Epidemiology and Psychiatric Sciences最新文献

{"title":"Subjective and objective sleep alterations in medication-naïve children and adolescents with autism spectrum disorder: a systematic review and meta-analysis.","authors":"Heeyeon Kim,&nbsp;Jae Han Kim,&nbsp;Junghwan Kim,&nbsp;Jong Yeob Kim,&nbsp;Samuele Cortese,&nbsp;Lee Smith,&nbsp;Ai Koyanagi,&nbsp;Joaquim Radua,&nbsp;Paolo Fusar-Poli,&nbsp;Andre F Carvalho,&nbsp;Gonzalo Salazar de Pablo,&nbsp;Jae Il Shin,&nbsp;Keun-Ah Cheon,&nbsp;Marco Solmi","doi":"10.1017/S2045796023000574","DOIUrl":"https://doi.org/10.1017/S2045796023000574","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to summarize the evidence on sleep alterations in medication-naïve children and adolescents with autism spectrum disorder (ASD).</p><p><strong>Methods: </strong>We systematically searched PubMed/Medline, Embase and Web of Science databases from inception through March 22, 2021. This study was registered with PROSPERO (CRD42021243881). Any observational study was included that enrolled medication-naïve children and adolescents with ASD and compared objective (actigraphy and polysomnography) or subjective sleep parameters with typically developing (TD) counterparts. We extracted relevant data such as the study design and outcome measures. The methodological quality was assessed through the Newcastle-Ottawa Scale (NOS). A meta-analysis was carried out using the random-effects model by pooling effect sizes as Hedges' <i>g</i>. To assess publication bias, Egger's test and <i>p</i>-curve analysis were done. A priori planned meta-regression and subgroup analysis were also performed to identify potential moderators.</p><p><strong>Results: </strong>Out of 4277 retrieved references, 16 studies were eligible with 981 ASD patients and 1220 TD individuals. The analysis of objective measures showed that medication-naïve ASD patients had significantly longer sleep latency (Hedges' <i>g</i> 0.59; 95% confidence interval [95% CI] 0.26 to 0.92), reduced sleep efficiency (Hedges' <i>g</i> -0.58; 95% CI -0.87 to -0.28), time in bed (Hedges' <i>g</i> -0.64; 95% CI -1.02 to -0.26) and total sleep time (Hedges' <i>g</i> -0.64; 95% CI -1.01 to -0.27). The analysis of subjective measures showed that they had more problems in daytime sleepiness (Hedges' <i>g</i> 0.48; 95% CI 0.26 to 0.71), sleep latency (Hedges' <i>g</i> 1.15; 95% CI 0.72 to 1.58), initiating and maintaining sleep (Hedges' <i>g</i> 0.86; 95% CI 0.39 to 1.33) and sleep hyperhidrosis (Hedges' <i>g</i> 0.48; 95% CI 0.29 to 0.66). Potential publication bias was detected for sleep latency, sleep period time and total sleep time measured by polysomnography. Some sleep alterations were moderated by age, sex and concurrent intellectual disability. The median NOS score was 8 (interquartile range 7.25-8.75).</p><p><strong>Conclusion: </strong>We found that medication-naïve children and adolescents with ASD presented significantly more subjective and objective sleep alterations compared to TD and identified possible moderators of these differences. Future research requires an analysis of how these sleep alterations are linked to core symptom severity and comorbid behavioural problems, which would provide an integrated therapeutic intervention for ASD. However, our results should be interpreted in light of the potential publication bias.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e48"},"PeriodicalIF":8.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10293635","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":"Insiders/outsiders of Canadian disability arts","authors":"Eliza Chandler, S. Lee, Lisa East, Megan Johnson","doi":"10.1017/S2045796023000598","DOIUrl":"https://doi.org/10.1017/S2045796023000598","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43872981","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":"School-based socio-emotional learning programs to prevent depression, anxiety and suicide among adolescents: a global cost-effectiveness analysis.","authors":"Y Y Lee,&nbsp;S Skeen,&nbsp;G J Melendez-Torres,&nbsp;C A Laurenzi,&nbsp;M van Ommeren,&nbsp;A Fleischmann,&nbsp;C Servili,&nbsp;C Mihalopoulos,&nbsp;D Chisholm","doi":"10.1017/S204579602300029X","DOIUrl":"https://doi.org/10.1017/S204579602300029X","url":null,"abstract":"<p><strong>Aims: </strong>Preventing the occurrence of depression/anxiety and suicide during adolescence can lead to substantive health gains over the course of an individual person's life. This study set out to identify the expected population-level costs and health impacts of implementing universal and indicated school-based socio-emotional learning (SEL) programs in different country contexts.