Epidemiology and Psychiatric Sciences最新文献

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Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence SSRI 后性功能障碍:量化发生率和流行率的障碍
IF 8.1 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-09-18 DOI: 10.1017/s2045796024000441
David Healy, Dee Mangin
{"title":"Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence","authors":"David Healy, Dee Mangin","doi":"10.1017/s2045796024000441","DOIUrl":"https://doi.org/10.1017/s2045796024000441","url":null,"abstract":"While sexual dysfunction is a well-known side effect of taking selective serotonin reuptake inhibitors (SSRIs), in an undetermined number of patients, sexual function does not return to pre-drug baseline after stopping SSRIs. The condition is known as post-SSRI sexual dysfunction (PSSD) and is characterised most commonly by genital numbness, pleasureless or weak orgasm, loss of libido and erectile dysfunction. This article provides a commentary on the incidence and prevalence of PSSD based on a combination of academic literature as well as clinical and research experience. A number of obstacles to quantifying the occurrence of PSSD are outlined including difficulty in designing a suitable study method. Other contextual obstacles include patient embarrassment at raising sexual concerns, the response of healthcare professionals, inability to stop an antidepressant due to withdrawal issues in a proportion of patients and patient unawareness that their sexual difficulties are linked to prior medication compounded by variability of online information and a lack of information aimed at public education. A definition of PSSD with diagnostic criteria has been published. A MedDRA code for PSSD has also been introduced, but this is yet to be adopted by regulators.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"17 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263842","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}
引用次数: 0
‘Broken souls’ vs. ‘mad ax man’ – changes in the portrayal of depression and schizophrenia in the German media over 10 years 破碎的灵魂 "与 "疯狂的斧头男"--10 年来德国媒体对抑郁症和精神分裂症的描述变化
IF 8.1 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-09-18 DOI: 10.1017/s204579602400043x
M. Sittner, T. Rechenberg, S. Speerforck, M.C Angermeyer, G. Schomerus
{"title":"‘Broken souls’ vs. ‘mad ax man’ – changes in the portrayal of depression and schizophrenia in the German media over 10 years","authors":"M. Sittner, T. Rechenberg, S. Speerforck, M.C Angermeyer, G. Schomerus","doi":"10.1017/s204579602400043x","DOIUrl":"https://doi.org/10.1017/s204579602400043x","url":null,"abstract":"Aims Population studies show the stigma of depression to diminish, while the stigma of schizophrenia increases. To find out whether this widening gap is reflected in the media portrayal of both disorders, this study compares the portrayal of depression and schizophrenia in German print media in 2010 vs. 2020. Methods We conducted a qualitative content analysis using a mixed deductive-inductive approach to establish a category system. In total, we analyzed 854 articles with the summative approach by Mayring. Results The study found a widening gap in the portrayal of schizophrenia and depression in German media between 2010 and 2020. Schizophrenia was depicted increasingly negative between 2010 and 2020, covering more negative stereotypes and focusing on its biological causes. Depression received increased attention and more neutral and professional coverage, with a greater emphasis on psychosocial causes and discussion of treatment options. Conclusions By showing a widening gap the study highlights how media may shape public views on mental illnesses and reflects public attitudes at the same time. Media analyses from other nations have shown similar trends. This emphasizes the need for responsible reporting to combat stigma and promote understanding worldwide. Therefore, the authors recommend a balanced coverage that includes accurate professional information about all mental illnesses.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"20 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263841","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}
引用次数: 0
Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach 捕捉向初级精神健康服务机构求诊的年轻人的临床复杂性:一种数据驱动的方法
IF 8.1 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-09-18 DOI: 10.1017/s2045796024000386
Caroline X. Gao, Nic Telford, Kate M. Filia, Jana M. Menssink, Sabina Albrecht, Patrick D. McGorry, Matthew Hamilton, Mengmeng Wang, Daniel Gan, Dominic Dwyer, Sophie Prober, Isabel Zbukvic, Myriam Ziou, Sue M. Cotton, Debra J. Rickwood
