Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose and objective: Anxiety poses a significant challenge for women of reproductive age globally, often leading to other mental health issues. However, research on anxiety prevalence among this demographic, particularly in Nepal, remains scarce. This study aims to fill this gap by identifying demographic, biological, and behavioral predictors of anxiety among reproductive-aged women in Nepal.

Method: Using data from the nationally representative Nepal Demographic and Health Survey 2022, this study employed the Generalized Anxiety Disorder (GAD-7) scale to assess anxiety prevalence. Descriptive and inferential statistics, including one-way ANOVA and stepwise multiple regression, were utilized for identifying the potential predictors of anxiety.

Result: This study found that 22.2% of reproductive-aged women in Nepal experience moderate to severe anxiety. The stepwise multiple regression revealed seven most influential factors, with depression (mild, moderate, severe) being the most influential predictor of anxiety, explaining 51.8% of the variance (R square change = 0.518; Sig. =<0.001). Self-reported health status (R square change = 0.010; Sig.=<0.001), experienced emotional violence (R square change = 0.007; Sig.=<0.001), and pregnancy termination (R square change = 0.002; Sig.=0.001) accounted for 1.0%, 0.7%, and 0.2% of the variance in anxiety, respectively. Other significant predictors of anxiety included husband's alcohol consumption, genital discharge, and household wealth status.

Conclusion: Anxiety is substantially prevalent among reproductive-aged women in Nepal, with sociodemographic factors playing a crucial role. Further research is needed to develop targeted socioeconomic, and behavioral interventions aimed at addressing anxiety and its broader impact on daily life, thereby ensuring the mental well-being of women of reproductive age.

Objective: The study aimed to examine the associations between experiences of racial discrimination within communities with suicide mortality rates for Aboriginal and Torres Strait Islander people.

Methods: Age-standardised suicide rates (ASRs) were calculated using suicides recorded by the Queensland Suicide Register (QSR) of Aboriginal and Torres Strait Islander people in Queensland from 2009 to 2015. Rate Ratios (RRs) were used to compare ASRs in areas with high and low levels of reported discrimination, and other comparative community-level risk and protective factors (remoteness, socio-economic resources, and Indigenous language use).

Results: The age-standardised suicide rate was 31.74 deaths per 100 000 persons/year for Aboriginal and Torres Strait Islander people for the years 2009-2015. ASRs were significantly higher in areas where more of the First Nations residents experienced recent discrimination (RR = 1.33; 95%CI = 1.05-1.70, p = 0.02), and the age-specific suicide rate was significantly higher for those aged 25-34 in areas with more discrimination (RR = 1.67; 95%CI = 1.04-2.74, p = 0.03). By comparison, the ASRs were not significantly higher in areas with regional and remote communities (RR = 1.10, CI 95%=0.75-1.61, p = 0.60), or areas with lower socioeconomic resources (RR = 0.86, 95%CI = 0.66-1.13, p = 0.28). Areas in which more First Nations residents spoke Indigenous languages had significantly lower ASRs (RR = 0.71; CI95%=0.53-0.95, p = 0.02).

Conclusion: Suicide mortality rates for Aboriginal and Torres Strait Islander people in Queensland were influenced by experiences of racial discrimination within communities and Indigenous language use, with greater associations reported than with socio-economic resources or remoteness. The findings reflect the public health risk of discrimination and provide evidence for enacting strategies to reduce institutional and personal discrimination to reduce suicide.

Purpose: The Clinical High Risk (CHR) concept has a limited transition risk to psychotic disorders (PD). This study investigates the association between affective and negative symptoms, currently not included in the CHR concept, and the risk of transition to PD in a community-based population of 2185 participants in Turkey.

Methods: Participants were assessed twice over six years using a multistage sampling technique. Two separate linear regression analyses were conducted on data from both assessments, investigating the relationship between affective and negative symptoms, subclinical and clinical psychotic experiences (PE) and progression to PD.

Results: The overall transition rate to PD was 1.3%. The analysis showed no increased risk of developing PD for the 'subclinical PE only' group at follow-up, compared to the 'no PE' group. However, being classified as having 'clinical PE only' (OR: 6.23; p = 0.010) and 'clinical PE + affective/negative symptoms' (OR: 8.48; p = 0.001) at baseline was associated with an increased risk of developing PD at follow-up. The presence of 'affective/negative symptoms' at baseline was associated with an increased risk of incident subclinical PE (RR: 1.98; p = 0.001), incident clinical PE (RR: 3.14; p = 0.001), and incident PD (RR: 4.21; p = 0.030) at follow-up.

