Social Psychiatry And Psychiatric Epidemiology[JOURNAL]
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200 papers
Characteristics and 12-month outcomes of clinically-referred children and young people at risk of body dysmorphic disorder.
Frisira E, Tan SF, Partlett C … +5 more , Holt G, Krebs G, Stringaris A, Marshall T, Sayal K
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 41429987 · Publisher ↗
PURPOSE: Body Dysmorphic Disorder (BDD) is impairing yet often under-detected in children and young people (CYP). This paper aims to describe the characteristics and 12-month outcomes of clinically referred CYP based on...
PURPOSE: Body Dysmorphic Disorder (BDD) is impairing yet often under-detected in children and young people (CYP). This paper aims to describe the characteristics and 12-month outcomes of clinically referred CYP based on their likelihood of having BDD. METHODS: This paper investigated 307 CYP aged 11–17 years from the STandardised DIagnostic Assessment (STADIA) trial for CYP with emotional difficulties referred to Child and Adolescent Mental Health Services (CAMHS). CYP and/or their parents completed the Development and Wellbeing Assessment (DAWBA) to assess the likelihood of meeting diagnostic criteria for emotional disorders, including BDD. Baseline and 12-month follow-up measures were collected from self- and/or parent- reports and healthcare records. RESULTS: Overall, 6.2% (95% confidence interval 3.8%, 9.5%) of referred CYP had probable BDD according to the DAWBA; however, no CYP received a BDD diagnosis from CAMHS clinicians. CYP with probable BDD were predominantly female (84%), white (89%) and came from diverse socio-economic backgrounds. Nearly three quarters (74%) of them scored very high for comorbid depression and generalised anxiety disorder, but only 47% had their referral accepted by CAMHS by 12 months. At baseline, 50% reported self-harm thoughts and 33% reported self-harm behaviours, with 42% reporting self-harm behaviours at 12 months. CONCLUSIONS: BDD is relatively common among CYP with emotional difficulties referred to CAMHS, but may be overlooked. CYP with probable BDD often meet criteria for depressive or anxiety disorders and exhibit high levels of self-harm thoughts and behaviours. Despite this, referral acceptance to CAMHS was no higher for CYP with probable BDD, highlighting the need to raise awareness about BDD among referrers and clinicians.
Postpartum depression and quality of life in the first year after childbirth: ethnic differences.
Alfayumi-Zeadna S, Touma LG, Weinreich M … +2 more , O'Rourke N, Cwikel J
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 41366117 · Publisher ↗
PURPOSE: Postpartum depression (PPD) is a complex condition that can have negative outcomes for mothers, children, and their families and may affect mothers' quality of life (QoL(. This study examined the impact of PPD s...
PURPOSE: Postpartum depression (PPD) is a complex condition that can have negative outcomes for mothers, children, and their families and may affect mothers' quality of life (QoL(. This study examined the impact of PPD symptoms (PPDs) on QoL among mothers in the first year postpartum, with a particular focus on vulnerable populations, specifically Arab women, and comparing them with Jewish mothers in Israel. METHODS: For this cross-sectional study, we recruited 601 mothers (478 Jewish, 123 Arab), up to 12 months postpartum. The questionnaire battery included the Edinburgh Postnatal Depression Scale (EPDS) and the WHOQoL-BREF Assessment (QoL). Elevated PPD symptoms were defined as EPDS ≥ 13. Statistical analysis included bivariate associations and multiple linear regression to identify factors associated with QoL, adjusted for sociodemographic and obstetric variables. RESULTS: The prevalence of PPDs in this sample was 23.8%, with 21% among Jewish and 33% among Arab mothers. PPDs were significantly associated with QoL, with higher EPDS scores correlating with lower QoL scores. Ethnicity also showed a significant association with QoL, with Arab mothers reporting lower QoL. Additionally, low income, unemployed mothers, and those experiencing obstetric complications reported significantly lower QoL. CONCLUSION: These findings highlight the importance of early screening, diagnosis, and treatment of PPD to improve postpartum QoL. The observed disparities underscore the need for culturally tailored interventions to address ethnic differences. Future research should develop targeted strategies addressing psychological and socioeconomic factors in vulnerable populations effected by PPD.
Childhood food insecurity trajectories and adolescent eating disorder symptoms: a UK cohort study.
Trompeter N, Opitz MC, Rabelo-da-Ponte FD … +4 more , Sharpe H, Desrivieres S, Schmidt U, Micali N
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 41350937 · Publisher ↗
PURPOSE: Food insecurity is increasingly linked with disordered eating. However, studies have not yet explored impacts of childhood food insecurity on disordered eating in adolescence. This study examined the links betwe...
