Social Psychiatry and Psychiatric Epidemiology最新文献

{"title":"Development and validation of a supported housing programme for homeless women with severe mental illness.","authors":"Lydia R Conger, Aarti Jagannathan, Erica Breuer, Senthil Amudhan, Jagadisha Thirthalli, L Ponnuchamy","doi":"10.1007/s00127-024-02797-w","DOIUrl":"10.1007/s00127-024-02797-w","url":null,"abstract":"<p><strong>Background: </strong>The bidirectional phenomenon of homelessness and Mental Illness (MI) creates a vicious circle that is hard to escape. In India, Homeless Women with Severe Mental Illness (HWSMI) often rely on institutional care due to the absence of family or community alternatives, which distances them from socio-economic, cultural, political resources and the right to live with dignity. Hence, there is a need to develop a model that will help reintegrate HWSMI into the community.</p><p><strong>Aim: </strong>We aimed to develop and validate (content and face validity) a supported housing programme (SHP) for HWSMI in Bengaluru, India.</p><p><strong>Method: </strong>We developed the SHP using 1) a needs assessment from HWSMI (n = 14), 2) qualitative interviews with Mental Health Professionals (MHPs) (n = 18), and 3) visits to organizations (n = 3) involved in reintegration and supported housing for HWSMI. We articulated a Theory of Change (ToC) for the program. Three international experts and seven Indian experts reviewed the same.</p><p><strong>Results: </strong>Five themes- Causes of homelessness/barriers to reintegration, consequences of homelessness, models/processes, facilitators, and needs of HWSMI and eighty sub-themes emerged from the qualitative thematic analysis of the interviews and observational visits. The themes and subthemes were organized as interventions in each phase of the SHP: Interventions in the tertiary care setting, transit home, and community.</p><p><strong>Conclusion: </strong>We describe the development and validation of a comprehensive need-based SHP. We will implement and test the feasibility of the SHP for HWSMI.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":"1311-1321"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807504","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":"Universal credit trajectories among individuals who access secondary mental health services: analysis of linked data.","authors":"Sharon A M Stevelink, Sarah Ledden, Ioannis Bakolis, Ray Leal, Ira Madan, Matthew Hotopf, Nicola T Fear, Thomas Lorentzen","doi":"10.1007/s00127-025-02930-3","DOIUrl":"https://doi.org/10.1007/s00127-025-02930-3","url":null,"abstract":"<p><strong>Purpose: </strong>To examine Universal Credit (UC) trajectories, and transitions between UC conditionality regimes among secondary care mental health service users. Sociodemographic and diagnostic characteristics associated with UC trajectories were explored.</p><p><strong>Methods: </strong>Mental health record data from 4876 individuals who attended mental health services were linked with administrative benefits data. An entry cohort was created including mental health service users who had received UC in 2016 and followed up for 4.5 years. Sequence analysis was used, followed by cluster analysis to identify typical UC trajectories. Sociodemographic and diagnostic characteristics associated with UC clusters were explored using multinominal logistic regression; results were presented as average marginal effects.</p><p><strong>Results: </strong>Six distinct UC clusters were identified. These clusters indicated: short-term UC searching for work (18.7%), medium-term UC searching for work (19.1%), long-term UC searching for work (21.4%), no work requirements (11.9%), UC working cluster (6.1%), and no work searching and caring responsibilities cluster (22.8%). Women were overrepresented in the medium-term UC searching for work cluster whereas older people were more likely to be in the long-term UC searching for work and no work requirements clusters. Those diagnosed with severe mental illness were overrepresented in the no work requirements group.</p><p><strong>Conclusion: </strong>Most trajectories were dominated by those required to search for work albeit for different time periods before exiting UC. One in ten people were assessed as unable to work for an extended period. Findings can be used to inform support for people with mental health problems vulnerable to conditionality or longer-term UC receipt.