Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: This study aimed to investigate the prevalence and sociodemographic determinants of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among Mozambican youth aged 15-24 years, as well as their help-seeking behaviors.

Methods: Data from 8,154 youth participants in the 2022-23 Mozambique Demographic Health Survey were analyzed. MDD and GAD were assessed using the PHQ-9 and GAD-7 scales, respectively. Univariate and multivariate logistic regression analyses were conducted to examine associations between sociodemographic factors and mental health outcomes and health-seeking behaviors.

Results: The prevalence of MDD and GAD among Mozambican youth was 7.5% for each condition. However, only 9.3% of those with either MDD or GAD sought help for their symptoms, primarily from family and friends. Females had significantly higher odds of experiencing both MDD and GAD but lower help-seeking behavior as compared to males. Unemployment, lower household wealth, and being single were associated with higher odds of both disorders and lower odds of help-seeking behaviors. Higher education increased the odds of GAD and help-seeking behaviors. Significant regional variations were observed, with conflict-affected regions including Cabo Delgado, Nampula, and Zambezia showing the highest prevalence of MDD and GAD.

Conclusion: This study reveals substantial mental health challenges among Mozambican youth, with notable disparities across sociodemographic groups and regions. The low rates of help-seeking behavior underscore the need for targeted interventions to improve mental health awareness and access to services for socio-demographically vulnerable youth.

Purpose: Meaningful connections, encompassing relationships providing emotional support, understanding, acceptance, and a sense of belonging, are vital for social inclusion and well-being of Individuals with serious mental illness (SMI). The mixed methods review critically explored multifaceted approaches supporting people with SMI to foster meaningful (non-intimate) social relationships or connections.

Methods: Searches of eight electronic databases returned 4882 records. Duplicate removal, title abstract, then full-text, screening and hand searching resulted in 23 records for inclusion. Studies were integrated using the CIVIC Framework emphasising the importance of Closeness, Identity, Valued relationships, Involvement, feeling Cared for and accepted.

Results: The review identified emotional and physical challenges, societal stigma, and other environmental factors to hinder making meaningful connections. Studies highlighted the necessity for interventions being adaptable, personalised, and encompassing of structured activities, peer and professional supports, and technology-assisted platforms.

Conclusion: The complexity of social interactions for those with SMI call for comprehensive, holistic strategies to nurture social relationships within their communities.

Purpose: Rising concern surrounds youth mental health in Canada, with growing disparities between females and males. However, less is known about recent trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status.

Methods: This study analyzed data from 96 683 youths aged 15-24 who participated in the nationally representative Canadian Community Health Survey (CCHS) between 2007 and 2022. Trends in absolute and relative inequalities in poor/fair self-rated mental health (SRMH) by sex, sexual orientation, racialized and Indigenous identity, and socioeconomic conditions were assessed.

Results: The percent of youths reporting poor/fair SRMH quadrupled from 4.3% in 2007-08 to 20.1% in 2021-22. During the same period, absolute inequalities in SRMH increased by 9.9% points (95% CI: 6.6, 12.9) for females compared to males, 11.4% points (95% CI: 4.6, 18.2) for Indigenous versus non-racialized youth, and 15.4% points (95% CI: 5.7, 25.1) for youth (aged 18-24) identifying as lesbian, gay, or bisexual (LGB) compared to heterosexual.

Conclusion: The sustained deterioration in youth SRMH over the past decade and a half has been accompanied by widening inequalities across several dimensions important for health equity in Canada. Action is needed to identify and implement effective programs and policies to support youth mental health and address disparities.

Purpose: Most studies on supported accommodations (SAs) for people with serious mental disorders have focused on effectiveness. Very few analysed the experiences and expectations of residents and professionals of SAs, which is fundamental to improving care. This study aimed to explore in depth the perspectives of residents and professionals of SAs in Portugal regarding the residents' previous contacts with mental health services, current experiences, and expectations.

Methods: A purposeful sample of 11 residents and 11 professionals from 11 different organisations managing SAs in Portugal was included. Semi-structured interviews were conducted using interview guides to assess previous experiences with mental health services, expectations, and suggestions to improve care. Thematic analysis was used.

Findings: Residents had a long history of mental health problems and contact with mental health services. Most had been referred to SAs due to poor family or social conditions. The majority of residents expected to stay at the SAs in the long-term, and did not mention major suggestions to improve. Professionals suggested several improvements, such as having more time allocation to work with the residents and revising maximum limits of lengths of stay.

Conclusions: Residents are seldom involved in decision-making. However, most were satisfied with care and hoped to remain in the SAs. Implications of this study apply to the political level (regarding the financing of SAs and the provision of community mental health care and other social supports) and to the clinical level (regarding training and family interventions).

Purpose: Exposure to traumatic events may lead to the development of Acute Stress Disorder (ASD) within the first month post-trauma in some individuals, while others may not exhibit ASD symptoms. ASD was introduced as a potential early indicator to identify those at higher risk of developing Posttraumatic Stress Disorder (PTSD), however, PTSD can occur in some individuals even without prior ASD. Assessing ASD post-trauma can assist in identifying those who would most benefit from intervention to prevent later PTSD, yet the predictive power of ASD varies across studies, with intensity of ASD symptoms and subthreshold PTSD often less considered.

