Social Psychiatry And Psychiatric Epidemiology[JOURNAL]
Sun
200 papers
Generalized anxiety disorder, psychiatric comorbidities, and suicide.
Chen LC, Huang WS, Tsai SJ … +6 more , Cheng CM, Chang WH, Bai YM, Su TP, Chen TJ, Chen MH
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 40858909 · Full text
BACKGROUND: Several studies have suggested a positive association between generalized anxiety disorder (GAD) and suicidal symptoms, particularly suicidal thoughts. Nevertheless, whether GAD is an independent risk factor...
BACKGROUND: Several studies have suggested a positive association between generalized anxiety disorder (GAD) and suicidal symptoms, particularly suicidal thoughts. Nevertheless, whether GAD is an independent risk factor for subsequent suicide is poorly understood. METHODS: Analyzing data on the entire Taiwanese population (N = 29,077,426), we followed 322,855 patients with GAD and 1,291,420 individuals without GAD matched for birth date and sex over the period from 2003 to 2017. Deaths by suicide were confirmed using Taiwan’s Database of All-cause Mortality. Psychiatric disorders comorbid with GAD were also assessed, specifically schizophrenia, bipolar disorder, major depression, alcohol use disorder, substance use disorders, obsessive-compulsive disorder, and neurodevelopmental disorders. RESULTS: A total of 2,051 (0.64%) individuals died by suicide in the GAD group, and 1,378 (0.11%) died by suicide in the control group. Cox regression models with adjustments for demographic characteristics, psychiatric comorbidities, and Charlson Comorbidity Index scores demonstrated that both men (hazard ratio [HR]: 2.64, 95% confidence interval [CI]: [2.29, 3.05]) and women (HR: 2.70, 95% CI: [2.33, 3.13]) with GAD were more likely to die by suicide than individuals in the control group DISCUSSION: GAD was a risk factor for death by suicide when controlling for various sociodemographic and clinical factors,including comorbid schizophrenia, bipolar disorder, major depressive disorder, and alcohol and substance use disorders.Suicide prevention strategies must be developed for individuals with GAD and associated psychiatric comorbidities.
Mental illness severity and characteristics among holocaust survivor immigrants, Non-Holocaust immigrants, and native israelis: A historical prospective study.
Keller S, Savitsky B, Manor O … +2 more , Heresco-Levy U, Lichtenberg P
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 40841836 · Full text
INTRODUCTION: Holocaust survivors were exposed to extreme trauma. More than half a million survivors immigrated to Israel over the years, as well as immigrants who didn't suffer the atrocities of the holocaust. Trauma an...
INTRODUCTION: Holocaust survivors were exposed to extreme trauma. More than half a million survivors immigrated to Israel over the years, as well as immigrants who didn't suffer the atrocities of the holocaust. Trauma and immigration are both risk factors for mental disorders. AIM: To describe differences in hospitalization characteristics and to determine whether there are differences in illness severity between mentally ill Holocaust Survivor Immigrants (HSI), non-Holocaust immigrants (NHI), and Native Israelis (NI). METHODS: An unidentified list of hospitalized psychiatric patients was extracted from the Israel psychiatric case registry according to the following criteria: Jewish patients who were born in Europe or Israel before 1944 and were admitted to a psychiatric ward between 1945 and 2010. 30,539 records were divided into three groups: Holocaust Survivor Immigrants, Native Israelis, and Non-Holocaust Immigrants. RESULTS: The number of first hospitalizations after age 70 is significantly higher at the HSI and NHI compared to NI. A significantly higher rate of suicide attempts was observed among HSI (13.8%), compared with the NI (11.8%) and NHI (9.7%). The odds for severe mental illness were significantly higher among HSI and NHI compared to NI by 84% and 66% among patients with psychotic disorders, twofold higher, and higher by 37% among patients with affective disorders, and threefold and 2.5 times higher among patients with anxiety. CONCLUSIONS: Exposure to the Holocaust trauma has an effect on patterns of psychiatric hospitalizations and the severity of Holocaust survivors' psychiatric illness. Immigration is an independent risk factor for severe mental illness, although its influence was less pronounced than direct Holocaust exposure. Exposure to severe trauma such as war during childhood has long-term effects on the course and severity of mental illnesses.
Correction: Problematic social media use and psychological symptoms in adolescents.
Mojtabai R
Soc Psychiatry Psychiatr Epidemiol · 2025 Nov · PMID 40826240 · Full text
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Adolescents' health and well-being into the COVID-19 pandemic: A two-wave prospective investigation- The HUNT study.
