Social Psychiatry And Psychiatric Epidemiology[JOURNAL]
Sun
200 papers
Beyond the sum of its parts: a scoping review on complex mental health care needs.
Luna VS, Joris M, Geert D … +3 more , Johan F, Marianne D, Broeck Kris VD
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41739159 · Publisher ↗
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Prevalence, determinants, and Help-Seeking behavior for major depressive disorder symptoms in the Lesotho population: A multilevel analysis from the Lesotho demographic and health survey 2023-24.
Noor STA, Yeasar S, Siddique S … +3 more , Das O, Tanvir SU, Islam RB
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733637 · Publisher ↗
PURPOSE: Major depressive disorder (MDD) is one of the most common mental health conditions worldwide, yet studies on this issue are scarce in Lesotho. The purpose of this study is to estimate the prevalence and associat...
PURPOSE: Major depressive disorder (MDD) is one of the most common mental health conditions worldwide, yet studies on this issue are scarce in Lesotho. The purpose of this study is to estimate the prevalence and associated factors of MDD symptoms, as well as help-seeking behavior among participants with MDD symptoms in Lesotho. METHODS: This study utilized data from the nationally representative, cross-sectional Lesotho Demographic and Health Survey (LDHS) 2023–2024. MDD symptoms were assessed using the Patient Health Questionnaire (PHQ-9), with scores of 10 or above classified as present. Multilevel mixed-effects logistic regression was employed to identify factors associated with MDD symptoms, accounting for the hierarchical nature of the data. RESULTS: Among the 6,481 respondents, the weighted prevalence of MDD symptoms was 6.3% (95% CI: 5.5, 7.2), with women (7.4%) experiencing a notably higher burden than men (5.2%). Specifically, women had 75% (AOR = 1.75, 95% CI: 1.35, 2.27) higher odds of MDD symptoms compared to men. Individuals residing in households with fewer than four people and those who used tobacco were also more likely to experience MDD symptoms. Conversely, rural residence was associated with a 45% lower likelihood of MDD symptoms (AOR = 0.55, 95% CI: 0.39, 0.77). Geographic disparities were evident, with Mohale’s Hoek showing higher odds (AOR = 3.19, 95% CI: 1.82, 5.58) and Mokhotlong showing lower odds (AOR = 0.36, 95% CI: 0.13, 0.97) than Maseru. Among individuals experiencing MDD symptoms, only 22.5% sought any form of help, and just 6.5% reported using medication for their condition. CONCLUSION: This study highlights a substantial mental health burden in Lesotho, with MDD symptoms influenced by sociodemographic and geographic factors. Low help-seeking rates emphasize the urgent need for comprehensive mental health strategies. Recommendations include strengthening community-based care, integrating mental health into primary care, reducing stigma through awareness, and improving service accessibility and affordability, particularly for vulnerable and underserved populations.
When stress Meets severity: dual pathways to depression among people with disabilities.
Lee GM, Lee HJ, Kim JH
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733636 · Publisher ↗
PURPOSE: This study investigated the interactive effects of disability severity and disability-related stress on depression among adults with disabilities in Korea, while also considering sociodemographic, behavioral, an...
PURPOSE: This study investigated the interactive effects of disability severity and disability-related stress on depression among adults with disabilities in Korea, while also considering sociodemographic, behavioral, and health-related factors. METHODS: We used three waves (2016–2018) of the nationally representative Panel Survey of Employment for the Disabled (PSED). The analytic sample included 4,349 respondents aged 15–64 years. Depression was self-reported (past-year). Independent variables were disability-related stress, disability severity, and their interaction. Multivariable logistic regressions estimated adjusted odds ratios (ORs) and 95% CIs; subgroup analyses were conducted by sex and age. RESULTS: Compared with no stress and mild disability, high stress with mild disability (OR = 8.16) and high stress with severe disability (OR = 9.23) were associated with markedly higher odds of depression, while marital status and employment were protective. In contrast, poor self-rated health and the need for regular treatment increased risk. Stratified analyses confirmed robustness across sex and age, and metropolitan residence showed an additional protective association. CONCLUSION: Our findings suggest that disability-related stress and disability severity jointly shape depression risk, indicating cumulative disadvantage. Policies should integrate stress management, accessible mental health care, and social participation (e.g., employment support, family/social networks) to promote health equity for people with disabilities in Korea.
Have public attitudes towards people with mental health conditions shifted in Singapore? Results from the mental health literacy study.
Gunasekaran S, Tay EH, Shahwan S … +8 more , Tan YB, Ong WJ, Tan BCW, Shafie S, Poh P, Abdin E, Chong SA, Subramaniam M
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41733635 · Full text
BACKGROUND: Public attitudes towards people with mental illnesses (PMI) shape their inclusion in society. In recent years, Singapore has introduced several nationwide mental health initiatives, including destigmatisation...