Conclusion: The results confirm the significance of the baseline severity of positive symptoms in predicting the transition to PD and suggest that both positive and affective/negative symptoms impact the transition risk to PD and incident psychotic symptoms. This highlights the potential utility of defining CHR groups based on a combination of positive, affective, and negative symptoms.

Purpose: Low perceived social support is associated with adverse effects on maternal mental health, and often coexists with other risk factors for offspring anxiety and attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether low maternal social support during pregnancy and early childhood predicted anxiety and ADHD symptoms in children at ages 3.5 and 8 years.

Methods: This study is part of the longitudinal, population-based Norwegian Mother, Father, and Child Cohort Study. Mothers were queried about perceived social support twice during pregnancy, and again at child ages 18 months and 3 years. They were interviewed about their children's symptoms of anxiety and ADHD at 3.5 years. At 8 years (n = 781), the Child Symptom Inventory-4 was used to identify children who fulfilled the criteria for anxiety disorders and ADHD. Logistic regression models estimated the risk of child anxiety and ADHD, depending on maternal social support.

Results: Low maternal social support predicted child anxiety symptoms at both ages 3.5 and 8 years as well as ADHD symptoms at 8 years. When including other maternal stressors and child risk factors, low maternal social support remained a significant predictor for child anxiety symptoms at 3.5 years, and there was a trend towards also predicting child anxiety and ADHD symptoms at 8 years.

Conclusion: The associations between low maternal social support and child symptoms of anxiety and ADHD found in the present study, suggest that focusing on mothers with low social support may hold significance for child symptoms years later.

Purpose: Significant numbers of people in England have fallen into a gap between primary care psychological therapies and specialist mental health services. We aim to examine pathways to care by looking at demographic variation in detection and referral to primary and secondary psychological services in south London.

Methods: Longitudinal descriptive study using a record linkage between a primary care database (Lambeth DataNet) and a secondary care mental health database (CRIS). We extracted data on mental health diagnosis, prescriptions and episodes of care in mental health services for all patients of working age registered from 1 January 2008 to 1 March 2018 (pre-covid era).

Results: Of those with a mental disorder detected in primary care (n = 110,419; 26.8%); 33.7% (n = 37,253) received no treatment; 21.3% (n = 23,548) exclusively accessed psychological treatment within NHS Talking Therapies and 7.6% accessed secondary care psychological therapies. People from minoritised groups were more likely to be prescribed psychotropic medication as the only treatment offered compared to the White British group. Men, Black African and Asian groups were less likely to access NHS Talking Therapies. People with a personality disorder diagnosis had the highest prevalence and number of NHS Talking Therapies treatment episodes (48.0%, n = 960), a similar percentage (44.1%, n = 881) received secondary care psychology treatment.

Conclusion: Our study highlights marked inequalities in access to psychological therapies for men and people from some minoritised ethnic groups across primary and secondary care and how individuals with personality disorders are offered multiple short-term courses in NHS Talking Therapies even where this is not recommended treatment.

Purpose: In 2022, the Shanghai municipal government enforced strict COVID-19 lockdown measures. Lockdown experiences for college students varied. Local students normally returned home and had familial support while non-local students relied more on institutional support when quarantining in dormitories. The difference could profoundly impact their access to necessary material resources and emotional support, affecting their mental health. This study compared the psychological effects of the Shanghai Lockdown on local and non-local college students using an explanatory-sequential mixed methods design.

Methods: Quantitative analyses of data from 327 college students examined local and non-local students' mental health outcomes during the lockdown. Follow-up qualitative interviews (N = 12) contextualized their sources of stress and group differences.

Results: Higher prevalences of probable anxiety (34.6%), depression (45.1%), and poor subjective mental well-being (65.4%) are found among non-local students compared to local students (23.7% anxiety, 29.4% depressive symptoms, and 47.9% poor well-being). Suicidal ideation was higher among local students (8.6% prevalence difference). Being a non-local college student was associated with increased odds of probable anxiety, depression, and poor well-being. Interviews identified group differences such that non-local students received more school support (i.e., food and financial) and perceived emotional support but faced poorer quarantine living environments compared to local peers.

Conclusions: Non-local college students were more vulnerable to the impact of lockdown. Our findings also provide insights into the impact of familial versus institutional support on student mental health during times of crisis.

