Social Psychiatry and Psychiatric Epidemiology最新文献

{"title":"Epidemiology of adult separation anxiety disorder in the Kingdom of Saudi Arabia: results from the Saudi National Mental Health Survey.","authors":"Saber Yezli, Norah Albedah, Lisa Bilal, Dan J Stein, Abdulhameed Al-Habeeb, Abdullah Al-Subaie, Yasmin Altwaijri","doi":"10.1007/s00127-025-02882-8","DOIUrl":"https://doi.org/10.1007/s00127-025-02882-8","url":null,"abstract":"<p><strong>Purpose: </strong>Adult separation anxiety disorder (ASAD) is thought to be prevalent and debilitating, yet many aspects of its epidemiology remain unclear. We aimed to investigate prevalence, course, correlates, comorbidity, impairment, and treatment of ASAD in Saudi Arabia.</p><p><strong>Methods: </strong>The study analyzed a subset of 1793 participants from the Saudi National Mental Health Survey; a nationally representative household sample of Saudi citizens. The survey used the CIDI 3.0 to produce prevalence estimates of ASAD and other common DSM-IV mental disorders. Cross tabulations, survival analysis and logistic regression were used to analyse the data.</p><p><strong>Results: </strong>The lifetime and 12-month prevalence of ASAD were 7.6% and 3.8%, respectively. Over half (51.7%) of participants with lifetime ASAD had onset in adulthood, and 50.5% of those with lifetime ASAD also had 12-month ASAD. Lifetime ASAD was significantly associated with being female (OR = 2.1), not being married (ORs = 2.2-3.2), having low education (OR = 0.4), and maladaptive family functioning (ORs = 3.6-6.7). Primary lifetime ASAD was a strong predictor of subsequent other mental disorders (ORs = 1.1-6.5). Further, mood, impulse, and substance use disorders were significantly associated with subsequent first onset of ASAD (ORs = 2.15-3.0). ASAD was severely impairing in the presence (59.0%) or absence (56.2%) of 12-month comorbidity. Among those with lifetime ASAD, only 26.1% reported treatment for a mental health condition.</p><p><strong>Conclusion: </strong>ASAD is prevalent, with a persistent course and associated impairment, as well as substantial comorbidity and limited treatment in Saudi Arabia. Increasing awareness, early diagnosis, and treatment of ASAD may help reduce its burden.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651820","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 effect of peer victimisation on cognitive development in childhood: evidence for mediation via inflammation.","authors":"Ellie Roberts, Marta Francesconi, Eirini Flouri","doi":"10.1007/s00127-025-02836-0","DOIUrl":"https://doi.org/10.1007/s00127-025-02836-0","url":null,"abstract":"<p><strong>Purpose: </strong>Peer victimisation, often a serious childhood stressor, has been associated with poor cognitive outcomes. The current study sought to uncover whether peer victimisation is associated with poor cognitive functioning in childhood via inflammation.</p><p><strong>Methods: </strong>Data from 4583 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. Path analysis was conducted to determine whether inflammation, measured using IL-6 and CRP levels (age 9), mediates the effects of peer victimisation (age 8), even after controlling for other stressors, on multiple cognitive outcomes, including working memory (age 10), reading (accuracy, speed, and comprehension) (age 9), spelling (age 9), response inhibition (age 10), attentional control (age 11), and selective attention (age 11).</p><p><strong>Results: </strong>IL-6 and CRP partially mediated the effects of peer victimisation on working memory, reading accuracy, and selective attention. IL-6 partially mediated the effect of peer victimisation on reading comprehension, while CRP partially mediated the effect of peer victimisation on reading speed. All effects were small. Inflammation did not mediate the effects of peer victimisation on spelling, response inhibition or attentional control.</p><p><strong>Conclusion: </strong>Peer victimisation may impact on some aspects of children's cognitive functioning via inflammation. The cognitive outcome specificity observed warrants further research.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651822","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":"Clinical treatment interventions in personal recovery stories of patients with severe mental illness: a qualitative study.","authors":"Robin Michael Van Eck, Auke Jelsma, Jelle Blondeel, Kimriek de Wilde-Schutten, Jannick Vincent Rutger Zondervan, Thijs Jan Burger, Astrid Vellinga, Mariken Beatrijs de Koning, Frederike Schirmbeck, Sylvia Gerritsen, Martijn Kikkert, Lieuwe de Haan","doi":"10.1007/s00127-025-02872-w","DOIUrl":"https://doi.org/10.1007/s00127-025-02872-w","url":null,"abstract":"<p><strong>Purpose: </strong>In quantitative research, small to medium associations were found between clinical and personal recovery in patients with severe mental illness (SMI). This finding may result from varying relationships between clinical and personal recovery depending on the individual patient. The aim of the current study was to explore the subjective experience of clinical treatment interventions in personal recovery stories of patients with severe mental illness.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 26 patients with SMI receiving treatment of a Flexible Assertive Community Treatment team in Amsterdam, the Netherlands. Thematic analysis was used.