Epidemiology and Psychiatric Sciences最新文献

{"title":"Association of adverse childhood experiences and gastrointestinal and liver diseases among middle-aged and elderly adults in China.","authors":"Yuanfeng Zhang, Chenglong Li, Zilun Wu, Yang Cao, Zumin Shi","doi":"10.1017/S2045796026100729","DOIUrl":"10.1017/S2045796026100729","url":null,"abstract":"<p><strong>Aims: </strong>Research on the link between threat-related and deprivation-related adverse childhood experiences (ACEs) and the risk of gastrointestinal (GI) and liver diseases in later life remains limited. This study aims to evaluate the independent associations of threat-related and deprivation-related ACEs with the development of GI and liver disorders in middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>This prospective cohort study used data from the China Health and Retirement Longitudinal Study, which included participants aged 45 and older who had complete ACE data, two health assessments, and no pre-existing GI or liver conditions at baseline. Participants reported on five threat-related and deprivation-related ACEs before age 17. GI and liver diseases were classified based on self-reported physician diagnoses.</p><p><strong>Results: </strong>The outcomes of GI and liver diseases are based on self-reported physician diagnosis and broad categories. Compared with no exposures, participants with two or more threat-related ACEs exhibited a higher risk of both chronic liver disease (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.04-1.52; <i>P</i> = 0.016) and GI disease (HR, 1.36; 95% CI, 1.20-1.55; <i>P</i> < 0.001); two or more deprivation-related ACEs showed stronger associations with GI disease (HR, 1.48; 95% CI, 1.28-1.70; <i>P</i> < 0.001); and no significant associations with liver disease risk across all exposure levels. Additionally, depressive symptoms accounted for 10.7% (<i>P</i> = 0.003) of the association between threat-related ACEs and liver disease risk and accounted for 12.7% (<i>P</i> < 0.001) of the association between threat-related ACEs and GI disease risk. Midlife loneliness accounted for 5.3% (<i>P</i> = 0.001) of the association between threat-related ACEs and incident GI diseases and for 3.7% (<i>P</i> = 0.004) of the association between deprivation-related ACEs and incident GI diseases.</p><p><strong>Conclusions: </strong>Threat-related ACEs are directly associated with an increased risk of liver and GI diseases. A modest proportion of this observed relationship is partially mediated through depressive symptoms and loneliness in middle age.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e40"},"PeriodicalIF":5.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519907","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":"Prevalence of unipolar mania in bipolar I disorder: a systematic review and meta-analysis of observational studies.","authors":"Francesco Bartoli, Daniele Cavaleri, Martina Citton, Giorgio Cucchi, Martina Monti, Aldo De Pietra, Cristina Crocamo, Giuseppe Carrà","doi":"10.1017/S2045796026100791","DOIUrl":"10.1017/S2045796026100791","url":null,"abstract":"<p><strong>Aims: </strong>Unipolar mania (UM), defined by the occurrence of manic episodes without a history of depression, is a topic of debate within the classification of affective disorders. However, its epidemiological burden remains unclear. This systematic review and meta-analysis aimed to estimate the prevalence of UM among individuals with bipolar type I disorder (BD-I) while exploring potential sources of heterogeneity.</p><p><strong>Methods: </strong>The study protocol was registered in Open Science Framework on 27 March 2025. Embase, MEDLINE and APA PsycInfo were searched. We included observational studies reporting data on UM prevalence rates in adults with BD-I. Pooled prevalence was estimated using the Freeman-Tukey double arcsine transformation, employing a restricted maximum likelihood random-effects model. Subgroup and meta-regression analyses were implemented to explore sources of heterogeneity.</p><p><strong>Results: </strong>We included 26 studies, encompassing 35 independent samples and 17,716 individuals with BD-I. The pooled prevalence of UM was 21.1% (95% confidence interval: 15.5-27.4%). Although potential publication bias was detected (Egger's <i>p</i> = 0.010), the trim-and-fill method did not impute any missing studies. No differences were found between clinical and community-based studies (<i>p</i> = 0.966). However, prevalence estimates were influenced by both geographical area (<i>p</i> = 0.020) and study quality (<i>p</i> = 0.014). Rate differences across studies may also be attributable to variations in UM diagnostic definition.</p><p><strong>Conclusions: </strong>People with UM represent a significant subset of BD-I cases worldwide, warranting greater clinical awareness. The observed rate variability emphasizes the impact of sociocultural and methodological factors on UM diagnosis. Further research is necessary to refine diagnostic criteria and evaluate optimal treatment approaches for individuals with UM.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e38"},"PeriodicalIF":5.