International Journal of Social Psychiatry最新文献

{"title":"A Clinically Applicable Framework for Cultural Personality Formulation: Integrating DSM-5 CFI with Narrative-Based Analysis.","authors":"Halil İbrahim Eren, Uğur Takım, Hasan Belli","doi":"10.1177/00207640261473296","DOIUrl":"10.1177/00207640261473296","url":null,"abstract":"","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1833-1835"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Causal Relationship Between Hikikomori and Psychological Features of New-Type Depression: A Longitudinal Study on Male Individuals With Hikikomori Condition.","authors":"Yudai Suzuki, Takahiro A Kato, Shinji Sakamoto","doi":"10.1177/00207640261456745","DOIUrl":"10.1177/00207640261456745","url":null,"abstract":"<p><strong>Aims: </strong>New-type depression, which exhibits characteristics that are different from those of traditional depression, is thought to be associated with hikikomori. However, a causal relationship has yet to be established. Thus, this study examined the causal relationship between the psychological characteristics of new-type depression (interpersonal sensitivity and privileged self) and hikikomori.</p><p><strong>Method: </strong>The analysis included 393 male individuals with hikikomori, with longitudinal data collected from participants by asking them to respond 3 times at 3-month intervals. Participants responded to scales to measure the psychological characteristics of new-type depression and the severity of hikikomori symptoms. We analyzed the data using a random-intercept cross-lagged panel model.</p><p><strong>Results: </strong>Our results showed significant cross-lag effects. In particular, our findings revealed that the extent of hikikomori at Time 1 increased IS and PS at Time 2, whereas IS and PS at Time 2 increased the extent of hikikomori at Time 3. Our data fit the model. These results suggest a self-reinforcing pattern in which hikikomori tendencies intensify with increasing IPS over time.</p><p><strong>Conclusion: </strong>We propose that it is important to address both new types of depression and hikikomori rather than addressing one or the other in the treatment of these two disorders. However, this study focused exclusively on individuals who were hikikomori, men, unemployed, and non-disabled. Future studies should include individuals without hikikomori infections or new types of depression.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1649-1656"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Anxiety Disorders Play a Role in Road Traffic Deaths? The Nested Case-Control Study of Drivers Killed in Fatal Motor Vehicle Accidents in Finland Between 1990 and 2011.","authors":"Tiia Hannila, Pirkko Riipinen, Helinä Hakko, Niina Sihvola, Anu-Helmi Halt","doi":"10.1177/00207640261457642","DOIUrl":"10.1177/00207640261457642","url":null,"abstract":"<p><strong>Background: </strong>Relatively little is known about the relationship between anxiety disorders and fitness-to-drive. This study analysis the characteristics of motor vehicle fatalities, involving drivers with hospital-diagnosed anxiety disorders, as well as the contribution of psychiatric comorbidity to the cause of these fatalities.</p><p><strong>Aims: </strong>In our population-based data of all deceased Finnish drivers we compare socio-demographic, driving-related and clinical characteristics of study subjects with anxiety disorders with matched control subjects without any history of hospital treated psychiatric disorders. We also explore whether the cause of death of drivers killed in motor vehicle accidents differs between those with anxiety disorders and comorbid psychiatric disorders.</p><p><strong>Methods: </strong>This study was based on OTI (The Finnish Crash Data Institute) data with linkage to two national registers: The Care Register for Health Care and the National Cause of Death Register. The initial study population included 4,930 drivers involved in fatal motor vehicle accidents in Finland between 1990 and 2011. It was confirmed that 93 drivers had received an anxiety disorder diagnosis (ICD-10 codes: F40-44) in the 5 years prior to their collision.</p><p><strong>Results: </strong>We found that drivers with anxiety disorders were more likely to be involved in crashes with suicidal intent (<i>OR</i> = 2.83, 95% CI [1.40, 5.72]), drivers who had previously experienced headaches or insomnia (<i>OR</i> = 4.99, 95% CI [1.34, 18.62]), and drivers who were impaired by alcohol or drugs (<i>OR</i> = 3.92, 95% CI [1.28, 11.98] when DUI was 0.5‰-1.19‰ and <i>OR</i> = 2.01, 95% CI [1.15, 3.52] when DUI was aggravated, BAC 1.2‰ or above). It was notable that the proportion of suicides increased when anxiety disorder occurred simultaneously with depression (20.7%) or other psychiatric disorders (24.0%). In the overall dataset, the most common cause of death was an accident (82.8%). Regarding to accidental deaths, no significant differences were observed between individuals with anxiety disorders and matched control subjects without any history of hospital treated psychiatric disorders.