A. Hamina, T. Paljärvi, A. Tanskanen, M. Lähteenvuo, J. Tiihonen, H. Taipale
{"title":"Use of antipsychotics and antidepressants in first-episode psychotic depression: A nationwide register-based study","authors":"A. Hamina, T. Paljärvi, A. Tanskanen, M. Lähteenvuo, J. Tiihonen, H. Taipale","doi":"10.1111/acps.13616","DOIUrl":"10.1111/acps.13616","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>According to guidelines, psychotic depression should be treated with both antipsychotics and antidepressants, but current practice is largely unknown. We investigated the prevalence of antipsychotic and antidepressant use in first-episode psychotic depression and factors related to antipsychotic use after the diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified individuals aged 16–65 with a first-episode diagnosis of psychotic depression (ICD-10 codes F32.3, F33.3) from nationwide data linkage of Finnish healthcare and population registers during 2000–2018. Point prevalence was measured as 2-week time windows every 3 months, investigating whether the individual had a modeled drug use period ongoing during the window or not, censoring to death and end of data linkage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population included 18,490 individuals (58.0% women; mean age 39.9 years, standard deviation 14.7). The prevalence of use for antidepressants (75.0%), antipsychotics (56.4%), and both (50.0%) were highest at 3 months after the diagnosis. The prevalence declined to 51.8%, 34.1%, and 28.7%, respectively, at 3 years after the diagnosis. In a logistic regression analysis, younger age (adjusted odds ratio < 25 vs. ≥55, 0.82 [95% confidence interval 0.73–0.91]), eating disorders (0.78 [0.66–0.92]), substance use disorders (0.80 [0.73–0.87]), and occupational inactivity (0.80 [0.73–0.87]) were associated with decreased odds of using antipsychotics at 3 months after diagnosis. Increased odds were found for diagnosis from inpatient care (1.74 [1.62–1.86]), and later year of cohort entry (2010–2014 vs. 2000–2004, 1.56 [1.42–1.70]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At most, half of the individuals with newly diagnosed psychotic depression used both antidepressants and antipsychotics. This likely has a negative impact on treatment success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"416-425"},"PeriodicalIF":6.7,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10542282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingying Ji, Zhiqiang Du, Kai Zheng, Ying Jiang, Caili Ren, Haohao Zhu, Ming Xiao, Tong Wang
{"title":"Bidirectional causal association between ischemic stroke and five mental disorders","authors":"Yingying Ji, Zhiqiang Du, Kai Zheng, Ying Jiang, Caili Ren, Haohao Zhu, Ming Xiao, Tong Wang","doi":"10.1111/acps.13606","DOIUrl":"https://doi.org/10.1111/acps.13606","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the bidirectional causal association between ischemic stroke and five mental disorders from a genetic perspective using two-sample Mendelian randomization (TSMR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-nucleotide polymorphisms (SNPs) associated with ischemic stroke were obtained from the genome-wide association study (GWAS) database, and those closely related to the exposure phenotype and satisfying the three core assumptions of Mendelian randomization were selected as instrumental variables (IVs). The main TSMR analysis was conducted using the inverse variance-weighted (IVW) method, and the robustness of the results was assessed using the weighted median, weighted mode, and MR Egger methods. Heterogeneity test, pleiotropy test, and sensitivity analysis were also conducted to further ensure the accuracy and stability of the research results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study found a positive correlation between ischemic stroke and depression [IVW method (FEM): OR = 1.002, 95%CI: 1.000–1.003, <i>P</i> = 0.023<0.05], but no significant causal association with schizophrenia, bipolar disorder, insomnia, or anxiety (<i>P</i> > 0.05). Reverse TSMR analysis showed no causal association between depression, schizophrenia, bipolar disorder, insomnia, anxiety, and ischemic stroke (<i>P</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study used TSMR to demonstrate from a genetic perspective that there is a positive correlation between ischemic stroke and depression, which increases the risk of depression. Proactive intervention for ischemic stroke might reduce the risk of depression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"359-367"},"PeriodicalIF":6.7,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6798118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maarten Pieter Rozing, Marie Kim Wium-Andersen, Ida Kim Wium-Andersen, Terese Sara Høj Jørgensen, Martin Balslev Jørgensen, Merete Osler