Kvaløy K, Sund ER, Rimehaug T … +3 more , Pape K, Ingul JM, Rangul V
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 40826239 · Full text
PURPOSE: Using data on Norwegian adolescents, this study aimed to explore changes in mental health, quality of life, somatic health complaints and loneliness from before and one year into the COVID-19 pandemic, also cons...
PURPOSE: Using data on Norwegian adolescents, this study aimed to explore changes in mental health, quality of life, somatic health complaints and loneliness from before and one year into the COVID-19 pandemic, also considering the changes according to socioeconomic position (SEP). METHODS: The study involved a cross-sectional comparative design with data from Young-HUNT4 (2017-2019) (n = 4347) and Young-HUNT COVID (May/June 2021) (n = 2033), aged 16-19 years. Additionally, longitudinal changes from Young-HUNT4 (n = 1565), aged 13-15 years, with follow-up in Young-HUNT COVID were explored. The impact of SEP was investigated through regression analyses and investigating prevalence changes in high and low SEP groups. RESULTS: In the cross-sectional comparison, boys and girls reported higher levels of loneliness and mental distress (boys only) into the pandemic compared to before, while general health and quality of life remained stable. Longitudinally, all factors changed adversely except for general health in boys. Comparing younger (13-15 years) with older (16-19 years) adolescents from Young-HUNT4, demonstrated the same adverse pattern as in the longitudinal sample. Poor health, poor quality of life and loneliness were more prevalent in the low compared to the high SEP group. In the low SEP group, mental distress, poor general health and life quality worsened in boys while improved in girls during the study period. CONCLUSION: Except for mental distress in boys, general health and life quality did not deteriorate in the study period, although loneliness increased in both sexes. In the low SEP group, girls seemed to cope better than boys where health and well-being even improved.
Expectations regarding transitioning into long-term care, social connectedness, and mental health of older adults.
Lane A, Dang L, Qin W … +2 more , Burgard S, Mezuk B
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 40826238 · Full text
PURPOSE: This study examined the association between perceived likelihood of moving into a nursing home and depressive and suicidal outcomes among adults aged 65+, and explored variation in those associations by two aspe...
PURPOSE: This study examined the association between perceived likelihood of moving into a nursing home and depressive and suicidal outcomes among adults aged 65+, and explored variation in those associations by two aspects of social connectedness: individual social networks and neighborhood social cohesion. METHODS: Data comes from the 2018 Health & Retirement Study (N = 7,897). Perceived likelihood of moving into a nursing home in the next five years was assessed using a probability scale (0-100%). Past-year elevated depressive symptoms, major depressive episodes (MDE), and passive suicidal ideation (PSI) were indexed by the Composite International Diagnostic Interview. Social networks (e.g., diversity and frequency of contact with social network, number of close relationships) and neighborhood social cohesion (e.g., living close to good friends, neighborhood social cohesion index) were self-reported. Multivariable logistic regression models were used to examine the association between nursing home expectations and depression outcomes; moderation by social connectedness was examined using interaction terms. RESULTS: The majority of respondents reported low perceived likelihood of moving into a nursing home (median: 5%, IQR: 0-20%). Higher perceived likelihood was positively associated with depressive symptoms (Odds Ratio [OR]: 1.06, 95% CI: 1.01, 1.11), MDE (OR: 1.08, 95% CI: 1.02, 1.15), and PSI (OR: 1.10, 95% CI: 1.04, 1.17). Having a close friend in the neighborhood heightened the association between expectations and mental health; other measures of social connectedness did not moderate this association. CONCLUSION: Older adults anticipating transitioning to long-term care may have unmet emotional support needs, particularly if they are socially-integrated in their neighborhood.
Identifying psychological distress data available in nationally representative surveys: A scoping review and case study of Australian surveys.
Varley D, Henry A, Halladay J … +10 more , Baillie A, Keyes K, Slade T, Chapman C, O'Dean S, Visontay R, Mewton L, Newton NC, Teesson M, Sunderland M
Soc Psychiatry Psychiatr Epidemiol · 2026 Jan · PMID 40789817 · Full text
PURPOSE: Mental health data are crucial for understanding trends in psychological distress. This scoping review aimed to identify and describe surveys of representative samples of the Australian household population that...
