Advancing urban mental health research: from complexity science to actionable targets for intervention

The repercussions of watching scenes of the escalating conflict in Gaza strip on the mental health of adolescents in a neighboring country

BACKGROUND

Over the past decade, prompt technological innovation has accelerated the news dissemination of armed conflict and wars through various media channels, yielding mass fear, anxiety, and depression. Adolescents are more susceptible to experiencing mental distress as a result of watching such uncensored scenes.

AIM

This study aimed to assess the psychological impact of exposure to conflict scenes in the Gaza Strip on the mental health of school adolescents.

METHODS

A cross-sectional study involved 519 adolescents aged 11-18 years, recruited through clustered sampling technique from private and public middle and high schools in Gharbia governorate, Egypt. An anonymous self-administered questionnaire was deployed and included the Arabic version of the depression, anxiety, and stress scale (DASS21).

RESULTS

Around 30% of the studied adolescents were diagnosed as stressed, 61.5% were depressed, and 57% were anxious. These adverse mental outcomes were more prevalent among females and adolescents in high schools. Additionally, participants who were regularly exposed to conflict scenes for an average of 5-7 days per week, with a viewing duration exceeding 3 h per day, were more likely to experience these mental issues.

CONCLUSIONS

The study unveiled a high prevalence rate of stress, depression, and anxiety among adolescents. This observation was positively associated with the frequency and intensity of media exposure to the conflict scenes in the area. Supportive initiatives and controlling exposure to media for adolescents in conflict zones have unequivocal value in ameliorating mental disorders.

How city living affects mental health-a qualitative exploration of urban stressors among adults in a megacity in India

BACKGROUND

India's rapid urbanization presents both opportunities and challenges, offering better healthcare and infrastructure while also impacting physical and mental health. The reasons behind the higher prevalence of mental health issues in urban areas remain underexplored, particularly in the Indian context. This study seeks to fill that gap by examining urban stressors in an Indian megacity, aiming to inform urban planning and enhance mental well-being.

METHOD

The study involved 24 in-depth interviews with non-slum residents aged 30-60 years. Data was collected based on predefined themes, categorized into physical and social urban environments, and further analyzed into subthemes.

RESULTS

Five key urban factors were consistently reported as negatively affecting mental health: housing issues, traffic and transportation challenges, neighborhood characteristics, cost of living, and employment-related stress. Additionally, factors such as water quality and availability, air and noise pollution, solid waste management, safety concerns, social cohesion, and the accessibility and affordability of recreational facilities contributed to varying levels of distress among different participant groups.

CONCLUSION

This study underscores the complex interaction between physical and social environmental factors in influencing mental health of residents of the city. The findings underscore the importance of adopting a multisectoral and inclusive approach to urban planning that places mental well-being at its core. Integrating mental health into city development guided by frameworks such as HiAP approach (Health in All Policies), the WHO Healthy Cities initiative, GAPS (Green, Active, Prosocial, and Safe places), among others can support the creation of inclusive and sustainable urban spaces in alignment with Sustainable Development Goal 11 (SDG 11). However, this study has certain limitations, primarily the lack of generalizability due to its qualitative design conducted in a single Indian megacity, as well as the absence of assessment of mental health outcomes using standardized mental health assessment tools.

A generational relational model of nature and mental wellbeing: results of a qualitative analysis

Introduction

There is a developing evidence base for the benefits of natural environments for health and mental wellbeing. However, given the increasing urbanisation of our planet and subsequent disconnection from our natural world, there is a danger that we may ultimately suffer from a nature 'generational amnesia'. The facets and mechanisms underpinning these relationships are poorly understood and theoretical frameworks are needed to aid further research. There is a paucity of research into the lived experiences of people with good wellbeing and their nature experiences, which has the potential to elucidate key elements of the nature-wellbeing relationship.

Methods

The current study used a qualitative design to explore themes concerning the lived experiences with nature, of 12 people with self-reported good wellbeing. Semi-structured interviews were carried out and data were analysed using thematic analysis.

Results

Two overarching themes of human-nature relationship and self-regulation encapsulated the data. Within the first, there were two superordinate themes of developmental and nature interconnectedness. Self-regulation consisted of managing health and flourishing.

Discussion

A theoretical model is proposed to help better understand these relational themes in a generational context. The model is informed by Cognitive Analytic Therapy and attachment theory and generates testable hypotheses for future research.

Debate: Urban versus rural environments - which is better for mental health? The one good thing about a small town…

Urban environments are related to higher prevalences of common mental disorders (addictions, anxieties and mood disorders) in adults. The mechanisms underlying this relationship are less clear. Cities function as a magnet, related to economic and educational opportunities, but are also related to urban stress and low well-being. Urban areas have larger inequalities, and people in deprived areas are at enhanced risk for mental health problems, which have been related both to environmental factors like pollution and to perceptions of the (social) environment, including perceived safety and social support. The interactions of vulnerability factors at different levels of description (e.g., within-person stress vulnerability vs. neighborhood stressors) can be considered a complex system. We here discuss what is known about growing up in an urban versus rural environment, with the aim to identify target points for mental health-related interventions in youth. We summarize this for three broad developmental periods: early life (first 1000 days), childhood, and adolescence into young adulthood, with implications for interventions.

