Social Psychiatry and Psychiatric Epidemiology最新文献

{"title":"Is university attendance associated with differences in health service use for a mental health problem in emerging adulthood? Evidence from the ALSPAC population-based cohort.","authors":"Tom G Osborn, Rob Saunders, Peter Fonagy","doi":"10.1007/s00127-025-02922-3","DOIUrl":"https://doi.org/10.1007/s00127-025-02922-3","url":null,"abstract":"<p><strong>Purpose: </strong>It is unclear whether attending university is associated with health service use for mental health problems in emerging adulthood. As this can be a marker of the onset of mental disorders, we aimed to investigate whether attending university was associated with health service use for a mental health problem by age 24.</p><p><strong>Methods: </strong>We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The analytic sample comprised of 2,649 individuals with data on university attendance reported approximately between ages 25 and 26, and health service use for a mental health problem reported around age 24. Logistic regression models were used to investigate the association between university attendance and health service use, employing confounder adjustment, multiple imputation and propensity score matching to assess the robustness of associations. The study was reported using STROBE guidelines.</p><p><strong>Results: </strong>University attendees were less likely to report having used services for mental health problems by 24 years compared to non-university attendees (6.5% vs. 11.4%, odds ratio (OR) = 0.54[95%CI = 0.40;0.72], p < 0.001). This association was robust in the fully adjusted model (aOR = 0.38[95%CI = 0.15;0.94], p = 0.04), propensity score matching and multiple imputation. There was evidence of a differential association among those who were and were not heterosexual and according to maternal education level.</p><p><strong>Conclusions: </strong>Our findings suggest individuals who attend university are less likely to use a health service for a mental health problem. Further longitudinal research is needed to investigate potential explanations for these differences.</p><p><strong>Pre-registration: </strong>A study protocol was submitted to the ALSPAC team.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal record linked analysis of an assertive community treatment programme in a suburban mental health hospital: emergency department presentations, hospital admissions and bed days.","authors":"Susanne Stanley, Ajay Velayudhan, Amanda Hellewell, Mitul Bhatt, Mohan Isaac","doi":"10.1007/s00127-025-02931-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02931-2","url":null,"abstract":"<p><p>This study aimed to objectively assess a long-term Assertive Community Treatment (ACT) programme run by a suburban mental health hospital in Western Australia. The study examined the programme by tracking Emergency Department (ED) presentations, hospital admissions and length of hospital stays (bed days) of people with severe mental illness who entered the programme. Between January 2008 - June 2019, 160 clients who attended the hospital had presentation and admission activities assessed at two time periods (1) PRE - the period from each client's first engagement with the mental health service up to their entering the service's ACT programme, and (2) DURING- which is the time that each client spent engaged in that ACT programme. No difference was found between ED presentations before the ACT programme as compared to during the ACT programme. Voluntary mental health hospital admissions were significantly lower during the programme than before the programme, but no difference was found for involuntary mental health hospital admissions. Both voluntary and involuntary hospital stays, however, showed a significant reduction in bed days for clients during their time in the ACT programme. This data shows the continued use of the ACT programme at suburban mental health services to be beneficial. While the number of ED presentations and involuntary admissions remained the same (although for different reasons), the reduction in voluntary hospital admissions and hospital bed days suggests that the increased provision of outpatient and home care through ACT is still working to support clients in the community keeping them out of more restrictive hospital settings.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Big Five personality traits associated with trajectories of depressive symptom among middle-aged and older adults in China?","authors":"Weichao Chen, Wanren Wang, Xiaoyan Wang","doi":"10.1007/s00127-025-02923-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02923-2","url":null,"abstract":"<p><strong>Background: </strong>Personality traits have been confirmed to be associated with mental health, but their influence on the trajectories of depressive symptoms among middle-aged and older adults in China is not well understood. This study seeks to identify distinct trajectories of depressive symptoms and explore their relationship with the Big Five personality traits in China.</p><p><strong>Methods: </strong>Data was collected from the China Family Panel Studies (CFPS) for 2016, 2018, 2020, and 2012 were used in this study. 5376 individuals aged 45 and older were included in this study. Latent growth mixture modeling was applied to identify distinct trajectories of depressive symptoms, and multinomial logistic regression was used to examine the association between personality traits and these trajectories.