</p><p><strong>Conclusion: </strong>The findings of this study suggest that assessment of suicidal intent may be particularly important when evaluating fitness to drive in patients with anxiety disorders, including those with psychiatric comorbidity, alongside consideration of substance use that may impair driving, and a history of headaches or insomnia.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1608-1616"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Profiles and Correlates of Mental Health Stigma in India.","authors":"Ananda Krishnan, Amrita Deb","doi":"10.1177/00207640261468250","DOIUrl":"10.1177/00207640261468250","url":null,"abstract":"<p><strong>Background: </strong>Stigma toward mental health problems is now being understood as a context-dependent, multidimensional concept. Nonetheless, empirical research continues to study stigma as a monolithic aspect, obscuring meaningful within-group variations. Such inquiries often obscure the people-centered patterns of stigma within the population. Recognizing such patterns aids in better understanding how stigma differentially influences help-seeking and resilience in the context of mental health.</p><p><strong>Aims: </strong>Accordingly, the present study seeks to identify latent profiles for stigmatizing attitudes and their correlates among Indian adults. The study also explores how these profiles potentially differ in resilience and help-seeking attitudes.</p><p><strong>Methods: </strong>The data were collected via a cross-sectional survey with 564 Indian adults. Standardized self-report measures like the Attitudes Toward Mental Health Problems Scale, the Connor-Davidson Resilience Scale - 10-item version, and the Inventory of Attitudes Toward Seeking Mental Health Services were used.</p><p><strong>Results: </strong>Latent Profile Analysis revealed a four-profile model that differed significantly in resilience and help-seeking attitudes. Further, a multinomial logistic regression revealed attitudes toward seeking mental health services, accessibility, reliance on religion, and mental health awareness as correlates of profile membership.</p><p><strong>Conclusion: </strong>The findings indicate the presence of multiple patterns of stigmatizing attitudes among Indian adults. The results of this study could inform practice, policy, and context-sensitive interventions to reduce stigma and promote the use of mental health services.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1747-1756"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsychosocial Complexity of Revolving Door Admissions in an Acute Psychiatric Unit: A Retrospective Cohort Study.","authors":"Mattia Marchi, Silvia I Rusu, Gianluca Fiore, Gloria Bizzarri, Ilaria Corbellini, Giulia Ferrazzi, Giulia Pollice, Alessia Mancini, Isabella Riguzzi, Roberto Salati, Luca Pingani, Gian M Galeazzi, Silvia Ferrari","doi":"10.1177/00207640261468242","DOIUrl":"10.1177/00207640261468242","url":null,"abstract":"<p><strong>Background: </strong>Frequent psychiatric rehospitalizations, commonly referred to as revolving door (RD) pose major challenges to community mental healthcare system and may reflect patients' bio-psycho-social (BPS) complexity.</p><p><strong>Aims: </strong>The aim of the current study was to investigate the association between BPS complexity and RD in an acute psychiatric hospital ward, located in a Northern Italy province serving around 500,000 inhabitants.</p><p><strong>Methods: </strong>A retrospective cohort study design was implemented to review all adult admissions between December 2021 and March 2023. Sociodemographic, clinical, and service-related data were extracted from the electronic clinical records. BPS complexity was assessed using the INTERMED tool. RD was defined as ⩾3 hospitalizations within 12 months. Survival analyses estimated hazard ratios (HRs) with corresponding 95% confidence intervals (95% CIs) for time-to-RD, under the assumption of proportional hazards.</p><p><strong>Results: </strong>A total of 322 patients were analyzed, and 31 (9.63%) met RD criteria. Compared to non-RD, RD patients displayed higher INTERMED scores, especially in psychological (HR: 1.28, 95% CI [1.06, 1.54]) and social (HR: 1.15 [1.05, 1.26]) domains. Living in a residential facility compared to a private house (HR: 7.14 [3.31, 15.38]), previous compulsory admissions (HR: 4.27 [1.73, 10.54]), long-acting injectable antipsychotic use at the first admission (HR: 3.46 [1.63, 7.35]), and receiving an individualized treatment plan at the community mental health center compared to not receiving it at the time of the first admission (HR: 5.30 [1.25, 22.42]) were all associated with an increased risk of RD during the follow-up.