Epidemiology and Psychiatric Sciences最新文献

{"title":"Characterization of antipsychotic utilization before clozapine initiation for individuals with schizophrenia: an innovative visualization of trajectories using French National Health Insurance data.","authors":"Edouard-Jules Laforgue,&nbsp;Marion Istvan,&nbsp;Anicet Chaslerie,&nbsp;Pascal Artarit,&nbsp;Geneviève Vallot,&nbsp;Pascale Jolliet,&nbsp;Marie Grall-Bronnec,&nbsp;Caroline Victorri-Vigneau","doi":"10.1017/S2045796023000732","DOIUrl":"10.1017/S2045796023000732","url":null,"abstract":"<p><strong>Aims: </strong>Despite recommendations to initiate clozapine after two unsuccessful trials of antipsychotics, clozapine is underprescribed and initiated too late. The aim of this study was to describe different antipsychotic treatment sequences in the 36 months before the initiation of clozapine and to characterize clusters of treatment trajectories.</p><p><strong>Methods: </strong>Using the French National Health Insurance database, a historical cohort study of the population in an area in western France was performed. The data from all new users of clozapine with a diagnosis of schizophrenia or schizoaffective disorder in the period of 2017-2018 were evaluated. All outpatient reimbursements for antipsychotics during the 36 months before clozapine initiation were analysed. Successive reimbursements for identical treatments were grouped into treatment trials (TTs), and different trajectories were clustered using a state sequence analysis.</p><p><strong>Results: </strong>The results showed 1191 TTs for 287 individuals. The mean number of TTs per individual was 3.2. Risperidone, aripiprazole and haloperidol were the main treatments delivered. The frequencies of antipsychotics used differed between monotherapies and combination therapies. A three-cluster typology was identified: one cluster (<i>n</i> = 133) of 'less treated' younger individuals with fewer TTs and shorter TT durations; a second cluster (<i>n</i> = 53) of 'more treated' individuals with higher numbers of TTs and combinations of antipsychotics; and a third cluster (<i>n</i> = 103) of 'treatment-stable' older individuals with longer TT durations.</p><p><strong>Conclusions: </strong>The results indicate that the median number of TTs during the 36 months before clozapine prescription was higher than the two recommended. The different trajectories were associated with individual characteristics and treatment differences, suggesting that additional studies of clinical parameters are needed to understand barriers to clozapine prescription.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e59"},"PeriodicalIF":8.1,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10313056","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":"Structural intervention at one bridge decreases the overall jumping suicide rate in Victoria, Australia.","authors":"J Dwyer,&nbsp;M J Spittal,&nbsp;K Scurrah,&nbsp;J Pirkis,&nbsp;L Bugeja,&nbsp;A Clapperton","doi":"10.1017/S2045796023000720","DOIUrl":"10.1017/S2045796023000720","url":null,"abstract":"<p><strong>Aims: </strong>There is clear evidence that installing safety barriers is effective in preventing jumping suicides from high-risk bridges with only moderate displacement to other nearby bridges. However, the impact of barriers on jumping suicides across broader geographical areas is not well understood. We examined patterns in jumping suicides across the state of Victoria, Australia, after a safety barrier was installed at the West Gate Bridge which, before the installation of the barrier, was the site of approximately 40% of Victoria's jumping suicides.</p><p><strong>Methods: </strong>We used negative binomial regression analyses on Victorian data from 2000 to 2019 to compare rates of jumping suicides at the West Gate Bridge, other bridges and non-bridge jumping locations before, during and after the West Gate Bridge barrier installation. We conducted linear regression analyses to examine whether the distance travelled from the deceased's usual residence to the location of their jumping suicide changed between the before, during and after barrier installation periods.</p><p><strong>Results: </strong>After installation of the barrier, there were no jumping suicides at the West Gate Bridge (rate ratio [RR] = 0.00, 95% credible intervals [95% Cr] = 0.00-0.0001) and there was strong evidence that the rate of jumping suicides at all locations declined by 65% (RR = 0.35, 95% Cr = 0.22-0.54). At other bridges, there was also evidence of a reduction (RR = 0.31, 95% Cr = 0.11-0.70), but there was no evidence of a change at non-bridge locations (RR = 0.74, 95% Cr = 0.39-1.30).</p><p><strong>Conclusion: </strong>After installation of the safety barrier at the West Gate Bridge, jumping suicide in Victoria decreased overall and at other bridges, and did not appear to change at non-bridge locations. Our findings show that when barriers are installed at a site responsible for a disproportionately high number of jumping suicides, they are not only highly effective at the site where the barriers are installed but can also have a prevention impact beyond the immediate locale at similar sites.