</p><p><strong>Methods: </strong>A Markov model was developed to examine the effectiveness of delivering universal and indicated school-based SEL programs to prevent the onset of depression/anxiety and suicide deaths among adolescents. Intervention health impacts were measured in healthy life years gained (HLYGs) over a 100-year time horizon. Country-specific intervention costs were calculated and denominated in 2017 international dollars (2017 I$) under a health systems perspective. Cost-effectiveness findings were subsequently expressed in terms of I$ per HLYG. Analyses were conducted on a group of 20 countries from different regions and income levels, with final results aggregated and presented by country income group - that is, low and lower middle income countries (LLMICs) and upper middle and high-income countries (UMHICs). Uncertainty and sensitivity analyses were conducted to test model assumptions.</p><p><strong>Results: </strong>Implementation costs ranged from an annual per capita investment of I$0.10 in LLMICs to I$0.16 in UMHICs for the universal SEL program and I$0.06 in LLMICs to I$0.09 in UMHICs for the indicated SEL program. The universal SEL program generated 100 HLYGs per 1 million population compared to 5 for the indicated SEL program in LLMICs. The cost per HLYG was I$958 in LLMICS and I$2,006 in UMHICs for the universal SEL program and I$11,123 in LLMICs and I$18,473 in UMHICs for the indicated SEL program. Cost-effectiveness findings were highly sensitive to variations around input parameter values involving the intervention effect sizes and the disability weight used to estimate HLYGs.</p><p><strong>Conclusions: </strong>The results of this analysis suggest that universal and indicated SEL programs require a low level of investment (in the range of I$0.05 to I$0.20 per head of population) but that universal SEL programs produce significantly greater health benefits at a population level and therefore better value for money (e.g., less than I$1,000 per HLYG in LLMICs). Despite producing fewer population-level health benefits, the implementation of indicated SEL programs may be justified as a means of reducing population inequalities that affect high-risk populations who would benefit from a more tailored intervention approach.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e46"},"PeriodicalIF":8.1,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10477081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10538244","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":"Post-traumatic stress disorder among LGBTQ people: a systematic review and meta-analysis.","authors":"Mattia Marchi,&nbsp;Antonio Travascio,&nbsp;Daniele Uberti,&nbsp;Edoardo De Micheli,&nbsp;Pietro Grenzi,&nbsp;Elisa Arcolin,&nbsp;Luca Pingani,&nbsp;Silvia Ferrari,&nbsp;Gian M Galeazzi","doi":"10.1017/S2045796023000586","DOIUrl":"https://doi.org/10.1017/S2045796023000586","url":null,"abstract":"<p><strong>Aims: </strong>Lesbian, gay, bisexual, transgender and queer people (LGBTQ) are at increased risk of traumatization. This systematic review aimed to summarize data regarding the risk of post-traumatic stress disorder (PTSD) for LGBTQ people and their subgroups.</p><p><strong>Methods: </strong>Medline, Scopus, PsycINFO and EMBASE were searched until September 2022. Studies reporting a comparative estimation of PTSD among LGBTQ population and the general population (i.e., heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment, were identified. Meta-analyses were based on odds ratio (OR and 95% confidence intervals [CI]), estimated through inverse variance models with random effects.</p><p><strong>Results: </strong>The review process led to the selection of 27 studies, involving a total of 31,903 LGBTQ people and 273,842 controls, which were included in the quantitative synthesis. Overall, LGBTQ people showed an increased risk of PTSD (OR: 2.20 [95% CI: 1.85; 2.60]), although there was evidence of marked heterogeneity in the estimate (<i>I</i>² = 91%). Among LGBTQ subgroups, transgender people showed the highest risk of PTSD (OR: 2.52 [95% CI: 2.22; 2.87]) followed by bisexual people (OR: 2.44 [95% CI: 1.05; 5.66]), although these comparisons are limited by the lack of data for other sexual and gender minorities, such as intersex people. Interestingly, the risk of PTSD for bisexual people was confirmed also considering lesbian and gay as control group (OR: 1.44 [95% CI: 1.07; 1.93]). The quality of the evidence was low.</p><p><strong>Conclusions: </strong>LGBTQ people are at higher risk of PTSD compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity in this at-risk population.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e44"},"PeriodicalIF":8.1,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/42/S2045796023000586a.PMC10387489.