Social Psychiatry and Psychiatric Epidemiology最新文献

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.

Purpose: Attention Deficit Hyperactivity Disorder (ADHD) and concurrent psychiatric comorbidities have been thoroughly investigated but less is known on how ADHD symptoms predict subsequent psychiatric disorders. The aim of this study is to examine whether ADHD symptoms in adolescence predict adult psychiatric disorders in a longitudinal unselected population-based cohort.

Methods: The study is based on the Northern Finland Birth Cohort 1986 (N = 9432), in which ADHD symptoms had been measured with the parent-filled Strengths and Weaknesses of ADHD Symptoms and Normal Behaviours (SWAN) questionnaire at the age of 16 years. Adult psychiatric disorders were retrieved from the nationwide registers up to age 35 years. The population was divided into tertiles based on ADHD symptoms and the correlations between middle and highest tertiles and certain later psychiatric disorders were examined with logistic regression analyses, taking family type, parents' education and adolescent-reported psychiatric symptoms as covariates.

Results: Among females, ADHD symptoms in adolescence predicted later anxiety and depressive disorders in both the crude and adjusted models for the middle and highest tertiles and substance use disorders in the highest tertile. The highest risk was associated with substance use disorders. In males, only anxiety disorders could be predicted for the middle and highest tertiles in all the analyses.

Conclusions: ADHD symptoms in adolescence predict multiple psychiatric disorders among females and anxiety disorders among males. ADHD symptoms should be addressed as soon as they appear even if they do not fulfil the diagnostic criteria for ADHD. More research needs to be done into this question.

Purpose: While transgender and non-binary (TNB) people face stress and oppressions placing them at greater risk of depression and anxiety compared to cisgender people, little research has explored mental health differences between subgroups. Drawing on an intersectionality framework, which examines how oppressive forces interact to impact health, this study investigated intersecting factors associated with mental health outcomes among TNB people in Canada.

Methods: Data were from Trans PULSE Canada's 2019 community-based, national survey of health and wellbeing among TNB people. Respondents reported sociodemographic characteristics, sex work history, disability, neurodiversity, sense of belonging in TNB spaces, and mental health. We conducted three conditional inference tree analyses to determine the combinations of social factors that predict depression, anxiety, and thriving.

Results: Analyses included 2058 respondents (Mean age = 31.1, SD = 11.1). Reporting age 16-49 years, physical/visible disability, sex work history, and/or lower socioeconomic status generally predicted poorer mental health. Among respondents below the low-income threshold, a sense of belonging in TNB spaces was associated with more thriving, but only if they were not autistic. For individuals with physical/visible disability, a sense of belonging predicted greater thriving and less depression.

Conclusion: Results highlight intersecting social and structural factors associated with increased risk of poor mental health among specific groups of TNB people, including lower socioeconomic status and/or a physical/visible disability, or being < 50 with a history of sex work. Individuals with better mental health reported more belonging in TNB spaces, which may suggest that sense of belonging in TNB spaces is protective.

Trial registration: Not applicable.

Background: Grief, a universally experienced response to death of a loved one, carries distinct emotional and behavioral dimensions. This study examines the psychometric properties and factorial validity of the Arabic adaptation of the Inventory of Complicated Grief (ICG), along with mediation pathways between emotional distress (anxiety, depression, and stress) and grief dimensions, moderated by resilience, life satisfaction, and religiosity.

Method: Data were collected from a sample of 423 Arabic-speaking adults residing in Libya and affected by the Libyan wars, ranging in age from 18 to 52 years (M = 29.93, SD = 6.73) RESULTS: Confirmatory factor analysis revealed a two-factor structure, cognitive/emotional symptoms. Convergent validity showed significant positive correlations between ICG scores and measures of psychological distress (anxiety, r = .24; depression, r = .22). Discriminant validity was confirmed through negligible associations with resilience (r = -.25) and satisfaction with life (r = -.12). Mediation analyses identified resilience as a significant mediator in pathways from distress to grief symptoms (anxiety to cognitive/emotional symptoms via resilience, estimate = .13, p = .023). Satisfaction with life and religiosity displayed limited indirect effects, underscoring the dominant role of resilience.