{"title":"Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach","authors":"Caroline X. Gao, Nic Telford, Kate M. Filia, Jana M. Menssink, Sabina Albrecht, Patrick D. McGorry, Matthew Hamilton, Mengmeng Wang, Daniel Gan, Dominic Dwyer, Sophie Prober, Isabel Zbukvic, Myriam Ziou, Sue M. Cotton, Debra J. Rickwood","doi":"10.1017/s2045796024000386","DOIUrl":"https://doi.org/10.1017/s2045796024000386","url":null,"abstract":"Aims The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering <jats:italic>headspace</jats:italic> services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings. Methods This retrospective study involved analysis of <jats:italic>headspace</jats:italic>’s clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors. Results A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a ‘high complexity’ group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing ‘distress complexity’ and ‘psychosocial complexity’ (about 20% each). Compared with the ‘distress complexity’ group, young people in the ‘psychosocial complexity’ group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different <jats:italic>headspace</jats:italic> services. Conclusions The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to <jats:italic>headspace</jats:italic> early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"77 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263843","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}
引用次数: 0
Effect of coercive measures on mental health status in adult psychiatric populations: a nationwide trial emulation 强制措施对成年精神病患者心理健康状况的影响:全国范围内的模拟试验
IF 8.1 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-09-12 DOI: 10.1017/s2045796024000416
S. Baggio, S. Kaiser, C.G. Huber, A. Wullschleger
{"title":"Effect of coercive measures on mental health status in adult psychiatric populations: a nationwide trial emulation","authors":"S. Baggio, S. Kaiser, C.G. Huber, A. Wullschleger","doi":"10.1017/s2045796024000416","DOIUrl":"https://doi.org/10.1017/s2045796024000416","url":null,"abstract":"Aims Healthcare staff use coercive measures to manage patients at acute risk of harm to self or others, but their effect on patients’ mental health is underexplored. This nationwide Swiss study emulated a trial to investigate the effects of coercive measures on the mental health of psychiatric inpatients at discharge. Methods We analysed retrospective longitudinal data from all Swiss adult psychiatric hospitals that provided acute care (2019–2021). The primary exposure was any coercive measure during hospitalization; secondary exposures were seclusion, restraint and forced medication. Our primary outcome was Health of the Nations Outcome Scale (HoNOS) score at discharge. We used inverse probability of treatment weighting to emulate random assignment to the exposure. Results Of 178,369 hospitalizations, 9.2% (<jats:italic>n</jats:italic> = 18,800) included at least one coercive measure. In patients exposed to coercive measures, mental health worsened a small but statistically significant amount more than in non-exposed patients. Those who experienced at least one coercive measure during hospitalization had a significantly higher HoNOS score (1.91-point, <jats:italic>p</jats:italic> &lt; .001, 95% confidence interval [CI]: 1.73; 2.09) than those who did not experience any coercive measure. Results were similar for seclusion (1.60-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 1.40; 1.79) and forced medication (1.97-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 1.65; 2.30). Restraint had the strongest effect (2.83-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 2.38; 3.28). Conclusions Our study presents robust empirical evidence highlighting the detrimental impact of coercive measures on the mental health of psychiatric inpatients. It underscores the importance of avoiding these measures in psychiatric hospitals and emphasized the urgent need for implementing alternatives in clinical practice.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"37 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175441","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}
引用次数: 0
Australian Youth Self-Harm Atlas: spatial modelling and mapping of self-harm prevalence and related risk and protective factors to inform youth suicide prevention strategies. 澳大利亚青少年自残地图:自残发生率及相关风险和保护因素的空间建模和绘图,为青少年自杀预防战略提供信息。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-09-09 DOI: 10.1017/S2045796024000301
E Hielscher, K Hay, I Chang, M McGrath, K Poulton, E Giebels, J Blake, P J Batterham, J G Scott, D Lawrence
{"title":"Australian Youth Self-Harm Atlas: spatial modelling and mapping of self-harm prevalence and related risk and protective factors to inform youth suicide prevention strategies.","authors":"E Hielscher, K Hay, I Chang, M McGrath, K Poulton, E Giebels, J Blake, P J Batterham, J G Scott, D Lawrence","doi":"10.1017/S2045796024000301","DOIUrl":"10.1017/S2045796024000301","url":null,"abstract":"<p><strong>Aims: </strong>Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people.</p><p><strong>Methods: </strong>A random sample of Australian adolescents (12-17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019.</p><p><strong>Results: </strong>Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm.</p><p><strong>Conclusions: </strong>This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth suicide prevention interventions and initiatives.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e34"},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153400","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}