BACKGROUND: Public attitudes towards people with mental illnesses (PMI) shape their inclusion in society. In recent years, Singapore has introduced several nationwide mental health initiatives, including destigmatisation efforts. The present study explored the differences in attitudes among the Singapore public in 2023 compared to 2015, and the sociodemographic correlates of attitudes in 2023. METHODS: Nationwide studies were conducted with residents in 2014–2015 (N = 3006) and 2022–2023 (N = 4195). Attitudes towards PMI included four factors: (1) social distancing, (2) tolerance/support for community care, (3) social restrictiveness, and (4) prejudice and misconception. Lower scores indicate better attitudes except for tolerance/support, where higher scores indicate better attitudes. Linear regression analysis was conducted to evaluate the differences in attitudes between 2015 and 2023, and multivariate linear regression was conducted to examine the sociodemographic correlates for each factor score. RESULTS: Respondents scored significantly better in 2023 as compared to 2015 for all factors (p < 0.001): social distancing (7.19 vs. 8.07), tolerance/support (15.23 vs. 14.81), social restrictiveness (6.22 vs. 7.21), and prejudice and misconception (14.06 vs. 15.36). Age, gender, marital status, ethnicity, educational levels and income levels were associated with attitudes in various domains. DISCUSSION & CONCLUSION: Improved public attitudes indicate a less stigmatising society. However, certain demographics continue to display poorer attitudes, underscoring the need for targeted interventions. Future efforts should integrate mental health promotion with primary care settings, engage community leaders, and provide opportunities for contact with PMI. Further research could also examine how factors such as prior contact with PMI shape these attitudes.
Early-Age onset of psychotic spectrum symptoms is highly prevalent and associated with greater illness severity in schizophrenia spectrum disorders that develop later in life.
Carmellini P, Cuomo A, Magno M … +4 more , Martella D, De Girolamo G, Gualtieri G, Fagiolini A
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733634 · Publisher ↗
AIMS: Early identification of symptoms in schizophrenia spectrum disorders (SSD) may improve clinical outcomes, yet the temporal trajectory and prognostic relevance of initial symptom dimensions remain unclear. This stud...
AIMS: Early identification of symptoms in schizophrenia spectrum disorders (SSD) may improve clinical outcomes, yet the temporal trajectory and prognostic relevance of initial symptom dimensions remain unclear. This study aimed to identify the earliest emerging symptoms among individuals with SSD and investigate their association with illness severity using a dimensional, data-driven approach. METHODS: We conducted a cross-sectional observational study including 160 adults with SSD, diagnosed using the via the Structured Clinical Interview for DSM-5 (SCID-5). Participants completed the Structured Clinical Interview for the Psychotic Spectrum - Self-Report (PSY-SR) PSY-SR questionnaire, which assesses lifetime psychotic spectrum symptoms across five domains: interpersonal sensitivity, paranoid traits, schizoid traits, misperceptions, and typical psychotic symptoms, with retrospective reporting of age at symptom onset. K-means clustering classified patients by severity based on total PSY-SR scores. Multinomial logistic regression identified factors linked to the more severe cluster. RESULTS: Two clusters were identified: Cluster 1 (less severe; n = 91) and Cluster 2 (more severe; n = 69). Cluster 2 had higher PSY-SR scores (81.2 vs. 42.0) and earlier symptom onset, particularly for interpersonal sensitivity (15.7 vs. 18.8 years, p = 0.013) and typical psychotic symptoms, including hallucinations and delusions (22.0 vs. 26.5 years, p < 0.001). In contrast, age at onset of paranoid traits and misperceptions did not significantly differ between clusters. FGA use was associated with Cluster 2 membership, likely reflecting greater clinical severity. (OR = 5.10, p = 0.008). Later onset of interpersonal sensitivity and typical psychotic symptoms was associated with reduced severity, lowering the probability of Cluster 2 membership by around 50% per additional year. CONCLUSIONS: In a cross-sectional sample of adults with SSD, earlier onset of interpersonal sensitivity and typical psychotic symptoms in SSD predicted worse outcomes. These findings support a dimensional understanding of symptom heterogeneity within SSD and suggest that systematic assessment of subthreshold and spectrum-level symptoms may contribute to improved early detection, risk stratification and more personalised interventions.
The effectiveness of high-intensity interval training (HIIT) in adults with psychiatric disorders: a scoping review.
Pan A, Piccirilli L, Capuzzi E … +1 more , Buoli M
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733633 · Publisher ↗
BACKGROUND: Psychiatric disorders are associated with significant disability, and patients sometimes respond partially to conventional therapies. OBJECTIVES: Purpose of the present manuscript is to summarize the availabl...
