Christine Leonhard Birk Sørensen, Finn B Larsen, Ute Bültmann, Oleguer Plana-Ripoll, Trine N Winding, Pernille B Steen, Karin Biering
{"title":"Estimating the associations between personal, health, lifestyle, and social factors on depressive symptoms from adolescence to adulthood: a fixed effect approach using panel data.","authors":"Christine Leonhard Birk Sørensen, Finn B Larsen, Ute Bültmann, Oleguer Plana-Ripoll, Trine N Winding, Pernille B Steen, Karin Biering","doi":"10.1093/eurpub/ckag122","DOIUrl":"10.1093/eurpub/ckag122","url":null,"abstract":"<p><p>Numerous studies have tried to understand the causes of mental health problems, mostly focusing on single exposures. These approaches often fail to capture the complex and interconnected nature of mental health problems. This study aims to investigate the associations of concurrent age-specific changes in explanatory factors, encompassing personal, health, lifestyle, and social factors and depressive symptoms in individuals aged 15 to 32 years. Individuals born in 1989 were followed from 2004 to 2021 with surveys at ages 15, 18, 21, 28, and 32. Inverse probability weights and multiple imputations with chained equations were used to account for attrition and missing data. Descriptive characteristics for each wave were estimated as well as the changes in depressive symptoms and explanatory variables between each wave. Fixed effect regression models and dominance analyses examined the contribution of change in each explanatory variable to the change in depressive symptoms between each wave. Lastly, analyses of asymmetric change were estimated to detect asymmetric associations of explanatory variables and depressive symptoms. The relative importance of the explanatory variables changed between age points. Between all age points, stress was the most dominant variable with a relative contribution above 30% between all age points, while the contribution of sense of coherence increased through the waves from 17% to 25%. Self-esteem, self-rated health, and psychosomatic symptoms had also high dominance with shifting contributions through the ages. The associations between explanatory factors and depressive symptoms are dynamic and preventive strategies should be tailored towards the different life stages.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuqing Jia, Emily Marie Ungermann, Katharina Feld, Kathrin Yen
{"title":"Structuring medico-legal autopsy data for public health surveillance using the 11th Revision of the International Classification of Diseases: a retrospective cohort study.","authors":"Yuqing Jia, Emily Marie Ungermann, Katharina Feld, Kathrin Yen","doi":"10.1093/eurpub/ckag158","DOIUrl":"10.1093/eurpub/ckag158","url":null,"abstract":"<p><p>Medico-legal autopsy case files contain prevention-relevant information on causes and circumstances of death but remain underused for surveillance because key detail is recorded as narrative text and terminology varies across jurisdictions. We evaluated whether the 11th Revision of the International Classification of Diseases can generate structured, surveillance-ready outputs from these records, while signalling where coding cannot preserve medico-legal meaning. In this retrospective study at the Institute of Forensic and Traffic Medicine, Heidelberg University Hospital, Germany, we screened consecutive medico-legal autopsy case files from 1 January 2022 to 31 December 2024 and analysed all eligible reports. We generated three output layers: causes of death, injury phenotypes, and external-cause dimensions for non-natural deaths. An expert-validated quality-flag framework identified representational limitations affecting surveillance interpretation. Of 935 screened files, 921 were analysed. Overall, 196 of 921 autopsies (21.3%) had one or more quality flags. Flags affected 119 of 921 cases (12.9%) in cause-of-death coding, 60 of 921 (6.5%) in injury phenotyping, and 35 of 423 non-natural deaths (8.3%) in external-cause dimensions. Flags were most prevalent among suicides (23 of 58, 39.7%); injury-related flags were most frequent in neck injuries (32 of 137, 23.4%). Among non-natural deaths, place and mechanism were codable in over 92% of cases. The 11th Revision of the International Classification of Diseases can support structured cause-of-death, injury, and external-cause outputs from medico-legal autopsy records for public health surveillance. However, routine use requires explicit signalling of residual uncertainty and classification limitations to preserve interpretability.