Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: There is a dearth of research on suicidal ideation (SI) that occurs specifically in the context of drinking alcohol. Alcohol use and binge drinking are both elevated among college students, among whom sexual and gender minority (SGM) students are at particular risk for SI. This manuscript examines alcohol use, SI, and SI specifically in the context of alcohol use among a large sample of undergraduate students and examines differences across sexual and gender minority groups.

Methods: Data were drawn from ~ 300,000 students who completed the American College Health Association National College Health Assessment (ACHA-NCHA) between Spring 2019 and Fall 2022. Participants reported identity variables and information about drinking behaviors and suicidal ideation over the past year. Multilevel models were used for all analyses.

Results: Risky drinking behaviors and higher blood alcohol content during the last episode of social drinking were associated with higher odds of SI while drinking. Rates of risky drinking behaviors, SI, and SI while drinking were elevated among SGM students with SGM men and nonbinary students reporting the highest rates across groups.

Conclusion: SI while drinking, which is seldom assessed in measures of either measures of suicidal thoughts or alcohol use behavior, is an important construct for further research to improve our understanding of high risk states for suicide. Given elevated rates of alcohol use and SI among college students, providing education and resources to reduce SI while drinking is a critical target for universities, particularly to reduce risk among vulnerable SGM students.

Objective: China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum.

Methods: A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics.

Results: The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet.

Conclusion: The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.

Purpose: Since the onset of the COVID-19 pandemic, most research has focused on the management of the acute symptoms of the disease. Yet some people tend to experience symptoms beyond the acute phase, defined as Post-COVID-19 Condition (PCC). This study aims to assess the impact of COVID-19 and PCC on anxiety and depression.

Methods: This is a prospective longitudinal cohort study among the Belgian adult population with recent SARS-CoV-2 infection for which contact tracing was initiated. A total of 3127 people were followed-up just after their infection and three months later (from April 2021 to January 2022). Anxiety and depression were assessed at the two stages using the GAD-7 (Generalized Anxiety Disorder) and the PHQ-9 (Patient Health Questionnaire).

Results: Three months after infection, participants with PCC (50%) had an increased probability of having both anxiety and depressive symptoms (p < 0.001). The proportion with anxiety and depressive symptoms at three months were significantly higher in people with PCC (11% and 19%) compared to people without persistent COVID symptoms (3.8% and 4.2%) and to a matched sub-sample not infected with SARS-CoV-2 (6.5% and 4.3%). Having at least one acute COVID-19 symptom (p < 0.001), experiencing financial loss following the infection (p < 0.001), and different PCC symptoms were associated with anxiety and depressive symptoms worsening over time.

Conclusions: This study showed that three months after a SARS-CoV-2 infection, one in two people suffer from PCC with significant consequences for their mental health. Follow-up on mental health must therefore have an important place in people suffering from PCC.

Aims: To characterize the register of a secondary diagnosis of mental illnesses in all chronic obstructive pulmonary disease (COPD) hospitalizations registered in Portugal from 2008 to 2015 and explore their impact on hospitalization outcomes.

Methods: A retrospective observational study was conducted. Hospitalizations of patients with at least 40 years old, discharged between 2008 and 2015 with a primary diagnosis of COPD (ICD-9-CM codes 491.x, 492.x and 496) were retrieved from a national administrative database. Comorbid psychiatric diagnoses were identified and defined by the HCUP Clinical Classification Software (CCS) category codes 650-670 (excluding 662). Length of hospital stay (LoS), admission type, in-hospital mortality, and estimated hospital charges were analyzed according to psychiatric diagnostic categories using sex and age-adjusted models.