</p><p><strong>Results: </strong>We found that most clinical treatment interventions can have both positive and negative impact on personal recovery: (1) receiving a diagnosis can lead to relief, but also to stigma, (2) medication has positive effects, but side-effects impair personal recovery, (3) hospitalization and (4) coercive treatment can be helpful, but can also impact the process of recovery negatively, (5) psychological treatment is experienced as beneficial.</p><p><strong>Conclusion: </strong>Mental healthcare practitioners' awareness of patients' diverging experiences regarding the impact of clinical treatment interventions on personal recovery is important to carry out recovery-supportive practice. Communicating a diagnosis with a hopeful narrative, developing personalized medication strategies and post-hospital reflection on the use of restraints are a good basis.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606967","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":"Sexual orientation differences in mental health service use and unmet mental health care needs: a cross-sectional population-based study of young adults.","authors":"Luis Roxo, John Pachankis, Richard Bränström","doi":"10.1007/s00127-025-02866-8","DOIUrl":"https://doi.org/10.1007/s00127-025-02866-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine sexual orientation differences in mental health services use and unmet mental health care needs, and to explore associated sociodemographic factors in a populational-based sample of Swedish young adults (aged 18-34).</p><p><strong>Methods: </strong>Data from the Pathways to Longitudinally Understanding Stress (PLUS) study were used (2019, N = 2,126, participation rate of 37.8%). We performed logistic regressions to model mental health services use and unmet mental health service needs, followed by a subgroup analysis among those with perceived need for mental health services. We also examined if associations between sociodemographic factors (gender, age, educational level, income, employment status, household composition, urbanicity and country of birth) and these outcomes varied by sexual orientation.</p><p><strong>Results: </strong>Around one-third (35.0%) of sexual minority individuals had used mental health services the previous year, versus 20.2% of heterosexuals (OR = 1.52, 95%CI = 1.17-1.96, p = 0.002). Unmet needs were more likely among sexual minority individuals (17.6%) than heterosexuals (11.8%, OR = 1.47, 95%CI = 1.09-2.00, p = 0.013), with no significant sexual orientation differences among participants perceiving a need for mental health services. Among those with perceived need for mental health services, it was estimated that 56% of sexual minority males had unmet needs (vs. 37% of heterosexual); no such difference existed among women. Other than gender, there were not significant interactions between sociodemographic factors and sexual orientation.</p><p><strong>Conclusion: </strong>Sexual minority individuals' higher mental health services use highlights the need for high-quality, culturally sensitive services. Future research should identify reasons for the greater proportion of unmet mental health service needs among sexual minority men.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606929","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":"Associations of common mental disorder severity with treatment contact and treatment intensity, and its changes over twelve years.","authors":"J Nuyen, S van Dorsselaer, M Tuithof, A I Luik, H Kroon, M Ten Have","doi":"10.1007/s00127-025-02869-5","DOIUrl":"https://doi.org/10.1007/s00127-025-02869-5","url":null,"abstract":"<p><strong>Purpose: </strong>To guide formal healthcare resource allocation for common mental disorders (CMDs), this study updates and expands earlier findings on the associations of CMD severity with treatment contact and intensity.</p><p><strong>Methods: </strong>Baseline data (2019-2022) of NEMESIS-3, a prospective study of a representative cohort of Dutch adults (18-75 years), were used. Severity of 12-month CMDs was assessed with the CIDI 3.0. Using multivariate analyses, its associations with 12-month treatment contact and intensity for emotional/substance-use problems were examined, both for general medical care (GMC) only and mental health care (MHC). Changes over time were identified by making comparisons with baseline data (2007-2009) of NEMESIS-2.</p><p><strong>Results: </strong>Persons with severe CMDs were more likely to have made contact with GMC only or MHC compared to persons without CMDs. Between 2007-2009 and 2019-2022 there was a greater increase in the contact rate with GMC only for moderate cases compared to persons without CMDs, while the increasing contact rate with MHC did not vary by CMD severity. Both among users of GMC only and MHC, receiving high-intensity treatment was more likely among severe cases compared to persons without CMDs. Between 2007-2009 and 2019-2022 there was a greater increase in the rate of high-intensity treatment for severe cases using GMC only, while results tentatively indicate that this rate declined among severe cases using MHC.</p><p><strong>Conclusion: </strong>Evidence was found that treatment of CMDs in GMC has been strengthened in the past twelve years. No indications were found that allocation of MHC resources to severe cases has improved.