PURPOSE: Food insecurity is increasingly linked with disordered eating. However, studies have not yet explored impacts of childhood food insecurity on disordered eating in adolescence. This study examined the links between patterns of childhood food insecurity and adolescent disordered eating. METHODS: Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort in the UK (6,723 participants; 55.7% girls). Food insecurity was reported by mothers from pregnancy to age 7. Disordered eating was reported by adolescents at ages 14, 16, and 18. RESULTS: Most participants experienced no food insecurity throughout childhood (n = 5,801, 77.9%), followed by low food insecurity (n = 416, 12.4%), time-limited food insecurity (n = 292, 6.0%), and persistent food insecurity (n = 214, 3.7%). At age 14 adolescents in the time-limited food insecurity group had higher odds of binge eating (OR = 1.63, p = .040), and those in the persistent food insecurity group had higher odds of compensatory behaviours compared those in the no food insecurity group (OR = 1.72, p = .025). No significant associations were observed with disordered eating at age 16. At age 18 adolescents in the time-limited food insecurity group compared to the no food insecurity group had higher odds of compensatory behaviours (OR = 1.68, p = .041). CONCLUSIONS: Findings showed that childhood food insecurity was linked with higher odds of disordered eating in adolescence. Interestingly, associations were observed for those experiencing either time-limited or persistent food insecurity, highlighting the potential impact of early childhood experiences.
Comparing patterns of recent mental health service use for predicting suicidal events following emergency department mental health visits in the United States: A national cohort study.
Schmutte T, Marcus SC, Xie M … +6 more , Cullen SW, Liu T, Ungar LH, Cardamone N, Williams NJ, Olfson M
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41331149 · Full text
OBJECTIVE: To examine patterns of recent service use to predict non-fatal suicidal events shortly following emergency department (ED) visits for mental health. METHODS: For this retrospective cohort study, we used Optum...
OBJECTIVE: To examine patterns of recent service use to predict non-fatal suicidal events shortly following emergency department (ED) visits for mental health. METHODS: For this retrospective cohort study, we used Optum electronic health record data from 2,445,597 ED mental health episodes (2015-2022) for persons aged ≥ 10 years. We then constructed a series of logistic regression models to evaluate how six permutations of characterizing prior 180-day mental health service use predicted acute non-fatal suicidal events within 180 days of ED discharge beyond demographic characteristics and ED mental health diagnoses. Model performance was assessed by area under the receiver operating curve (AUC). RESULTS: Overall, 7.2% (n = 176,000) of episodes resulted in an acute suicidal event within 180 days. Model performance improved from demographic characteristics and ED mental health diagnoses (AUC = 0.76) when past 180-day service use variables were added, but with minimal differences between a binary variable of any mental health service use compared to monthly counts, weighted slopes, or interactions (AUC's 0.78-0.82). The final model containing demographics, ED mental diagnosis, and past 180-day service use yielded an AUC of 0.83. The most predictive past service use variables were any inpatient or ED event for self-harm or suicide ideation (OR = 5.45, 95% CI = 5.37, 5.54) and any ED mental health visit (OR = 1.87, 95% CI = 1.84, 1.90). CONCLUSIONS: As part of evaluating suicide risk in ED settings, information about recent acute care for mental health, suicidal ideation, or self-harm use significantly contributes to the short-term prediction of non-fatal suicidal events.
Stressful work experience over time and depression in late midlife: results from a longitudinal cohort study in Germany.
Prel JD, Siegrist J, Rohrbacher M … +1 more , Hasselhorn HM
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41331148 · Publisher ↗
PURPOSE: Previous prospective findings of elevated risk of depression following exposure to stressful work in terms of effort-reward imbalance (ERI) were based on a single exposure measurement. With this study, we set ou...
PURPOSE: Previous prospective findings of elevated risk of depression following exposure to stressful work in terms of effort-reward imbalance (ERI) were based on a single exposure measurement. With this study, we set out to analyse longitudinal associations of single and twofold exposure measurement with depression among middle-aged employees. METHODS: Data were derived from the first two waves (2011 and 2014) of the prospective lidA cohort study in Germany, including 3,104 middle-aged employed men and women. Participants with depression at baseline were excluded. Work stress (effort-reward ER) ratio and work-related over-commitment (WOC) and depression (Beck's Depression Inventory) were assessed at both waves. Time-invariant (birth year, sex, education) and time-varying covariates (employment, control, physical health) were adjusted for. Multiple logistic regression analyses were conducted to estimate the odds of depression for single or twofold high exposure, and generalized estimation equations (GEE) to analyze mean associations between moderate and high exposure and outcome over both waves. RESULTS: 5.9% of male and 9.8% of female participants experienced depression during the observation period. Cases were more frequent among those scoring high on work stress measures, those with poor physical health and part-time work. In the fully adjusted GEE model, the estimated risk ratio of depression was 1.60 (95%-CI: 1.05; 2.44) for moderate and 2.49 (1.67; 3.71) for high exposure to ERI work stress on average over time. Similar effects were observed for WOC. CONCLUSION: Elevated risk ratios of depression were observed in associations with moderate and high exposure to stressful work (ERI) over time.
