Social Psychiatry And Psychiatric Epidemiology[JOURNAL]
Sun
200 papers
The architecture of depression and comorbid symptoms in chinese vocational college students: a dual-method network analysis.
Song Z, Yu Y, Liu S … +4 more , Liang S, Song L, Mao Y, Nie S
Soc Psychiatry Psychiatr Epidemiol · 2026 Jul · PMID 42399460 · Publisher ↗
PURPOSE: Our study aimed to delineate the architecture of psychopathology in a large, understudied cohort of Chinese vocational college students, identifying common foundations and subgroup-specific symptom pathways. MET...
PURPOSE: Our study aimed to delineate the architecture of psychopathology in a large, understudied cohort of Chinese vocational college students, identifying common foundations and subgroup-specific symptom pathways. METHODS: We assessed 9,040 students (65.67% male; M = 19.63, SD = 1.08) from a single institution using the Symptom Checklist-90. Network Analysis (NA) was used to map comorbidity patterns and identify central and bridge symptoms, and Network Comparison Tests (NCT) were performed to examine structural differences across gender and grade levels. Bayesian Network Analysis (BNA) was applied to infer putative directional pathways. Finally, we applied the Hierarchical Influence Model (HIM) to improve the interpretability of the Bayesian network. RESULTS: A consistent architecture emerged: depression functioned as the central bridge symptom in the undirected networks and was identified as the primary upstream node in the Bayesian networks across all subgroups. However, downstream pathways diverged significantly. NCT results confirmed statistically significant edge-level differences across gender and grade. For males, depression associated with a cognitive-to-avoidant trajectory; for females, it associated with an affective-to-externalizing pathway. Analysis also revealed distinct patterns across grades. Distinct developmental patterns also emerged: freshmen and juniors showed an affective-to-externalizing pathway consistent with responses to transitional stress, whereas sophomores displayed an affective-to-avoidant pathway linked to social withdrawal. CONCLUSIONS: Our findings reveal a dual structure: a universal foundation centered on depression, branching into gender- and grade-specific pathways. While depression represents a universal focal point for early intervention, the distinct downstream cascades underscore the necessity of tailored mental health strategies for this emerging adult population.
Social deprivation in adolescence and risk of depression in young adulthood: a longitudinal analysis of linked administrative data from Northern Ireland.
Menting SGP, McDowell R, Redican E … +3 more , Rosato M, Murphy J, Leavey G
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42377415 · Publisher ↗
PURPOSE: Socioeconomic deprivation may elevate the risk of depression. This study examines how the effect of area-level deprivation during adolescence on antidepressant prescribing varies by urbanicity in young adulthood...
PURPOSE: Socioeconomic deprivation may elevate the risk of depression. This study examines how the effect of area-level deprivation during adolescence on antidepressant prescribing varies by urbanicity in young adulthood in Northern Ireland. METHODS: A cohort of 120,907 individuals aged 10-14 years in 2010 was tracked through to 2021 using linked administrative data. Antidepressant prescriptions were recorded annually; area-level deprivation was assessed in 2010 using the Northern Ireland Multiple Deprivation Measure (NIMDM). A random-intercept logistic regression model, with calendar year treated as a random effect, was used to analyse the relationship between area-level deprivation in 2010 and antidepressant prescribing from 2010 to 2021, adjusting for age, sex and urbanicity (urban/rural). The effect of area-level deprivation was allowed to vary by urbanicity. Analyses were repeated for different types of antidepressants. RESULTS: 30,243 (25.0%) young people received antidepressants at least once over the study period. The likelihood of receiving antidepressants in the first year of the study (2010) was highest for young people residing in the most deprived urban areas (51, 0.23%) and lowest for those living in the least deprived rural areas (< 10, < 0.45%). After adjusting for confounders, the conditional probability of receiving antidepressants in 2021 for those living in the most deprived urban areas in 2010 was an estimated 20.3% (95%CI 20.0%, 20.7%), compared to 15.9% (95%CI 14.9%, 16.9%) who lived in the most deprived rural areas in 2010 and 14.8% (95%CI 14.1%, 15.5%) who lived in the least deprived rural areas in 2010. Similar trends were observed for different types of antidepressants. DISCUSSION: Urban environments may expose young individuals to additional risks, with early disadvantage leading to lasting mental ill-health effects. In contrast, rural areas may have fewer prescriptions due to limited access to healthcare and challenges in capturing localized rural deprivation using area-level measures. CONCLUSION: This study underscores the importance of targeted mental health interventions for deprived urban adolescents. Further research is needed to better understand the relationship between deprivation and youth mental health in rural areas.
Internalizing and externalizing pathways to adolescent substance use disorders: A Multi-level analysis in Nigerian schools.
