Social Psychiatry And Psychiatric Epidemiology[JOURNAL]
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200 papers
The influence of clinical and sociodemographic variables on employment and education for Danish youth with a psychotic disorder: a population-based national registry study.
Bonnesen TG, Hansen AP, Langagergaard V … +3 more , Graham MLS, Jørgensen S, Pedersen P
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 41922814 · Publisher ↗
PURPOSE: This population-based cohort study aimed to examine how clinical and sociodemographic characteristics are associated with employment and educational status 3 and 5 years after a first-episode psychotic disorder....
PURPOSE: This population-based cohort study aimed to examine how clinical and sociodemographic characteristics are associated with employment and educational status 3 and 5 years after a first-episode psychotic disorder. METHODS: The study included individuals diagnosed with a psychotic disorder between 2012 and 2017 in the Central Denmark Region. Register-based data were obtained from the CROSS-TRACKS cohort. Logistic regression analyses were used to determine the association between sociodemographic and clinical factors and the likelihood of being employed or enrolled in education at 3- and 5-year follow-up. RESULTS: A total of 2,493 individuals aged 18-35 years were included in the analyses. At 3- and 5- years post-diagnosis, 19.6% and 21.6%, respectively, were employed or enrolled in education. In adjusted analyses, baseline employment or educational participation and being married were associated with higher odds of attachment at both follow-up time points. Female sex was associated with lower odds of attachment at the 3-year follow-up only, while schizophrenia was associated with lower odds of employment or educational engagement at the 5-year follow-up. More frequent psychiatric outpatient visits during the first two years post-diagnosis were associated with higher odds of attachment at both follow-up points, whereas psychiatric hospitalization was associated with lower odds. CONCLUSION: Marital status, employment or educational participation at diagnosis, and engagement with psychiatric outpatient care were associated with later attachment to employment or education, highlighting the importance of early and sustained support following first-episode psychosis.
Mental health literacy and stigma among culturally and linguistically diverse adolescents in Australia: a comparative study.
Lu S, Hart LM, Jorm AF … +4 more , Gregg K, Slewa-Younan S, Zhao Y, Morgan AJ
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41894013 · Publisher ↗
PURPOSE: Using baseline data from a large trial, this study examined general mental health literacy, mental health first aid intentions and actions, and stigmatising attitudes among culturally and linguistically diverse...
PURPOSE: Using baseline data from a large trial, this study examined general mental health literacy, mental health first aid intentions and actions, and stigmatising attitudes among culturally and linguistically diverse (CALD) adolescents in Victoria, Australia, compared to their non-CALD peers. METHODS: Participants were senior secondary school students from diverse socioeconomic backgrounds. CALD adolescents (n = 426) spoke a language other than English at home, while non-CALD adolescents (n = 2,714) spoke only English. Outcomes were assessed using two vignettes depicting fictional characters with depression (with suicidal ideation) or anxiety. Multivariate linear or logistic regressions assessed the impact of CALD status on mental health literacy and stigma. P-values were adjusted using Holm's method, where applicable, to mitigate the increased risk of Type I errors due to multiple comparisons. RESULTS: Adolescents from CALD and non-CALD backgrounds showed similar help-seeking intentions for own mental health and willingness and confidence to assist peers. However, univariate and multivariate analyses consistently indicated that CALD adolescents were much less likely to recognise common mental health problems. Among CALD adolescents, 63.5% recognised depression with suicidal thoughts, compared with 84.2% of their non-CALD peers (odds ratio (OR) = 0.37 [95% CI: 0.21 to 0.63], p < 0.001); similarly, only 37.3% of CALD adolescents correctly recognised anxiety, compared with 61.8% among non-CALD ones (OR = 0.54 [95% CI: 0.33 to 0.87], p = 0.036). CALD adolescents also demonstrated significantly lower quality in helpful mental health first aid actions (β = -0.42 [95% CI: -0.70 to -0.14], p = 0.006) and stronger "weak-not-sick" stigmatising attitudes (β was 0.32 [95% CI: 0.20 to 0.43] for depression and 0.23 [95% CI: 0.10 to 0.35] for anxiety, respectively). CONCLUSION: These results suggest significant disparities in multiple components of mental health literacy and stigma among CALD Australian adolescents compared to their non-CALD peers, underscoring the need for the development and implementation of targeted interventions to address these inequities.
Psychological distress, PTSD, and complex PTSD in a war-torn population: a two-wave longitudinal study among medical students in Gaza.
Aldabbour B, Halimy M, Elottol Y … +2 more , Abuabada A, Dardas LA
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41894012 · Publisher ↗
BACKGROUND: Since October 2023, civilians in Gaza have endured prolonged military assaults, repeated displacement, and the collapse of essential services-conditions that impose severe, cumulative psychological trauma. Me...
