Psychiatry research communications最新文献

Suicidal ideation and suicide attempts are associated with mental disorders, especially with depression. A random sample representative of the general adult population living in Finland participated in a nationwide health examination survey. Of the 25-item Hopkins Symptom Checklist (HSCL-25), the item asking suicidal ideation (“To what extent have you been troubled in the last 7 days thoughts of ending your life?“) was used for the assessment of suicidal ideation. Mental disorders were assessed with a self-report during the interview and verified with the Munich version of the Composite International Diagnostic Interview (M-CIDI). Their contribution to suicidal ideation (n ​= ​4387) was analyzed using adjusted logistic regression models. Anxiety disorders (OR ​= ​6.65, p ​< ​0.001), depressive disorders (OR ​= ​3.95, p ​< ​0.001) and alcohol use disorders (OR ​= ​2.75, p ​= ​0.031) were associated with suicidal ideation after adjustment for the total alcohol consumption (grams per year), age (in years), gender (female or male), education level (basic, middle, or high), and region of residence (five catchment areas of university hospitals covering the geographical area of the country). Any anxiety disorder, social phobia, dysthymia, and generalized anxiety disorder were associated most strongly with suicidal ideation in this rank order.

Background

Psychosis is associated with physical health comorbidities. Exercise and a healthy diet can improve cardiometabolic risk and mental wellbeing. This study explores the feasibility, acceptability, and experiences of a physical health group for clients experiencing psychosis.

Methods

The group was developed and refined following consultation with service-users and culturally appropriate peer support workers. It included eight weekly sessions. The aims of the group were to provide psychoeducation on healthy living and to build motivation to engage in healthy living. Attendance, completion, and satisfaction were recorded to determine feasibility and acceptability of local service delivery. Clients took part in follow-up qualitative interviews to understand experiences of attending the group. Interviews were analysed using thematic analysis.

Results

Twenty-five clients were referred to the group. Overall, 10 clients enrolled in the group. Clients who enrolled in the group attended a median of 4.5 sessions. The mean satisfaction score for all sessions combined was 9.15/10 [SD 1.18]. Seven individual interviews were conducted. Two themes emerged. 1) Positive views towards the group, with clients feeling more aware of the benefits of healthy living, and clients finding the group setting motivating. 2) Considerations when planning healthy living support, which reflected subthemes in difficulties maintaining healthy living and concerns that the group should not be about weight loss.

Limitations

Investigations were limited to one mental health provider.

Conclusions

It was feasible and acceptable to implement a healthy living group for clients with psychosis in a community mental health team, and this intervention was met with positivity.

Shortages of psychiatrists can lead to disparities in access to mental healthcare. We examined block-level access to psychiatric services via geospatial analysis of locations registered with National Provider Identifier numbers accounting for travel time. Among 718 counties from 12 states, 208 (29%) counties had less than half of their population within 30-min travel time, while only 51 (6%) provided their entire population convenient access to psychiatrists. A considerable amount of the population resides in areas underserved by psychiatry services with varied disparities by rurality and state. Improving access to care could improve mental health outcomes in vulnerable populations.

Background

We examined the relationship between baseline cardiovascular (CV) disease/risk factors and longitudinally-collected scores on the patient health questionnaire (PHQ-9) depression scale using an outpatient sample of individuals with mental illness (PCARES Registry, 2015–2020).

Methods

Individuals with ≥2 repeated PHQ-9 assessments over one-year from the baseline PHQ-9 measurement (N = 2110) were included for trajectory modeling, with five depression symptom severity trajectory groups determined a priori (lowest, lower, middle, higher, and highest). Proportional odds models provided the association between baseline CV disease/risk factors and the odds of belonging to the more severe depression symptom trajectory group. In a sub-sample (baseline PHQ-9 score ≥10), linear-mixed effects models provided the association between baseline CV disease/risk factors and longitudinal PHQ-9 scores (N = 1118).

Results

2110 individuals included 65% females, 87% non-Hispanic white, 50% in lower and middle severity groups, with mean ± SD age: 43.0 ± 16.8 years and PHQ-9 score: 10.8 ± 7.0. Adjusting for socio-demographics and BMI [OR (95% CI)]: individuals with baseline hypertension [1.4 (1.2–1.7)], diabetes [1.3 (1.0–1.6)], dyslipidemia [1.2 (1.0–1.4)], tobacco use [2.0 (1.6–2.6)], and higher number of CV disease/risk factors (P-trend<0.0001) had significantly higher odds of more severe depression symptom trajectories; longitudinal PHQ-9 scores significantly decreased during 1-year follow-up, and the decrease was relatively lesser in individuals with hypertension or ≥1 CV disease/risk factors than those without these conditions.

Limitations

Clinic-based patient sample limits generalizability of findings.

Conclusions

Presence/absence of baseline CV risk factors significantly influenced longitudinal depression symptom severity among psychiatry outpatients, demonstrating the need for depression screening and surveillance among individuals with CV risk factors.

Why are people from less affluent social groups more likely to engage in addictive behaviours and to transition from recreational use to addiction? One contributing factor may be the influence that the environment has on decision-making. To test this, we examined the relationship between subjective social status, impulsivity, and engagement with addictive behaviours in 500 adults in the United Kingdom. Regression and Path Analyses were used to examine the direct and indirect relationships between subjective social status, trait impulsivity, and potentially addictive behaviours, including alcohol consumption, gambling, tobacco and drug use, and gaming. Social status was predictive of trait impulsivity but did not directly predict all of the addictive behaviours that we examined. Instead, we found an indirect relationship between subjective social status and trait impulsivity, and between trait impulsivity and participation with addictive behaviours. The data are important for our understanding of the role that environment plays in the development of individual differences and the distribution of addiction behaviour across social groups. We anticipate that early screening tools or interventions can be developed where individuals with low social status and high trait impulsivity are alerted to their increased risk of addiction.

