Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: Despite rich data on neighborhood safety perception's role in shaping depressive symptoms, a comprehensive view of this dynamic interplay remains a frontier. This study seeks to unravel the intricate interplay of neighborhood safety perception and depressive symptoms, utilizing the lens of social safety theory.

Methods: Employing the 2016 and 2020 waves of the China Family Panel Studies (CFPS), this study utilized ordered logistic regression (ologit) for statistical analysis. The approach encompassed descriptive analysis of variables, Spearman's correlation analyses to explore associations between variables, and a moderated mediation analysis. Sensitivity analyses were also conducted to affirm the robustness of findings against model assumptions and data processing techniques.

Results: The study uncovered a significant negative correlation between neighborhood safety perception and depressive symptoms (Direct effect =  - 0.338, Z =  - 2.564, p = 0.010). A key finding was the steeper slope of the relationship between neighborhood safety perception and neighborhood relation perception among individuals with a higher perception of neighborhood environment quality. As neighborhood environment quality perception increases, the strength of the mediated negative impact on depressive symptoms intensifies (- 0.102 >  - 0.132 >  - 0.162).

Conclusion: This study offers a comprehensive moderated mediation model that establishes a novel connection between neighborhood safety perception and depressive symptoms. It integrates the complexities of social safety theory and social information processes, revealing key strategies such as enhancing perceived neighborhood environment quality and neighborhood relationship quality.

Purpose: The effects of the COVID-19 pandemic on mental health issues such as depression and anxiety are well-documented in the literature, but its influence on suicidal patterns shows divergent results. We aim to comprehensively synthesize evidence on potential changes or stability of suicide rates during the COVID-19 pandemic worldwide.

Methods: A comprehensive search of studies reporting suicide rates before and during the COVID-19 pandemic was conducted. Eligible studies reported incidences of confirmed suicides (suspected in special cases) for two time periods, before (until February 2020) and during (from March 2020 to June 2021) the COVID-19 pandemic. A meta-analysis of proportions using a random-effect model was performed to estimate the pre- and during-pandemic incidence rates of suicide with 95% confidence intervals. Differences in pre- and during-pandemic rates were formally tested using a heterogeneity test.

Results: A total of 34 studies were included in the review capturing suicide data from over 40 countries and regions. The meta-analysis outputs did not indicate a significant change in suicide rates during the COVID-19 pandemic. The pooled suicide rate in the studied period before the pandemic was 11.38 per 100,000 (95% CI 9.35-13.42) and in the period during the pandemic was 10.65 per 100,000 (95% CI 8.61-12.68).

Conclusion: No significant change in suicide rates was observed during the COVID pandemic from a global perspective for the periods examined. A longer follow-up can provide additional insights into such suicide trends globally. Improvements in data reporting, specifically with implementation of real-time surveillance, is imperative to provide adequate suicide prevention and support.

Purpose: Delaying high school start times prolongs weekday sleep. However, it is not clear if longer sleep reduces depression symptoms and if the impact of such policy change is the same across groups of adolescents.

Methods: We examined how gains in weekday sleep impact depression symptoms in 2,134 high school students (mean age 15.16 ± 0.35 years) from the Minneapolis metropolitan area. Leveraging a natural experiment design, we used the policy change to delay school start times as an instrument to estimate the effect of a sustained gain in weekday sleep on repeatedly measured Kandel-Davies depression symptoms. We also evaluated whether allocating the policy change to subgroups with expected benefit could improve the impact of the policy.

Results: Over 2 years, a sustained half-hour gain in weekday sleep expected as a result of the policy change to delay start times decreased depression symptoms by 0.78 points, 95%CI (-1.32,-0.28), or 15.6% of a standard deviation. The benefit was driven by a decrease in fatigue and sleep-related symptoms. While symptoms of low mood, hopelessness, and worry were not affected by the policy on average, older students with greater daily screen use and higher BMI experienced greater improvements in mood symptoms than would be expected on average, signaling heterogeneity. Nevertheless, universal implementation outperformed prescriptive strategies.

Conclusion: High school start time delays are likely to universally decrease fatigue and overall depression symptoms in adolescents. Students who benefit most with respect to mood are older, spend more time on screens and have higher BMI.