BACKGROUND: Since October 2023, civilians in Gaza have endured prolonged military assaults, repeated displacement, and the collapse of essential services-conditions that impose severe, cumulative psychological trauma. Medical students constitute a particularly vulnerable civilian subgroup, balancing personal insecurity with clinical and academic duties amid war. This study examined how prolonged war exposure affects psychological distress and post-traumatic stress disorder (PTSD) and explored the prevalence and predictors of Complex PTSD (CPTSD) among medical students in Gaza. METHODS: We conducted a longitudinal study involving 74 medical students in Gaza across two time points (June 2024 and May 2025). Participants, enrolled in one of two local medical schools, completed validated Arabic versions of the Depression, Anxiety, and Stress Scale (DASS-21), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ). Changes in psychological symptoms over time were assessed using paired sample t-tests. Repeated-measures ANOVA was used to assess whether changes differed by gender, and multiple linear regression was used to identify predictors of CPTSD at the second screening in 2025. RESULTS: Significant changes were observed over time in displacement patterns and trauma exposure, with both forced migration and the number of traumatic events increasing markedly (p < 0.001). Although some reductions in symptom scores were observed, psychological distress and trauma-related symptoms remained high. Sixty-two (83.8%) and 56 (75.7%) of participants met the cutoff criteria for PTSD (PCL-5 instrument) in 2024 and 2025, respectively. In 2025, 39% of participants met ICD-11 criteria for PTSD (ITQ instrument), 19% met criteria for complex PTSD (CPTSD), and 28.4% reported disturbances in self-organization. Additionally, 64%, 43%, and 43% of participants reported severe to extremely severe levels of depression, anxiety, and stress, respectively, in 2025. Females consistently reported higher levels of distress across all domains, although changes over time did not significantly differ by gender. PTSD symptom severity in 2025 was the only significant predictor of CPTSD (β = 0.485, p < 0.001) in a model explaining 79% of the variance in CPTSD scores (R² = 0.806), while trauma exposure and general psychological distress were not significant predictors. CONCLUSION: Although general psychological symptoms showed modest improvement, the persistently high rates of PTSD and the emergence of complex PTSD underscore the long-term mental health effects of prolonged conflict in Gaza. These findings underscore the need to prioritize trauma-informed mental health interventions for Gaza's medical students-a group essential to the region's future healthcare system-addressing not only acute distress but also the cumulative effects of chronic trauma on identity, self-regulation, and functioning.
Visitation and stratification of help-seeking youth with mental health problems: a three-year follow-up study.
Madelaire LF, Rimvall MK, Jeppesen P … +1 more , Vassard D
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41879972 · Publisher ↗
PURPOSE: Stage-based stepped care approaches aim to address gaps between prevention and specialized treatment for mental disorders by directing proportionate interventions in a timely manner. We examined whether increasi...
PURPOSE: Stage-based stepped care approaches aim to address gaps between prevention and specialized treatment for mental disorders by directing proportionate interventions in a timely manner. We examined whether increasing stage level, assigned after visitation of youths seeking help in a primary care municipal setting, reflected an increased risk of adverse outcomes after three years. METHODS: Help-seeking youths (6-16 years) were stratified into three stages of developmental psychopathology based on the severity and impact of parent- and self-reported mental health problems corresponding to following levels of need for actions: low-intensity intervention (Stage 1); moderate-intensity preventive intervention, (Stage 2); suggested referral to specialized mental health services (Stage 3). Information on diagnosed mental disorders and prescription of psychotropic medications over the following 3.6 years (median follow-up) was retrieved from the Danish National Registries. Outcomes were compared across the staged groups and compared to an age-matched population-based comparison group (N = 16,980, reference group). RESULTS: Among 566 help-seeking youths, n = 74 (13%) were stratified to Stage 1, n = 436 (77%) to Stage 2, and n = 56 (10%) to Stage 3. Hazard ratios (95% confidence intervals) of receiving a psychiatric diagnosis during three years of follow-up were 3.2 (1.9-5.2) for Stage 1, 3.9 (3.2-4.8) for Stage 2, and 9.0 (6.2-13.3) for Stage 3. Similar stepwise increasing estimates were present regarding use of psychotropic medications, school absence and notifications of concern. CONCLUSION: Increased risk of later psychiatric morbidity with increased stage level supports the clinical utility of the stage-based stratification-model for early detection and treatment in the primary care sector.
The epidemiology of personality disorders in Norway: a nationwide patient registry study.
Valstad M, Eftedal NH, Yang T … +4 more , Kvarstein EH, Reichborn-Kjennerud T, Ystrom E, Czajkowski N
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41874590 · Publisher ↗
PURPOSE: To better understand the developmental course of personality disorders and the scope of diagnosis and treatment in specialist health care, we estimate incidence rates of specialist health care personality disord...
PURPOSE: To better understand the developmental course of personality disorders and the scope of diagnosis and treatment in specialist health care, we estimate incidence rates of specialist health care personality disorder diagnosis by age, gender, and calendar time, as well as lifetime risks, in the whole population of Norway. The measures provided are foundational for developmental theories of personality disorders, for treatment planning, and for later epidemiological studies. METHODS: We studied every person born 1940 or later and resident and at risk in Norway between January 1st, 2010 and December 31st, 2022 (n = 6,040,689). We used Poisson regression with penalized cubic splines to model incidences of personality disorder diagnosis across age, gender, and calendar time, and calculated lifetime risks while accounting for competing risks of death and emigration. RESULTS: Across specific disorders, incidence was highest in young adulthood. The lifetime risk of any personality disorder diagnosis in specialist health care was 5.4%. The two most incident specific diagnoses were borderline and avoidant personality disorders. Generally, incidence increased through the study period, with an incidence rate ratio (IRR) of 1.21 between 2022 and 2010 – this trend was largely due to borderline (IRR = 1.40) and avoidant (IRR = 1.66) personality disorder becoming more common. Lifetime risk of any personality disorder diagnosis was higher among women (cumulative incidence = 6.7%) than among men (cumulative incidence = 4.1%), and increased more through the study period among women (IRR = 1.34) than among men (IRR = 1.03). CONCLUSION: Personality disorders are common in the Norwegian population, often first identified in specialist health care during early adulthood.
