BMC Psychiatry最新文献

Background: Mental disorders are a major public health issue, causing 4.9% of global disability-adjusted life years (DALYs). In Jordan, factors like regional conflicts, economic changes, and population growth contribute to this burden. This study examines the trends and risk factors of mental disorders in Jordan from 1990 to 2021 using Global Burden of Disease (GBD) data.

Methods: We analyzed prevalence, deaths, and DALYs of mental disorders from the GBD 2021 dataset, reporting both all-age numbers and age-standardized rates. Key risk factors, including behavioral risks, bullying, childhood sexual abuse, and substance use, were assessed.

Results: Mental disorder cases in Jordan rose by 279.8%, from 514,234 in 1990 to 1,953,087 in 2021. Anxiety and depression were the most common in 2021. All-age DALYs increased by 649.6%, while age-standardized DALY rates showed a slight 4.3% rise. Females had higher mental disorder prevalence and DALY rates, while males had higher substance use disorder rates. Behavioral risks, bullying, and childhood sexual abuse were major contributors.

Conclusion: The burden of mental disorders in Jordan has grown significantly over three decades. Limited resources, stigma, and regional instability worsen the issue. Policies focusing on stigma reduction, mental health integration, and prevention are essential.

Background: Mental healthcare for people with a severe mental illness (SMI) is increasingly being delivered in a deinstitutionalized setting. Community-dwelling, ambulatory care and support, and the associated treatment goals have implications for the roles and experiences of family members and close friends of people with an SMI. This study aims to provide a deeper understanding of what social network members of people with an SMI need to cope with the effects of the illness and possible caregiving responsibilities and remain involved.

Methods: This qualitative study focusses on the perspectives of social network members of people with an SMI residing in independent or supported housing in an urban setting. Between 2020 and 2023, thirty adult family members, partners, and friends of people with an SMI were interviewed. We used reflexive thematic analysis to analyze the data, resulting in three themes of perceived needs and useful support.

Results: (1) Needs related to mental healthcare and support services to the person with an SMI. Quality care and support for the person with an SMI were a priority for participants. They specifically wanted more robust care and support concerning mental health crises, daytime activities and housing support. (2) Needs concerning the way mental healthcare and support services involve the social network. Participants wanted professionals providing care and support to the person with an SMI to structurally acknowledge the role, possibilities and limitations of the social network around that person. (3) Needs resulting from their relationship with a person with an SMI. Many participants wanted information and education about SMI and the care provision, improved interaction skills, financial and practical assistance, social and peer support, the opportunity to (temporarily) take a step back or psychological support for themselves.

Conclusions: Creating a closer connection between the worlds of social network members and professionals is crucial. Social network members can experience a profound sense of loss and desperation as they navigate the complexities of being a family member, partner or friend of a person with an SMI. Recognizing how this desperation and deep-felt loss feed into the high hopes and expectations that social network members place on mental healthcare and support services, can help professionals in their interaction with social network members. This study underscores the importance of mental healthcare and support services in structurally extending its attention to social network members of people with an SMI. Considering the impact of the illness on social network members and acknowledging their needs and expectations, can contribute to social network members and professionals finding common ground, fostering a more sustainable support system around people with an SMI.

Background: Anxiety disorders are increasing worldwide, untreated anxiety is linked to maternal and child health outcomes. The purpose of this study is to test psychometric properties of the Perinatal Anxiety Screening Scale (PASS) among Chinese women.

Methods: The PASS was translated into Chinese following Beaton's intercultural debugging guide. A total of 494 women in the antenatal and postnatal phase participated ( 268 antenatal and 186 postnatal ) were recruited between March 2023 and July 2023 from two hospitals in Sichuan Province, China. The instruments included the demographic characteristics form, PASS, Edinburgh Postnatal Depression Scale (EPDS), and Generalized Anxiety Disorder-7 (GAD-7). The confirmatory factor analysis (CFA), internal consistency reliability and convergent validity were assessed.