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915117","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":"Specific effects of five subtypes of childhood maltreatment on suicide behaviours in Chinese adolescents: the moderating effect of sex and residence.","authors":"Chang Peng,&nbsp;Junhan Cheng,&nbsp;Fajuan Rong,&nbsp;Yan Wang,&nbsp;Yafei Tan,&nbsp;Yizhen Yu","doi":"10.1017/S2045796023000604","DOIUrl":"https://doi.org/10.1017/S2045796023000604","url":null,"abstract":"<p><strong>Aims: </strong>Although childhood maltreatment has been widely supported to be a robust predictor of suicide behaviours, the effects of different childhood maltreatment subtypes remain controversial and inconclusive. Moreover, whether the effects differ by sex in urban and rural adolescents is still unknown. This study aimed to quantify the associations between five subtypes of childhood maltreatment and different suicide behaviour involvement.</p><p><strong>Methods: </strong>A multistage cluster sampling method was adopted from April to December 2021 for adolescents aged 12 to 18 across five representative provinces of China. The Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment subtypes. Suicide behaviour involvement was classified as none group, suicide ideator, suicide planner and suicide attempter. Confounding variables include demographic characteristics, smoking, drinking alcohol, depression and anxiety.</p><p><strong>Results: </strong>Among a total of 18,980 adolescents, 2021 (10.6%) were suicide ideator, 1595 (8.4%) were suicide planner and 1014 (5.3%) were suicide attempter. Rural females had the highest proportion of suicide ideator (13.8%) and suicide planner (11.5%). Multinomial logistic regression analysis indicated that five childhood maltreatment subtypes were independently associated with suicide behaviours, except for associations between sexual abuse and suicide ideator as well as suicide planner (<i>p</i> > 0.05). Moreover, these associations differ by sex and residence. After adjusted for interactions of different subtypes, structural equation model indicated that the direct effects of childhood maltreatment subtypes on suicide behaviours from high to low were emotional abuse (<i>β</i> = 0.363, <i>p</i> < 0.001), physical abuse (<i>β</i> = 0.100, <i>p</i> < 0.001) and sexual abuse (<i>β</i> = 0.033, <i>p</i> = 0.003), while the effects of physical neglect and emotional neglect were not significant (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Five subtypes of childhood maltreatment have specific and non-equivalence associations with suicide behaviours. Emotional abuse may have the strongest effect, and sexual abuse have an acute effect on suicide behaviours. Suicide prevention programs for Chinese adolescents could focus on those who experienced emotional, physical and sexual abuse. Furthermore, strategies should be tailored by sex and residence, and rural females deserve more attention.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e45"},"PeriodicalIF":8.1,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915111","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":"Substance use before or during pregnancy and the risk of child mortality, perinatal morbidities and congenital anomalies.","authors":"Charles Tzu-Chi Lee,&nbsp;Vincent Chin-Hung Chen,&nbsp;Johnny Kuang-Wu Lee,&nbsp;Shu-I Wu,&nbsp;Gillian Cheng,&nbsp;Tzu-Min Kao,&nbsp;Shih-Yuan Wang,&nbsp;Michael Gossop","doi":"10.1017/S2045796023000549","DOIUrl":"https://doi.org/10.1017/S2045796023000549","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate child mortality, perinatal morbidities and congenital anomalies born by women with substance misuse during or before pregnancy (DP or BP).</p><p><strong>Methods: </strong>Taiwan Birth Registration from 2004 to 2014 linking Integrated Illicit Drug Databases used to include substance misuse participates. Children born by mothers convicted of substance misuse DP or BP were the substance-exposed cohort. Two substance-unexposed comparison cohorts were established: one comparison cohort selected newborns from the rest of the population on a ratio of 1:1 and exact matched by the child's gender, child's birth year, mother's birth year and child's first use of the health insurance card; another comparison cohort matched newborns from exposed and unexposed mothers by their propensity scores calculated from logistic regression.</p><p><strong>Results: </strong>The exposure group included 1776 DP, 1776 BP and 3552 unexposed individuals in exact-matched cohorts. A fourfold increased risk of deaths in children born by mothers exposed to substance during pregnancy was found compared to unexposed group (hazard ratio [HR] = 4.54, 95% confidence interval (CI): 2.07-9.97]. Further multivariate Cox regression models with adjustments and propensity matching substantially attenuated HRs on mortality in the substance-exposed cohort (aHR = 1.62, 95% CI: 1.10-2.39). Raised risks of perinatal morbidities and congenital anomalies were also found.