Epidemiology and Psychiatric Sciences最新文献

{"title":"Let's talk about recovery in mental health: an international Delphi study of experts by experience.","authors":"E Guerrero, M Barrios, H M Sampietro, A Aza, J Gómez-Benito, G Guilera","doi":"10.1017/S2045796024000490","DOIUrl":"10.1017/S2045796024000490","url":null,"abstract":"<p><strong>Aims: </strong>The concept of recovery is featured in the strategic plans of the World Health Organization as well as in other national mental health plans; however, there have been differing interpretations of what it means. This article aims to achieve a consensus on the key aspects of recovery in mental health from the perspective of movements of users and survivors of psychiatry at an international level. Four specific objectives were proposed in this study: (1) to identify what recovery in mental health means, (2) to identify the indicators that a person is progressing in their recovery, (3) to determine the factors that facilitate the recovery process, and (4) to determine the factors that hinder the recovery process.</p><p><strong>Methods: </strong>A three-round e-Delphi study was conducted with the participation of 101 users and survivors of psychiatry, adhering to the CREDES checklist to ensure methodological rigour.</p><p><strong>Results: </strong>The results reveal 26 key aspects that define recovery, 31 indicating that a person is progressing in their recovery process, 8 that facilitate recovery and 12 that hinder recovery. The most agreed-upon statements for defining recovery highlight the importance of empowerment, leading a fulfilling life, ensuring safe-living conditions and acknowledging individuals as holders of rights. Similarly, empowerment and agency were highly agreed upon as relevant recovery indicators. Key findings underscore the significance of a supportive and respectful social environment in facilitating recovery, while coercion, discrimination and lack of support from significant others hinder recovery.</p><p><strong>Conclusions: </strong>Despite cultural differences and recovery's subjective nature, our results demonstrate that an international consensus on critical recovery aspects is attainable. Highlighting a significant shift, we emphasize the 'Transition' process to signify moving away from the biomedical model approach and advocating for collective rights. Our findings advocate for empowerment, users' rights and the move towards person-centred care that integrates social, political and economic contexts. These consensus statements lay the groundwork for future research across diverse regions and cultures, offering insights into recovery's meaning and potential for innovative approaches in diagnosis, intervention and evaluation.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e41"},"PeriodicalIF":5.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307438","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":"Obsessive-compulsive disorder and suicide: a longitudinal study in Taiwan.","authors":"Mu-Hong Chen, Tai-Long Pan, Chih-Ming Cheng, Wen-Han Chang, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Shih-Jen Tsai","doi":"10.1017/S2045796024000477","DOIUrl":"10.1017/S2045796024000477","url":null,"abstract":"<p><strong>Aims: </strong>Research evidence has established an association of obsessive-compulsive disorder (OCD) with suicidal thoughts and suicide attempts. However, further investigation is required to determine whether individuals with OCD have higher risk of death by suicide compared with those without OCD.</p><p><strong>Methods: </strong>Of the entire Taiwanese population, between 2003 and 2017, 56,977 individuals with OCD were identified; they were then matched at a 1:4 ratio with 227,908 non-OCD individuals on the basis of their birth year and sex. Suicide mortality was assessed between 2003 and 2017 for both groups. Time-dependent Cox regression models were used to investigate the difference in suicide risk between individuals with versus without OCD.</p><p><strong>Results: </strong>After adjustment for major psychiatric comorbidities (i.e., schizophrenia, bipolar disorder and major depressive disorder), the OCD group had higher risk of suicide (hazard ratio: 1.97, 95% confidence interval: 1.57-2.48) during the follow-up compared with the comparison group. Furthermore, OCD severity, as indicated by psychiatric hospitalizations due to OCD, was positively correlated with suicide risk.</p><p><strong>Conclusions: </strong>Regardless of the existence of major psychiatric comorbidities, OCD was found to be an independent risk factor for death by suicide. A suicide prevention program specific to individuals with OCD may be developed in clinical practice in the future.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e42"},"PeriodicalIF":5.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282301","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":"Outsider art in Croatia.","authors":"Daniela Bilopavlovic","doi":"10.1017/S2045796024000349","DOIUrl":"10.1017/S2045796024000349","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e36"},"PeriodicalIF":5.