{"title":"Use of hypnotic-sedative medication and risk of falls and fractures in adults: A self-controlled case series study","authors":"Maarten Pieter Rozing, Marie Kim Wium-Andersen, Ida Kim Wium-Andersen, Terese Sara Høj Jørgensen, Martin Balslev Jørgensen, Merete Osler","doi":"10.1111/acps.13610","DOIUrl":"10.1111/acps.13610","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the risk of falls and fractures in users of benzodiazepines, Z-drugs, or melatonin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We followed 699,335 adults with a purchase of benzodiazepines, Z-drugs, or melatonin in the Danish National Prescription Registry between 2003 and 2016 for falls and fractures in the Danish National Patient Registry between 2000 and 2018. A self-controlled case-series analysis and conditional Poisson regression were used to derive incidence rate ratios (IRR) of falls and fractures during six predefined periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 62,105 and 36,808 adults, respectively, experienced a fall or fracture. For older adults, the risk of falls was highest during the 3-month pre-treatment period (IRR<sub>men+70</sub>, 4.22 (95% confidence interval, 3.53–5.05), IRR<sub>women + 70</sub>, 3.03 (2.59–3.55)) compared to the baseline (>1 year before initiation). The risk continued to be higher in the later treatment periods. Contrarily, in men and women aged 40–69 years, the risk was only higher in the 3-month pre-treatment period. The incidence of falls among young men and women was slightly lower after initiation of sedating medication (treatment period, IRR<sub>men15–39</sub>, 0.66 (0.50–0.86), IRR<sub>women15–39</sub>, 0.65 (0.51–0.83)). Analyses with fractures as outcome yielded similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although falls and fractures occur more often in persons using sedative-hypnotic medication, the higher risk of falls and fractures in the pre-treatment period relative to the period directly after treatment, suggests that this association is better explained by other factors that elicited the prescription of this medication rather than the adverse effects of the sedative-hypnotic medication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"394-404"},"PeriodicalIF":6.7,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10526165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donya Merza, Bahar Amani, Calan Savoy, Zoryana Babiy, Peter J. Bieling, David L. Streiner, Mark A. Ferro, Ryan J. Van Lieshout
{"title":"Online peer-delivered group cognitive-behavioral therapy for postpartum depression: A randomized controlled trial","authors":"Donya Merza, Bahar Amani, Calan Savoy, Zoryana Babiy, Peter J. Bieling, David L. Streiner, Mark A. Ferro, Ryan J. Van Lieshout","doi":"10.1111/acps.13611","DOIUrl":"10.1111/acps.13611","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet just 10% receive evidence-based care. This randomized controlled trial aimed to determine if a synchronous online 9-week group cognitive-behavioral therapy (CBT) intervention delivered by mothers who have recovered from postpartum depression (i.e., peers) could effectively improve PPD and its comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 183) in this study lived in Ontario, Canada, were ≥18 years-old, had an infant <12 months, were fluent in English, and scored ≥10 on the Edinburgh Postnatal Depression Scale (EPDS). They were randomized to experimental (received intervention plus treatment as usual (TAU)) or waitlist control (TAU plus the intervention after a 9-week wait) groups. Depression, anxiety, social support, mother-infant bonding, and infant temperament were assessed at baseline and 9 weeks later. Outcomes were assessed in the experimental group 3 months post-intervention to assess stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant reductions were observed in EPDS (<i>B</i> = 5.99; <i>p</i> < 0.001; <i>d</i> = 1.32) and Generalized Anxiety Disorder Questionnaire-7 scores (<i>B</i> = 5.94; <i>p</i> < 0.001; <i>d</i> = 1.22), improvements that remained stable 3 months post-intervention in the experimental group. Maternal social support (<i>p</i> = 0.02; <i>d</i> = 0.40), infant-focused anxiety (<i>p</i> = 0.02; <i>d</i> = 0.54), and infant negative emotionality (<i>p</i> < 