Epidemiology and Psychiatric Sciences最新文献

{"title":"Risk of mortality and complications in people with depressive disorder and co-occurring diabetes mellitus: a systematic review and meta-analysis.","authors":"Matthew Tsz Ho Ho, Kwun Nam Chan, Will Chi Yuen Chiu, Lucy Lo Wah Tsang, Heidi Ka Ying Lo, Steven Yiu Long Wong, Kenneth Shut Wah Chan, Mimi Mei Cheung Wong, Ho Hon Wong, Wai Chung Lam, Pui Fai Pang, Wing Chung Chang","doi":"10.1017/S2045796026100882","DOIUrl":"https://doi.org/10.1017/S2045796026100882","url":null,"abstract":"<p><strong>Aims: </strong>People with depressive disorder have increased premature mortality and higher rates of diabetes mellitus than general population. Evidence shows that diabetes may further increase their risk of premature death from diabetes-related complications, especially cardiovascular diseases (CVDs). Earlier studies examining depression-associated outcomes in diabetes patients have shown mixed results and were hindered by important limitations, especially the use of self-reported questionnaires to ascertain depression, causing misclassification bias by identifying subclinical symptoms or diabetes distress. Associations of depression with specific diabetes complications have not been systematically evaluated. This meta-analysis aimed to investigate the risk of mortality and complications among patients with depression and co-occurring diabetes (depression-diabetes group) relative to patients with diabetes-only (diabetes-only group), on their all-cause mortality rates, and if applicable cause-specific mortality rates, and occurrence of specific diabetes complications.</p><p><strong>Methods: </strong>We systematically reviewed and quantitatively synthesized diabetes-related outcomes in patients with depression by searching Embase, MEDLINE, PsycInfo and Web-of-Science from inception to 20 December 2024, and included studies that examined mortality and complication outcomes in depression-diabetes group relative to diabetes-only group. Results were synthesized by random-effects meta-analytic models, with stratified-analyses (subgroup analyses and meta-regression) by study-level characteristics, including age, gender, study period, geographic region, follow-up duration and nature of diabetes sample. The study was registered with PROSPERO (CRD42024595145).</p><p><strong>Results: </strong>Twenty-six studies were identified from nine geographic regions. Regarding mortality risk, depression-diabetes group exhibited increased risks of all-cause mortality (RR = 1.30 [95% CI: 1.21-1.39]) and CVD-specific mortality (1.15 [1.02-1.29]) relative to diabetes-only group. Regarding complication risk, depression-diabetes group showed increased risk of complications (1.28 [1.18-1.40]) relative to diabetes-only group, especially in incident-diabetes sample signifying advanced disease stage upon presentation, with stratified-analyses showing higher risk of metabolic complications (1.63 [1.33-1.99]) and cardiovascular complications (1.20 [1.11-1.29]), and lower likelihood of retinopathy (0.84 [0.76-0.94]), albeit comparable rates of cerebrovascular complications (1.36 [0.99-1.87]), nephropathy (1.09 [0.93-1.27]) and peripheral-vascular complications (0.97 [0.79-1.18]). Both overall mortality and complication risks were present in various regions and persisted over time. Heterogeneities were noted and could not be entirely explained by stratified analyses.</p><p><strong>Conclusions: </strong>Our study demonstrated that patients with depression and co-occurrin","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e49"},"PeriodicalIF":5.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148885994","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":"Long-term suicide risk in lung cancer patients: a nationwide cohort study.","authors":"Jung Eun Yoo, Jin-Hyung Jung, Kyung-Do Han, Dong Woog Yoon, Seonghye Kim, Ji Hyun An, Jong Ho Cho, Dong Wook Shin","doi":"10.1017/S2045796026100870","DOIUrl":"https://doi.org/10.1017/S2045796026100870","url":null,"abstract":"<p><strong>Aims: </strong>Lung cancer patients have a higher risk of suicide, but the long-term patterns and how they differ by treatment type have not been fully characterized. To investigate longitudinal suicide risk among lung cancer patients who underwent surgery compared to matched controls and to examine variations over time by treatment modality and patient characteristics.