Adewuya AO, Njokanma F, Wright KO
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42377414 · Publisher ↗
BACKGROUND: Research on adolescent substance use disorders (SUDs) in sub-Saharan Africa has largely overlooked the role of psychopathology, focusing instead on demographic correlates. This study tests a multi-level, ment...
BACKGROUND: Research on adolescent substance use disorders (SUDs) in sub-Saharan Africa has largely overlooked the role of psychopathology, focusing instead on demographic correlates. This study tests a multi-level, mental health-centered framework to explain SUD etiology among Nigerian adolescents, seeking to elucidate psychological pathways and explain an identified rural-urban difference in SUD prevalence. METHODS: This study is a cross-sectional analysis of data from the Lagos Schools Emotional and Behavioral Health Survey (LSEBHS), a representative sample of 9,441 secondary school students. Multi-level logistic regression was used to examine the contributions of internalizing and externalizing mental health pathways, test for mediation of social stressors, and explore gender-specific risk profiles. RESULTS: Mental health comorbidities were the strongest predictors of SUD. Both internalizing and externalizing disorders showed significant independent associations, though internalizing conditions demonstrated the largest effects. Major depressive disorder conferred the highest risk (AOR = 4.89; 95% CI [3.69-6.49]), followed by conduct disorder among externalizing conditions (AOR = 3.40; 95% CI [2.45-4.72]). The internalizing pathway was particularly pronounced among females (AOR = 6.83 for depression). Mental health conditions significantly mediated the effect of academic stress on SUD risk. The elevated prevalence of SUD in rural areas was explained by a greater clustering of untreated mental health burden and family violence. A cumulative risk index identified that 16.8% of adolescents fell into a high-risk category. CONCLUSION: Adolescent SUD in Nigeria appears to be driven primarily by underlying psychological distress. These findings suggest the need for a paradigm shift in prevention, moving from universal drug education toward integrated, gender-sensitive mental health screening and intervention, particularly in underserved rural communities.
Prevalence of mental disorders among young people living in urban slums of low- and middle- income countries: A systematic review and Meta-analysis.
Bella-Awusah T, Fola-Bolumole O, Jilka S … +4 more , Read U, Omigbodun O, Singh S, Giacco D
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42360424 · Publisher ↗
PURPOSE: Young people living in slums are at increased risk of poor mental health. We examined the prevalence and correlates of mental disorders among youth living in slums in low-and middle-income countries (LMICs). MET...
PURPOSE: Young people living in slums are at increased risk of poor mental health. We examined the prevalence and correlates of mental disorders among youth living in slums in low-and middle-income countries (LMICs). METHODS: A search of seven databases (MEDLINE, Embase, PsycINFO, Scopus, Web of Science, CINAHL, and African Journals Online) was conducted from inception to September 2022 and updated to March 2026. Studies were screened by two independent reviewers who also extracted data and assessed the study quality and risk of bias using the Joanna Briggs Institute critical appraisal tool (JBI). Meta-analyses were carried out using the random effects model (REML) to estimate prevalence and 95% CI. RESULTS: We identified 24 studies out of 3,946 citations, reporting data on depression, post- traumatic stress disorder (PTSD), anxiety, and alcohol use disorders (AUDs), involving 26,794 participants. The pooled prevalences were depression 31% (95% CI: 0.23-0.40; I 99·4%; p < 0·01), PTSD 24% (95% CI: 0.14-0.35; I 99·08%; p < 0·01), anxiety disorders 35% (95% CI: 0.20-0.53, I 98·91%; p < 0·01), AUDs 23% (95% CI:0.10-0.38, I 99·08%; p < 0·01). Food insecurity and violence exposure were the most reported risk factors, whereas adult support and neighbourhood connectedness were the most reported protective factors. CONCLUSION: Young people living in slums carry a disproportionate burden of mental disorders. There is an urgent need for contextually grounded policies and interventions to mitigate identified risk factors, strengthen protective factors, and break down barriers to treatment for those in need.
Natural disasters and suicidality in Australia: a systematic review.
Trott M, Lockett C, Arnautovska U … +3 more , Kisely S, Crompton D, Siskind D
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42360423 · Publisher ↗
PURPOSE: To systematically review Australian evidence examining associations between exposure to natural disasters and suicidal behaviours, including suicidal ideation, suicide attempts, and suicide mortality. METHODS: A...