Preventing common mental health problems by increasing neighbourhood socioeconomic status: a mental health impact assessment in Rotterdam, the Netherlands

Neighbourhood socioeconomic status (NSES) has been identified as a determinant of mental health. In this study, we aimed to quantify how many cases of common mental health problems could be prevented by increasing NSES in the most socioeconomically deprived neighbourhoods in Rotterdam, the Netherlands, and how the increases in NSES would affect mental health inequalities. We used publicly available data for conducting a quantitative Health Impact Assessment (HIA) of two counterfactual policy scenarios. In Scenario 1, we set the NSES to the Rotterdam median score for all neighbourhoods which were below the Rotterdam median. In Scenario 2, we set the NSES score to the Dutch national average socioeconomic status score for the neighbourhoods that were below the national average. We estimated that Scenario 1 could prevent 5847 (95% CI, 2700-7999) or 10.7% of annual cases of common mental health problems, and Scenario 2 could prevent 10 713 (95% CI, 4875-14 799) or 19.6% of annual cases in Rotterdam while also reducing mental health inequalities between neighbourhoods in both scenarios. Given the substantial improvements in population mental health that enhanced neighbourhood socioeconomic conditions would bring, policy implementation is urgently needed.

Societal spirits in the silver streak: Unraveling complexity in drinking habits of the mature adult population

BACKGROUND

The complex interactions between an individual's drinking behavior and their social environment is crucial but understudied, particularly in mature adult populations. Our aim is to unravel these complexities by investigating how personal drinking patterns are related to those of one's social environment over time, and what the interplay is with personal factors such as occupational prestige and smoking behavior.

METHOD

The present study adopts an innovative graphical autoregressive (GVAR) panel network modeling approach to investigate the dynamics between personal drinking habits and social environmental factors, utilizing a comprehensive longitudinal dataset from the Framingham Heart Study with a large sample of predominantly mature adults (N = 1719-5718) connected within a social network. We explored both temporal and contemporaneous associations between individuals' drinking habits (self-reported), smoking behavior (self-reported), perceived job prestige (Treiman prestige score), and the drinking behaviors of their social environment. The latter consists of the proportion of abstaining, moderate drinking, and heavy drinking social connections of each subject.

RESULTS

Our findings reveal significant associations between participants' behavior and that of their peers, with reciprocal interactions, substantiating the importance of the influence of one's social network for mature individuals. We found dynamic, reciprocal associations between an individual's drinking behavior and that of their peers, with periods of increased or decreased drinking correlating with increased connections to heavy drinkers or abstainers, respectively. In addition, when individuals drink more than usual, they also tend to consume more cigarettes, and vice versa.

CONCLUSIONS

The reciprocal feedback loops identified between an individual's drinking behavior and their social environment highlight the crucial role of social influences in shaping drinking behavior, including among older people. This emphasizes the need to consider social elements in the development of future theories, models, and interventions aimed at addressing problematic alcohol consumption in this vulnerable population.

Secular trends in the prevalence of schizophrenia among different age, period and cohort groups between 1990 and 2019

BACKGROUND

Schizophrenia remains a major public health challenge, and designing efforts to manage it requires understanding its prevalence over time at different geographic scales and population groups.

METHODS

Drawing on data from the Global Burden of Disease study 2019, annual percentage change of schizophrenia was assessed across different age, period and cohort groups at different geographic scales from 1990 to 2019. We examined associations of prevalence with the sociodemographic index.

RESULTS

Global prevalence of schizophrenia in 2019 was 23.60 million (95 % uncertainty interval: 20.23-27.15), with China, India, the USA and Indonesia accounting for 50.72 % of it. Global prevalence increased slightly from 1990 to 2019, with an annual percentage change of 0.03 % (95 % confidence interval 0.01-0.05). Regions with intermediate sociodemographic index accounted for greater proportion of prevalence increasing than regions with high index. Prevalence decreased among those born after 1979 in regions with intermediate sociodemographic index, whereas it consistently improved among all birth cohorts in regions with low index. Regardless of sociodemographic index, prevalence was highest among individuals 30-59 years old than younger or older groups.

CONCLUSIONS

Prevalence of schizophrenia has shown small increases globally over the last three decades. The burden of disease is heavier in relatively less affluent regions, and it disproportionately affects individuals 30-59 years in all regions. Meanwhile, for regions with lower sociodemographic indices, the recent increasing burden among birth cohorts is more pronounced. These findings may help guide futural design of measures to manage or prevent schizophrenia in communities at higher risk.