Bereavement and mental health factors associated with seeking and receiving support following loss among Canadian bereaved adults.
Redican E, Langford A, Hyland P … +2 more , Karatzias T, Shevlin M
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 41331147 · Publisher ↗
PURPOSE: The death of a loved one is one of life's most ubiquitous events that can increase risk of mental health difficulties. Bereavement support is one of the few factors influencing grief-related mental health outcom...
PURPOSE: The death of a loved one is one of life's most ubiquitous events that can increase risk of mental health difficulties. Bereavement support is one of the few factors influencing grief-related mental health outcomes that can be modified after bereavement. This study sought to determine the proportion of bereaved people that want and receive support from different sources following a bereavement, and the bereavement and mental health-related factors associated with wanting and receiving bereavement support. METHODS: Data was derived from a cross-sectional survey of bereaved adults (n = 1170) living in Ontario, Canada. RESULTS: Over a third of the sample (38.9%; n = 455) reported wanting support in coping with their loss. These individuals exhibited distinct loss-related characteristics and reported higher levels of anxiety, depression, and prolonged grief symptoms. Most of these individuals received support and a small number of participants who didn't want support received it regardless. The most common sources of support were family members, friends, and other bereaved individuals, and these sources were generally found to be helpful. Those who accessed multiple types of support were those with the highest levels of anxiety, depression, and prolonged grief symptoms. CONCLUSION: Most individuals wanting support after a loss can access it and find it beneficial. The desire for support is closely tied to psychological distress, highlighting the need to prioritize formal support for those in distress and rely on existing social networks for those who are not. Such an approach embodies an 'assets-based' bereavement model, enhancing community capacity for effective support provision.
Social inclusion profiles in first episode psychosis and their links to social cognition and symptoms: A cluster analysis approach.
Murrihy S, Cotton S, Phillips L … +5 more , Filia K, Nesbitt A, Allott K, Killackey E, Watson A
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41331146 · Publisher ↗
BACKGROUND: Many young people with first episode psychosis (FEP) experience challenges in key areas of social inclusion, including housing, finances, employment or education, and social relationships. However, there is d...
BACKGROUND: Many young people with first episode psychosis (FEP) experience challenges in key areas of social inclusion, including housing, finances, employment or education, and social relationships. However, there is diversity in these challenges, and it is unclear how social inclusion relates to potentially modifiable treatment factors such as social cognition. Here we aimed to identify distinct social inclusion profiles using cluster analysis and examine their associations with social cognition and other clinical factors. METHODS: 145 young people (aged 15-25) who had experienced a FEP completed assessments of demographics, clinical symptomology, social inclusion, functioning, quality of life (QoL), and social cognition. K-means cluster analyses identified social inclusion subgroups. Kruskal-Wallis and Wilcoxon rank-sum post-hoc tests were used to compare subgroups on psychosocial factors and multinomial regression models were used to examine whether social cognition was associated with the subgroups, controlling for clinical factors. RESULTS: Three clusters emerged: low inclusion/low participation (LI-LP), moderate inclusion/low participation (MI-LP), and high inclusion/high participation (HI-HP). Social cognition was not associated with subgroup membership. LI-LP had greater depressive and less expressive negative symptoms than both other subgroups, and more severe motivation/pleasure negative symptoms than HI-HP. CONCLUSION: Distinct FEP subgroups with varying subjective and objective social inclusion, shaped by external psychosocial and clinical factors were revealed. The findings highlight the need for holistic and personalised care to improve social inclusion for individuals with FEP and suggest that targeting depressive and motivational negative symptoms may be potential avenues to achieve this.
Clinical outcomes in first-episode schizophrenia: identifying predictors of relapse.
Kelebie M, Kibralew G, Fentahun S … +9 more , Rtbey G, Aderaw M, Endeshaw W, Belachew M, Muche M, Nakie G, Tesfaw K, Takelle GM, Tadesse G
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41288687 · Publisher ↗
BACKGROUND: Schizophrenia is a chronic psychiatric disorder marked by recurrent relapses, which significantly affect long-term clinical and functional outcomes. Early relapse following a first episode of psychosis is lin...