PURPOSE: Mental health data are crucial for understanding trends in psychological distress. This scoping review aimed to identify and describe surveys of representative samples of the Australian household population that measured psychological distress, and to provide a case study illustrating how datasets can be systematically summarized to assist researchers to more easily identify available datasets. METHODS: We systematically searched PubMed and data archives for surveys state or nationally representative of the Australian household population that assessed psychological distress. RESULTS: We provide a searchable metadata database characterizing 283 identified datasets from 41 studies (25 cross-sectional, 16 longitudinal) conducted between 1989 and 2023. Thirty-nine psychological distress instruments were used, with the Kessler Psychological Distress scale (K10) [1] most common (n = 114 datasets). Surveys also frequently measured demographics, physical health, and socioeconomic information. Stratified random sampling of geographic areas was the most common sampling frame, and adults the most frequently sampled group. There was notably less representation of important subgroups of the population, including youth, Aboriginal and Torres Strait Islander people, and people with disabilities, despite evidence of high distress prevalence in these groups. CONCLUSIONS: This review provides valuable metadata summarizing available psychological distress datasets, including information on sampling designs, instrumentation, and covariates. This metadata is available to other researchers, enabling efficient identification of relevant datasets, promoting data sharing, and supporting future data integration. This method for systematically compiling metadata can be replicated for data related to other topics important to public health to facilitate greater data utilization.
Healthcare experiences and barriers as predictors of suicidal thoughts and behaviors among transgender adults: an elastic net regression analysis.
Mournet AM, Ball MI, Kleiman EM
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 40775401 · Full text
PURPOSE: Suicide is a critical public health concern, particularly among transgender and gender diverse (TGD) individuals The current study aims to identify structural and interpersonal barriers as well as protective fac...
PURPOSE: Suicide is a critical public health concern, particularly among transgender and gender diverse (TGD) individuals The current study aims to identify structural and interpersonal barriers as well as protective factors that impact suicide risk among transgender and gender diverse adults. METHODS: The currently analyses utilize the TransPop dataset, the first national probability sample of 274 adult transgender adults in the United States. Elastic net regression was used to examine the relationships between the set of 17 healthcare predictor variables and STB outcome variables. RESULTS: Worries about negative evaluation from healthcare providers emerged as highly important variables across STB outcomes. Inability to access healthcare due to the cost of seeing a doctor was associated with increased suicide plans. Having insurance was associated with decreased odds of suicidal ideation with intent. CONCLUSIONS: There is a need for increased supportiveness and acceptance from healthcare providers as well as a need to ensure that TGD individuals have access to high-quality mental and physical healthcare.
Exploring the COVID-19 pandemic's impact on mood, anxiety, and neurocognitive disorders in older adults: sex, geographic context, and healthcare setting considerations.
Paquet J, Hibbard K, Brett-MacLean P
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 40770133 · Publisher ↗
INTRODUCTION: Older adults face unique risk factors for psychiatric illness, including comorbid medical concerns, loss, and loneliness. With the older adult population expected to triple in the next two decades, understa...
INTRODUCTION: Older adults face unique risk factors for psychiatric illness, including comorbid medical concerns, loss, and loneliness. With the older adult population expected to triple in the next two decades, understanding patterns of prevalent psychiatric disorders, including anxiety, mood, and neurocognitive disorders is crucial for treatment and policy planning. METHODS: This longitudinal cohort design examined anxiety, mood, and neurocognitive disorders among older adults in Alberta, utilizing physician billing data from 2017 to 2022. Rates of presentations were compared before, during, and after the COVID-19 pandemic. The study assessed the influence of sex, geographic location (urban, rural) and healthcare setting (outpatient, emergency department, inpatient). Descriptive statistics, ANOVA, and regression analyses were performed to assess the impact of these factors on presentations. RESULTS: Alberta's older adults had 1,365,423 presentations for mood, anxiety, and neurocognitive disorders from 2017 to 2022 with outpatient services comprising the majority, increased 28.18% during the pandemic. Anxiety was the most common (45.47%), followed by mood (34.76%) and neurocognitive disorders (18.77%). ANOVA showed no significant differences across pandemic phases for mood, anxiety or neurocognitive disorders. Regression analyses identified sex, geographic locations, and healthcare setting as significant predictors, with healthcare setting having the strongest effect. Interactions between sex, geographic location, and healthcare setting were significant for mood and anxiety disorders. CONCLUSION: Psychiatric presentations varied by disorder, influenced by demographic and contextual factors. Healthcare setting was a significant predictor across all disorders. The lack of pandemic-related effects suggests a consistent impact across phases, highlighting the need for ongoing evaluation on the pandemic's long-term effects.
Prevalence, risk and protective factors of postpartum depression and anxiety symptoms in the Allada district, Benin.
Youshaa M, van der Waerden J, Zoumenou R … +4 more , Massougbodji A, Boivin MJ, Bodeau-Livinec F, Marr K
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 40770132 · Publisher ↗
PURPOSE: Postpartum depression symptoms (PPDS) and postpartum anxiety symptoms (PPAS) are a major global public health issue, especially in low-resource settings. This study aimed to determine the prevalence of PPDS and...
