Social Psychiatry and Psychiatric Epidemiology最新文献

{"title":"Association of social isolation and loneliness with incident cardiovascular diseases: results from a nationally prospective cohorts in China.","authors":"Jingru Zha, Mingzhuang Chen","doi":"10.1007/s00127-025-02894-4","DOIUrl":"https://doi.org/10.1007/s00127-025-02894-4","url":null,"abstract":"<p><strong>Aims: </strong>Social isolation and loneliness are associated with increased risk of cardiovascular disease (CVD). Most research examining the effects of social isolation and loneliness on CVD is based in Western countries. This study examined the effects of loneliness and social isolation on cardiovascular disease in China.</p><p><strong>Methods: </strong>Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Social isolation, loneliness and CVD were measured at baseline. The analytical sample size was 6,860 for the analysis of self-reported CVD. Cox proportional-hazard regression adjusted for confounding factors were used to assess the association between baseline isolation, loneliness, and CVD.</p><p><strong>Results: </strong>Incident CVD was followed-up from 2011 to 2018. During the 7 years of follow-up, we found that loneliness was associated with an increased risk of CVD events (adjusted HR, 1.24; 95% CI, 1.06-1.44). In the moderately isolated group, loneliness was significantly associated with an elevated risk of incident CVD after adjusting for all confounders (adjusted HR, 1.40; 95% CI, 1.13-1.73). Loneliness was significantly associated with an increased risk of incident CVD among female participants (adjusted HR, 1.29; 95% CI, 1.07-1.56).</p><p><strong>Conclusions: </strong>Loneliness significantly increased the risk of incident CVD, while social isolation did not exhibit a similar correlation. Our findings suggest that targeted and practical social interventions could improve the accuracy and efficiency of identifying individuals at high risk.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055590","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 community socioeconomic factors and opioid use disorder across an urban-to-rural spectrum in Pennsylvania: an electronic health record-based case-control study.","authors":"Melissa N Poulsen, Cara M Nordberg, Joseph DeWalle, Meghann Reeder, Wade Berrettini, Brian S Schwartz","doi":"10.1007/s00127-025-02897-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02897-1","url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate the role of community socioeconomic conditions in creating opioid-related risk environments, we assessed community-level socioeconomic measures in association with opioid use disorder (OUD) across a diverse geography.</p><p><strong>Methods: </strong>We conducted a case-control study using medical records (2012-2020) from a Pennsylvania health system to identify cases of OUD (n = 14,674) and controls (n = 58,696; frequency-matched on age, sex, year, medical record duration). Residential addresses were used to assign community-level measures: community socioeconomic deprivation (CSD), high proportional housing costs (HPHC), population in service occupations (PSO), and community credit score (CCS). Logistic regression analyzed associations of community type (city census tracts [CCT], boroughs, townships) and community socioeconomic features (stratified by community type) with OUD, adjusting for demographics and individual-level socioeconomic status.</p><p><strong>Results: </strong>CCT or borough (versus township) residence was associated with higher OUD odds. CSD, HPHC, and CCS were associated with OUD across community types; PSO was only associated in CCTs. The highest (versus lowest) level of CSD was associated (odds ratio, 95% CI) with higher OUD odds among individuals in townships (1.18 [1.03, 1.36]), boroughs (1.34 [1.09, 1.63]), and CCTs (1.46 [1.13, 1.88]). \"Good\" (versus \"high fair\") CCS was associated with lower odds in townships (0.78 [0.71, 0.86]), boroughs (0.56 [0.41, 0.77]), and CCTs (0.73 [0.44, 1.22]).</p><p><strong>Conclusion: </strong>Findings indicate poor community socioeconomic conditions are related to higher OUD risk, highlight the value of research regarding opioid-related risk environments, and suggest structural and policy interventions, such as vocational training and rent subsidies, as important for addressing the root causes of OUD.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028190","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":"Under the covert norm: a qualitative study on the role of residency culture in burnout.","authors":"Mónica Armas-Neira, Ithandehui Jaimes-Jiménez, Bernardo Turnbull, Alma Vargas-Lara, Adara López-Covarrubias, Jatsiri Negrete-Meléndez, Manuel Mimiaga-Morales, Sandra Montes de Oca-Mayagoitia, Lilia Monroy-Ramírez de Arellano","doi":"10.1007/s00127-025-02856-w","DOIUrl":"https://doi.org/10.1007/s00127-025-02856-w","url":null,"abstract":"<p><strong>Purpose: </strong>Burnout has become a major concern within healthcare. Medical residents comprise a notorious at-risk population in which approximately half of the population is affected. While previous work highlights the role of organizational risk factors as the main contributors to occupational burden, research on culture in medicine as a potential organizational risk factor is limited. The main objective of this qualitative study was to explore the expression of cultural norms from the medical resident perspective to establish the stage for future high-impact interventions.