引用次数: 0
Factors associated with chronic depressive symptoms across adolescence and young adulthood: a UK birth cohort study. 青春期和青年期慢性抑郁症状的相关因素:英国出生队列研究。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-06-26 DOI: 10.1017/S2045796024000350
B B Durdurak, B Williams, A Zhigalov, A Moore, P Mallikarjun, D Wong, S Marwaha, I Morales-Muñoz
{"title":"Factors associated with chronic depressive symptoms across adolescence and young adulthood: a UK birth cohort study.","authors":"B B Durdurak, B Williams, A Zhigalov, A Moore, P Mallikarjun, D Wong, S Marwaha, I Morales-Muñoz","doi":"10.1017/S2045796024000350","DOIUrl":"10.1017/S2045796024000350","url":null,"abstract":"<p><strong>Aims: </strong>Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people.</p><p><strong>Methods: </strong>We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms.</p><p><strong>Results: </strong>Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms.</p><p><strong>Conclusions: </strong>Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e32"},"PeriodicalIF":5.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450145","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}
引用次数: 0
Longitudinal associations between post-traumatic stress and post-traumatic growth among older adults 11 years after a disaster. 灾难发生 11 年后,老年人的创伤后压力与创伤后成长之间的纵向联系。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-06-26 DOI: 10.1017/S2045796024000362
Hiroyuki Hikichi, Kanako Taku, Jun Aida, Katsunori Kondo, Ichiro Kawchi
{"title":"Longitudinal associations between post-traumatic stress and post-traumatic growth among older adults 11 years after a disaster.","authors":"Hiroyuki Hikichi, Kanako Taku, Jun Aida, Katsunori Kondo, Ichiro Kawchi","doi":"10.1017/S2045796024000362","DOIUrl":"10.1017/S2045796024000362","url":null,"abstract":"<p><strong>Aims: </strong>Previous studies have reported inconsistent findings regarding the association between post-traumatic stress (PTS) and post-traumatic growth (PTG). Three major issues could account for this inconsistency: (1) the lack of information about mental health problems before the disaster, (2) the concept of PTG is still under scrutiny for potentially being an illusionary perception of personal growth and (3) the overlooking of PTS comorbidities as time-dependent confounding factors. To address these issues, we explored the associations of PTS and PTG with trauma-related diseases and examined the association between PTS and PTG using marginal structural models to address time-dependent confounding, considering pre-disaster covariates, among older survivors of the 2011 Japan Earthquake and Tsunami.</p><p><strong>Methods: </strong>Seven months before the disaster, the baseline survey was implemented to ask older adults about their health in a city located 80 km west of the epicentre. After the disaster, we implemented follow-up surveys approximately every 3 years to collect information about PTS and comorbidities (depressive symptoms, smoking and drinking). We asked respondents about their PTG in the 2022 survey (<i>n</i> = 1,489 in the five-wave panel data).</p><p><strong>Results: </strong>PTG was protectively associated with functional disability (coefficient -0.47, 95% confidence interval (CI) -0.82, -0.12, <i>P</i> < 0.01) and cognitive decline assessed by trained investigators (coefficient -0.07, 95% CI -0.11, -0.03, <i>P</i> < 0.01) and physicians (coefficient -0.06, 95% CI -0.11, -0.02, <i>P</i> < 0.01), while PTS was not significantly associated with them. Severely affected PTS (binary variable) was associated with higher PTG scores, even after adjusting for depressive symptoms, smoking and drinking as time-dependent confounders (coefficient 0.35, 95% CI 0.24, 0.46, <i>P</i> < 0.01). We also found that an ordinal variable of the PTS score had an inverse U-shaped association with PTG.</p><p><strong>Conclusion: </strong>PTG and PTS were differentially associated with functional and cognitive disabilities. Thus, PTG might not simply be a cognitive bias among survivors with severe PTS. The results also indicated that the number of symptoms in PTS had an inverse U-shaped association with PTG. Our findings provided robust support for the theory of PTG, suggesting that moderate levels of psychological struggles (i.e., PTS) are essential for achieving PTG, whereas intense PTS may hinder the attainment of PTG. From a clinical perspective, interventions that encourage social support could be beneficial in achieving PTG by facilitating deliberate rumination.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e33"},"PeriodicalIF":5.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450146","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}
引用次数: 0
Mortality risk and mood stabilizers in bipolar disorder: a propensity-score-weighted population-based cohort study in 2002-2018. 双相情感障碍患者的死亡风险与情绪稳定剂:2002-2018 年基于倾向分数加权的人群队列研究。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-05-23 DOI: 10.1017/S2045796024000337
Joe Kwun Nam Chan, Corine Sau Man Wong, Catherine Zhiqian Fang, Samson Chun Hung, Heidi Ka Ying Lo, Wing Chung Chang