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"'So, this feels very different and, you know, kindly': a mixed methods study of arts on prescription in secondary care.","authors":"Nicola J Holt, Donna Baber, Caroline Elliott","doi":"10.1093/eurpub/ckag151","DOIUrl":"10.1093/eurpub/ckag151","url":null,"abstract":"<p><p>Arts on Prescription (AoP) programmes occur within primary care and community settings. The aim of this study was to examine the impact of AoP delivered in secondary care, on patient wellbeing, social connection, and experiences of care. A mixed-methods design was used. Quantitative data were collected from 61 patients referred to AoP through secondary care outpatient services for cancer, chronic pain, weight management, breathlessness, or neuromuscular conditions. Wellbeing and loneliness were assessed pre- and post-participation in the AoP programme. Mood and loneliness were assessed before and after each arts workshop. Qualitative methods focused on experiences of AoP and were collected through semi-structured interviews and focus groups (n = 12) and analysed using thematic analysis. Wellbeing scores increased significantly over the course of the programme, alongside reductions in loneliness. Arts workshops increased relaxation, contentment, and social connection. Thematic analysis led to four themes: (i) Connection to others-feeling supported, inspired, and understood; (ii) Making space-providing relaxing, protected time; (iii) Becoming-renewed confidence, and opening to new opportunities; and (iv) Relationships with healthcare-reframing interactions with secondary care, validating referrals, and supporting the management of health conditions. AoP in secondary care demonstrates potential as an effective approach, replicating effects in primary care, including improved wellbeing and social connection. However, additional merits in this context relate to healthcare relationships, and using the arts to manage health conditions. Embedding AoP within secondary care may reduce burden on services by supporting psychosocial needs alongside medical care.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interpregnancy interval and maternal postpartum depression and anxiety: findings from the APrON cohort.","authors":"Peighton Johnson, Nicole Letourneau, Maryam Kebbe","doi":"10.1093/eurpub/ckag153","DOIUrl":"10.1093/eurpub/ckag153","url":null,"abstract":"<p><p>Shorter interpregnancy intervals (IPI) are linked to adverse maternal health outcomes, such as pre-eclampsia and gestational diabetes mellitus. The link between IPI and maternal mental health has not been examined despite its potential clinical implications. The aim of this study was to examine associations between IPI and postpartum symptoms of depression (PPD) and anxiety (PPA). We retrieved data from the APrON study. Mothers (n = 613) completed the Edinburgh Postpartum Depression Scale to assess depression and the Symptoms Checklist-90 to assess anxiety within 1 year of the second child's delivery. IPI was categorized into <6, 6-11, 12-17, 18-23, 24-59, and 60-119 months. Logistic generalized linear modeling was performed. Mothers ≥35 years of age had twice the odds of PPD (OR = 2.06, 95% CI: 1.25-3.36, P = .0041) compared to mothers <35 years. Mothers with high social support had 54% lower odds of PPD (OR = 0.46, 95% CI: 0.29-0.72, P = .00074) compared to mothers with low social support. Mothers with a history of PPD and/or PPA had 3× greater odds of PPD (OR = 3.00, 95% CI: 1.47-5.96, P = .0020) compared to those without a history. Social support postpartum and history of depression and/or anxiety were also associated with PPA (P < .05). IPI was not related to maternal PPD or PPA in this cohort. Comprehensive mental health support programs and resources are warranted not only postnatally, but prenatally and throughout gestation, particularly in older mothers and those with mental illness history.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tove Nilsson, Emma Brulin, Mikko Härmä, Per Gustavsson, Carolina Bigert, Abid Lashari, Jenny Selander, Seth Addo
{"title":"Shift work and medically certified sickness absence due to common mental disorders among nursing staff: a prospective cohort study.","authors":"Tove Nilsson, Emma Brulin, Mikko Härmä, Per Gustavsson, Carolina Bigert, Abid Lashari, Jenny Selander, Seth Addo","doi":"10.1093/eurpub/ckag163","DOIUrl":"10.1093/eurpub/ckag163","url":null,"abstract":"<p><p>Sickness absence due to common mental disorders is rising among healthcare staff, yet evidence on the impact of shift work remains inconsistent. This study examined the association between shift work and the risk of first-time medically certified sickness absence (>14 days) due to common mental disorders (CMDs) among nursing staff. This 11-year prospective