BACKGROUND: Schizophrenia is a chronic psychiatric disorder marked by recurrent relapses, which significantly affect long-term clinical and functional outcomes. Early relapse following a first episode of psychosis is linked to increased illness chronicity, higher hospitalization rates, and greater psychosocial impairment. While antipsychotic treatment can reduce the risk of relapse, recurrence remains common. Identifying predictors of relapse is essential for optimizing treatment strategies; however, evidence from low-resource settings, such as Ethiopia, is limited. This study aimed to examine clinical outcomes and identify key predictors of relapse among individuals with first-episode schizophrenia in Ethiopia. METHODS: An institutional-based retrospective cohort study was conducted at the University of Gondar Specialized Hospital, including 710 adults diagnosed with schizophrenia who received antipsychotic treatment and maintained regular follow-up over one year. Clinical outcomes were assessed using the Clinical Global Impressions-Schizophrenia (CGI-SCH) scale, which evaluates symptom severity across positive, negative, depressive, and cognitive domains and Outcomes were dichotomized into good clinical improvement and poor clinical improvement. Antipsychotic side effects and medication adherence were assessed using the Glasgow Antipsychotic Side-Effects Scale (GASS) and the Medication Adherence Rating Scale (MARS-10), respectively. Clinical outcomes and predictors of relapse were analyzed using Cox proportional hazards and multivariable logistic regression models, with statistical significance set at P < 0.05. RESULTS: Among the 710 individuals diagnosed with schizophrenia, 457 (64.4%) achieved favorable clinical outcomes. The highest therapeutic response was observed in patients treated with Olanzapine, with 168 (36.8%) demonstrating significant clinical improvement. During the follow-up period, 33.5% of patients experienced at least one relapse episode. In multivariable Cox regression analysis, younger age (18-30 years; AHR = 1.43, 95% CI: 1.07-1.9), living alone (AHR = 1.31, 95% CI: 1.03-1.73), a positive family history of suicidal attempts (AHR = 1.45, 95% CI: 1.13-1.85), and the presence of moderate anti-psychotic side effects (AHR = 2.23, 95% CI: 1.42-3.5) were significant predictors of poor clinical outcomes. Furthermore, poor medication adherence (OR = 1.57, 95% CI: 1.07-2.13), presence of suicidal ideation (OR = 2.22, 95% CI: 1.54-3.22), younger age (OR = 1.42, 95% CI: 1.11-1.81), and lack of formal education (OR = 1.30, 95% CI: 1.10-1.53) were significant predictors of relapse among individuals with schizophrenia. CONCLUSION: This study reveals that most individuals with schizophrenia achieve favorable clinical outcomes, relapse remains a major concern, affecting about one-third of patients. Poor outcomes are significantly associated with younger age, living alone, a family history of suicidal attempts, and moderate anti-psychotic side effects, whereas relapse is more likely among those with poor medication adherence, suicidal ideation, younger age, and lack of formal education. These findings highlight the need for early identification of high-risk patients and the implementation of targeted interventions to improve adherence, reduce relapse, and enhance recovery, especially in resource-limited settings.
Associations between social determinants of health and loneliness trajectories among middle-aged and older adults: a network perspective.
Wang X, Wei L, Zhao P … +5 more , Zhou Y, Zhou W, Yu J, Chen H, Wang C
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 41288686 · Publisher ↗
OBJECTIVES: Social determinants of health (SDoH) are increasingly recognized as fundamental determinants of mental and social well-being. However, the extent to which cumulative, domainal, and individual SDoH shape lonel...
OBJECTIVES: Social determinants of health (SDoH) are increasingly recognized as fundamental determinants of mental and social well-being. However, the extent to which cumulative, domainal, and individual SDoH shape loneliness trajectories in middle and later life remains unclear. METHODS: This study employed longitudinal data from the China Family Panel Studies (2012-2022). Group-based trajectory modeling (GBTM) was used to classify distinct loneliness trajectories. Logistic regression analyses evaluated the associations between SDoH and trajectory groups. To further explore interrelationships, network analysis was applied to identify central nodes of SDoH. RESULTS: A total of 11,877 participants were analyzed. GBTM revealed two patterns of loneliness: persistently low and persistently high. Participants with greater cumulative exposure to SDoH (OR = 1.26, 95% CI: 1.22-1.30) were significantly more likely to exhibit persistently high loneliness trajectories. Network analysis identified "residence" and "education level" as the most central nodes. DISCUSSION: This study underscores the importance of addressing cumulative disadvantages across the life course. Efforts to promote healthy aging should prioritize narrowing urban-rural gaps in social infrastructure and ensuring equitable lifelong learning opportunities, which may mitigate the persistently high loneliness trajectory.
National survey of community attitudes to prevention of mental health problems.
J Morgan A, Jorm AF, Carbone S … +2 more , Tsiamis E, Reavley NJ
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 41233649 · Publisher ↗
PURPOSE: Improving population mental health will require greater investment in prevention, yet the level of community support for such efforts is unclear. This study aimed to examine the Australian public's attitudes abo...