Association of urban environments with Atherosclerotic cardiovascular disease: A prospective cohort study in the UK Biobank

Urban environments and cardiovascular health are closely linked, yet only a few specific exposures have been explored in isolation and mostly adopting cross-sectional design. The influence of socioeconomic status and genetic predisposition also remains unclear. Hence, leveraging the UK Biobank data (n = 206,681), we conducted a prospective analysis of 213 urban environmental variables and their association with atherosclerotic cardiovascular disease (ASCVD). The ExWAS and regularized Cox models analyses highlighted air pollution, industrial sites, and complex street networks as primary environmental risk factors. Instead, land-use density of leisure, public services, infrastructure and residential, and drinking water hardness showed a negative association with ASCVD risk. By integrating sparse canonical correlation and mediation analyses, we found distinct urban environment patterns through diverse pathways influence ASCVD. The environment characterized by pollution and complex streets impact ASCVD through adverse mental health (mediation proportion:30.7 %, 95 % CI:22.4 %-44.0 %), while highly-developed community and high-water hardness environment via cardiometabolic status (22.6 %, 95 % CI:19.7 %-26.0 %). Further, we found low socioeconomic status amplifies disadvantaged urban environment effects on ASCVD, yet there were no similar findings for ASCVD genetic predisposition. This research deepened our understanding of city-cardiovascular health links and the role of socioeconomic status, with implications for urban planning and public health interventions.

Urbanization, loneliness and mental health model - A cross-sectional network analysis with a representative sample

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on the relationship between urbanization and mental health is lacking. This cross-sectional study aimed to explore the relationships of the physical environment (spatial cohesion and urban environment) and social factors (neighborhood cohesion) with mental health (stress, anxiety and depression symptoms) and physical health and the mediating role of loneliness based on the proposed theoretical model. The study was conducted in Metropolis GZM (Silesia, Poland) in a representative sample of 3296 residents (48% women). The measurements used were the PSS-10, GAD-7, PHQ-9, R-UCLA3 and neighborhood cohesion scale. ANOVA results showed that city residents had better mental health indices than residents of villages and small towns. The network approach revealed that urbanization was one of the most influential nodes and played the role of a bridge between all other nodes. The model was confirmed and showed that the relationships between the physical environment and mental health were consecutively mediated by neighborhood cohesion and loneliness. Spatial cohesion related to factors of the physical environment and physical health, while physical health was directly connected to sociodemographic factors and weakly to stress. Anxiety was the strongest risk factor. Mental health can be improved by social and architectural factors, such as strengthening neighborhood cohesion and improving neglected buildings.

Defining Urbanicity in the Context of Psychosis Research: A Qualitative Systematic Literature Review

BACKGROUND AND HYPOTHESIS

Numerous studies have found that being born or raised in urban environments increases the odds of developing psychosis in Northern and Western Europe. However, available research from Southern Europe, Latin America, and Asia has reported null results. A limitation in most studies to date is the inadequate characterization of urban and rural life components that may contribute to varying psychosis risk across regions.

STUDY DESIGN

To deepen our understanding of the different concepts and measures of urbanicity and related factors in psychosis research, we conducted a qualitative systematic literature review extracting information from studies published between 2000 and 2024.

STUDY RESULTS

Sixty-one articles met the inclusion and exclusion criteria and were used in the thematic analysis. The analysis revealed that urbanicity lacked a single, coherent definition across studies and regions. Three major categories of themes were developed from the analysis: (1) Urbanicity comprises several interconnected constructs, (2) Urbanicity measurements vary between countries from the Global North and the Global South, and (3) Urbanicity operates through key neighborhood-level mechanisms.

CONCLUSIONS

Future research on urbanicity and psychosis should consider the potential limitations of urbanicity's conceptualization and operationalization and aim to address these limitations by focusing on contextual, historical, and community-level factors, utilizing locally validated measures, and employing mixed-method designs.

Uncovering the determinants of brain functioning, behavior and their interplay in the light of context

Notwithstanding the huge progress in molecular and cellular neuroscience, our ability to understand the brain and develop effective treatments promoting mental health is still limited. This can be partially ascribed to the reductionist, deterministic and mechanistic approaches in neuroscience that struggle with the complexity of the central nervous system. Here, I introduce the Context theory of constrained systems proposing a novel role of contextual factors and genetic, molecular and neural substrates in determining brain functioning and behavior. This theory entails key conceptual implications. First, context is the main driver of behavior and mental states. Second, substrates, from genes to brain areas, have no direct causal link to complex behavioral responses as they can be combined in multiple ways to produce the same response and different responses can impinge on the same substrates. Third, context and biological substrates play distinct roles in determining behavior: context drives behavior, substrates constrain the behavioral repertoire that can be implemented. Fourth, since behavior is the interface between the central nervous system and the environment, it is a privileged level of control and orchestration of brain functioning. Such implications are illustrated through the Kitchen metaphor of the brain. This theoretical framework calls for the revision of key concepts in neuroscience and psychiatry, including causality, specificity and individuality. Moreover, at the clinical level, it proposes treatments inducing behavioral changes through contextual interventions as having the highest impact to reorganize the complexity of the human mind and to achieve a long-lasting improvement in mental health.