</p><p><strong>Conclusions: </strong>Higher complexity in psycho-social domains and history of coercive treatments increased the risk of RD. Addressing psychological distress, social disconnection, and agency in community care may support clinicians in recognizing and anticipating risk factors for RD.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1524-1534"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Affiliate Stigma and Patient Internalized/Anticipated Stigma in Bipolar Disorder: A Multicenter Dyadic Study.","authors":"Fatih Ekici, Cengiz Akkaya, Ece Buyuksandalyaci Tunç, Serap Özçetinkaya Erdoğan, Lut Tamam, Bahri İnce, Ömer Aydemir, Funda Akın, Vefa Erbasan, Kürşat Altınbaş","doi":"10.1177/00207640261468240","DOIUrl":"10.1177/00207640261468240","url":null,"abstract":"<p><strong>Background: </strong>Stigma in bipolar disorder is commonly conceptualized as an individual-level experience, but it may also be embedded within family systems. Family members may develop affiliate stigma, and patient-relative stigma dimensions may co-occur within dyads. Dyadic studies assessing these dimensions concurrently remain limited.</p><p><strong>Aims: </strong>This multicenter dyadic study examined the association between relatives 'affiliate/family stigma and patients' internalized/anticipated stigma in bipolar disorder, and explored associations between stigma-related dimensions and illness-burden indicators.</p><p><strong>Methods: </strong>The sample comprised 184 adults with bipolar disorder in remission and one adult relative per patient, recruited from seven centers across Türkiye. Diagnoses were confirmed using the SCID-5-CV. Stigma was assessed using parallel patient and relative forms of the newly developed Turkish-language Patient-Relative Stigma Questionnaire for Bipolar Disorder (PRSQ-BD). Psychometric analyses included internal consistency, exploratory and confirmatory factor analyses, and discriminant-separability indices. Dyadic associations were examined using linear mixed-effects models with random intercepts for center. Lifetime episode count and bipolar episode-related hospitalizations were analyzed using negative binomial regression models.</p><p><strong>Results: </strong>Higher relatives' affiliate/family stigma was associated with higher patient internalized/anticipated stigma after adjustment for sociodemographic and clinical variables. Patients' public stigma beliefs showed a strong statistical association with internalized/anticipated stigma. Patient internalized/anticipated stigma was statistically associated with lifetime episode count and hospitalization count. In dyadic hospitalization models, relatives' internalized/anticipated stigma was also statistically associated with hospitalization count.</p><p><strong>Conclusions: </strong>These exploratory findings indicate that patient and relative stigma-related dimensions are associated within dyads and are statistically related to illness-burden indicators. Given the preliminary psychometric status of the PRSQ-BD and the cross-sectional design, findings should be interpreted as dyadic associations among theoretically specified mean-item indices, not as evidence of validated mechanisms, temporal pathways, or causal effects.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1657-1667"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Mental Health Workforce Composition and National Depression Prevalence: Cross-National Evidence From the WHO Mental Health Atlas 2020 and the Global Burden of Disease Study 2019.","authors":"Christopher Lomas","doi":"10.1177/00207640261424406","DOIUrl":"10.1177/00207640261424406","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether the national availability and composition of mental health professionals, primarily non-psychiatrist providers, are associated with the population prevalence of depression, controlling for economic and demographic factors.</p><p><strong>Methods: </strong>A cross-sectional ecological analysis used data from 131 countries, sourcing workforce statistics from the WHO Mental Health Atlas 2020 and depression prevalence from GBD 2019. Ordinary Least Squares (OLS) regression models, adjusted for log Gross Domestic Product (GDP) per capita and urbanisation, assessed total workforce density, disaggregated provider densities (psychiatrists vs. psychologists) and the psychiatrist share of the workforce. Heteroskedasticity-consistent standard errors were applied.