BACKGROUND: Psychiatric disorders are associated with significant disability, and patients sometimes respond partially to conventional therapies. OBJECTIVES: Purpose of the present manuscript is to summarize the available literature on the effectiveness of high-intensity interval training (HIIT) in patients affected by mental conditions. The primary research question is whether HIIT can improve the symptoms of various psychiatric conditions, possibly in augmentation to standard therapies. METHODS: The review was conducted following the PRISMA guidelines adapted for scoping reviews. A bibliographic search was conducted on the following database sources: Pubmed, Embase and Scopus. English-language publications about HIIT intervention in adult patients with mental disorders were reviewed. Fourteen studies met the inclusion criteria and were finally included in this review. RESULTS: HIIT contributes to reduce the global severity of illness of several psychiatric conditions, with an effectiveness at least comparable to other non-pharmacological approaches (effect size d range: 0.36–2.10). Most studies regard patients affected by schizophrenia or depressive disorders. CONCLUSIONS: HIIT may be considered a complementary option to improve symptoms of several psychiatric conditions. More studies are needed to identify the best patient profile for this protocol.
Mapping the evolution of stigmatization in mental disorders: A bibliometric analysis from 1974 to 2024.
Goktas P, Dikec G
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41733632 · Full text
BACKGROUND: This bibliometric study scrutinizes the thematic evolution of research on stigma and discrimination in mental disorders, covering a span of five decades. It reflects on the shifting paradigms within the stigm...
BACKGROUND: This bibliometric study scrutinizes the thematic evolution of research on stigma and discrimination in mental disorders, covering a span of five decades. It reflects on the shifting paradigms within the stigma-focused mental health research community from 1974 to 2024. METHODS: A comprehensive bibliometric analysis was employed using the Bibliometrix R package and VOSviewer software, analyzing 1,892 articles from databases like Scopus, Web of Science, PubMed Central, and APA PsycInfo. Adherence to PRIBA guidelines ensured a holistic representation of the evolving research narrative. RESULTS: The analysis outlined three distinct periods: the Genesis Period (1974 - 2007), focusing on foundational concepts of mental disorders and stigma; the Growth Period (2008 - 2015), which experienced a broadening into themes of discrimination and diagnostic refinement; and the Rapid Growth Period (2016 - 2024), characterized by a surge in research on child mental disorders and the impacts of posttraumatic stress disorder. Network analyses highlighted significant journals, key authors, and international collaborations that have shaped this field. CONCLUSIONS: The study maps a significant transformation in stigma-focused mental health research themes over fifty years, highlighting the growing complexity and the need for ongoing research into stigma and discrimination. It calls for interdisciplinary approaches to tackle these enduring challenges effectively.
Psychotropic medication non-adherence and its determinants among adult psychiatric patients in Ethiopia.
Getnet M, Gashaw F, Salelew E … +2 more , Fanta B, Kelebie M
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733631 · Publisher ↗
BACKGROUND: Mental illness remains a significant global public health concern, yet it is largely manageable through psychotropic medications and psychotherapy. However, non-adherence to prescribed psychotropic medication...
BACKGROUND: Mental illness remains a significant global public health concern, yet it is largely manageable through psychotropic medications and psychotherapy. However, non-adherence to prescribed psychotropic medications is a major barrier to effective treatment and long-term symptom control. This challenge compromises clinical outcomes, increases relapse rates, and places a burden on healthcare systems. Understanding the extent and contributing factors of medication non-adherence is essential for designing targeted interventions at both clinical and community levels. This study aims to assess the prevalence of psychotropic medication non-adherence and identify its determinants among adult psychiatric patients in Ethiopia. METHODS: An institution-based cross-sectional study was carried out between November 1 to November 30, 2024, among adult psychiatric outpatients who were diagnosed according to DSM-5-TR criteria and were receiving psychotropic treatment. Participants were selected using a consecutive sampling technique. Medication non-adherence was assessed using the 10-item Medication Adherence Rating Scale (MARS). Data were collected through face-to-face interviews and review of medical records. Bi-variable and multivariable binary logistic regression analyses were performed to identify associated factors, with statistical significance set at p-value < 0.05. RESULTS: Out of a total of 418 participants, the prevalence of psychotropic medication non-adherence was 44.7% (95% CI: 40.0-50.0). Factors significantly associated with non-adherence included experiencing medication side effects (AOR = 4.67, 95% CI: 2.68-8.16), Lack of enrollment in the Community-Based Health Insurance scheme (AOR = 2.41, 95% CI: 1.06-5.5), current substance use (AOR = 6.71, 95% CI: 2.01-22.36), presence of comorbid medical illness (AOR = 5.42, 95% CI: 1.79-16.4), and perceived stigma (AOR = 3.63, 95% CI: 1.91-6.87). CONCLUSION: Nearly half of the adult psychiatric outpatients in this study were non-adherent to psychotropic medications. Key factors associated with non-adherence included medication side effects, Lack of enrollment in the Community-Based Health Insurance scheme, current substance use, comorbid medical conditions, and perceived stigma. These findings highlight the need for integrated interventions addressing both clinical and psychosocial barriers to improve medication adherence and treatment outcomes among psychiatric patients in Ethiopia. Targeted strategies should be implemented at both healthcare facility and community levels.
