SSM. Mental health最新文献

Introduction

Investigations of migration effects on mental health conditions, including depression are sparse in low- and middle-income countries (LMIC), yet mental health may play a role in a decision to migrate, and migration in turn can impact on mental health outcomes.

Methods

This paper uses two waves of data from the Migrant Health Follow-Up Study, a young adult cohort of 2967 internal migrants and residents of the Agincourt study site in rural northeast South Africa to explore the relationship between internal migration and depressive symptoms, as measured on the Center for Epidemiological Studies Depression (CES-D) scale. We employ logistic regression analysis to investigate selectivity of migrants in relation to depressive symptoms, and we fit generalized linear models to analyse depressive symptoms (CES-D scores) as a function of migration status and sociodemographic and health characteristics, accounting for temporal sequence.

Results

Although we observe systematically low reporting of depressive symptoms, average CES-D scores are lower among migrants (comprising approximately 53% of the cohort) compared to Agincourt residents at both survey timepoints. We do not find evidence of a selection effect in relation to mental health among those newly migrating between Wave 2 and 3 (n = 1393). In analyses of the CES-D score outcome, the significant influence of migration status on depressive symptoms is reduced with the inclusion of controls in the models. Consistent employment and higher levels of education are associated with lower CES-D scores, while diagnosis of a chronic condition is associated with higher scores.

Conclusion

The relationship between migration and depressive symptoms is influenced by factors preceding a migration and destination-place characteristics and experiences. Further examination of the role of migration at different stages of the process, along with continuing attention to psychosocial measurement considerations for LMIC subpopulations, can improve our understanding of these complex interrelationships and contribute to evidence.

More than one-in-eight young adults in the US between the ages of 16–24 were not in employment, education, or training (NEET) in 2020 – a level not seen since the Great Recession. This study examines the long-term association between NEET status in emerging adulthood and later depressive symptoms using the National Longitudinal Study of Adolescent to Adult Health (1995–2018). Growth curve models chart the association between NEET status and depressive symptoms over time in the US. The analytic sample includes 9349 individuals and 28,047 person-wave observations for respondents between ages 18 to 43. In a fully specified model, respondents who reported NEET status in emerging adulthood (ages 18–26), exhibited greater depressive symptoms across emerging adulthood through early midlife (ages 33–43) (b = 0.44, 95% CI 0.33, 0.54) compared to those participating in employment, education, or training. Associations persisted even after accounting for early life disadvantage and using propensity score matching to further diminish possible sources of bias. Results indicate that disconnection from school and work during emerging adulthood may constitute a risk factor for depressive symptoms through early midlife.

This paper examines how the mental health and participation in work-related and social activities of women in Afghanistan has been impacted by the socio-political changes that have been enforced since August 2021. The study hypothesizes that women across Afghanistan from diverse sectors, both formal and informal, are negatively affected by the imposed restrictions, and that it impacts their participation in the workforce, their mental health, and their overall living conditions. The analysis within this paper is based on 124 Key Informative Interviews (KIIs) and Focus Group Discussions (FGDs), which included 33 men and 154 women across six geographic regions of Afghanistan. The findings suggest that within formal and informal job sectors, women have felt a significant disconnect from the market and the community in which they were once thriving, and as a result have experienced worsened living conditions and diminished social status. The paper discusses the significance of women’s participation in the workforce and the positive and meaningful impact women can bring to their communities; highlighting women’s frustration and documenting firsthand accounts of women’s experiences in this new socio-political landscape. It also highlights the new initiatives women are undertaking to continue their work and engage in social activities.

Understanding why people identify themselves as having a mental disorder is crucial for making sense of recent rises in self-diagnosis and help-seeking. Previous studies have implicated factors such as levels of distress, mental health literacy, and stigma. Motivated by concept creep research, we tested whether self-diagnosis is also associated with the expansiveness of people's concepts of mental disorder. A nationally representative sample of 474 Americans completed measures of distress, impairment, mental health literacy, stigma, and newly validated concept breadth scales, in addition to current and lifetime mental disorder (both self- and professionally-diagnosed) and help-seeking. Structural equation modeling demonstrated that participants with broader concepts of disorder were more likely to self-diagnose and seek help, independent of distress and impairment, mental health literacy, and low stigma. Holding broader concepts also partially accounted for higher levels of self-diagnosis among younger and more liberal participants and predicted self-diagnosis independently of formal diagnosis. Implications for the surge in self-diagnosis and concerns about pathologization of everyday life are discussed.

This qualitative exploratory research delves into the intricate life narratives of forcibly displaced individuals residing within the Emergency Transit Mechanism in Niger, employing a methodology grounded in life narrative analysis. The primary objective is to gain a comprehensive understanding of the potential stressors and traumatic experiences encountered by these individuals, encompassing both psychological and physiological dimensions, while also examining the dynamics of resilience and elements contributing to their overall well-being. The findings, derived through thematic content analysis, underscore the cumulative nature of traumatic events experienced by migrants throughout their lifetimes and across various stages of the migration continuum. The study, in alignment with extant scholarly literature, identifies thematic categories such as “A scenario of conflict and mourning, " everyday experience of violence and discrimination,” “health at risk”, and " Seeking security.” Refugees recount enduring multiple traumas, including familial bereavements and losses resulting from conflicts and militarized violence. Furthermore, the analysis elucidates a profound interplay between traumatic occurrences, subjective well-being, and resilience among the studied population. Despite confronting adverse living circumstances, refugees demonstrate indicators of subjective well-being, hinting at the potential for resilience and recovery. This challenges conventional diagnostic frameworks such as Post-Traumatic Stress Disorder (PTSD) and underscores the necessity for a nuanced understanding of trauma's multifaceted impacts. Nevertheless, the study underscores the urgent need for a more robust and contextually attuned mental health support infrastructure, advocating for a deeper exploration of the socio-political determinants underpinning forced migration. By comprehending the root causes of displacement through a socio-political lens, policymakers and practitioners can devise comprehensive strategies and interventions aimed at both prevention and mitigation of factors precipitating forced migration. This approach seeks to foster a global landscape wherein compassionate and well-informed interventions proactively address the underlying drivers of displacement.