</p><p><strong>Results: </strong>Adjusted analysis showed a significant inverse association between overall workforce density and prevalence (β = -.031, <i>p</i> < .001) suggesting that higher workforce density correlates with lower depression prevalence. Psychologist density showed a stronger inverse association (β = -.038, <i>p</i> = .001) than psychiatrist density (β = -.024, <i>p</i> = .048) suggesting that greater availability of psychologists is more strongly correlated with lower depression prevalence. Critically, a higher proportion of psychiatrists was independently associated with increased depression prevalence (β = 1.89 percentage points, <i>p</i> = .032). Analysis of regional variation indicated that the inverse association between psychologist availability and depression prevalence was globally observed, with the steepest marginal effects noted in lower-income settings.</p><p><strong>Conclusion: </strong>Mental health workforce expansion is correlated with reduced depression, notably when systems include non-psychiatrist providers. These findings indicate that broadening service delivery capacity beyond psychiatric care could potentially improve the effectiveness of national mental health systems, pending further investigation.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1680-1688"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internalized Stigma in Adolescents With Major Depressive Disorder and Their Parents: Associations With Functioning, Help-Seeking, Beliefs, and Social Support.","authors":"Hilal Nur Çalık Şentürk, Tezan Bildik","doi":"10.1177/00207640261424410","DOIUrl":"10.1177/00207640261424410","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with major depressive disorder (MDD) often internalize stigma, undermining functioning and help-seeking. Parents may likewise internalize stigma about their child's condition, shaping family dynamics and care engagement.</p><p><strong>Aim: </strong>To examine internalized stigma in adolescents with MDD and their parents, and its associations with adolescent depressive severity, perceived social support, beliefs about mental illness, help-seeking attitudes, and adolescents' global functioning.</p><p><strong>Method: </strong>Cross-sectional tertiary-clinic study (July-October 2023) of 55 adolescents (12-18 years) with DSM-5 MDD and one parent each (<i>n</i> = 55); 81.8% of adolescents were female. Adolescents completed BDI, SSDS, ISMI-CA, BTMI, MSPSS, and ATSPPH-SF; clinicians rated GAF. Parents completed BDI, P-ISMI, BTMI, and ATSPPH-SF. Group comparisons, correlations, and multivariable linear regression were used.</p><p><strong>Results: </strong>Parents of adolescents with a suicide attempt or non-suicidal self-injury (NSSI) reported higher P-ISMI (higher alienation and stereotype endorsement; for NSSI also higher perceived discrimination and social withdrawal). Greater adolescent depressive severity correlated with higher self-stigma across SSDS subscales, which related to poorer GAF and lower MSPSS. Higher parental depressive symptoms correlated with higher P-ISMI. Adolescents' social-inadequacy self-stigma was associated with parental social withdrawal. Help-seeking attitudes were more positive with increasing adolescent age and education. Longer psychiatric follow-up related to higher parental stereotype endorsement and social withdrawal, whereas higher parental education related to lower perceived discrimination. In multivariable models, adolescent depressive symptoms predicted poorer functioning, and parental depressive symptoms explained substantial variance in parental internalized stigma, whereas other predictors showed more limited independent effects.</p><p><strong>Conclusion: </strong>Internalized stigma in adolescents with MDD and their parents is strongly associated with clinical burden and functioning in this clinical, predominantly female sample. Findings underscore internalized stigma as a family-embedded, interconnected process and suggest that integrating family-inclusive, stigma-informed care that strengthens social support may improve youth depression management and treatment engagement.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1734-1746"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disordered Eating in Patients With Remission Schizophrenia: A Highly Prevalent but Largely Under-Explored Condition Despite Its Potential Relation to Psychopathology.","authors":"Hafize Miray Aytaç, Ipek Ozonder Unal, Nesrin Buket Tomruk, Cenk Varlik","doi":"10.1177/00207640261424409","DOIUrl":"10.1177/00207640261424409","url":null,"abstract":"<p><strong>Background: </strong>Disordered eating (DE) remains a relatively under-researched topic in schizophrenia.</p><p><strong>Aim: </strong>This study aimed to investigate prevalence and biopsychosocial correlates of DE in patients with remission schizophrenia.