</p><p><strong>Methods: </strong>We identified 37,215 individuals newly diagnosed with lung cancer between 2010 and 2017 who underwent lung resection within 1 year of diagnosis, along with 1:3 age- and sex-matched controls. Subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for suicide were estimated using a competing risk analysis.</p><p><strong>Results: </strong>The cohort (mean age 64.0 years; 62.5% male) was followed for a mean of 7.6 years. There were 154 suicides among lung cancer patients (incidence rate 0.6 per 1,000 person-years). Suicide risk peaked during the first year after surgery (sHR 1.88, 95% CI 1.23-2.87) and declined in subsequent years. Patients who underwent surgery alone had a higher risk in the first year (sHR 1.66, 95% CI 1.02-2.69), which gradually decreased over time. In contrast, patients treated with adjuvant chemotherapy or radiotherapy experienced a substantially higher initial risk (e.g., sHR 7.00, 95% CI 3.00-16.37 for surgery + radiotherapy) and maintained a moderate increase in suicide risk even beyond 5 years. Subgroup analyses showed an especially elevated first-year suicide risk among younger adults aged 20-49 years, males, and never smokers.</p><p><strong>Conclusions: </strong>Suicide risk for lung cancer patients is highest during the first postoperative year, particularly for those who receive multimodal therapy, or are younger adults, males, or never smokers. These findings emphasize the need to prioritize early, tailored psychosocial support in survivorship care to help mitigate long-term suicide risk.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e48"},"PeriodicalIF":5.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705723","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":"Retirement timing, living arrangements and mental health: a multi-method investigation using Survey of Health, Ageing and Retirement in Europe.","authors":"Jane Maddock, Cassandra Simmons, Jacques Wels, Praveetha Patalay","doi":"10.1017/S2045796026100833","DOIUrl":"10.1017/S2045796026100833","url":null,"abstract":"<p><strong>Aims: </strong>The relationship between retirement and mental health remains unclear, with mixed evidence likely driven by methodological challenges and heterogeneity across population subgroups. This study explores the relationship between retirement, time since retirement and mental health, focusing on differences between those living alone and cohabiting.</p><p><strong>Methods: </strong>We used data from 10,698 participants (48,815 observations) in the Survey of Health, Ageing and Retirement in Europe, waves 1-8, spanning 20 countries and 16 years. Participants were included if they were employed at baseline and retired during follow-up. We applied a triangulated approach using (1) multilevel linear spline models to examine trajectories and (2) fixed-effects instrumental variable analyses (IV) using statutory retirement age as an instrument to establish causal effects. The outcome was depressive symptoms measured using the EURO-D scale (higher scores indicate more depressive symptoms).</p><p><strong>Results: </strong>Multilevel spline models showed minimal change in depressive symptoms before retirement. At retirement, a small decline in EURO-D scores was indicated (-0.07 points per year [95% CI: -0.13 to -0.0003]), followed by an increase starting two years post-retirement (0.09 per year, 95% CI: 0.02 to 0.16). IV analyses showed that retirement was associated with fewer depressive symptoms (-0.26, 95% CI: -0.45 to -0.07). Individuals living alone reported higher depressive symptoms, but cohabitation status did not moderate the relationship between retirement and mental health.</p><p><strong>Conclusions: </strong>Retirement is associated with a short-term reduction in depressive symptoms, but the effect diminishes over time. While individuals living alone consistently report higher depressive symptoms, cohabitation status does not moderate the retirement-mental health relationship.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e47"},"PeriodicalIF":5.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673172","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}