</p><p><strong>Results: </strong>Three depressive symptom trajectories were identified: stable increasing with low starting point (53.18%), descending type with high starting point (8.03%), and stable at middle level (38.78%). Higher extraversion scores was associated with lower depressive symptom trajectories, while higher levels of openness and neuroticism were associated with an increased risk of severe depressive symptom trajectories. Heterogeneity analyses revealed that, among individuals aged 45-60, conscientiousness was negatively associated with depressive symptoms, while openness was positively related to depression. Among older adults (≥ 60 years), extraversion showed the strongest protective effect against depressive symptoms, while higher openness demonstrated a notably stronger association with depression. Additionally, females showed stronger associations between personality traits and depressive symptom than males.</p><p><strong>Conclusion: </strong>Different trajectories of depressive symptoms are observed among middle-aged and older adults in China. The findings underscore the importance of tailored mental health monitoring, with distinct approaches needed for different genders and age groups.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between occupation, attitudes towards mental health problems in the workplace and mental health stigma.","authors":"Gloria Cheung, Amy Ronaldson, Claire Henderson","doi":"10.1007/s00127-025-02927-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02927-y","url":null,"abstract":"<p><strong>Purpose: </strong>Discrimination against people with mental health problems in the workplace is still prominent. Characteristics of occupations can influence aspects of stigma and attitudes to mental health problems in the workplace context. We investigated occupational differences in mental health stigma, and attitudes to mental health in the workplace.</p><p><strong>Methods: </strong>Data from the British Social Attitudes 2015 survey were used. Logistic and linear regression models were conducted to investigate associations between occupational categories, stigma as measured by desire for social distance, and attitudes towards mental health in the workplace.</p><p><strong>Results: </strong>We found occupational differences in attitudes towards mental health in the workplace, but not in levels of stigma. Compared to managerial and professional workers, lower supervisory and technical workers (group 4), semi-routine and routine workers (group 5) were less likely to believe that paid work is good for mental health (group 4: odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.24-0.61; group 5: OR = 0.34, 95% CI = 0.24-0.49) and people with depression should return to work when they can do some or most of the job (group 4: OR = 0.67, 95% CI = 0.48-0.94; group 5: OR=0.52, 95% CI=0.41-0.66). People in semi-routine and routine occupations were less likely to believe that having schizophrenia should not affect promotion at work (OR = 0.78, 95% CI = 0.62-0.97) than managerial and professional workers.</p><p><strong>Conclusions: </strong>Our findings reinforce the importance of job characteristics on attitudes to mental health in the workplace. More support is needed for small companies to help them develop mental health policies. Modifications are needed to improve job control and ensure adjustments can be made.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unique characteristics of \"families of choice\" and families of origin of older LGBTQ + adults: are they related to mental health?","authors":"Ella Cohn-Schwartz, Sigal Gooldin, Lian Meiry, Robert Heidemann, Yaacov G Bachner","doi":"10.1007/s00127-025-02919-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02919-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study joins a growing body of research on the different types of families of aging individuals belonging to sexual and gender minorities. We explore the characteristics of \"families of choice\" (who are close enough to be considered as family) and families of origin of LGBTQ + older adults and their associations with mental health.</p><p><strong>Methods: </strong>Data for this study were collected via an online survey with self-identified lesbian, gay, bi-sexual, transgender, queer and others (LGBTQ +) adults aged 50 + (n = 432). Participants were asked about characteristics of the relationships with their families of choice and their families of origin, depressive symptoms and well-being.</p><p><strong>Results: </strong>The results indicated that most participants had a family of choice, numbering five people on average. They also reported having about four close family of origin members. Several differences emerged when comparing the two types of families: The relationships with families of origin were more stable, while families of choice were more committed, more likely to accept participants' sexual orientation and the relationship with members of families of choice had fewer negative aspects. Regression analyses showed that individuals had better mental health if they had more close family of origin members, more family of choice members and a partner, if the relationship with their families of choice were more stable and less negative.</p><p><strong>Conclusion: </strong>These findings shed light on the unique sources of support among LGBTQ + older adults and their associations with mental health.