</p><p><strong>Conclusions: </strong>Increased risks of child mortality, perinatal morbidities or congenital anomalies were found in women with substance use during pregnancy. From estimates before and after adjustments, our results showed that having outpatient visits or medical utilizations during pregnancy were associated with substantially attenuated HRs on mortality in the substance-exposed cohort. Therefore, the excess mortality risk might be partially explained by the lack of relevant antenatal clinical care. Our finding may suggest that the importance of early identification, specific abstinence program and access to appropriate antenatal care might be helpful in reducing newborn mortality. Adequate prevention policies may be formulated.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e43"},"PeriodicalIF":8.1,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915109","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":"Frequency and machine learning predictors of severe depressive symptoms and suicidal ideation among university students.","authors":"Nicola Meda, Susanna Pardini, Paolo Rigobello, Francesco Visioli, Caterina Novara","doi":"10.1017/S2045796023000550","DOIUrl":"10.1017/S2045796023000550","url":null,"abstract":"<p><strong>Aims: </strong>Prospective studies on the mental health of university students highlighted a major concern. Specifically, young adults in academia are affected by markedly worse mental health status than their peers or adults in other vocations. This situation predisposes to exacerbated disability-adjusted life-years.</p><p><strong>Methods: </strong>We enroled 1,388 students at the baseline, 557 of whom completed follow-up after 6 months, incorporating their demographic information and self-report questionnaires on depressive, anxiety and obsessive-compulsive symptoms. We applied multiple regression modelling to determine associations - at baseline - between demographic factors and self-reported mental health measures and supervised machine learning algorithms to predict the risk of poorer mental health at follow-up, by leveraging the demographic and clinical information collected at baseline.</p><p><strong>Results: </strong>Approximately one out of five students reported severe depressive symptoms and/or suicidal ideation. An association of economic worry with depression was evidenced both at baseline (when high-frequency worry odds ratio = 3.11 [1.88-5.15]) and during follow-up. The random forest algorithm exhibited high accuracy in predicting the students who maintained well-being (balanced accuracy = 0.85) or absence of suicidal ideation but low accuracy for those whose symptoms worsened (balanced accuracy = 0.49). The most important features used for prediction were the cognitive and somatic symptoms of depression. However, while the negative predictive value of worsened symptoms after 6 months of enrolment was 0.89, the positive predictive value is basically null.</p><p><strong>Conclusions: </strong>Students' severe mental health problems reached worrying levels, and demographic factors were poor predictors of mental health outcomes. Further research including people with lived experience will be crucial to better assess students' mental health needs and improve the predictive outcome for those most at risk of worsening symptoms.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e42"},"PeriodicalIF":5.9,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920981","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":"Changes in employment status and income before and after newly diagnosed depressive disorders in Taiwan: a matched cohort study using controlled interrupted time series analysis.","authors":"Yu-Ling Chen,&nbsp;Wei-Hsiang Liao,&nbsp;Shih-Heng Wang,&nbsp;Yin-Ju Lien,&nbsp;Chia-Ming Chang,&nbsp;Shih-Cheng Liao,&nbsp;Wei-Lieh Huang,&nbsp;Chi-Shin Wu","doi":"10.1017/S2045796023000562","DOIUrl":"https://doi.org/10.1017/S2045796023000562","url":null,"abstract":"<p><strong>Aims: </strong>We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan.</p><p><strong>Methods: </strong>Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year.</p><p><strong>Results: </strong>A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups.</p><p><strong>Conclusions: </strong>The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e41"},"PeriodicalIF":8.