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e58"},"PeriodicalIF":8.1,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308487","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":"Suicide rates among patients with first and second primary cancer.","authors":"Yanting Jiang,&nbsp;Yiqi Wang,&nbsp;Xiaofei Cheng,&nbsp;Ziyang Zhou,&nbsp;Jili Wang,&nbsp;Haogang Yu,&nbsp;Guorong Yao,&nbsp;Zhongjie Lu,&nbsp;Xin Chen,&nbsp;Senxiang Yan,&nbsp;Feng Zhao","doi":"10.1017/S2045796023000690","DOIUrl":"10.1017/S2045796023000690","url":null,"abstract":"<p><strong>Aims: </strong>With advancements in cancer treatments, the survival rates of patients with their first primary cancer (FPC) have increased, resulting in a rise in the number of patients with second primary cancer (SPC). However, there has been no assessment on the incidence of suicide among patients with SPC. This study assessed the occurrence of suicide among patients with SPC and compared them with that in patients with FPC.</p><p><strong>Methods: </strong>This was a retrospective, population-based cohort study that followed patients with FPC and SPC diagnosed from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 17 registries database between 1 January 2000 and 31 December 2019.</p><p><strong>Results: </strong>For patients with SPC, an age of 85+ years at diagnosis was associated with a higher incidence of suicide death (HR, 1.727; 95% CI, 1.075-2.774), while the suicide death was not considerably different in the chemotherapy group (<i>P</i> > 0.05). Female genital system cancers (HR, 3.042; 95% CI, 1.819-6.361) accounted for the highest suicide death among patients with SPC. The suicide death distribution of patients with SPC over time indicated that suicide events mainly occurred within 5 to 15 years of diagnosis. Compared with patients with FPC, patients with SPC in general had a lower risk of suicide, but increased year by year.</p><p><strong>Conclusion: </strong>The risk of suicide was reduced in patients with SPC compared with patients with FPC, but increased year by year. Therefore, oncologists and related health professionals need to provide continuous psychological support to reduce the incidence of suicide. The highest suicide death was found among patients with female genital system cancer.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e57"},"PeriodicalIF":8.1,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10283961","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":"Development and validation of a new standardized measure for assessing experiences of discrimination within mental health services. A participatory research project.","authors":"Antonio Lasalvia,&nbsp;Stefano Pillan,&nbsp;Giulia Marzocco,&nbsp;Anna Ambrosini,&nbsp;Franco Veltro,&nbsp;Tecla Pozzan,&nbsp;Camilla D'Astore,&nbsp;Doriana Cristofalo,&nbsp;Mirella Ruggeri,&nbsp;Chiara Bonetto","doi":"10.1017/S2045796023000689","DOIUrl":"10.1017/S2045796023000689","url":null,"abstract":"<p><strong>Aims: </strong>People with mental disorders frequently report experiences of discrimination within mental health services, which can have significant detrimental effects on individuals' well-being and recovery. This study aimed to develop and validate a new standardized measure aiming to assess experiences of stigmatization among people with mental disorders within mental health services.</p><p><strong>Methods: </strong>The scale was developed in Italian and tested for ease of use, comprehension, acceptability, relevance of items and response options within focus group session. A cross-sectional validation survey was conducted among mental health service users in Italy. Exploratory factor analysis with Promax oblique rotation, the Kaiser<b>-</b>Meyer<b>-</b>Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient.</p><p><strong>Results: </strong>Overall, 240 people with mental disorders participated in the study; 56 also completed the retest evaluation after 2 weeks. The 18 items of the scale converged over a two-factor solution ('Dignity violation and personhood devaluation' and 'Perceived life restrictions and social exclusion'), accounting for 56.4% of the variance (KMO 0.903; Bartlett's test <i>p</i> < 0.001). Cronbach's alpha for the total score was 0.934. The scale showed one item with kappa above 0.81, four items between 0.61 and 0.80, ten items between 0.41 and 0.60, two items between 0.21 and 0.40 and only one item below 0.20. ICC was 0.928 (95% CI 0.877-0.958). Kendall's tau-b ranged from 0.450 to 0.617 (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The newly developed scale represents a valid and reliable measure for assessing experiences of stigma among patients receiving care within mental health services. The scale has provided initial evidence of being specifically tailored for individuals with psychotic and bipolar disorders. However, the factorial structure of the scale should be replicated through a confirmatory factor analysis on a larger sample of individuals with these conditions.