{"title":"Real-world antipsychotic prescribing patterns and mortality in schizophrenia: a registry cohort study from China.","authors":"Hongbo He, Lingyan Dai, Sicong Ma, Fu-Jun Jia, Bin Chen, Haicheng Lin, Shi-Bin Wang, Wenyan Tan, Jie Li","doi":"10.1017/S204579602610078X","DOIUrl":"10.1017/S204579602610078X","url":null,"abstract":"<p><strong>Aims: </strong>Schizophrenia is a chronic psychiatric disorder associated with significantly elevated mortality. While antipsychotics are the cornerstone of treatment, their long-term effects on survival remain uncertain, particularly in non-Western populations. We aimed to assess the real-world association between antipsychotic treatment patterns and all-cause mortality among adults with schizophrenia in China.</p><p><strong>Methods: </strong>This population-based cohort study included 435,816 adults from the Community Schizophrenia Registry System of Guangdong Province, China. Patients were classified into four groups: antipsychotic monotherapy, polytherapy, non-antipsychotic treatment and non-drug treatment. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for mortality.</p><p><strong>Results: </strong>Over a median follow-up of 7.2 years, 73,527 deaths (16.9%) occurred. Antipsychotic polytherapy (57.6%) was the most common regimen, followed by monotherapy (27.6%). Compared with the non-drug group, mortality risks were significantly lower for polytherapy (aHR: 0.18; 95% CI: 0.18-0.19), monotherapy (aHR: 0.24; 95% CI: 0.24-0.25) and non-antipsychotic treatment (aHR: 0.22; 95% CI: 0.21-0.23). Both first- and second-generation antipsychotics showed comparable mortality benefits. While most polytherapy regimens performed similarly to or better than monotherapy, combinations like risperidone-sulpiride were associated with higher mortality. Subgroup analyses showed stronger benefits in women, younger individuals, rural residents and those with less severe illness.</p><p><strong>Conclusions: </strong>Antipsychotic treatment is associated with significantly reduced mortality among patients with schizophrenia in China, with effects varying by patient characteristics and drug regimen.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e46"},"PeriodicalIF":5.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668533","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}

{"title":"Incidence, prevalence and determinants of substance-induced mental disorders in British Columbia, 2022-2023: a population-based study.","authors":"Mana Mohebbian, Christian G Schütz, Rosemin Kassam, Arminée Kazanjian, Joseph H Puyat","doi":"10.1017/S2045796026100869","DOIUrl":"10.1017/S2045796026100869","url":null,"abstract":"<p><strong>Aims: </strong>Substance-induced mental disorders (SIMD) are an under-recognized consequence of psychoactive substance use, despite major implications for treatment needs, health service demand and outcomes. In the context of British Columbia's (BC's) ongoing toxic drug emergency, we aimed to (1) estimate the incidence and prevalence of SIMD in the provincial population and (2) describe socio-demographic, geographic, clinical and substance-specific patterns over a two-year period.</p><p><strong>Methods: </strong>We conducted a retrospective, population-based study using linked administrative health data from Population Data BC for residents aged ≥12 years between 1 January 2022 and 31 December 2023. SIMD cases were identified using a novel algorithm combining diagnostic codes with temporal linkage between substance-related events (poisoning, withdrawal or substance use disorder) and subsequent psychiatric diagnoses. Incident cases had no record of the same mental disorder in the previous two years; prevalent cases met SIMD criteria at any point in the study period. We calculated monthly, annual and cumulative incidence and prevalence rates per 10,000 population, stratified by sex, age group, health authority, urban/rural residence, neighbourhood income, psychiatric diagnosis, substance class, concurrent substance use disorder, involuntary treatment and mortality.</p><p><strong>Results: </strong>We identified 37,474 incident and 83,307 prevalent SIMD cases over two years, corresponding to a cumulative incidence of 77.5 and prevalence of 171.4 per 10,000 population. Monthly rates fluctuated in 2022, followed by a rise through 2023, with highest incidence (35.2 per 10,000) and prevalence (328.3 per 10,000) in May 2023. Males accounted for 62% of incident and 59% of prevalent cases; mean age was 43 years, with highest proportions in the 25-44 age range. Northern and Vancouver Island Health Authorities had the greatest burden. On average, individuals with SIMD had 3.2-3.6 healthcare visits per month. Cannabis- and hallucinogen-induced disorders were concentrated among younger people, while alcohol- and tobacco-related SIMD predominated in older adults; stimulant-related SIMD showed the highest hospitalization and involuntary treatment rates. Only about one-third of prevalent and fewer than one in five incident cases had a recorded concurrent substance use disorder.