PURPOSE: Improving population mental health will require greater investment in prevention, yet the level of community support for such efforts is unclear. This study aimed to examine the Australian public's attitudes about the prevention of mental health problems (e.g. depression and anxiety conditions). METHODS: A probability-based panel provider recruited 6,142 Australians aged 16-75 + to complete an online survey. Survey items were developed to assess attitudes about prevention of physical and mental health problems, and support for government action on prevention of mental health problems. Data were weighted to be representative of the Australian adult population. RESULTS: 80.9% of respondents rated mental health as a top Australian government priority to prevent health problems. 14.6% of respondents thought that mental health problems were not preventable, 24.3% were not sure, and 61% agreed they were preventable, with younger adults being more positive. 79.5% of respondents agreed that the Australian government should play a role in preventing mental health problems in the population and 64.7% thought mental health funding should be spent equally on prevention and treatment. The most important age groups to focus on were adolescence and young adulthood and the most important areas were healthy housing, mental health promotion in schools, and reducing socioeconomic inequality. CONCLUSION: There was strong support for prevention of mental health problems as a government priority to improve the health of Australians. Findings can inform where prevention literacy efforts should focus and where government investment in prevention should be targeted to align with community expectations.
The mental health of US veterans before and after the COVID-19 pandemic: examining the demographic and environmental correlates of courses of distress in the LIGHT cohort.
Fox AB, Nillni YI, Rossi FS … +2 more , Duke CC, Galovski TE
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 41233648 · Publisher ↗
PURPOSE: We examined courses of distress in US veterans before, during, and after the COVID-19 pandemic and the impact of demographic and environmental characteristics on patterns of distress. METHODS: We used survey dat...
PURPOSE: We examined courses of distress in US veterans before, during, and after the COVID-19 pandemic and the impact of demographic and environmental characteristics on patterns of distress. METHODS: We used survey data (n = 1064; M = 38.85, 49.1% female) from the Longitudinal Investigation of Gender, Health, and Trauma (LIGHT) study. Using data from three time points (pre-pandemic, peri-pandemic, and post-pandemic), participants were classified into one of five groups based on whether they met clinical cut-offs for depression, generalized anxiety, and/or PTSD at a given time point. We then examined demographic and environmental correlates of group membership and used relative importance analyses to identify the strongest correlates of group membership. RESULTS: For female and younger veterans, distress increased from pre-pandemic to peri-pandemic, decreased from peri-pandemic to post-pandemic, and then returned to pre-pandemic levels two years later. For male and older veterans, there was no change in distress from pre-pandemic to peri-pandemic, an increase in distress from peri-pandemic to post-pandemic, then a return to pre-pandemic distress levels. Most participants were classified as Resistant (60.1%), followed by Persistent (20.5%), Remitted (7.6%), Exacerbated (6.4%), and Resilient (5.5%). Income, community danger, neighborhood cohesion, and post-pandemic related distress were the strongest correlates of persistent distress, the most vulnerable group. CONCLUSION: Overall, veterans were resilient in response to the pandemic. However, findings suggest that female and younger veterans were disproportionately impacted. The relationships we identified between environmental factors and persistent distress underscore the need for interventions that address both individual and structural factors that impact distress.
Influences on help-seeking for serious mental illness in Dhaka, bangladesh: a mixed-methods study.
Jilka S, Siddiqi B, Winsper C … +9 more , Bouliotis G, Read UM, Soron T, Shammin A, Smith SJ, Morroni D, Ahmed HU, Omigbodun O, Singh SP
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41174073 · Full text
PURPOSE: Early intervention can improve mental health outcomes for people living with serious mental illness (SMI). Understanding what factors influence patients' health help-seeking decisions are important in low and mi...
PURPOSE: Early intervention can improve mental health outcomes for people living with serious mental illness (SMI). Understanding what factors influence patients' health help-seeking decisions are important in low and middle-income countries (LMICs) where resources and outcomes are poor, particularly in slums, to help inform targeted intervention approaches. METHODS: A concurrent triangulation mixed methods study conducted in Dhaka, Bangladesh, using a quantitative pathway to care questionnaire with individuals from a local slum (Korail) attending the National Institute for Mental Health (NIMH), a specialised hospital for mental health services. Qualitative interviews were conducted with people with SMI and family caregivers living in Korail. RESULTS: 28,896 patients attended NIMH between 24th September 2022 and 25th September 2023 and only 0.11% (n = 33) came from the Korail slum. 46% had previously seen a faith or traditional healer. Qualitative interviews with people with SMI and caregivers in Korail showed that spiritual possession was among several perceived causes of SMI. Participants also percieved pharmacological treatment as expensive and potentially harmful. However participants also reported a lack of knowledge about specialist mental health facilities and spending considerable funds and resources on healers and private medical providers in the hope of cure. CONCLUSIONS: Help-seeking among families living in slums in Dhaka is pluralistic, with complex influences on treatment choice. Understanding help-seeking behaviour and care pathways is crucial to design an equitable health system and improve access to effective mental health care.