cohort study included 25 120 nurses and nursing assistants employed for one year or more between 2008 and 2019 in Region Stockholm. Shift work data were obtained from an employee register, and CMD-related sickness absence (N = 2792) from the Swedish Social Insurance Agency, for the study period 2009-2020. Discrete-time proportional hazards models estimated hazard ratios, adjusted for demographic factors and profession. Shift work was assessed in the year preceding sickness absence. Lower hazard ratios (HRs) for sickness absence due to CMDs were found among shift workers with night shifts (HR 0.80, 95% CI 0.72-0.89) and among permanent night workers (HR 0.81, 95% CI 0.65-0.99), compared with day workers. Frequent night shifts (>121/year) were associated with a lower risk (HR 0.77, 95% CI 0.65-0.90) compared with non-night workers. Among non-night workers, frequent quick returns (>49/year) from afternoon shifts (defined as less than 11 hours between shifts) were associated with a lower HR (HR 0.72, 95% CI 0.56-0.92) compared with never having quick returns. Shift work among nursing staff was associated with a lower risk of sickness absence due to common mental disorders. This finding may reflect a selection of healthy individuals for night-shift work.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tiago Correia, Martin McKee, Christina Pagel, Gavin Yamey
{"title":"Uncertainty on trial: the Fauci diary disclosure and the protection of scientific deliberation.","authors":"Tiago Correia, Martin McKee, Christina Pagel, Gavin Yamey","doi":"10.1093/eurpub/ckag160","DOIUrl":"10.1093/eurpub/ckag160","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johannes Beller, Julia Graßhoff, Stefanie Sperlich, Siegfried Geyer
{"title":"Depression trends in Europe: sociodemographic differences.","authors":"Johannes Beller, Julia Graßhoff, Stefanie Sperlich, Siegfried Geyer","doi":"10.1093/eurpub/ckag168","DOIUrl":"10.1093/eurpub/ckag168","url":null,"abstract":"<p><p>Depression represents a critical concern for public mental health. This study examines time trends in the prevalence of elevated depressive symptoms throughout Europe and investigates socioeconomic differences. Data were derived from the European Social Survey waves of 2006, 2012, 2014, and 2023 (15 countries; N = 106 814). Prevalence of elevated depressive symptoms was assessed using the 8-item Center for Epidemiological Studies Depression Scale. Analyses were stratified by age, gender, education, income, occupation, limitation, and European region. Multilevel logistic regression models were used to analyze trends. Findings revealed substantial reductions over time in the prevalence of elevated depressive symptoms among older adults, smaller reductions in middle-aged individuals, and constant trends among the younger population. Considerable variations in depression trends were observed across most sociodemographic subgroups. Particularly beneficial trends were found in Eastern European middle-aged and older adults. Conversely, increasing trends among younger adults were mostly evidenced for Northern Europe, with similar patterns suggested for younger individuals with higher education and income. Additionally, those with limitations maintained an extremely high prevalence of elevated depressive symptoms over time, especially among younger individuals. Thus, while generally favorable trends were observed in older and middle-aged adults, increases in the prevalence of elevated depressive symptoms were found for parts of the younger population in Europe. Differential trends across sociodemographic groups were particularly present in terms of education, limitation, and geographic region. The findings highlight the necessity for targeted public health interventions addressing vulnerable groups. Further analyses are needed to identify intermediary determinants explaining these patterns.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julie Martin, Nelly Sénac, Karin Zürcher, Luc Lebon
{"title":"Political arguments for and against tobacco tax increases in the Swiss Parliament (2010-2025).","authors":"Julie Martin, Nelly Sénac, Karin Zürcher, Luc Lebon","doi":"10.1093/eurpub/ckag141","DOIUrl":"10.1093/eurpub/ckag141","url":null,"abstract":"<p><p>Increasing taxation is one of the most effective tobacco control policies. However, cigarette taxes in Switzerland remain lower than in other European countries. This study analyses the arguments supporting or opposing an increased taxation that were put forward by members of the Swiss Parliament and by the Swiss Government between 2010 and 2025. Arguments in favour of higher taxes are mainly youth protection and taxation according to product risk. Arguments against higher taxes are mainly illicit and cross-border trade, followed by the negative economic impact. The Government often takes a status quo approach when responding to parliamentary requests.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kenta Okuyama, Sara Larsson Lönn, Ardavan M Khoshnood, Shervin Assari, Jan Sundquist, Kristina Sundquist