PURPOSE: To systematically review Australian evidence examining associations between exposure to natural disasters and suicidal behaviours, including suicidal ideation, suicide attempts, and suicide mortality. METHODS: A systematic review was conducted in accordance with a pre-registered protocol (CRD42023471489), PRISMA, and SwiMS guidelines. Databases were searched in May 2026. Eligible studies were Australian observational studies examining droughts, floods, bushfires, heatwaves, or storms in relation to suicidal ideation, suicide attempts, or death by suicide. Risk of bias was assessed using Joanna Briggs Institute tools. Findings were narratively synthesised. RESULTS: Twelve studies met inclusion criteria. Evidence linking natural disasters to suicide mortality was mixed and inconsistent, particularly in short-term post-disaster analyses. In contrast, individual-level studies more consistently reported increased odds of suicidal ideation and self-harm following disaster exposure. Associations were strongest for prolonged drought, heat exposure, displacement, and cumulative or repeated disaster exposure, with several studies demonstrating dose response patterns. Most studies were judged to have moderate risk of bias, commonly due to exposure misclassification and limited control of confounding variables. CONCLUSION: In Australia, natural disasters are more consistently associated with non-fatal suicidal behaviours than with suicide mortality. Post-disaster mental health responses should incorporate monitoring of these behaviours beyond the immediate recovery phase.
Z-topia: Gen Z perspectives on mental health in a changing climate.
Guo K, Meas D, Bower M
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42360422 · Publisher ↗
Climate change poses significant mental health risks for young people, with literature suggesting mental ill-health in the current generation of young people could rise as the climate crisis evolves, necessitating the ne...
Climate change poses significant mental health risks for young people, with literature suggesting mental ill-health in the current generation of young people could rise as the climate crisis evolves, necessitating the need for both continued research and action. Drawing on our perspectives as Generation Z lived experience researchers - grounded in clinical practice, intersectional youth mental health advocacy, global health, and community development, we reflect on the dual pressures young people face - praised for their ambition and burdened with the responsibility of addressing these problems, while simultaneously denied the power to meaningfully enact their devised solutions.Informed by emerging literature and our lived experience, we propose a Generation Z utopia ('Z-topia'), our conceptual vision of what young people can and should be empowered to achieve, through the intersections between imagination, reflection and decisive action. In Z-topia, climate-related distress is recognised not as individual pathology, but as a collective, emotional and rational response to ecological crisis. Z-topia imagines young people empowered to design and lead transformative climate action, embedding climate action into everyday life and fostering a reciprocal relationship between people and the planet. This vision reframes youth climate distress as a foundation for agency and social change, offering a pathway towards more inclusive, sustainable, and mentally healthy futures.
Generalised anxiety disorder (GAD-7) in Ukrainian sample during wartime.
Aleksina N, Shyroka A, Gerasimenko O … +4 more , Lavrynenko D, Savchenko O, Blanch A, Malas O
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42347887 · Publisher ↗
PURPUSE: This study aims to providing evidence of validity of the Generalised Anxiety Disorder scale (GAD-7) in a general adult Ukrainian population (n = 1,101) during wartime. It also seeks to determine measurement inva...
PURPUSE: This study aims to providing evidence of validity of the Generalised Anxiety Disorder scale (GAD-7) in a general adult Ukrainian population (n = 1,101) during wartime. It also seeks to determine measurement invariance by gender, age, and other socio-economic factors; identify central symptoms; and propose interventions tailored to specific needs. METHOD: Data were analysed using Confirmatory Factor Analysis, Network Analysis, and Analysis of Variance. RESULTS: The findings support the validity of a unidimensional model for the GAD-7. Strict invariance was observed among older-aged participants and related subgroups, as well as between displaced/non-displaced individuals and military/non-military groups. In contrast, younger participants, and related subgroups such as singles, university students, and individuals with low incomes, only showed metric invariance compared to these other groups. The data suggest variations in the perception and reporting of anxiety between younger and older adults, consistent with NwA findings. Although GAD-3 and GAD-2 were central symptoms for all groups, among younger individuals and related subgroups, GAD-1 ("Feeling nervous, anxious, or on edge") was the most central symptom. Conversely, among older individuals and related subgroups, GAD-5 ("Being so restless that it is hard to sit still") emerged as the most central symptom. The results indicate lower levels of anxiety in individuals under 25 years of age, university students, not coupled, and non-displaced individuals. It also supports the use of NwA for understanding the psychopathology of anxiety and the development of targeted intervention strategies based on age and context. The discussion addresses findings across subgroups and proposes contextually aligned interventions. CONCLUSION: The GAD-7 demonstrated adequate validity for assessing anxiety in the Ukrainian adult population during wartime, revealing differences in the structure and centrality of symptoms according to age and other sociodemographic factors.
Gender difference in the relationship between celebrity worship and Chinese adolescents' binge eating: the chain mediating role of desire for fame and self-control.
Lyu Z, Wang X, Fu S … +1 more , Zheng P
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42310218 · Publisher ↗
Through a survey on celebrity worship, binge eating, desire for fame and self-control, we recruited a sample of 748 Chinese adolescents (aged 11-17) to explore the gendered mechanisms linking celebrity worship to binge e...