Association of health screening participation with cardiovascular mortality and suicide in patients with schizophrenia and bipolar disorder.
Lim J, Mun K, Na B … +1 more , Lee Y
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41854716 · Publisher ↗
BACKGROUND: Patients with schizophrenia (SCZ) and bipolar disorder (BD) face higher risks of premature mortality from both natural (e.g., cardiovascular disease) and unnatural causes (e.g., suicide). Notwithstanding thes...
BACKGROUND: Patients with schizophrenia (SCZ) and bipolar disorder (BD) face higher risks of premature mortality from both natural (e.g., cardiovascular disease) and unnatural causes (e.g., suicide). Notwithstanding these findings, the impact of general health screening participation on mortality outcomes in this population remains underexplored. METHODS: Using the Korean National Health Insurance Database, this retrospective cohort study included 120,308 patients with SCZ and 147,221 patients with BD patients aged ≥ 20 years, newly diagnosed between 2007 and 2018. The primary exposure was participation in the national health screening program. Time-dependent Cox proportional hazards models, adjusted for demographic and clinical covariates, were used to assess associations between screening participation and all-cause, cardiovascular (CVD), and suicide mortality. RESULTS: Standardized mortality ratios were 4.67 for SCZ and 2.93 for BD compared to the general population. Screening rates were lower than the general population and varied by age, sex, income, and psychiatric comorbidity. Screening participation was associated with lower mortality hazards across all outcomes. Adjusted hazard ratios for all-cause, CVD, and suicide mortality were 0.63, 0.56, and 0.82 for SCZ, and 0.56, 0.43, and 0.75 for BD. Lower hazards of CVD mortality were most pronounced in those aged ≥ 40 years, while lower hazards of suicide were most notable in those < 40. DISCUSSION: Participation in national health screenings is associated with significantly lower mortality hazards among individuals with SCZ and BD. Integrating physical health assessments into psychiatric care and improving screening participation may help reduce mortality and health disparities in this population.
Prevalence and predictors of post-traumatic stress disorder, depression, and anxiety among community-dwelling women victim-survivors of intimate partner violence.
Astridge A, Copas C, Hannon O … +10 more , Martins BD, Knight JM, Ponsford J, Spitz G, Meyer S, McDonald SJ, Padgett C, Chen Z, Shultz SR, Symons GF
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41838071 · Publisher ↗
PURPOSE: We aimed to take a detailed approach to examine difference in the extent and nature of IPV victimisation and their association with PTSD, depression, and anxiety. METHODS: 100 community-dwelling IPV victim-survi...
PURPOSE: We aimed to take a detailed approach to examine difference in the extent and nature of IPV victimisation and their association with PTSD, depression, and anxiety. METHODS: 100 community-dwelling IPV victim-survivors and 59 controls in Melbourne completed a series of questionnaires on IPV, adverse childhood experiences (ACEs), brain injury, resilience, PTSD, depression, and anxiety. Prevalence of PTSD, depression, and anxiety in victim-survivors were compared to controls using chi-square tests. Then we used logistic regressions to examine differences in the nature and extent of IPV victimisation and their association with PTSD, depression, and anxiety. RESULTS: We found an increased prevalence of probable PTSD (52.3% versus 1.7%), depression (47.6% versus 5.1%) and anxiety (53.3% versus 9.5%) in community-dwelling victim-survivors compared to controls. More lifetime IPV experiences, increased number of IPV relationships, less time since the most recent IPV relationship, experiences of sexual IPV, increased ACEs, and lower resilience were factors significantly associated with PTSD, depression, and/or anxiety among victim-survivors. CONCLUSION: Overall, victim-survivors had an increased prevalence of adverse mental health outcomes. We found that several IPV experiences, ACEs, and resilience were significantly associated with the odds of probable PTSD, depression, and anxiety. Underscoring the complexity of IPV experiences and the need for trauma-informed care.
Parental death and parental substance use problems during childhood and the risk of DSM-5 substance use, suicidality and mental health disorders.
Giang CW, Evans-Polce RJ, Kcomt L … +5 more , Dickinson K, Gurnik H, Truchan J, Hess I, McCabe SE
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41824018 · Publisher ↗
PURPOSE: This study examines the associations between childhood parental death and parental substance-related problems and DSM-5 substance use disorders (SUDs), suicide attempt, and mental health discorders (mood, anxiet...