</p><p><strong>Methods: </strong>Data were gathered from 87 semistructured interviews with residents in Mexico City and analyzed through a grounded theory lens.</p><p><strong>Results: </strong>The analysis revealed harmful customary practices within medical residency culture. A distorted hierarchical system was responsible for promoting abusive power dynamics that fed into a 'covert norm' that continually infringed on formal regulations. This system is partly sustainable due to poor reporting mechanisms and self-perpetuating behaviors through normalization and violent enforcement.</p><p><strong>Conclusion: </strong>The findings suggest that burnout was independently associated with and occurred in the context of covert conventions that defy guidelines. However, further studies are needed to assess proper organizational interventions that reject covert sociocultural normative conformity to support a more humanistic side of medical culture.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039332","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 features and mortality outcomes of people transferred from prison to forensic mental health units: a nationwide 14-year retrospective cohort study.","authors":"James A Foulds, Ruth Cunningham, Toni L Pitcher, Chris Frampton, Stuart A Kinner, Ben Beaglehole","doi":"10.1007/s00127-025-02893-5","DOIUrl":"https://doi.org/10.1007/s00127-025-02893-5","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a cohort of people transferred from prison to psychiatric hospital care and their mortality outcomes.</p><p><strong>Methods: </strong>Retrospective nationwide cohort of people (n = 1320) transferred from prison to a psychiatric hospital in New Zealand from 2009 to 2022. Follow up commenced at the first transfer and ended on 30 June 2023 or death if earlier. Ministry of Health records were used to describe the cohort and their service utilization profile. Records were linked to official mortality data, and mortality ratios were calculated using publicly available life tables.</p><p><strong>Results: </strong>The cohort was 85% male and 55% Māori, with a median age of 31.2 years. Most had a psychotic disorder (74%) or bipolar disorder (11%) and there were high levels of coexisting substance use disorder. Follow-up duration ranged from 2 months to 14.5 years (median 7.5 years) after the first transfer, of which 17% was in a psychiatric hospital. The age and sex-standardised mortality ratio for the cohort compared to the New Zealand population was 4.7 (95% CI 3.6-5.9). Among deaths with a known cause, 60% were from natural causes and 40% were from injuries including suicide.</p><p><strong>Conclusion: </strong>Despite extended periods of psychiatric hospitalization there was high mortality among people in the cohort. Investment in targeted prevention and coordinated, continuous healthcare is needed for people with a serious mental illness who experience incarceration.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812629","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 burden of mental disorders and substance abuse in the Middle East and North Africa (MENA) region: findings from the Global Burden of Disease Study.","authors":"Yazan Nagi, Yazan A Al-Ajlouni, Omar Al Ta'ani, Magdalena Bak, Nour Makarem, Ali Haidar","doi":"10.1007/s00127-025-02885-5","DOIUrl":"https://doi.org/10.1007/s00127-025-02885-5","url":null,"abstract":"<p><strong>Background: </strong>Mental disorders pose significant morbidity and mortality risks globally. Despite this, research on mental health in the Middle East and North Africa (MENA) region is scarce, hindered by social stigmas and limited healthcare expenditure. This study, utilizing the Global Burden of Disease (GBD) database, aims to address this gap by examining the prevalence, incidence, and demographic patterns of mental disorders in MENA.</p><p><strong>Methods: </strong>This ecological study draws on the GBD data to assess the prevalence and burden of mental disorders and substance abuse across the MENA region from 1990 to 2019. Utilizing age-standardized rates of prevalence and Disability-Adjusted Life Years (DALYs), we examine the evolving burden of mental disorders, variations among MENA countries, and trends in associated risk factors by age and gender.</p><p><strong>Results: </strong>From 1990 to 2019, the MENA region witnessed varying trends in mental disorders. The age-standardized prevalence rate in 2019 was 14,938 per 100,000 individuals, experiencing a 2.1% decrease overall. However, all-age prevalence surged by 86.2%. Disorders like schizophrenia and depressive disorders exhibited substantial increases, contrasting with a 128.1% rise in substance use disorders. Temporal analysis revealed fluctuations in DALY trends, capturing the dynamic nature of mental health burdens over time. Risk factors, including bullying victimization and intimate partner violence, underwent shifts, reflecting changing contributors to mental health burden.</p><p><strong>Conclusion(s): </strong>Despite a decrease in age-standardized prevalence rates in 2019, the substantial all-age prevalence rise demands attention. Temporal analysis unraveled nuanced trends, emphasizing the complex interplay of sociocultural factors. The shifting prominence of risk factors underscores the dynamic nature of mental health burdens, necessitating region-specific interventions that address both prevalence patterns and contributing factors. Future research should delve into the specific sociocultural determinants influencing the observed trends, allowing for tailored interventions to mitigate the burden of mental health disorders in the MENA region.