Conclusion: These findings reinforce the suitability of the Arabic ICG as a reliable tool for assessing grief in Arabic-speaking populations, while highlighting the protective role of resilience in grief management. Implications extend to culturally sensitive interventions and resilience-building therapeutic approaches.

Purpose: To assess the burden of anxiety disorders in the elderly and temporal trends at global, regional, and national levels during 1990-2021.

Methods: Data on incidence, prevalence, and disability-adjusted life years (DALYs) of anxiety disorders in the elderly over 60 years old were extracted from the Global Burden of Disease Study 2021. Average annual percentage changes were determined to analyze the trends in age-standardized rates between 1990 and 2021. Correlation between age-standardized rates and Socio-demographic Index (SDI) was assessed using Spearman's rank-correlation analysis. We used a meta-regression model to estimate the incidence, prevalence, and DALY rates before and during the COVID-19 pandemic.

Results: In 2021, 4.49 million incident cases, 53.07 million prevalent cases, and 5.83 million DALYs were estimated in the elderly worldwide. The age-standardized incidence rate of anxiety disorders in older adults increased slightly, while prevalence and DALY rates remained stable. Middle SDI regions had the highest number of incident cases, prevalent cases, and DALYs, with the highest age-standardized prevalence and DALY rates in high SDI regions. Age-standardized prevalence and DALY rates of anxiety disorders were higher among elderly women than men. During the COVID-19 pandemic, the incidence rate of anxiety disorders among older adults rose by 7.82%, while prevalence and DALY rates increased by approximately 6%.

Conclusion: Over the past three decades, the increasing burden of anxiety disorders among older adults has significantly added to the global mental health challenges. This burden is intensified by socioeconomic factors, especially in middle SDI regions, and exacerbated by the COVID-19 pandemic.

Background: Adolescents frequently experience symptoms of mental disorders (SOMD) and engage in health risk behaviors (HRB), both of which significantly contribute to global disability and mortality. Despite this, data on these issues remain limited in low- and middle-income countries (LMICs), including Vietnam. This study aims to estimate the prevalence of SOMD and HRB and examine their associations among high school students in Vietnam.

Methods: A cross-sectional survey was conducted with 3,025 students from four high schools and four continuing education centers across Ho Chi Minh City. Participants completed a self-administered questionnaire capturing demographic information, HRB (using the YBRS scale), and SOMD (using the DASS-21 screening scale). SOMD assessments focused on symptoms of depression, anxiety, and stress rather than clinical diagnoses, while HRB covered substance use, risk-taking, physical fighting, suicidal ideation, unsafe sexual behaviors, unhealthy diet, physical inactivity, and sleep deprivation.

Results: Of the 2,631 students included in the analysis, prevalence rates were 42.6% for symptoms of depression, 50.3% for symptoms of anxiety, and 31.1% for symptoms of stress. Engagement in HRB varied widely, from 4.0% for unsafe sexual behaviors to 79.9% for physical inactivity, with 91.6% reporting involvement in multiple HRB. Students experiencing SOMD were significantly more likely to engage in HRB compared to those without SOMD, with odds ratios ranging from 1.24 to 4.64.

Conclusion: SOMD and HRB represent dual and interrelated challenges among Vietnamese adolescents, underscored by their high prevalence. These findings emphasize the critical need for integrated interventions addressing both mental health symptoms and health risk behaviors, especially in resource-constrained LMIC settings.

Purpose: The aim of this study is to examine if the social inequality in adolescent mental health has changed in the past decades (2002-2022) by studying the associations between socioeconomic status (SES) and mental health measures in 15-year-old adolescents.

