Epidemiology and Psychiatric Sciences最新文献

{"title":"Gender disparity and post-traumatic stress disorder and elevated psychological distress in humanitarian migrants resettled in Australia: the moderating role of socioeconomic factors.","authors":"Demelash Woldeyohannes Handiso, Jacqueline A Boyle, Eldho Paul, Frances Shawyer, Joanne C Enticott","doi":"10.1017/S2045796024000489","DOIUrl":"10.1017/S2045796024000489","url":null,"abstract":"<p><strong>Aims: </strong>Humanitarian migrants are at increased risk of post-traumatic stress disorder (PTSD) and elevated psychological distress. However, men and women often report varying degrees of stress and experience different challenges during migration. While studies have explored PTSD, psychological distress, gender, and resettlement stressors, they have not explored the interplay between these factors. This study aims to address that gap by investigating gender disparities in PTSD and psychological distress among humanitarian migrants in Australia, with a focus on the moderating role of socioeconomic factors.</p><p><strong>Methods: </strong>This study used data from five waves of the Building a New Life in Australia (BNLA) survey, a longitudinal study of 2,399 humanitarian migrants who arrived in Australia in 2013. PTSD and psychological distress were measured using the PTSD-8 and Kessler-6 (K6) scales, respectively. We conducted generalised linear mixed-effect logistic regression analyses stratified by gender.</p><p><strong>Results: </strong>Female humanitarian migrants exhibited a significantly higher prevalence of PTSD and psychological distress than males over five years of resettlement in Australia. Women facing financial hardship, unemployment, or residing in short-term housing reported greater levels of PTSD and distress compared to men.</p><p><strong>Conclusions: </strong>Women facing financial hardship, inadequate housing, and unemployment exhibit higher rates of PTSD and psychological distress, underscoring the significant impact of socioeconomic factors. Addressing these challenges at both individual and systemic levels is essential for promoting well-being and managing mental health among female humanitarian migrants.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e60"},"PeriodicalIF":5.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590259","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 overestimation of the effect sizes of psychotherapies for depression in waitlist controlled trials: a meta-analytic comparison with usual care controlled trials.","authors":"Pim Cuijpers, Clara Miguel, Mathias Harrer, Marketa Ciharova, Eirini Karyotaki","doi":"10.1017/S2045796024000611","DOIUrl":"10.1017/S2045796024000611","url":null,"abstract":"<p><strong>Aims: </strong>There is considerable evidence that waiting list (WL) control groups overestimate the effect sizes of psychotherapies for depression. It is not clear, however, what are the exact causes for this overestimation. We decided to conduct a meta-analytic study to compare trials on psychotherapy for depression with a WL control group against trials with a care-as-usual (CAU) control group.</p><p><strong>Methods: </strong>We used an existing meta-analytic database of randomized trials comparing psychological treatments of adult depression with control groups and selected trials using a WL or a CAU control group. We used subgroup and meta-regression analyses to examine differences in effect sizes between WL and CAU controlled trials.</p><p><strong>Results: </strong>We included 333 randomized controlled trials (472 comparisons; total number participants: 41,480), 141 with a WL and 195 with a CAU control group (3 included both). We found several significant differences between WL and CAU controlled trials (in type of therapy examined, treatment format, recency, target group, recruitment strategy, number of treatment arms and number of depression outcome measures). The overall effect size indicating the difference between treatment and control at post-test for all comparisons was <i>g</i> = 0.77 (95% confidence interval [CI]: 0.71; 0.84) with high heterogeneity (<i>I</i>² = 84; 95% CI: 82; 85). A highly significant difference was observed between studies with a CAU control group (<i>g</i> = 0.63; 95% CI: 0.55; 0.71; <i>I</i>² = 85; 95% CI: 83; 86) and studies with a WL (<i>g</i> = 0.95; 95% CI: 0.85; 1.04; <i>I</i>² = 80; 95% CI: 78; 82; <i>p</i> for difference < 0.001). This difference remained significant in all sensitivity analyses, including a meta-regression analysis in which we adjusted for all differences in characteristics of studies with a WL versus CAU control group. We also found that pre-post effect sizes in WL control conditions (<i>g</i> = 0.37; 95% CI: 0.28; 0.46) were significantly smaller than change within CAU conditions (<i>g</i> = 0.64; 95% CI: 0.50; 0.78). We found few indications that pre-post effect sizes within therapy conditions differed between WL and CAU controlled trials.