Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: Psychotic like experiences (PLEs) are relatively common during adolescence and associated with a range of negative outcomes. There is evidence that sexual minorities are at increased risk of mental health problems including depression, anxiety, self-harm and suicidality. However, no study has investigated the association between sexual orientation and psychotic experiences during adolescence. We compared trajectories of PLEs in sexual minority and heterosexual adolescents from 12 to 24 years of age.

Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants provided data on sexual orientation at age 16 and PLEs at ages 12, 17 and 24. We used multi-level logistic regression models to test associations between sexual orientation and PLEs, before and after adjusting for covariates. We investigated whether the association differed according to time-point and sex using interaction terms.

Results: We found evidence that the odds of PLEs were 2.35 times (95% Confidence Interval 1.79-3.06, p < 0.0001) higher among sexual minority compared with heterosexual adolescents, across all ages, after adjusting for covariates. There was no evidence that the association between sexual orientation and PLEs differed according to time-point (p = 0.50) or sex (p = 0.29).

Conclusion: We found an increased risk of psychosis in sexual minorities compared with heterosexuals, which was present from around 12 years of age and persisted until age 24. Early interventions to prevent this mental health inequality could include universal interventions to promote inclusivity and acceptance of diverse sexual orientations.

Purpose: An increase in excessive Internet use (EIU) among adolescents during the COVID-19 pandemic was suggested in many studies. However, these studies were mostly based on cross-sectional and/or unrepresentative samples.

Methods: Using data from a nationwide Finnish school survey in the years 2017, 2019 and 2021 (N = 450,864; aged 13-20 years), changes in the prevalence of EIU (EIUS, 5-item) were assessed. The effects of COVID-19 (year 2021 vs. 2017/2019 combined) and linear trend were analyzed in logistic regression models. Models were adjusted for loneliness, depression, anxiety, and sociodemographic factors.

Results: Among males, EIU prevalence varied minimally (7.8-8.1%) from 2017 to 2021. Among females, the prevalence increased from 6.8 to 11.7% and the effect of COVID-19 was significant (OR = 1.53; p < 0.001). Including the linear trend in the model turned the COVID-19 effect on EIU among females non-significant (p = 0.625), whereas the trend was significant (OR = 1.17; p < 0.001). Adjusting the models with mental health-related factors attenuated the effect of COVID-19 to some extent, but not the effect of linear trend.

Conclusions: There is a sex difference in the way the prevalence of EIU developed from 2017 to 2021 among Finnish adolescents. In males, there was no indication of increased prevalence of EIU and among females, while the effect of COVID-19 was first found, it was also suggested to be a product of a trend already started before the COVID-19 pandemic. These results are in contrast with some earlier studies suggesting an effect of COVID-19 on EIU.

Background: Since 2015, ~ 8 million Venezuelans have fled what was once Latin America's most prosperous nation, with many relocating to nearby Colombia and others migrating to the United States (U.S.). Emerging research suggests that migration-related cultural stress is a challenge for Venezuelans and is related to an increased risk of mental health problems. However, it remains uncertain how cultural stress and mental health outcomes manifest over time and across countries.

Methods: We use independent sample t-tests to compare survey data from multiple studies of Venezuelan migrants in Bogotá and Medellín, Colombia, and the U.S. State of Florida. Data collected include self-report measures on discrimination, negative context of reception (NCR), and depression and post-traumatic stress disorder (PTSD) screening diagnoses, collected from distinct cross-national cohorts in 2017 (N = 638) and 2023-2024 (N = 1241).

Results: Self-reported NCR and discrimination were consistently higher among Venezuelan migrants in Colombia than among Venezuelans in Florida. Levels of cultural stress within countries were variable, with NCR decreasing across years in Florida and discrimination increasing in both Florida and Colombia. Many Venezuelan migrants reported symptoms of mental health problems, with half of the sample in Colombia (54-56%) and two-fifths of the sample in Florida (39-41%) screening positive for depression in 2017 and 2023-2024. Individuals exposed to higher levels of cultural stress were substantially more likely to screen positive for depression and PTSD.

Conclusions: This study is the first to examine cultural stress and mental health among Venezuelan migrants across national contexts and different stages of the still-unfolding international migration crisis.