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972067","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":"Can we interrogate public databases to fill critical gaps in mental health epidemiology? Testing the association between cannabis and psychosis in the UK as an example.","authors":"Gianfranco Di Gennaro,&nbsp;Marco Colizzi","doi":"10.1017/S2045796023000537","DOIUrl":"https://doi.org/10.1017/S2045796023000537","url":null,"abstract":"<p><p>The psychoactive properties of cannabis have been known forever. Since 1987, several prospective studies have suggested an increased risk of psychosis among cannabis users, with alternative explanations failing to account for such an effect. A cause-effect relationship has thus been implied. Further evidence has indicated that there is a dose-response relationship, and high-potency cannabis varieties confer the greatest risk of psychosis. As cannabis use has become more common over the last decades, one would expect a related increase in the number of schizophrenia cases. However, evidence in this regard remains equivocal for several reasons, including relying on databases that are not primarily designed to address such question and the issue that solid information regarding the incidence of schizophrenia is a relatively recent acquisition. Recent years have seen the development of online web publications, such as Google Trends and \"Our World in Data\", where data are explorable and interactable for tracking and comparing trends over specific periods and world regions. By using such databases, we believe that the question whether changes in cannabis use are associated with changes in schizophrenia rates can be answered, at least partly. Therefore, we tested these tools by evaluating trends in cannabis use and both cases and prevalence of schizophrenia in the United Kingdom, one of the countries where the incident rates for psychotic disorder have been suggested to be particularly increased by cannabis consumption. Crossing data from these tools revealed that interest in cannabis has been growing at the country level for over 10 years, with a parallel overlapping raise in psychosis cases and prevalence. Following up on this example, let us think of how many public health opportunities these public resources may offer. The question now is whether public health interventions for the benefit of the general population will follow suit.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e40"},"PeriodicalIF":8.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699442","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":"Population-based cohort study of oral contraceptive use and risk of depression.","authors":"T Johansson, S Vinther Larsen, M Bui, W E Ek, T Karlsson, Å Johansson","doi":"10.1017/S2045796023000525","DOIUrl":"10.1017/S2045796023000525","url":null,"abstract":"<p><strong>Aim: </strong>Research on the effect of oral contraceptive (OC) use on the risk of depression shows inconsistent findings, especially in adult OC users. One possible reason for this inconsistency is the omission of women who discontinue OCs due to adverse mood effects, leading to healthy user bias. To address this issue, we aim to estimate the risk of depression that is associated with the initiation of OCs as well as the effect of OC use on lifetime risk of depression.</p><p><strong>Methods: </strong>This is a population-based cohort study based on data from 264,557 women from the UK Biobank. Incidence of depression was addressed via interviews, inpatient hospital or primary care data. The hazard ratio (HR) between OC use and incident depression was estimated by multivariable Cox regression with OC use as a time-varying exposure. To validate causality, we examined familial confounding in 7,354 sibling pairs.</p><p><strong>Results: </strong>We observed that the first 2 years of OC use were associated with a higher rate of depression compared to never users (HR = 1.71, 95% confidence interval [CI]: 1.55-1.88). Although the risk was not as pronounced beyond the first 2 years, ever OC use was still associated with an increased lifetime risk of depression (HR = 1.05, 95% CI: 1.01-1.09). Previous OC use were associated with a higher rate of depression compared to never users, with adolescent OC users driving the increased hazard (HR = 1.18, 95% CI: 1.12-1.25). No significant association were observed among adult OC users who had previously used OCs (HR = 1.00, 95% CI: 0.95-1.04). Notably, the sibling analysis provided further evidence for a causal effect of OC use on the risk of depression.</p><p><strong>Conclusions: </strong>Our findings suggest that the use of OCs, particularly during the first 2 years, increases the risk of depression. Additionally, OC use during adolescence might increase the risk of depression later in life. Our results are consistent with a causal relationship between OC use and depression, as supported by the sibling analysis. This study highlights the importance of considering the healthy user bias as well as family-level confounding in studies of OC use and mental health outcomes. Physicians and patients should be aware of this potential risk when considering OCs, and individualized risk-benefit assessments should be conducted.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e39"},"PeriodicalIF":8.1,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707075","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}