Epidemiology and Psychiatric Sciences最新文献

{"title":"Peer-led recovery groups for people with psychosis in South Africa (PRIZE): Results of a randomized controlled feasibility trial.","authors":"Laura Asher, Bongwekazi Rapiya, Julie Repper, Tarylee Reddy, Bronwyn Myers, Gill Faris, Inge Petersen, Charlotte Hanlon, Carrie Brooke-Sumner","doi":"10.1017/S2045796024000556","DOIUrl":"10.1017/S2045796024000556","url":null,"abstract":"<p><strong>Aims: </strong>The aims of this feasibility trial were to assess the acceptability and feasibility of peer-led recovery groups for people with psychosis in a low-resource South African setting, to assess the feasibility of trial methods, and to determine key parameters in preparation for a definitive trial.</p><p><strong>Methods: </strong>The design was an individually randomised feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone. Ninety-two isiXhosa-speaking people with psychosis and forty-seven linked caregivers were recruited from primary care clinics and randomly allocated to trial arms in a 1:1 allocation ratio. TAU comprised anti-psychotic medication delivered in primary care. The intervention arm comprised six recovery groups including service users and caregivers. Two-hour recovery group sessions were delivered weekly in a 2-month auxiliary social worker (ASW)-led phase, then a 3-month peer-led phase. To explore acceptability and feasibility, a mixed methods process evaluation included 25 in-depth interviews and 2 focus group discussions at 5 months with service users, caregivers and implementers, and quantitative data collection including attendance and facilitator competence. To explore potential effectiveness, quantitative outcome data (functioning, relapse, unmet needs, personal recovery, stigma, health service use, medication adherence and caregiver burden) were collected at baseline, 2 months and 5 months post randomisation. Trial registration: PACTR202202482587686.</p><p><strong>Results: </strong>Qualitative interviews revealed that recovery groups were broadly acceptable with most participants finding groups to be an enjoyable opportunity for social interaction, and joint problem-solving. Peer facilitation was a positive experience; however a minority of participants did not value expertise by lived experience to the same degree as expertise of professional facilitators. Attendance was moderate in the ASW-led phase (participants attended 59% sessions on average) and decreased in the peer-led phase (41% on average). Participants desired a greater focus on productive activities and financial security. Recovery groups appeared to positively impact on relapse. Relapse occurred in 1 (2.2%) of 46 participants in the recovery group arm compared to 8 (17.4%) of 46 participants in the control arm (risk difference -0.15 [95% CI: -0.26; -0.05]). Recovery groups also impacted on the number of days in the last month totally unable to work (mean 1.4 days recovery groups vs 7.7 days control; adjusted mean difference -6.3 [95%CI: -12.2; -0.3]). There were no effects on other outcomes.</p><p><strong>Conclusion: </strong>Peer-led recovery groups for people with psychosis in South Africa are potentially acceptable, feasible and effective. A larger trial, incorporating amendments such as increased support for peer facilitators, is needed to demonstrate intervention effectiveness definitively.","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e47"},"PeriodicalIF":5.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399809","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":"Young adults, particularly young women, account for an increasingly large share of Dutch mental healthcare expenditure over the period between 2015 and 2021.","authors":"L Dijkstra, S Gülöksüz, A Batalla, J van Os","doi":"10.1017/S2045796024000404","DOIUrl":"10.1017/S2045796024000404","url":null,"abstract":"<p><strong>Aims: </strong>There is increasing concern over the mental distress of youth in recent years, which may impact mental healthcare utilisation. Here we aim to examine temporal patterns of mental healthcare expenditures in the Netherlands by age and sex in the period between 2015 and 2021.</p><p><strong>Methods: </strong>Comprehensive data from health insurers in the Netherlands at the 3-number postal code level were used for cluster weighted linear regressions to examine temporal patterns of mental healthcare expenditure by age group (18-34 vs 35-65). The same was done for medical specialist and general practitioner costs. Additionally, we examined interactions with gender, by adding the interaction between age, year and sex to the model.</p><p><strong>Results: </strong>Mental healthcare costs for younger adults (18-34) were higher than those for older adults (35-65) at all time points (β = 0.22, 95%-CI = 0.19; 0.25). Furthermore there was an increase in the strength of the association between younger age and mental healthcare costs from β = 0.22 (95%-CI = 0.19; 0.25) in 2015 to β = 0.37 (95%-CI = 0.35; 0.40) in 2021 (<i>p</i> < 0.0001) and this was most evident in women (<i>p</i> < 0.0001). Younger age was associated with lower general practitioner costs at all time points, but this association weakened over time. Younger age was also associated with lower medical specialist costs, which did not weaken over time.