Family immigration status and suicidal thoughts and behaviors in Latino adolescents in California.
Platt R, Creedon T, Alvarez K … +2 more , Stuart EA, Wilcox HC
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41733630 · Publisher ↗
PURPOSE: To examine the relationship between family immigration status and adolescent suicidal thoughts and behaviors (STB) in a population-based sample of Latino youth in California, and, to examine whether gender moder...
PURPOSE: To examine the relationship between family immigration status and adolescent suicidal thoughts and behaviors (STB) in a population-based sample of Latino youth in California, and, to examine whether gender moderates the association between family immigration status and youth STB. METHODS: Using linked parent and adolescent data from the 2011-2019 California Health Interview Survey (CHIS) (N = 3,155 adolescents self-identifying as Hispanic/Latino), we built a series of logistic regression models, calculating adjusted odds of STB and including a gender-by-family citizenship status interaction term. RESULTS: . Overall, adolescents in mixed status dyads (in which the child was a citizen and the parent child was not a citizen or Lawful Permanent Resident (LPR)), and non-citizen adolescents were less likely to report STB compared to adolescents in dyads where both parent and child were citizens (prevalence of past year suicidal ideation 3.5%, 1.6% and 7.0%, respectively). However, differences emerged by gender. CONCLUSIONS: Latino youth are not a monolith in terms of risk and protective factors for STB. Further research is needed to understand differences within Latino communities to inform suicide prevention efforts.
The relationship between complex PTSD and dissociation: longitudinal findings across Western and South Asian female samples.
Fung HW, Lay CM, Yuan GF … +16 more , Chau AKC, Reyes MES, Jaya ES, Mukhtar F, Lian AEZ, Derin G, Bengwasan PD, Kuriala GK, Uludag K, Hartanto S, Dewantary NI, Novrianto R, Zhang ZJ, Huang CHO, Wang SC, Lam SKK
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41697343 · Publisher ↗
PURPOSE: Post-traumatic stress disorder (PTSD) and dissociation are common responses to trauma, especially interpersonal and betrayal trauma. Dissociation has been proposed to be a core concept in understanding PTSD. How...
PURPOSE: Post-traumatic stress disorder (PTSD) and dissociation are common responses to trauma, especially interpersonal and betrayal trauma. Dissociation has been proposed to be a core concept in understanding PTSD. However, little is known about the bidirectional relationship between dissociation and ICD-11 complex PTSD (CPTSD) symptoms. This study examined the relationship between classical PTSD, disturbances in self-organization (DSO), and dissociative symptoms across two culturally different samples. METHODS: Participants from Western and South Asian countries completed validated measures of PTSD, DSO, and dissociation two times, approximately six months apart. RESULTS: Across the Western (N = 101) and South Asian (N = 160) samples, at baseline, 71.7% to 84.2% of participants with probable CPTSD exhibited co-occurring dissociative symptoms, while 70.0% to 72.3% of participants with dissociative symptoms had probable PTSD or CPTSD. Dissociative symptoms were less common in participants with probable PTSD (20.0% to 28.6%). In addition, dissociative symptoms predicted subsequent levels of classical PTSD symptoms across the two samples (β = 0.241 to 0.246, p < .01). The predictive role of dissociative symptoms on DSO symptoms was only observed in the South Asian sample (β = 0.231, p = .011). Neither PTSD nor DSO symptoms predicted dissociative symptoms in both samples. CONCLUSION: This study provides updated and cross-cultural data showing that dissociation is associated with an increase in PTSD symptoms over time, though its association with DSO symptoms is less clear. Assessment, prevention, and treatment of PTSD should take dissociative symptoms into consideration.
Occurrence and trajectories of psychiatric disorders in adults with gambling disorder: a longitudinal register-based study of the Finnish population.
Palomäki J, Grönroos T, Heiskanen M … +2 more , Levola J, Salonen AH
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41686232 · Publisher ↗
PURPOSE: To determine the co-occurrence and temporal trajectories between gambling disorder (GD) and other psychiatric diagnoses in the Finnish population. METHODS: Data were retrieved from two healthcare registers cover...