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469647","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":"Intersectional inequalities in childhood maltreatment and adolescent emotional problems in England: a random-coefficient MAIHDA analysis - CORRIGENDUM.","authors":"Laura Havers, Mina Fazel, Melanie Smuk, Daisy Fancourt, Peter Fonagy, Paul McCrone, Gabriela Pavarini, Kamaldeep Bhui, Georgina M Hosang, Sania Shakoor","doi":"10.1017/S2045796026100766","DOIUrl":"10.1017/S2045796026100766","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e37"},"PeriodicalIF":5.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410971","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":"Mapping trajectories of child and adolescent psychopathology: ascertainment of mental health needs in a general population-ERRATUM.","authors":"Ida Scheel Rasmussen, Philip Wilson, Gritt Overbeck, Claus Thorn Ekstrøm, Else Marie Olsen, Katrine Strandberg-Larsen","doi":"10.1017/S2045796026100754","DOIUrl":"10.1017/S2045796026100754","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e36"},"PeriodicalIF":5.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411114","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":"Social inclusion inequalities between individuals with mental disorders and the general population: a systematic review and meta-analysis.","authors":"Giulia Pollice, Mattia Marchi, Maria Trapani, Alice Pagnucco, Silvia Ferrari, Luca Ghirotto, Luca Pingani, Gian Maria Galeazzi","doi":"10.1017/S2045796026100730","DOIUrl":"10.1017/S2045796026100730","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Social inclusion is increasingly recognised as a key determinant of health and well-being, encompassing participation in social, economic, political and cultural life through access to resources, opportunities and relationships. Individuals with mental disorders are at increased risk of social exclusion, yet existing evidence often relies on broad population-level indicators that fail to capture the multidimensional nature of inclusion. This systematic review aimed to compare levels of social inclusion between these groups using validated psychometric instruments and to identify the dimensions in which disparities are most pronounced.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The review followed PRISMA guidelines. A two-step search strategy was conducted across PubMed, Embase, PsycINFO, Scopus, CINAHL and Web of Science. First, validated measures of social inclusion and related constructs were identified. Second, studies applying these instruments in individuals with and without mental disorders were retrieved. Eligible studies included adults with clinician-established or self-reported diagnosis of mental disorders and comparison groups from the general population. A random-effects meta-analysis was conducted to estimate standardised mean differences (SMDs) with 95% confidence intervals (CIs) between the two groups, while a thematic narrative synthesis explored domain-specific inequalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ten studies met inclusion criteria, and six were included in the meta-analysis, comprising 844 individuals with mental disorders and 1086 controls. Individuals with mental disorders reported significantly lower levels of social inclusion than the general population (SMD = -0.91; 95% CI: -1.25 to -0.56). The narrative synthesis identified inequalities across several interconnected domains. Individuals with mental disorders experienced weaker social relationships, lower perceived support, reduced community participation and fewer opportunities for meaningful engagement. Marked disadvantages were also observed in employment, income, education and housing, including financial hardship, insecure living conditions and neighbourhood dissatisfaction. Several studies highlighted discrepancies between objective indicators of participation and subjective experiences of inclusion, indicating that participation alone may not reflect a sense of belonging or access to valued social roles. Socioeconomic position, gender and ethnicity appeared to intensify exclusion across domains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Individuals with mental disorders experience substantial inequalities in social inclusion across interconnected relational, community and socioeconomic domains. These disparities are shaped by broader structural conditions and compounded by intersecting forms of disadvantage, including socioeconomic position, gender and ethnicity. The findings highlight the need for multidimensional, intersectional and person-centre","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e35"},"PeriodicalIF":5.