Neural Correlates of Early-Life Urbanization and Their Spatial Relationships with Gene Expression, Neurotransmitter, and Behavioral Domain Atlases

Previous neuroimaging research has established associations between urban exposure during early life and alterations in brain function and structure. However, the molecular mechanisms and behavioral relevance of these associations remain largely unknown. Here, we aimed to address this question using a combined analysis of multimodal data. Initially, we calculated amplitude of low-frequency fluctuations (ALFF) and gray matter volume (GMV) using resting-state functional and structural MRI to investigate their associations with early-life urbanization in a large sample of 511 healthy young adults. Then, we examined the spatial relationships of the identified neural correlates of early-life urbanization with gene expression, neurotransmitter, and behavioral domain atlases. Results showed that higher early-life urbanization scores were correlated with increased ALFF of the right fusiform gyrus and decreased GMV of the left dorsal medial prefrontal cortex and left precuneus. Remarkably, the identified neural correlates of early-life urbanization were spatially correlated with expression of gene categories primarily involving immune system process, signal transduction, and cellular metabolic process. Concurrently, there were significant associations between the neural correlates and specific neurotransmitter systems including dopamine, acetylcholine, and serotonin. Finally, we found that the ALFF correlates were associated with behavioral terms including "perception," "sensory," "cognitive control," and "reasoning." Apart from expanding existing knowledge of early-life urban environmental risk for mental disorders and health in general, our findings may contribute to an emerging framework for integrating social science, neuroscience, genetics, and public policy to respond to the major health challenge of world urbanization.

The association between urbanization and depression in the elderly: A network analysis from the complexity science perspective

IMPORTANCE

The global increase in urbanization has coincided with a rise in depression prevalence. However, the effect of urbanization on depression remains controversial, especially for the elderly.

OBJECTIVE

To clarify how urbanization impacts depression in the elderly from a network perspective.

DESIGN, SETTING, AND PARTICIPANTS

This sectional cohort study used data from China Health and Retirement Longitudinal Study (CHARLS).

MAIN OUTCOMES AND MEASURES

The occurrence of depressive symptoms in urban and rural elderly residents. Network metrics of depressive symptoms.

RESULTS

Of the 13,993 participants, lower incidence of depressive symptoms was observed in urban (26.3 %, 95 % CI, 24.7 %-27.8 %) than in rural (40.4 %, 95 % CI, 39.5 %-41.3 %, P < 0.0001) residents. However, higher incidence of depressive symptoms was observed in urban (26.3 %, 95 % CI, 25.2 %-28.4 %) than in rural (17.5 %, 95 % CI, 16.1 %-18.9 %, P < 0.0001) residents in a subset of 2898 pairs of participants after PSM. No difference in the network structure and metrics between urban and rural residents before (M = 0.071, p = 0.054, S = 0.037, p = 0.80) and after (M = 0.085, p = 0.133, S = 0.086, p = 0.47) PSM was detected. The networks structure revealed that negative affect was strongly connected to somatic symptoms and that the two anhedonic symptoms were also strongly connected.

CONCLUSIONS

The current study indicated the homogeneity of the ultimate nature of depression between rural and urban residents from the network perspective, supporting the viewpoint that urbanization might not impose influence on depression. Further researches delving deeper into the complexity of the issue may provide new insights into our understanding of depression in an urban environment among the elderly.

Symptoms of a feather flock together? An exploratory secondary dynamic time warp analysis of 11 single case time series of suicidal ideation and related symptoms

Suicidal ideation fluctuates over time, as does its related risk factors. Little is known about the difference or similarities of the temporal patterns. The current exploratory secondary analysis examines which risk symptoms have similar time dynamics using a mathematical algorithm called dynamic time warping (DTW). Ecological momentary assessment data was used of 11 depressed psychiatric outpatients with suicidal ideation who answered three daytime surveys at semi-random sampling points for a period of three to six months. Patients with 45 assessments or more were included. Results revealed significant inter-individual variability in symptom dynamics and clustering, with certain symptoms often clustering due to similar temporal patterns, notably feeling sad, hopelessness, feeling stuck, and worrying. The directed network analyses shed light on the temporal order, highlighting entrapment and worrying as symptoms strongly related to suicide ideation. Still, all patients also showed unique directed networks. While for some patients changes in entrapment directly preceded change in suicide ideation, the reverse temporal ordering was also found. Relatedly, within some patients, perceived burdensomeness played a pivotal role, whereas in others it was unconnected to other symptoms. The study underscores the individualized nature of symptom dynamics and challenges linear models of progression, advocating for personalized treatment strategies.

Exploring the mechanisms underlying increased risk of depressive disorder in ethnic minority populations in Europe: A causal loop diagram

BACKGROUND

Multiple ethnic minority populations in Europe show high risk of major depressive disorder (MDD), with ethnic discrimination and low socioeconomic position (SEP) as established risk factors. How this risk is shaped by the interactions between these, and other social factors, remains to be elucidated. We aimed to develop a causal-loop diagram (CLD) to gain a better understanding of how factors at the intersection of ethnic discrimination and SEP dynamically interact to drive MDD risk.

METHODS

We iteratively mapped the interactions and feedback loops between factors at the intersection of ethnic discrimination and SEP, drawing input from (i) a series of two interviews with a range of MDD domain experts, (ii) an existing CLD mapping the onset of MDD across psychological, biological, and social dimensions at the level of the individual, and (iii) other relevant literature.

