Social Psychiatry and Psychiatric Epidemiology最新文献

{"title":"From loneliness to depression: A longitudinal diagnostic study among Norwegian university students.","authors":"Mari Hysing, Keith J Petrie, Allison G Harvey, Børge Sivertsen","doi":"10.1007/s00127-025-02989-y","DOIUrl":"https://doi.org/10.1007/s00127-025-02989-y","url":null,"abstract":"<p><strong>Purpose: </strong>Loneliness is an increasing public health concern among young adults. There is insufficient prior research on the association between loneliness and depressive disorder among students in higher education.</p><p><strong>Methods: </strong>This prospective population-based cohort study from Norway invited all full-time students aged 18-35 to participate in the 2022 Students' Health and Wellbeing Study (SHoT). Of the 53,362 respondents, a subgroup of 16,418 students was randomly selected for diagnostic follow-up, with valid data from 10,460 participants. Loneliness was assessed in 2022 using the Three-Item Loneliness Scale (T-ILS) and Major Depressive Episodes (MDE) were assessed in 2023 using a self-administered electronic version of the Composite International Diagnostic Interview, version 5.0 (CIDI 5.0).</p><p><strong>Results: </strong>A clear dose-response relationship was observed: students in the highest loneliness quintile had a substantially increased risk of MDE one year later. After adjusting for age and baseline anxiety and depression symptoms, the relative risk (RR) for MDE in the highest versus lowest T-ILS quintile was 2.02 (95% CI: 1.58-2.63) for females and 2.64 (95% CI: 1.63-4.49) for males-representing a ~ 70-75% reduction from unadjusted estimates. The overall prevalence of MDE was 21.1% in females and 11.2% in males. Formal interaction analyses indicated a statistically significant multiplicative interaction by sex, but no evidence of additive interaction.</p><p><strong>Conclusions: </strong>Loneliness is a strong and independent predictor of MDE in young adults, even after accounting for baseline mental health. Targeting loneliness may be important for preventing depression in university populations.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082279","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":"Typologies of hurricane trauma exposure: a person centered approach.","authors":"Maria Duque, Maria Fernanda Garcia, Cara Antonaccio, Spencer Sandberg, Oh Sehun, Melissa M Bates, Jose Rodriguez, Mildred M Maldonado-Molina, Seth J Schwartz, Christopher P Salas-Wright","doi":"10.1007/s00127-025-02994-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02994-1","url":null,"abstract":"<p><strong>Purpose: </strong>Hurricane María (2017) and the subsequent large-scale migration of Puerto Ricans serve as a stark example of how extreme weather events, population displacement, and equity concerns impact the health of vulnerable populations. The aim of the present study is to examine the classes of hurricane-related experiences among Puerto Rican \"María migrants\" and to assess the relationship between different types of hurricane exposure and posttraumatic stress.</p><p><strong>Methods: </strong>The present study was conducted with 319 Puerto Rican Hurricane María migrants on the U.S. mainland. Using a person-centered approach, we aimed to identify (1) typologies of hurricane trauma exposure and (2) mapped these latent classes onto positive PTSD screens, sociodemographic characteristics, and geographic location in Puerto Rico at the time of the storm using descriptive spatial analysis tools.</p><p><strong>Results: </strong>Notwithstanding the widespread devastation caused by Hurricane María across Puerto Rico, the disaster did not affect María migrants equally. We extracted four latent classes of hurricane trauma exposure: (a) Universal Loss (59.2%), (b) Job Loss + No Food/Water (28.7%), (c) Multidimensional Exposure (5.6%), and (d) Universal loss + Injury (6.5%). By far, the highest rates of positive PTSD screens were reported among members of the Multidimensional Exposure (5.6%) class, as 59% of individuals in this class screened positive for PTSD.</p><p><strong>Conclusions: </strong>Positive PTSD screens are better explained by hurricane trauma typology than by geographic proximity to the hurricane's landfall or remoteness from urban centers. Implications for practice and policy are discussed.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082293","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":"Hispanic sexual minority individuals, linguistic acculturation, and behavioral health: Evidence of a healthy migrant effect.","authors":"James C Hodges, Sehun Oh, Christopher P Salas-Wright","doi":"10.1007/s00127-025-02995-0","DOIUrl":"https://doi.org/10.1007/s00127-025-02995-0","url":null,"abstract":"<p><strong>Purpose: </strong>Stress-based theories suggest that sexual minority Hispanic migrants are at increased risk of adverse behavioral health outcomes. However, a body of descriptive evidence shows migrants exhibit improved health outcomes. Responding to calls for intersectional investigations of the 'healthy migrant effect,' we quantitatively examine whether sexual minority status moderates the relationship between English proficiency (a proxy for acculturation) and behavioral health.