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210628","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":"Intersectional inequalities in childhood maltreatment and adolescent emotional problems in England: a random-coefficient MAIHDA analysis.","authors":"Laura Havers, Mina Fazel, Melanie Smuk, Daisy Fancourt, Peter Fonagy, Paul McCrone, Gabriela Pavarini, Kamaldeep Bhui, Georgina M Hosang, Sania Shakoor","doi":"10.1017/S2045796026100699","DOIUrl":"10.1017/S2045796026100699","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Childhood maltreatment and adolescent mental health problems are unequally distributed, with the highest burdens among marginalised groups including females and those experiencing socioeconomic disadvantage. However, little is known about how the psychological consequences of maltreatment vary across intersecting social positions (e.g., socioeconomically disadvantaged females). Prior quantitative work has largely focused on average differences across a limited number of groups, obscuring non-additive intersectional patterning. Because social realities are structured by overlapping systems of privilege and oppression (e.g., relating to gender, socioeconomic position, ethnicity, age, and place), we leveraged recent methodological advances to address this gap. Accordingly, this study aimed to (i) map inequalities in adolescent emotional problems and the effects of maltreatment across intersectional positions; and (ii) describe the extent to which inequalities in emotional problems reflect additive and non-additive (intersectional) effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were analysed from 19 590 students aged 11-16 years who participated in the OxWell 2023 Student Survey in England, United Kingdom. Within a random-coefficient Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA), individuals were nested in 180 intersectional strata defined by combinations of social positions relating to gender, ethnicity, household poverty, school year group, and school-level deprivation (also entered as additive main effects). Emotional problems (Revised Child Depression and Anxiety Scale; RCADS-11) were regressed on maltreatment exposure (Short Childhood Maltreatment Questionnaire) as the primary effect of interest. Stratum-specific predicted emotional problems and maltreatment effects were estimated, and between-stratum variance was partitioned into additive and residual non-additive components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Maltreatment was associated with higher levels of emotional problems, with stratum-specific increases ranging from +3.20 to +6.14 scale points. Socioeconomically disadvantaged females and individuals who selected 'other' or 'prefer not to say' for gender showed the highest levels of emotional problems and among the strongest maltreatment effects. Between-stratum inequalities in emotional problems were largely accounted for by maltreatment exposure and the additive contributions of the included social positions. However, residual non-additive effects were also evident, particularly among individuals exposed to maltreatment, where 5.25% of between-stratum variance remained unaccounted for by additive effects (compared with 3.46% among those not exposed).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this large community sample of adolescents in England, the detrimental effects of maltreatment on emotional problems appear pervasive but not uniform across intersectional social positions. A","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e34"},"PeriodicalIF":5.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155792","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":"Mental healthcare utilization among migrants and Swedish-born adults accounting for probable needs, 2006-2022.","authors":"Joseph Junior Muwonge, Beata Jablonska, Christina Dalman, Bo Burström, Maria Rosaria Galanti, Anna-Clara Hollander","doi":"10.1017/S2045796026100717","DOIUrl":"10.1017/S2045796026100717","url":null,"abstract":"<p><strong>Aims: </strong>Migrants use less mental healthcare than non-migrants, but it is unclear how much this reflects differing needs and whether this gap has changed over time. We examined differences in mental healthcare use by migrant status between 2006 and 2022 while considering probable mental healthcare needs.</p><p><strong>Methods: </strong>We used data from four cross-sectional surveys conducted in Stockholm County (2006, 2010, 2014 and 2021) in which self-reported need indicators, including psychological distress, were measured. Survey participants, 81,650 adults (18-64), were linked to administrative registries to estimate differences in mental healthcare use (both likelihood and frequency), within 6 months of survey response. Logistic regression and zero-truncated negative binomial regression were used, with survey weights and adjustments for sex, age, income, education, psychological distress (main need-indicator), general health status and long-term limiting illness.