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188388","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 impairment and associated factors among patients with mood disorders receiving care at public hospitals in Gedeo zone, Southern Ethiopia.","authors":"Biazin Yenealem Mekuriaw, Hibist Wondmu, Marye Asfaw, Chalachew Kassaw, Alemayehu Molla","doi":"10.1007/s00127-025-02932-1","DOIUrl":"https://doi.org/10.1007/s00127-025-02932-1","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is characterized by difficulty in attention, memory, problem-solving, and decision-making. It is strongly linked to mood disorders and affects work performance, social interactions, medication adherence, and overall quality of life. Despite the high burden of the problem, evidence on its prevalence and contributing factors remains scarce in low- and middle-income countries. This study aimed to determine the prevalence and associated factors of cognitive impairment among individuals with mood disorders.</p><p><strong>Method: </strong>A cross-sectional study was conducted at Gedeo Zone public hospitals. A systematic sampling technique was used to select a total of 422 individuals receiving care for mood disorders. The outcome variable was assessed using the Montreal Cognitive Assessment (MoCA). The data were entered into Epi Data version 4.2 and analyzed using STATA version 17. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with cognitive impairment. The presence of an association was examined with an adjusted odd ratio with a 95% confidence interval and variables with P values less than 0.05 were considered a statistically significant association.</p><p><strong>Result: </strong>The prevalence of cognitive impairment among individuals with bipolar disorders and depressive disorders was 34.5% (95% CI: 32.7-36.9) and 38.7% (95% CI: 36.4-40.8), respectively. Having a longer duration of treatment [AOR = 1.87 (95% CI: 1.57, 2.94)], a duration of illness 10 years and above [AOR = 2.13 (95% CI 1.23, 4.48)], and severe depressive symptoms [AOR = 2.15 (95% CI 1.14, 4.97)] were significantly associated with cognitive impairment among individuals with depressive disorders. Medication non-adherence [AOR = 1.48 (95% CI: 1.34, 2.78)], a long duration of illness [AOR = 1.42 (95% CI: 1.09, 2.48)], and severe manic symptoms [AOR = 2.16 (95% CI: 1.18, 5.28)] were significantly associated with cognitive impairment among participants with bipolar disorders.</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of cognitive impairment in patients with mood disorders. Therefore, early screening and intervention for cognitive impairment in mood disorder patients are essential to deliver holistic care and improve treatment outcomes. Integrating cognitive assessments into routine mental health evaluations can help identify early deficits and enable tailored interventions. Additionally, cognitive remediation strategies such as structured patient education, side-effect management, and medication adjustments should be prioritized to enhance adherence and overall recovery.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182884","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":"Individual, intergenerational, and contextual factors associated with coping strategies, coping variability, and perceived coping efficacy among young adults.","authors":"Claudia Trudel-Fitzgerald, Jennifer O'Loughlin, Briana Mezuk, Nabil Bouizegarene, Eliane Sauvageau, Marie-Pierre Sylvestre","doi":"10.1007/s00127-025-02926-z","DOIUrl":"https://doi.org/10.1007/s00127-025-02926-z","url":null,"abstract":"<p><strong>Purpose: </strong>Stress-related coping is an important mechanism of mental health functioning. However, the distribution of coping processes across various factors (e.g., individual like sex, contextual like perceived social status) remain under-explored. This study identified individual, intergenerational, and contextual factors associated with coping strategies, variability in their use (as a proxy for using strategies flexibly across contexts), and perceived coping efficacy to handle stressors among young adults.</p><p><strong>Methods: </strong>Participants from the Nicotine Dependence in Teens study (NDIT; N = 827) completed the validated Coping Inventory for Stressful Situations scale in 2011-12 (age ~ 24). Data on many factors, including race/ethnicity, intergenerational education patterns, and perceived social status, were collected from 1999-2000 (at NDIT inception; age 12-13) to 2011-12. Linear and multinominal regressions modeled the associations between individual, intergenerational, and contextual factors and coping strategies, variability, and efficacy, separately.</p><p><strong>Results: </strong>Women versus men reported more frequent use of emotion-, distraction-, and social diversion-oriented strategies and higher variability levels (e.g., B_emotion=0.40, 95%CI = 0.28, 0.51), but less frequent use of task-oriented strategies and lower coping efficacy (e.g., B_efficacy=-0.46, 95%CI=-0.59, -0.32). Higher incomes, more educated mothers, and higher perceived social status in the community were associated with more frequent use of task-oriented strategies and coping efficacy, and less frequent use of emotion-oriented strategies. Other factors, including race/ethnicity, marital status, and school socio-economic status, were not robustly related to coping processes.