Purpose: To estimate the time trend in the prevalence of suicidal behaviors including ideation and attempts in Chinese adolescents; to examine the association between suicidal behaviors and overweight (OW)/obesity (OB) and self-perceived weight status.

Methods: Data from Youth Risk Behavior Surveys conducted in Ningbo in 2007, 2012, 2017 and 2022 were used for the study. A multistage sampling procedure was used to select respondents aged 12 to 19 years who participated in each survey. Repeated cross-sectional data of anthropometry, weight perception and suicidal behaviors were collected through self-administered questionnaires. A generalized linear model was used to assess associations of ideation and attempts, and weight status and self-perceived weight status.

Results: The sample sizes for each survey wave were 937, 889, 1528 and 2655. The prevalence of ideation increased from 11.95% in 2007 to 18.15% in 2022, while the prevalence of attempts remained stable (4.48%-4.26%). An increasing trend in ideation and attempts was found in adolescents who were OW/obese and self-perceived OW/OB from 2007 to 2022. Self-perceived OW/OB adolescents had a significant increase in ideation. Girls had higher likelihood of ideation and attempts for both weight status and self- perceived weight status. While, adolescents aged 12.0-15.9 years had higher odds of ideation than those aged 16.0-19.9 years.

Conclusion: Adolescents' self-weight perception, rather than actual weight status, is a critical risk factor of increased likelihood of ideation and attempts in Chinese adolescents. Our findings can support to promote self-esteem growth in school-based health education programmes for prevention of suicidality and psychological health problems.

Purpose: Recent evidence shows that loneliness is associated with socioeconomic factors. However, studies often focus on traditional socioeconomic indicators (income, occupation, educational level) only, disregarding other important socioeconomic determinants, such as job insecurity, housing conditions or material deprivation. Therefore, we analyse the association of a broad range of socioeconomic indicators with loneliness. Moreover, we investigate potential age and gender differences in this relationship.

Methods: We used cross-sectional data from the Barcelona Health Survey 2021, representative of the population of Barcelona (Spain). Individuals over the age of 14 were selected (n = 3,337). The outcome was a loneliness score based on 4 items of the UCLA scale. Loneliness was regressed on a series of sociodemographic and emerging socioeconomic correlates. Linear regression models were fitted, and potential age and gender moderation effects were tested by means of two-way interactions.

Results: Job insecurity and precarity-related factors, such as having a temporary job or working without a contract, material deprivation and financial difficulties, as well as poor housing conditions and facing housing insecurity were associated with increased loneliness levels. While the association between loneliness and precarity-related factors is stronger among younger individuals, material deprivation is associated with increased loneliness among older workers and women.

Conclusion: Beyond sociodemographic individual characteristics, socioeconomic factors are strongly associated with loneliness levels in the population. Findings support the relevance of broadening the scope of socioeconomic indicators, assessing both material conditions as well as perceived insecurity.

Purpose: This study aimed to explore the relationship between the masculine norm of self-reliance and suicidal thoughts among Australian men, hypothesising that lack of help-seeking might mediate the relationship between high self-reliance and the emergence of suicidal thoughts.

Methods: This study used data from on the Australian Longitudinal Study on Male Health 'Ten to Men', a prospective longitudinal cohort study that began in 2013/2014 with boys and men aged 10-55 years (N = 16,021) at wave 1. The focus was on men who participated in waves 1 and 2 (2013/2014, 2015/2016) and had linked administrative data. A causal mediation analysis was conducted to quantify the total effect of self-reliance at wave 1 on suicidal thoughts at wave 2, and to investigate the extent of mediation by help-seeking between waves 1 and 2.

Results: High self-reliance was associated with an increased odds of suicidal thoughts (OR = 1.46, 95% CI 1.24-1.72). However, there was no significant mediating effect of a lack of help-seeking on the relationship between self-reliance and suicidal thoughts (OR = 1.00, 95% CI 0.99-1.01).

Conclusion: Findings suggest that highly self-reliant men are at an increased risk of experiencing suicidal thoughts; however, this relationship is not explained by lack of help-seeking. Future studies could explore other potential mechanisms to better understand why highly self-reliant men are more likely to experience suicidal thoughts.

Introduction: Deliberate self-harm (DSH) is a public health concern and the high rates among adolescents and females warrant continuous monitoring. The aim of this study was to determine trends in DSH rates by gender and age in Denmark during 2000-2021 using joinpoint regression analysis.