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606966","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 estimates of depression and anxiety symptoms among adolescents in Bermuda, according to age, gender and race.","authors":"Daniel Cavanagh, Laura M Hart, Shawnee Basden, Shurong Lu, Nicola Reavley","doi":"10.1007/s00127-025-02829-z","DOIUrl":"https://doi.org/10.1007/s00127-025-02829-z","url":null,"abstract":"<p><strong>Purpose: </strong>Common mental disorders (CMDs) among adolescents, such as anxiety and depression, are associated with significant impairment and have been exacerbated by the COVID-19 pandemic. The Caribbean, including Bermuda, lacks sufficient CMD prevalence data to inform policy and service provision for adolescent mental health. This study sought to estimate the prevalence of depression and anxiety symptoms among adolescents in Bermuda.</p><p><strong>Methods: </strong>This cross-sectional study surveyed middle and high school students aged 10-18 years in Bermuda. 15 schools participated in data collection. Online surveys conducted between November 2022 - June 2023 gathered demographic data and assessed depression symptoms using the PHQ-8, anxiety symptoms using the GAD-7, and impairment across daily activities, school/work and relationships.</p><p><strong>Results: </strong>Of a total of 2,526 adolescents in Bermuda who self-reported depression and anxiety symptoms, the estimate prevalence of moderate to severe depression symptoms was 31.3%. Prevalence was significantly higher among older adolescents, females and those that identified as Black or Minority. Among the 25.2% who reported moderate to severe anxiety symptoms, prevalence was significantly higher among older adolescents, females and those who did not identify as Minority. Furthermore, 65.6% of adolescents self-reporting moderate to severe depression symptoms reported comorbid moderate to severe anxiety symptoms. The rates of impairment for depression and anxiety were 22.6% and 19.1%, respectively.</p><p><strong>Conclusion: </strong>The prevalence of depressive and anxiety symptoms among Bermuda's adolescents is high, surpassing post-pandemic global averages. Findings improve our understanding of CMDs in the Caribbean and provide direction for improved policy and service provision in Bermuda.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606969","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 relationship between gender identity, economic stressors, social support, concurrent substance use and suicidal ideation.","authors":"Sara W Kelly, Sarah E Donohue, Kathleen Rospenda, Kristin L Moilanen, Niranjan S Karnik, Jesse D Herron, Timothy P Johnson, Judith A Richman","doi":"10.1007/s00127-025-02868-6","DOIUrl":"10.1007/s00127-025-02868-6","url":null,"abstract":"<p><strong>Purpose: </strong>To examine a comprehensive list of demographic, substance use, economic, and social factors associated with suicidal ideation (SI) among middle-aged adults.</p><p><strong>Methods: </strong>Cross-sectional data were obtained from a national sample of middle-aged adults between February and November 2022. The study's final sample include 1,337 respondents who represented the adult population of persons aged 40-60 years in the United States. Bivariate and multivariate statistics were employed to identify significant factors associated with past year SI, including the examination of factors associated with single SI and multiple instances of SI in the past year.</p><p><strong>Results: </strong>Of the sample, 140 (10.4%) reported SI in the past year. Among those, more than half (60.0%, n = 84) reported SI multiple times in the past year. Multivariable logistic regression indicated that those who reported a lower standard of living compared to their parents/caregivers (adjusted odds ratio [aOR] 2.62), were a gender minority (aOR 7.06), engaged in concurrent substance use (aOR 3.29), or were unemployed (aOR 1.80) had significantly higher odds of past year SI, whereas higher social support was protective against SI (aOR 0.69). Multinomial regression found that concurrent substance use, unemployment, and having a lower standard of living than their parents/caregivers predicted repeated past year SI whereas higher social support was protective against multiple SI experiences (aOR 0.65).</p><p><strong>Conclusion: </strong>Middle-aged adults reporting concurrent substance use, lower social support, unemployment and were gender minority had higher odds of past year SI. These findings underscore the need to develop public health and clinical interventions tailored to these highest-risk middle-aged adults in order to prevent suicide.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606931","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":"A machine learning language model approach to evaluating mental health awareness content across Spanish- and English-language social media posts on Twitter.","authors":"Melissa J DuPont-Reyes, Wenxue Zou, Jinxu Li, Alice P Villatoro, Lu Tang","doi":"10.1007/s00127-025-02870-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02870-y","url":null,"abstract":"<p><strong>Purpose: </strong>Mental health information appears on social media in varying levels of quality and may or may not be productive information to users, particularly in relation to healthcare decision-making and community living among diverse populations coping with mental health problems. To better understand the mental health landscape on social media, this study validated a language model approach to evaluating the availability and sentiment of mental health awareness content across Spanish- and English-language social media posts on Twitter (currently X) to inform future mental health communication guidelines.