Results: The mean age of the participant was 31.67 years (SD = 3.78; range from 23 to 49). The CFA showed that four-factor model of the Chinese-PASS had an excellent fit to the data ( χ2 = 1481.2477; df = 425; χ2/df = 3.485; RMSEA = 0.071; CFI = 0.871; NNFI = 0.828; TLI = 0.859; and IFI = 0.871). The Cronbach's alpha coefficient of total scale was 0.950, and the split-half reliability of total scale was 0.907. The PASS significantly correlated with EPDS (r = 0.732) and GAD-7 (r = 0.763). The area under the ROC curve for PASS scores was 0.91 (SE = 0.01; 95% CI = 0.89-0.94). At cut-off score of ≥ 19.5, the sensitivity was 0.87. The area under the ROC curve for GAD-7 scores was 0.89 (SE = 0.02; 95% CI = 0.86-0.92). At cut-off score of ≥ 3.5, the sensitivity was 0.82.

Conclusions: The result of this study show that the Chinese-PASS had a reasonably adequate validity and reliability and can be used to screen for anxiety disorder among women during the perinatal period.

Background: Adolescent suicide is a major public health concern; therefore, this study evaluated the factors related to suicide risk in adolescents.

Methods: A questionnaire-based, cross-sectional survey was conducted in Beijing, China. Participants completed general information questionnaires developed for this study: the Patient Health Questionnaire-9; Generalized Anxiety Disorder 7-item; Revised Adverse Childhood Experience Questionnaire; Self-Hate Scale; Adolescent Non-Suicidal Self-Injury Assessment Questionnaire; and the Chinese version of the five-item MINI, suicide module. SPSS 22.0 software was used for the data statistics and Spearman's correlation analysis, and the significance of the mediating effect was tested using the non-parametric percentile bootstrapping method with bias correction.

Results: Girls had a higher risk of suicide than boys (χ² = 16.443). Adolescents with suicide risk compared to those without suicide risk were more likely to experience depression (z = 19.359, p < .001), anxiety (z = 19.958, p < .001), adverse childhood experiences (z = 17.866, p < .001), self-hate (z = 18.926, p < .001), and non-suicidal self-injury (z = 21.593, p < .001). In the mediation analysis, adverse childhood experiences directly affected suicide risk; the direct effect was 0.135, with 50.94% of the variance explained (p < .001). Adverse childhood experiences indirectly affected suicide risk through self-hate; the indirect effect was 0.130, with 49.06% of the variance explained (p < .001).

Conclusions: Sex, depression, anxiety, adverse childhood experiences, self-hate, and non-suicidal self-injury were associated with suicide risk in adolescents. Self-hate mediated the relationship between adverse childhood experiences and suicide risk. Suicide prevention efforts should focus on reducing the negative impact of these risk factors. This study provides important evidence-based support for adolescent suicide prevention and intervention strategies.

Clinical trial number: Not applicable.

Background: The relationship between obesity and mental health has attracted attention. However, large sample studies on the relationship between visceral fat obesity and depression are lacking. This study aimed to explore the relationship between visceral fat obesity and depression by using visceral adiposity index (VAI) and lipid accumulation product (LAP). Additionally, it sought to explore the potential mediating role of sleep duration in these associations.

Methods: The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2020, including 19,659 participants. Depression was measured using the nine-item Patient Health Questionnaire. Weighted multivariable regression analysis was used to evaluate the correlation of VAI and LAP with depression. The potential non-linear relationship was determined using smooth curve fitting and threshold effect analysis. Additionally, mediation analysis was performed to investigate the potential mediating role of sleep duration. The stability of the relationship was assessed through sensitivity analysis.

Results: VAI and LAP were closely related to depression. In the fully adjusted model, VAI and LAP in the highest quartile increased the association of depression by 52% (OR = 1.52, 95% CI 1.20-1.92, P < 0.001) and 51% (OR = 1.51, 95% CI 1.19-1.91, P < 0.001), respectively, compared with the lowest quartile. Specific saturation effects for VAI, LAP, and depression were identified by smoothed curve fitting, with inflection points of 3.81 and 98.55, respectively. Additionally, mediation analysis revealed that 5.1% and 2.8% of the associations between VAI and LAP with depression were mediated through sleep duration. The results of the sensitivity analysis showed interactions between hypertension and cardiovascular disease in the associations of VAI, and depression (P < 0.05).

Conclusion: VAI and LAP are associated with depression in US adults. The associations between VAI and LAP with depression are non-linear, which may be mediated through sleep duration. The study highlights the potential of VAI and LAP as valuable tools for the prevention and management of depression.

Background: Neuroinflammatory processes are directly involved in the pathogenesis of non-suicidal self-injury (NSSI) among adolescents. However, their role in predicting the outcome of adolescent NSSI is unknown. This study aimed to explore the relationship between inflammatory cytokines and their effect on NSSI treatment through a prospective investigation.