PURPOSE: Postpartum depression symptoms (PPDS) and postpartum anxiety symptoms (PPAS) are a major global public health issue, especially in low-resource settings. This study aimed to determine the prevalence of PPDS and PPAS in Benin, Sub-Saharan Africa, at one year postpartum and to identify associated risk and protective factors. METHODS: Pregnant women were recruited for a longitudinal mother-child cohort in the Allada District of Benin, and a cross-sectional analysis was performed on data collected at one-year postpartum. Maternal depression and anxiety symptoms were assessed one year postpartum using the Edinburgh Postnatal Depression Scale (EPDS)-validated in Benin and translated into Fon-and its anxiety subscale (EPDS-3 A). Cut-off scores for high depressive and anxiety symptoms were ≥ 13 and ≥ 6, respectively. Potential risk and protective factors including maternal, child characteristics, socioeconomic status, and social support were analyzed using multivariable-adjusted logistic regression models. RESULTS: At one year postpartum, 13% of 742 mothers had PPDS, and 21% PPAS. Risk factors for PPDS included recent alcohol consumption (previous three months) (aOR = 1.88; 95%CI: 1.17-3.02) and food insecurity (aOR = 4.47; 95%CI: 1.29-17.4), while partner cohabitation reduced PPDS odds (aOR = 0.45; 95%CI: 0.26-0.80). PPAS risk factors included recent alcohol consumption (aOR = 2.17; 95%CI: 1.44-3.28) and regular child care support from 3 + childcare providers (aOR = 2.91; 95%CI: 1.50-5.68). Protective factors for PPAS included the minority Aizo ethnicity (aOR = 0.58; 95%CI: 0.36-0.93) and living in an individual house (aOR = 0.45; 95%CI: 0.24-0.85). CONCLUSION: This study sheds light on the prevalence of PPDS and PPAS at one year postpartum in the Beninese context, as well as associated factors. Findings underscore the importance of establishing postpartum psychological follow-up and targeted strategies to support maternal mental health in low-resource settings, addressing both socioeconomic vulnerabilities and social support structures.
Effects of sarcopenic obesity on depressive symptoms and their trajectories: findings from the CHARLS 2011-2020.
Su S, Wang K, Yang Z … +5 more , Zhou Y, Ma R, Chen S, Zhou M, Yang Y
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 40770131 · Publisher ↗
PURPOSE: Sarcopenia and obesity are recognized factors associated with the onset of depression. Our study aims to clarify the specific impact of sarcopenic obesity on depression development and the longitudinal trajector...
PURPOSE: Sarcopenia and obesity are recognized factors associated with the onset of depression. Our study aims to clarify the specific impact of sarcopenic obesity on depression development and the longitudinal trajectories of depressive symptoms. METHODS: Data from the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS) were utilized, including 8532 participants aged ≥ 45 years. Cox proportional hazards regression assessed the effect of sarcopenic obesity on the incidence of depression. Restricted cubic spline (RCS) regression explored the relationship between components of sarcopenic obesity (waist circumference, BMI, handgrip strength, and appendicular skeletal muscle mass index (ASM/Ht)) and depression risk. Group-based trajectory modeling (GBTM) identified depressive symptom trajectories among 7895 participants. Multivariate logistic regression analyzed the influence of sarcopenic obesity and other covariates on depressive symptom trajectories. RESULTS: Sarcopenic non-obesity (HR = 1.15; 95% CI: 1.03-1.28) and sarcopenic obesity (HR = 1.28; 95% CI: 1.04-1.58) were associated with increased depression risk. RCS analysis revealed a significant dose-response relationship between components of sarcopenic obesity (waist circumference, BMI, handgrip strength, and ASM/Ht) and depression risk (P for overall trend < 0.05). Three depressive symptom trajectories over the nine years were identified: relatively stable (48.1%), moderate growth (41.8%), and rapid growth (10.1%). Sarcopenic obesity (OR = 2.22, 95% CI: 1.40-3.51) was identified as a potential factor influencing variability in depressive symptom trajectories. CONCLUSIONS: Sarcopenic obesity is associated with an increased risk of depression and may affect the progression of depressive symptoms. Improving muscle mass and strength and maintaining moderate abdominal fat in middle-aged and older adults could help prevent depression.
Stigmatizing attitudes and causal beliefs for depression and social anxiety among adolescents in Bermuda.
Cavanagh D, Hart LM, Basden S … +1 more , Reavley N
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 40770130 · Full text
PURPOSE: Stigmatizing attitudes towards individuals with mental illness are common among adolescents. Limited research exists on stigmatizing attitudes and causal beliefs about common mental disorders in adolescent popul...