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e54"},"PeriodicalIF":8.1,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252915","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 temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis.","authors":"Frank Iorfino, Mathew Varidel, Roman Marchant, Sally Cripps, Jacob Crouse, Ante Prodan, Rafael Oliveria, Joanne S Carpenter, Daniel F Hermens, Adam Guastella, Elizabeth Scott, Jai Shah, Kathleen Merikangas, Jan Scott, Ian B Hickie","doi":"10.1017/S2045796023000616","DOIUrl":"10.1017/S2045796023000616","url":null,"abstract":"<p><strong>Aims: </strong>The needs of young people attending mental healthcare can be complex and often span multiple domains (e.g., social, emotional and physical health factors). These factors often complicate treatment approaches and contribute to poorer outcomes in youth mental health. We aimed to identify how these factors interact over time by modelling the temporal dependencies between these transdiagnostic social, emotional and physical health factors among young people presenting for youth mental healthcare.</p><p><strong>Methods: </strong>Dynamic Bayesian networks were used to examine the relationship between mental health factors across multiple domains (social and occupational function, self-harm and suicidality, alcohol and substance use, physical health and psychiatric syndromes) in a longitudinal cohort of 2663 young people accessing youth mental health services. Two networks were developed: (1) 'initial network', that shows the conditional dependencies between factors at first presentation, and a (2) 'transition network', how factors are dependent longitudinally.</p><p><strong>Results: </strong>The 'initial network' identified that childhood disorders tend to precede adolescent depression which itself was associated with three distinct pathways or illness trajectories; (1) anxiety disorder; (2) bipolar disorder, manic-like experiences, circadian disturbances and psychosis-like experiences; (3) self-harm and suicidality to alcohol and substance use or functioning. The 'transition network' identified that over time social and occupational function had the largest effect on self-harm and suicidality, with direct effects on ideation (relative risk [RR], 1.79; CI, 1.59-1.99) and self-harm (RR, 1.32; CI, 1.22-1.41), and an indirect effect on attempts (RR, 2.10; CI, 1.69-2.50). Suicide ideation had a direct effect on future suicide attempts (RR, 4.37; CI, 3.28-5.43) and self-harm (RR, 2.78; CI, 2.55-3.01). Alcohol and substance use, physical health and psychiatric syndromes (e.g., depression and anxiety, at-risk mental states) were independent domains whereby all direct effects remained within each domain over time.</p><p><strong>Conclusions: </strong>This study identified probable temporal dependencies between domains, which has causal interpretations, and therefore can provide insight into their differential role over the course of illness. This work identified social, emotional and physical health factors that may be important early intervention and prevention targets. Improving social and occupational function may be a critical target due to its impacts longitudinally on self-harm and suicidality. The conditional independence of alcohol and substance use supports the need for specific interventions to target these comorbidities.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e56"},"PeriodicalIF":5.9,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197010","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":"Changes on depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population.","authors":"J L Ayuso-Mateos, D Morillo, J M Haro, B Olaya, E Lara, M Miret","doi":"10.1017/S2045796023000677","DOIUrl":"10.1017/S2045796023000677","url":null,"abstract":"<p><strong>Aims: </strong>To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain, and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown.</p><p><strong>Methods: </strong>Data from a longitudinal adult population-based cohort from Madrid and Barcelona were analysed (<i>n</i> = 1103). Face-to-face home-based (pre-pandemic) and telephone interviews were performed. Depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Population prevalence estimates and multivariable logistic regressions were computed.</p><p><strong>Results: </strong>Prevalence rates of depression changed significantly from before to after the COVID-19 outbreak (from 3.06% to 12.00%; <i>p</i> = 0.01) and per sex and age groups. Individuals reporting COVID-19 concerns (odds ratio [OR] = 3.11; 95% confidence interval [CI] = 1.45-6.69) and those feeling loneliness (OR = 1.99; 95% CI = 1.52-2.61) during the lockdown were at increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.57; 95% CI = 0.39-0.83), while individuals perceiving social support during the confinement were at lower risk of developing suicidal thoughts (OR = 0.21; 95% CI = 0.09-0.46). Greater disability during the lockdown was also associated with the risk of suicidal ideation (OR = 2.77; 95% CI = 1.53-5.03).