Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: How well the over 200,000 U.S. servicemembers who complete military service each year navigate the transition to civilian life may impact their later-life outcomes, with smoother transitions increasing resilience to later life stressors and leading to better long-term outcomes. The purpose of this study was to examine whether veterans who experience better military-to-civilian transitions are less vulnerable to poor mental health when faced with later stressors.

Methods: Data were drawn from a population-based sample of U.S. veterans (N = 9,566) who completed six biannual surveys on their health and well-being throughout the first three years following separation from military service (2016-2019), and another a year into the COVID-19 pandemic (2021). We examined veterans' vocational, financial, and social readjustment patterns using latent growth modeling and impacts on subsequent mental health using logistic regressions.

Results: The majority of veterans reported consistently high vocational and social well-being but low financial well-being during the initial transition from service, with approximately 15% reporting declining well-being in each domain. In turn, well-being trajectories predicted veterans' odds of experiencing probable mental health conditions (depression and anxiety) during the pandemic, even after accounting for background characteristics, prior mental health, and additional stressful/traumatic experiences. In contrast with those with consistently low well-being, those with initially low then increasing vocational, financial, and social well-being reported similar mental health as those with consistently high well-being.

Conclusions: These results underscore the importance of bolstering support for transitioning veterans and point to strategies that can be applied to improve their longer-term mental health.

Purpose: Agricultural producers face unique stressors that significantly impact mental health, including depressive symptoms, anxiety, and suicidal ideation. This study offers a novel application of the Stress Process Model (SPM) to examine how agriculture-related stress, social support, and resilience shape mental health outcomes among agricultural producers.

Methods: N = 525 Illinois farmers participated in mailed surveys, with data collected in two panels: June-August 2020 (N = 296) and March-May 2021 (N = 229). Participants completed the Perceived Stress Scale, Farm Stress Survey, Multidimensional Scale of Perceived Social Support, and Brief Resilient Coping Scale. Mental health outcomes were assessed, along with general health. Data was analyzed using structural equation modeling in R.

Results: Higher perceived and agricultural stress were linked to increased depressive symptoms, anxiety symptoms, and suicidal ideation. Social support reduced depressive symptoms (β = -0.121, p < .001) and suicidal ideation (β = -0.216, p < .001), mediating and moderating the relationship between stress and mental health. Resilience moderated the effects of stress, lowering depressive symptoms (β = -0.100, p = .001) and anxiety symptoms (β = -0.088, p < .001).

Conclusion: Findings highlight the importance of addressing occupational stress, enhancing social support, and promoting resilience to improve the health of agricultural producers. Interventions should target stress reduction and support systems based on the SPM framework.

Purpose: Physical illness describes long-term physical health conditions such as asthma, diabetes, and epilepsy. Mental or neurodevelopmental disorder (MND) that co-occurs with physical illness in childhood is associated with poorer outcomes for children and their families. There is a need for contemporary estimates of physical-MND burden to inform resource allocation and reduce occurrence. This descriptive study estimated the prevalence of morbidity status and compared prevalence of MNDs among children with or without physical illness.

Methods: Data come from the 2019 Canadian Health Survey on Children and Youth, a representative cross-sectional study conducted by Statistics Canada. Physical illnesses and MNDs were reported by the person most knowledgeable about the child.

Results: The sample included children aged 5 to 17 years (n = 33,715). In total, 49.5% of children had at least one physical illness and 17.9% had at least one MND. Physical-MND multimorbidity was reported for 9.8% of children. Among children with any physical illness, MNDs were present in 19.9%. Among children with no physical illness, the prevalence of MNDs was 14.1%. Differences in prevalence of MNDs across types of physical illnesses were small in magnitude (h=-0.02 to 0.35).

Conclusion: Findings show that childhood physical-MND multimorbidity is common, highlighting the need for screening of MNDs among Canadian children with physical illness. Integrated care models are necessary to comprehensively address the physical and MND health needs of children. These estimates of morbidity snapshot the time immediately prior to the COVID-19 pandemic and have critical utility as baselines for future post-COVID-19 studies.

Purpose: This study examines how different forms of social isolation, such as living alone, lack of community engagement, and unemployment, are associated with mental health in mid-life (ages 42-46), a life stage often overlooked when examining the impacts of social isolation.

Methods: Using longitudinal data (1999-2016) from two British birth cohort studies: 1970 British Cohort Study N = 16,585 and the 1958 National Child Development Study N = 15,806, this study investigated whether different forms of isolation have independent effects, contribute to cumulative risk, or interact additively or multiplicatively.

Results: Effects varied by isolation type and mental health outcomes. Being out of employment was linked to higher psychological distress and lower life satisfaction and self-rated health, while living alone was only associated with lower life satisfaction. Limited contact with friends and relatives and a lack of community engagement were associated with lower life satisfaction and self-rated health. Greater social isolation corresponded to increased psychological distress, lower life satisfaction, and poorer self-rated health, demonstrating cumulative risk. Effects appeared additive rather than multiplicative. No consistent sex or cohort differences were observed.

Conclusion: The study underscores the need to examine both separate and combined effects of social isolation across the complete mental health state. Isolation in its various forms was detrimental for mental health in mid-life and was most consistently linked to lower life satisfaction. Efforts to reduce isolation and its negative mental health impacts must recognise the complexity of these experiences.

Background: Anorexia nervosa is a severe psychiatric disorder with high morbidity and mortality. Traditionally linked to high-income regions, its recognition is growing in low- and middle-income countries. This study analyzes the global, regional, and national burden of anorexia nervosa from 1990 to 2021 using GBD 2021 data and offers projections to 2040.