RESULTS

Through tracing the feedback loops in the resulting CLD, we identified ten driving mechanisms for MDD onset in ethnic minorities (two related to ethnic discrimination, SEP, social network and support, and acculturation, as well as one relating to the living environment and self-stigma towards MDD); and four factors that modulate these mechanisms (recent migration, religious affiliation, neighborhood social environment, and public stigma towards MDD). The intersecting nature of ethnic discrimination and SEP, combined with the reinforcing dynamics of the identified driving mechanisms across time- and spatial scales, underscores the excess exposure to circumstances that increase MDD risk in ethnic minorities.

CONCLUSIONS

While this CLD requires validation through future studies, the intersecting and reinforcing nature of the identified driving mechanisms highlights that tackling the high risk of MDD in ethnic minorities may require intervening at multiple targets, from the individual (e.g., psychological interventions targeting negative beliefs or reducing stress) to the societal level (e.g., addressing labor market discrimination).

Associations between perceived occupational stressors and symptoms severity of depression, anxiety and stress among academic faculty: First cross-sectional study from Qatar

BACKGROUND

Mental health concerns among university faculty are on the rise, with reports of anxiety, depression, and occupational stress, impacting the higher education community. In Qatar, an assessment of faculty mental health has not been previously realized. The objectives of the current study were twofold: Firstly, to evaluate the extent of perceived occupational stress, depression, anxiety, and stress, and secondly, to assess the association among these mental health parameters.

METHODS

A cross-sectional study was conducted among faculty using an online, self-administered, anonymous, voluntary survey. All faculty were included by sending the survey to their institutional emails. In addition to faculty demographics and general health status, the survey measured perceived stress due to academic job roles using the Faculty Stress Index (FSI) with its five distinct domains, and assessed faculty mental health using the Depression, Anxiety, and Stress Scale-21 items (DASS-21). Modified Poisson regression with robust variance was used to assess how FSI influences levels of depression, anxiety, and stress.

RESULTS

A total of 112 faculty responded to the survey. The highest faculty self-perceptions of mental health conditions were for anxiety (63% at least moderate), followed by depression (30% at least moderate), and least for stress (26% at least moderate). The overall mean FSI score was 48.8 ± 29.4; time constraint and rewards and recognition domains scored highest (18.5 ± 11.4 and 13.3 ± 9.3 respectively) while the departmental influence domain scored least (4.8 ± 4.4). Increased risk of at least moderate levels of self-perceived depression and stress were significantly associated with higher FSI score (p˂0.001). Increased risk of at least moderate levels of depression were less likely among faculty aged 50 years and above (p = 0.034), while increased risk of at least moderate levels of anxiety were more likely among faculty from humanities colleges (p = 0.027).

CONCLUSIONS

This is the first investigation of university faculty mental health in Qatar, indicating multifactorial perceived occupational stress, associated with higher perceived severity of mental health conditions. These baseline results establish links between specific occupational stressors for faculty and their mental well-being. As such, assessment of mental health conditions, controlling occupational stress, and developing tailored mental health interventions for faculty, are strategic to implement and foster well-being of academics. Further research into mental health of faculty and designing effective interventions that consider their specific stressors and associated factors are warranted.

Depressive disorder benefits of cities: Evidence from the China

BACKGROUND

Rapid urbanization is a major trend in global population migration. There is growing debate about whether this urban-rural disparity exacerbate depression at the individual level. This study aims to investigate how urban living has a beneficial impact on individual mental health.

METHODS

Based on the data of 15,764 participants in the 2018 China Health and Retirement Longitudinal Study (CHARLS), we perform analysis of variance to identify the gap in depression levels between urban and rural areas. Extensive comparisons and detailed statistical analyses are carried out to demonstrate the differences in social participation between urban and rural residents. Finally, we conduct a series of mediation and moderation analyses to reveal the underlying mechanisms of depressive disorder benefits of cities.

RESULTS

The results indicate that those who lived in urban areas were less likely to suffer from depression (β = -1.461, 95 % CI = [-1.691, -1.235], p < 0.001). Social engagement is found to mediate the relationship between residence type (β = 0.164, 95 % CI = [0.136, 0.193], p < 0.001) and individual depression (β = -0.462, 95 % CI = [-0.587, -0.337], p < 0.001). City size plays a moderating role in the association between urban living and social engagement.

LIMITATIONS

The mechanism is conducted through cross-sectional data. Self-reported depression status is accessed in this study, which could lead to measurement error.

CONCLUSION

This study demonstrates the beneficial effects of urban living on individual depression, and reveals the mechanism by which urbanization at different scales affects the prevalence of depression.

Which individual, social, and urban factors in early childhood predict psychopathology in later childhood, adolescence and young adulthood? A systematic review

Background

A comprehensive picture is lacking of the impact of early childhood (age 0-5) risk factors on the subsequent development of mental health symptoms.