Through a survey on celebrity worship, binge eating, desire for fame and self-control, we recruited a sample of 748 Chinese adolescents (aged 11-17) to explore the gendered mechanisms linking celebrity worship to binge eating through the chain mediation of desire for fame and self-control. The results revealed a significant mediating role of self-control in the relationship between celebrity worship and binge eating behaviors in both genders. Moreover, this effect was more pronounced in girls than in boys. Additionally, among boys, higher levels of celebrity worship was associated with greater desire for fame, which was in turn associated with lower self-control and higher levels of binge eating. This study highlights the mediating roles of desire for fame and self-control in the relationship between celebrity worship and binge eating, as well as the gender differences.
Pathways from non-communicable diseases to depression among older adults in India.
Yadav K, Bhutia DT
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42295354 · Publisher ↗
BACKGROUND: Depression co-occurring with non-communicable diseases is a major public health concern among ageing population, particularly in low and middle-income countries like India. But, the complex hidden patterns, p...
BACKGROUND: Depression co-occurring with non-communicable diseases is a major public health concern among ageing population, particularly in low and middle-income countries like India. But, the complex hidden patterns, predictors and interrelationships among functional health, lifestyle behaviours and NCDs burden in shaping depressive symptoms remain insufficiently explored. METHODS: The present study utilized data from the Longitudinal Ageing Study in India Wave-1 (2017-2018), comprising 59,298 individuals aged 45 years and above. Exploratory and confirmatory factor analyses were conducted to derive latent constructs of functional limitations, lifestyle behaviours and NCDs burden. Structural equation modeling was used to examine direct and indirect associations with depressive symptoms and ordinal regression modeling was applied to assess important predictors of depression severity. RESULTS: Approximately 40% of participants reported some level of depressive symptoms. Three latent domains were identified, representing functional limitations, lifestyle behaviours and NCDs burden. The SEM showed acceptable fit (CFI = 0.923, RMSEA = 0.062). Functional limitations exhibited the strongest positive association with depressive symptoms (β = 2.052, p < 0.001), followed by NCDs burden and lifestyle behaviours. Ordinal regression modeling results were consistent with functional impairment and poor self-rated health emerging as key predictors of higher depression severity. CONCLUSION: The findings suggest that functional health plays a central role in the relationship between chronic disease burden, lifestyle factors and depressive symptoms. Interventions aimed at maintaining functional ability, alongside integrated management of NCDs and promotion of healthy behaviours, may help improve mental health outcomes among ageing population.
Household income during childhood and risk of youth suicide attempts and deaths: a register-based study from Finland.
Nieminen V, Suokas K, Autio R … +3 more , Hakulinen C, Aaltonen K, Pirkola S
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42295353 · Publisher ↗
PURPOSE: Socioeconomic inequalities during childhood are related to a variety of adverse mental health outcomes. However, youth suicide deaths have rarely been studied in this respect. We examined whether household incom...
PURPOSE: Socioeconomic inequalities during childhood are related to a variety of adverse mental health outcomes. However, youth suicide deaths have rarely been studied in this respect. We examined whether household income during childhood is associated with the risk of youth suicide attempts and deaths. METHODS: In this register-based cohort study all individuals born in Finland between 1991 and 2005 were followed from the age of 15 to either suicide or suicide attempt, death by other causes, emigration, or the end of the study period (31st December 2020). Household income was measured throughout childhood with two commonly used measures, cumulative income and income trajectories, and at specific ages (5, 10, and 15). Penalized splines and Cox regression models estimated the associations between household income and suicide attempts and deaths. We selected additionally adjusted models with a best-fitting set of cofactors for both outcomes. Additionally, we reported income-specific cumulative risks. RESULTS: During the follow-up period of 6.8 million person-years (n = 886,748), 9,811 first suicide attempts (60.9% females) and 964 suicides (28.5% females) occurred. Lower household income was associated with an increased risk of suicide attempts after adjusting for cofactors including parental mental disorders, suicide, education, urbanicity, birth origin and age. However, household income was not associated with suicide deaths when parental mental disorders were considered. CONCLUSION: Low income during childhood is associated with youth suicide attempts, but not with suicide deaths. Dying from suicide is a rare and extreme event, and treating non-lethal suicidal acts as a proxy for suicide requires caution.
Trends and disparities in self-reported past-month poor mental health among individuals using cannabis in the U.S., 2016-2023.
Jiang X, Lv G, Li M … +2 more , Yuan J, Lu ZK
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42274737 · Publisher ↗
Using 2016-2023 data from the Behavioral Risk Factor Surveillance System (BRFSS), this study examined trends in self-reported past-month poor mental health (≥ 1 day) among individuals using cannabis and disparities in su...