Methods: Thirty-two healthy adolescents and 199 adolescents who had engaged in NSSI were recruited. Blood samples were obtained from all participants to determine the concentration of inflammatory cytokines at enrollment. Thereafter, the NSSI group completed surveys on their NSSI behaviors after 3, 6, and 12 months. The outcomes of their NSSI behaviors were evaluated using the indexes of NSSI number and NSSI impulsivity.

Results: The results showed that the mean NSSI number and NSSI impulsivity of the participants both showed a decline tendency over time. However, regarding the NSSI number, the significant treatment effect only emerged after 6 months. The abnormal rates of IL-1βand IL-8 levels of the NSSI group were significantly higher than those of healthy controls (χ² = 3.945, 27.394; P < 0.05). In the regression models, high IL-8 level (β: 0.225, 95% CI: 0.001, 0.005; p = 0.001), high TNF-α level (β: 0.157, 95% CI: 0.023, 0.244; p = 0.018), and low IL-10 level (β: - 0.261, 95% CI: - 2.678, - 0.901; p = 0.017) could predict the treatment effect of NSSI number. High level of IL-8 (β: 0.233, 95% CI: 0.002, 0.009; p = 0.001) and long duration of medical treatment (β: 0.285, 95% CI: 0.234, 0.649; p < 0.001) could predict the treatment effect of NSSI impulsivity. When considering the two indexes together, the role of screened-out cytokines, IL-8 (OR = 1.065, 95% CI: 1.032,1.099; p < 0.001), TNF-α (OR = 1.839, 95% CI: 1.063, 3.182; p = 0.029) and IL-10 (OR = 0.031, 95% CI: 0.002, 0.541; p = 0.017), were still stable.

Conclusions: Employing the assessment of inflammatory cytokines among adolescents who engage in NSSI may be helpful in predicting their treatment outcome and designing other suitable treatment schemes in advance.

Trial registration: registered in https://www.medicalresearch.org.cn/ . Retrospectively registered: registered in https://www.chictr.org.cn/ .

Registration number: ChiCTR2500097375. Date of registration: 18th February, 2025.

Background: Bus drivers face complex work challenges and high infection risks, particularly heightened during the COVID-19 pandemic, which significantly affects their mental health. This study used network analysis to conduct a longitudinal follow-up of the psychological symptom network of bus drivers, utilizing the Symptom Checklist-90-Revised (SCL-90-R).

Design: A repeated-measures self-controlled observational design was used to survey 1,600 intercity bus drivers in a city in southern Anhui, China, in September 2022 and January 2023, respectively, and participant data were analyzed using regularized partial correlation network analysis.

Results: A total of 1134 (74.56%) completed the two surveys, 1121 (98.9%) were male, with a mean age of 47.3 ± 6.27 years, and all had junior high school education and above. The results showed a significant reduction in the severity of psychological symptoms among bus drivers the second time around. Anxiety remained the core symptom in the network; however, depression emerged as a secondary core symptom following the relaxation of policies related to COVID-19. Additionally, the weights of significant edges in the symptom network also changed.

Conclusion: Although this study lacked causal inference and relied on self-reported symptoms, it reveals changes in bus drivers' psychological symptom networks under two psychological physical examinations, highlighting the implications of COVID-19 and subsequent policy changes for future research and intervention to improve mental health among this population.

Background: Schizophrenia is a severe mental health condition with high impact on those affected and their families. Community-based rehabilitation (CBR) is a recommended treatment component for schizophrenia in low- and middle-income countries (LMIC), as it seeks to address complex social, health and economic needs. There is little evidence on the effects of CBR on caregivers of people with schizophrenia. RISE, conducted in Ethiopia, was the first randomised controlled trial of CBR for schizophrenia in a low-income country. In this paper, we extend our previous examination of caregiver impact by (1) investigating the impact of CBR on caregiver stigma and burden, (2) assessing effect modification of outcomes, and (3) determining predictors of caregiver outcomes at 12 months.