Results: Of 66,661 COPD hospitalizations, 25,869 (38.8%) were episodes with a registered psychiatric comorbidity. These were more likely to correspond to younger inpatients (OR = 2.16, 95%CI 2.09-2.23; p < 0.001), to stay longer at the hospital (aOR = 1.08, 95%CI 1.05-1.12; p < 0.001), to incur in higher estimated hospital charges (aOR = 1.37, 95%CI 1.33-1.42; p < 0.001) and to be urgently admitted (aOR = 1.33, 95%CI 1.23-1.44; p < 0.001). After adjustment for age, in-hospital mortality was lower for episodes with psychiatric diagnoses (aOR = 0.90; 95%CI 0.84-0.96; p < 0.001), except for organic and neurodegenerative diseases category and developmental disorders, intellectual disabilities and disorders usually diagnosed in infancy, childhood, or adolescence category.

Discussion: These findings corroborate the additional burden placed by psychiatric disorders on COPD hospitalizations, highlighting the importance of individualizing care to address these comorbidities and minimize their impact on treatment outcomes.

Purpose: We present a psychometric evaluation of the Center for Epidemiologic Studies Depression Boston Form (CES-D-B) for use with different Latino subgroups as there is inconsistency regarding its performance across subgroups of Latinos, a large and rapidly growing cultural group in the United States.

Methods: We evaluated the reliability and structural validity of the scores generated by the CES-D-B using four distinct Latino samples residing in US: Mexicans, Venezuelans, Cubans, and "other Latinos" (total N = 1033). To further explore structural validity of CES-D-B scores, we conducted measurement invariance analyses across different countries of origin, gender groups, educational levels, and languages of assessment (English, Spanish).

Results: For all four samples, CES-D-B scores were highly reliable as indicated with the coefficients ranging from 0.82 to 0.88, and the factor structure provided an adequate fit to the data with the fit indices CFI/TLI ranging from 0.96 to 0.99, RMSEA estimates between 0.02 and 0.07, and SRMR estimates between 0.02 and 0.04. While measurement invariance analyses for different educational levels indicated scalar invariance across all samples, the same level of measurement equivalency was achieved only for Mexicans and Venezuelans with varying gender and languages of assessment.

Conclusions: The findings indicated that CES-D-B scores are internally consistent, possess a strong four-factor structure, and have somewhat equivalent psychometric properties across diverse Latino groups. Findings from this study highlight the importance of considering gender and languages of assessment when assessing depressive symptoms of various Latino subgroups.

Purpose: The temporal trend of suicide in patients with cannabis use disorder (CUD) is important to investigate, considering the recent increases in THC concentration in cannabis products. This study describes the annual suicide rates in patients with CUD from 2010 to 2021. To investigate if any change in suicide rate was specific to CUD, we compared these suicide rates with corresponding data for patients with alcohol use disorders (AUD) and other substance use disorders (SUDs).

Method: The study used a time series design. We used a national registry linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry from 2010 to 2021, including patients with CUD (ICD-10 code F12), AUD (F10), or other SUDs (F11; F13-F16; F18-F19) who died by suicide, supplemented with the total number of patients treated with specific disorders to estimate the suicide rates. The trend was analyzed by comparing the annual suicide rate to 2010 and using Poisson regression, adjusting for gender, age, and mental disorders.

Results: We found increased annual incidence rate ratios for patients with CUD in 2018 (IRR = 2.14 (95% CI 1.14-3.99)) and onwards and an increasing time trend over the study period (IRR = 1.08 (1.05-1.12)). No increases in trends were found for AUD or other SUDs. The time trend for CUD was attenuated when adjusting for depressive or anxiety disorders (aIRR = 1.00 (0.92-1.08)) or other SUDs (aIRR = 0.96 (0.87-1.06)).

Conclusions: Increasing suicide rates were found in patients with CUD. Comorbid anxiety and depression or other SUDs, but not other mental disorders, could partly explain these results.

Purpose: Mental health challenges are a pressing concern in Australia, which account for a significant portion of the disease burden and economic costs, yet a substantial number of those affected do not utilise necessary professional support. This study evaluates distance decay effect on adults' community mental health services in North Metropolitan Western Australia and explores factors influencing service use.