Purpose: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores.

Methods: This study utilized self-reported survey data from 56,008 Canadian students (grades 7-12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10).

Results: RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score.

Conclusion: This study highlights RF's utility in identifying important correlates of adolescent depressive symptoms. RF's natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression.

Purpose: Though individuals with depression and those with poor working conditions are more likely to be on long-term sickness absence (LTSA), less is known about how working conditions may modify the associations between depression status and LTSA. This study aims to examine the association between depression and LTSA among Swedish workers with different levels of job strain and its individual components (job demands and job control).

Methods: All Swedish workers 30 - 60 years old (N = 3,065,258) were studied in 2005. At baseline (2005-2010), workers were categorized as: without depression, being prescribed antidepressants, and being in inpatient/outpatient care. Job strain was measured using a Swedish Job Exposure Matrix, and data on LTSA were obtained from 2011 to 2021. The association between depression and LTSA was assessed using Cox proportional-hazards regression stratified by categories of job strain.

Results: Compared to workers without depression, workers with depression had higher risk of LTSA across all job strain levels. Depression was associated with the highest hazards of LTSA in active jobs, but a similar population attributable fraction (PAF) was found across categories of job strain, indicating similarities between the different categories.

Conclusion: There was evidence of a moderating effect of job strain in the relationship between depression and LTSA, but also evidence that this was due to differences in baseline depression prevalence in the different job strain categories. Future research is needed to determine alternative factors which could be relevant for reducing LTSA among those who have already developed depression.

Purpose: To examine the dose‒response relationships of sedentary behavior (SB) and physical activities (PAs) with depression, and to explore the effects of replacing SB with PAs on depression risk.

Methods: The study used data from UK Biobank aged 37 to 73 years. Light physical activity (LPA), moderate-to-vigorous activity (MVPA), sleep duration, and total sedentary behavior (TSB) were measured by accelerometers. Self-reported SB was also adopted when daily screen-sedentary behavior time (SSB) and leisure-sedentary behavior time (LSB) were the focus. Incident depression was obtained from the part of mental and behavioral disorders in the "first occurrence fields" of UK Biobank. A Cox proportional hazard model and isotemporal substitution model were performed to explore the associations of LPA, MVPA, TSB, LSB, SSB, and sleep on depression and the effects of replacing SB time with equal PA time.

Results: Highest levels of MVPA (HR = 0.58, 95%CI: 0.50-0.68) were associated with decreased depression risk compared with the lowest level (Q1). Longer SSB time (HR = 1.18, 95%CI: 1.06-1.32), LSB time (HR = 1.19, 95%CI: 1.07-1.32), and TSB time (HR = 1.17, 95%CI: 1.00-1.38) could increase depression risk significantly. Replacing 1h/day TSB, SSB, and LSB with MVPA brought the greatest risk reductions [31% (HR = 0.69, 95%CI: 0.62-0.77), 30% (HR = 0.70, 95%CI: 0.65-0.77), and 29% (HR = 0.71, 95%CI: 0.65-0.77)]. Under the same conditions, the effects of LPA replacement were also significant, but weaker than those of MVPA. Subgroup analyses showed that replacing 1h/d TSB with LPA could significantly decrease the depression risk for the females, but not for the males.

Conclusion: Large benefits for reducing the risk of incident depression could be attained by replacing a period of TSB, SSB, or LSB with equal PA time, especially for MVPA. Regular PA and less SB were recommended for improving mental health.

Purpose: Household economic adversity during adolescence is hypothesized to be a risk factor for poor mental health later in life. To test this hypothesis, we conducted a quasi-experimental analysis of an economic shock, the Great Recession of 2007-2009. We tested if going through adolescence during the Great Recession was associated with increased risk of major depressive episodes (MDE) and mental health treatment in young adulthood with potential moderation by household poverty to explore differences by economic adversity.

Methods: We analyzed data on young adults age 18-29 years from the 2005-2019 National Survey on Drug Use and Health (N = 145,394). We compared participants who were adolescents during the recession to those followed-up prior to the recession. Regression analysis tested effect modification by household poverty status.