</p><p><strong>Conclusions: </strong>WL control conditions considerably overestimate the effect sizes of psychological treatments, compared to trials using CAU control conditions. This overestimation is probably caused by a smaller improvement within the WL condition compared to the improvement in the CAU condition. WL control conditions should be avoided in randomized trials examining psychological treatments of adult depression.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e56"},"PeriodicalIF":5.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581673","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":"Network analytical investigation of relationships between symptoms of common mental disorders among refugees and asylum seekers in Türkiye.","authors":"G Kurt, M Ekhtiari, A de Graaff, M Ersahin, P Specker, M Sijbrandij, A Nickerson, C Acartürk","doi":"10.1017/S2045796024000696","DOIUrl":"10.1017/S2045796024000696","url":null,"abstract":"<p><strong>Aims: </strong>Forcibly displaced people, such as refugees and asylum-seekers (RAS), are at higher risk of mental disorders, mainly post-traumatic stress disorder (PTSD), depression and anxiety. Little is known about the complex relationships between these mental disorders among culturally and linguistically diverse RAS. To investigate this, the present study applied a novel network analytical approach to examine and compare the central and bridge symptoms within and between PTSD, depression and anxiety among Afghan and Syrian RAS in Türkiye.</p><p><strong>Methods: </strong>A large-scale online survey study with 785 Afghan and 798 Syrian RAS in Türkiye was conducted in 2021. Symptoms of PTSD (the short form of Post-Traumatic Stress Disorders Checklist [PCL-5]), depression and anxiety (Hopkins Symptoms Checklist-25) [HSCL-25]) were measured via self-administrated validated instruments. We conducted network analysis to identify symptoms that are most strongly connected with other symptoms (central symptoms) and those that connect the symptoms of different disorders (bridge symptoms) in R Studio using the qgraph package.</p><p><strong>Results: </strong>Overall, Afghans and Syrians differed in terms of network structure, but not in network strength. Results showed that feeling blue, feeling restless and spells of terror or panic were the most central symptoms maintaining the overall symptom structure of common mental disorders among Afghan participants. For Syrian participants, worrying too much, feeling blue and feeling tense were identified as the central symptoms. For both samples, anger and irritability and feeling low in energy acted as a bridge connecting the symptoms of PTSD, depression and anxiety.</p><p><strong>Conclusion: </strong>The current findings provide insights into the interconnectedness within and between the symptoms of common mental disorders and highlight the key symptoms that can be potential targets for psychological interventions for RAS. Addressing these symptoms may aid in tailoring existing evidence-based interventions and enhance their effectiveness. This contributes to reducing the overall mental health burden and improving well-being in this population.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e59"},"PeriodicalIF":5.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575811","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":"Association of a history of depression with infertility, miscarriage and stillbirth: a longitudinal cohort study.","authors":"Chen Liang, Hsin-Fang Chung, Annette J Dobson, Gita D Mishra","doi":"10.1017/S2045796024000374","DOIUrl":"10.1017/S2045796024000374","url":null,"abstract":"<p><strong>Aims: </strong>The role of depression in subsequent infertility, miscarriage and stillbirth remains unclear. This study aimed to examine the association of a history of depression with these adverse outcomes using a longitudinal cohort study of women across their reproductive life span.</p><p><strong>Methods: </strong>This study used data from participants in the Australian Longitudinal Study on Women's Health who were born in 1973-1978. Participants (<i>N</i> = 8707) were followed up every 3 years from 2000 (aged 22-27) to 2018 (aged 40-45). Information on a diagnosis of depression was collected from each survey, and antidepressant medication use was identified through pharmaceutical prescription data. Histories of infertility, miscarriage, and stillbirth were self-reported at each survey. Time-lagged log-binomial models with generalized estimating equations were used to assess the association of a history of depression up to and including in a given survey with the risk of fertility issues in the next survey.