The intersection between race/ethnicity and adverse childhood experiences and its association with depression.
Rangavajhula KV, Muraleedharan A, Adaralegbe N … +5 more , Clark F, Nagar A, Osazuwa-Peters N, Babatunde OA, Adjei Boakye E
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 41174072 · Full text
PURPOSE: We assessed the association between number of adverse childhood experiences (ACEs) and depression among adults and explored the association by race/ethnicity. METHODS: We used data from the 2020 Behavioral Risk...
PURPOSE: We assessed the association between number of adverse childhood experiences (ACEs) and depression among adults and explored the association by race/ethnicity. METHODS: We used data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) among 127,577 adult respondents (≥ 18 years old). The exposure was the number of ACEs classified as zero, one, two-three, and ≥ four. The outcome was a self-reported history of depression diagnosis (yes/no). Weighted multivariable logistic regression models examined the association between ACEs and depression stratified by race/ethnicity. Each model was adjusted for age, gender, smoking status, income, education, marital status, and body mass index. RESULTS: In this sample, 36%, 23%, 21%, and 20% reported having experienced zero, one, two-three, and ≥ four ACEs, respectively. Depression was reported by 19% of survey respondents. There was a significant interaction between the number of ACEs and race/ethnicity, and depression (p = 0.0003), thus, analyses were stratified by race/ethnicity. Respondents who experienced ≥ 4 ACEs had higher odds of reporting depression: non-Hispanic Whites (aOR = 4.07; 95% CI: 3.55, 4.65), non-Hispanic Blacks (aOR = 3.96, 95% CI: 2.68, 5.86), or Hispanics (aOR = 7.73; 95% CI: 4.48, 13.35). Respondents with 2-3 ACEs had higher odds of reporting depression: non-Hispanic Whites (aOR: 2.41, 95% CI. 2.11- 2.76), non-Hispanic Blacks (aOR: 1.94, 95% CI. 1.19- 3.17), and Hispanics (aOR: 2.86, 95% CI. 1.64- 4.98). CONCLUSION: We found that individuals with two or more ACEs were more likely to report a depression diagnosis, irrespective of race/ethnicity. This finding highlights the need to monitor individuals with an increasing number of ACEs for depression.
Searching for people with psychosis in the global south: mapping and establishing a case surveillance system in South Africa (PSYMAP-ZN study).
Burns JK, Ntlantsana V, Mkhombo T … +19 more , Paruk S, Thela L, Juby V, Duba B, Sbiya M, Wambua GN, Naidu T, Cohen A, du Plessis S, Hoek HW, Kirkbride JB, Morgan C, Roberts T, Susser E, Swartz L, Tanser F, Tomita A, Veling W, Chiliza B
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41174071 · Full text
PURPOSE: Relatively little epidemiological evidence on psychosis from diverse settings in the Global South exists, where many people with untreated psychosis seek help outside of formal health service settings. Here, we...
PURPOSE: Relatively little epidemiological evidence on psychosis from diverse settings in the Global South exists, where many people with untreated psychosis seek help outside of formal health service settings. Here, we report a preliminary mapping study of formal and informal community resources within a catchment area in South Africa that established an infrastructure that could be used to detect a representative sample of individuals with untreated psychosis. METHODS: PSYMAP-ZN is a 3-year study of incidence, clinical presentation and associated risk factors for untreated psychosis in Msunduzi Municipality in South Africa. We conducted a preliminary mapping study of the region in which we aimed to document all potential providers of care (gatekeepers) in both formal (health services) and informal (folk) sectors, with the purpose of enrolling them in a collaborative case surveillance system. We drew on official sources, local knowledge from key stakeholders and utilised snowballing techniques. RESULTS: We established a surveillance system which included (a) all secondary mental health and primary care services (b) the majority of informal providers (including traditional health practitioners, religious institutions) and (c) a wide range of key informants. CONCLUSION: Expanding the global knowledge base on psychosis to diverse settings in the Global South requires a surveillance and case-detection method that includes (in addition to formal health settings) informal settings and local key informant knowledge in the community. This preliminary 'mapping' process established a platform for the ongoing PSYMAP study of untreated psychosis in South Africa.
The impact of COVID-19 on the trajectory of Australian tertiary students' mental health, 2017-2023.
Burns RA, Crisp DA, Butterworth P
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 41168483 · Publisher ↗
AIMS: It is purported that tertiary students are at greater risk for poor mental health outcomes in comparison with their non-tertiary peers and those not in education, although the evidence for this is mixed. This paper...