Methods: This study is a register-based study consisting of seven cross-sectional analyses of associations between adolescents' SES, defined as family income and parents' educational level, and mental health, defined as mental disorder diagnosis and medication use. The population consists of all registered residents in Denmark who turned 15 years in the years 2002-2022. All data was obtained from Danish population-based registers. The prevalence of mental health measures was calculated, and the associations between SES and mental health were analysed with log-binomial regression.

Results: The prevalence of mental disorder diagnoses and medication use of adolescents increased during the past two decades. Associations between SES and mental health were found between all measures during the period, however, a trend toward decreasing associations for low-SES groups and stable odds ratios for high-SES groups compared to the middle-SES were observed. Diagnosis-specific analyses-including eight diagnostic categories-revealed divergent trends, such as increasing associations for SES and substance use disorders and decreasing associations for SES and mood disorders.

Conclusion: This study highlights persistent but evolving social inequalities in adolescent mental health in Denmark from 2002 to 2022. While the prevalence of mental health diagnoses increased, changes in inequality patterns were diagnosis-specific, suggesting that broader societal trends may influence types of mental disorders differently.

Purpose: To examine Universal Credit (UC) trajectories, and transitions between UC conditionality regimes among secondary care mental health service users. Sociodemographic and diagnostic characteristics associated with UC trajectories were explored.

Methods: Mental health record data from 4876 individuals who attended mental health services were linked with administrative benefits data. An entry cohort was created including mental health service users who had received UC in 2016 and followed up for 4.5 years. Sequence analysis was used, followed by cluster analysis to identify typical UC trajectories. Sociodemographic and diagnostic characteristics associated with UC clusters were explored using multinominal logistic regression; results were presented as average marginal effects.

Results: Six distinct UC clusters were identified. These clusters indicated: short-term UC searching for work (18.7%), medium-term UC searching for work (19.1%), long-term UC searching for work (21.4%), no work requirements (11.9%), UC working cluster (6.1%), and no work searching and caring responsibilities cluster (22.8%). Women were overrepresented in the medium-term UC searching for work cluster whereas older people were more likely to be in the long-term UC searching for work and no work requirements clusters. Those diagnosed with severe mental illness were overrepresented in the no work requirements group.

Conclusion: Most trajectories were dominated by those required to search for work albeit for different time periods before exiting UC. One in ten people were assessed as unable to work for an extended period. Findings can be used to inform support for people with mental health problems vulnerable to conditionality or longer-term UC receipt.

Purpose: There is a lack of multigenerational research on the extent to which mental health is informed by transmission of multiple disadvantages across previous generations. This study aims to investigate how family socioeconomic and psychosocial disadvantages cluster and transition over grandparental and parental generations, and how this might be associated with grandchild psychiatric disorders.

Methods: We utilized a cohort study with data following three generations from the Stockholm Birth Cohort Multigenerational Study, including 11,299 individuals born in 1953 (parental generation), their 22,598 parents (grandparental generation), and 24,707 adult children (grandchild generation). Family disadvantages as exposures were measured across two periods- grandparental adulthood (parental childhood) and parental adulthood (grandchild childhood), and included socioeconomic (i.e., low income, non-employment, overcrowding, and single parenthood) and psychosocial aspects (i.e., single parenthood, teenage motherhood, psychiatric disorders, and criminality of father). Psychiatric disorders in the adult grandchildren as outcome were defined by hospitalizations with a main or contributing diagnosis reflecting mental and behavioral disorders from age 18 until 2019.

Results: Multiple disadvantages within the grandparental and parental generations, respectively, predicted higher probabilities of grandchild psychiatric disorders. Multigenerational transmission is evident in that grandchildren with combinations of grandparental socioeconomic disadvantages and parental psychosocial disadvantages had comparably high probabilities of psychiatric disorders. Importantly, improved socioeconomic and psychosocial circumstances across previous generations predicted comparably low probabilities of grandchild psychiatric disorders.

Conclusion: Mental health of future generations is informed by the transmission of multiple disadvantages across previous generations, and the transition from grandparental socioeconomic disadvantages into parental psychosocial disadvantages is particularly important.