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812633","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":"Factors influencing the length of stay in the psychiatric unit of a Ghanaian teaching hospital: a retrospective study.","authors":"Stephen Wemakor, Kwabena Kusi-Mensah, John-Paul Omuojine, Richard Mensah, Ruth Owusu-Antwi","doi":"10.1007/s00127-025-02889-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02889-1","url":null,"abstract":"<p><strong>Purpose: </strong>The psychiatric length of stay (LOS) in community-based hospital facilities in sub-Saharan Africa reflects the quality of service delivery and the presence of resource challenges. This study aimed to determine the average LOS and identify factors associated with prolonged LOS in the psychiatric unit of a Ghanaian teaching hospital.</p><p><strong>Methods: </strong>The study analysed 1143 hospital discharge records of psychiatric inpatients at Komfo Anokye Teaching Hospital Psychiatric Unit from January 2016 to October 2020. LOS greater than the median of 10 days was classified as prolonged. We performed multivariable logistic regression to determine factors associated with prolonged LOS.</p><p><strong>Results: </strong>The mean LOS was 12 days, and the median LOS was 10 days. Bipolar and related disorders (aOR = 1.68 95% CI (1.28-2.21)), substance use disorders (aOR = 1.98 95% CI (1.19-3.30)), co-occurring mental health and substance use disorders (aOR = 2.30 95% CI (1.20-4.56)), and being discharged home directly (aOR = 1.91 95% CI (1.03-3.69)) was associated with a longer hospital stay, while suicide-related behaviour (aOR = 0.27 95% CI (0.09-0.72)) was associated with decreased odds of prolonged hospital stay.</p><p><strong>Conclusion: </strong>Possible interventions to reduce the length of psychiatric stay in the general hospital setting include improving functional integration of mental health into primary care and implementing transitional treatment programmes like partial hospitalisation and intensive outpatient treatment programmes. Improving access to residential substance use treatment is another intervention that can help decrease the burden of prolonged psychiatric stays.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804678","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 prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study.","authors":"Nayan Parlikar, Linn Beate Strand, Kirsti Kvaløy, Geir Arild Espnes, Unni Karin Moksnes","doi":"10.1007/s00127-025-02888-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02888-2","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a recognized risk factor for anxiety and depression, yet research on its interaction with low resilience remains sparse, particularly across the adolescent-to-adult transition. This study investigates how adolescent loneliness, both independently and in interaction with low resilience, influences anxiety and depression in young adulthood.</p><p><strong>Methods: </strong>This study utilized longitudinal data from The Trøndelag Health Study (HUNT) to track adolescents (13-19 years) from Young-HUNT3 (2006-08) through to HUNT4 (2017-19). Loneliness was assessed via a single-item measure, while resilience was estimated using the Resilience Scale for Adolescents. Anxiety and depression outcomes at the 11-year follow-up were measured using the Hospital Anxiety and Depression Scale. Multivariable logistic regression analyses were done to analyze the associations. Moreover, interaction effects were evaluated using relative excess risk due to interaction (RERI).</p><p><strong>Results: </strong>Loneliness during adolescence independently predicted anxiety and depression in young adulthood. Adolescents experiencing both loneliness and low resilience showed notably higher risks compared to other groups (highly resilient adolescents without loneliness [reference], highly resilient adolescents with loneliness, and adolescents with low resilience and low loneliness). The combined effect of loneliness and low resilience exhibited a synergistic interaction on the additive scale, although it was not statistically significant (RERI 0.13, 95% CI -2.39-2.65).</p><p><strong>Conclusion: </strong>Adolescent loneliness and low resilience independently predict anxiety and depression in young adulthood. The interaction between loneliness and low resilience further heightens these risks. This underscores the importance of early interventions that focus on resilience-building during adolescence and reducing the impacts of loneliness on mental health.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804680","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":"Investigating the impact of parallel media engagement initiatives on suicide reporting in Canada and Israel.","authors":"Mark Sinyor, Daniella Ekstein, Prudence Po Ming Chan, Yu Vera Men, Racheli Starostintzki Malonek, Ayal Schaffer, Thomas Niederkrotenthaler, Marnin J Heisel, Benjamin I Goldstein, Donald A Redelmeier, Paul Taylor, Rachel Mitchell, Rosalie Steinberg, Yossi Levi-Belz","doi":"10.1007/s00127-025-02886-4","DOIUrl":"https://doi.org/10.1007/s00127-025-02886-4","url":null,"abstract":"<p><strong>Purpose: </strong>To contrast changes in suicide-related media reporting quality during parallel initiatives to engage national media in Canada and Israel.