Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: Suicide rates are high among older adults, yet research on risk factors associated with suicide in this age group remain largely unexplored. This study aims to examine the relationship between suicide and sociodemographic characteristics among individuals aged 60 and older.

Methods: We utilized data from Norwegian national registries, identifying individuals aged 60 and older who died by suicide between 2005 and 2019 (n = 2060, 70.7% males), and used a case-control design. To examine the relationships between suicide and sociodemographic factors, we used descriptive analyses and conditional multivariate logistic regression analyses, stratified by sex and age categories.

Results: Among individuals aged 60 to 69, risk factors for suicide included receiving a disability pension (odds ratio (OR) = 2.79 males, OR = 7.71 females), having mixed income sources (OR = 1.79 males, OR = 3.70 females), living alone (OR = 2.49 males, OR = 2.46 females), and living in urban areas, which was associated with an increased risk for females (OR = 1.85). Among males, living alone was also a significant risk factor for suicide in the 70 to 79 age group (OR = 1.85), and those aged 80 and above (OR = 2.16). Living in rural areas reduced risk for females aged 80 and above (OR = 0.05).

Conclusion: This first register-based study of suicide in older adults in Norway highlights that living arrangements, urbanization level, and income source are significant risk factors for suicide among older adults. Interventions to improve social connectedness, with a focus on the urban-rural divide, could potentially reduce suicide risk. Sex and age categories should be considered in future research and when implementing preventive measures.

Purpose: Socioeconomic disadvantage can exacerbate psychosis outcomes, yet the long-term impact of financial deprivation remains underexplored. This study examined how financial deprivation at first-episode psychosis affects clinical, functional, and neurocognitive outcomes over four years.

Methods: Participants were 240 adults (26-55 years) from the Jockey Club Early Psychosis project in Hong Kong, China. Financial deprivation was defined as household income < 50% of the median for household size. Regression analyses assessed the predictive value of baseline financial deprivation on four-year outcomes, controlling for sociodemographic and premorbid confounders. Age-subgroup analyses explored differential effects across developmental periods (< 33, 33-42, > 42 years).

Results: At baseline, 121 participants (51.7%) were financially deprived, characterized by lower education, more siblings, foreign-born status, and residence in public housing. Baseline financial deprivation predicted worse four-year clinical, functional, and quality of life outcomes four years later. Financial hardship did not appear to predict neurocognitive outcomes at follow-up. Age-subgroup analyses indicated the strongest and most consistent effects in participants > 42 years, with minimal to modest effects in younger subgroups.

Conclusions: Financial deprivation during early psychosis represents a high-risk subgroup, particularly in later adulthood, with persistent symptomatic and functional impairments. Early identification and age-sensitive interventions, such as vocational support, social benefits assistance, and programs promoting social integration and independent living, are essential. Policy measures targeting socioeconomic disadvantage may mitigate long-term impacts on illness trajectory and recovery.

Purpose: Disparities in mental health across sexual orientation groups and among young adults have long been discussed. The aim of this cross-sectional study was to investigate the moderating effects of sexual orientation on the associations between social factors and depressive symptoms as well as suicidal ideation in young adults.

Methods: The study included 6,337 participants aged 18-25y in 2022 from the French EpiCov cohort. The outcome variables were depressive symptoms and suicidal ideation. Poisson regressions with robust error variance were performed to investigate the associations between social factors and outcomes according to sexual orientation (lesbian, gay, bisexual, other, or not defining themselves according to their sexuality: sexual minority (SM); heterosexual or not wishing to answer: Not belonging to SM (NSM)).

Results: The prevalence of depressive symptoms and suicidal ideation was higher in the SM than in the NSM group. Regarding depressive symptoms, significant moderating effects of sexual orientation were observed for female vs male sex (NSM: adjusted Prevalence Ratio (aPR) 1.58[1.28-1.95], SM: aPR 1.03[0.78-1.36]) and age category 22-25y vs 18-21y (NSM: aPR 1.32[1.05-1.67], SM: aPR 0.78[0.59-1.03]). Regarding suicidal ideation, significant moderating effect was observed for not being vs being in a relationship (NSM: aPR 1.55[1.14-2.12], SM: aPR 0.82[0.59-1.13]).

Conclusion: In this study conducted in 2022, well-known social risk factors of mental problems do not explain the higher prevalence of depressive symptoms and suicidal ideation among young SM group. Further studies are needed to understand the specific challenges faced by these young people.

Purpose: Both social isolation and cognitive impairment are important public health issues that affect the quality of life of older adults. Our study aims to clarify the direction of their relationship and to illustrate the mediating role played by depressive symptoms.