Methods: Data on the prevalence, years lived with disability (YLDs), and age-standardized rates of anorexia nervosa were obtained from the GBD 2021 study, covering 204 countries and regions. The study used various statistical methods, including the Assessment of Health Inequalities, Frontier Analyses, Temporal Trend Analysis and Bayesian Age-Period-Cohort (BAPC) model, to analyze trends, regional disparities, and forecast future disease burden. Results were stratified by Socio-Demographic Index (SDI) regions, age, and gender.

Results: From 1990 to 2021, the global prevalence of anorexia nervosa increased by 38.79%, with YLDs rising by 38.57%. High-SDI regions consistently showed the highest burden of the disorder, with significant increases in both prevalence and YLD rates. In contrast, low-SDI regions exhibited lower burdens, likely reflecting underreporting and diagnostic challenges. Female populations continued to bear a higher burden than males, although the prevalence of anorexia nervosa among males has steadily increased. Forecasts to 2040 predict continued increases in disease burden, particularly among females.

Conclusions: Anorexia nervosa's global burden has risen, especially in high-SDI regions. The increasing prevalence, particularly among females, underscores the need for targeted public health interventions, early diagnosis, and culturally appropriate treatments. Projections show continued growth in the disorder's burden.

Purpose: To estimate how social disparities in child psychiatric symptoms might change following hypothetical interventions targeting sports, outdoor play, and screen time at age 10.

Methods: We used data from 9,778 children of the Generation R Study, a prospective population-based cohort in Rotterdam, the Netherlands. Social inequality variables included sex, maternal education, and migration background. Primary caregivers filled out the validated Child Behavior Checklist to report on children's internalizing and externalizing symptoms at the age of 13. The hypothetical interventions (i.e., outdoor play, sports participation, and screen time) were parent-reported at age 10. We used sequential G-estimation to estimate the inequality with and without the hypothetical intervention.

Results: Children with migration backgrounds (46.3%) and low maternal education (53.3%) were associated with relatively more internalizing and externalizing symptoms than peers, with disparities of 0.125 and 0.177 standard deviations, respectively. Girls had more internalizing symptoms (0.106 SD), while boys had more externalizing symptoms (0.154 SD). Increasing sports participation reduced disparities in internalizing symptoms linked to maternal education (β = -0.014; 95% CI: -0.024, -0.003), while outdoor play and screen time interventions showed limited effects. None of the hypothetical interventions led to a statistically significant reduction in social disparities in externalizing symptoms.

Conclusions: This study underscores the persistence of sex, cultural, and socioeconomic disparities in youth mental health. While sports participation showed a potential effect in reducing disparities in internalizing symptoms, its impact on externalizing symptoms and other interventions was negligible. Future efforts should focus on identifying more effective strategies for addressing these disparities.

Purpose: PAX Good Behaviour Game (PAX-GBG), a school-based mental health promotion approach, has been shown to improve children's mental health and academic outcomes. Given that these effects have yet to be shown in Indigenous populations, a partnership with First Nations communities was created to evaluate PAX-GBG's effectiveness among First Nations children living in Canada.

Methods: In this clustered randomized controlled trial, we used population-based administrative data that allowed de-identified individual-level linkages. Our cohort from 20 First Nations schools was assigned to PAX-GBG (n = 468) or wait-list control (n = 255). We used multi-level regression modeling and propensity score weighting to estimate group differences in mental health and academic outcomes over time (2011-2020).

Results: PAX-GBG group children had significantly greater decreases in conduct problems (β:-1.08, standard error(se):0.2505, p < .0001), hyperactivity-inattention (β:-1.13, se:0.3617, p = .0018), and peer problems (β:-1.10, se:0.3043, p = .0003) and a greater increase in prosocial scores (β:2.68, se:0.4139, p < .0001) than control group children. The percentage of PAX-GBG group children meeting academic expectations was higher than control group children. However, only third-grade numeracy (odds ratio (OR):4.30, confidence interval (CI):1.34 - 13.77) and eighth-grade reading and writing (OR:2.78, CI:1.01 - 7.67) were statistically significant. We found no evidence that PAX-GBG was associated with less emotional problems, diagnosed mental disorders, or greater student engagement or mathematics.

Conclusion: These findings suggest that PAX-GBG is a promising intervention in improving First Nations children's mental health and academic outcomes. What remains unclear is whether these findings are generalizable to all First Nations and how adding supports for program implementation would influence these findings.

Purpose: Participation rates in population-based health surveys have been declining for decades, with nonresponse bias being a serious threat to the validity and generalizability of results. The aim of the study was to examine differences between participants and nonparticipants invited to a psychiatric diagnostic interview survey in terms of sociodemographic and health characteristics, and use of health services for mental health problems, including diagnoses.

Methods: The study sample for the follow-up psychiatric diagnostic interview was recruited among participants in the fourth survey of the Trøndelag Health Study (HUNT4) in Norway. Information about sociodemographic and health characteristics was gathered from the main survey, while data on health service use was collected by linking records from primary and specialist patient registries with information about participation status.

Results: Male sex, younger age, being unmarried, having lower educational attainment, and having lower income were associated with higher odds for nonparticipation. Contact with the primary or specialist health services for mental health problems and hospitalization for a mental disorder more than a year before or after invitation date, were associated with lower odds for nonparticipation, especially for diagnoses indicating affective disorders, anxiety disorders, personality disorders, hyperkinetic disorders or milder mental complaints.

Conclusion: Contrary to most prior studies examining nonresponse bias, the results indicate that people who had been in contact with the health services for mental health problems were more inclined to participate in a survey focused on mental disorders. The direction of nonresponse bias should be carefully considered and adjusted for in population-based studies.