PURPOSE: This study examines the associations between childhood parental death and parental substance-related problems and DSM-5 substance use disorders (SUDs), suicide attempt, and mental health discorders (mood, anxiety, post truamatic stress) in adulthood.. METHODS: Using data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309), we compared four mutually exclusive groups who experienced the following before age 18: parental death and no parental substance use problems; parental substance use problems and no parental death; both parental death and parental substance use problems; and neither parental death nor substance use problems. We examined differences in adverse childhood experiences (ACEs), suicidality, and six DSM-5 SUD and mental health disorders. Parental death and parental substance-related problems were treated as exposures rather than included in the ACEs measure. RESULTS: Parentally-bereaved individuals who experienced parental substance-related problems reported significantly greater number of ACEs (M = 5.34) compared to all other groups. Parentally-bereaved individuals who experienced parental substance-related problems had greater odds of a suicide attempt and all six DSM-5 SUD and mental health disorder outcomes (aOR range = 2.06-3.59) compared to parentally-bereaved individuals without parental substance-related problems. They also had greater odds of a suicide attempt and four DSM-5 SUD and mental health disorders (aOR range = 1.19-1.46) compared to those who experienced parental substance use problems and no parental death. Some differences were attenuated in models adjusting for ACEs; however, differences remained for six of the seven outcomes. CONCLUSION: Individuals who experienced parental death and parental substance-related problems have increased risk for suicidality, DSM-5 SUD, and mental health disorders which may warrant additional trauma-informed mental health care in bereavement services.
A prospective study of VR-assessed state paranoia and anxiety suggests threat-related developmental pathways in adolescence.
Inan C, Samaey C, Vansteelandt K … +4 more , Lecei A, Gayer-Anderson C, Valmaggia L, van Winkel R
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41824017 · Publisher ↗
PURPOSE: Adolescence is a sensitive period for the emergence of subclinical psychotic experiences, including paranoid ideation. Understanding their developmental course in relation to common mental health difficulties su...
PURPOSE: Adolescence is a sensitive period for the emergence of subclinical psychotic experiences, including paranoid ideation. Understanding their developmental course in relation to common mental health difficulties such as anxiety, is important for clarifying etiological processes and potential progression to clinical psychosis. This study longitudinally examined the possible bidirectional relationship between anxiety and paranoia assessed in a Virtual Reality setting in adolescents aged 12 to 18 and the role of childhood threat experiences, as part of the EMBRACE study. METHODS: Data were collected in two waves, 18 months apart at baseline. State paranoia was assessed using the State Social Paranoia Scale (SSPS) in two distinct Virtual Reality (VR) environments. Anxiety was measured with the Revised Children's Anxiety and Depression Scale (RCADS25), while childhood threat exposure was evaluated using the Juvenile Victimization Questionnaire (JVQ). Linear and multiple regression analyses were conducted to examine associations and moderation effects. RESULTS: At baseline, 120 adolescents participated, of whom 97 completed both waves. State paranoia in a school canteen VR environment at baseline significantly predicted state paranoia in a VR bar environment 18 months later (β = 0.45, SE = 0.10, p < 0.001). Similarly, anxiety at baseline strongly predicted anxiety at follow-up (β = 0.46, SE = 0.10, p < 0.001), but no associations were found between state paranoia and anxiety over time in either direction. Childhood threat exposure moderated the relationship between baseline state paranoia and anxiety at follow-up (β = -0.17, SE = 0.06, p = 0.009), with adolescents experiencing higher state paranoia and threat exposure at baseline showing lower anxiety at follow-up. In contrast, the interaction between Wave 1 anxiety and Wave 1 childhood threat exposure in predicting follow-up state paranoia was non-significant (β = -0.17, SE = 0.11, p = .117). CONCLUSION: VR can capture subtle paranoid ideation in ecologically valid, dynamic social interactions that are consistent over time and across different VR environments. The developmental trajectories of paranoia and anxiety may diverge depending on childhood threat exposure, highlighting the role of early adversity in shaping their interplay.
Midlife exposure to neighborhood greenness and later-life cognitive decline: The Multi-Ethnic Study of Atherosclerosis.
Besser LM, Chang LC, Evenson KR … +12 more , Galvin JE, Heckbert SR, Hirsch JA, James P, Jimenez MP, Kaufman J, Lockhart SN, Mitsova D, Moore KA, Sachs BC, Hughes T, Roux AVD
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41824016 · Publisher ↗
PURPOSE: We investigated whether living in greener neighborhoods in midlife is associated with slower cognitive decline in later life. METHODS: We used data on 2,881 participants from the population-based Multi-Ethnic St...
PURPOSE: We investigated whether living in greener neighborhoods in midlife is associated with slower cognitive decline in later life. METHODS: We used data on 2,881 participants from the population-based Multi-Ethnic Study of Atherosclerosis. Geocoded residential addresses (1980–2009) were used to derive midlife neighborhood greenness exposure defined as a 10-year mean of annual normalized difference vegetation index values (based on satellite imagery) during the midlife period (ages 45–54). Cognitive testing over ~ 10 years, when the participants were ≥ 55-year-olds, captured global cognition and processing speed. Multivariable linear mixed effects regression estimated associations between the 10-year midlife greenness measure and global cognition and processing speed z-scores in later life and whether greenness-cognition associations varied by age at first cognitive visit. RESULTS: Greater midlife greenness was associated with slower annual decline in processing speed in the overall sample. We found no differences in associations by age at first cognitive visit. CONCLUSION: In an ethnoracially and geographically diverse US cohort, living in greener neighborhoods in midlife was associated with slower cognitive decline (i.e., processing speed) in later life.
