Social Psychiatry and Psychiatric Epidemiology最新文献

Purpose: To elucidate the role of community socioeconomic conditions in creating opioid-related risk environments, we assessed community-level socioeconomic measures in association with opioid use disorder (OUD) across a diverse geography.

Methods: We conducted a case-control study using medical records (2012-2020) from a Pennsylvania health system to identify cases of OUD (n = 14,674) and controls (n = 58,696; frequency-matched on age, sex, year, medical record duration). Residential addresses were used to assign community-level measures: community socioeconomic deprivation (CSD), high proportional housing costs (HPHC), population in service occupations (PSO), and community credit score (CCS). Logistic regression analyzed associations of community type (city census tracts [CCT], boroughs, townships) and community socioeconomic features (stratified by community type) with OUD, adjusting for demographics and individual-level socioeconomic status.

Results: CCT or borough (versus township) residence was associated with higher OUD odds. CSD, HPHC, and CCS were associated with OUD across community types; PSO was only associated in CCTs. The highest (versus lowest) level of CSD was associated (odds ratio, 95% CI) with higher OUD odds among individuals in townships (1.18 [1.03, 1.36]), boroughs (1.34 [1.09, 1.63]), and CCTs (1.46 [1.13, 1.88]). "Good" (versus "high fair") CCS was associated with lower odds in townships (0.78 [0.71, 0.86]), boroughs (0.56 [0.41, 0.77]), and CCTs (0.73 [0.44, 1.22]).

Conclusion: Findings indicate poor community socioeconomic conditions are related to higher OUD risk, highlight the value of research regarding opioid-related risk environments, and suggest structural and policy interventions, such as vocational training and rent subsidies, as important for addressing the root causes of OUD.

Background: This study aimed to identify groups of risk perception of illicit drug consumption and associated sociodemographic and mental health factors in Singapore.

Methods: A representative sample of 6,509 Singapore citizens and permanent residents aged 15 to 65 years was randomly selected for participation over 14 months. Information on perceived risk related to illicit drug consumption, and correlates were collected via questionnaires. Data were analysed using latent class analysis to identify risk perception profiles. Logistic regression analyses were performed to determine the sociodemographic and mental health correlates across different risk perception profiles.

Results: Four profiles emerged; high risk perception across all substances and frequencies, low risk perception across all substances and frequencies, low risk perception of cannabis, and low risk perception of occasional illicit drug consumption. About 9.4% (n = 557) reported low risk perception of cannabis. Males (vs. females, RR: 2.15, 95% CI: 1.57-2.94) were more likely to have a low risk perception of cannabis. Those aged 35-65 years (35-49 vs. 15-34, RR: 0.37, 95% CI: 0.25-0.54; 50-65 vs. 15-34, RR: 0.19, 95% CI: 0.10-0.37), with secondary school (vs. degree and above, RR: 0.23, 95% CI: 0.13-0.39) or pre-tertiary (vs. degree and above, RR: 0.42, 95% CI: 0.29-0.61) education were less likely to have a low risk perception of cannabis. Ever-smokers (vs. non-smokers, RR: 1.86, 95% CI: 1.31-2.64), and those grouped as "safe drinking" (vs. abstainers, RR: 3.80, 95% CI: 2.50-5.77) or "hazardous drinking" (vs. abstainers, RR: 7.00, 95% CI: 3.69-13.28) were more likely to perceive low risk of cannabis. Individuals with a low risk perception across all substances and profiles were more likely to report symptoms of anxiety (OR: 7.17, 95% CI: 1.31-38.98) when compared to high risk perception across all substances and frequencies individuals.

Conclusions: These findings provide critical insights for tailoring prevention and education initiatives to address substance use behaviours in Singapore.

Purpose: Being outside of the labor and education system during young adulthood, a status termed not in education, employment, or training (NEET), is a risk factor for later social and health outcomes. This study examined whether parental substance use (PSU) moderates the relationship between personal alcohol consumption and NEET. Such information may inform screening practices.