Using 2016-2023 data from the Behavioral Risk Factor Surveillance System (BRFSS), this study examined trends in self-reported past-month poor mental health (≥ 1 day) among individuals using cannabis and disparities in subgroups. From 2016 to 2023, the prevalence of self-reported past-month poor mental health (≥ 1 day) among those using cannabis increased from 54.54% to 67.88%. Women reported higher rates than men (77.08% vs. 60.14%). Young adults (25-34) showed the largest increase (from 51.42% to 77.67%). Hispanics (69.17%) exhibited the highest prevalence in 2023. Findings underscore the need for mental health screening and targeted counseling as cannabis legalization expands.
Cognitive remediation therapy in low-and-middle-income countries (LAMICs) for people with psychosis: a systematic review of its efficacy on functional and cognitive outcomes.
Vig Y, Gebreegziabher Y, Hanlon C … +1 more , Cella M
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42274736 · Publisher ↗
PURPOSE: Cognitive difficulties are commonly present in people with psychosis and are associated with poor functional outcomes. Evidence from high-income countries (HICs) indicates that cognitive remediation (CR) is an e...
PURPOSE: Cognitive difficulties are commonly present in people with psychosis and are associated with poor functional outcomes. Evidence from high-income countries (HICs) indicates that cognitive remediation (CR) is an effective treatment for cognitive difficulties. Evidence from low and middle-income countries (LAMICs) is emerging. This study reviews the evidence for CR for people with psychosis in LAMICs. METHODS: Seven databases (GIM, SCOPUS, WoS, APA PsycINFO, Global Health, Medline(R), and Embase) were searched. Two reviewers screened the studies retrieved independently against the eligibility criteria. Risk of bias was assessed using ROB 2.0 and ROBINS-I. The results on CR efficacy, alongside application and delivery, were synthesised narratively. RESULTS: Fourteen studies from countries in Africa, Asia and South America were included. CR delivery modality and settings varied, including those delivered at home and by caregivers and health care workers. Thirteen studies showed that CR was beneficial for cognition, with small to large effect sizes. Nine studies showed that CR can improve functioning, with small to moderate effect sizes. The studies showed that CR was safe and well-tolerated. The effect of CR did not differ by setting, dosage, delivery agent or mode of delivery. CONCLUSIONS: CR could be a useful approach to reduce the burden of cognitive difficulties in people with psychosis in LAMIC. The adaptations to CR evaluated by the included studies could be used and further evaluated globally to provide novel, culturally acceptable and scalable implementation approaches for CR.
Sex-specific drivers of non-affective psychotic disorders within migrant groups: A 25-year retrospective cohort study of 2 million migrants.
Khan JA, Edwards J, Le B … +2 more , Lizotte D, Anderson KK
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42262592 · Publisher ↗
PURPOSE: Migration is a well-established risk factor for psychotic disorders; however, little is known about factors that may contribute to the risk of psychosis within migrant populations and whether these associations...
PURPOSE: Migration is a well-established risk factor for psychotic disorders; however, little is known about factors that may contribute to the risk of psychosis within migrant populations and whether these associations differ by sex. Thus, we sought to identify sex-specific factors that modify the risk of non-affective psychotic disorder (NAPD) among migrant groups. METHODS: We constructed a retrospective cohort of first-generation migrants who arrived in Ontario (Canada) between 1992-2011 (n = 1,964,884). Cohort members were followed in linked health administrative data to identify first-onset cases of NAPD using a validated algorithm. We stratified Poisson regression models by sex to estimate the effects of sociodemographic and migration-related factors on the risk of NAPD among men and women separately. RESULTS: The incidence of NAPD was higher among migrant men than women (IRR = 1.20, 95% CI: 1.16, 1.23). African origin, family sponsorship, refugee status, and lack of proficiency in the official languages were associated with a higher risk of NAPD among both sexes, with a more pronounced effect in men. North African or Middle Eastern origin and younger age at migration showed specificity of effect for a higher risk of NAPD among men only. Among adult migrants (age 19 +), marital and common-law relationships exerted a greater protective effect among men, whereas higher education was protective among men only. CONCLUSION: We identified sex-based differences in factors that modify psychosis risk among migrant groups. These sex-specific factors may help explain variations in NAPD incidence and define high-risk subgroups for targeted prevention and early intervention efforts.
Experiences of discrimination and positive treatment among people who support a person with a mental health condition: a nationally representative survey.
Rainbow C, Morgan AJ, Green R … +2 more , McNaught G, Reavley NJ
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42262591 · Publisher ↗
PURPOSE: Stigma and discrimination compound the burden experienced by informal caregivers of people with mental illness, impacting their wellbeing. Prior caregiver stigma research has relied on qualitative or convenience...