AIMS: It is purported that tertiary students are at greater risk for poor mental health outcomes in comparison with their non-tertiary peers and those not in education, although the evidence for this is mixed. This paper examines the mental health differences between tertiary and non-tertiary students, and those not enrolled in study, and then examines the changes in mental health in the years prior to, during and post the COVID-19 pandemic. METHODS: Participants were from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a longitudinal household panel survey. For this study, N = 21,385 participants provided at least one observation on the relevant education and mental health measures between 2017 and 2023. Mental Health was operationalised with the four mental health subscales from the Short Form-36 and included the MHI-5, a measure of psychological distress, Vitality, Social Functioning, and Role Emotion subscales. RESULTS: Over the study period, there were no differences in levels of Vitality or Social Functioning between education status. Those enrolled in undergraduate programs reported lower MHI-5 (b = -1.17 (SE = 0.38); P = .011) and Role Emotional (b = -2.49 (SE = 0.79); P = .010) scores, but these differences were substantively smaller than the differences reported between age, employment and sex. There were substantive changes in all mental health outcomes with the onset of COVID, particularly for Role Emotion. Two-way interactions between education and time were reported for the MHI, Vitality and Social Functioning subscales with those enrolled in undergraduate and postgraduate reporting slightly larger declines. CONCLUSIONS: In comparison with the magnitude of differences between sex, employment and age groups, there was only weak evidence for differences between education levels. There was weak evidence for changes in mental health between education levels over the study period. Stabilisation in more recent years suggest some adaptation to the COVID-19 pandemic.
Correction: Exploring the association between adolescent psychotic-like experiences and components of social performance using a multi-level virtual reality paradigm.
Kiernan G, Kohl P, Tas E … +5 more , Berg F, Wolf M, Nguyen PM, Valmaggia L, Rus-Calafell M
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41145725 · Full text
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Elevated prodromal psychotic symptoms lead to impaired social functioning via loneliness: A longitudinal mediation study.
Marcham L, Richardson T, Kelley NJ … +1 more , Ellett L
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41145724 · Full text
PURPOSE: Although previous studies have considered loneliness as a mediator of the relationship between prodromal psychotic symptoms and impaired social functioning, there is lack of consensus regarding directionality of...
PURPOSE: Although previous studies have considered loneliness as a mediator of the relationship between prodromal psychotic symptoms and impaired social functioning, there is lack of consensus regarding directionality of effects. We tested two competing hypotheses: Prodromal psychotic symptoms lead to deficits in social functioning via loneliness, vs. social functioning deficits lead to amplification of prodromal psychotic symptoms via loneliness. METHODS: We implemented a longitudinal mediational design measuring variables (social functioning, loneliness and prodromal symptoms) at three time points over 6 to 8 months (N = 276) in a sample of British undergraduate students. We tested four longitudinal mediation path models across the three time points, controlling for age, gender and ethnicity. RESULTS: Longitudinal mediational analyses suggest that both baseline prodromal symptoms and baseline distress about prodromal symptoms lead to small-to-moderate (standardized indirect effects = - 0.02) impairments in social functioning 6 to 8 months later via loneliness. However, baseline impairments in social functioning did not augment prodromal symptoms or symptom distress 6 to 8 months later. CONCLUSION: The results suggest that prodromal psychotic symptoms and distress about symptoms lead to impairments in social functioning via loneliness but not vice versa. These results suggest the need for preventative strategies to target loneliness which could prevent subsequent exacerbation of social functioning deficits. Future studies need to examine loneliness as a mechanism in the relationship between prodromal psychotic symptoms and social functioning across cultures, age groups, and over longer time periods.
Prevalence of sexual minorities and its association with mental health among Chinese adolescents: a nationally representative cross-sectional study.
Lai W, Li L, Shi J … +7 more , Wu H, Zhang Y, Huang G, Wang W, Guo L, Zhang WH, Lu C
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41125936 · Publisher ↗
PURPOSE: Mental health disparities in sexual minority adolescents have emerged as public health concerns worldwide. This study aimed to investigate the prevalence of sexual minorities and its association with mental heal...
PURPOSE: Mental health disparities in sexual minority adolescents have emerged as public health concerns worldwide. This study aimed to investigate the prevalence of sexual minorities and its association with mental health problems among Chinese adolescents, and explored sex difference and the role of social support in the foregoing associations. METHODS: A total of 66,812 adolescents were included from eight provinces via a multi-stage, stratified cluster, random sampling method in 2021. Sampling weights were used to estimate the prevalence, and propensity score-weighted multivariable logistic regression models were conducted in the analyses. Stratified analyses by sex and social support were also conducted. RESULTS: Of the total sample, the mean (SD) age was 14.9 (1.8) years, with 33,206 boys (52.4%) and 33,721 girls (47.6%). The weighted prevalence of adolescents who identified as heterosexual, homosexual, bisexual and unsure was 80.4%, 2.0%, 9.1% and 8.5%, respectively. Compared with heterosexual, homosexual adolescents were associated with higher odds of depressive symptoms (propensity score-weighted [PSW] adjusted odds ratio [AOR], 2.64; 95% CI, 2.17-3.22), anxiety symptoms (PSW AOR, 1.88; 95% CI, 1.55-2.29), non-suicidal self-injury (PSW AOR, 1.83, 95% CI, 1.55-2.17), suicidal ideation (PSW AOR, 2.34; 95% CI, 1.98-2.77), and suicidal attempt (PSW AOR, 2.39, 95% CI, 1.93-2.98). Sex-stratified analyses showed stronger associations between sexual minority status and most mental health problems for boys than for girls. Sexual minority adolescents with low social support were associated with poorer mental health compared to those with high social support. CONCLUSION: Homosexual and bisexual adolescents experienced poorer mental health status than their heterosexual peers, with homosexual adolescents showing slightly stronger associations with mental health risks than bisexual adolescents. More support from family, school and society are recommended to improve the well-being of sexual minority adolescents.