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282302","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":"Effectiveness of partial restriction of access to means in jumping suicide: lessons from four bridges in three countries","authors":"Sangsoo Shin, Jane Pirkis, Angela Clapperton, Matthew Spittal, Lay San Too","doi":"10.1017/s2045796024000428","DOIUrl":"https://doi.org/10.1017/s2045796024000428","url":null,"abstract":"Aims Restricting access to means by installing physical barriers has been shown to be the most effective intervention in preventing jumping suicides on bridges. However, little is known about the effectiveness of partial restriction with interventions that still allow jumping from the bridge. Methods This study used a quasi-experimental design. Public sites that met our inclusion criteria were identified using Google search and data on jumping suicides on Bridge A (South Korea), Bridges B and C (the United States) and Bridge D (Canada) were obtained from the relevant datasets. Incidence rate ratios (IRRs) were estimated using Poisson regressions comparing suicide numbers before and after the installation of physical structures at each site. Results Fences with sensor wires and spinning handrails installed above existing railings on the Bridge A, and fences at each side of the entrances and the midpoint of main suspension cables on the Bridge D were associated with significant reductions in suicides (IRR 0.37, 95% Confidence Interval (CI) 0.26 <jats:italic>−</jats:italic> 0.54; 0.26, 95% CI 0.09 − 0.76). Installation of bird spike on the parapet on the Bridge B, and fences at the front of seating alcoves on the Bridge C were not associated with changes in suicides (1.21, 95% CI 0.88 − 1.68; 1.49, 95% CI 0.56 − 3.98). Conclusions Partial means restriction (such as fences with sensor wires and spinning bars at the top, and partial fencing at selected points) on bridges appears to be helpful in preventing suicide. Although these interventions are unlikely to be as effective as interventions that fully secure the bridge and completely prevent jumping, they might best be thought of as temporary solutions before more complete or permanent structures are implemented.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"20 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263840","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":"Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence","authors":"David Healy, Dee Mangin","doi":"10.1017/s2045796024000441","DOIUrl":"https://doi.org/10.1017/s2045796024000441","url":null,"abstract":"While sexual dysfunction is a well-known side effect of taking selective serotonin reuptake inhibitors (SSRIs), in an undetermined number of patients, sexual function does not return to pre-drug baseline after stopping SSRIs. The condition is known as post-SSRI sexual dysfunction (PSSD) and is characterised most commonly by genital numbness, pleasureless or weak orgasm, loss of libido and erectile dysfunction. This article provides a commentary on the incidence and prevalence of PSSD based on a combination of academic literature as well as clinical and research experience. A number of obstacles to quantifying the occurrence of PSSD are outlined including difficulty in designing a suitable study method. Other contextual obstacles include patient embarrassment at raising sexual concerns, the response of healthcare professionals, inability to stop an antidepressant due to withdrawal issues in a proportion of patients and patient unawareness that their sexual difficulties are linked to prior medication compounded by variability of online information and a lack of information aimed at public education. A definition of PSSD with diagnostic criteria has been published. A MedDRA code for PSSD has also been introduced, but this is yet to be adopted by regulators.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"17 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Broken souls’ vs. ‘mad ax man’ – changes in the portrayal of depression and schizophrenia in the German media over 10 years","authors":"M. Sittner, T. Rechenberg, S. Speerforck, M.C Angermeyer, G. Schomerus","doi":"10.1017/s204579602400043x","DOIUrl":"https://doi.org/10.1017/s204579602400043x","url":null,"abstract":"Aims Population studies show the stigma of depression to diminish, while the stigma of schizophrenia increases. To find out whether this widening gap is reflected in the media portrayal of both disorders, this study compares the portrayal of depression and schizophrenia in German print media in 2010 vs. 2020. Methods We conducted a qualitative content analysis using a mixed deductive-inductive approach to establish a category system. In total, we analyzed 854 articles with the summative approach by Mayring. Results The study found a widening gap in the portrayal of schizophrenia and depression in German media between 2010 and 2020. Schizophrenia was depicted increasingly negative between 2010 and 2020, covering more negative stereotypes and focusing on its biological causes. Depression received increased attention and more neutral and professional coverage, with a greater emphasis on psychosocial causes and discussion of treatment options. Conclusions By showing a widening gap the study highlights how media may shape public views on mental illnesses and reflects public attitudes at the same time. Media analyses from other nations have shown similar trends. This emphasizes the need for responsible reporting to combat stigma and promote understanding worldwide. Therefore, the authors recommend a balanced coverage that includes accurate professional information about all mental illnesses.