Social Psychiatry and Psychiatric Epidemiology最新文献

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).

Purpose: Attitudes toward schizophrenia and depression have evolved differently over the last decades, exposing people with schizophrenia to growing stigma. Classic descriptions of schizophrenia symptoms as being particularly unrelatable might offer an explanation for this gap in attitudes that has not yet been tested. We examine to what extent relatability explains the difference in social distance toward people with depression or schizophrenia.

Methods: We developed the 8-item "Relatability Scale", measuring to what extent people can relate to someone described as having either depression or schizophrenia, and used it in an online quota sample of 550 respondents in Germany. Beyond, we elicited the desire for social distance, continuum beliefs, emotional reactions, perceived dangerousness, general empathy, and previous contact.

Results: The Relatability Scale showed good psychometric properties and construct validity. Differences in relatability alone explained 63.6% of this difference in social distance between depression and schizophrenia. Adding continuum beliefs increased this amount to 83.0%. All other variables combined explained 53.2% of the difference in social distance between disorders.

Conclusion: Differences in both relatability and continuum beliefs seem key to understanding different reactions to someone with depression or schizophrenia. Anti-stigma interventions could be optimized in order to increase relatability and continuum beliefs particularly regarding people with severe, psychotic mental disorders.

Purpose: The aim was to examine the association between a wide range of potentially traumatic events (PTEs) experienced in childhood, adulthood or both, and hazardous alcohol use, including the relationship between the total sum of PTEs and hazardous alcohol use in middle aged and elderly adults. Previous studies have predominantly focused on childhood PTEs or isolated PTEs and more severe alcohol problems, little focus has been given to middle aged and elderly adults with hazardous alcohol use and PTE experiences.

Methods: We used logistic regression analysis to study the relation between a broad range of PTEs and hazardous alcohol defined by the alcohol use disorder identification test (AUDIT) in 19,128 women and men aged 40 years and above participating in the seventh survey of the Norwegian population-based Tromsø Study in 2015-2016. Alcohol abstainers were excluded from the analyses.

Results: Experience of violence, sexual abuse, bullying, painful or frightening medical and dental treatments, and serious illness or accident by a loved one were associated with higher odds for hazardous alcohol use. Further, there were higher odds of hazardous alcohol use per additional experienced PTE (OR = 1.22, 95% CI 1.20-1.25, p ≤ 0.001).

Conclusion: PTEs were prevalent among participants who had a hazardous alcohol use. Also, most of the PTEs occurring in childhood, adulthood or both were independently related to hazardous alcohol use. Moreover, the findings indicate an association in the relationship between the number of PTEs and hazardous alcohol use.

Purpose: Mental health problems among adolescents have become more prevalent in recent years. Parents' and siblings' mental health might be affected by living with a depressed adolescent. This study examines how the mental health of family members develops in the years before and after an adolescent seeks help for depression.

Methods: Unique Norwegian register data that cover the full population are used to estimate models with individual fixed effects. The development in the probability of mental health consultations for parents and older siblings in families with a second-born adolescent seeking help for depression from a GP for the first time is compared to the respective development in families where the second-born adolescent has not had such health care consultation.

Results: Results indicate that adolescents' depression consultations are associated with a simultaneous increase in mental health consultations in parents and siblings. Mothers and fathers are affected similarly, although the effect seems to be short-lived. Siblings experience a short-term increase in mental health consultations, in addition to a steeper long-term increase across the observation period, compared to peers in families where the second-born adolescent does not seek help for depression. Events that might affect the mental health of multiple family members simultaneously, specifically parental breakup and unemployment, did not explain the observed patterns.

Conclusion: Help-seeking for mental health problems is temporally aligned across family members. Intra- and intergenerational spillovers might contribute to this.

Background: A recent environmental systems theory of negative symptoms in schizophrenia (SZ) proposes a role for reductions in social networks that exist within microsystems (i.e., the contexts in which social interactions occur). However, it is unclear which aspects of social networks are most impacted in SZ and whether these are differentially associated with specific domains of negative symptoms. The current study aimed to address these gaps in the literature using a novel social network tool in combination with Ecological Momentary Assessment (EMA) and clinical ratings of negative symptoms.