PURPOSE: Stigmatizing attitudes towards individuals with mental illness are common among adolescents. Limited research exists on stigmatizing attitudes and causal beliefs about common mental disorders in adolescent populations in the Caribbean. This study seeks to understand the stigmatizing attitudes and beliefs about the causes of depression and social phobia (social anxiety) among adolescents in Bermuda. METHODS: This cross-sectional study surveyed students aged 10–19 years attending middle or high school in Bermuda. Online surveys conducted between November 2022 and June 2023 gathered data including demographics and symptoms of depression or anxiety, as well as correct problem recognition, stigmatizing attitudes and causal beliefs about a mental health problem described in a vignette. RESULTS: A total of 2,522 adolescents in Bermuda (70% of eligible participants) provided valid data for the depression (n = 1277) or social anxiety (n = 1245) vignette. Across both vignettes, reporting female gender was associated with less stigmatizing attitudes, while adolescents who identified their race as Black or Minority reported more stigmatizing attitudes. About three in ten adolescents reported a reluctance to disclose either social anxiety or depression. Respondents were more likely to believe in a psychosocial cause than a chemical imbalance cause of mental illness. CONCLUSION: This study suggests there is a need to address stigmatizing attitudes among young people in Bermuda. In particular, anti-stigma campaigns need to be targeted to changing attitudes among those with higher stigma, including males or those reporting Black or Minority race.
Relationship between COVID-19 stigma and anxiety symptoms in university students during the COVID-19 pandemic.
Luo K, Ren L, Wang J … +3 more , Liu C, Luo X, Li K
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 40770129 · Publisher ↗
BACKGROUND: The COVID-19 pandemic after isolation removal increased stigmatizing attitudes and anxiety, but there is a lack of studies analyzing the relationship between stigmatizing attitudes and anxiety symptoms after...
BACKGROUND: The COVID-19 pandemic after isolation removal increased stigmatizing attitudes and anxiety, but there is a lack of studies analyzing the relationship between stigmatizing attitudes and anxiety symptoms after isolation lifting. This study aimed to explore the complex relationship between the SARS-CoV-2 stigma and anxiety symptoms in patients with SARS-CoV-2 and healthy populations. METHODS: We conducted a cross-sectional survey in which 1,730 university students reported COVID-19 stigmatizing attitudes and anxiety symptoms. These included university students who were either infected or uninfected individuals. We estimated the complex relationship between stigmatizing attitudes and anxiety symptoms using network analysis methods. RESULTS: During the COVID-19 pandemic, stigmatizing attitudes and anxiety observed in the infected group were 32.86% and 28.28%, respectively, and in the uninfected group were 34.64% and 22.79%, respectively. Network analysis showed that A2 (Uncontrollable worry) had the strongest expected influence centrality and S1 (Stereotype) had the strongest bridge expected influence centrality; network comparative analysis of the infected and uninfected groups revealed a significant difference in the expected influence centrality for S1; and directed acyclic graph analysis showed that node A2 had the highest priority. CONCLUSION: We recommend developing appropriate strategies for safeguards, such as the dissemination of relevant knowledge to at-risk populations, to cope with stigmatizing attitudes and anxiety symptoms among university students.
A meta-analysis of the role of neighborhood deprivation in psychotic disorders.
James SH, Galvan T, Zollicoffer A … +1 more , Strauss GP
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 40770128 · Full text
PURPOSE: Although current interventions have proven effective for improving outcomes for individuals with psychotic disorders, this population continues to encounter challenges and health disparities. Recently, researche...
PURPOSE: Although current interventions have proven effective for improving outcomes for individuals with psychotic disorders, this population continues to encounter challenges and health disparities. Recently, researchers have investigated how social determinants of health influence the incidence and outcomes of psychotic disorders. In particular, neighborhood deprivation (i.e., a composite index capturing the social, material, and environmental challenges of a particular area relative to the broader area [1]), has been investigated in numerous studies on psychotic disorders but research has yet to consolidate and quantify its significance. The current meta-analysis assesses neighborhood deprivation and its relationship to psychotic disorder incidence and symptoms. METHODS: Articles published prior to April 1, 2024 were identified via two bibliographic databases: PubMed and PsycINFO. The literature search yielded 17 studies consisting of 59,719 cases for the meta-analysis investigating the relation between neighborhood deprivation and psychotic disorder incidence. Six studies of 2,790 cases were included in the meta-analysis assessing the relation between neighborhood deprivation and psychotic disorder symptoms. RESULTS: There was a robust relation between psychotic disorder incidence and neighborhood deprivation, such that as neighborhood deprivation within an area increased so too did the incidence. There was no evidence of a substantial relationship between neighborhood deprivation and psychotic disorder symptoms. CONCLUSIONS: The results of this study identified a social determinant of health that has high relevance to the incidence of psychotic disorders. Findings underscore the need to develop multi-level interventions to address neighborhood deprivation and reduce resource inequalities across geographical locations.