</p><p><strong>Conclusions: </strong>SIMDs are common, clinically complex and unevenly distributed across demographic and geographic groups in BC. The high rates, substantial service use and frequent occurrence outside documented substance use disorder diagnoses underscore the need for improved detection of SIMD, integration of psychiatric and addiction care and regionally tailored prevention and treatment strategies within the ongoing toxic drug emergency.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e45"},"PeriodicalIF":5.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600681","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}

{"title":"Implementation outcomes of the WHO psychosocial intervention problem management plus in humanitarian settings: a systematic review.","authors":"Michela Marchetti, Federica Patania, Matilde Piccoli, Richard A Bryant, Iryna Frankova, Marcio Gagliato, Dharani Keyan, Giuliana Mazzoni, Ana C Molina, Marit Sijbrandij, Anke Witteveen, Orso Muneghina, Corrado Barbui, Marianna Purgato","doi":"10.1017/S2045796026100845","DOIUrl":"10.1017/S2045796026100845","url":null,"abstract":"<p><strong>Aims: </strong>Populations affected by humanitarian crises, including conflict, disasters and displacement, are frequently exposed to elevated psychological distress, while access to mental health services remains scarce. Problem Management Plus (PM+), a low-intensity psychological intervention developed by the World Health Organization, has shown clinical efficacy. However, evidence on its implementation in humanitarian contexts remains limited. This systematic review aimed to synthesize available evidence on the implementation outcomes of PM+ and its delivery formats (individual, group and digital) in such settings. The review included individual PM+, group PM+ and Step-by-Step.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, we systematically searched four databases (PubMed, Scopus, Web of Science and CENTRAL) for studies published up to June 2025. Eligible studies included populations in humanitarian settings receiving PM+ in any format and reported at least one implementation outcome based on Proctor's framework (acceptability, adoption, appropriateness, feasibility, fidelity, cost, penetration and sustainability). Data extraction and quality appraisal were conducted independently by two reviewers. The protocol for this systematic review was prospectively registered in PROSPERO (Registration No. CRD42024551943).</p><p><strong>Results: </strong>Of 2093 records screened, 23 studies met inclusion criteria, representing 5377 participants across diverse humanitarian contexts. Feasibility (70% of studies) and acceptability (65%) were the most frequently assessed outcomes, with consistently positive findings, including adequate recruitment, retention and cultural adaptability of PM+. Evidence was strongest for participant and provider acceptability and feasibility of delivery, whereas system-level outcomes such as sustainability, adoption, penetration and cost were rarely reported. Delivery by trained non-specialist providers was common and supported by supervision structures. Fidelity assessments (43%) demonstrated high adherence to intervention manuals. In contrast, sustainability (9%) and cost evaluations (17%) were infrequently reported. Barriers to implementation included stigma, population mobility and resource constraints, while facilitators included contextual adaptation, community engagement and ongoing supervision.</p><p><strong>Conclusions: </strong>PM+ demonstrates strong feasibility and acceptability when delivered by trained non-specialist providers in humanitarian contexts. However, gaps remain in evidence on long-term sustainability, cost-effectiveness and policy integration. The limited availability of system-level implementation data constrains conclusions regarding large-scale integration of PM+ in humanitarian settings. Future research should employ standardized implementation science metrics and focus on strategies to enhance scalability and embed PM+ within existing health systems.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e44"},"PeriodicalIF":5.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600705","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}