Methods: Data were extracted from the Mental Health Information Data Collections including the records of consumers receiving face-to-face services from the Community Mental Health Clinics in the North Metro Health Service during March 2022 to March 2023. Additionally, socio-demographic information for each suburb and population data were obtained from the Australian Bureau of Statistics. The distance between residential suburbs and clinic locations was calculated. Descriptive statistics were used to describe the characteristics of the study population. A hierarchical linear regression analysis was used to explore whether the distance of suburb to the nearest community clinic was related to service utilisation.

Results: A total of 3,453 consumers received direct services across the North Metro Health Service Community Mental Health Clinics. Findings highlighted the impact of proximity to clinics on service utilisation, with suburbs closer to clinics exhibiting higher visit rates (p = 0.004). The data also showed a strong positive correlation between gender (percentage of females in the suburb) and living in socially and economically disadvantaged areas with consumer visits per thousand residents.

Conclusions: These findings underscore the importance of addressing accessibility barriers and tailoring mental health services to meet the diverse needs of the community.

Background: Ample evidence has been generated regarding the effectiveness of school-based mental health interventions as part of the continuum of care for children and capacity building of teachers to deal with the emotional and behavioral challenges of students. The increasing trend of utilization of teachers as the natural support system of children and the huge financial impact of public health interventions highlights the need to review all available evidence regarding multilevel factors that facilitate or pose a challenge to the provision of School Mental Health Programs (SMHP) using teachers as providers. The current review aims to map extracted evidence under the Consolidated Framework for Implementation Research (CFIR) domains to support future implementation research on school-based mental health services.

Methods: The scoping review included experimental, qualitative studies, and systematic reviews involving teacher-led mental health programs conducted in the school setting to improve the socio-emotional well-being of children and adolescents irrespective of time and geographical limitations. All (published and unpublished) evidence in English from Pubmed, Cochrane database of systematic reviews and clinical trials, Scopus, and Science Direct was searched using keywords and Boolean combinations and extracted using study designs, place of study, year of publication, sample size, and target population. A qualitative analysis of implementation facilitators and barriers cited by the studies was carried out and mapped on CFIR.

Results: This review identified barriers and facilitators of implementation across school-based mental health Programs in 29 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation, and the characteristics of individuals involved in implementation. These included the availability of structural characteristics, positive school culture, organizational readiness, committed leadership, and beliefs of the providers.

Conclusion: Findings highlight the need for early assessment of contextual factors acting as barriers and facilitators and careful execution following realistic planning and stakeholders' engagement to ensure the success of SMHP.

Purpose: Patients with schizophrenia have a higher risk of cannabis use disorder and may be uniquely affected by the legalization of recreational cannabis. This study examined whether cannabis legalization led to changes in acute care utilization among patients with schizophrenia.

Method: Using linked health administrative data, we included adult patients with schizophrenia in Ontario from October 2015 to May 2021 (n = 121,061). We examined the differences in cannabis, psychosis, and mental health-related emergency department (ED) visits over three periods: pre-legalization, legalization of flowers and herbs (phase 1), and legalization of edibles, extracts, and topicals (phase 2) using interrupted time-series methods.

Results: Our study found that phase 1 was associated with decreases in cannabis-related, mental health-related, and cannabis + psychosis-related ED visits among the patients with schizophrenia. Notably, an immediate 25.8% (95% CI 13.8-37.6%) decrease in cannabis-related ED visits was observed in men, and an immediate 18.5% decrease in mental health-related ED visits (95% CI 6.0-31.2%) in women. These decreases were also shown in the comparative ITS models, demonstrating that the changes observed were distinct from trends in the general population. However, phase 2 was not associated with any significant changes.

Conclusions: Despite higher baseline rates of acute care utilization among patients with schizophrenia, cannabis legalization was associated with significant reductions, particularly during phase 1. Our findings suggest that regulatory measures accompanying legalization could enhance the quality and safety of cannabis products, potentially leading to fewer adverse health outcomes in vulnerable patient populations. Further research is needed to optimize healthcare responses for this vulnerable population.