Methods: Participants included 40 outpatients diagnosed with SZ and 35 demographically matched healthy controls (CN) who completed the sociogram, Brief Negative Symptom Scale (BNSS), and 7 days of EMA surveys assessing anhedonia, avolition, and asociality. ANOVAs examined group differences in social network characteristics. Correlations examined associations between social network characteristics and negative symptoms measured via the BNSS and EMA.

Results: Results indicated that: (1) SZ had greater social network reductions than CN, including lower: network density, number of microsystems, people in microsystems, connections across and within microsystems (p's < 0.05, d-value range 0.58 to 0.74); (2) these social network reductions were associated with greater severity of negative symptoms on the BNSS (r range - 0.28-0.34, p < .05) and asociality measured via EMA surveys (r's = - 0.24 to - 0.26, p's < 0.05).

Conclusions: Findings clarified the nature of social network dysfunction in SZ and identify novel targets for psychosocial interventions focused on modifying the number of social microsystems and the connections within/across these microsystems.

Background: The bidirectional phenomenon of homelessness and Mental Illness (MI) creates a vicious circle that is hard to escape. In India, Homeless Women with Severe Mental Illness (HWSMI) often rely on institutional care due to the absence of family or community alternatives, which distances them from socio-economic, cultural, political resources and the right to live with dignity. Hence, there is a need to develop a model that will help reintegrate HWSMI into the community.

Aim: We aimed to develop and validate (content and face validity) a supported housing programme (SHP) for HWSMI in Bengaluru, India.

Method: We developed the SHP using 1) a needs assessment from HWSMI (n = 14), 2) qualitative interviews with Mental Health Professionals (MHPs) (n = 18), and 3) visits to organizations (n = 3) involved in reintegration and supported housing for HWSMI. We articulated a Theory of Change (ToC) for the program. Three international experts and seven Indian experts reviewed the same.

Results: Five themes- Causes of homelessness/barriers to reintegration, consequences of homelessness, models/processes, facilitators, and needs of HWSMI and eighty sub-themes emerged from the qualitative thematic analysis of the interviews and observational visits. The themes and subthemes were organized as interventions in each phase of the SHP: Interventions in the tertiary care setting, transit home, and community.

Conclusion: We describe the development and validation of a comprehensive need-based SHP. We will implement and test the feasibility of the SHP for HWSMI.

Purpose: Stigma cultures in healthcare settings are the organizational-level norms values, assumptions, physical façades, and practices that govern day to day activities and interactions. Aspects include poor quality of care, coercive care, a punitive and patronizing atmosphere, and disempowerment to make treatment decisions. To evaluate the effectiveness of interventions to reduce stigma cultures in healthcare settings, valid and reliable measures are needed. This paper describes the development and preliminary testing of a measure to assess mental illness related stigma in healthcare cultures from the perspectives of service users.

Methods: Item generation was grounded in the lived experiences of people with a mental or substance use disorder (n = 20) reflecting their personal experiences with physical or mental healthcare encounters. Wherever possible, items were adapted from existing scales. Items were rated on a 4-point agreement scale with higher scores indicating higher stigma. Following the qualitative analysis, survey data (n = 2,476) were collected and exploratory and confirmatory factor analysis on split halves of the sample were conducted.

Results: The analyses provided statistical support for a 23-item unidimensional scale that could be used in any healthcare setting to assess key aspects of stigma cultures such as poor quality of care or lack of person-centered care. Reliability was high (0.92) and aggregated scale scores (ranging from 0 to 92) were approximately normal.

Conclusions: Though further testing is needed, the resulting Stigma Cultures in Healthcare scale is intended to be used across a range of physical and mental healthcare settings to assess the extent to which key aspects of care are experienced as stigmatizing by clients with mental or substance use disorders.

Purpose: Social isolation and loneliness have been long-standing public health concerns, and the coronavirus disease 2019 (COVID-19) pandemic has exacerbated these issues. Therefore, this study aimed to investigate the associations of social isolation and loneliness during the pandemic with experience of COVID-19 infection and hospitalization in the Japanese population.