</p><p><strong>Methods: </strong>We coded media articles in Canada's and Israel's highest circulating newspapers (major broadsheet and tabloid newspapers, respectively) for putatively harmful and putatively protective suicide-related content. A sample of 150 articles (30/year) from each country was randomly selected for three time points: 2012 (T1; prior to media engagement), 2016-2017 (T2; early media engagement), and 2018-2019 (T3; late media engagement). Chi-square tests and binary logistic regression investigated overall between-country differences in reporting quality over time.</p><p><strong>Results: </strong>Following media engagement, adherence to guidelines improved over time in both countries for most variables. Over time, fewer Canadian and more Israeli articles covered celebrity suicide (OR = 4.97; 95%CI 1.68-16.69); more Canadian and fewer Israeli articles covered warning signs for suicide (OR = 0.30; 95%CI 0.12-0.78). Comparing articles over the entire timespan (T1-T3), a higher proportion of Israeli tabloid articles included putatively harmful content, such as mentioning suicide means (Israel: 65.3% vs. Canada 25.3%, χ²(1) = 48.4, p < 0.001), and a higher proportion of Canadian broadsheet articles included putatively protective content, such as providing information on intervention (Israel: 2.0% vs. Canada 27.3%, χ²(1) = 38.5, p < 0.001).</p><p><strong>Conclusion: </strong>Media engagement appeared to confer benefits in both countries and publication formats. A higher proportion of Canadian articles adhered to several specific recommendations. Our findings must be interpreted in the context of differences in format between major Canadian and Israeli newspapers (broadsheet vs. tabloid) and the much higher total volume of suicide-related articles in Canada.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804679","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 mental health age gradient by gender identity.","authors":"Samuel Mann, Megan S Schuler, Annaliese Paulson, Michael S Dunbar","doi":"10.1007/s00127-025-02895-3","DOIUrl":"https://doi.org/10.1007/s00127-025-02895-3","url":null,"abstract":"<p><p>Using data from the Behavioral Risk Factor Surveillance System (BRFSS) 2017-2022 we estimated adjusted and unadjusted differences in self-reported number of poor mental health days (past month) between gender minority (GM) and cisgender adults. We document that the disparity is largest among younger individuals. Among 18- to 23-year-olds, GM adults report on average 14.5 days of poor mental health, compared to 6.3 days for cisgender individuals, yielding an unadjusted disparity of 8.2 days [95% CI: 7.15, 9.24]. This disparity decreases with age - among people over the age of 73, the observed difference was 1.7 days [95% CI: 0.13, 3.27].</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789311","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":"Mediators of functioning and quality of life among people living with schizophrenia participating in the culturally adapted family psychoeducation (KUPAA) trial in Tanzania.","authors":"Joseph R Egger, Sylvia Kaaya, Paul Lawala, Praxeda Swai, Beatrice Thadei, Anna Minja, Kayla Hendrickson, Madeline Jin Van Husen, Ellen Lukens, Ezra Susser, Lisa Dixon, Joy Noel Baumgartner","doi":"10.1007/s00127-025-02896-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02896-2","url":null,"abstract":"<p><strong>Purpose: </strong>KUPAA is a culturally adapted version of Family Psychoeducation (FPE) that has shown to be beneficial to people living with schizophrenia-spectrum disorders (PLWS), who may experience limitations across multiple functional domains. Family Psychoeducation can lead to improvement in functional outcomes that align with recovery goals; however, the mechanisms of action are unclear. The current study objective is to identify mechanisms by which the KUPAA intervention reduces disability and improves quality of life among care-seeking PLWS in Tanzania.</p><p><strong>Methods: </strong>This clinical trial was conducted at Muhimbili National Hospital and Mbeya Zonal Referral Hospital and included a total of 66 dyads composed of PLWS ages 18-50 years and their caregivers. A causal mediation framework employing the g-formula was used to estimate the indirect effects of the KUPAA intervention on disability and quality of life, through the mediated pathways of hopefulness, self-stigma and generalized self-efficacy.</p><p><strong>Result: </strong>A greater decrease in mean disability score and increase in quality of life score was observed among KUPAA participants, compared to controls. We found that generalized self-efficacy mediates 33% of the effect of KUPAA on quality of life and generalized self-efficacy and hope each mediate 36% of the effect of KUPAA on disability.</p><p><strong>Conclusion: </strong>Results provide preliminary support for the hypothesis that KUPAA can reduce disability and improve quality life by reducing stigma, increasing hope and strengthening self-efficacy. Future psychosocial programs for PLWS should consider tailoring their interventions to focus on reducing stigma, increasing hope and fostering self-efficacy.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781654","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}