Objective

In this systematic review, we investigated which individual, social and urban factors, experienced in early childhood, contribute to the development of later anxiety and depression, behavioural problems, and internalising and externalising symptoms in youth.

Methods

Embase, MEDLINE, Scopus, and PsycInfo were searched on the 5th of January 2022. Three additional databases were retrieved from a mega-systematic review source that focused on the identification of both risk and protective indicators for the onset and maintenance of prospective depressive, anxiety and substance use disorders. A total of 46,450 records were identified and screened in ASReview, an AI-aided systematic review tool. We included studies with experimental, quasi-experimental, prospective and longitudinal study designs, while studies that focused on biological and genetical factors, were excluded.

Results

Twenty studies were included. The majority of studies explored individual-level risk factors (N = 16). Eleven studies also explored social risk factors and three studied urban risk factors. We found evidence for early predictors relating to later psychopathology measures (i.e., anxiety and depression, behavioural problems, and internalising and externalising symptoms) in childhood, adolescence and early adulthood. These were: parental psychopathology, exposure to parental physical and verbal violence and social and neighbourhood disadvantage.

Conclusions

Very young children are exposed to a complex mix of risk factors, which operate at different levels and influence children at different time points. The urban environment appears to have an effect on psychopathology but it is understudied compared to individual-level factors. Moreover, we need more research exploring the interaction between individual, social and urban factors.

Making cities mental health friendly for adolescents and young adults

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.

The association between urbanization and adolescent depression in China

Background

With the rapid urbanization in many countries, more attention is being paid to the relationship between urbanization and mental health, especially depression. However, in countries with rapid urbanization, few empirical studies exist on the relationship between urbanization and adolescent depression.

Methods

Nationally representative survey data from the China Family Panel Studies in 2012, 2016 and 2018 were used. Data of 1,588 adolescents were obtained from 25 provinces. Depression was measured using the Center for Epidemiology Studies of Depression 20-item score. The urbanization rate was obtained from the National Bureau of Statistics of China. The generalized estimating equation was used to estimate the statistical relationship.

Results

The participants' mean age at baseline was 15 years, and 51.2% (813/1,588) of participants were male. After adjusting for all covariates (gender, age, ethnicity, level of education, marital status, urban/rural areas, body mass index, self-rated health, academic pressure, smoking, drinking and exercise), the rate of urbanization was monotonically and negatively associated with adolescent depression (odds ratio 0.34, 95% CI [0.14-0.79]). Compared with female adolescents, male adolescents had a lower risk of depression (odds ratio 0.80, 95% CI [0.67-0.97]).

Conclusion

In the context of China, urbanization has a positive effect on the mental health of adolescents. Female adolescents are more likely to experience depression than male adolescents.

Area-level Measures of the Social Environment: Operationalization, Pitfalls, and Ways Forward

People's mental health is intertwined with the social environment in which they reside. This chapter explores approaches for quantifying the area-level social environment, focusing specifically on socioeconomic deprivation and social fragmentation. We discuss census data and administrative units, egocentric and ecometric approaches, neighborhood audits, social media data, and street view-based assessments. We close the chapter by discussing possible paths forward from associations between social environments and health to establishing causality, including longitudinal research designs and time-series social environmental indices.

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

Using network analysis to identify leverage points based on causal loop diagrams leads to false inference

Network analysis is gaining momentum as an accepted practice to identify which factors in causal loop diagrams (CLDs)-mental models that graphically represent causal relationships between a system's factors-are most likely to shift system-level behaviour, known as leverage points. This application of network analysis, employed to quantitatively identify leverage points without having to use computational modelling approaches that translate CLDs into sets of mathematical equations, has however not been duly reflected upon. We evaluate whether using commonly applied network analysis metrics to identify leverage points is justified, focusing on betweenness- and closeness centrality. First, we assess whether the metrics identify the same leverage points based on CLDs that represent the same system but differ in inferred causal structure-finding that they provide unreliable results. Second, we consider conflicts between assumptions underlying the metrics and CLDs. We recognise six conflicts suggesting that the metrics are not equipped to take key information captured in CLDs into account. In conclusion, using betweenness- and closeness centrality to identify leverage points based on CLDs is at best premature and at worst incorrect-possibly causing erroneous identification of leverage points. This is problematic as, in current practice, the results can inform policy recommendations. Other quantitative or qualitative approaches that better correspond with the system dynamics perspective must be explored.

Urbanicity and depression: A global meta-analysis

BACKGROUND

Previous meta-analyses have revealed that in adult and older adult populations of developed countries, depression is more prevalent in urban than rural areas. No meta-analyses have identified the effects of urbanicity on the general age demographic for developing countries. We conducted a meta-analysis of urban-rural differences in depression across all age demographics for developed and developing countries.

METHODS

PubMed and PsycINFO databases were searched for studies published between 1980 and 2020. Studies were included if they reported prevalences of urban and rural depression, or odds ratios comparing urban-rural depression prevalence. Studies were excluded for: nonrepresentative samples, non-standard measures of depression, and reporting continuous outcomes only. Meta-analytic models of urban-rural differences in the odds of depression were conducted across country development levels and age demographics.