</p><p><strong>Method: </strong>A total of 208 stable patients with schizophrenia including those with DE (<i>n</i> = 75; Eating Attitudes Test [EAT-40] scores ⩾30 or binge eating disorder [BED] diagnosis or Night Eating Questionnaire [NEQ] scores >30) and those with healthy eating (<i>n</i> = 133) were evaluated in terms of Positive and Negative Syndrome Scale (PANSS) positive scale, Calgary Depression Scale for Schizophrenia (CDSS), Childhood Trauma Questionnaire (CTQ) and Pittsburg Sleep Quality Index (PSQI).</p><p><strong>Results: </strong>At least one component of DE was noted in 36.1% of patients with remission schizophrenia, including BED (17.8%) patients, the risk of NES (NEQ > 30; 20.7%) and risk of eating disorder (EAT-40 ⩾ 30; 14.4%). Metabolic risk factors including elevated weight circumference (<i>p</i> < .001), overweight (<i>p</i> < .001), obesity (<i>p</i> < .001) and hypercholesterolemia (<i>p</i> = .039) were significantly more prevalent in in the DE versus healthy eating group. PANSS excitement (<i>p</i> = .008) and hostility (<i>p</i> = .022), CDSS total (<i>p</i> = .003) and emotional abuse (<i>p</i> = .003) and PSQI total (<i>p</i> < .001) scores were significantly higher in the DE versus healthy eating group. NEQ scores were negatively correlated with years in remission (<i>r</i> = -.189, <i>p</i> = .006) and positively correlated with PANSS delusions (<i>r</i> = .217, <i>p</i> = .002), excitement (<i>r</i> = .211, <i>p</i> = .002) and hostility (<i>r</i> = .207, <i>p</i> = .003) scores and CTQ physical abuse scores (<i>r</i> = .153, <i>p</i> = .027).</p><p><strong>Conclusions: </strong>Presence of comorbid DE in the setting of remission schizophrenia seems to be closely related to more frequent excitement/hostility symptoms and a shortened remission time, besides its association with metabolic risk factors, childhood emotional abuse, comorbid depression and poor sleep quality. Screening for DE in patients with schizophrenia, regardless of the phase, seems to be of critical importance to prevent adverse outcomes of unrecognized DE on physical, emotional and mental well-being of patients during the entire course of disease.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1593-1607"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catastrophic Health Expenditure in Mental Health as Coercion in Post-Suicide Attempt Care: A Population-Based Study in Latin America.","authors":"Felipe Agudelo-Hernández, Laura Fernanda Murillo-Alzate","doi":"10.1177/00207640261426477","DOIUrl":"10.1177/00207640261426477","url":null,"abstract":"<p><strong>Background: </strong>Despite an increase in mental health problems, there is low implementation of mental health services, high catastrophic health spending, and a high incidence of coercive mental health practices. This could hinder recovery after a suicide attempt.</p><p><strong>Aims: </strong>To analyze catastrophic spending and coercive practices, and their relationship with variables associated with recovery (depression and well-being) and with the functioning of health services (continuity of care), in people who attempted suicide during 2024 and 2025 in Caldas, Colombia.</p><p><strong>Method: </strong>A cross-sectional and population-based was conducted with stratified random sampling in Colombia. Validated instruments were applied to determine subjective well-being, depressive symptoms and continuity of care in health services. To determine the perception of coercive practices in the care of suicidal behaviors in health services, an instrument was used that divided coercive practices into formal (physical abuse, isolation, forced hospitalization) and informal (involuntary medication, lack of participation in treatment planning).</p><p><strong>Results: </strong>A multiple linear regression was calculated for formal and informal coercion. The model for formal coercion explained 21% of the variance, and the model for informal coercion explained 63.2%, both with high coefficients for catastrophic health expenditures. Compared to those who did not report coercion, those who did reported it presented with more depressive symptoms, worse continuity of care, catastrophic health expenditures, and a lower socioeconomic status.</p><p><strong>Conclusions: </strong>There is a relationship between the coercive practices perceived and catastrophic spending on mental health services for psychosocial recovery. Those subjected to any coercive practice may have worse outcomes in terms of catastrophic mental health spending and depressive symptoms. Catastrophic spending is proposed as a form of structural coercion that could hinder psychosocial recovery.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1555-1568"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}