PURPOSE: To determine the co-occurrence and temporal trajectories between gambling disorder (GD) and other psychiatric diagnoses in the Finnish population. METHODS: Data were retrieved from two healthcare registers covering primary and specialized care, including 5,172 individuals aged 18 or over (3,720 males, 1,452 females) with diagnosed GD (ICD-10 code F63.0). We also retrieved information on all other psychiatric diagnosis dates (codes F00-99) between 1996 and 2024 for every individual, alongside their official sex, year of birth, and whether GD was a primary, secondary, or long-term diagnosis. Linear mixed modelling (LMM) was used to analyse longitudinal data on multiple diagnosis occurrences. RESULTS: Mood, anxiety, and substance use disorders (SUDs) had the highest co-occurrence with GD both preceding and following its diagnosis, indicating bidirectional comorbidity patterns. The most common comorbid categories included unipolar depression, phobic anxiety disorders, alcohol use disorder, and bipolar disorder. Mood disorder comorbidity was especially prominent among women, and SUD comorbidity among men. Most psychiatric diagnoses occurred 112 to 2,697 days before GD (LMM p-values 0.38 - <0.001, marginal and conditional R² = 0.13 and 0.47, respectively). Comorbid diagnoses after GD were, on average, temporally closer to GD onset than diagnoses before GD.Diagnosis occurrences were significantly more frequent among individuals with GD than among psychiatric controls in most diagnostic categories. CONCLUSIONS: There were distinct and sex-specific temporal trajectories between GD and other psychiatric diagnoses, with mood-, anxiety-, and SUDs showing the strongest and most reciprocal associations. Social and health care professionals should screen for GD among those seeking treatment for these disorders, particularly given the increased suicide risk.
Early childhood and early adolescent predictors of internalising symptoms in adolescents: findings from a longitudinal study in a high-risk South African environment.
Du Toit S, Haag K, Tomlinson M … +4 more , Sherr L, Marlow M, Stewart J, Skeen S
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41670682 · Publisher ↗
PURPOSE: This study investigates predictors of internalising symptoms among adolescents aged 16 to 19 years in a high-risk context in South Africa. Specifically, it explores early childhood (antenatal to 18 months postpa...
PURPOSE: This study investigates predictors of internalising symptoms among adolescents aged 16 to 19 years in a high-risk context in South Africa. Specifically, it explores early childhood (antenatal to 18 months postpartum), and early adolescent (13 to 14 years) predictors of internalising symptoms measured during later adolescence (16-19 years), aiming to identify key factors influencing mental health outcomes in this vulnerable population. METHODS: Utilising a unique 18-year longitudinal dataset, we included a total of 314 adolescent participants from South Africa in the analysis and employed an adaptive elastic net regularised regression to analyse the effects of 18 predictors from early childhood and early adolescence on internalising symptoms at ages 16 to 19 years. The broadband scale for "internalising" from the Youth Self Report (ages 11-18) was used as the outcome measure. Data collected at five time points across three phases of the longitudinal study were included in the analysis. RESULTS: Key predictors of internalising symptoms were female sex (β=-4.30; 95% CI [-4.42;4.19]). Early childhood predictors with significant associations were maternal depression (β = 1.70; 95% CI [1.56;1.84]) and caregiver employment (β=-0.37; 95% CI [-0.46;-0.29]). In early adolescence, significant predictors included informal house type (β = 0.82; 95% CI [0.71;0.93]), caregiver alcohol use (β = 0.74; 95% CI [0.67;0.81]), exposure to violence (β = 0.73; 95% CI [0.67;0.78]), friend support (β=-0.61; 95% CI [-0.67;-0.55]), food insecurity (β = 0.51; 95% CI [0.46;0.56]), family support (β=-0.33; 95% CI [-0.37;-0.29]), and self-esteem (β=-0.33; 95% CI [-0.37;-0.29]). CONCLUSION: This study identifies key predictors of internalising symptoms in adolescents from high-risk context, focusing on caregiver variables and social connections. Maternal / Primary cargiver depression and caregiver unemployment in early childhood have lasting effects, highlighting the need for early intervention. In early adolescence, factors such as social environment and caregiver stability are crucial. These insights can inform targeted interventions and policies to support adolescent mental health in high-risk contexts.
Childhood adversity subgroups and their associations with mental health symptoms among Rhode Island young adults.
Ziobrowski HN, Fleur RS, Rosenthal SR
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41670681 · Publisher ↗
PURPOSE: People who experience childhood adversity often experience more than one type, yet traditional modeling approaches may not adequately account for complex adversity patterns. We used a person-centered approach to...