Identifying the vulnerable among the vulnerable: applying quantitative intersectionality methods to assess potential inequities in the HIV continuum of care for people living with schizophrenia in the united States.
Wesson P, Vittinghoff E, Thomas MD … +6 more , Crystal S, Hermida R, Walkup J, Cournos F, Olfson M, Mangurian C
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 40760187 · Full text
BACKGROUND: People living with schizophrenia face disproportionate risk of HIV, yet HIV testing remains low. Differential testing rates and engagement in care may be impacted by compounding social marginalization, partly...
BACKGROUND: People living with schizophrenia face disproportionate risk of HIV, yet HIV testing remains low. Differential testing rates and engagement in care may be impacted by compounding social marginalization, partly linked to structural barriers. Grounded in intersectionality, we set out to identify the riskiest intersectional positions for HIV testing and engagement in HIV care in the United States. METHODS: We created a retrospective cohort of people living with schizophrenia and matched controls, using 2012 national Medicaid claims data. We coded intersectional positions based on schizophrenia diagnosis, race/ethnicity, sex, and age. We used Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models to assess intersectional effects for two outcomes, HIV testing and retention in HIV care (RIC) defined as ≥2 CD4 or HIV viral load tests ≥90 days apart. RESULTS: Of 777,887 patients in the testing cohort, 7.7% tested for HIV; 39% of the 17,913 patients in the RIC cohort were retained in care. In MAIHDA models without fixed effects, intersectional positions explained 12.7% of the variance in HIV testing and 7.4% of the variance in RIC. In final models including fixed and random effects, intersectional positions accounted for 1.4% of the variance in HIV testing and 0.8% of the variance in RIC. Older Black men with schizophrenia had lower-than-expected RIC prevalence in final models. CONCLUSION: Intersectional MAIHDA models can identify both vulnerable and resilient intersectional positions. The antagonistic intersectional effects for older Black men with schizophrenia highlight the need for targeted interventions to address structural barriers.
Duration of untreated psychosis and diagnostic delay in homeless patients with schizophrenia- a Copenhagen based clinical study.
Handest R, Mølstrøm IM, Henriksen MG … +1 more , Nordgaard J
Soc Psychiatry Psychiatr Epidemiol · 2025 Dec · PMID 40745027 · Full text
PURPOSE: Psychiatric disorder is a well-established risk factor for homelessness, and homelessness amplifies social, physical, and mental health risks. Yet, little is known about the extent and nature of diagnostic delay...
PURPOSE: Psychiatric disorder is a well-established risk factor for homelessness, and homelessness amplifies social, physical, and mental health risks. Yet, little is known about the extent and nature of diagnostic delays, including the duration of untreated psychosis (DUP), among homeless individuals with schizophrenia. This study aimed to address that gap by examining DUP, diagnostic delays, illness trajectories, psychopathology, and substance use in this population. METHODS: We conducted an exploratory cross-sectional study of 35 homeless individuals with schizophrenia, using in-depth psychosocial interviews, standardized psychopathological assessments, and social functioning scales, incl. the Positive and Negative Syndrome Scale (PANSS) and the Examination of Anomalous Self-Experience (EASE). RESULTS: The sample (mean age 32.6 years; 82.9% male) included 17 patients with paranoid schizophrenia and 10 with disorganized (hebephrenic) schizophrenia; 54% had a comorbid substance use disorder (SUD). The mean DUP was 15.5 years, with an average 6.7-year delay between first psychiatric contact and formal non-substance induced psychosis diagnosis. Patients with SUD showed shorter DUP compared to those without. Psychopathological measurements - including a mean PANSS score of 71.7 and a mean EASE score of 21.3 - were comparable to other schizophrenia samples, with no major differences between patients with or without SUD. CONCLUSION: Our findings indicate that the extraordinarily long DUP and diagnostic delays in this homeless sample are not explained by substance use, symptom profile, or schizophrenia subtype but point to systemic barriers in recognizing and managing severe mental illness. There is an urgent need to improve psychiatric services for homeless individuals with schizophrenia.
A short form of the Spanish version of the Netherlands empowerment list: development and validation.
Sampietro HM, Guilera G, Berrío ÁI … +3 more , Barrios M, Rojo JE, Gómez-Benito J
Soc Psychiatry Psychiatr Epidemiol · 2026 Mar · PMID 40739456 · Full text
PURPOSE: The Netherlands Empowerment List (NEL) is the only psychometric instrument for evaluating empowerment that has been adapted and validated for use in the Spanish-speaking population. Although the Spanish NEL has...