Precariousness and depressed mood: a network analysis in the multi-ethnic HELIUS study.
Elsenburg LK, Stronks K, Galenkamp H … +5 more , Lakerveld J, Lok A, Park K, Vasconcelos VV, Nicolaou M
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41824015 · Publisher ↗
PURPOSE: Precariousness, which refers to experiencing a high level of insecurity and instability in life, manifests in multiple life dimensions and can give rise to mental health issues. Associations with mental health a...
PURPOSE: Precariousness, which refers to experiencing a high level of insecurity and instability in life, manifests in multiple life dimensions and can give rise to mental health issues. Associations with mental health are potentially influenced by migration background. In this study, we examine the associations between precariousness in different life dimensions and depressed mood among individuals with and without migration background. METHODS: We included 22,039 participants from the baseline measurement of the HELIUS (HEalthy LIfe in an Urban Setting) study, representing the six largest ethnic groups in Amsterdam. We used 13 indicators of precariousness in five life dimensions (employment, financial, housing, cultural and social), 9 assessed through a self-report questionnaire and 4 from neighborhood-level data. Depressed mood was classified as > 9 on the Patient Health Questionnaire (PHQ-9, Dutch version). Network models were applied, stratified by migration background. RESULTS: In total, 14.6% experienced depressed mood. Among those who experienced precariousness in at least four dimensions, the corresponding number was 22.1% to 46%, depending on the specific dimensions of precariousness that were experienced. Associations between depressed mood and indicators of precariousness were similar for those with and without a migration background. Depressed mood was associated with marginal work or unemployment, social satisfaction, social frequency, income inadequacy, discrimination, and financial difficulties, and additionally with lost friendship and health literacy among those with a migration background. CONCLUSION: Individuals with and without depressed mood differ markedly in their experience of precariousness, but associations are mostly consistent between those with and without a migration background.
Psychometric properties of WHO's schedules for clinical assessment in neuropsychiatry (SCAN): a systematic review.
Fekadu W, Mhiretu A, Alem A … +5 more , Brugha T, van Ommeren M, Chatterji S, Hanlon C, Fekadu A
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41801339 · Publisher ↗
BACKGROUND: WHO’s Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is often used as the gold standard for psychiatric classification. We systematically reviewed studies on the psychometric properties of SCAN t...
BACKGROUND: WHO’s Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is often used as the gold standard for psychiatric classification. We systematically reviewed studies on the psychometric properties of SCAN to support its adaptation to the revised international classification systems. METHODS: We searched PubMed, PsycINFO, Embase, Global Health, and Global Index Medicus up to April 17, 2025, and contacted experts. The protocol was registered in PROSPERO (CRD42024522395). RESULTS: Titles and abstracts of 4,241 records were screened, with 296 full-text articles evaluated. Ninety-three articles were included in the final review: forty-six assessing SCAN’s psychometric properties and 47 validating other measures using SCAN as a gold standard. The internal consistency of the SCAN and its predecessor, the Present State Examination (PSE), ranged from good to excellent. Both demonstrated acceptable intra-rater, inter-rater, and test-retest reliability, with reliability especially high for psychotic disorders. There was also evidence supporting concurrent, construct, semantic, and content validity, although there was an absence of evidence for predictive validity. We also found acceptable psychometric properties for the different syndrome-based sections of the SCAN. CONCLUSION: Although recent, high-quality studies are scarce, the SCAN is a promising tool for diagnosing a variety of psychiatric issues, particularly psychotic disorders. It demonstrates established reliability and evidence of concurrent, construct, semantic, and content validity. However, there is a need to revise the current version of SCAN to align it with contemporary diagnostic systems. Additionally, further research is required, especially regarding the assessment of non-psychotic conditions.
Alcohol use disorder and associated factors among individuals with severe mental illnesses in Africa: a systematic review and meta-analysis.
Kelebie M, Kibralew G, Tadesse G … +8 more , Nakie G, Takelle GM, Ali D, Gashaw F, Muche M, Workie Y, Yiglet Z, Fentahun S
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41790247 · Publisher ↗
BACKGROUND: Alcohol Use Disorder (AUD) is a major global contributor to disability and mortality, significantly adding to the overall disease burden. It is particularly prevalent among individuals with severe mental illn...