</p><p><strong>Results: </strong>Non-Nordic migrants were more likely to report increased levels of psychological distress but were less likely to use services than non-migrants. The gap in mental healthcare use was initially marginal but increased with adjustment for mental healthcare needs, as well as over time (2006-2022). The odds ratios comparing the likelihood of mental healthcare use between European migrants with Swedish-born individuals decreased from 0.93 (95% confidence intervals: 0.77-1.11) in 2006/2007 to 0.48 (0.39-0.59) in 2021/2022, adjusting for sociodemographic factors and psychological distress. For non-European migrants, the corresponding odds ratios decreased from 0.72 (0.62-0.85) to 0.46 (0.39-0.54). Further adjustments for general health status and long-term limiting illness widened the gap even more. In 2021/2022, the gap was larger in secondary than in primary care and for online than in-office services.Nordic-born migrants had similar utilization patterns as Swedish-born individuals. Differences in the frequency of outpatient visits between migrants and Swedish-born individuals, conditional on having at least one visit, were marginal. For instance, the rate ratios comparing non-European migrants with Swedish-born individuals changed from 0.67 (0.48-0.93) in 2006/2007 to 0.90 (0.65-1.26) in 2021/2022.</p><p><strong>Conclusions: </strong>Despite indicating greater needs, non-Nordic migrants faced persistent inequities in mental healthcare access, but differences in intensity/continuity of care were marginal among those who accessed services. Inequities in access grew over the study period and were largest during the COVID-19 pandemic, particularly in access to online mental healthcare services and specialized care. These findings should be interpreted cautiously given potential selection bias from declining survey participation and changes in distress scales.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e33"},"PeriodicalIF":5.4,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148596","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":"Long-term effectiveness of banning highly hazardous pesticides on suicide mortality: a 12-year quasi-experimental study in South Korea.","authors":"Yangwoo Kim, Inah Kim, Jeehee Min, Soo-Jin Lee","doi":"10.1017/S2045796026100705","DOIUrl":"10.1017/S2045796026100705","url":null,"abstract":"<p><strong>Aims: </strong>Pesticide self-poisoning accounts for 14-20% of global suicides, predominantly in agricultural regions where highly hazardous pesticides (HHPs) remain accessible. This poses a critical challenge in South Korea despite its advanced healthcare system. In response, South Korea implemented a phased ban on HHPs, including paraquat, beginning in November 2011. This study aimed to evaluate the long-term effect of this ban on pesticide suicide mortality.</p><p><strong>Methods: </strong>We conducted an interrupted time series study using national mortality data from 2004 to 2023, with autoregressive integrated moving average errors to account for autocorrelation. Sensitivity analyses included alternative intervention timings, period definitions and outcome measures. The primary outcome was the monthly count of pesticide-related suicides.</p><p><strong>Results: </strong>Among 268,869 suicide deaths recorded during the study period, 34,962 (13.0%) involved pesticide poisoning. The monthly pesticide suicide counts declined from a mean of 244 before the ban to 81 afterwards. The interrupted time series analysis revealed no immediate level change following the ban (-0.204; 95% confidence interval [CI]: -0.989 to 0.581; <i>P</i> = 0.61) but showed a significant acceleration in the decline during the first 36 months (initial slope change: -0.122; 95% CI: -0.163 to -0.082; <i>P</i> < 0.001). Counterfactual projections estimated 10,846 deaths averted (95% CI: -567 to 29,715), representing a 48% model-based reduction. These effects were robust across all sensitivity analyses. Structural breakpoint analysis identified an increase in gas poisoning suicides in August 2008, more than three years before the ban, indicating no evidence of method substitution. The demographic profiles of pesticide and gas poisoning suicides differed substantially.</p><p><strong>Conclusions: </strong>The ban on HHPs in South Korea was associated with a sustained decline in pesticide suicide mortality over 12 years, with no evidence of method substitution. These findings support the means restriction through pesticide regulation as an effective suicide prevention strategy.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e32"},"PeriodicalIF":5.4,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041589","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 association between chronotype and incident dementia: exploring age, educational-attainment and sex differences.","authors":"Ana Neeltje Wenzler, Aart C Liefbroer, Richard Oude Voshaar, Nynke Smidt","doi":"10.1017/S2045796026100687","DOIUrl":"10.1017/S2045796026100687","url":null,"abstract":"<p><strong>Aims: </strong>Chronotype reflects individual variation in circadian rhythm (CR) (e.g., morningness versus eveningness). CR and chronotype have been associated with dementia pathology, and recent literature suggests that impaired sleep quality and CR disturbances may represent relevant causal factors for dementia. Current evidence is scarce and consists of just a small number of cross-sectional analyses and one longitudinal study. The aim of this study is to investigate the longitudinal association between chronotype and dementia risk in the older adult population, aged 60 years and older.