</p><p><strong>Methods: </strong>We used pooled cross-sectional data from the Hispanic respondents to the 2015-2019 National Survey on Drug Use and Health. We used logistic regression models to examine the association of the level of English proficiency with past-year major depressive episode (MDE) and past-year substance use disorder (SUD) and used interactions to examine the moderating effect of sexual minority status.</p><p><strong>Results: </strong>For both MDE and SUD, sexual minority Hispanic individuals with lower levels of English proficiency had lower odds of reporting adverse outcomes than sexual minority individuals with higher levels of English proficiency and did not have significantly different outcomes than their heterosexual counterparts. The direction of these relationships did not change when stratified by gender.</p><p><strong>Conclusions: </strong>There appears to be a healthy migrant effect with regard to sexual minority Hispanic individuals and behavioral health outcomes. This also suggests that acculturation may be a uniquely important risk factor for this population. Preventative efforts should be targeted at this group to avoid the development of behavioral health concerns.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082301","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 latent profile analysis of positive psychotic symptoms and dissociative symptoms in the general population: their associations with childhood trauma and outcomes.","authors":"Bryan Ho-Wang Yu, Anson Kai Chun Chau, Chui- De Chiu, Suzanne Ho-Wai So","doi":"10.1007/s00127-025-02992-3","DOIUrl":"https://doi.org/10.1007/s00127-025-02992-3","url":null,"abstract":"<p><strong>Purpose: </strong>Psychosis and dissociation are inter-correlated syndromes. As they are both multifaceted constructs, individuals experiencing positive psychotic and dissociative symptoms may have heterogeneous presentations of co-occurring symptomatology. This study aimed to identify phenotypes of individuals with varying degrees of these co-occurring symptoms in the general population, while also examining the impact of childhood trauma and prospective emotional and functional outcomes associated with these phenotypes.</p><p><strong>Method: </strong>Participants were recruited from the general population through diverse means. At baseline and six months after, adults (age 18-65) were assessed for positive psychotic symptoms, dissociative symptoms, depression, anxiety, and functioning using an online survey. Childhood trauma was assessed at baseline only. Distinct subgroups were estimated by latent profile analysis, with childhood trauma examined as predictor of the profiles. The identified profiles were compared on emotional and functional outcomes at both timepoints.</p><p><strong>Results: </strong>The community sample consisted of 2,958 individuals (mean age = 34.69; 72.5% female). Four distinct profiles were identified - 'low overall', 'moderate (hallucinatory)', 'moderate (dissociative)', and 'high overall'. Emotional/sexual abuse and physical neglect notably differentiated the 'low overall' profile from the other three profiles, with sexual abuse specifically linked to the 'high overall' and 'moderate (hallucinatory)' profiles. The 'high overall' and 'moderate (dissociative)' profiles exhibited persistent elevated depression across timepoints than the other profiles.</p><p><strong>Conclusions: </strong>Distinct profiles of varying levels of co-occurring positive psychotic and dissociative symptoms were identified in the general population. The implications for early identification and intervention of these commonly co-occurring symptoms are discussed.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071044","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":"Association of social determinants of health and psychological distress among adults in the united states: a cross-sectional study.","authors":"Jiehua Wei, Linbin He, Luying Fan, Fan Xia, Lizhang Chen, Tingting Wang","doi":"10.1007/s00127-025-02991-4","DOIUrl":"https://doi.org/10.1007/s00127-025-02991-4","url":null,"abstract":"<p><strong>Purpose: </strong>Psychological distress (PD) affects health and healthcare utilization. This study uses a novel, comprehensive social determinants of health (SDOH) risk score to examine the association between cumulative social disadvantage and PD in a large, nationally representative sample from the National Health Interview Survey (NHIS).</p><p><strong>Methods: </strong>Data from the 2013 to 2017 NHIS was employed, including 124,361 adults aged ≥ 18 years. The Kessler 6 scale was used to assess PD. We measured SDOH across five domains: economic stability, education, healthcare system, neighborhood, and food security. An SDOH aggregate score was calculated, representing the cumulative number of individual unfavorable SDOH. Multivariable models were utilized to examine the association between SDOH score quartiles and PD.