , Million Veteran Program , Jean C. Beckham , Nathan A. Kimbrel
People with lower levels of social connection are at increased risk for suicidal thoughts and behaviors. This extends to populations at greater risk of death by suicide, including U.S. military veterans. Despite this well-established association, it is unclear which measures of social connection are most useful in identifying veterans who could benefit from intervention to prevent suicide. To this end, we used data from the Million Veteran Program (MVP) to investigate the measures of social connection most strongly associated with suicidal thoughts and behaviors. Our sample included 264,626 veterans who reported on three measures of social connection—marital status, household size, and perceived social support—and were assessed for suicidal thoughts and behaviors using electronic health records. Veterans who were partnered (OR = 0.78, 95% CI [0.76–0.80], p < .001), living with others (OR = 0.71, 95% CI [0.70–0.73], p < .001), or reported higher levels of social support (OR = 0.67, 95% CI [0.65–0.69], p < .001), were less likely to have suicidal thoughts and behaviors. These associations varied by veterans’ age, sex, and era of military service. When combined into a single risk score, lower levels of social connection were associated with greater likelihood of suicidal thoughts and behaviors (β = 1.42, 95% CI [1.40–1.43], p < .001). Social support, particularly positive social interactions, showed the strongest associations with suicidal thoughts and behaviors in elastic net regression models. Common measures of social connection, particularly social support, could be useful in assessing suicide risk and treatment needs for veterans.
社会联系水平较低的人有自杀想法和行为的风险更高。包括美国退伍军人在内的自杀死亡风险较高的人群也是如此。尽管这种关联已得到证实,但目前还不清楚哪种社会联系测量方法最有助于识别哪些退伍军人可以从预防自杀的干预措施中获益。为此,我们利用 "百万退伍军人计划"(Million Veteran Program,MVP)的数据,调查了与自杀想法和行为最密切相关的社会联系措施。我们的样本包括 264,626 名退伍军人,他们报告了三种社会联系措施--婚姻状况、家庭规模和感知到的社会支持,并使用电子健康记录对他们的自杀想法和行为进行了评估。有伴侣的退伍军人(OR = 0.78,95% CI [0.76-0.80],p
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引用次数: 0
Structural brain connectivity does not associate with childhood trauma in individuals with schizophrenia 精神分裂症患者的大脑结构连接与童年创伤无关。
IF 3.7 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-07 DOI: 10.1016/j.jpsychires.2024.10.030
Maria R. Dauvermann , Laura Costello , Leila Nabulsi , Genevieve Mc Philemy , Emma Corley , Andrea Fernandes , Pramath Kakodkar , Wee Xuan Neo , David Mothersill , Laurena Holleran , Brian Hallahan , Colm McDonald , Gary Donohoe , Dara M. Cannon

Background

Schizophrenia is a brain dysconnectivity disorder. However, it is not well understood whether the experience of childhood trauma (CT) affects dysconnectivity in individuals with schizophrenia (SZ). Using a network-based approach, we examined whether self-reported CT would explain additional variance compared to whole-brain topology and structural connectivity changes in SZ versus healthy controls (HC).

Material and methods

CT was assessed in 51 SZ (mean age ± standard deviation 44 ± 11 years) and 140 HC (34.0 ± 12 years). Structural brain networks were constructed from T1-weighted MR and diffusion-MRI scans using non-tensor based tractography. Group differences in whole-brain topology and permutation-based statistics were examined and corrected for age and sex.

Results

SZ showed reductions in efficiency, strength, clustering and density (p < 0.01) as well as increases in path length (F(range) = 4.71–18.1, p < 0.03) when compared to HC. We also observed hypoconnectivity in a subnetwork of frontotemporal, frontoparietal and occipital regions in SZ relative to HC (T > 4.0, p < 0.001). However, we did not find that high CT levels were related to structural network differences or structural connectivity changes in SZ.

Conclusions

CT did not impact on topology or subnetwork connectivity changes in SZ. High CT levels were also not associated with any differences in network organisation irrespective of diagnosis. However, our findings confirm that SZ showed both network-level reductions and increases in a subnetwork. These findings suggest that the patterns of neuroanatomical dysconnectivity in established schizophrenia may not be influenced by CT. Future studies are needed to investigate the association between CT and structural dysconnectivity in schizophrenia.
背景:精神分裂症是一种大脑连接障碍性疾病。然而,童年创伤(CT)经历是否会影响精神分裂症(SZ)患者的连接障碍,目前尚不十分清楚。利用基于网络的方法,我们研究了自我报告的CT是否能解释精神分裂症患者与健康对照组(HC)的全脑拓扑和结构连通性变化之间的额外差异:对 51 名 SZ(平均年龄 ± 标准差 44 ± 11 岁)和 140 名 HC(34.0 ± 12 岁)进行了 CT 评估。利用基于非张量的牵引成像技术,通过T1加权磁共振和弥散磁共振扫描构建大脑结构网络。对全脑拓扑结构和基于置换统计的组间差异进行了研究,并对年龄和性别进行了校正:结果:SZ 在效率、强度、聚类和密度方面均有所下降(p(范围)=4.71-18.1,p 4.0,p 结论:CT 对拓扑和密度没有影响:CT 对 SZ 的拓扑或子网络连接变化没有影响。无论诊断与否,高 CT 水平也与网络组织的任何差异无关。然而,我们的研究结果证实,SZ 既表现出网络层面的减少,也表现出子网的增加。这些发现表明,已确诊的精神分裂症患者的神经解剖学连接障碍模式可能不受 CT 的影响。未来的研究还需要进一步探讨 CT 与精神分裂症结构连接障碍之间的关联。
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Journal of psychiatric research
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