PURPOSE: Stigma and discrimination compound the burden experienced by informal caregivers of people with mental illness, impacting their wellbeing. Prior caregiver stigma research has relied on qualitative or convenience samples, limiting knowledge of groups most affected. This Australian study is the first nationally representative survey of caregiver experiences of discrimination and positive treatment. METHODS: Participants (N = 2,164) were recruited from a probability-based online panel using stratified random sampling and weighting for age, gender, education, and language background. Descriptive statistics examined prevalence of stigma, discrimination and positive treatment experiences. Multiple regression models were used to assess sociodemographic differences in experiences and associations with psychological distress and wellbeing. RESULTS: Positive treatment experiences were common, with 67.9% (95% CI: 65.4, 70.2) of caregivers reporting understanding from friends and family and 59.6% (95% CI: 57.1, 62.1) feeling valued by the care recipient's treating team. However, 34.3% (95% CI: 31.9, 36.8) reported role concealment, and 18.8% (95% CI: 16.8, 20.9) unfavourable treatment at least sometimes. Positive treatment experiences were more prevalent among caregivers who were older or with higher levels of education, whereas experiences of discrimination were more common among caregivers from non-English speaking backgrounds. Women were less likely to conceal their caregiving role. Positive treatment was associated with lower distress and higher wellbeing, whereas discrimination was associated with higher distress and lower wellbeing. CONCLUSION: Despite encouraging levels of support, experiences of caregiver discrimination are common and impact on psychological distress and wellbeing. Multi-pronged strategies are needed to address inequities, strengthen peer support and caregiver-inclusive practice frameworks.
Disparities in healthcare access among sexual and gender minority individuals with generalized anxiety disorder in the US.
Agrawal V, Razzak A, Oorjitham N
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42262590 · Publisher ↗
PURPOSE: We aimed to quantify and compare the prevalence of healthcare access barriers among individuals diagnosed with generalized anxiety disorder (GAD), focusing on differences between sexual and gender minority (SGM)...
PURPOSE: We aimed to quantify and compare the prevalence of healthcare access barriers among individuals diagnosed with generalized anxiety disorder (GAD), focusing on differences between sexual and gender minority (SGM) and non-SGM adults. We also examined whether intersecting identities further compounded these barriers to inform equitable healthcare policy. METHODS: We analyzed data (2017-2022) from the All of Us Program, a nationwide database of self-reported surveys, electronic health records, and demographic information. Our sample included 8,841 adults diagnosed with GAD. Participants were classified as SGM if they identified as lesbian, gay, bisexual, transgender, nonbinary, intersex, or another sexual/gender minority identity. We examined eight healthcare access barriers-four cost-related (e.g., delaying mental health or specialist visits due to cost) and four non-cost-related (e.g., lack of transportation, feeling disrespected). Adjusted logistic regression models were used to compare the odds of experiencing each barrier between SGM and non-SGM groups, and stratified analyses considered race/ethnicity and gender. RESULTS: Among 8,841 participants with GAD, 1,267 (14%) were SGM. After adjusting for sociodemographic factors, SGM individuals demonstrated significantly higher odds of all cost-related barriers (e.g., delaying mental health visits: AOR = 1.53, 95% CI [1.30-1.79]) and non-cost barriers (e.g., feeling disrespected: AOR = 1.47, 95% CI [1.29-1.68]). Disparities were pronounced among Hispanic/Latino and non-Hispanic Black SGM adults and SGM women, illustrating multiple intersecting disadvantages. CONCLUSION: SGM individuals with GAD experience substantially greater healthcare access barriers than their non-SGM peers. These challenges are magnified for those with intersecting marginalized identities, highlighting a need for culturally competent, inclusive healthcare policies and practices.
Assessing the impact of social cohesion on suicide-related emergency calls: a spatial modeling approach.
Montagud-Andrés M, Marco M, López-Quílez A … +3 more , Escobar-Hernández P, Lila M, Gracia E
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42262589 · Publisher ↗
PURPOSE: Given the relevance of community-level approaches to suicide prevention, this study aims to examine how neighborhood social cohesion relates to spatial variation in suicide-related emergency calls and whether it...