</p><p><strong>Results: </strong>A total of 124,361 adults (mean [SD] age 50.2 [18.1] years; 67,035 women [53.9%]) were included in the analysis. In models fully adjusted for age, sex, ethnicity, region, cardiovascular risk factors, atherosclerotic cardiovascular diseases, and comorbidities, participants in the highest quartile of adverse SDOH burden (Q4) were associated with higher odds of moderate PD (OR, 3.67; 95% CI, 3.42-3.93) and severe PD (OR, 15.23; 95% CI, 11.97-19.36), respectively, than those in Q1. At nearly each quartile, a higher prevalence rate of PD was observed among females, middle-aged, and non-Hispanic White adults compared to their counterparts.</p><p><strong>Conclusions: </strong>In a large, nationally representative sample of US adults, adverse SDOH was associated with increased PD. Assessing and mitigating the multifaceted adverse SDOH could serve as a strategy to help identify individuals with PD and improve existing PD prevention frameworks.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071054","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":"Differences in emotion regulation components underlie the sexual orientation disparity in depressive symptoms: a prospective, Population-based study of young adults.","authors":"Ilana Seager van Dyk, Caroline G Rutherford, John E Pachankis, Richard Bränström, Mark L Hatzenbuehler","doi":"10.1007/s00127-025-02974-5","DOIUrl":"https://doi.org/10.1007/s00127-025-02974-5","url":null,"abstract":"<p><strong>Purpose: </strong>Hatzenbuehler's psychological mediation framework proposes that difficulties in emotion regulation (ER), which are driven in part by excess exposure to stigma-related experiences, contribute to sexual orientation-related mental health disparities. However, existing research on the framework has largely focused on a small number of ER variables in non-probability samples.</p><p><strong>Methods: </strong>To address these limitations, we examined whether a large complement of ER components mediates the prospective association between sexual minority status and depressive symptoms, using longitudinal data from a population-based sample of 1,208 Swedish young adults (aged 18-35). Data were collected in 2020 (ER, depressive symptoms) and 2021 (depressive symptoms). Participants completed 12 measures of ER, spanning a diverse array of ER constructs (e.g., emotional awareness, cognitive reappraisal, access to ER strategies).</p><p><strong>Results: </strong>Sexual minorities exhibited significantly more ER difficulties on nine out of the 12 ER components, and higher depressive symptoms, compared to heterosexuals. Eight of the 12 ER components independently mediated the association between sexual minority status and increases in depressive symptoms one year later, and two components (brooding rumination, difficulty identifying positive emotions) mediated this relationship when all 12 ER components were entered into the model simultaneously.</p><p><strong>Conclusion: </strong>These findings provide evidence from a population-based, longitudinal study that a wide range of ER factors underlie sexual orientation-related disparities in depressive symptoms during a developmental period of heightened risk.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006774","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":"Food insecurity and postnatal depression: the mediating effect of perceived social support among women in Khayelitsha, South Africa.","authors":"S Mathew, C Lund, N Seward","doi":"10.1007/s00127-025-02986-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02986-1","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the mechanisms through which poverty influences perinatal depression can provide insight into how to develop interventions to improve maternal mental health. To address this question, we aim to estimate indirect effects of important mediators on the causal relationship between food insecurity and symptoms of postnatal depression.</p><p><strong>Methods: </strong>We used data from the control arm of the Africa Focus on Intervention Research for Mental health - South Africa (AFFIRM-SA) trial that included pregnant women with perinatal depression. Interventional effects (used for models that may have multiple correlated mediators) were used to decompose the total effect of food insecurity captured at baseline on symptoms of perinatal depression reducing by at least 40% (using the 17-item HDRS instrument - yes/no) at three months after delivery of the baby, into the following indirect effects: number of antenatal visits attended; suicidality at eight months gestation; and levels of social support captured at eight months gestation using the Multidimensional Scale of Perceived Social Support.</p><p><strong>Results: </strong>Food insecurity was associated with a 15% reduced probability of symptoms of depression improving at three months post-delivery (-0·151, bias-corrected 95% CI: - 0.267, -0·032), of which 48% was mediated through reduced levels of social support in women exposed to food insecurity (-0.073: bias-corrected 95% CI: -0.146, -0.029). There was no conclusive evidence to support the mediating effects of attending antenatal visits and suicidality.</p><p><strong>Conclusions: </strong>Our findings suggest that providing social support can help to reduce symptoms of postnatal depression. Future research should explore developing and evaluating a package of care for pregnant women with perinatal depression that improves food security and levels of social support. This research suggests that policy makers and practitioners have a renewed focus on increasing social support systems for women during the perinatal period, especially in cases of food insecurity.