Epidemiology and Psychiatric Sciences最新文献

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"title":"The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990-2019: a systematic analysis for GBD 2019.","authors":"Zhi-Yang Mo, Ze-Zhen Qin, Jun-Jie Ye, Xin-Xuan Hu, Rui Wang, Ya-Ye Zhao, Ping Zheng, Qiao-Shan Lu, Qiao Li, Xian-Yan Tang","doi":"10.1017/S2045796024000295","DOIUrl":"10.1017/S2045796024000295","url":null,"abstract":"<p><strong>Aims: </strong>Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990-2019.</p><p><strong>Methods: </strong>We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age-period-cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.</p><p><strong>Results: </strong>During 1990-2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990-2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60-64 in women, and at the age of 75-84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5-9. Population living during 2000-2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.</p><p><strong>Conclusions: </strong>Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000-2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065187","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":"The double burden of severe mental illness and cancer: a population-based study on colorectal cancer care pathways from screening to end-of-life care.","authors":"A-V Seppänen, F Daniel, S Houzard, C Le Bihan, M Coldefy, C Gandré","doi":"10.1017/S2045796024000234","DOIUrl":"10.1017/S2045796024000234","url":null,"abstract":"<p><strong>Aims: </strong>Cancer is one of the main causes of death in persons with severe mental illness (SMI). Although their cancer incidence is similar, or sometimes even potentially lower compared to the general population, their cancer mortality remains higher. The role of healthcare provision and care equity in this mortality is increasingly being addressed in research, but available studies are limited in their scope. In this context, our aim was to compare colorectal cancer (CRC) care pathways from screening to end-of-life care in patients with and without pre-existing SMI on a national scale.</p><p><strong>Methods: </strong>This research leverages real-world data from the French national health claims database, covering the entire population, to assess cancer screening, diagnosis, treatment and post-treatment follow-up as well as quality of care (QOC) pathways among patients with incident CRC in 2015-2018, considering whether they had pre-existing SMI. We matched patients with SMI with three patients without - on age, sex, region of residence, year of cancer incidence and cancer type and location at presentation - as well as nationally established quality of CRC care indicators and regression models adjusting for relevant socio-economic, clinical and care provider-related covariates.</p><p><strong>Results: </strong>Among patients with incident CRC, 1,532 individuals with pre-existing SMI were matched with individuals without SMI. After adjusting for covariates, both colon and rectal cancer patients with SMI were less likely to participate in the national CRC screening programme and to receive advanced diagnostic examinations (e.g., colonoscopies and several complementary diagnostic examinations). They also had lower odds of receiving combined treatments (e.g., neoadjuvant chemotherapy, radiotherapy and excision) and of having access to targeted therapy or capecitabine but higher odds for invasive care (e.g., stoma). Colon cancer patients with SMI were also more likely to have no treatment at all, and rectal cancer patients with SMI were less likely to receive post-treatment follow-up. Suboptimal QOC was observed for both groups of patients, but to a higher extent for patients with SMI, with statistically significant differences for indicators focusing on diagnosis and post-treatment follow-up.</p><p><strong>Conclusions: </strong>Our findings reveal discrepancies across the care continuum of CRC between individuals with and without SMI and provide initial avenues on where to focus future efforts to address them, notably at the entry and exit stages of cancer care pathways, while calling for further research on the mechanisms preventing equity of physical healthcare for individuals with SMI.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921724","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":"Sickness absence and associations with sociodemographic factors, health risk behaviours, occupational stressors and adverse mental health in 40,343 UK police employees.","authors":"S Parkes, P Irizar, N Greenberg, S Wessely, N T Fear, M Hotopf, S A M Stevelink","doi":"10.1017/S2045796024000283","DOIUrl":"10.1017/S2045796024000283","url":null,"abstract":"<p><strong>Aims: </strong>Police employees may experience high levels of stress due to the challenging nature of their work which can then lead to sickness absence. To date, there has been limited research on sickness absence in the police. This exploratory analysis investigated sickness absence in UK police employees.</p><p><strong>Methods: </strong>Secondary data analyses were conducted using data from the Airwave Health Monitoring Study (2006-2015). Past year sickness absence was self-reported and categorised as none, low (1-5 days), moderate (6-19 days) and long-term sickness absence (LTSA, 20 or more days). Descriptive statistics and multinomial logistic regressions were used to examine sickness absence and exploratory associations with sociodemographic factors, occupational stressors, health risk behaviours, and mental health outcomes, controlling for rank, gender and age.</p><p><strong>Results: </strong>From a sample of 40,343 police staff and police officers, forty-six per cent had no sickness absence within the previous year, 33% had a low amount, 13% a moderate amount and 8% were on LTSA. The groups that were more likely to take sick leave were women, non-uniformed police staff, divorced or separated, smokers and those with three or more general practitioner consultations in the past year, poorer mental health, low job satisfaction and high job strain.</p><p><strong>Conclusions: </strong>The study highlights the groups of police employees who may be more likely to take sick leave and is unique in its use of a large cohort of police employees. The findings emphasise the importance of considering possible modifiable factors that may contribute to sickness absence in UK police forces.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":null,"pages":null},"PeriodicalIF":8.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847285","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}