Methods: Data from 5399 respondents who participated in three longitudinal surveys in the China Health and Retirement Longitudinal Survey (CHARLS) were analyzed. Cross-lagged panel model was used to determine the longitudinal relationship between social isolation, depressive symptoms, and cognitive function.

Results: After controlling for confounders, higher levels of social isolation predicted subsequent more severe cognitive function score (wave1-wave2: β = - 0.039, SE = 0.015, P = 0.009; wave2-wave3: β = - 0.057, SE = 0.017, P = 0.001), and 37.5% of this effect was mediated through depressive symptoms (β = - 0.002, SE = 0.001, P = 0.022). Similarly, lower cognitive function predicted subsequent higher social isolation (wave1-wave2: β = - 0.062, SE = 0.014, P < 0.001; wave2-wave3: β = - 0.039, SE = 0.015, P = 0.009), but depressive symptoms did not play a mediating role in this process (β = - 0.001, SE = 0.001, P = 0.072).

Conclusion: There is a potential bidirectional relationship between social isolation and cognitive function in which depressive symptoms play a partially mediating role.

Background: Depression may be a contributing factor to cholelithiasis. However, the exact correlation between cholelithiasis and depression severity remains unclear.

Methods: First, a two-sample Mendelian randomization (MR) analysis was performed to validate previous research findings, utilizing separate datasets for major depressive disorder (MDD) and cholelithiasis. The MDD dataset (135,458 cases, 344,901 controls) came from a published GWAS, and cholelithiasis data (19,023 cases, 195,144 controls) were sourced from FinnGen. The primary analytical approach for the MR study was the inverse variance weighting (IVW) method. Second, an observational study based on the National Health and Nutrition Examination Survey (NHANES) was conducted to explore the relationship between the severity of depression and cholelithiasis. 7071 participants were included in the observational study in total. Depression severity (no, mild, moderate, severe) was measured by Patient Health Questionnaire-9 (PHQ-9). Weighted multivariable-adjusted logistic regression was employed to assess the association between depression severity and cholelithiasis.

Results: In the MR study, the IVW analysis revealed that MDD may increase the risk of cholelithiasis (OR 1.25, 95% CI 1.07-1.45, P = 0.004). The observational study showed that moderate (OR 1.06, 95% CI 1.00-1.11, p = 0.037) and severe (OR 1.07, 95% CI 1.00-1.15, p = 0.044) depression rises the incidence of cholelithiasis. However, no significant association was found between mild depression and cholelithiasis (p = 0.275).

Conclusions: Moderate and severe depression might rise the incidence of cholelithiasis, while mild depression may not. Further validation through prospective studies is necessary.

Purpose: Adult separation anxiety disorder (ASAD) is thought to be prevalent and debilitating, yet many aspects of its epidemiology remain unclear. We aimed to investigate prevalence, course, correlates, comorbidity, impairment, and treatment of ASAD in Saudi Arabia.

Methods: The study analyzed a subset of 1793 participants from the Saudi National Mental Health Survey; a nationally representative household sample of Saudi citizens. The survey used the CIDI 3.0 to produce prevalence estimates of ASAD and other common DSM-IV mental disorders. Cross tabulations, survival analysis and logistic regression were used to analyse the data.

Results: The lifetime and 12-month prevalence of ASAD were 7.6% and 3.8%, respectively. Over half (51.7%) of participants with lifetime ASAD had onset in adulthood, and 50.5% of those with lifetime ASAD also had 12-month ASAD. Lifetime ASAD was significantly associated with being female (OR = 2.1), not being married (ORs = 2.2-3.2), having low education (OR = 0.4), and maladaptive family functioning (ORs = 3.6-6.7). Primary lifetime ASAD was a strong predictor of subsequent other mental disorders (ORs = 1.1-6.5). Further, mood, impulse, and substance use disorders were significantly associated with subsequent first onset of ASAD (ORs = 2.15-3.0). ASAD was severely impairing in the presence (59.0%) or absence (56.2%) of 12-month comorbidity. Among those with lifetime ASAD, only 26.1% reported treatment for a mental health condition.

Conclusion: ASAD is prevalent, with a persistent course and associated impairment, as well as substantial comorbidity and limited treatment in Saudi Arabia. Increasing awareness, early diagnosis, and treatment of ASAD may help reduce its burden.

Background and aim: Increasing numbers of people are unable to work due to mental illness and this is an increasing problem on both a personal and societal level. In Germany, a workplace integration management system (BEM) has been legally required since 2004 to support return to work (RTW). However, its uptake and success, especially regarding mental illnesses, is still unclear. This study was conducted to identify the current state of RTW after episodes of mental illnesses from the perspective of workplace integration managers and explore potential barriers and facilitators that influence the course and outcome of the BEM process.