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006785","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":"Area-level factors associated with variation in involuntary psychiatric hospitalisation across England: a cross-sectional, ecological study.","authors":"Matilda Minchin, Colette Christiansen, Lucy Maconick, Sonia Johnson","doi":"10.1007/s00127-024-02748-5","DOIUrl":"10.1007/s00127-024-02748-5","url":null,"abstract":"<p><strong>Purpose: </strong>Involuntary hospitalisations for mental health care are rising in many high income countries, including England. Looking at variation between areas can help us understand why rates are rising and how this might be reversed. This cross-sectional, ecological study aimed to better understand variation in involuntary hospitalisations across England.</p><p><strong>Method: </strong>The unit of analysis was Clinical Commissioning Groups (CCGs), NHS bodies responsible for delivering healthcare to local areas in England. 205 CCGs were included in the analysis. Demographic, clinical, and socioeconomic variables at CCG-level were extracted from national, open access data bases. The outcome variable was the rate of involuntary hospitalisation for psychiatric care under the 1983 Mental Health Act in 2021/22.</p><p><strong>Results: </strong>There was a four-fold difference between the CCGs with the highest and lowest involuntary hospitalisations. In an adjusted analysis, CCGs with a higher percentage of severe mental illness in the population, higher percentage of male population, and higher community and outpatient mental health care use showed a higher rate of involuntary hospitalisation. Depression, urbanicity, deprivation, ethnicity, and age were not strongly associated with involuntary hospitalisation after adjustment. These variables explained 10.68% of the variation in involuntary hospitalisations across CCGs.</p><p><strong>Conclusion: </strong>Some demographic and clinical variables explained variation in involuntary hospitalisation between areas in England, however, most of the variance was unexplained. Complex relationships between urbanicity, deprivation, age, and ethnicity need to be further explored. The role of other influences, such as variation in service organisation or clinical practice, also need to be better understood.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":"2049-2059"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness and health-related quality of life in Chinese adolescents: the mediating role of depressive symptoms and the moderating role of age.","authors":"Wanting Hu, Xiuqiong Feng, Wangnan Cao, Jinghua Li, Shengyu Luo, Li Lin, Dezhong Chen, Weiqing Chen, Vivian Yawei Guo","doi":"10.1007/s00127-025-02834-2","DOIUrl":"10.1007/s00127-025-02834-2","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the alarming prevalence of loneliness in adolescents, few studies addressed its impact on health-related quality of life (HRQOL). This study aimed to investigate the association between loneliness and HRQOL in adolescents, as well as the mediating role of depressive symptoms and the moderating role of age in this association.</p><p><strong>Methods: </strong>A cross-sectional study surveyed 6743 middle school adolescents, assessing loneliness with the 6-item UCLA Loneliness Scale and HRQOL through the Pediatric Quality of Life Inventory Version 4.0. Depressive symptoms were assessed by the Patient Health Questionnaire-9. Pearson correlation analysis was performed to determine the correlation among the main variables. A moderated mediation analysis was established to evaluate the mediating role of depressive symptoms and the moderating role of age in the association between loneliness and HRQOL.</p><p><strong>Results: </strong>Of the participating adolescents, 25.0% (1687) reported experiencing high-level loneliness. The findings revealed a significant association between loneliness and lower scores across all HRQOL dimensional and summary scales. Specifically, with every additional point in loneliness scores, the HRQOL total scale scores changed by -2.06 (95% CI: -2.13 to -2.00) points. Depressive symptoms were identified as a partial mediator, with mediation effects ranging from 24.31% for social functioning to 62.50% for school functioning. Additionally, age negatively moderated the link between loneliness and depressive symptoms in above mediation model.</p><p><strong>Conclusions: </strong>The link between loneliness and poorer HRQOL in adolescents highlighted the need to prioritize this vulnerable group. Our findings also indicated the importance of addressing depressive symptoms and age differences among lonely adolescents to preserve their HRQOL.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":"2201-2211"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460337","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":"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":"2099-2106"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378473/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}