</p><p><strong>Methods: </strong>Linking data from the Lifelines Cohort Study and data from Vektis obtained by Statistics Netherlands led to a sample for analysis of <i>n</i> = 16,757 participants. Chronotype was measured with the Munich ChronoType Questionnaire (MCTQ) between 2011 and 2015. Chronotype was categorised into five categories: extremely early, slightly early, intermediate, slightly late, extremely late. Dementia incidence was based on having at least one dementia indicator from the Vektis dataset in the years 2018 until 2024. A discrete-time survival model was used to examine the association between chronotype and dementia. Age was specified as the underlying time scale in the discrete-time logistic survival analysis. Sex was included as a covariate. Interactions between age, sex, and educational attainment and chronotype were measured by including relevant interaction terms in the model.</p><p><strong>Results: </strong>The median age in the sample was 65 years old, and 54% was female. In total, 7% got dementia during a mean follow-up period of 6.6 years. Most individuals had an intermediate chronotype (56%), with about 20% of the individuals having a slightly early and late chronotype, and only about 3% having an extremely early and late chronotype. Individuals with a slightly early (HR, 1.26 [95% CI: 1.08, 1.46]) and an extremely late chronotype (HR, 1.42 [95% CI: 1.00, 2.02]) had an elevated risk of dementia. There were no significant interactions.</p><p><strong>Conclusions: </strong>Having a slightly early as well as an extremely late chronotype was associated with an elevated risk of dementia.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e31"},"PeriodicalIF":5.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835295","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 evolution of suicide mortality in Europe: decline with persistent disparities in an age-period-cohort analysis.","authors":"Bo Zhang, Maggie Meiqi Xin, Manqi Zheng, Zijuan Fan, Luyao Hu, Chun Hao, Jing Gu, Wangnan Cao, Vivian Yawei Guo, Dannuo Wei, Stuart Gilmour, Sophia Achab, Anise Man Sze Wu, Yu Tao Xiang, Fengsu Hou, Jinghua Li","doi":"10.1017/S2045796026100663","DOIUrl":"10.1017/S2045796026100663","url":null,"abstract":"<p><strong>Aims: </strong>Pronounced variations in suicide mortality persist across Europe. Understanding long-term temporal patterns through age, period and cohort (APC) effects, alongside suicide means, is essential for tailored prevention. This study aims to determine how suicide mortality rates in Europe have changed across APC dimensions at national and subregional levels.</p><p><strong>Methods: </strong>Our analysis was restricted to European countries with complete age- and sex-specific suicide mortality data from 1990 to 2019 within the World Health Organization mortality database. The analysis comprised two components. The first component disentangled long-term suicide mortality trends (1990-2019) into APC dimensions using an age-period-cohort model via the National Cancer Institute's APC Web Tool. The second component involved an assessment of suicide means, restricted to 2010-2019 and to countries with detailed International Classification of Diseases, 10th Revision (ICD-10) cause-of-death data.</p><p><strong>Results: </strong>In 2019, Europe recorded 47,793 male and 13,111 female suicide deaths. Overall suicide mortality rates declined in most subregions from 1990 to 2019, with the largest reductions among Eastern European men, from 77.81 (95% CI: 77.17-78.45) per 100,000 in the mid-1990s to 22.93 (95% CI: 22.58-23.28) per 100,000 by 2019, although this region retained the highest male suicide burden. Age-specific risk patterns differed markedly: among men, risk peaked in early adulthood and then declined in Eastern Europe, while in Western and Southern Europe, it was lower and more stable but rose after age 60; for women, risk was generally lower, with peaks in early adulthood in Eastern Europe and in midlife elsewhere. Period reflected continued improvement, especially in Eastern Europe where the period risk in 2015-2019 was approximately 60% lower than 2000-2004. Cohort effects similarly showed progressive declines. However, upward trends emerged among younger generations. In Northern Europe, the cohort relative risk for females increased from 0.73 (95% CI: 0.68-0.78) in the 1980 cohort to 0.90 (95% CI: 0.70-1.04) in the 2000 cohort. While the completeness of suicide means analysis varied by subregion, the primary data indicated that hanging was the predominant means for both sexes during 2010-2019.</p><p><strong>Conclusions: </strong>Despite an overall decline, suicide mortality in Europe exhibits persistent regional and demographic differences. This study reveals emerging risks among younger cohorts, specifically Northern European women and Southern European men, signalling shifting patterns that are not apparent from overall temporal trends alone. This evolving risk profile calls for sustained surveillance and research to investigate the drivers of these population-specific vulnerabilities.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"35 ","pages":"e30"},"PeriodicalIF":5.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835316","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}