Background

Ovarian cancer (OC) patients have an increased risk for a mental health illness (MHI) after their cancer diagnosis, but limited research exists on whether this risk differs by race/ethnicity. Hence, we used SEER-Medicare data to evaluate racial/ethnic differences in MHI incidence among OC patients aged 65+.

Methods

Non-Hispanic (NH) Black, NH White, and Hispanic women diagnosed with OC in 2008–2015 without a mental health history 12 months prior to their cancer diagnosis were identified from SEER-Medicare. Cox proportional hazards regression evaluated new MHI incidence in the first five years post diagnosis and the differences by race/ethnicity. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for demographic/clinical covariates and healthcare access (HCA) dimensions.

Results

We identified 5441 OC patients, including 364 NH Black (6.7%), 4982 NH White (91.6%), and 95 Hispanic (1.7%) patients. About 41% of NH White, 33.3% of NH Black, and 37.2% of Hispanic OC patients were diagnosed with MHI during the follow-up period between 2008 and 2016. In the fully adjusted model, NH Black OC patients were less likely to be diagnosed with any MHI (aHR: 0.67, 95% CI: 0.54, 0.82), depression (aHR: 0.66, 95% CI: 0.51, 0.85), and anxiety disorder (aHR: 0.64, 95% CI: 0.49, 0.84), while Hispanic OC patients were less likely to be diagnosed with anxiety disorder (aHR: 0.56, 95% CI: 0.33, 0.95) compared to NH White OC patients.

Discussion

NH Black OC patients are less likely to receive a clinical MHI diagnosis compared to NH White OC patients. Further studies on racial differences in MHI incidence after OC diagnosis in primary cohorts are needed to better estimate population-level prevalence less vulnerable to exposure misclassification and to account for patient-level factors impacting MHI.

Objective

The goal of this scoping review was to assess the scope and nature of evidence concerning culturally sensitive grief treatment and support interventions, aiming to provide valuable insights for future research on grief intervention development.

Introduction

Prolonged grief disorder (PGD), associated with adverse psychosocial outcomes, requires treatment. The norms of a person's culture influence grief expression, mourning rituals, and perspectives on death. Despite increasing interest in culturally sensitive grief interventions, a comprehensive synthesis of evidence is lacking. A scoping review was deemed fitting to address this gap.

Inclusion criteria

This review included studies featuring participants experiencing clinically relevant grief and engaged in culturally sensitive psychosocial grief interventions. It included studies conducted in non-WEIRD contexts or those focusing on sociocultural (sub)groups distinct from the majority (in terms of age, religion, sexual orientation, etc).

Methods

Following JBI methodology for scoping reviews, 13 databases were searched (Scopus, Embase, Cochrane, Sociological Abstracts, IBSS, PTSDpubs, PsycINFO, PsycArticles, PSYNDEX, MEDLINE, CINAHL, SocINDEX, and Web of Science). Limits included language (English and German), peer-reviewed articles and publication date (from 2000). The two-step screening process (titles and abstracts, full text) was piloted, and data were extracted and collated.

Results

Eighteen studies were included, displaying diversity in geographical location, methodology, and target populations. Interventions targeted various forms of clinically relevant grief, lost relationships, and sociocultural groups. Cultural adaptation processes varied, with seven studies using a top-down approach. Sources of information for formative research involved theoretical models and empirical data, while local experts and qualitative research (e.g., key informant interviews) informed cultural adaptation. Outcome measures were diverse, with 15 studies showing significant pre-post intervention changes, while two did not.

Conclusions

The review highlighted the emerging significance of culturally sensitive interventions for PGD, emphasizing the need for standardized approaches and further research. By shedding light on gaps and providing recommendations, it offers insights for future researchers in this field.

Rising mortality due to suicides, overdoses, and substance-related diseases, also called “deaths of despair,” has attracted significant academic, public, and media attention in recent years. This type of mortality, and key precursor “diseases of despair” like depressive mood and substance-related problems, tend to concentrate in people affected by deindustrialization and the loss of well-paid industrial jobs, that is, working-age adults with less than a BA degree. It is thought that risks build up when young adults with less education struggle to find decent jobs upon entering the labor market, which in turn triggers (1) subjective perceptions of being stuck in lower socioeconomic rungs; and (2) exposure to chronic stressors in various domains (e.g., housing, relationships). This study examined whether wages were related to diseases of despair (i.e., depressive mood and substance-related problems) through these two types of processes in a longitudinal sample (N = 543) overrepresenting young Canadian adults with lower educational attainment followed from their mid-teens to their mid-20s. Psychological processes and outcomes were self-reported, whereas exposure to stressors was assessed with a gold-standard interview-based protocol. After taking into account key potential confounders measured in adolescence (e.g., stressor exposure, mental health symptoms), results show that wages in early adulthood (in the early and mid-20s) were indirectly associated with depressed mood and substance-related problems in the mid-20s, through internal psychological processes and external exposure to chronic stressors. The specific processes in play varied by outcome. For depressive mood, subjective perceptions of one's relative socioeconomic position emerged as particularly relevant, whereas for substance-related problems, significant indirect associations emerged only when both internal psychological processes and external exposures to stressors were considered jointly. Access to decent jobs offering good wages among young adults without university degrees should thus be considered when designing policies aimed at reducing diseases of despair in younger generations.