</p><p><strong>Conclusion: </strong>Findings document the distribution of coping processes across individual, intergenerational, and contextual factors among young adults, which may more broadly increase understanding of social disparities in mental health.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163514","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 RECAPACITA PROJECT: comparative study of the clinical, neuropsychological, and functional profile of people with severe mental disorder and partial and total capacity modification.","authors":"Silvia Marcó-García, Georgina Guilera, Marta Ferrer-Quintero, Susana Ochoa, Gemma Escuder-Romeva, Elena Rubio-Abadal, Arantxa Martínez-Mondejar, Núria Del Cacho, Vanessa Montalbán-Roca, Ana Escanilla-Casal, Sol Balsells-Mejía, Elena Huerta-Ramos","doi":"10.1007/s00127-025-02907-2","DOIUrl":"https://doi.org/10.1007/s00127-025-02907-2","url":null,"abstract":"<p><strong>Background: </strong>Evaluating the decision-making capacity of individuals with Severe Mental Disorder (SMD) is essential for compliance with the 2006 Convention on the Rights of People with Disabilities. In Spain, capacity was historically determined through judicial procedures, resulting in partial or total capacity modification (CM). The abolition of this procedure in 2021 has left a gap in addressing the needs of this population, creating challenges under the new legal framework.</p><p><strong>Aim: </strong>The RECAPACITA project studied the clinical, neuropsychological, and functional profiles of individuals with SMD and CM, focusing on differences between partial (pCM) and total (tCM) modifications.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 77 adult patients with SMD and CM (47 tCM, 30 pCM) from the Parc Sanitari Sant Joan de Déu mental health network (Spain). Sociodemographic, clinical, functional, and neuropsychological data were collected, along with an independent assessment of mental capacity.</p><p><strong>Results: </strong>Around 87% of sample had a schizophrenia spectrum disorder; pCM patients presented more substance-related and personality disorders as a secondary diagnosis. While no statistically significant differences were observed between groups, clinically, tCM group presents greater clinical alteration, lower insight, sustained attention, coding capacity, processing speed and resistance to interference compared to pCM group. tCM group had worse social functioning, and lower scores in reasoning and appreciation when assessing mental capacity.</p><p><strong>Conclusions: </strong>Individuals with tCM show greater clinical impairment and higher support needs compared to those with pCM. With the practical and legal abolition of tCM, it is essential to ensure that these individuals' persistent challenges are adequately addressed, as their needs remain significant despite the disappearance of this legal category.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152228","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 and determinants of orthorexia nervosa among Turkish adolescents.","authors":"Selman Yildirim, Bahadir Turan, Samiye Çilem Bilginer, Esra Hoşoglu","doi":"10.1007/s00127-025-02928-x","DOIUrl":"https://doi.org/10.1007/s00127-025-02928-x","url":null,"abstract":"<p><strong>Purpose: </strong>Given the prevalence and diversity of eating issues among adolescents, understanding the epidemiological aspects of orthorexia nervosa (ON) in this demographic, along with identifying associated clinical factors, sociodemographic traits, eating habits and parental attitudes, holds paramount importance both clinically and scientifically. This study aimed to ascertain the prevalence of ON among Turkish high school adolescents aged 14-18 and explore potential correlates of this clinical condition.</p><p><strong>Method: </strong>In the initial phase, 1784 adolescents completed the Data Form, Orthorexia Nervosa Inventory (ONI) and Parent Style Scale (PSS), while their parents filled out the the parental version of the revised Child Anxiety and Depression Scale (RCADS). Subsequently, clinical interview and The Kiddie-Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version (KD-SADS-PL) were conducted with 9 adolescents with high risk for ON to assess comorbidities.</p><p><strong>Results: </strong>The study revealed ON prevalence of 0.5%, with 0.3% in boys and 0.6% in girls. Rural residency, dietary supplement use, and pet ownership correlated with higher ONI scores (p = 0.022, p = 0.002, p = 0.042 respectively). OCD and panic disorder symptoms (B = 0.307, p < 0.001 and B = 0.165, p = 0.018 respectively), increased BMI, and anxiety scores were associated with elevated ONI scores. Authoritarian parenting was significantly related to ONI total scores (B = 1.69, p = 0.018).