{"title":"Mortality risk and mood stabilizers in bipolar disorder: a propensity-score-weighted population-based cohort study in 2002-2018.","authors":"Joe Kwun Nam Chan, Corine Sau Man Wong, Catherine Zhiqian Fang, Samson Chun Hung, Heidi Ka Ying Lo, Wing Chung Chang","doi":"10.1017/S2045796024000337","DOIUrl":"10.1017/S2045796024000337","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Accumulating studies have assessed mortality risk associated with mood-stabilizers, the mainstay treatment for bipolar disorder (BD). However, existing data were mostly restricted to suicide risk, focused on lithium and valproate and rarely adequately adjusted for potential confounders. This study aimed to assess comparative mortality risk with all, natural and unnatural causes between lithium, valproate and three frequently prescribed second-generation antipsychotics (SGA), with adjustment for important confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This population-based cohort study identified 8137 patients with first-diagnosed BD, who had exposed to lithium (&lt;i&gt;n&lt;/i&gt; = 1028), valproate (&lt;i&gt;n&lt;/i&gt; = 3580), olanzapine (&lt;i&gt;n&lt;/i&gt; = 797), quetiapine (&lt;i&gt;n&lt;/i&gt; = 1975) or risperidone (&lt;i&gt;n&lt;/i&gt; = 757) between 2002 and 2018. Data were retrieved from territory-wide medical-record database of public healthcare services in Hong Kong. Propensity-score (PS)-weighting method was applied to optimize control for potential confounders including pre-existing chronic physical diseases, substance/alcohol use disorders and other psychotropic medications. PS-weighted Cox proportional-hazards regression was conducted to assess risk of all-, natural- and unnatural-cause mortality related to each mood-stabilizer, compared to lithium. Three sets of sensitivity analyses were conducted by restricting to patients with (i) length of cumulative exposure to specified mood-stabilizer ≥90 days and its medication possession ratio (MPR) ≥90%, (ii) MPR of specified mood-stabilizer ≥80% and MPR of other studied mood-stabilizers &lt;20% and (iii) monotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Incidence rates of all-cause mortality per 1000 person-years were 5.9 (95% confidence interval [CI]: 4.5-7.6), 8.4 (7.4-9.5), 11.1 (8.3-14.9), 7.4 (6.0-9.2) and 12.0 (9.3-15.6) for lithium-, valproate-, olanzapine-, quetiapine- and risperidone-treated groups, respectively. BD patients treated with olanzapine (PS-weighted hazard ratio = 2.07 [95% CI: 1.33-3.22]) and risperidone (1.66 [1.08-2.55]) had significantly higher all-cause mortality rate than lithium-treated group. Olanzapine was associated with increased risk of natural-cause mortality (3.04 [1.54-6.00]) and risperidone was related to elevated risk of unnatural-cause mortality (3.33 [1.62-6.86]), relative to lithium. The association between olanzapine and increased natural-cause mortality rate was consistently affirmed in sensitivity analyses. Relationship between risperidone and elevated unnatural-cause mortality became non-significant in sensitivity analyses restricted to low MPR in other mood-stabilizers and monotherapy. Valproate- and lithium-treated groups did not show significant differences in all-, natural- or unnatural-cause mortality risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our data showed that olanzapine and risperidone were associated with higher mortality risk than lithium, and further supported the clinic","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e31"},"PeriodicalIF":5.9,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080791","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}
引用次数: 0
Time-varying living arrangements and suicide death in the general population sample: 14-year causal survival analysis via pooled logistic regression. 普通人群样本中的时变生活安排与自杀死亡:通过集合逻辑回归进行的 14 年因果生存分析。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-05-23 DOI: 10.1017/S2045796024000325
Z Narita, T Shinozaki, A Goto, H Hori, Y Kim, H C Wilcox, M Inoue, S Tsugane, N Sawada
{"title":"Time-varying living arrangements and suicide death in the general population sample: 14-year causal survival analysis via pooled logistic regression.","authors":"Z Narita, T Shinozaki, A Goto, H Hori, Y Kim, H C Wilcox, M Inoue, S Tsugane, N Sawada","doi":"10.1017/S2045796024000325","DOIUrl":"10.1017/S2045796024000325","url":null,"abstract":"<p><strong>Aims: </strong>While past research suggested that living arrangements are associated with suicide death, no study has examined the impact of sustained living arrangements and the change in living arrangements. Also, previous survival analysis studies only reported a single hazard ratio (HR), whereas the actual HR may change over time. We aimed to address these limitations using causal inference approaches.