PURPOSE: People who experience childhood adversity often experience more than one type, yet traditional modeling approaches may not adequately account for complex adversity patterns. We used a person-centered approach to identify subgroups of individuals with distinct childhood adversity profiles and compared this method with traditional approaches to examine their associations with young adult mental health. METHODS: Data came from 1,022 young adults aged 18–25 years in the 2022 Rhode Island Young Adult Survey, a cross-sectional, community-based web survey. Participants self-reported anxiety (GAD-7) and depressive (CES-D-10) symptoms and 14 types of childhood adversities. Latent class analysis (LCA) identified childhood adversity subgroups. We used modified Poisson regression models to examine associations of childhood adversity with mental health outcomes. We compared models using individual adversities (specificity approach), sum-scores (cumulative approach), and LCA-derived subgroups (person-centered approach). RESULTS: Childhood adversities were individually weakly associated with mental health outcomes (prevalence ratios [PRs] < 2.0), and people who experienced more forms of childhood adversity were more likely to report high anxiety and depressive symptoms. We identified four childhood adversity latent classes. Groups characterized by multiple forms of maltreatment, household dysfunction, and family mental illness were the most likely to report poor mental health outcomes, and estimates were greater in magnitude compared to the cumulative approach (PRs > 4.0 and 5.5 for high anxiety and depressive symptoms, respectively, for the highest risk subgroup “High cumulative household threat and deprivation”). CONCLUSION: LCA may better estimate the impact of complex patterns of childhood adversity on mental health than traditional approaches.
Migration background and specialized mental health care utilization in young adults: a register-based study in the Netherlands.
Alozkan Sever C, Ceccarelli C, Cuijpers P … +7 more , Mittendorfer-Rutz E, van Dam JP, Akhtar A, Oelrich O, van der Ven E, Witteveen AB, Sijbrandij M
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41670680 · Publisher ↗
PURPOSE: This study aimed to examine the differences in specialized mental health care utilization among young conflict-affected migrants in the Netherlands, compared to their Dutch-born and non-conflict-affected peers,...
PURPOSE: This study aimed to examine the differences in specialized mental health care utilization among young conflict-affected migrants in the Netherlands, compared to their Dutch-born and non-conflict-affected peers, and to assess the role of benefit receipt and duration of stay. METHODS: This register-based study included 1,219,051 individuals aged 18–25 residing in the Netherlands on 1 January 2015. Participants were followed until 31 December 2018 for specialized mental health care contact. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) were estimated using Cox regression. Exploratory analyses examined how benefit receipt and duration of stay relate to specialized mental health service use. RESULTS: Compared to Dutch-born individuals, both conflict-affected (aHR 0.91, 95%CI 0.88–0.95) and non-conflict-affected migrants (aHR 0.63, 95%CI 0.61–0.65) had lower overall specialized mental health care utilization. Conflict-affected migrants showed higher utilization for psychotic (aHR 3.99, 95%CI 2.39–4.69) and anxiety disorders (aHR 1.27, 95%CI 1.17–1.38), whereas non-conflict-affected migrants had higher utilization for psychotic disorders (aHR 2.03, 95%CI 1.72–2.34) compared to Dutch-borns. Patterns of utilization also varied by benefit receipt and duration of stay, with differences across diagnostic categories. CONCLUSION: Young migrants had lower overall use of specialized mental health care than Dutch-born peers, but higher use for psychotic, and anxiety disorders, varying by migration background. As unmet need cannot be assessed from our data, it remains unclear whether lower use reflects reduced need or access barriers. However, findings underscore persistent disparities and the need for policies ensuring equitable access.
The double-burden of poverty on cognition hypothesis: a systematic review of the mechanisms of the effect of poverty in early life on the development and expression of cognition in adolescence and adulthood.
Brina KR, da Silva Dias M, Soares PSM … +1 more , Hartwig FP
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41670679 · Publisher ↗
Given the established detrimental effect of poverty in early life on later cognition, understanding the mechanisms underlying this relationship is important to design interventions to mitigate such inequities. However, e...
Given the established detrimental effect of poverty in early life on later cognition, understanding the mechanisms underlying this relationship is important to design interventions to mitigate such inequities. However, eliminating inequities may not be enough. It is likely that poverty in early life is also associated with reduced qualification and job opportunities, in which case the benefit of healthy cognitive development could be mitigated or even neutralized. We referred to this potential effect of early poverty on both the development and expression as the double-burden hypothesis (DBH). This study systematically reviews the literature on the mechanisms by which childhood poverty can affect cognitive outcomes later in life and includes original studies that either quantified the role of mediators of the effect of early-life socioeconomic position (SEP) on cognition or that assessed whether early SEP modifies the relationship between later IQ and income. Of the 27 articles selected, all studied mediation and consistently identified educational attainment and adult SEP as key mediators. However, much of the available evidence is limited by retrospective measures, confounding, and selection bias. This suggests that while direct effects of childhood poverty might exist, most of its impact on later-life cognition operates through modifiable mechanisms. Reinforcing the importance of interventions that target early-life environments to reduce the long-term impacts of childhood poverty. Further studies with robust methods are needed to confirm these findings and provide more reliable estimates. Moreover, the present review shows that effect modification is an underexplored route to further develop effective, equitable interventions.