{"title":"Adverse childhood experiences and adolescent mental health: trajectories of internalizing, externalizing and prosocial behaviour in a longitudinal cohort study.","authors":"Iftikhar Ahmed Charan, Wang Chongjin, Shazia Soomro","doi":"10.1017/S2045796026100808","DOIUrl":"10.1017/S2045796026100808","url":null,"abstract":"<p><strong>Aims: </strong>Adverse childhood experiences (ACEs) shape children's socioemotional development, yet longitudinal evidence from low- and middle-income countries remains limited. This study examined how ACEs relate to internalizing, externalizing and prosocial behaviours from childhood to adolescence in a rural Pakistani cohort.</p><p><strong>Methods: </strong>Data were drawn from the Bachpan Cohort, a longitudinal study including 1,791 observations across three waves: ages 4-5, 8-9 and 12-15 years. ACEs were assessed using an adapted ACE-International Questionnaire. Outcomes were measured using the Strengths and Difficulties Questionnaire. Network analysis, dose-response modelling and moderation analyses were employed.</p><p><strong>Results: </strong>Emotional neglect was the most prevalent ACE (83.7%). Parental psychiatric issues, parental trauma exposure and emotional neglect were the most central ACE stressors. A dose-response relationship emerged: compared to children with no ACEs, those with four or more ACEs showed higher internalizing (incidence ratio [IR] = 4.24) and externalizing problems (IR = 3.42) and lower prosocial behaviour (IR = 0.90). Girls showed greater internalizing vulnerability; boys showed more externalizing problems. ACE effects on internalizing problems strengthened with age.</p><p><strong>Conclusions: </strong>ACEs are strongly associated with internalizing, externalizing and prosocial outcomes from childhood to adolescence. Findings highlight the need for tiered, gender-sensitive and developmentally appropriate interventions in low-resource settings.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e43"},"PeriodicalIF":5.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591115","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}

{"title":"Beyond awareness: 25 years of population data on the impact of Australia's Beyond Blue.","authors":"Nicola J Reavley, Meredith Harris, Jane Pirkis, Amy Morgan","doi":"10.1017/S2045796026100857","DOIUrl":"10.1017/S2045796026100857","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e41"},"PeriodicalIF":5.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577470","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}

{"title":"Effectiveness of peer-delivered Problem Management Plus for Immigrants (PMP-I) in reducing stress, anxiety, and depressive symptoms among Bhutanese adults resettled in Massachusetts, United States: a pilot randomized controlled trial.","authors":"Kalpana Poudel-Tandukar, Holly Laws, Christopher R Martell, Shan Rai, Razu Ramdam, Jerrold S Meyer, Elizabeth R Bertone-Johnson, Cynthia S Jacelon, Steven D Hollon","doi":"10.1017/S2045796026100742","DOIUrl":"10.1017/S2045796026100742","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Refugees bear the highest burden of mental health issues; however, they often underuse available mental health services. Interventions aimed at those with diagnosed conditions frequently do little to prevent the onset of disorders. Problem Management Plus for Immigrants (PMP-I) is a prevention intervention adapted from the World Health Organization's Problem Management Plus (PMP). PMP-I includes psychoeducation, problem-solving, behavioural activation, social support and networking, and mind-body exercises. This pilot randomized controlled trial (RCT) aimed to evaluate the impact of PMP-I on mental, social and emotional well-being outcomes among Bhutanese refugees resettled in Massachusetts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Bhutanese individuals aged 18 or older who had resettled in Massachusetts and scored ≤14 on the Patient Health Questionnaire-9 (PHQ-9) were randomly assigned to two groups: PMP-I (&lt;i&gt;n&lt;/i&gt; = 58 families) and a talk programme with a community support services pamphlet (&lt;i&gt;n&lt;/i&gt; = 58 families). Trained community interventionists delivered five sessions of PMP-I to intervention participants in their family settings. Primary outcomes included scores on measures of stress (Cohen Perceived Stress Scale-10), and