</p><p><strong>Conclusions: </strong>Continuous reinforcement of mental health preventive and intervening measures is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e55"},"PeriodicalIF":5.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144911","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":"Vitamin D and suicidality: a Chinese early adolescent cohort and Mendelian randomization study.","authors":"Mengyuan Yuan, Yonghan Li, Junjie Chang, Xueying Zhang, Shaojie Wang, Leilei Cao, Yuan Li, Gengfu Wang, Puyu Su","doi":"10.1017/S2045796023000665","DOIUrl":"10.1017/S2045796023000665","url":null,"abstract":"<p><strong>Aims: </strong>Previous cross-sectional and case-control studies have proposed that decreased vitamin D levels are positively correlated with the risk of suicidality in adults. However, limited studies have examined the association between vitamin D and suicidality in adolescents. This study aimed to investigate the relationship between serum vitamin D and suicidality risk among early adolescents.</p><p><strong>Methods: </strong>Data were obtained from a Chinese early adolescent cohort. In this cohort, seventh-grade students from a middle school in Anhui Province were invited to voluntarily participate in the baseline assessments and provide peripheral blood samples (in September 2019). The participants were followed up annually (in September 2020 and September 2021). Serum 25-hydroxyvitamin D [25(OH)D] and vitamin D-related single-nucleotide polymorphisms at baseline were measured in November 2021. Traditional observational and Mendelian randomization (MR) analyses were performed to examine the relationship between serum 25(OH)D at baseline and the risk of baseline and incident suicidality (i.e., suicidal ideation [SI], plans and attempts).</p><p><strong>Results: </strong>Traditional observational analysis did not reveal a significant linear or non-linear association of serum 25(OH)D concentration with the risks of baseline and 2-year incident suicidality in the total sample (<i>P</i> > .05 for all). Sex-stratified analysis revealed a non-linear association between the 25(OH)D concentration and the risk of baseline SI in women (<i>P</i>_overall = .002; <i>P</i>_non-linear = .001). Moreover, the risk of baseline SI in the 25(OH) insufficiency group was lower than that in the 25(OH) deficiency group in the total sample (odds ratio [OR] = 0.69, 95% confidence interval [CI] = 0.51-0.92, <i>P</i> = .012). This difference remained significant in women (OR = 0.59, 95% CI = 0.40-0.87, <i>P =</i> .008) but not in men (OR = 0.78, 95% CI = 0.53-1.15, <i>P =</i> .205). Additionally, both linear and non-linear MR analyses did not support the causal effect of serum 25(OH)D concentration on the risk of baseline, 1-year and 2-year incident suicidality (<i>P</i> > .05 for all).</p><p><strong>Conclusions: </strong>This study could not confirm the causal effect of vitamin D on suicidality risk among Chinese early adolescents. Future studies must confirm these findings with a large sample size.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e52"},"PeriodicalIF":5.9,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125947","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":"Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study.","authors":"Ana Portillo-Van Diest,&nbsp;Gemma Vilagut,&nbsp;Itxaso Alayo,&nbsp;Montse Ferrer,&nbsp;Franco Amigo,&nbsp;Benedikt L Amann,&nbsp;Andrés Aragón-Peña,&nbsp;Enric Aragonès,&nbsp;Ángel Asúnsolo Del Barco,&nbsp;Mireia Campos,&nbsp;Isabel Del Cura-González,&nbsp;Meritxell Espuga,&nbsp;Ana González-Pinto,&nbsp;Josep M Haro,&nbsp;Amparo Larrauri,&nbsp;Nieves López-Fresneña,&nbsp;Alma Martínez de Salázar,&nbsp;Juan D Molina,&nbsp;Rafael M Ortí-Lucas,&nbsp;Mara Parellada,&nbsp;José M Pelayo-Terán,&nbsp;Aurora Pérez-Zapata,&nbsp;José I Pijoan,&nbsp;Nieves Plana,&nbsp;Teresa Puig,&nbsp;Cristina Rius,&nbsp;Carmen Rodríguez-Blázquez,&nbsp;Ferran Sanz,&nbsp;Consol Serra,&nbsp;Iratxe Urreta-Barallobre,&nbsp;Ronald C Kessler,&nbsp;Ronny Bruffaerts,&nbsp;Eduard Vieta,&nbsp;Víctor Pérez-Solá,&nbsp;Jordi Alonso,&nbsp;Philippe Mortier","doi":"10.1017/S2045796023000628","DOIUrl":"https://doi.org/10.1017/S2045796023000628","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.</p><p><strong>Methods: </strong>This is a multicenter prospective cohort study. Spanish healthcare workers (<i>N</i> = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).</p><p><strong>Results: </strong>Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.</p><p><strong>Conclusions: </strong>TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e50"},"PeriodicalIF":8.1,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125943","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":"Investigating risk of self-harm and suicide on anniversaries after bereavement by suicide and other causes: a Danish population-based self-controlled case series study.","authors":"Alexandra Pitman, Yanakan Logeswaran, Keltie McDonald, Julie Cerel, Gemma Lewis, Annette Erlangsen","doi":"10.1017/S2045796023000653","DOIUrl":"10.1017/S2045796023000653","url":null,"abstract":"<p><strong>Aims: </strong>To investigate mechanisms of suicide risk in people bereaved by suicide, prompted by observations that bereaved people experience higher levels of distress around dates of emotional significance. We hypothesised that suicide-bereaved first-degree relatives and partners experience an increased risk of self-harm and suicide around dates of (i) anniversaries of the death and (ii) the deceased's birthday, compared with intervening periods.