BACKGROUND: Alcohol Use Disorder (AUD) is a major global contributor to disability and mortality, significantly adding to the overall disease burden. It is particularly prevalent among individuals with severe mental illnesses (SMI), such as bipolar disorder (BD), schizophrenia (SCZ), and major depressive disorder (MDD), and is often accompanied by comorbid psychiatric conditions that further exacerbate its effects. Due to impairments in memory, cognitive control, mood regulation, impulsivity, and emotional stability, individuals with mental health disorders-including schizophrenia and mood disorders-are at an increased risk of developing AUD. This review aims to determine the pooled prevalence of AUD and identify its associated factors among individuals with severe mental illness in Africa. METHODS: Primary studies were systematically retrieved from PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library. This review included twenty original research articles that examined the prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness in Africa. Data extraction and article evaluation were independently performed by two reviewers to ensure accuracy and minimize bias. All studies included in the meta-analysis underwent a rigorous quality assessment, and only those with a score of 5 or higher on the evaluation criteria were incorporated into the final analysis. Given the heterogeneity among the included studies, a random-effects meta-analysis was employed, and potential publication bias was evaluated using Egger's weighted regression test, funnel plots, and trim-and-fill plots. The review protocol was prospectively registered with PROSPERO (ID: CRD42024535636). RESULTS: This review included 20 primary studies encompassing a total of 7,540 participants. The pooled prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness (SMI) was 33.26% (95% CI: 26.41-40.12). Factors significantly associated with AUD included male sex (OR = 3.45; 95% CI: 2.13-5.59), younger adults (OR = 3.12; 95% CI: 1.92-5.08), participants reporting current cigarette use (OR = 4.80; 95% CI: 3.03-7.69), and a family history of alcohol use (OR = 3.25; 95% CI: 2.82-4.65). CONCLUSION: This review reveals that Alcohol Use Disorder is highly prevalent among individuals with severe mental illness in Africa. The findings indicate that being male, younger adults, participants reporting current cigarette use, or having a family history of alcohol use significantly increases the risk of AUD. These results emphasize the importance of incorporating targeted screening, early intervention, and integrated treatment approaches into mental health services to effectively address and reduce the impact of AUD within this population.
Youth mental health treatment gap in lebanon: correlates of barriers to accessing child and adolescent mental health services (CAMHS).
Bolhuis K, Shamseddeen W, Ghandour LA … +2 more , Elbejjani M, Maalouf FT
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41784655 · Publisher ↗
PURPOSE: The mental health treatment gap is an important issue for young people in the East Mediterranean Region as financial constraints and cultural factors continue to play a limiting role. This paper examined predict...
PURPOSE: The mental health treatment gap is an important issue for young people in the East Mediterranean Region as financial constraints and cultural factors continue to play a limiting role. This paper examined predictors and barriers for help-seeking for mental health problems in children and adolescents in Lebanon. METHODS: The Psychopathology in Children and Adolescents in Lebanon Study, a nationally-representative household sample of n = 1,517 youth aged 5-17 years, was used. Parents and adolescents completed several self-reported mental health questionnaires, and a demographic information sheet. Potential barriers to care utilization assessed included: (i) discomfort in discussing mental health, (ii) stigmatization, (iii) distrust in effectiveness of mental healthcare, (iv) costs, (v) unavailability of nearby services. Regression models were conducted to examine the correlates of help-seeking for psychiatric disorders. RESULTS: Of the n = 498 youth with a positive screen for a psychiatric disorder, only n = 25 (5.0%) reported ever receiving professional mental healthcare services. Male gender, receiving school accommodation, higher parent-reported hyperactivity and depression were associated with help-seeking after adjustment for other variables. For children with a positive screen who had not sought help, the most often endorsed barriers were costs (22.3% major barrier) and unavailability of nearby services (16.1% major barrier). CONCLUSION: This study showed that costs and unavailability of nearby services were the biggest barriers to help-seeking among children and adolescents in Lebanon, underscoring the importance of incorporating mental health in public health policies and budget allocation in the East Mediterranean Region.
Mortality following cancer diagnosis among people with non-affective psychoses: mediation by stage at diagnosis and time to treatment initiation.
Wootten JC, Richard L, Karp I … +3 more , Blanchette PS, Solmi M, Anderson KK
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41784654 · Publisher ↗
BACKGROUND: People with psychotic disorders have greater mortality rates following cancer diagnosis, compared to people without psychotic disorders. Prior examinations of the effect of psychotic disorders on survival fol...
BACKGROUND: People with psychotic disorders have greater mortality rates following cancer diagnosis, compared to people without psychotic disorders. Prior examinations of the effect of psychotic disorders on survival following cancer diagnosis mediated by stage at diagnosis and treatment disparities did not accommodate for multiple mediators and post-exposure confounding. The present study sought to estimate analogues of the natural indirect effects of having NAPD on mortality following cancer diagnosis, mediated through stage at diagnosis and time to treatment initiation. METHODS: We identified cases of cancer diagnosed between 1995 and 2019 among people with non-affective psychotic disorders (NAPD) and a comparison group without NAPD, constructed using Ontario health administrative data. Death from any cause was identified using register data. Inverse probability of treatment weighted Cox models were used to estimate the effect of NAPD on mortality following cancer diagnosis mediated by stage at diagnosis and time to treatment initiation, adjusting for relevant confounders. RESULTS: The analytic sample included 3,643 people with NAPD and 15,174 people without NAPD who developed cancer. People with NAPD had a 66% greater adjusted hazard of all-cause mortality than people without NAPD (95%CI = 1.55,1.78). The HR estimate for the indirect effect mediated through stage at diagnosis was 1.09 (95%CI = 1.05,1.13) and HR estimate for the indirect effect mediated through time to treatment initiation was 1.00 (95%CI = 0.96,1.04). CONCLUSIONS: Our findings suggest that a relatively small proportion of the effect of NAPD on mortality is mediated by stage at diagnosis, while time to treatment initiation does not mediate that effect. This excess risk is potentially mediated by other patient, provider, and system-related factors in cancer care.