Methods: Data were sourced from the Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale, web-based national survey of individuals aged 15-79. This study used JACSIS data from 2020 to 2022, representing the first and third years of the pandemic. Social isolation was measured by the frequency of direct and indirect contact with people other than co-residing family members. Loneliness was evaluated using the UCLA Loneliness Scale, while COVID-19 infection and hospitalization were self-reported.

Results: A total of 13,612 individuals were included, of whom 1.5% had experienced hospital admission due to COVID-19, and 9.3% were infected but not hospitalized. Social isolation was inversely associated with COVID-19 infection risk (odds ratio = 0.77; 95% confidence interval: 0.66-0.90), while a higher level of loneliness was related to hospitalization (odds ratio = 2.21; 95% confidence interval: 1.59-3.09). Sex-stratified analyses revealed stronger associations in men than women.

Conclusion: This study highlights the complex relationship between psychosocial factors and infectious disease outcomes, underscoring the need for comprehensive approaches to address the multifaceted challenges posed by global health crises.

Purpose: To determine the prevalence of childhood mental and emotional health concerns and care seeking patterns among foreign-born MENA children compared to US- and foreign-born White children before and after adjusting for covariates.

Methods: Data from the 2000-2018 National Health Interview Survey (NHIS) were analyzed. Poor toddler mental health in the past two months (2-3 years) and childhood emotional difficulties (4-17 years) in the past six months were measured. Parents also reported whether (yes/no) their child saw a doctor for behavioral or emotional concerns in the past 12 months.

Results: Parents of foreign-born MENA young children (ages 2-3 years) were less likely to report mental health concerns (44.8%) compared to US-born White counterparts (67.3%; p <.05). Parents of foreign-born MENA children were less likely to report emotional difficulties compared to US- and foreign-born White children (21.9% and 19.3%, respectively; p's < 0.05). Foreign-born MENA children with mental or emotional health concerns had lower odds of seeing a doctor in the last 12 months for emotional/behavioral problems (OR = 0.45; 95% CI = 0.24-0.86) or mental health concerns (OR = 0.47; 95% CI = 0.27-0.83) compared to their US-born White counterparts after adjusting for sociodemographic factors.

Conclusion: Parents of foreign-born MENA children reported fewer mental and emotional health concerns compared to US-born Whites. Those with mental and emotional health concerns were less likely to seek mental health care compared to their US-born White counterparts. Further research is needed to confirm and expand on these findings once a unique racial/ethnic identifier for MENA children is made available for measuring national mental health statistics.

Purpose: To explore the relationship between adverse childhood experiences (ACEs) and incident dementia, and examine the mediating effect of cognitive reserve-enhancing factors from life course perspective. Further, we verified the heterogeneities of associations of ACEs, enhancing factors, and dementia by dementia genetic risk.

Methods: Data was from the US Health and Retirement Study, involving 51,327 observations (50+) with a 10-year follow-up. Dementia was determined by the modified Telephone Interview for Cognitive Status. Six ACEs were assessed from two dimensions namely financial adversity and childhood trauma. Cognitive reserve-enhancing factors were rated during three periods of life-course, namely early-life stage (educational attainment,), adulthood (household income) and late-life stage (weekly physical activity). Genetic risk was evaluated by polygenic risk score for Alzheimer's disease. Cox regression models were conducted to examine the association between ACEs and dementia risk where ACEs were deemed as a continuous variable. "Mediation" package in R was used to test the mediating effect. Subgroup analysis was conducted to verify the heterogeneity of dementia genetic risk.

Results: Participants with one additional number of ACEs was associated with increased risk of dementia (HR = 1.08, 95% CI: 1.02, 1.16). The correlation of the number of ACEs and dementia was fully mediated by early-life stage enhancing factor and partially mediated by adulthood enhancing factor. The above mediating roles only exist among those with moderate and high dementia genetic risk.

Conclusion: Exposure to a larger number of ACEs is significantly linked to dementia, and cognitive reserve-enhancing factors might mediate this association. Early interventions on the adverse life condition and emphasis on older adults with moderate and high genetic dementia risk were recommended.