RESULTS

From 1597 records screened and 302 full texts assessed for eligibility, 80 studies (N = 539,557) were included for meta-analysis. Urban residence was significantly associated with a higher prevalence of depression in developed countries (OR = 1.30, 95 % CI [1.17, 1.46], z = 4.75, p < .001), which was primarily driven by urban-rural differences in the general population age demographic (OR = 1.37, 95 % CI [1.22, 1.54], z = 5.38, p < .001).

LIMITATIONS

Studies reporting urban-rural differences in depression in terms of continuous symptom severity scores were not included.

CONCLUSIONS

Urbanicity appears to uniquely be associated with a higher prevalence of depression in developed countries, but not in developing countries.

"World-Informed" Neuroscience for Diversity and Inclusion: An Organizational Change in Cognitive Sciences

By nature, humans are "tojisha (participating subjects/player-witnesses)" who encounter an unpredictable real world. An important characteristic of the relationship between the individual brain and the world is that it creates a loop of interaction and mutual formation. However, cognitive sciences have traditionally been based on a model that treats the world as a given constant. We propose incorporating the interaction loop into this model to create "world-informed neuroscience (WIN)". Based on co-productive research with people with minority characteristics that do not match the world, we hypothesize that the tojisha and the world interact in a two-dimensional way of rule-based and story-based. By defining the cognitive process of becoming tojisha in this way, it is possible to contribute to the various issues of the real world and diversity and inclusion through the integration of the humanities and sciences. The critical role of the brain dopamine system as a basis for brain-world interaction and the importance of research on urbanicity and adolescent development as examples of the application of WIN were discussed. The promotion of these studies will require bidirectional translation between human population science and animal cognitive neuroscience. We propose that the social model of disability should be incorporated into cognitive sciences, and that disability-informed innovation is needed to identify how social factors are involved in mismatches that are difficult to visualize. To promote WIN to ultimately contribute to a diverse and inclusive society, co-production of research from the initial stage of research design should be a baseline requirement.

Reduction in the use of green spaces during the COVID-19 pandemic and its impact on mental health

Our study examined the use of green spaces before and during the pandemic in a large cohort of Italian twins and evaluated its impact on measures of mental health (depressive, anxiety, stress symptoms). Twins were analysed as individuals and as pairs. A twin design approach was applied to minimize confounding by genetic and shared environmental factors. Questionnaires from 2,473 twins enrolled in the Italian Twin Registry were screened. Reduced green space use was associated with significantly higher levels of depression, anxiety and distress. Being a woman, residing in urban areas, and having a high perceived risk of the outbreak resulted in a higher likelihood to modify green space use, with a negative impact on mental health.

A neurocognitive model of early onset persistent and desistant antisocial behavior in early adulthood

It remains unclear which functional and neurobiological mechanisms are associated with persistent and desistant antisocial behavior in early adulthood. We reviewed the empirical literature and propose a neurocognitive social information processing model for early onset persistent and desistant antisocial behavior in early adulthood, focusing on how young adults evaluate, act upon, monitor, and learn about their goals and self traits. Based on the reviewed literature, we propose that persistent antisocial behavior is characterized by domain-general impairments in self-relevant and goal-related information processing, regulation, and learning, which is accompanied by altered activity in fronto-limbic brain areas. We propose that desistant antisocial development is associated with more effortful information processing, regulation and learning, that possibly balances self-relevant goals and specific situational characteristics. The proposed framework advances insights by considering individual differences such as psychopathic personality traits, and specific emotional characteristics (e.g., valence of social cues), to further illuminate functional and neural mechanisms underlying heterogenous developmental pathways. Finally, we address important open questions and offer suggestions for future research to improve scientific knowledge on general and context-specific expression and development of antisocial behavior in early adulthood.

Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium

BACKGROUND

This paper aims at analysing the impact of partial non-response in the association between urban environment and mental health in Brussels. The potential threats of the partial non-response are biases in survey estimates and statistics. The effect of non-response on statistical associations is often overlooked and evidence in the research literature is lacking.

METHODS

Data from the Belgian Health Interview Survey 2008 and 2013 were used. The association between non-response and potential determinants was explored through logistic regressions.

RESULTS

Participants with low income, low educational levels, lower or higher age or in households with children were less likely to respond. When adjusting for socio-economic variables, non-response was higher in areas which are less vegetated, more polluted or more urbanised. Because the determinants of non-response and depressive disorders were similar, it is reasonable to assume that there will be more people with mental health problems among the non-respondents. And because more non-responses were found in low vegetation areas, the protective association between green spaces and mental health may be underestimated.

CONCLUSION

Our capacity to measure the association between the urban environment and health is affected by non-response in surveys. The non-random spatial and socio-economic distribution of this bias affects the research findings.

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

The global burden of schizophrenia and the impact of urbanization during 1990-2019: An analysis of the global burden of disease study 2019

BACKGROUND AND HYPOTHESIS

The burden of schizophrenia is increasing. Assessing the global distribution of schizophrenia and understanding the association between urbanization factors and schizophrenia are crucial.