0.01; <i>d</i> = 0.23) also improved post-intervention and remained stable 3 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Online peer-delivered group CBT for PPD can effectively treat PPD and anxiety, and improve social support, infant-focused anxiety, and negative emotionality in infants. This intervention could provide the means to increase access to treatment for those experiencing PPD and improve outcomes for mothers, birthing parents, and families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"150 5","pages":"422-432"},"PeriodicalIF":5.3,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James Luccarelli, Daniel Humphrey, Thomas H. McCoy Jr., Michael E. Henry, Martina Mueller, Stephen J. Seiner
{"title":"Changes in self-reported suicidal ideation during treatment with electroconvulsive therapy: A retrospective cohort study","authors":"James Luccarelli, Daniel Humphrey, Thomas H. McCoy Jr., Michael E. Henry, Martina Mueller, Stephen J. Seiner","doi":"10.1111/acps.13603","DOIUrl":"10.1111/acps.13603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Suicidal ideation (SI) is common in patients with depressive symptoms, who are the most common recipients of electroconvulsive therapy (ECT). We sought to quantify changes in self-reported SI occurring during treatment with ECT, and to identify factors associated with persistence of SI in patients beginning treatment with SI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Retrospective, single-center cohort study of patients receiving ECT and who self-reported symptoms using Quick Inventory of Depressive Symptomatology (QIDS) prior to ECT and after treatment #5 or #10. Changes in QIDS-reported SI over the course of ECT were calculated, and logistic regression models were performed to assess factors associated with reporting SI at the end of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2554 provided baseline and follow-up SI scores, of whom, 1931 (75.6%) endorsed SI at baseline. There was a reduction in SI with ECT treatment (McNemar's test; df = 1, Χ<sup>2</sup> = 803.7; <i>p</i> < 0.001), and in adjusted models 64.0% of individuals with baseline SI reported resolution of SI with ECT treatment, while 3.3% without baseline SI reported SI at the end of treatment. Higher baseline SI severity and outpatient treatment were associated with a higher odds of persistent SI among individuals beginning treatment with SI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Electroconvulsive therapy treatment was associated with reductions in self-reported SI. These results support the use of ECT in the treatment of patients with SI, but further research is needed to determine the effects of ECT on suicidal behavior.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 6","pages":"553-560"},"PeriodicalIF":6.7,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simina Toma, Mark Sinyor, Rachel H. B. Mitchell, Ayal Schaffer
{"title":"Transdiagnostic suicidality in depression: More similar than different?","authors":"Simina Toma, Mark Sinyor, Rachel H. B. Mitchell, Ayal Schaffer","doi":"10.1111/acps.13600","DOIUrl":"https://doi.org/10.1111/acps.13600","url":null,"abstract":"<p>While extensive work has been conducted regarding risk factors for suicide attempts and deaths, clinical prediction of suicide-related behaviour at an individual level remains an unmet challenge.<span><sup>1</sup></span> Given this reality, some have recommended a shift from risk prediction to risk management and a focus on formulation and therapeutic engagement.<span><sup>2</sup></span> There is a paucity of prospective data directly comparing suicidal behaviour across commonly encountered psychiatric conditions and their symptom severity. Major depressive disorder (MDD), bipolar disorder (BD) and borderline personality disorder (BPD) are known to be associated with higher risk for suicidal ideation, suicide attempt and death by suicide than the general population, especially during the course of major depressive episodes (MDEs).<span><sup>3</sup></span> Mood disorders and BPD also frequently co-occur, with about 20% of adults with BD having comorbid BPD and an even higher frequency of BPD traits.<span><sup>4, 5</sup></span> The dynamic interplay between depressive symptom fluctuation, baseline BPD traits and emergence of suicidal behaviour is of great clinical relevance.</p><p>In this edition of the journal, Isometsä et al. examine suicide attempts and suicidal ideation prospectively in a cohort of outpatients with an MDE within the context of MDD, BD or comorbid with BPD.