</p><p><strong>Conclusion: </strong>This study significantly contributes to the literature by delineating the prevalence of ON in adolescents, identifying associated risk factors, elucidating psychopathological associations of orthorexic symptoms, and identifying the relationship between parenting styles and ON. Such insights into the factors influencing ON can aid in demystifying its nature.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136547","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":"Trends in psychotropic medication across occupation types before and during the Covid-19 pandemic: a linked administrative data study.","authors":"Finola Ferry, Lisa Kent, Michael Rosato, Emma Curran, Gerard Leavey","doi":"10.1007/s00127-025-02909-0","DOIUrl":"https://doi.org/10.1007/s00127-025-02909-0","url":null,"abstract":"<p><strong>Purpose: </strong>Using linked administrative data, this study provides the first longitudinal analysis of mental health among workers across occupational groups prior to and during the Covid-19 pandemic. Eleven years of data were analysed to examine whether the pandemic period coincided with changes in psychotropic medication for workers across broad occupational groupings.</p><p><strong>Methods: </strong>Data from Northern Ireland (NI) Enhanced Prescribing Database (EPD) was linked with NI Longitudinal Study (NILS) to examine trends in anti-depressants, anxiolytics and hypnotics (2011-2021) among NI workers (N = 200,004) across nine major occupation groups. Quarterly prescriptions were examined prior to and during pandemic restrictions (Q1-2011 to Q4-2019; and Q1-2020 to Q4-2021, respectively). Auto-regressive integrated moving average (ARIMA) models were trained to compare 'forecasted' and 'observed' rates during the pandemic period, stratified by occupational group.</p><p><strong>Results: </strong>Q2-2020 coincided with lower-than-expected receipt of anxiolytics and anti-depressants for several broad occupation types. Receipt of anxiolytic prescriptions among managers, directors/senior officials dropped below expected levels for the three quarters from Q3-2020 to Q1-2021. Finally, a notable increase in anti-depressants for a prolonged period was found among staff in caring/leisure and related professions, as well as higher rates of hypnotics in Q2-2021.</p><p><strong>Conclusion: </strong>Our study provides the first longitudinal examination of variation in mental health across occupation types prior to and during the Covid-19 pandemic, using available linked administrative data. Findings suggest that occupation type was an important pandemic-related stressor and point to potential higher risk occupations that could be the focus of targeted interventions in future pandemics.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121166","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":"Conceptualising workplace loneliness: a qualitative investigation with UK workers.","authors":"Bridget T Bryan, Elena Triantafillopoulou, Vaughan Parsons, Louise Arseneault, Timothy Matthews","doi":"10.1007/s00127-025-02925-0","DOIUrl":"https://doi.org/10.1007/s00127-025-02925-0","url":null,"abstract":"<p><strong>Purpose: </strong>Loneliness has been identified as an important risk factor for mental health problems, and concern about its impact on workers' health and wellbeing has grown in recent years. While a body of workplace loneliness research is emerging, the degree to which existing definitions of the phenomenon reflect workers' experiences has not been investigated. This study aims to develop an evidence-based conceptualisation of workplace loneliness that can inform future research and interventions aiming to improve workers' mental health and wellbeing.</p><p><strong>Methods: </strong>Semi-structured interviews exploring experiences of social connection, loneliness and work were conducted with a diverse sample of 31 UK-based workers. The interviews were supplemented with a social mapping task. Interview data were analysed inductively using reflexive thematic analysis. Social maps were analysed using a thematic analysis approach informed by a visual semiology framework.</p><p><strong>Results: </strong>Three themes were identified, in which loneliness was conceptualised as disconnection from (1) colleagues, (2) one's organisation, and (3) society. Across each theme, disconnection and loneliness were experienced as an unfulfilled desire to feel that one's authentic self was understood, valued or belonged as a result of one's work or occupation.</p><p><strong>Conclusions: </strong>Workplace loneliness comprises not only dissatisfaction with interpersonal relationships at work, but also a sense of disconnection from larger social groups and structures, particularly one's employing organisation and society as a whole. Definitions of workplace loneliness that acknowledge the role of the social and organisational context, as well as professional relationships, are needed to better reflect the lived experience of loneliness at work.