</p><p><strong>Results: </strong>Women with a history of depression (excluding postnatal depression) were at higher risk of infertility [risk ratio (RR) = 1.34, 95% confidence interval (CI): 1.21-1.48], miscarriage (RR = 1.22, 95%CI: 1.10-1.34) and recurrent miscarriages (≥2; RR = 1.39, 95%CI: 1.17-1.64), compared to women without a history of depression. There were too few stillbirths to provide clear evidence of an association. Antidepressant medication use did not affect the observed associations. Estimated RRs of depression with infertility and miscarriage increased with age.</p><p><strong>Conclusions: </strong>A history of depression was associated with higher risk of subsequent infertility, miscarriage and recurrent miscarriages.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e55"},"PeriodicalIF":5.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575810","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":"Testing whether multi-level factors protect poly-victimised children against psychopathology in early adulthood: a longitudinal cohort study.","authors":"F Blangis, L Arseneault, A Caspi, R M Latham, T E Moffitt, H L Fisher","doi":"10.1017/S2045796024000660","DOIUrl":"10.1017/S2045796024000660","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Exposure to multiple forms of victimisation in childhood (often referred to as poly-victimisation) has lifelong adverse effects, including an elevated risk of early-adulthood psychopathology. However, not all poly-victimised children develop mental health difficulties and identifying what protects them could inform preventive interventions. The present study investigated whether individual-, family- and/or community-level factors were associated with lower levels of general psychopathology at age 18, among children exposed to poly-victimisation. Additionally, it examined whether these factors were specific to poly-victimised children or also associated with fewer mental health difficulties in young adults regardless of whether they had been poly-victimised.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a population-representative cohort of 2,232 children born in 1994-1995 across England and Wales and followed to 18 years of age (with 93% retention, n = 2,066). Poly-victimisation (i.e., exposure to two or more of physical abuse, sexual abuse, emotional abuse and neglect, physical neglect, bullying by peers, and domestic violence) and nine putative protective factors (intelligence quotient, executive functioning, temperament, maternal and sibling warmth, atmosphere at home, maternal monitoring, neighbourhood social cohesion, and presence of a supportive adult) were measured prospectively between ages 5 and 12 years from interviews with mothers and children, surveys of neighbours, child-protection referrals, and researchers' observations. Early-adulthood psychopathology was assessed in interviews with each twin at age 18 and used to construct a latent factor of general psychopathology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Approximately a third (n = 720) of participants were prospectively defined as exposed to poly-victimisation (53% male). Poly-victimised children had greater levels of general psychopathology at age 18 than non-poly-victimised children (adjusted [adj.] β = 4.80; 95% confidence interval [95% CI] 3.13, 6.47). Presence of a supportive adult was the only factor robustly associated with lower levels of general psychopathology among poly-victimised children (adj.β = -0.61; 95% CI -0.99, -0.23). However, this association was also evident in the whole sample regardless of poly-victimisation exposure (adj.β = -0.52; 95% CI -0.81, -0.24) and no significant interaction was observed between the presence of a supportive adult and poly-victimisation in relation to age-18 general psychopathology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Having at least one adult to turn to for support was found to be associated with less psychopathology in early adulthood among both poly-victimised and non-poly-victimised children. This suggests that strategies to promote better availability and utilisation of supportive adults should be implemented universally. However, it may be benefic","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e58"},"PeriodicalIF":5.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575812","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":"Predictors of new-onset suicide risk and persistent suicide risk among young adult lesbian, gay and bisexual individuals experiencing the COVID-19 pandemic: a follow-up study.","authors":"Cheng-Fang Yen, Ching-Shu Tsai, Yu-Ping Chang, Peng-Wei Wang","doi":"10.1017/S2045796024000635","DOIUrl":"10.1017/S2045796024000635","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan.</p><p><strong>Methods: </strong>Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up.</p><p><strong>Results: </strong>In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (<i>p</i> = .003), who perceived greater levels of microaggression (<i>p</i> < .001), and who had greater levels of problematic Internet use at baseline (<i>p</i> = .024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (<i>p</i> = .023).