</p><p><strong>Methods: </strong>We conducted a self-controlled case series study using national register data on all individuals living in Denmark from 1 January 1980 to 31 December 2016 and who were bereaved by the suicide of a first-degree relative or partner (spouse or cohabitee) during that period, and who had the outcome (any episode of self-harm or suicide) within 5 years and 6 weeks of the bereavement. We compared relative incidence of suicidal behaviour in (i) the first 30 days after bereavement and (ii) in the aggregated exposed periods (6 weeks either side of death anniversaries; 6 weeks either side of the deceased's birthdays) to the reference (aggregated unexposed intervening periods). As an indirect comparison, we repeated these models in people bereaved by other causes.</p><p><strong>Results: </strong>We found no evidence of an elevated risk of suicidal behaviour during periods around anniversaries of a death or the deceased's birthdays in people bereaved by suicide (adjusted incidence rate ratio [IRR_adj] = 1.00; 95% confidence interval [CI] = 0.87-1.16) or other causes (IRR_adj = 1.04; 95% CI = 1.00-1.08) compared with intervening periods. Rates were elevated in the 30 days immediately after bereavement by other causes (IRR_adj: 1.95, 95% CI: 1.77-2.22).</p><p><strong>Conclusions: </strong>Although people bereaved by suicide are at elevated risk of self-harm and suicide, our findings do not suggest that this risk is heightened around emotionally significant anniversaries. Bereavement care should be accessible at all points after a traumatic loss as needs will differ over the grief trajectory.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e53"},"PeriodicalIF":8.1,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128807","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":"Do values and political attitudes affect help-seeking? Exploring reported help-seeking for mental health problems in a general population sample using a milieu framework.","authors":"J Spahlholz,&nbsp;E Baumann,&nbsp;R Müller-Hilmer,&nbsp;R Hilmer,&nbsp;C Sander,&nbsp;S Schindler,&nbsp;S Speerforck,&nbsp;M C Angermeyer,&nbsp;G Schomerus","doi":"10.1017/S2045796023000641","DOIUrl":"https://doi.org/10.1017/S2045796023000641","url":null,"abstract":"<p><strong>Aims: </strong>Help-seeking for mental health problems is facilitated and hindered by several factors at the individual, interpersonal and community level. The most frequently researched factors contributing to differences in help-seeking behaviour are based on classical socio-demographic variables, such as age, gender and education, but explanations for the observed differences are often absent or remain vague. The present study complements traditional approaches in help-seeking research by introducing a milieu approach, focusing on values and political attitudes as a possible explanation for differences in help-seeking for emotional mental health problems.</p><p><strong>Methods: </strong>A representative cross-sectional survey of <i>N</i> = 3,042 respondents in Germany was conducted through face-to-face interviews about past help-seeking for mental health problems, socio-demographic characteristics and values and political attitudes.</p><p><strong>Results: </strong>Multivariate logistic regression analyses indicated that belonging to a cosmopolitan intellectual milieu group was significantly associated with an increased likelihood of past help-seeking for mental health issues (psychotherapeutic/psychological help-seeking [OR = 2.09, 95% CI: 1.11-3.93, <i>p</i> < 0.05) and primary care (OR = 2.21, 95% CI: 1.15-4.24, <i>p</i> < 0.05]), whereas members of individualist and conservative milieu groups were less likely to report having sought help from a psychotherapist, but not from a general practitioner. Increased odds ratios were also found for a number of socio-demographic variables, such as being aged 26 years and over, a female gender and more than 12 years of formal education. Associations between socio-demographic variables remained significant, and the explained variance of the used models improved considerably when milieu variables were added.</p><p><strong>Conclusions: </strong>We discuss how milieu-specific patterns were relevant for explaining differences in mental health service use in addition to socio-demographic factors. It seems promising to consider help-seeking from a milieu perspective to improve disparities in access to and the use of psychotherapy as well as to resource allocation.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"32 ","pages":"e49"},"PeriodicalIF":8.1,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126737","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}