<span><sup>6</sup></span> Findings include higher rates of suicide attempts in those with BPD, a correlation between suicide attempts/suicidal ideation and BPD symptom severity as measured by the borderline personality disorder severity index (BPDSI) at baseline, and a correlation between severity of suicidal ideation and depressive symptom severity. Although the rates of suicidal ideation and attempts are lower over the period of follow up in the BD group than in the other two groups, the link between depression severity changes and suicidality is greater in this group. Hopelessness is found to be a transdiagnostic predictor of suicidal ideation. Interestingly, non-suicidal self-injury (NSSI) is also high in the MDD group, and not only in the BPD group. NSSI is lower in the BD group.</p><p>This work provides an important contribution to the field based on the prospective design and direct comparison of uniform and relevant outcomes between these three commonly encountered clinical groups. The sample is comprised of treatment-seeking subjects in an outpatient clinic, with on average moderate depression severity at baseline. While the strictly outpatient setting may reduce generalizability to other settings, the outpatient setting is particularly salient as past work has demonstrated the most common mental health contact prior to suicide completion is an ambulatory care visit, rather than emergency room visit or psychiatric hospitalisation.<span><sup>7</sup></span> Furthermore, the rate of lifetime suicide attempts in this group is 15.6% for the MDD group, 30% for the BD gro","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 3","pages":"219-221"},"PeriodicalIF":6.7,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5689431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hirofumi Hirakawa, Takeshi Terao, Koji Hatano, Masanao Shirahama, Kentaro Kohno
{"title":"Increasing the uptake of 18F-fluorodeoxyglucose in the left hippocampus after 4 weeks of bright light exposure in healthy participants: A randomized controlled study","authors":"Hirofumi Hirakawa, Takeshi Terao, Koji Hatano, Masanao Shirahama, Kentaro Kohno","doi":"10.1111/acps.13609","DOIUrl":"https://doi.org/10.1111/acps.13609","url":null,"abstract":"Bright light therapy (BLT) has been used to treat seasonal affective disorders, depression, and bipolar depression; however, the precise mechanism remains unclear. Neurogenesis in the human brain occurs in the hippocampal dentate gyrus (DG). Stress-induced structural remodeling in the adult hippocampus provides a cellular basis for understanding the impairment of neural plasticity in the human hippocampus in depression. Antidepressant treatment both restores neurogenesis in the hippocampus and serves to normalize behavior in depression animal models, suggesting that deficits in neurogenesis of hippocampus can act as a potential target for depression therapies. Thus, we hypothesized that bright light (BL) may induce neurogenesis in the human hippocampus, especially in the DG. We previously reported that 5-day BL significantly increased the uptake of F-fluorodeoxyglucose (FDG) in the right olfactory cortex, however significant metabolic change did not detect in the hippocampus. The limitations of our previous study are the lack of the direct evidence for neurogenesis and a short duration of BL. Therefore, we previously conducted a randomized controlled trial that revealed a 4-week period of BL in healthy participants resulted in an increase in the volume of the left hippocampal DG-head. This research letter used and analyzed the data of F-FDG positron emission tomography (PET), which was performed simultaneously with magnetic resonance imaging in the previous study.","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"457-459"},"PeriodicalIF":6.7,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41229913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Using polygenic risk scores to investigate the evolution of smoking and mental health outcomes in UK biobank participants","authors":"Lloyd Balbuena, Evyn Peters, Doug Speed","doi":"10.1111/acps.13601","DOIUrl":"10.1111/acps.13601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Mendelian randomization studies report a bi-directional relation between cigarette smoking and mental disorders, yet from a clinical standpoint, mental disorders are the focus of treatment. Here, we used an event history framework to understand their evolution in the life course. Our objective was to estimate the relative contribution of genetic predispositions and self-reported