</p><p><strong>Conclusions: </strong>Young adults, particularly young women, account for an increasing share of mental healthcare expenditure in the Netherlands. This suggests that mental distress in young people is increasingly met by a response from the medical system. To mitigate this trend a public mental health approach is needed.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e48"},"PeriodicalIF":5.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399810","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 roots of the concept of depth art.","authors":"Goran Stojčetović","doi":"10.1017/S2045796024000398","DOIUrl":"10.1017/S2045796024000398","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e45"},"PeriodicalIF":5.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388981","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 pain and mental health comorbidity.","authors":"Ketan Bhatt, Angela Cano Palomares, Liisa Jutila, Iben Rohde, Patrice Forget","doi":"10.1017/S204579602400057X","DOIUrl":"10.1017/S204579602400057X","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e46"},"PeriodicalIF":5.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364904","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":"Interactions of the CSF3R polymorphism and early stress on future orientation: evidence for the differential model of stress-related growth.","authors":"Yiqun Gan, Lizhong Wang, Yidi Chen, Lei Zheng, Xiaoli Wu, Gang Chen, Yueqin Hu","doi":"10.1017/S2045796024000581","DOIUrl":"10.1017/S2045796024000581","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to explore the concept of future orientation, which encompasses individuals' thoughts about the future, goal-setting, planning, response to challenges and behavioural adjustments in evolving situations. Often viewed as a psychological resource, future orientation is believed to be developed from psychological resilience. The study investigates the curvilinear relationship between childhood maltreatment and future orientation while examining the moderating effects of genotype.</p><p><strong>Methods: </strong>A total of 14,675 Chinese adults self-reported their experiences of childhood maltreatment and their future orientation. The influence of genetic polymorphism was evaluated through genome-wide interaction studies (GWIS; genome-wide association study [GWAS] using gene × environment interaction) and a candidate genes approach.</p><p><strong>Results: </strong>Both GWAS and candidate genes analyses consistently indicated that rs4498771 and its linked single-nucleotide polymorphisms, located in the intergenic area surrounding CSF3R, significantly interacted with early trauma to influence future orientation. Nonlinear regression analyses identified a quadratic or cubic association between future orientation and childhood maltreatment across some genotypes. Specifically, as levels of childhood maltreatment increased, future orientation declined for all genotypes. However, upon reaching a certain threshold, future orientation exhibited a rebound in individuals with specific genotypes.</p><p><strong>Conclusions: </strong>The findings suggest that individuals with certain genotypes exhibit greater resilience to childhood maltreatment. Based on these results, we propose a new threshold model of stress-related growth.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e44"},"PeriodicalIF":5.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364903","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 group problem management plus in distressed Syrian refugees in Türkiye: a randomized controlled trial.","authors":"C Acarturk, G Kurt, Z İlkkurşun, A M de Graaff, R Bryant, P Cuijpers, D Fuhr, D McDaid, A L Park, M Sijbrandij, P Ventevogel, E Uygun","doi":"10.1017/S2045796024000453","DOIUrl":"10.1017/S2045796024000453","url":null,"abstract":"<p><strong>Aims: </strong>Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, Türkiye.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles).</p><p><strong>Results: </strong>Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, <i>p</i> = 0.045, <i>d</i> = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference -0.17, 95 % CI -0.32, -0.02, <i>p</i> = 0.028, <i>d</i> = 0.27) and anxiety (adjusted mean difference -0.21, 95 % CI -0.37, -0.05, <i>p</i> = 0.009, <i>d</i> = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference -1.98, 95 % CI -3.93, -0.02, <i>p</i> = 0.048, <i>d</i> = 0.26).</p><p><strong>Conclusion: </strong>In this study in an urban setting in Türkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"33 ","pages":"e43"},"PeriodicalIF":5.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343974","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":"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}