Purpose: This study aimed to examine childhood neighbourhood quality, peer relationships, and trajectories of depressive symptoms among middle-aged and older Chinese adults.

Methods: The data came from the longitudinal dataset from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018). Depressive symptoms were measured repeatedly using the ten-item Centre for Epidemiologic Studies Depression Scale (CES-D-10). Latent growth modelling was used to capture the trajectory of depressive symptoms by childhood neighbourhood quality, and peer relationships.

Results: The mean level of depressive symptoms increased gradually in the follow-up period. Poorer childhood neighbourhood quality, and peer relationships were significantly associated with higher levels of depression in later life (β = 0.18 and β = 0.28 for aged 45-59, p < 0.001; β = 0.16 and β = 0.33 for aged 60 and over, p < 0.001) at baseline and a faster increase in depressive symptoms with age for childhood neighbourhood quality (β = 0.03, p < 0.01 for aged 45-59; β = 0.05, p < 0.01 for aged 60 and over). For males and females, poorer childhood neighbourhood quality, and peer relationships predicted higher levels of depression at baseline (β = 0.17 and β = 0.36 for males, p < 0.001; β = 0.16 and β = 0.27 for females, p < 0.001), and only neighbourhood quality was associated with a higher rate of change in depression during follow-up (β = 0.03, and β = 0.04, p < 0.05, respectively).

Conclusion: Poorer childhood neighbourhood quality was associated with the slope of change in depressive symptoms. Efforts towards improving childhood living conditions may help to prevent the detrimental health effects of such early life disadvantages.

Purpose: Although suicidal ideation (SI) is a serious concern in Canada, its prevalence and related factors among Black individuals are poorly documented. Using data from the Mental Health of Black Communities in Canada project (BeCoMHeal), this study aimed to assess the prevalence of SI in Black individuals aged 15-40 years old in Canada, the mediating role of traumatic life events in the association between depression and SI, and the moderating role of racial microaggressions and internalized racism.

Methods: Eight hundred and sixty participants aged between 15 and 40 years (M_age =24.96, SD = 6.29) completed the online questionnaire assessing sociodemographic data, depression symptoms, traumatic life events, racial microaggressions, internalized racism, and SI.

Results: Findings showed that 25.7% of the participants reported having experienced SI (26.5% women, 22.7% men, 𝛘² = 1.08, p = .299). The moderated-mediation model revealed that traumatic life events fully mediated the association between depression and SI (B = 0.12, p = .004; 95% CI, [0.04, 0.20]) and that racial microaggressions (B = - 0.03, p = .042; 95% CI [-0.07, - 0.00]) and internalized racism (B = 0.06, p = .006; 95% CI [0.02, 0.10]) moderated this relationship.

Conclusion: These findings underscore the importance of addressing racial microaggressions and internalized racism in therapy contexts among Black individuals to mitigate the potential negative impacts on their mental health. They also emphasize the need to develop effective, culturally sensitive, and racially adapted suicide prevention and intervention programs for Black communities in Canada.

Objective: To investigate the mediating role of depressive symptoms in the relationship between negative life events (NLEs) and suicidality, as well as to test the moderating effect of self-esteem in the mediation model.

Methods: A total of 3,003 adolescents from Han, Tibetan, and Yi ethnic groups living in Western China were included in this study. Utilizing the structural equation model, a mediation model and a moderated mediation model were constructed.

Results: The presence of NLEs was positively associated with suicidality (β = 0.17, p < 0.001). Depressive symptoms partially mediated the relationship between NLEs and suicidality (indirect effect β = 0.19, p < 0.001). Self-esteem moderated both the antecedent and subsequent segments of the mediating paths of "NLEs → depressive symptoms → suicidality" and the direct relationship between NLEs and suicidality. Among adolescents with a low level of self-esteem, the mediating effect coefficient of depressive symptoms was higher at 0.18 (95% confidence interval (CI): 0.14-0.23), in contrast to adolescents with a high level of self-esteem, where the mediating effect coefficient of depressive symptoms was 0.04 (95% CI: 0.02-0.07).

Conclusion: NLEs are directly associated with an increased risk of suicidality and indirectly related to suicidality by increasing the risk of depressive symptoms among adolescents. Self-esteem can moderate the mediating effect of depressive symptoms and the relationship between NLEs and suicidality. The intervention strategy for preventing suicidality among adolescents who have experienced NLEs should focus on reducing depressive symptoms and improving self-esteem.