Methods: Participants included 2,940 respondents (15-25-year-olds) to a 2014 Danish national survey. In this historical cohort study, survey data were linked with register data on respondents' parents and follow-up register data on respondents' educational/employment status (2015-2018). The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) identified respondents with hazardous drinking. PSU was measured using survey and register data. Our outcome identified those who were NEET during 1 + years follow-up. Analyses included gender stratified multivariable logistic regressions.

Results: Survey-based PSU was associated with higher odds of NEET (OR = 1.67, p <.001). An AUDIT-C + by survey PSU interaction was statistically significant for females (OR = 2.70, p =.007): AUDIT-C + females with survey PSU had higher odds of NEET than AUDIT-C + females without survey PSU. Results were similar using register PSU. For both genders, other parental factors (unemployment and psychiatric problems) were also associated with higher odds of NEET.

Conclusion: Using family history (including unemployment, psychiatric problems, and substance use) may enhance screening to identify emerging adults at risk of adverse social outcomes. Survey- and register-based PSU were similarly associated with NEET, suggesting that asking emerging adults about their parents' substance use may be as informative as more objective measures of family risk.

Purpose: Research on alcohol use disorder has exclusively focused on either its symptom-level mechanisms-the network perspective or sociodemographic determinants-epidemiological research. Moreover, such research failed to stratify analyses for important person-level factors (e.g., sex or ethnicity). Here, we combine network and epidemiological research and stratify analyses by person-level factors.

Method: Using Bayesian inference, we estimated (1) a logistic regression model predicting past-year alcohol consumption from various sociodemographic factors within a large, multiethnic, urban sample in the Netherlands (complete sample: N = 22,164), (2) a cross-sectional network model of alcohol use symptoms and sociodemographic factors among alcohol drinkers of the same sample (drinkers: N = 10,877), and (3) stratified networks at the sex- and ethnic- levels in the same drinkers subsample.

Results: All of our examined sociodemographic factors predicted past-year alcohol consumption (in order of magnitude: religion, sex, education, employment, perceived ethnic discrimination, and age). Our Bayesian analysis of networks revealed three notable patterns. First, religion was uniquely and negatively related to adverse alcohol use problems (such as having an injury due to drinking). Second, socioeconomic proxies (education and employment) were positively related to binge drinking, but negatively related to its adverse effects (such as 'needing a drink in the morning'). Finally, employment and education were particularly negatively related to alcohol use symptoms within male and female networks, respectively.

Conclusion: Our results suggest that alcohol use symptoms are differentially related to sociodemographic factors and that these effects are moderated by sex and ethnicity. Our highlighted network links and Bayesian methodologies could prove useful for future research and prevention and intervention efforts on alcohol use disorders.Word count: 4198 words.

Purpose: Population-based studies of alcohol-related trends typically collapse across sex while examining race and/or age, limiting understanding of shifts in alcohol involvement at the intersection of sex, race, and age. Therefore, this study evaluated population-level trends in alcohol use and alcohol use disorder (AUD) symptoms as disaggregated within Hispanic, Black, and White female and male U.S. early and middle adults.

Methods: Data were from years 2002 to 2019 of the National Survey on Drug Use and Health, Participants were 18 to 64, Hispanic, Black, or White, and consumed any alcohol. Annualized linear change estimates were computed to assess trends in past-month drinking days and AUD symptoms. Between groups analyses were also conducted to examine (a) sex differences within ethnoracial identity and (b) ethnoracial differences within sex. All analyses were further stratified across early (age 18 to 29) and middle adults (age 30 to 64).

Results: Number of drinking days increased only among Black early adult females and Black middle adult females and decreased for all males except for Black middle adults, with the strongest decrease for Black early adult males. AUD symptoms decreased for all early adult males, and most strongly among Black males. Among middle adults, AUD symptoms decreased only among Hispanic males and increased among White males and females.