The impact of alcohol use disorder and PTSD comorbidity on risk of suicide attempt.
Edwards AC, Lönn SL, Amstadter AB … +6 more , Stephenson M, Lannoy S, Crump C, Sundquist J, Kendler KS, Sundquist K
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41649526 · Publisher ↗
BACKGROUND: Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are frequently comorbid and are individually associated with increased risk of suicidal behavior. However, whether their comorbidity exacerb...
BACKGROUND: Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are frequently comorbid and are individually associated with increased risk of suicidal behavior. However, whether their comorbidity exacerbates this risk has not been adequately investigated. METHODS: Using a Swedish birth cohort (born 1970-1990; N = 799,203-858,983), we employed Aalen's linear hazards models to evaluate the risk of non-fatal suicide attempt (SA) as a function of registration for AUD and/or PTSD. Models were stratified by sex and considered the temporal ordering of AUD and PTSD. We adjusted for registrations of major depression (MD) and other key covariates. RESULTS: The overall incidence of SA ranged from 16.52 to 19.29 per 10,000 person-years (PY). In models adjusted for MD and other covariates, PTSD accounted for an additional 12.19-22.09 SA cases per 10,000 PY; the corresponding range for AUD was 43.24-80.04, and the difference in effect size across predictors was more pronounced where AUD preceded PTSD. Comorbidity exacerbated risk: The interaction between PTSD and AUD accounted for 71.13-179.41 additional SA cases per 10,000 PY. In secondary models, interactions between AUD and MD conferred additional SA risk (40.50-127.88 additional SA cases per 10,000 PY), while interactions between PTSD and MD were very weak and, in most cases, negative (-13.26-3.29). CONCLUSIONS: PTSD and AUD are independently associated with SA, but risk is substantially exacerbated among comorbid individuals. While the total effect of these conditions on SA risk is overall comparable across sexes, females whose PTSD precedes AUD are particularly burdened by comorbidity.
Social disconnection and subsequent mental disorders: a population-based cohort study.
Alsner KB, Laustsen LM, Lasgaard M … +2 more , Grønkjær MS, Plana-Ripoll O
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41649525 · Full text
PURPOSE: Social disconnection has been linked to adverse health outcomes, including higher risks of mental disorders. However, previous studies have primarily focused on depression, with limited exploration of other ment...
PURPOSE: Social disconnection has been linked to adverse health outcomes, including higher risks of mental disorders. However, previous studies have primarily focused on depression, with limited exploration of other mental disorders and demographic variations. This study investigates the association between social disconnection and a range of subsequent mental disorders in a large, population-based cohort. METHODS: A cohort study was conducted using data from 162,483 participants of the Danish National Health Survey, linked to national health registers. Social disconnection was assessed through survey measures of loneliness, social isolation, and low social support. Incident cases of mental disorders were identified using hospital-based diagnoses and included in seven categories. Poisson regression was applied to estimate incidence rate ratios (IRRs) adjusted for demographics, country of birth, and socio-economic resources. RESULTS: Individuals who were socially disconnected had a higher incidence rate of mental disorders in all seven categories: substance use disorders, schizophrenia spectrum disorders, bipolar disorder, major depressive disorder, neurotic and anxiety-related disorders, personality disorders, and a combined category of any aforementioned disorder. Loneliness overall showed the strongest associations (range of IRRs, 2.94 to 4.94) compared to social isolation (range of IRRs, 1.47 to 4.80) and low social support (range of IRRs, 1.32 to 2.82). While associations were generally similar across sexes, contrasting age trends were indicated for loneliness and social isolation. CONCLUSION: Strong associations were consistently found between social disconnection and subsequent mental disorders, highlighting the potential for targeted public health interventions. Future research should investigate causal mechanisms and directional relations to refine prevention strategies.
Loneliness, depression, and generalized anxiety across eight countries.
Abdalla SM, Banda B, Pickerel M … +3 more , Rosenberg SB, Sharma S, Galea S
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41644667 · Full text
BACKGROUND: Loneliness is increasingly recognized as a global public health concern linked to adverse mental health outcomes. However, cross-national evidence on its distribution and association with depression and gener...