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of suicidal ideation, suicide attempts and suicide deaths in people living with HIV: Are there differences between geographic locations or sexes? : An overview of systematic reviews with meta-analysis.","authors":"Juan-Carlos Hernández-Rodríguez, Marta Infante-Cano, Cristina García-Muñoz, Javier Matias-Soto, Olga Villar-Alises, Saul Pineda-Escobar, Javier Martinez-Calderon","doi":"10.1007/s00127-025-02916-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02916-1","url":null,"abstract":"<p><strong>Background: </strong>Preventing suicide is an important clinical and research priority according to the World Health Organization across lifespan.</p><p><strong>Objective: </strong>This study summarizes the prevalence of suicidal ideation, attempts, and suicide deaths among people living with HIV (PLWH) and explores geographic and sex-based differences in metaanalyses.</p><p><strong>Methods: </strong>An overview of systematic reviews was conducted using CINAHL, Embase, PsycINFO, and PubMed, covering inception to 16th August 2024.AMSTAR 2 evaluated methodological quality, and review overlap was calculated.</p><p><strong>Results: </strong>Twelve systematic reviews were included, with the highest overlap for suicide attempts in Africa (CCA = 13%). Meta-analyses showed pooled prevalence of suicidal ideation ranging from 13.8 to 22.1% in Africa, 27.1-30.1% in Asia, 33.7% in Europe, 14.3% in North America, and 27.5% in South America. Suicide attempts ranged from 3.7 to 12.5% in Africa, 3.6-11.2% in Asia, and 20.09% in the Americas. Among males, suicidal ideation prevalence was 40% in PLWH, suicide attempts 16.8%, and suicide deaths 1.5% PLWH. Among females, suicidal ideation was 32.8%, suicide attempts 29.0%, and suicide deaths 1.2% in PLWH.</p><p><strong>Conclusion: </strong>Suicidal ideation and attempts are prevalent in PLWH, with notable geographic and sex-based differences.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in psychological distress and associated factors among Hong Kong young adults in post-COVID-19 era: a latent transition analysis.","authors":"Haorui Li, Ted Chun Tat Fong, Yu Cheng Hsu, Wendy Wing Yan So, Tsz Mei Lam, William G Hayward, Paul Siu Fai Yip","doi":"10.1007/s00127-025-02912-5","DOIUrl":"https://doi.org/10.1007/s00127-025-02912-5","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic has brought negative impacts on young adults' mental health. The present study aimed to examine the transition of psychological distress classes in young adults after the pandemic and the associated factors.</p><p><strong>Methods: </strong>A total of 577 young adults (mean age = 25.9 years, SD = 4.4) in Hong Kong participated in a longitudinal online survey on mental health in 2022 and 2023. The participants completed the 10-item Chinese Health Questionnaire and self-constructed items on COVID-19 distress, financial distress, and social distress. Latent class analysis was used to classify the participants into latent classes of psychological distress. Latent transition analysis was conducted with measurement invariance to examine the transition amongst the latent classes from 2022 to 2023 and the associations with changes in the stressors.</p><p><strong>Results: </strong>The data supported three latent classes of psychological distress. A third of the participants belonged to the High-distress class with elevated symptoms and its prevalence decreased from 34.3% to 27.8% over one year. 40.9% and 10.0% of the Moderate-distress and High-distress classes transitioned to the Low-distress class after the pandemic, respectively. Financial distress (OR = 3.14, 95% CI = 1.17-8.41) and social distress (OR = 3.25, 95% CI = 1.70-6.21) was significantly linked to higher odds of transitioning from the Low-distress to High-distress class. Increased social distress was associated with decreased odds (OR = 0.57, 95% CI = 0.39-0.84) of improvement from the High-distress to Moderate-distress class.</p><p><strong>Conclusion: </strong>The findings suggest an overall reduction in psychological distress among young adults after the pandemic. Increases in financial and social distresses after COVID-19 showed significant effects on worsening psychological distress.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the intersections between ethnicity, area-level deprivation, and inpatient-related features amongst patients with psychotic disorders: a mental health electronic records analysis.","authors":"Charlotte Humphreys, Jo Hodgekins, Hitesh Shetty, Peter Schofield, Rob Stewart, Sherifat Oduola","doi":"10.1007/s00127-025-02908-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02908-1","url":null,"abstract":"<p><strong>Purpose: </strong>Ethnic and area-level deprivation disparities in psychiatric inpatient outcomes amongst patients with psychotic disorders are known. However, how these two variables intersect to influence features of inpatient care is unclear. We investigated this intersection.</p><p><strong>Methods: </strong>Using de-identified electronic health data from inpatient services at a large south London mental healthcare provider, we identified a sample of 6767 working-age patients with non-affective psychotic disorders who were admitted between 2016 and 2019. Logistic and negative binomial regressions were used to examine the relationships between ethnicity (and then deprivation) with inpatient-related features (compulsory admission, psychiatric intensive unit admission, length of stay and number of admissions), adjusting for confounders. The sample was stratified by area-level deprivation to understand the intersection of ethnicity, deprivation and these inpatient-related features.