Conclusions and relevance: National trends in alcohol use and AUD symptoms are distinct across subpopulations at the intersection of sex, race, and age. Continued disaggregated analyses across heterogeneous U.S. subpopulations are needed to better inform clinical care.

Purpose: This scoping review has two primary aims: (1) to synthesize U.S.-based studies utilizing dried blood spot (DBS) sampling to examine associations between psychosocial factors and systemic inflammation, as measured by C-reactive protein (CRP), and (2) to evaluate the methodological utility of DBS for advancing inclusive, population-based biomarker research. We explore DBS adoption, variability in methods and findings, and how this approach can enhance understanding of health disparities driven by psychosocial stressors.

Methods: A comprehensive search of databases including MEDLINE, Embase, Cochrane Library, CINAHL Plus, and PsycINFO was conducted. Inclusion criteria encompassed U.S.-based studies employing DBS sampling to quantify CRP in relation to psychosocial factors. Studies were categorized into four domains: socioeconomic and neighborhood contexts, adverse life events and trauma, social experiences and interpersonal dynamics, and mental health and emotional well-being. Data were extracted, synthesized, and narratively analyzed.

Results: Thirty studies met inclusion criteria, with sample sizes ranging from 20 to 13,236. Key findings indicated strong associations between psychosocial stressors (e.g., discrimination, social isolation) and elevated CRP. Few studies conducted sex- or gender-based analyses. DBS was particularly effective for research in underrepresented populations, enabling cost-effective, minimally invasive sampling in diverse and resource-limited settings.

Conclusion: This review highlights DBS as an important tool for psychiatric biomarker research, offering scalability and inclusivity. Findings affirm the link between psychosocial factors and systemic inflammation, suggesting avenues for targeted interventions. Future research should explore additional biomarkers and psychosocial determinants with sex stratified analyses to better understand inflammation-related health disparities.

Background: Patients with psychiatric disorders experience a higher all-cause mortality compared with the general population. The aim of our study was to investigate the causes of death in psychiatric patients.

Methods: We retrospectively reviewed medical and autopsy records of clinically diagnosed psychiatric patients who underwent autopsy, from January 2012 to December 2021. We collected data related to demographics, medical history and autopsy findings. Statistical analysis included descriptive statistics, crossings and trend analysis.

Results: A total of 826 deaths among psychiatric patients were collected, including 622 (75.3%) men and 204 (24.7%) women. The rate of deaths in psychiatric patients increased over the years (R² = 0.65). The mean age at death was 47.3 ± 13.9 years. Schizophrenia was the most frequent psychiatric diagnosis (41.4%). 331 (40.1%) had been receiving antipsychotic drugs. The primary manner of death was suicide (53.2%), with hanging (23%) and drowning (7.6%) as the most frequent methods. Natural causes accounted for 23.8% (primarily cardiovascular disease (56.9%) and respiratory disorder (14.7%)), followed by undetermined deaths (21.4%) and homicide (1.6%).

Conclusions: Suicide and cardiovascular diseases were the major causes of death in psychiatric patients. Suicide risk stratification, lifestyle and cardio-metabolic factor modifications and careful antipsychotic management are crucial for reducing mortality in psychiatric patients.

Purpose: To identify associations of past-year witnessing violence with expectancies (anticipated effects) for alcohol and cannabis use in Black, Latinx, and White youth, including possible variations by level of neighborhood advantage and/or race/ethnicity.

Methods: Data were drawn from Follow-up 3 of the Adolescent Brain Cognitive Development Study (n=7,332; weighted distributions: 45.53% girl, 52.33% boy, 2.14% other gender; 11.80% Black, 25.13% Latinx, 63.07% White; weighted mean age=12.94 [SE=0.01]). Positive and negative expectancies were measured using the AEQ-AB for alcohol and the MEEQ-B for cannabis. Neighborhood disadvantage was captured via the Area Deprivation Index (ADI) and analyzed as quartiles. General linear models were fitted to data for each of the four expectancies scores, adjusting for socioeconomic status indicators and testing for witnessing violence by race/ethnicity interactions. Quartile-specific regression coefficients were produced.