Methods: A cohort design was applied to national register data on all individuals aged 10 + years living in Denmark during 2000-2021. DSH episodes were identified in somatic and psychiatric hospital data. Sex- and age-specific incidence rates (IR) were calculated by calendar years. Using joinpoint regression analyses, segments of change and their annual percent change (APC) were identified.

Results: The highest DSH rates were observed for males and females aged 19-24 years with IRs of 146.8 (95% CI 142.9-150.7) and 378.6 (95% CI 372.1-385.0) per 100,000 person-years, respectively. Major changes in DSH rates were found for the youngest age groups. A step decrease was found for males aged 19-24 years (-18.4; 95% CI -31.9- -2.3; p = < 0.030) during 2012 to 2015. A significant decline was observed during 2012-2016 for females aged 19-24 years (-18.9; 95% CI -26.8 - -10.2; p = 0.001). Poisoning was the most frequently used method.

Conclusion: Seemingly, the financial recession in 2008 did not affect Danish DSH rates. Significant declines were observed for females in the years where means restrictive measures had been installed; thus, supporting their potential effect. Fluctuations in DSH rates among adolescents and young adults in recent years underscore the importance of continued monitoring.

Purpose: To assess the risk of acute infections in patients with first ever diagnosed depression compared to patients with no diagnosed depression in a primary-care database.

Methods: We conducted a cohort study using the UK CPRD GOLD database (2000-2019). We identified patients aged 18 years or older with a recorded Read code for depression (cohort entry date) and compared them to patients with no Read codes for depression using risk set sampling. Comparison groups were frequency-matched on age and sex, and comparison patients were required to have ≥ 1 general practitioner (GP) contact within 14 days before cohort entry. The primary outcome was a composite of outpatient diagnosed acute infections, including respiratory, gastrointestinal, urogenital infections and septicemia) within the two-years after cohort entry. We applied propensity score fine stratification and estimated incidence rates and IR ratios (IRR) using negative binomial regression.

Results: In a weighted population of 285,922 patients with diagnosed depression and 285,921 comparison patients, the IR of acute infections was 97.3/1000 person-years (py) in patients with and 83.7/1000 py in patients with no diagnosed depression. The weighted IRR of acute infection was 1.18 (95% CI 1.16-1.20) comparing those with and with no diagnosed depression. Excluding patients with baseline comorbidities yielded an IRR even closer to the null: 1.07 (95% CI, 1.04-1.09).

Conclusions: Our results suggest that patients with diagnosed depression are not at a meaningfully increased risk of acute infections compared to patients with no diagnosed depression. Slightly increased overall relative risks of infections can be explained by residual differences in health care utilization and by the severity of comorbidities.

Purpose and objective: Anxiety poses a significant challenge for women of reproductive age globally, often leading to other mental health issues. However, research on anxiety prevalence among this demographic, particularly in Nepal, remains scarce. This study aims to fill this gap by identifying demographic, biological, and behavioral predictors of anxiety among reproductive-aged women in Nepal.

Method: Using data from the nationally representative Nepal Demographic and Health Survey 2022, this study employed the Generalized Anxiety Disorder (GAD-7) scale to assess anxiety prevalence. Descriptive and inferential statistics, including one-way ANOVA and stepwise multiple regression, were utilized for identifying the potential predictors of anxiety.

Result: This study found that 22.2% of reproductive-aged women in Nepal experience moderate to severe anxiety. The stepwise multiple regression revealed seven most influential factors, with depression (mild, moderate, severe) being the most influential predictor of anxiety, explaining 51.8% of the variance (R square change = 0.518; Sig. =<0.001). Self-reported health status (R square change = 0.010; Sig.=<0.001), experienced emotional violence (R square change = 0.007; Sig.=<0.001), and pregnancy termination (R square change = 0.002; Sig.=0.001) accounted for 1.0%, 0.7%, and 0.2% of the variance in anxiety, respectively. Other significant predictors of anxiety included husband's alcohol consumption, genital discharge, and household wealth status.

Conclusion: Anxiety is substantially prevalent among reproductive-aged women in Nepal, with sociodemographic factors playing a crucial role. Further research is needed to develop targeted socioeconomic, and behavioral interventions aimed at addressing anxiety and its broader impact on daily life, thereby ensuring the mental well-being of women of reproductive age.