</p><p><strong>Results: </strong>Patients from all areas except the least deprived were at greater risk of compulsory admission, admission to psychiatric intensive care units and more frequent admissions compared with patients from the least deprived areas. All minoritised ethnic patients were more likely to be compulsorily admitted compared with White British patients. Living in the least deprived areas appeared to offer protection against compulsory admission for some ethnic minority groups, but not Black British or Asian patients.</p><p><strong>Conclusions: </strong>This study showed how psychiatric inpatient-related features for patients with non-affective psychotic disorders were explained not only by the separate effects of area-level deprivation and ethnicity but also by the unique intersections of these two factors. Our findings have implications for policy and interventions aimed at reducing the drivers of inpatient admissions by addressing social stressors in deprived areas and among ethnic minority patients.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation of Latinx health status disparities during the COVID-19 pandemic by social determinants of health.","authors":"Jorge I Ramírez García, Veronica Oro, Elizabeth L Budd, Anne Marie Mauricio, Stephanie De Anda, Ellen H McWhirter, Leslie D Leve, David S DeGarmo","doi":"10.1007/s00127-025-02890-8","DOIUrl":"https://doi.org/10.1007/s00127-025-02890-8","url":null,"abstract":"<p><strong>Purpose: </strong>The hypothesis that health status disparities exist because of high levels of social disadvantages, the Social Determinants of Health - Health Disparities (SDOH-HD) hypothesis by Ramírez García [1], was investigated among adults (N = 1,833) attending SARS-CoV-2 testing events at 71 community sites.</p><p><strong>Methods: </strong>A Multilevel Structural Equation Model (CFI = 1.0, SRMRs ≤ 0.03), with cross-sectional self-reported data, operationalized health status with latent individual level and latent community site level variables. At the individual level, health variables met full or partial metric equivalence between participants who answered the survey in Spanish versus in English (CFIs = 0.99, SRMRs ≤ 0.03).</p><p><strong>Results: </strong>Consistent with the SDOH-HD, high food insecurity and/or low levels of education among Latinxs putatively mediated (abs = 0.01 to 0.08, ps < 0.05) worse individual level general health (Within Level Model R² = 0.10, p <.05) or worse individual level psychological distress (Within Level Model R² = 0.11, p <.05) compared to non-Latinx Whites. However, three SDOH - unemployment, housing instability, and discrimination - did not support the SDOH-HD. Community site level SDOH - social vulnerability, and minority status indices - were not significantly related to site level health status, but site level psychological distress was lower in rural than in urban sites (γ = - 0.39, p <.05).</p><p><strong>Conclusion: </strong>Taken together, the results delineate that equitable implementation of food security and education interventions may mitigate health status Latinx disparities. The SDOH-HD was partially supported, underscoring the need to investigate further these and additional SDOH-HD pathways.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depersonalization/derealization and its relationship to mood and anxiety disorders in the National Comorbidity Survey-Replication (NCS-R).","authors":"Daphne Simeon, Dan J Stein","doi":"10.1007/s00127-025-02915-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02915-2","url":null,"abstract":"<p><strong>Background: </strong>Depersonalization/derealization (dpdr) is known to occur across mood and anxiety disorders (MAD) and has been proposed as a marker of worse illness. However, despite the well-known clinical association, there are no epidemiological data on the relationship between dpdr and MAD.</p><p><strong>Method: </strong>In this NCS-R analysis clinically significant dpdr (DPDR-C) was defined as \"sometimes\" or \"often\" past-month endorsement of depersonalization and/or derealization in the absence of other pathological dissociation. Six past-month MAD diagnoses were examined: DSM-IV generalized anxiety disorder, panic disorder, social phobia, major depression, bipolar I, and bipolar II.  RESULTS: National DPDR-C one-month prevalence was 0.9%. After excluding all cases with past-month posttraumatic stress disorder or non-dpdr pathological dissociation, 21.2% of DPDR-C cases were accounted for by MAD while 3.0% of MAD cases endorsed DPDR-C, ranging from 0% (generalized anxiety disorder) to 11.8% (comorbid mood and anxiety disorder). DPDR-C was not uniquely related to any MAD disorder, and was not associated with MAD age of onset, chronicity, or impairment. Rather, DPDR-C was significantly associated with number of comorbid MAD disorders and with mood/anxiety comorbidity.</p><p><strong>Conclusion: </strong>At the epidemiologic level DPDR-C was uncommon in MAD but was more likely to occur in the presence of combined mood and anxiety disturbance, which may cause greater disruption to the usual sense of self and thus trigger unreality experiences.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042121","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}