Results: Witnessing violence was most prevalent in the highest (most disadvantaged) ADI quartile. Across quartiles, positive alcohol expectancies (βs:0.12-0.26) and positive cannabis expectancies (βs:0.20-0.38) were elevated in youth who witnessed violence; associations were weakest in the lowest quartile. Associations with negative expectancies were non-significant for alcohol and lower only in the second highest quartile for cannabis. All race/ethnicity interactions were non-significant.

Conclusions: Risk conferred by witnessing violence manifests early in the development of alcohol and cannabis use, shaping anticipated positive effects even before many youth initiate use. In addition to lower exposure, residing in an advantaged neighborhood may modestly mitigate risk associated with witnessing violence for developing positive expectancies, underscoring the importance of intervening early with youth in disadvantaged neighborhoods.

Purpose: People with substance use disorders (SUD) have multiple associated health and social conditions that may lead to unmet needs, even among those receiving professional support. Furthermore, the fragmented nature of care provision may also contribute to unmet needs. Therefore, we assessed the needs of service users with SUD and identified their need profiles and their determinants. We aimed to identify possible gaps in care that were likely to hamper recovery pathways and to examine whether the care supply was tailored to users' needs.

Methods: A convenience sample of 562 service users with SUD drawn from diverse mental health services in Belgium, including specialised services for SUD, were assessed using the Camberwell Assessment of Needs- Short Appraisal Schedule (Patient version). Additional indicators, including social integration, substance use behaviours, service utilisation, and well-being, were also collected. A Latent Class Analysis was performed to identify need profiles.

Results: Three classes of need profiles were identified. The largest class comprised 40% of the sample and included individuals with few needs. The second class encompassed 35% of the sample and represented those whose needs were mainly met by professionals. The third class, accounting for 25% of the sample, included individuals with many unmet needs. Across classes, company, intimate relationships, and sexual expression were the most reported unmet needs. Poor social integration and subjective well-being were associated with more needs, either met or unmet. Females (OR = 2.76, p = 0.025), and those using social services (OR = 2.54, p = 0.022), homecare and outreach services (OR = 3.683, p = 0.003) were more likely to report met needs. In contrast, using multiple substances was associated with unmet needs (OR = 3.87, p = 0.008). There was no significant association between need profiles and the use of specialised services for SUD.

Conclusion: Needs of people with SUD go beyond substance use and encompass social relationships. Although no major differences in need profiles were observed based on service utilisation, social integration and interpersonal relationships deserve greater attention from the perspective of the personal recovery of people with SUD.

Purpose: To describe a cohort of people transferred from prison to psychiatric hospital care and their mortality outcomes.

Methods: Retrospective nationwide cohort of people (n = 1320) transferred from prison to a psychiatric hospital in New Zealand from 2009 to 2022. Follow up commenced at the first transfer and ended on 30 June 2023 or death if earlier. Ministry of Health records were used to describe the cohort and their service utilization profile. Records were linked to official mortality data, and mortality ratios were calculated using publicly available life tables.

Results: The cohort was 85% male and 55% Māori, with a median age of 31.2 years. Most had a psychotic disorder (74%) or bipolar disorder (11%) and there were high levels of coexisting substance use disorder. Follow-up duration ranged from 2 months to 14.5 years (median 7.5 years) after the first transfer, of which 17% was in a psychiatric hospital. The age and sex-standardised mortality ratio for the cohort compared to the New Zealand population was 4.7 (95% CI 3.6-5.9). Among deaths with a known cause, 60% were from natural causes and 40% were from injuries including suicide.

Conclusion: Despite extended periods of psychiatric hospitalization there was high mortality among people in the cohort. Investment in targeted prevention and coordinated, continuous healthcare is needed for people with a serious mental illness who experience incarceration.