PURPOSE: Given the relevance of community-level approaches to suicide prevention, this study aims to examine how neighborhood social cohesion relates to spatial variation in suicide-related emergency calls and whether its inclusion enhances model performance compared to sociodemographic factors alone. METHODS: We analyzed geocoded data on suicide-related emergency calls (N = 6,271) aggregated across 552 census block groups in Valencia (Spain) from 2021 to 2023, provided by the Valencian Regional Government. Sociodemographic indicators were obtained from official municipal statistics (2020), and neighborhood social cohesion was measured using survey data collected across census block groups between 2021 and 2022. Bayesian hierarchical Poisson models were implemented to estimate area-level associations, including models with (1) sociodemographic covariates only, (2) addition of social cohesion, (3) inclusion of an unstructured spatial random effect, and (4) a full spatial model with structured and unstructured random effects. RESULTS: The model including sociodemographic factors, social cohesion, and an unstructured random effect provided the best overall fit. Including social cohesion markedly improved model fit and revealed a robust negative association with suicide-related emergency calls: areas with lower cohesion showed a higher relative risk. Additionally, indicators of social disorganization were positively associated with call rates, confirming their joint contribution to neighborhood-level differences in suicide-related calls. CONCLUSION: The results support the association between higher community social cohesion and lower rates of suicide-related emergency calls. Introducing neighborhood-level social cohesion improves the explanatory power of the spatial model, highlighting its role in neighborhood inequalities and its potential to guide targeted preventive interventions.
Living happily ever after: longitudinal insights into enduring mental health and wellbeing.
de Vries LP, Middeldorp CM, Bartels M
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42234128 · Publisher ↗
PURPOSE: Enduring Mental Health (EMH) reflects maintaining good psychological functioning without developing mental health problems. Estimates of the proportion of individuals who have EMH vary widely. We investigated EM...
PURPOSE: Enduring Mental Health (EMH) reflects maintaining good psychological functioning without developing mental health problems. Estimates of the proportion of individuals who have EMH vary widely. We investigated EMH across the lifespan, defined not only as absence of mental health problems, but also as consistent presence of high wellbeing. To explore how defining EMH affects the phenotype, we included both stricter and broader lenient thresholds for mental health problems and low wellbeing. METHODS: Data came from 16,030 Netherlands Twin Register participants (35% male; mean birth year 1970) with ≥ 4 assessments over 8-20 years. For each EMH definition, preregistered analyses included computation of prevalence, genetic and environmental influences using twin modeling, and phenotypic and genetic correlates including education, personality, social factors and polygenic scores. RESULTS: Threshold choice for low mental health strongly affected prevalence of EMH: 71% (absence of problems),93% (high wellbeing), and 71% (combined) for stricter thresholds versus 42%, 82%, and 42% for lenient thresholds of low mental health. Heritability (46-61%) and patterns of associations were similar across definitions. Optimism, social support, and good self-rated health were positively associated with EMH (OR = 1.5-2.9), while neuroticism, loneliness, and stress lowered the likelihood (OR = 0.3-0.8). CONCLUSION: Defining EMH using different thresholds for mental health changed prevalence estimates, whereas heritability and correlates were broadly similar across definitions. Threshold choice is important for estimating how common EMH is, while the consistent pattern of correlates suggest shared underlying mechanisms that can inform prevention to help individuals maintain mental health.
Prevalence and incidence of mental disorders among First Nations and other individuals using methamphetamine in Manitoba, Canada.
Enns JE, Phillips-Beck W, Freier A … +17 more , Shimmin C, Sherzoi O, Owczar H, Fransoo G, McCulloch S, McDonald N, Sarkar J, Dragan R, Friesen EL, Simmons M, Bolton J, Konrad G, Nepon J, Balogun OD, Casidsid HJM, Nickel NC, and the Methamphetamine Use in Manitoba Research Team
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42234127 · Publisher ↗
INTRODUCTION: Methamphetamine use can precipitate or exacerbate mental health disorders. In Winnipeg, Canada, First Nations are at particular risk of harms associated with addiction and mental illness. This study examine...
INTRODUCTION: Methamphetamine use can precipitate or exacerbate mental health disorders. In Winnipeg, Canada, First Nations are at particular risk of harms associated with addiction and mental illness. This study examines the prevalence and incidence of comorbid mental health disorders among First Nations and other Winnipeggers using methamphetamine. METHOD: Using population-based administrative health data, we identified First Nations and all other Winnipeg (AOW) residents who had a methamphetamine-related health system contact between 2013 and 2020 (cases) and created control groups that were matched on age, sex, and postal code. We then determined five-year prevalence and one-year incidence of mood, psychotic, personality, and non-amphetamine substance use disorders, in each group. Differences between cases and controls were analyzed using generalized linear regression models after applying high-dimensional propensity score matching to account for potential confounding variables. RESULTS: 4,796 cases and 43,916 controls were included in the study. Both First Nations and AOW with a methamphetamine-related health system contact had higher five-year prevalence (First Nations odds ratio [OR]: 1.92, 95% confidence interval: 1.69-2.18, AOW OR: 3.38, 95% CI: 3.01-3.79) and one-year incidence (First Nations rate ratio (RR): 2.42, 95% CI: 1.88-3.10, AOW RR: 1.83, 95% CI: 1.53-2.20) of mental health disorders vs. their respective comparison group. The baseline five-year prevalence of mental health disorders was higher in the First Nations control group (51.8%) than in the AOW group (38.4%). CONCLUSION: Methamphetamine use is associated with a higher prevalence of mental health disorders and the baseline prevalence of mental health disorders is disproportionately high among First Nations.