</p><p><strong>Methods: </strong>A comprehensive list of mental health awareness hashtags in Spanish and English was developed by bilingual investigators to download tweets containing these hashtags in both languages from the Twitter Academic API from 09/19/22 - 10/10/22. Data extraction and cleaning of duplicate tweets resulted in a final sample of 28,268 Spanish and 205,774 English tweets for sentiment and structural topic analysis across the two languages.</p><p><strong>Results: </strong>Fifteen unique topics emerged for both Spanish and English tweets including overlapping themes of awareness, self-care, lived experience, and service providers. Topics in Spanish tweets were more often significantly associated with negative emotions compared to English tweets. Yet English tweets also included misappropriation of mental health labels to make political statements and market products.</p><p><strong>Conclusions: </strong>Mental health awareness content on Twitter appears not to be consistently available or aligned with clinical values, disadvantaging Spanish-language social media users, possibly leading to divergent priorities concerning population mental health. Nevertheless, natural language processing techniques offers a viable method to further understand unequal mental health awareness content across various language and cultural social media.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568673","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":"Exploring ageism and ageing anxiety: a cross-sectional study in Egypt.","authors":"Alaa S Abdelkader, Rana Elbayar, Aya Ahmed Ashour, Mariam M Alwerdani, Abdallah Elgabry, Sara A Hashish, Ayat Ashour","doi":"10.1007/s00127-025-02846-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02846-y","url":null,"abstract":"<p><strong>Background: </strong>Ageism and ageing anxiety are obstacles to health equity in the community. This study aims to assess ageism and ageing anxiety in Egypt and to elaborate on factors associated with ageism among Egyptians.</p><p><strong>Method: </strong>We conducted a cross-sectional online survey on 359 adult Egyptians using a predesigned questionnaire to assess socio-demographic factors, the Fraboni Scale on Ageism (FSA), the Ageing Anxiety Scale (AAS), one question about contact with older adults, and another question about religiosity.</p><p><strong>Results: </strong>The mean age of respondents was 27.91 years (SD = 8.99), with over half aged between 18 and 25 years, and the majority being women (68%). The mean total score of ageism was 72.79 (6.3) out of 116, while the mean total score of anxiety of ageing was 54.33 (8.83) out of 100. Male gender (B = 0.117, p = 0.024), infrequent contact with older adults (B = 0.163, p = 0.002), ageing anxiety (B = 0.238, p = 0.000), and insufficient income (B = 0.202, p = 0.007) were associated with increased ageism scores.</p><p><strong>Conclusion: </strong>The observed associations between ageism and factors such as male gender, infrequent contact with older adults, insufficient income, and ageing anxiety highlight the potential need for focused educational initiatives. Implementing comprehensive educational programs that not only inform individuals about the ageing process but also promote positive intergenerational interactions could serve as a promising strategy to combat ageism.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568675","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":"Cognitive trajectories in older adults and associated mortality and predictors.","authors":"Elena Lobo, Concepción De la Cámara, Patricia Gracia-García, Pedro Saz, Raúl López-Antón, Antonio Lobo","doi":"10.1007/s00127-025-02862-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02862-y","url":null,"abstract":"<p><strong>Purpose: </strong>To test the hypotheses that declining cognitive aging trajectories would increase mortality risk and that predictors of mortality would differ between trajectory groups.</p><p><strong>Methods: </strong>This is a sub-study of the ZARADEMP project studying dementia and depression in older adults aged 55 years or more, conducted in Zaragoza, Spain, including 2403 cognitively healthy individuals who had completed at least three of the four waves in a 12-year follow-up. The three cognitive trajectories previously identified were based on the Mini-Mental State Examination (MMSE). Mortality information obtained from the city's official population registry was registered up to 6 years after the end of the fourth wave of the study. Cox proportional hazard regression analyses for analyzing the risk of death were performed globally and for each cognitive trajectory.</p><p><strong>Results: </strong>At follow-up, 42.4% of the participants had died. Individuals in class 2-moderate-stable and in class 3-low-and-declining had a 24% and 96%, respectively, higher risk of mortality than those in class 1-high-to-moderate. Those younger and women showed significant lower risks of death in all the classes. Being single, with diabetes, dependency in basic Activities of Daily Living, ex-drinkers, smokers, and ex-smokers increased the risk in class 2. Hypertension showed a higher risk of death in the high-to-moderate group. In the low-and-declining trajectory, anxiety nearly tripled the risk of death.</p><p><strong>Conclusion: </strong>Trajectories with cognitive decline are associated with higher mortality, with the risk of death showing a gradient. Predictors of mortality differ by cognitive trajectory; the differences being observed even among the cognitively healthier groups.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568674","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}