</p><p><strong>Conclusion: </strong>Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e57"},"PeriodicalIF":5.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567296","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":"Mediating pathways between attention deficit hyperactivity disorder and type 2 diabetes mellitus: evidence from a two-step and multivariable Mendelian randomization study.","authors":"J Zhang, Z K Chen, R D Triatin, H Snieder, C H L Thio, C A Hartman","doi":"10.1017/S2045796024000593","DOIUrl":"10.1017/S2045796024000593","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes (T2D) is a global health burden, more prevalent among individuals with attention deficit hyperactivity disorder (ADHD) compared to the general population. To extend the knowledge base on how ADHD links to T2D, this study aimed to estimate causal effects of ADHD on T2D and to explore mediating pathways.</p><p><strong>Methods: </strong>We applied a two-step, two-sample Mendelian randomization (MR) design, using single nucleotide polymorphisms to genetically predict ADHD and a range of potential mediators. First, a wide range of univariable MR methods was used to investigate associations between genetically predicted ADHD and T2D, and between ADHD and the purported mediators: body mass index (BMI), childhood obesity, childhood BMI, sedentary behaviour (daily hours of TV watching), blood pressure (systolic blood pressure, diastolic blood pressure), C-reactive protein and educational attainment (EA). A mixture-of-experts method was then applied to select the MR method most likely to return a reliable estimate. We used estimates derived from multivariable MR to estimate indirect effects of ADHD on T2D through mediators.</p><p><strong>Results: </strong>Genetically predicted ADHD liability associated with 10% higher odds of T2D (OR: 1.10; 95% CI: 1.02, 1.18). From nine purported mediators studied, three showed significant individual mediation effects: EA (39.44% mediation; 95% CI: 29.00%, 49.73%), BMI (44.23% mediation; 95% CI: 34.34%, 52.03%) and TV watching (44.10% mediation; 95% CI: 30.76%, 57.80%). The combination of BMI and EA explained the largest mediating effect (53.31%, 95% CI: -1.99%, 110.38%) of the ADHD-T2D association.</p><p><strong>Conclusions: </strong>These findings suggest a potentially causal, positive relationship between ADHD liability and T2D, with mediation through higher BMI, more TV watching and lower EA. Intervention on these factors may thus have beneficial effects on T2D risk in individuals with ADHD.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e54"},"PeriodicalIF":5.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497349","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 effectiveness of Problem Management Plus at 1-year follow-up for Syrian refugees in a high-income setting.","authors":"Anne M de Graaff, Pim Cuijpers, Mariam Elsawy, Sam Hunaidy, Barbara Kieft, Noer Gorgis, Jos W R Twisk, Yenovk Zakarian, Theo K Bouman, Miriam J J Lommen, Ceren Acarturk, Richard Bryant, David McDaid, Naser Morina, A-La Park, Peter Ventevogel, Marit Sijbrandij","doi":"10.1017/S2045796024000519","DOIUrl":"10.1017/S2045796024000519","url":null,"abstract":"<p><strong>Aims: </strong>Problem Management Plus (PM+) has been effective in reducing mental health problems among refugees at three-month follow-up, but there is a lack of research on its long-term effectiveness. This study examined the effectiveness of PM+ in reducing symptoms of common mental disorders at 12-month follow-up among Syrian refugees in the Netherlands.</p><p><strong>Methods: </strong>This single-blind, parallel, controlled trial randomised 206 adult Syrians who screened positive for psychological distress and impaired functioning to either PM+ in addition to care as usual (PM+/CAU) or CAU alone. Assessments were at baseline, 1 week and 3 months after the intervention and 12 months after baseline. Outcomes were psychological distress (Hopkins Symptom Checklist [HSCL-25]), depression (HSCL-25 subscale), anxiety (HSCL-25 subscale), posttraumatic stress disorder symptoms (PCL-5), functional impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS).</p><p><strong>Results: </strong>In March 2019-December 2022, 103 participants were assigned to PM+/CAU and 103 to CAU of which 169 (82.0%) were retained at 12 months. Intention-to-treat analyses showed greater reductions in psychological distress at 12 months for PM+/CAU compared to CAU (adjusted mean difference -0.17, 95% CI -0.310 to -0.027; <i>p</i> = 0.01, Cohen's <i>d</i> = 0.28). Relative to CAU, PM+/CAU participants also showed significant reductions on anxiety (-0.19, 95% CI -0.344 to -0.047; <i>p</i> = 0.01, <i>d</i> = 0.31) but not on any of the other outcomes.