Gender-specific economic interventions for women's mental health and well-being in South Asia: a systematic review.
Katiyar J, Keynejad R
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41784653 · Publisher ↗
BACKGROUND: The prevalence of common mental disorders (CMDs) in South Asia is higher among women than men. Reasons include lower socioeconomic status and greater exposure to social, economic and environmental disadvantag...
BACKGROUND: The prevalence of common mental disorders (CMDs) in South Asia is higher among women than men. Reasons include lower socioeconomic status and greater exposure to social, economic and environmental disadvantage. Economic determinants are important, modifiable risk factors for CMDs. AIMS: This systematic review aimed to evaluate the evidence for impacts of economic interventions on women's well-being and CMD outcomes in South Asia. METHOD: We searched for peer-reviewed quantitative research studies in eight databases (3ie, EconLit, Embase Classic, Embase, Global Health, J-PAL, Medline, APA PsychInfo, Scopus) and studies included in relevant systematic reviews of economic interventions which measured CMDs and well-beingamong female participants in South Asia. We assessed the risk of bias of included studies using the Joanna Briggs Institute checklist. Following data extraction, we synthesised our findings through narrative synthesis. RESULTS: We identified eight eligible studies evaluating five types of economic intervention: microfinance, employment, conditional cash transfers, self-help groups (SHGs) and economic empowerment programmes. Studies were conducted in Afghanistan (n = 1), Bangladesh (n = 2) and India (n = 5). Approximately 60% of studies reported statistically significant associations between receipt of economic interventions and improved CMD symptoms or well-being among female participants. Risk of bias was moderate and study designs were heterogeneous. Attention to gendered risks of economic interventions in countries with strong patriarchal norms was limited. CONCLUSION: The limited published evidence suggests that economic interventions can have positive impacts on CMDs and well-being among women in South Asia. However, methodological limitations and lack of geographical representation mean that further research is needed to evaluate the risks and benefits of economic interventions for diverse women in South Asia.
Basaglia: the psychiatrist as intellectual, theoretician, and activist for a dialogic citizen psychiatry.
Becker T, Degano-Kieser L, Stanghellini G
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41770334 · Publisher ↗
PURPOSE: Franco Basaglia (1924–1980) was a psychiatrist who played an important role in transforming mental health care in Italy during the 1960s and 1970s. Current mental health debates focus on community care, recovery...
PURPOSE: Franco Basaglia (1924–1980) was a psychiatrist who played an important role in transforming mental health care in Italy during the 1960s and 1970s. Current mental health debates focus on community care, recovery, and co-production. Against this background, the paper describes theoretical references used by Basaglia and colleagues to psychiatric phenomenology, Jean-Paul Sartre, and Michel Foucault, and the role of psychiatrists as professionals and intellectuals, with a view to their relevance to current mental health care issues. METHODS: The paper is based on a non-systematic search and meta-narrative review of sources in Italian, French. and German, including the Archivio Basaglia in Venice, Italy. RESULTS: Basaglia and colleagues were influenced by phenomenology, Sartre, and Foucault. The tradition of psychiatric phenomenology helped in focusing on the ‘person’, the ‘body’, and the deprivation of individual rights among mental hospital patients. Sartre’s concepts of a ‘personal ontology of freedom’ evolving towards collective action found an echo in Foucault’s archaeology of madness which highlighted the societal construction of madness and emphasized the knowledge-power link in professional practice. Basaglia insisted on linking theory to anti-institutional work and psychiatric reform practice. CONCLUSION: Basaglia’s thinking helped mobilize forces toward reform, and his focus on co-production of psychiatric knowledge with experts by experience was ahead of its time. This could help sharpen the concept of recovery during the current crisis of European mental health reform, moving in the direction of more pronounced attention towards the (non-market) economic concepts of social choice and common goods, and towards more user-controlled services.
Risk factors for repeat self-harm hospitalisation following hospital admissions for suicidal ideation and self-harm among Aboriginal and non-Aboriginal people: a retrospective cohort study using linked administrative data.
Leckning B, Borschmann R, Hirvonen T … +3 more , Silburn SR, Guthridge S, Robinson GW
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41758224 · Publisher ↗
PURPOSE: The Northern Territory (NT) experiences the highest rates of hospitalisations involving self-harm in Australia, especially amongst Aboriginal people. Given self-harm is a strong predictor of suicide risk, it is...