Methods: A prospective cohort study on 426 health workers exposed to the Beirut Port Blast assessed DSM-5 ASD and symptom intensity using self-report questionnaire at two distinct time points: 9-15 and 21-27 days post blast. DSM-5 PTSD was assessed afterwards at 6-7 months via self-report questionnaire post-exposure. Probit models predicted full and subthreshold PTSD.

Results: Using ASD diagnosis alone, the sensitivity 9-15 days after trauma was better than 21-27 days after trauma (75.68% vs. 58.06%); when stratified by intensity, however, sensitivity increased from 41.66% among those with low intensity to 92% among those with high intensity. Specificity, however, was better 21-27 days after trauma (77.82%) compared with 9-15 days (60.98%). Positive Predictive Value of ASD increased, and Negative Predictive Value decreased, with time since exposure and when adding intensity with diagnosis. ASD diagnosis plus intensity achieved better prediction of PTSD and subthreshold PTSD.

Conclusion: Screening for PTSD should include ASD and its intensity, improving predictive ability for later PTSD, incorporatingfull threshold and subthreshold PTSD. Specificity increases with time since exposure, suggesting a high rate of false positives when assessing ASD soon after trauma. This highlights the need to prioritize individuals for early preventive measures after trauma.

Purpose: Females experiencing family violence as victims are at increased risk of emergency department mental health presentations. However, few studies have examined this association for males and perpetrators. We examined whether family violence reports to police were associated with contemporaneous mental health presentations and whether this differed for males and females and those that the police identified as perpetrators and victims.

Method: Victoria Police provided lifetime data on family violence reports for 2,990 individuals who were the subject of family violence reports as either perpetrators or victims in 2016/17. This sample was linked to emergency mental health presentations from the Victorian Emergency Minimum Dataset. The association between monthly number of family violence reports and same-month emergency mental health presentations was examined over a one year period using multilevel logistic regression.

Results: The number of family violence reports as either victim or perpetrator in any month was associated with significantly increased odds of an emergency department mental health presentation in the same month. An interaction effect was found between the sex of the individual and the number of family violence reports as a perpetrator, such that female perpetrators were at higher risk of emergency department mental health presentations compared to male perpetrators.

Conclusion: Police-reported family violence is associated with increased mental health emergency department presentations in the same month. The association is particularly strong for females who are identified as perpetrators. Strengthened collaboration between those responding to family violence and those responding to mental health crises is needed to help identify and address overlapping needs.

Purpose: Loneliness is a pervasive phenomenon that is linked to adverse health outcomes. Unemployed individuals with mental illnesses (UMIs) constitute a high-risk group, with substantial implications for both health and vocational (re)integration. This study aims to gain deeper insights into the relationships between psychological problems and symptoms of psychopathology and loneliness in UMIs.

Methods: Our research is based on a sample from LIPSY, a project that aims to maintain or restore employability. Two regression analyses were conducted on a sample of unemployed participants diagnosed with a mental illness (ICD-10: F-code) with the outcome variable loneliness (UCLA). In the first analysis, age, gender, education, cohabitation status, and social network size (LSNS-6) were used as predictors; in the second one, the nine symptom dimensions (SCL-90) - (1) Somatization, (2) Obsessive-Compulsive, (3) Interpersonal Sensitivity, (4) Depression, (5) Anxiety, (6) Anger-Hostility, (7) Phobic Anxiety, (8) Paranoid Ideation, (9) Psychoticism -were added.

Results: Our sample included 397 participants with an average age of 35.8 years, 53.1% were female. The final regression showed significant positive associations between higher levels of education, Interpersonal Sensitivity, Depression, and the outcome loneliness, and a significant negative relationship between Somatization and loneliness.

Conclusion: The high scores on all SCL-90 dimensions, and the links identified between Somatization, Interpersonal Sensitivity, Depression, and loneliness highlight the importance of psychological screening and/or diagnostics in this high-risk group and offer several starting points for prevention measures as well as interventions.

Purpose: During the COVID-19 pandemic, an increase in loneliness as well as mental health issues was detected. However, research on the association between loneliness and mental disorders is sparse. The aim of this study was to examine loneliness and associated social and emotional factors in patients with a psychiatric disorder and to investigate potential predictors of loneliness.

Methods: Participants were N = 230 patients currently receiving psychiatric treatment at the Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Germany. A cross-sectional survey included questionnaires on loneliness, life satisfaction, need to belong, interpersonal trust, stress, and resilience.

Results: Most participants (n = 91, 39.6%) suffered from depression, followed by anxiety disorder (n = 43, 18.7%). Significantly higher loneliness levels compared to norm samples were detected in all three loneliness questionnaires (all p <.05), and overall n = 128 (57.7%) reported to feel lonely. In addition, participants reported lower life satisfaction, lower interpersonal trust, and lower resilience than the general population (all p <.05). No significant differences in loneliness levels between different psychiatric diagnoses were revealed. It was found that lower satisfaction with life, lower interpersonal trust and lower resilience were significantly associated with higher loneliness (all p <.05).

Conclusion: This study underlines the importance to continue research on loneliness in people with mental disorders after the COVID-19 pandemic since the majority of patients reported to feel lonely. Further, tailored therapy-accompanying interventions to prevent loneliness in patients with a psychiatric disorder should be designed and evaluated to meet patients' diverse needs e.g., through online programs.

Trial registration: German Clinical Trial Registration: DRKS00023741 (registered on April 6, 2021).