Longitudinal trends and causal relationships of depression, anxiety, and sleep quality among MSM newly diagnosed with HIV.
Yang X, Li Z, Shao Y … +5 more , Li J, Ye J, Liu A, Xin L, Sun L
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42234126 · Publisher ↗
PURPOSE: This study aimed to characterize the longitudinal trajectories of depression, anxiety, and poor sleep among MSM newly diagnosed with HIV, and secondarily to explore potential causal relationships of HIV infectio...
PURPOSE: This study aimed to characterize the longitudinal trajectories of depression, anxiety, and poor sleep among MSM newly diagnosed with HIV, and secondarily to explore potential causal relationships of HIV infection on these mental health outcomes. METHODS: A prospective repeated-measures study was conducted between 2017 and 2020 at Beijing Youan Hospital. Newly diagnosed MSM patients with HIV were consecutively enrolled. Depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Follow-up assessments were performed at 4, 12, and 24 weeks to track longitudinal changes in mental health status. As a complementary approach, Mendelian randomization (MR) analysis was employed to explore potential causal relationships of HIV infection on depression, anxiety, and sleep disturbances. RESULTS: A total of 1,170 MSM newly diagnosed with HIV were enrolled. The prevalence of depression, anxiety, and poor sleep decreased from 26.82%, 33.90%, and 65.91% at baseline to 12.75%, 15.47%, and 46.28% at week 24, respectively. Longitudinal analysis revealed that the prevalence of poor sleep among MSM newly diagnosed with HIV remained above 45% throughout the follow-up period, consistently exceeding the peak prevalence of depression or anxiety by over 20%. While depression and anxiety declined rapidly by week 4 and remained predominantly mild, a modest rebound occurred for moderate-to-severe cases at week 24 and for poor sleep at week 12. Notably, individuals with normal baseline sleep also exhibited a slight rebound increase in PSQI scores at week 12. MR analysis found no potentially causal association between HIV infection and depression (IVW: OR = 1.001, P = 0.208), anxiety (OR = 1.001, P = 0.051), and sleep disorders (OR = 1.002, P = 0.893), respectively. CONCLUSIONS: Although the overall prevalence of mental problems showed a declining trend, poor sleep demonstrated persistence and a rebound pattern. Proactive screening and mental support during the initial post-diagnosis period are essential to address modifiable risk factors and improve long term outcomes.
Social position and antidepressant dose trajectories: a latent class analysis of a french cohort linked to the reimbursement register.
Alcalde E, Wiernik E, Rigal L
Soc Psychiatry Psychiatr Epidemiol · 2026 Jun · PMID 42223654 · Publisher ↗
PURPOSE: Antidepressant (AD) doses may vary depending on symptom severity over time. Individuals in lower social positions experience more severe and recurrent depressive episodes, yet it remains unclear whether and how...
PURPOSE: Antidepressant (AD) doses may vary depending on symptom severity over time. Individuals in lower social positions experience more severe and recurrent depressive episodes, yet it remains unclear whether and how their AD dosage reflects this higher burden. This study aimed to identify AD dose trajectories in a population-based sample and examine their associations with social position indicators. METHODS: We used data from the French CONSTANCES cohort linked to the national drug reimbursement register. We included incident AD users who initiated a selective serotonin reuptake inhibitor or a selective norepinephrine reuptake inhibitor during their cohort inclusion year. We adopted a Latent Class Mixed Modeling framework to identify AD daily dose trajectories, adjusting for severity proxies. Multinomial regression models assessed the association between trajectory membership and baseline social position indicators. RESULTS: Overall, 4520 participants (63% women) were included. Four latent AD trajectories were identified: a "Constant" class including most participants (94%) characterized by stable dosing around 20 mg fluoxetine-equivalents; and three classes smaller classes showing varying patterns: a "High-decreasing" class (3.5%), a "High-sharp-decrease" class (1.32%), and "Low-slight-increase" (1.16%). In terms of social position, participants living in the most deprived areas were more likely to follow the 'High-decreasing' class than the 'Constant' one, while participants living alone were more likely to belong to the "High-sharp-decrease" class compared to the "Constant". CONCLUSIONS: AD dose trajectories showed little heterogeneity with most users following a stable dosing pattern and only small groups displaying fluctuating patterns. Social position influence may be more prominent in determining AD initiation than in shaping dose patterns over time.
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