</p><p><strong>Conclusions: </strong>PM+ is effective in reducing psychological distress and symptoms of anxiety over a period up to 1 year. Additional support such as booster sessions or additional (trauma-focused) modules may be required to prolong and consolidate benefits gained through PM+ on other mental health and psychosocial outcomes.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e50"},"PeriodicalIF":5.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497351","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":"Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States.","authors":"J Grullon, D Soong, R Wong","doi":"10.1017/S204579602400060X","DOIUrl":"10.1017/S204579602400060X","url":null,"abstract":"<p><strong>Aims: </strong>Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race-ethnicity and dementia.</p><p><strong>Methods: </strong>We analyzed 11 years (2011-2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race-ethnicity was associated with incident dementia risk.</p><p><strong>Results: </strong>Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period (<i>t</i> = -7.35, <i>p</i> < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], <i>p</i> < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], <i>p</i> = .11). Race-ethnicity was not a significant moderator in the association between social isolation and dementia.</p><p><strong>Conclusions: </strong>Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race-ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e53"},"PeriodicalIF":5.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497350","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":"Challenges in transitioning from adolescent to Adult Mental Health Services for young adults with ADHD in Italy: an observational study.","authors":"Elisa Roberti, Antonio Clavenna, Eleonora Basso, Carmela Bravaccio, Maria Pia Riccio, Maurizio Pincherle, Maddalena Duca, Claudia Giordani, Francesca Scarpellini, Rita Campi, Michele Giardino, Michele Zanetti, Valeria Tessarollo, Ilaria Costantino, Maurizio Bonati","doi":"10.1017/S2045796024000544","DOIUrl":"10.1017/S2045796024000544","url":null,"abstract":"<p><strong>Aims: </strong>Ensuring a successful transition to Adult Mental Health Services (AMHS) is fundamental for attention deficit/hyperactivity disorder (ADHD) patients to prevent adverse scenarios in adults (e.g., psychiatric disorders, substance or alcohol abuse). Yet, most European nations do not have appropriate transition guidelines and still fail to adequately support transition processes. This study aims to enquire about the current transition paths in Italy and the perceived experiences of the patients and their clinicians.</p><p><strong>Methods: </strong>The present observational study collected 36 interviews with young adults with ADHD who turned 18 between 2017 and 2021. Simultaneously, two questionnaires were filled in by the clinicians (both from paediatric and AMHS) who were involved in their transition paths. These tools collected information about the transition process, the services that cared for the young adults and well-being indicators such as impairment in daily life, employment status and the presence of sentinel events (e.g., critical stage accesses to the emergency room or hospitalizations). Successful and failed referrals were analysed.</p><p><strong>Results: </strong>A referral to an AMHS was attempted for 16 young adults (8 before age 18 and 8 when turning 18), and 8 patients (22.2% overall) were successfully taken into the care of the AMHS. Twenty patients were not referred since it was deemed unnecessary (<i>N</i> = 6) or because of the lack of specialized services or compliance (<i>N</i> = 14). At the time of the interview, only nine participants were still under AMHS care. Of eleven individuals with a high need for care (identified by the level of impairment, support needs or sentinel events), five were not followed by a mental health professional at the time of the interview.</p><p><strong>Conclusions: </strong>For the majority of ADHD young adults, a transition path was never started or completed. While this is partly due to mild levels of impairment, in many cases it was difficult to find a service that could care for the adult patient. Only one out of four young adults are successfully transferred to AMHS care. Creating or improving evidence-based transition guidelines should be a priority of the public health system to ensure healthcare for as many patients as possible. The results of this study will converge towards the need for recommendations for the transition of services from adolescence to adulthood for young people with ADHD for Italian clinical practice.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e49"},"PeriodicalIF":5.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497348","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}