PURPOSE: The Netherlands Empowerment List (NEL) is the only psychometric instrument for evaluating empowerment that has been adapted and validated for use in the Spanish-speaking population. Although the Spanish NEL has demonstrated good psychometric properties, it is relatively lengthy. This study aimed to develop and validate a short form of the Spanish NEL. METHOD: The sample comprised 406 users of community mental health services, split into two groups. With the development subsample (n = 200), we developed a short form of the Spanish NEL based on the factor loadings obtained through exploratory factor analysis. The validation subsample (n = 206) was then used to evaluate its psychometric properties (internal structure, differential item and test functioning by gender, internal consistency, temporal stability, and validity based on relationships with other variables). Additionally, percentile ranks for each raw score were calculated using the total sample (n = 406). RESULTS: We developed a 12-item short form of the Spanish NEL, confirmed its unidimensionality, and demonstrated that the scale scores had excellent internal consistency and temporal stability. Scores on the Spanish NEL-12 also correlated strongly with measures of empowerment, recovery, hope, and perceived social support. CONCLUSION: The results suggest that scores on the Spanish NEL-12 provide a valid and reliable measure of empowerment in Spanish-speaking users of mental health services. Furthermore, the study provides preliminary percentile scores to support its use in clinical settings for evaluating empowerment.
Preconception parental personality disorder and psychosocial outcomes during the perinatal period: a prospective population-based study.
Wilson CA, Husin HM, Dashti SG … +10 more , Catalao R, Borschmann R, Brown S, Howard LM, Kerr JA, Monk-Cunliffe J, Moran P, Patton GC, Olsson CA, Spry E
Soc Psychiatry Psychiatr Epidemiol · 2026 Feb · PMID 40730700 · Full text
PURPOSE: Birthing individuals with personality disorder in young adulthood before pregnancy may be at increased risk of potentially modifiable adverse outcomes in the perinatal period that impact parental and child healt...
PURPOSE: Birthing individuals with personality disorder in young adulthood before pregnancy may be at increased risk of potentially modifiable adverse outcomes in the perinatal period that impact parental and child health. We aimed to investigate the perinatal psychosocial outcomes of preconception (prior to pregnancy) personality disorder. METHODS: Prospective analysis of 398 birthing individuals with 609 infants from Victorian Intergenerational Health Cohort Study (VIHCS). Preconception personality disorder was measured using the Standardised Assessment of Personality (SAP) at age 24. A range of parental outcomes were assessed during pregnancy and at one year postpartum (age 28 to 37). Log-binomial generalised estimating equations were used to estimate univariable associations between preconception personality disorder and each perinatal outcome. RESULTS: Individuals with preconception personality disorder (compared to those without) were approximately two times more likely to have antenatal anxiety symptoms (risk ratio (RR) 2.08, 95% confidence interval (CI) 1.19-3.65) and reduced social support (antenatal RR 2.01, 95% CI 0.98-4.13; postnatal RR 1.38, 95% CI 0.91-2.10). Weaker associations were also observed for experiencing stressful life events (RR 1.37, 95% CI 0.98-1.90) and, albeit with less certainty, for poorer partner relationship quality (RR 1.44, 95% CI 0.78-2.64) and depressive symptoms (antenatal RR 1.56, 95% CI 0.84-2.91; postnatal RR 1.44, 95% CI 0.73-2.83). Close to null associations were observed for parents' self-efficacy or perceived parent-infant bond. CONCLUSION: The findings highlight a group who may be vulnerable to multiple adverse perinatal outcomes; those with personality disorder and their families may benefit from additional support both with pregnancy planning and into parenthood.
The silent struggle of ageing with SMI: a narrative review of physical health disparities in older adults with serious mental illness.
Howe J, Lindsey L
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 40715449 · Full text
PURPOSE: Individuals with serious mental illness (SMI) experience a significantly reduced life expectancy compared to peoplewithout SMI, affecting millions worldwide. While cardiovascular disease, diabetes, and metabolic...
PURPOSE: Individuals with serious mental illness (SMI) experience a significantly reduced life expectancy compared to peoplewithout SMI, affecting millions worldwide. While cardiovascular disease, diabetes, and metabolic syndrome are well-recognisedphysical health conditions in this population, this article addresses the unique challenges in managing dementia, cancer,menopause, osteoporosis, and oral health in the context of SMI and ageing. METHODS: This article presents a conceptually informed narrative review of ageing-related physical health disparities experiencedby people living with SMI. A narrative review approach was adopted to allow for a targeted and iterative synthesis of evidenceacross five underexplored domains: dementia, cancer, menopause, osteoporosis, and oral health. These domains were selecteddue to their public health significance, under-representation in the literature, and relevance to the lived experiences of older adultswith SMI. RESULTS: Despite their substantial impact on the well-being of individuals with SMI, these areas often receive less attention.Diagnostic overshadowing, limited specialised knowledge among mental health staff about physical health, and the siloed nature ofhealthcare delivery contribute to delays in diagnosis and treatment. CONCLUSION: To improve health outcomes and life expectancy for people with SMI, there is an urgent need for integratedhealthcare approaches. Collaborative models that bridge the gap between mental and physical healthcare are essential to ensuretimely access to holistic care and address the unique needs of this vulnerable population as they age.