</p><p><strong>Methods: </strong>Multi-point data from a general Japanese population sample were used. Participants reported their living arrangements twice within a 5-year time interval. After that, suicide death, non-suicide death and all-cause mortality were evaluated over 14 years. We used inverse probability weighted pooled logistic regression and cumulative incidence curve, evaluating the association of time-varying living arrangements with suicide death. We also studied non-suicide death and all-cause mortality to contextualize the association. Missing data for covariates were handled using random forest imputation.</p><p><strong>Results: </strong>A total of 86,749 participants were analysed, with a mean age (standard deviation) of 51.7 (7.90) at baseline. Of these, 306 died by suicide during the 14-year follow-up. Persistently living alone was associated with an increased risk of suicide death (risk difference [RD]: 1.1%, 95% confidence interval [CI]: 0.3-2.5%; risk ratio [RR]: 4.00, 95% CI: 1.83-7.41), non-suicide death (RD: 7.8%, 95% CI: 5.2-10.5%; RR: 1.56, 95% CI: 1.38-1.74) and all-cause mortality (RD: 8.7%, 95% CI: 6.2-11.3%; RR: 1.60, 95% CI: 1.42-1.79) at the end of the follow-up. The cumulative incidence curve showed that these associations were consistent throughout the follow-up. Across all types of mortality, the increased risk was smaller for those who started to live with someone and those who transitioned to living alone. The results remained robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>Individuals who persistently live alone have an increased risk of suicide death as well as non-suicide death and all-cause mortality, whereas this impact is weaker for those who change their living arrangements.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e30"},"PeriodicalIF":5.9,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080794","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}
引用次数: 0
Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement. 社会参与多样性对重新安置期间人道主义移民心理健康的贡献。
IF 5.9 2区 医学
Epidemiology and Psychiatric Sciences Pub Date : 2024-05-23 DOI: 10.1017/S2045796024000313
Weiqing Jiang, Yuwei Yang, Yitong He, Qianyu Liu, Xueqing Deng, Yilin Hua, Alimila Hayixibayi, Yanyan Ni, Lan Guo
{"title":"Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement.","authors":"Weiqing Jiang, Yuwei Yang, Yitong He, Qianyu Liu, Xueqing Deng, Yilin Hua, Alimila Hayixibayi, Yanyan Ni, Lan Guo","doi":"10.1017/S2045796024000313","DOIUrl":"10.1017/S2045796024000313","url":null,"abstract":"<p><strong>Aims: </strong>By the end of 2022, an estimated 108.4 million individuals worldwide experienced forced displacement. Identifying modifiable factors associated with the mental illness of refugees is crucial for promoting successful integration and developing effective health policies. This study aims to examine the associations between the changes in the diversity of social participation and psychological distress among refugees throughout the resettlement process, specifically focusing on gender differences.</p><p><strong>Methods: </strong>Utilizing data from three waves of a longitudinal, nationally representative cohort study conducted in Australia, this study involved 2399 refugees interviewed during Wave 1, 1894 individuals interviewed during Wave 3 and 1881 respondents during Wave 5. At each wave, we assessed psychological distress and 10 types of social participation across 3 distinct dimensions, including social activities, employment and education. The primary analysis employed mixed linear models and time-varying Cox models. Gender-stratified analyses and sensitivity analyses were performed.</p><p><strong>Results: </strong>Refugees engaging in one type or two or more types of social participation, compared with those not engaging in any, consistently had lower psychological distress scores (<i>β</i> = -0.62 [95% confidence interval (CI), -1.07 to -0.17] for one type of social participation; <i>β</i> = -0.57 [95% CI, -1.04 to -0.10] for two or more types of social participation) and a reduced risk of experiencing psychological distress (hazard ratio [HR] = 0.81 [95% CI, 0.65-0.99] for one type of social participation; HR = 0.77 [95% CI, 0.61-0.97] for two or more types of social participation) during the resettlement period. When stratifying the results by gender, these associations in the adjusted models only remained significant in male refugees. Moreover, three specific types of social participation, namely sporting activities, leisure activities and current employment status, were most prominently associated with a reduced risk of psychological distress.</p><p><strong>Conclusions: </strong>The findings of this cohort study suggest that social participation was consistently associated with reduced risks of psychological distress among male refugees during resettlement. These findings highlight the significance of promoting meaningful social participation and interaction may be an effective strategy to improve the mental health of refugees and facilitate their successful integration into society, especially among male refugees.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e29"},"PeriodicalIF":5.9,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080788","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}
引用次数: 0
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