Results: Adolescent exposure to the Great Recession was associated with higher likelihood of MDE during young adulthood (aOR = 1.30, 95% CI = 1.23, 1.37); there was no relationship with mental health treatment. Effects on MDE were stronger among those in households with higher incomes compared to those living in poverty.

Conclusion: Findings support the hypothesis that exposure to the Great Recession during adolescence may have increased risk for MDE, but raise questions about whether the mechanism of this association is economic distress.

Purpose: Considerable empirical evidence indicates that stressful life experiences may have a negative impact on mental health. However, it is unclear how multiple adverse experiences may intersect to influence symptoms of depression and anxiety. Using a syndemics approach to identify potential synergistic effects between major stressors, we aimed to quantify the roles of multiple recent adverse life experiences on depression and anxiety symptoms.

Methods: A population-representative sample of 1090 Australian adults (53% women, M_age 47 years) completed a cross-sectional survey in 2022 that assessed mental health and retrospective reports of nine specific stressful life experiences in the past year.

Results: The most common adverse life experiences in the past year were financial problems (64%), loneliness (63%), or a major health problem (51%). In multivariate logistic regression analyses, financial problems, personal health problems, health problems in a close contact, relationship problems and loneliness were significantly associated with both depression and anxiety symptoms (p < 0.05). There was just one synergistic interaction and one buffering interaction of combined adversities on anxiety, and no synergistic interactions of adverse experiences on depression. The perceived impact of combined adversities was associated with both depression (b = 0.59, p < 0.001) and anxiety (b = 0.48, p < 0.001).

Conclusion: Adversity was strongly associated with depression and anxiety. Inconsistent with a syndemics framework, there were very few synergistic relationships between different types of adversities, suggesting that different adverse experiences may independently influence mental health. The findings indicate important opportunities for early intervention to prevent depression and anxiety during difficult times.

Background: South Korea had the highest suicide rates in the OECD and one of the largest (16.4%) increases in the minimum wage in 2018. Prior studies have provided evidence that increases in minimum wage reduce suicide rates in the population, but no study examined the effects of the policy change on individual-level suicidal behaviour.

Methods: Our study sample was built using the 2015-2019 waves of the Korean Welfare Panel Survey, a population-representative longitudinal survey. The sample consisted of 5146 participants, including those earning above minimum wage (control) and minimum wage earners (treatment) based on their 2018/19 earnings. The outcome of the study was suicidal ideation, which is an important precursor to other suicidal behaviours, and was captured using self-reported measures. We examined the impact of the 2018 minimum wage hike in Korea on suicidal ideation, using a difference-in-differences design.

Results: The minimum wage increase was associated with a 1.6% points reduction (95% CI: -2.8% to -0.5%) in self-reported suicidal ideation. Stronger policy effects were shown among women and older age groups.

Conclusions: Our study demonstrates that public policies employing a population-based approach, such as increasing minimum wages, could serve as an effective intervention to mitigate suicidal ideation among low-income workers.

Purpose: Previous studies have reported that levels of rurality and deprivation are factors associated with suicide risk. Reports on the association between rurality, deprivation and suicide incidence during the COVID-19 pandemic are scarce. The study aims to investigate how suicide rates evolved in areas with different levels of rurality and deprivation among Japanese adults aged 20 years or older between 2009 and 2022.

Methods: This study used population density in 2020 as an indicator of rurality and per capita prefectural income in 2019 as a proxy for deprivation in Japan's 47 prefectures. Joinpoint regression analysis was performed to analyze secular trends in suicide rates by rurality and deprivation.

Results: Suicide rates for both men and women at different levels of rurality and deprivation remained roughly parallel during the research period. Suicide rates for men and women at all levels of rurality and deprivation were on a downward trend until around 2019, just before the onset of the pandemic. Following this, suicide rates in women showed a clear upward trend, while the trend in suicide rates for men also changed around 2019, with a slightly increasing or flat trend thereafter. Changes in suicide rates were greater among women and those aged 20-59 years.

Conclusions: In Japan, time trends in suicide rates for both men and women have changed before and after the pandemic, but levels of rurality and deprivation across the 47 prefectures do not appear to have contributed much to these changes.