anxiety and depression (Hopkins Symptoms Checklist-25), assessed at baseline, 6-week and 3-month post-intervention. Secondary outcomes included hair cortisol, coping, coping self-efficacy, social support, social network, family conflict resolution and family satisfaction. Linear mixed-effects models were used to analyse differences in changes in outcomes between the intervention and control groups, adjusting for baseline scores on the primary outcomes, as well as age, duration of residence, marital status and history of chronic diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 232 participants recruited (116 families) were retained throughout the project. The intervention group evidenced a significantly greater decrease than the control group at both 6-week and 3-month post-intervention assessments on the primary outcomes of stress, anxiety, and depressive symptom scores. Similarly, the intervention group demonstrated significantly higher scores at both the 6-week and 3-month periods after the intervention compared to the control group on measures of coping, family conflict resolution, self-efficacy, family satisfaction and social networking with large effect sizes (Cohen's &lt;i&gt;d&lt;/i&gt; &gt; 0.8, &lt;i&gt;p&lt;/i&gt; &lt; .01). Hair cortisol concentrations did not differ significantly between the intervention and control groups at either baseline or 3-month post-intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The PMP-I improved the mental, social and emotional well-being of Bhutanese adults (PHQ-9 score ≤ 14) resettled in Massachusetts. Peer-delivered, family-centred PMP-I offers a significant public health benefit; however, a large-scale, RCT involving diverse refugee groups is necessary to replicate its success nationwide ","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e42"},"PeriodicalIF":5.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577493","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}

{"title":"Childhood maltreatment and joint trajectories of social isolation and depression as predictors of cognitive impairment in late midlife: a prospective cohort study.","authors":"Diego A Díaz-Faes, Molly Maxfield, Cathy S Widom","doi":"10.1017/S204579602610081X","DOIUrl":"10.1017/S204579602610081X","url":null,"abstract":"<p><strong>Aims: </strong>Childhood maltreatment has been associated with increased risk of cognitive impairment in later life, but little is known about whether distinct joint trajectories of social isolation and depression across midlife predict this risk.</p><p><strong>Methods: </strong>Using a prospective cohort design with documented childhood maltreatment and matched controls (<i>N</i> = 1196) followed from ages 0 to 11 into late midlife, we modelled joint trajectories of social isolation and depression (ages 29-47) using group-based trajectory modelling (GBTM) and examined their associations with cognitive impairment with no dementia (CIND) at age 59 through modified Poisson regression, controlling for risk factors related to neurodegenerative outcomes (i.e., hypertension, diabetes, obesity, limited physical activity, hearing impairment, smoking, excessive alcohol consumption and traumatic brain injury).</p><p><strong>Results: </strong>GBTM identified four groups: 'Not isolated or depressed' (67.7%), 'Moderately isolated' (11.7%), 'Moderately depressed' (16.5%) and 'Chronically isolated and depressed' (4.1%). Using the 'Not isolated or depressed' group as the reference category, membership in the highest-risk trajectory ('Chronically isolated and depressed') was associated with a 41.5% higher risk of CIND, whereas the 'Moderately isolated' and 'Moderately depressed' groups did not differ significantly from the reference group. Black non-Hispanic participants and those with documented childhood maltreatment histories had 32.8% and 21.2% higher risk of CIND, respectively, and each additional year of education was associated with a 4.9% reduction in CIND risk.</p><p><strong>Conclusions: </strong>Sustained co-occurring social isolation and depression from early to mid-adulthood predicted increased risk of CIND independent of established risk factors, highlighting prolonged social and emotional difficulties as modifiable targets for late midlife cognitive health.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e39"},"PeriodicalIF":5.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548271","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}