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"20 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach","authors":"Caroline X. Gao, Nic Telford, Kate M. Filia, Jana M. Menssink, Sabina Albrecht, Patrick D. McGorry, Matthew Hamilton, Mengmeng Wang, Daniel Gan, Dominic Dwyer, Sophie Prober, Isabel Zbukvic, Myriam Ziou, Sue M. Cotton, Debra J. Rickwood","doi":"10.1017/s2045796024000386","DOIUrl":"https://doi.org/10.1017/s2045796024000386","url":null,"abstract":"Aims The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering <jats:italic>headspace</jats:italic> services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings. Methods This retrospective study involved analysis of <jats:italic>headspace</jats:italic>’s clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors. Results A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a ‘high complexity’ group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing ‘distress complexity’ and ‘psychosocial complexity’ (about 20% each). Compared with the ‘distress complexity’ group, young people in the ‘psychosocial complexity’ group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different <jats:italic>headspace</jats:italic> services. Conclusions The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to <jats:italic>headspace</jats:italic> early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"77 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of coercive measures on mental health status in adult psychiatric populations: a nationwide trial emulation","authors":"S. Baggio, S. Kaiser, C.G. Huber, A. Wullschleger","doi":"10.1017/s2045796024000416","DOIUrl":"https://doi.org/10.1017/s2045796024000416","url":null,"abstract":"Aims Healthcare staff use coercive measures to manage patients at acute risk of harm to self or others, but their effect on patients’ mental health is underexplored. This nationwide Swiss study emulated a trial to investigate the effects of coercive measures on the mental health of psychiatric inpatients at discharge. Methods We analysed retrospective longitudinal data from all Swiss adult psychiatric hospitals that provided acute care (2019–2021). The primary exposure was any coercive measure during hospitalization; secondary exposures were seclusion, restraint and forced medication. Our primary outcome was Health of the Nations Outcome Scale (HoNOS) score at discharge. We used inverse probability of treatment weighting to emulate random assignment to the exposure. Results Of 178,369 hospitalizations, 9.2% (<jats:italic>n</jats:italic> = 18,800) included at least one coercive measure. In patients exposed to coercive measures, mental health worsened a small but statistically significant amount more than in non-exposed patients. Those who experienced at least one coercive measure during hospitalization had a significantly higher HoNOS score (1.91-point, <jats:italic>p</jats:italic> &lt; .001, 95% confidence interval [CI]: 1.73; 2.09) than those who did not experience any coercive measure. Results were similar for seclusion (1.60-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 1.40; 1.79) and forced medication (1.97-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 1.65; 2.30). Restraint had the strongest effect (2.83-point higher score, <jats:italic>p</jats:italic> &lt; .001, 95% CI: 2.38; 3.28). Conclusions Our study presents robust empirical evidence highlighting the detrimental impact of coercive measures on the mental health of psychiatric inpatients. It underscores the importance of avoiding these measures in psychiatric hospitals and emphasized the urgent need for implementing alternatives in clinical practice.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"37 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Australian Youth Self-Harm Atlas: spatial modelling and mapping of self-harm prevalence and related risk and protective factors to inform youth suicide prevention strategies.","authors":"E Hielscher, K Hay, I Chang, M McGrath, K Poulton, E Giebels, J Blake, P J Batterham, J G Scott, D Lawrence","doi":"10.1017/S2045796024000301","DOIUrl":"10.1017/S2045796024000301","url":null,"abstract":"<p><strong>Aims: </strong>Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people.</p><p><strong>Methods: </strong>A random sample of Australian adolescents (12-17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019.</p><p><strong>Results: </strong>Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm.</p><p><strong>Conclusions: </strong>This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth suicide prevention interventions and initiatives.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e34"},"PeriodicalIF":5.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with chronic depressive symptoms across adolescence and young adulthood: a UK birth cohort study.","authors":"B B Durdurak, B Williams, A Zhigalov, A Moore, P Mallikarjun, D Wong, S Marwaha, I Morales-Muñoz","doi":"10.1017/S2045796024000350","DOIUrl":"10.1017/S2045796024000350","url":null,"abstract":"<p><strong>Aims: </strong>Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people.</p><p><strong>Methods: </strong>We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms.</p><p><strong>Results: </strong>Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms.</p><p><strong>Conclusions: </strong>Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e32"},"PeriodicalIF":5.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}