PURPOSE: The Northern Territory (NT) experiences the highest rates of hospitalisations involving self-harm in Australia, especially amongst Aboriginal people. Given self-harm is a strong predictor of suicide risk, it is important to identify the distinct risk factors for a repeat hospitalisation involving self-harm amongst Aboriginal and non-Aboriginal people in the NT hospitalised for suicidal ideation and self-harm. METHODS: A retrospective cohort study was designed to follow-up patients with a first hospital admission involving suicidal ideation and/or self-harm between 1 July 2001 and 31 December 2013. Survival analysis techniques were used to estimate probability of and risk factors for repeat hospitalisation involving self-harm up to 31 December 2018 for Aboriginal and non-Aboriginal people separately. RESULTS: The risk of repeat hospitalisation involving self-harm was higher (HR 1.39; 95% CI: 1.22-1.59) amongst Aboriginal (n = 2,304) than non-Aboriginal people (n = 2,087). Compared to suicidal ideation only at first hospital admission, a higher risk of repetition was observed for any self-harm method (aHR: 1.71; 95% CI: 1.37-2.12) amongst Aboriginal people and self-poisoning only (aHR: 1.45; 95% CI: 1.13-1.85) amongst non-Aboriginal people. Previous substance misuse was associated with a higher risk of repeat hospitalisation involving self-harm for Aboriginal (aHR: 1.7; 95% CI: 1.38-2.1) and non-Aboriginal (aHR: 1.6; 95% CI: 1.14-2.25) people. For non-Aboriginal people, several mental health diagnoses were associated with higher risks of repetition. CONCLUSION: The distinct risk factors for repeat hospitalisation involving self-harm between Aboriginal and non-Aboriginal people emphasises the importance of comprehensive psychosocial assessment and culturally tailored clinical interventions and community-based solutions to properly understand and address risk factors for each group.
Prevalence and associations of lifetime, 12-month, and 30-day suicidal thoughts and behaviours among 3,702 First-Year university students in New Zealand.
Mason A, Winter T, Fortune S … +2 more , Taumoepeau M, Rapsey CM
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41758223 · Publisher ↗
BACKGROUND: Reliable epidemiological data about the prevalence, age-of-onset, and correlates of suicide-related outcomes are critical for effective suicide prevention. The present study aimed to investigate the lifetime...
BACKGROUND: Reliable epidemiological data about the prevalence, age-of-onset, and correlates of suicide-related outcomes are critical for effective suicide prevention. The present study aimed to investigate the lifetime and past 12-month prevalence of suicidal thoughts, plans, attempts. We then investigated whether these outcomes were associated with socio-demographic variables and mental disorders among first-year university students in New Zealand. METHODS: Data were collected between 2021 and 2023 through online self-report surveys as part of New Zealand's contribution to the World Mental Health International College Surveys initiative. The final sample consisted of n = 3,702 first-year university students (overall response rate: 24.2%). Suicide-related outcomes were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS). Weighted prevalence estimates were calculated and data were analysed using multivariable statistical methods. RESULTS: Overall, 54.1% of respondents reported experiencing suicidal thoughts across their lifetime, with 29.6% having made a suicide plan, and 10.1% making at least one suicide attempt. Twelve-month prevalence of these outcomes was 37.4% (thoughts), 29.5% (plan), and 2.9% (attempt), respectively, and 12-month persistence among lifetime cases for these outcomes ranged from two-thirds for ideation to one-quarter for attempts. Non-heterosexual orientation and experiences of Major Depressive Disorder, Bipolar Disorder, or Post-Traumatic Stress Disorder were associated with greater likelihood of suicide-related outcomes. CONCLUSIONS: Suicide-related outcomes are highly prevalent and persistent among first-year university students in New Zealand. Our findings demonstrate that specific demographic characteristics and experiences of mental disorder are associated with greater likelihood of suicide-related outcomes and highlight the need for effective initiatives to support first-year university students.
Racial discrimination in healthcare and public settings as a predictor of suicidal ideation onset among U.S. Adults with baseline depressive symptoms.
Kim S, Tang F, Wilkialis L … +3 more , Hassan AN, Fung KP, Le Foll B
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41758222 · Publisher ↗
PURPOSE: Suicide is one of the leading causes of death globally. Few studies have assessed whether racial discrimination in healthcare settings, as distinct from discrimination in other public settings, predicts the onse...
PURPOSE: Suicide is one of the leading causes of death globally. Few studies have assessed whether racial discrimination in healthcare settings, as distinct from discrimination in other public settings, predicts the onset of suicidal ideation among a nationally representative sample of U.S. adults with depressed mood or anhedonia at baseline to inform clinical and structural interventions. METHODS: Data were drawn from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), yielding a total analytic sample of 2,123 participants. Multivariate logistic regression was used to examine associations between perceived racial discrimination in healthcare or public settings and the onset of SI at three-year follow-up (Wave 2). Sociodemographic correlates of SI were also examined. RESULTS: Among the analytic sample (n = 2,123), 205 participants (9.7%) developed new‑onset SI, and 36 (1.7%) reported a new‑onset SA over the three‑year follow‑up. Healthcare-based racial discrimination was strongly associated with SI onset (aOR = 1.63; 95% CI: 1.12–2.38), whereas racial discrimination in a public setting showed a smaller association with SI after adjusting for sociodemographic factors (aOR = 1.25; 95% CI: 0.98–1.58). CONCLUSION: These findings suggest that perceived racial discrimination in healthcare may represent a significant risk factor for SI. Future research is needed to replicate these findings and investigate underlying mechanisms to inform targeted suicide prevention efforts among vulnerable populations.
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