BACKGROUND: Loneliness is increasingly recognized as a global public health concern linked to adverse mental health outcomes. However, cross-national evidence on its distribution and association with depression and generalized anxiety is limited. METHODS: We analyzed data from the 2023-2024 Global Social Determinants of Health Survey, a cross-sectional, nationally representative survey of 7,997 adults across Brazil, France, India, Indonesia, Nigeria, the Philippines, Türkiye, and the United States. Depression and generalized anxiety were measured using PHQ-9 and GAD-7 screening tools, respectively, while loneliness was self-reported. Weighted bivariate and multivariate (logistic and Poisson regression) models were used to estimate associations between loneliness and mental health outcomes, adjusting for demographic factors. FINDINGS: Overall, 38.9% of respondents reported loneliness, 9.2% met criteria for depression, and 5.5% for generalized anxiety. Loneliness was more common among younger adults, women, individuals with lower income or education, unmarried individuals, and urban residents. In fully adjusted models, loneliness was associated with depression (OR 2.82 [95% CI: 2.25-3.54]) and generalized anxiety (OR 3.89 [95% CI 2.86-5.28]). INTERPRETATION: Loneliness is common and strongly associated with depression and generalized anxiety across diverse settings. These findings underscore the importance of integrating strategies that promote social connection into mental health policy and interventions. Future research should explore causal pathways.
Proactive coping with racial discrimination May exacerbate race-based traumatic stress in diverse young adults.
Rastogi R, Woolverton GA, Wong SHM … +3 more , Yip T, Hahm HC, Liu CH
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41629632 · Publisher ↗
PURPOSE: Racial discrimination is consistently linked with post-traumatic stress symptomatology. It is essential to identify adaptive coping strategies in order to disrupt racial disparities in mental health. Proactive c...
PURPOSE: Racial discrimination is consistently linked with post-traumatic stress symptomatology. It is essential to identify adaptive coping strategies in order to disrupt racial disparities in mental health. Proactive coping with discrimination-efforts taken before or during an exposure in order to minimize its harmful effects-is a potential avenue to minimize race-based traumatic stress. METHODS: We tested proactive coping as a moderator of the association between everyday discrimination and race-based traumatic stress symptoms among 1,433 racially diverse U.S. young adults. We further disaggregated results to examine trends across Asian, Black, and Latiné respondents. RESULTS: In the full analytic sample, proactive coping appeared to exacerbate the link between everyday discrimination exposure and race-based traumatic stress symptoms. The race-stratified analyses suggest that this finding was driven by Black and Latiné young adults. In Asian respondents, there was no moderation nor a direct association of proactive coping. CONCLUSION: The results suggest that proactive coping may reflect increased racial vigilance and self-monitoring-behaviors reflective of traumatic stress symptomatology. Future research must further disentangle anticipatory coping styles to understand their unique utility and identify means of promotion. Clinicians might prioritize using mindfulness- and acceptance-based therapeutic approaches with clients, to mitigate vigilance and avoidance of stressful race-related emotionality.
Persistence of loneliness and low self-esteem from adolescence through age 60 in the United States: results from the Monitoring the Future Panel Study.
Keyes KM, Joseph V, Jager J … +2 more , Olfson M, Patrick ME
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41611875 · Full text
BACKGROUND: Depression, loneliness and other psychological distress symptoms are common in the US; lifetime cumulative estimates and life course prospective persistence is under-studied. We use national data with repeate...
BACKGROUND: Depression, loneliness and other psychological distress symptoms are common in the US; lifetime cumulative estimates and life course prospective persistence is under-studied. We use national data with repeated assessment to provide lifetime cumulative risk estimates for the US. METHODS: Longitudinal data from Monitoring the Future panel study on individuals (N = 421) followed from age 18 (in 1976-1978) to age 60 (in 2018-2020), with mean = 12.4 assessments (range 5-13). Psychological distress included three subscales: loneliness (2 items), low self-esteem (4 items), depressive symptoms (4 items). RESULTS: By age 60, 73.91% had [Formula: see text]1 period of high loneliness; 24.84% had 3+ periods of high loneliness. A total of 65.72% had [Formula: see text]1 period of low self-esteem. Most risk accumulated during early adulthood; 56.40% had high loneliness and 46.38% had low self-esteem by age 25/26. Those with high loneliness at age 18 had 3.72 (95% C.I. 2.09, 6.63) times the odds of high loneliness, 4.28 (95% C.I. 2.10, 8.71) times the odds of high depressive symptoms, and 2.61 (95% C.I. 1.47, 4.65) times the odds of low self-esteem at age 60. Associations were of similar magnitude for age 18 low self-esteem predicting age 60 distress. CONCLUSION: By age 60, most US adults will have experienced at least 1 period of high loneliness or low self-esteem, and the majority of risk accumulates early in adulthood. Adolescent distress prospectively predicts later life distress, thus intervention and prevention efforts in adolescence are potentially critical for addressing late life mental health problems.
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