This study evaluated whether a parent-as-respondent measure, the Coolidge Autistic Symptom Survey (CASS-84), could differentiate among children with mild, moderate, or severe autism spectrum disorder (ASD), children with attention-deficit/hyperactivity disorder (ADHD), and children developing typically. A total of 201 parents were recruited on Amazon's Mechanical Turk to complete the CASS-84 regarding their child (5–17 years old) and reported their children's diagnosis as either ASD (severity), ADHD, or developing typically. Parents also completed an 18-item scale of ADHD symptoms. A one-way analysis of variance demonstrated that the CASS-84 successfully differentiated ASD, ADHD, and typical development, but could not differentiate between mild and moderate forms of ASD, nor mild ASD from ADHD. The present results warrant further investigation with larger samples.

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.

Background

Little is known about the relationship of depression with incident cardiovascular disease (CVD) among American Indians (AIs), a population with a high burden of depressive symptoms and CVD. In this study, we examined the association of depressive symptoms with CVD risk among AIs and assessed whether an objective marker of ambulatory activity influenced the relationship.

Methods

The study comprised participants from the Strong Heart Family Study, a longitudinal study of CVD risk among AIs free of CVD at baseline (2001–2003) and who participated in a follow-up examination (n ​= ​2209). The Center for Epidemiologic Studies of Depression Scale (CES-D) was used to assess depressive symptoms and depressive affect. Ambulatory activity was measured using Accusplit AE120 pedometers. Incident CVD was defined as new myocardial infarction, coronary heart disease, or stroke (through 2017). Generalized estimating equations were used to examine the association of depressive symptoms with incident CVD.

Results

27.5% of participants reported moderate or severe depressive symptoms at baseline and 262 participants developed CVD during follow-up. Compared to participants who reported no depressive symptoms, the odds ratios for developing CVD among those who reported mild, moderate, or severe symptoms were: 1.19 (95% CI: 0.76, 1.85), 1.61 (95% CI: 1.09, 2.37), and 1.71 (95% CI: 1.01, 2.91), respectively. Adjustment for activity did not alter findings.

Limitations

CES-D is a tool used to identify individuals with depressive symptoms and not a measure of clinical depression.

Conclusion

Higher levels of reported depressive symptoms were positively associated with CVD risk in a large cohort of AIs.

Purpose

Delirium is a serious neuropsychiatric syndrome, which can lead to poor outcomes, especially among patients with critical illness, but is easily missed among psychiatric patients. Some delirium-associated risks have been confirmed for critical patients and psychiatric patients. Nevertheless, the research about delirium in psychiatric patients with critical illness is rare.

Methods

This study aims to investigate the prevalence and risk factors of delirium in psychiatric patients with critical illness. We assessed 425 patients diagnosed with critical illness from Shenzhen Kangning hospital from January 1, 2019, to December 31, 2021, and registered their demographic information, medical history and comorbidities. Patients underwent a psychiatric examination using the Confusion Assessment Method (CAM).

Results

Among the 425 critical illness inpatients, 143 had delirium (prevalence of 33.6%). The most common associations were infectious disease (46.9%), electrolyte disturbance (48.3%), cerebrovascular disease (39.9%), and liver or kidney dysfunction (26.6%). The married status (OR ​= ​3.450, p ​< ​0.001), infectious diseases (OR ​= ​2.862, p ​< ​0.001), electrolyte disturbances (OR ​= ​1.991, p ​= ​0.009) and the organic mental disorder (OR ​= ​5.611, p ​< ​0.001) were independent non-modifiable factors associated with an increased risk of delirium.

Conclusions

According to the study results, the delirium prevalence was about 33%. The organic mental disorder, infectious disease, electrolyte disturbance, cerebrovascular disease, and liver or kidney dysfunction were the risk factors for delirium in psychiatric patients with critical illness. Unexpectedly, the use of olanzapine or haloperidol showed no relevance to delirium.

Multiple studies have found that suicidal beliefs, measured with items from the Suicide Cognitions Scale (SCS), are significant predictors of future suicidal behavior and outperform suicidal ideation. These studies have not considered suicidal behavior and suicidal ideation as discrete outcomes, however, clouding interpretability. In this study, 2744 primary care patients completed self-report assessments during routine clinic visits. Incidence of suicidal ideation and suicidal behavior during the 12-month follow-up was assessed via phone interview. Multinomial logistic regression models were used to determine if suicidal beliefs and suicidal ideation significantly differentiated three groups: patients with follow-up suicidal behavior (SB), patients with follow-up suicidal ideation but no suicidal behaviors (SI), and patients with neither (no SI/SB). Suicidal beliefs and suicidal ideation significantly differentiated SB and SI from no SI/SB, but only suicidal beliefs significantly differentiated SB from SI. Results support the clinical utility of assessing suicidal beliefs with SCS items, confirm the superiority of suicidal beliefs over suicidal ideation as indicators of future suicidal behavior, and suggest suicidal ideation is a risk factor for future suicidal ideation but not future suicidal behavior.