Suicide and sociodemographic factors among older adults in Norway: a register-based study.
Johansen AT, Bélanger SM, Reneflot A … +5 more , Hem E, Aakhus E, Øien-Ødegaard C, Stene-Larsen K, Hartberg CB
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 41120621 · Full text
PURPOSE: Suicide rates are high among older adults, yet research on risk factors associated with suicide in this age group remain largely unexplored. This study aims to examine the relationship between suicide and sociod...
PURPOSE: Suicide rates are high among older adults, yet research on risk factors associated with suicide in this age group remain largely unexplored. This study aims to examine the relationship between suicide and sociodemographic characteristics among individuals aged 60 and older. METHODS: We utilized data from Norwegian national registries, identifying individuals aged 60 and older who died by suicide between 2005 and 2019 (n = 2060, 70.7% males), and used a case-control design. To examine the relationships between suicide and sociodemographic factors, we used descriptive analyses and conditional multivariate logistic regression analyses, stratified by sex and age categories. RESULTS: Among individuals aged 60 to 69, risk factors for suicide included receiving a disability pension (odds ratio (OR) = 2.79 males, OR = 7.71 females), having mixed income sources (OR = 1.79 males, OR = 3.70 females), living alone (OR = 2.49 males, OR = 2.46 females), and living in urban areas, which was associated with an increased risk for females (OR = 1.85). Among males, living alone was also a significant risk factor for suicide in the 70 to 79 age group (OR = 1.85), and those aged 80 and above (OR = 2.16). Living in rural areas reduced risk for females aged 80 and above (OR = 0.05). CONCLUSION: This first register-based study of suicide in older adults in Norway highlights that living arrangements, urbanization level, and income source are significant risk factors for suicide among older adults. Interventions to improve social connectedness, with a focus on the urban-rural divide, could potentially reduce suicide risk. Sex and age categories should be considered in future research and when implementing preventive measures.
Impact of financial deprivation in first-episode psychosis: a prospective 4-year follow-up study.
Hui CLM, Lui ECY, Wong CCL … +7 more , Choi EMH, Yang NCL, Suen YN, Lee EHM, Chan SKW, Chang WC, Chen EYH
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 41107576 · Full text
PURPOSE: Socioeconomic disadvantage can exacerbate psychosis outcomes, yet the long-term impact of financial deprivation remains underexplored. This study examined how financial deprivation at first-episode psychosis aff...
PURPOSE: Socioeconomic disadvantage can exacerbate psychosis outcomes, yet the long-term impact of financial deprivation remains underexplored. This study examined how financial deprivation at first-episode psychosis affects clinical, functional, and neurocognitive outcomes over four years. METHODS: Participants were 240 adults (26-55 years) from the Jockey Club Early Psychosis project in Hong Kong, China. Financial deprivation was defined as household income < 50% of the median for household size. Regression analyses assessed the predictive value of baseline financial deprivation on four-year outcomes, controlling for sociodemographic and premorbid confounders. Age-subgroup analyses explored differential effects across developmental periods (< 33, 33-42, > 42 years). RESULTS: At baseline, 121 participants (51.7%) were financially deprived, characterized by lower education, more siblings, foreign-born status, and residence in public housing. Baseline financial deprivation predicted worse four-year clinical, functional, and quality of life outcomes four years later. Financial hardship did not appear to predict neurocognitive outcomes at follow-up. Age-subgroup analyses indicated the strongest and most consistent effects in participants > 42 years, with minimal to modest effects in younger subgroups. CONCLUSIONS: Financial deprivation during early psychosis represents a high-risk subgroup, particularly in later adulthood, with persistent symptomatic and functional impairments. Early identification and age-sensitive interventions, such as vocational support, social benefits assistance, and programs promoting social integration and independent living, are essential. Policy measures targeting socioeconomic disadvantage may mitigate long-term impacts on illness trajectory and recovery.
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