smoking status (never, former, and present smoker) to hospitalizations for major depression, bipolar disorder, and schizophrenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We calculated polygenic risk scores (PRS) for ever smoking, pack-years of smoking as a proportion of adult life, and neuroticism in 337,140 UK Biobank participants of white British ancestry. These PRS and self-reported smoking status were entered as explanatory variables in survival models for hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The estimated single nucleotide polymorphisms heritabilities (<i>h</i><sup>2</sup>) were 23%, 5.7%, and 5.7% for pack-years, ever smoking, and neuroticism respectively. PRS pack-years and PRS neuroticism were associated with higher hospitalization risk for mental disorders in all smoking status groups. The hazard for mental health hospitalization was higher in both previous (HR: 1.50, CI: 1.35–1.67) and current (HR: 3.58, 2.97–4.31) compared to never smokers, after adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Since genetic liabilities for smoking and neuroticism are fixed at conception and smoking initiation generally started before age 20, our results show that preventing smoking in adolescents probably prevents the development of mental disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 5","pages":"447-456"},"PeriodicalIF":6.7,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chu-Syuan Cheng, Wen-Yin Chen, Hu-Ming Chang, Chun-Hung Pan, Sheng-Siang Su, Shang-Ying Tsai, Chiao-Chicy Chen, Chian-Jue Kuo
{"title":"Unfavorable cancer mortality-to-incidence ratios in patients with schizophrenia: A nationwide cohort study in Taiwan, 2000–2019","authors":"Chu-Syuan Cheng, Wen-Yin Chen, Hu-Ming Chang, Chun-Hung Pan, Sheng-Siang Su, Shang-Ying Tsai, Chiao-Chicy Chen, Chian-Jue Kuo","doi":"10.1111/acps.13604","DOIUrl":"https://doi.org/10.1111/acps.13604","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Studies on cancer incidence and mortality in patients with schizophrenia have reported inconsistent findings. In this study, we simultaneously investigated cancer incidence and mortality in patients with schizophrenia and evaluated the cancer mortality-to-incidence ratio (MIR), which is rare in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the Taiwan National Health Insurance Database, we collected the data of 107,489 patients who received a diagnosis of schizophrenia between 2000 and 2019. Data regarding cancer incidence and mortality were obtained from the Taiwan Cancer Registry and National Mortality Database, respectively. In total, 3881 incident cancer cases and 2288 cancer mortality cases were identified. Standardized incidence ratios (SIRs), mortality rate ratios (MRRs), and MIRs were compared between patients with schizophrenia and the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall rate of cancer incidence was slightly lower (SIR: 0.95; 95% confidence interval [CI]: 0.92–0.98; <i>p</i> < 0.001) and that of cancer mortality was higher (MRR: 1.29; 95% CI: 1.23–1.3; <i>p</i> < 0.001) in patients with schizophrenia than in the general population. The MIR for overall cancer was significantly higher in the patients with schizophrenia. The relative MIR (MIR of patients with schizophrenia divided by that of the general population) was 1.36 (95% CI: 1.30–1.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MIR was significantly higher in the patients with schizophrenia than in the general population, indicating the possible presence of healthcare disparities. Additional studies are required to investigate the potential association between the significantly higher MIR in patients with schizophrenia and healthcare disparities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"148 4","pages":"347-358"},"PeriodicalIF":6.7,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6975191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie Baumann, Andreas Staudt, Danny Horesh, Malin Eberhard-Gran, Susan Garthus-Niegel, Antje Horsch
{"title":"Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study","authors":"Sophie Baumann, Andreas Staudt, Danny Horesh, Malin Eberhard-Gran, Susan Garthus-Niegel, Antje Horsch","doi":"10.1111/acps.13595","DOIUrl":"10.1111/acps.13595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results seem to support a dose–response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"150 5","pages":"446-457"},"PeriodicalIF":5.3,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10325957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}