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112457","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":"Sex differences in lifetime suicide attempts in retired older adults between 2000 and 2021 in France: results from six national surveys.","authors":"Helen-Maria Vasiliadis, Christophe Léon, Mathilde Husky","doi":"10.1007/s00127-025-02921-4","DOIUrl":"https://doi.org/10.1007/s00127-025-02921-4","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine sex differences in the prevalence of lifetime suicide attempts in retired older adults aged between 65 and 75 years across six national surveys in France.</p><p><strong>Methods: </strong>This secondary data analysis draws on data from six cross-sectional surveys (2000, 2005, 2010, 2014, 2017 and 2021) from the Health Barometer ran by Public Health France which included representative samples of the general population of metropolitan France. The current study sample included retired older adults aged 65 to 75 years across all surveys (n = 18,120). Prevalence differences and ratios between waves with corresponding 95% CI were reported. Analyses were stratified by sex. Multivariable analyses were also carried out to ascertain the independent association between sex, living alone, education, income level, and region of residence urbanicity in relation to the presence of a lifetime suicide attempt. Analyses were weighted according to sampling weights based on the probability of inclusion in the study to ensure that the sample was representative of the French general population.</p><p><strong>Results: </strong>There has been an increase in lifetime suicide attempts among retired older adults over the past two decades, with women consistently reporting a higher prevalence of lifetime suicide attempts than men over all time periods. Compared with the early 2000s, a stronger association between socio-demographic factors and lifetime suicide attempts was found two decades later.</p><p><strong>Conclusions: </strong>The study findings highlight the need for public health programs to focus on populations at risk of social exclusion, such as those living alone and those with low incomes. Future studies are needed to further confirm the increasing trends in lifetime suicide attempts and their associated factors.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112534","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":"Income inequality and deaths of despair: a population-based study of 19 million Canadian adults.","authors":"Jason Mulimba Were, Gregory Farmer, Claire Benny, Brendan T Smith, Shelby Yamamoto, Katerina Maximova, Candace I J Nykiforuk, Frank Trovato, Ambikaipakan Senthilselvan, Arjumand Siddiqi, Roman Pabayo","doi":"10.1007/s00127-025-02913-4","DOIUrl":"https://doi.org/10.1007/s00127-025-02913-4","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the association between regional level income inequality (a relative measure of socioeconomic disparity) and deaths of despair and assess whether this association is moderated by age, gender, racialized minority status, and income.</p><p><strong>Methods: </strong>Data from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) study were used. A cohort of Canadian adults (n = 19,436,790) within 288 CDs were followed from May 2006 to December 2019. Multilevel Cox-proportional hazard regression was used to estimate the association between income inequality and time to deaths attributed to suicide, drug overdose, and alcohol.</p><p><strong>Results: </strong>In models adjusted for confounders, income inequality was associated with time to death due to alcohol (HR = 1.14; 95% CI: 1.05, 1.25), drug overdose (HR = 1.19; 95% CI: 1.06, 1.33), and deaths of despair (HR = 1.05; 95% CI: 1.00, 1.11). Significant interactions were primarily observed in cases of deaths attributed to drug overdose. The association between income inequality and the hazards for drug overdose deaths was stronger for individuals aged 40-49 (HR = 1.71; 95% CI: 1.24, 2.37), males (HR = 1.69; 95% CI: 1.22, 2.35), from low-income households (HR = 1.69; 95% CI: 1.22, 2.35), self identified as White (HR = 1.69; 95% CI: 1.22, 2.35) and those living in low-income areas (HR = 1.69; 95% CI: 1.22, 2.35).</p><p><strong>Conclusion: </strong>Income inequality is associated with high risk of deaths of despair. Additionally, this association is significantly moderated by age, gender, racialized minority status and income at the household and area levels. As such, our findings suggest the need to address income inequality in interventions for reducing deaths of despair among Canadian adults.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112470","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}