Impact of the COVID-19 pandemic on antidepressant use in eleven European regions: a comparative time series analysis 2018-2022.
Selke Krulichová I, Hallberg A, Selke GW … +12 more , Aaltonen K, Casula M, Fürst J, Gvozdanović K, Hajiebrahimi M, Kurdi A, Nyberg F, Olmastroni E, Rättö H, Slabý J, Wettermark B, Mueller T
Soc Psychiatry Psychiatr Epidemiol · 2026 Apr · PMID 40696201 · Full text
PURPOSE: The COVID-19 pandemic had detrimental effects on the mental health of populations, with differing influences on different demographic groups. Varying national countermeasures to the pandemic may have further imp...
PURPOSE: The COVID-19 pandemic had detrimental effects on the mental health of populations, with differing influences on different demographic groups. Varying national countermeasures to the pandemic may have further impacted these effects. This study aimed to explore the effects of the pandemic on dispensed volumes of antidepressants in outpatient settings in different regions of Europe and to assess potential age- and sex-related differences of its impact on incidence of antidepressant dispensing. METHODS: We used descriptive and interrupted time series analyses of pharmacy dispensing data on volumes. For six regions, we analysed volume and incident use stratified by age and sex. RESULTS: During the pandemic, the preexisting long-term trend in unstratified dispensed volumes significantly increased only in Slovenia and Germany and weakened in Scotland and Wales (estimated changes in slope + 0.16, + 0.10, - 0.23, and - 0.68 defined daily doses per thousand inhabitants per day, respectively, for each month). The stratified quarterly analysis revealed the greatest relative increase in females aged 0-17 (+ 64% in Sweden to + 167% in Croatia in the last quarter of 2022 compared with the last quarter of 2019). Both rate of change and difference between sexes were lower in higher age groups. Incidence increased most steeply in females aged 0-17, where the estimated pandemic-related increase explained 11% (Sweden) to 55% (Lombardy) of new patients receiving antidepressants. CONCLUSION: Our findings indicate the need to develop targeted mental health supporting measures to increase resilience, especially in young people, and mitigate the impact of potential future public health crises.
The peer-led Honest, Open, Proud program to decrease the impact of mental illness stigma among German military personnel: randomized controlled trial.
Rüsch N, Helms C, Hörger J … +8 more , Höhle B, Bernert H, Muschner P, Rose C, Corrigan PW, Mulfinger N, Zimmermann P, Willmund GD
Soc Psychiatry Psychiatr Epidemiol · 2026 May · PMID 40696200 · Full text
PURPOSE: Due to widespread stigma in the military, many military servicemembers with mental illness struggle with discrimination, self-stigma and decisions whether to disclose their condition. This study had the aim to e...
PURPOSE: Due to widespread stigma in the military, many military servicemembers with mental illness struggle with discrimination, self-stigma and decisions whether to disclose their condition. This study had the aim to evaluate the efficacy of Honest, Open, Proud (HOP), a four-session peer-led group program adapted to support military personnel with disclosure decisions and to reduce stigma's impact, in the German military. METHODS: Ninety-nine active servicemembers with mental illness were randomized to HOP and treatment as usual (TAU) or to TAU alone. The two primary endpoints were stigma stress three weeks after baseline (T1/after HOP for HOP participants) and psychological quality of life six weeks after baseline (T2/after the HOP booster session). This randomized-controlled trial was registered before recruitment onset at ClinicalTrials.gov (NCT03218748). RESULTS: Compared to the control group, stigma stress decreased significantly among HOP participants at T1 (d = 0.64), while there was no significant effect of HOP on psychological quality of life at T2. HOP had significant positive effects on secondary outcomes at T2: overall quality of life, self-stigma, depressive symptoms, empowerment, well-being, attitudes to disclosure and to help-seeking, and secrecy. Reductions in stigma stress, secrecy, and marginally in overall quality of life (p = 0.055), remained significant twelve weeks after baseline (T3). CONCLUSION: This trial provides initial evidence that HOP for active military servicemembers is feasible and effective in terms of stigma stress, disclosure decisions, depressive symptoms, quality of life and well-being. HOP may be a valuable addition to mental health services and peer support in the military.
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