{"title":"Substance use disorders among refugee and non-refugee immigrants in Sweden.","authors":"Kenta Okuyama, Sara Larsson Lönn, Ardavan M Khoshnood, Shervin Assari, Jan Sundquist, Kristina Sundquist","doi":"10.1093/eurpub/ckag152","DOIUrl":"10.1093/eurpub/ckag152","url":null,"abstract":"<p><p>Evidence is inconclusive on whether immigrants are at higher risk of substance use disorders compared to non-immigrants. We investigated the risk of drug and alcohol use disorder (DUD and AUD) in first- and second-generation immigrants with refugee and non-refugee backgrounds using the nationwide Swedish longitudinal healthcare and legal registers. We included 798 141 males and 756 903 females who turned 16 years of age between 2005 and 2020. DUD and AUD were identified between ages 16 and 25 years using healthcare and legal registers. Immigrants were categorized into first- and second-generation refugees and non-refugees. Cox proportional hazard models estimated DUD and AUD risk in relation to immigrant status (non-immigrants as reference), adjusting for covariates. Sensitivity analyses were conducted using healthcare register data only. DUD risks were higher among most refugee and non-refugee immigrants compared to non-immigrants, i.e. hazard ratios (HRs) ranged from HR: 1.05, 95% CI: 0.95-1.15 (first-generation female refugees) to HR: 2.63, 95% CI: 2.54-2.73 (first-generation male refugees). AUD risks among immigrants were lower or similar to non-immigrants, i.e. HRs ranged from HR: 0.55, 95% CI: 0.49-0.62 (first-generation female refugees) to HR: 1.17, 95% CI: 1.03-1.34 (first-generation male non-refugees). Sensitivity analyses restricted to healthcare registers yielded somewhat attenuated associations for DUD, particularly among first-generation male refugees. Refugee and non-refugee immigrants in Sweden were generally at elevated risk of DUD, whereas AUD risks were largely similar to or lower than that of non-immigrants. The findings were broadly robust in analyses restricted to healthcare data.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helena Koprivnikar, Zala Jeras, Gorazd Levičnik, Jaana Markkula, Kateryna Marushko, Hanna Ollila, Mirela Strandzheva, Dunja Šulc, Taija Voutilainen
{"title":"Mystery shopping of tobacco, nicotine and alcohol products in 20 European countries: a cross-sectional study in the JAPreventNCD project.","authors":"Helena Koprivnikar, Zala Jeras, Gorazd Levičnik, Jaana Markkula, Kateryna Marushko, Hanna Ollila, Mirela Strandzheva, Dunja Šulc, Taija Voutilainen","doi":"10.1093/eurpub/ckag164","DOIUrl":"10.1093/eurpub/ckag164","url":null,"abstract":"<p><p>Ensuring high compliance with age restrictions on tobacco/nicotine and alcohol sales is essential to prevent access and use among youth. Mystery shopping is a way to check compliance with age restrictions. The aim of this survey was to compare the status of and experiences with mystery shopping of tobacco/nicotine and alcohol products in European countries. We conducted a cross-sectional survey to explore the use and characteristics of mystery shopping practices. The information was obtained from the identified contacts in 30 European countries. Mystery shopping was conducted in 20 out of 30 countries, mostly for both groups of products. In around two thirds of countries with mystery shopping, it was conducted regularly and on the national level, including different subcategories of tobacco/nicotine products (including new tobacco/nicotine products) and alcoholic beverages. All countries had conducted mystery shopping at physical points of sale, but rarely online. Methods of mystery shopping practices varied among countries. In most countries, the mystery shoppers were minors and the financial and human resources were not always ensured, raising concerns regarding the ethical aspects and continuation of mystery shopping use. Mystery shopping practices vary among European countries. Developing standardized, sustainable, and ethically sound protocols for effective mystery shopping would facilitate use of mystery shopping across countries, support comparability of results, and promote sharing of best practices. Future efforts should include online sales channels, which are increasingly used by youth.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}