Methods: Data are from the cluster-randomised controlled RISE trial, which investigated CBR and facility-based care versus facility-based care alone among 166 people with schizophrenia and 166 linked caregivers in 48 sub-districts in Ethiopia. We analyse the effect of CBR on caregiver stigma, unemployment and burden measured with the WHO Family Interview Schedule-Impact at 6 and 12 months; and caregiver depression, reduction in work due to caregiving and caregiver burden measured with the Involvement Evaluation Questionnaire at 6 months. Logistic and linear regression models adjusted for clustering by sub-district and health centre were used for binary and continuous outcomes respectively. Effect modification by caregiver sex, age, baseline of the outcome, and baseline disability were assessed. Baseline factors associated with caregiver outcomes across the whole cohort at 12 months were investigated using hierarchal regression modelling.

Results: Data were available for 112 caregivers at 6 months (67%), and 149 caregivers at 12 months (90%). There was evidence that CBR was associated with greater tendency to reduce work due to caregiving at 6 months (OR:2.40, 95%CI:1.06-5.45). No evidence of an intervention effect was found on unemployment, depression, stigma or other aspects of caregiver burden. There was no evidence for effect modification. Higher baseline disability was independently associated with greater caregiving burden at 12 months (β:0.26, 95%CI:0.14-0.37).

Conclusions: There appeared to be no positive intervention effect of CBR on caregiver stigma, unemployment and burden in this analysis. Improving the outcomes of caregivers of people with schizophrenia in LMIC requires interventions and research addressing the needs of caregivers, for instance by integrating social and livelihoods interventions.

Trial registration: Clinical Trials.gov Identifier NCT02160249. Registered on 3 June 2014.

Background: Long-acting injectable antipsychotics (LAIs) reduce relapses in schizophrenia; however, most clinicians reserve LAIs for nonadherence with oral antipsychotics (OAs) or severe disease.

Methods: US psychiatric clinicians were surveyed regarding their schizophrenia management practices and use of LAIs. Respondents were grouped by LAI use (high [≥ 31% of patients using LAIs], low [≤ 14% using LAIs]; mid not analyzed) and mindset based on their response to "Which of the following best fits the current way you view your use of [LAIs] for your patients with schizophrenia?"

Results: Respondents (n = 380) were distributed across LAI use (106 high, 130 low) and mindset (123 early-use, 88 severity-reserved, 113 adherence-reserved, 56 LAI-hesitant) subgroups. Across subgroups, clinicians estimated that OA nonadherence was lower for patients in their practice (21-52%) than for patients nationwide (50-56%). Compared with other subgroups, greater proportions with high LAI use or an early-use mindset were confident in key aspects of LAI treatment like dosing, managing side effects, and access (67-74% high LAI use, 59-70% early-use vs. 11-57% other subgroups; P < .05 each), agreed it was "worth [their] time to resolve issues with the insurance company" (42%, 45% vs. 16-30%; P < .05 each), and were optimistic they would be able to do so (23%, 20% vs. 2-11%; P < .05 each). Clinicians with high LAI use estimated the proportion of patients who initially accept LAIs to be higher (mean, 56%) than clinicians with low LAI use (45%, P < .01); there were no differences among mindsets (49-54%). Clinicians with high LAI use or early-use mindset were more likely to "use any means necessary to ensure that a patient is on an LAI" than clinicians in other subgroups (44% high LAI use, 51% early-use vs. 5-22% other subgroups; P < .01 each) or had used guardianship to assist with treatment (70%, 69% vs. 32-56%; P < .05 each).

Conclusions: These results indicate that multiple factors (e.g., environmental/demographic factors, access, attitudes, motivation, knowledge/confidence) combine to influence LAI use, and highlight the need to tailor educational materials aimed at improving patient outcomes through increased LAI use.

Background: Care providers working with adolescents with anorexia nervosa (AN) encounter difficulties inherent in the illness (denial, ambivalence) and those related to the fact that it is most often the parents who bring adolescents to care units. Our aim was to study attitudes towards care among adolescents with AN treated in a specialised day hospital using an analysis of letters written before and after treatment.

Methods: Adolescents (12-20 years old) treated for AN in a specialised day hospital, providing multidisciplinary care while enabling a return to schooling inside the facility were included. We analysed 50 admission letters and 23 goodbye letters using general inductive analysis. A mirror analysis was conducted.

Results: In the admission letters, symptoms, calls for help, and reports on the adolescents' care trajectories were central themes. Among the categories noted in both the admission and the goodbye letters, some were similar, some mirrored others and a few differed.

Conclusions: This study highlights how ambivalence and motivations towards care, recovery and illness all interact. It also shows the evolution of the adolescents' positions via their narratives on their experience of care, the constraints involved and its benefits for them. The results are discussed in a care perspective.