Methods: Semi-structured interviews with BEM managers (N = 14) from the greater Munich area were performed and analyzed using Thematic Analysis.

Results: In their work, BEM managers tend to find themselves in a field of tension between the personal concerns of returning employees and the employer's business interests. They experience mistrust and lack of openness on the part of the returnees, while employers show little willingness to fully invest in the process. Lack of or incorrect information about BEM and on mental illness seems to promote these disruptive factors, as well as others.

Conclusion: Broad education on BEM appears to be a promising means to reduce fear among returnees and to better reach the processes potential. In addition, a more open approach to mental illness could simplify the process for all involved.

Purpose: While social support is widely viewed as a protective factor against posttraumatic stress disorder (PTSD), few studies have directly tested whether social support buffers the long-term effects of pre-existing PTSD symptoms or baseline combat exposure among Veterans (i.e., the stress-buffering hypothesis).

Methods: To address this gap, the current study tested perceived social support as a moderator of the effects of baseline PTSD symptoms and combat exposure on PTSD symptoms at 10-year follow up in a sample of post-911 Veterans (N = 783).

Results: Higher levels of combat exposure and baseline PTSD symptoms predicted elevated PTSD symptoms at 10-year follow-up. Perceived social support moderated these effects, such that the impacts of baseline symptoms and combat exposure were attenuated for Veterans with high levels of perceived support. However, buffering effects were less evident at higher levels of combat exposure and were not significant at very high levels of baseline PTSD symptoms.

Conclusion: While findings are broadly consistent with the stress-buffering hypothesis, results of the present study suggest that the benefits of perceived social support may be less evident at higher levels of combat exposure. Results also offer preliminary evidence that perceived social support is less protective for Veterans with severe pre-existing symptoms.

Background: Ageism and ageing anxiety are obstacles to health equity in the community. This study aims to assess ageism and ageing anxiety in Egypt and to elaborate on factors associated with ageism among Egyptians.

Method: We conducted a cross-sectional online survey on 359 adult Egyptians using a predesigned questionnaire to assess socio-demographic factors, the Fraboni Scale on Ageism (FSA), the Ageing Anxiety Scale (AAS), one question about contact with older adults, and another question about religiosity.

Results: The mean age of respondents was 27.91 years (SD = 8.99), with over half aged between 18 and 25 years, and the majority being women (68%). The mean total score of ageism was 72.79 (6.3) out of 116, while the mean total score of anxiety of ageing was 54.33 (8.83) out of 100. Male gender (B = 0.117, p = 0.024), infrequent contact with older adults (B = 0.163, p = 0.002), ageing anxiety (B = 0.238, p = 0.000), and insufficient income (B = 0.202, p = 0.007) were associated with increased ageism scores.

Conclusion: The observed associations between ageism and factors such as male gender, infrequent contact with older adults, insufficient income, and ageing anxiety highlight the potential need for focused educational initiatives. Implementing comprehensive educational programs that not only inform individuals about the ageing process but also promote positive intergenerational interactions could serve as a promising strategy to combat ageism.

Purpose: Loneliness has been identified as an important risk factor for mental health problems, and concern about its impact on workers' health and wellbeing has grown in recent years. While a body of workplace loneliness research is emerging, the degree to which existing definitions of the phenomenon reflect workers' experiences has not been investigated. This study aims to develop an evidence-based conceptualisation of workplace loneliness that can inform future research and interventions aiming to improve workers' mental health and wellbeing.

Methods: Semi-structured interviews exploring experiences of social connection, loneliness and work were conducted with a diverse sample of 31 UK-based workers. The interviews were supplemented with a social mapping task. Interview data were analysed inductively using reflexive thematic analysis. Social maps were analysed using a thematic analysis approach informed by a visual semiology framework.

Results: Three themes were identified, in which loneliness was conceptualised as disconnection from (1) colleagues, (2) one's organisation, and (3) society. Across each theme, disconnection and loneliness were experienced as an unfulfilled desire to feel that one's authentic self was understood, valued or belonged as a result of one's work or occupation.

Conclusions: Workplace loneliness comprises not only dissatisfaction with interpersonal relationships at work, but also a sense of disconnection from larger social groups and structures, particularly one's employing organisation and society as a whole. Definitions of workplace loneliness that acknowledge the role of the social and organisational context, as well as professional relationships, are needed to better reflect the lived experience of loneliness at work.