STUDY DESIGN

We conducted a two-stage analysis utilizing public data from GBD (global burden of disease) 2019 and the World Bank. First, the distribution of schizophrenia burden at the global, regional, and national levels as well as temporal trends was analyzed. Then, four composite indicators of urbanization (including demographic, spatial, economic, and eco-environment urbanization) were constructed from ten basic indicators. Panel data models were used to explore the relationship between urbanization indicators and the burden of schizophrenia.

RESULTS

In 2019, there were 23.6 million people with schizophrenia, an increase of 65.85% from 1990, and the country with the largest ASDR (age-standardized disability adjusted life years rate) was the United States of America, followed by Australia, and New Zealand. Globally, the ASDR of schizophrenia rose with the sociodemographic index (SDI). In addition, six basic urbanization indicators including urban population proportion, employment in industry/services proportion, urban population density, the population proportion in the largest city, GDP, and PM_2.5 concentration were positively associated with ASDR of schizophrenia, with the largest coefficients being urban population density. Overall, demographic, spatial, economic, and eco-environment urbanization all had positive effects on schizophrenia, and the estimated coefficients indicated that demographic urbanization was the most significant influence.

CONCLUSIONS

This study provided a comprehensive description of the global burden of schizophrenia and explored urbanization as a factor contributing to the variation in the burden of schizophrenia, and highlighted policy priorities for schizophrenia prevention in the context of urbanization.

Social and physical neighbourhood characteristics and 10-year incidence of depression and anxiety in older adults: Results from the Longitudinal Aging Study Amsterdam

OBJECTIVE

A growing literature suggests that neighbourhood characteristics are associated with mental health outcomes, but the evidence in older adults is inconsistent. We investigated the association of neighbourhood characteristics, pertaining to demographic, socio-economic, social and physical environment domains, with the subsequent 10-year incidence of depression and anxiety, in Dutch older adults.

METHODS

In the Longitudinal Aging Study Amsterdam depressive and anxiety symptoms were assessed four times between 2005/2006 and 2015/2016, using the Center for Epidemiological Studies Depression Scale (n = 1365) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (n = 1420). Neighbourhood-level data on urban density, percent population over 65 years of age, percent immigrants, average house price, average income, percent low-income earners, social security beneficiaries, social cohesion, safety, proximity to retail facilities, housing quality, percent green space, percent water coverage, air pollution (particulate matter (PM2.5)), and traffic noise, were obtained for study baseline years 2005/2006. Cox proportional hazard regression models, clustered within neighbourhood, were used to estimate the association between each neighbourhood-level characteristic and the incidence of depression and anxiety.

RESULTS

The incidence of depression and anxiety was 19.9 and 13.2 per 1000 person-years, respectively. Neighbourhood characteristics were not associated with the incidence of depression. However, various neighbourhood characteristics were associated with an increased incidence of anxiety, including: higher urban density level, higher percent immigrants, greater proximity to retail facilities, lower housing quality score, lower safety score, higher PM2.5 levels and less green space.

CONCLUSION

Our results indicate that several neighbourhood characteristics are associated with anxiety but not with depression incidence in older age. Several of these characteristics have the potential to be modifiable and thus could serve as a target for interventions at the neighbourhood-level in improving anxiety, provided that future studies replicate our findings and provide further evidence for a causal effect.

Assessing the degree of urbanisation using a single-item self-report measure: a validation study

The differential impact of rural versus urban residence on mental health remains a controversial topic that requires more in-depth investigations. This calls for a valid and easy measure to assess the degree of urbanisation. The purpose of the present study was to determine the utility of a single-item self-report measure (SIDU) as a tool to classify areas along the rural-urban continuum. The validity of the SIDU was assessed by comparing its scores (1-7) to a commonly used objective surrogate measure of the degree of urbanisation (i.e. surrounding address density, SAD) in two independent older adult samples (A: N = 36, 65+; B: N = 121, 55+). SIDU scores approximated SAD scores, with r = .77 to 0.82, (A), and r = .79 to 0.83 (B). A SIDU threshold score of 6 most accurately distinguished extremely urbanised areas from other areas. Altogether, our findings suggest that SIDU scores could be used as proxy of SAD. Since self-report leaves room for the consideration of additional aspects that confer an urban settlement, this single-item scale may be even more comprehensive, and circumvents the collection and handling of highly sensitive location data when the primary goal is solely to distinguish urbanisation subgroups.

Modifiable and nonmodifiable factors associated with anxiety, depression, and stress after one year of the COVID-19 pandemic

BACKGROUND

People worldwide have experienced various mental health issues during the COVID-19 pandemic. This study investigates the modifiable and nonmodifiable predictors of anxiety, depression, and stress among Bangladeshi participants after one year of the pandemic.

METHOD

A large group of adult participants (N = 1897), recruited from eight administrative divisions in Bangladesh, completed an online survey in May and June 2021 when the Movement Control Order was in place. We used the Beck Anxiety Inventory, Patient Health Questionnaire-9, and Perceived Stress Scale-4 to assess the participants' anxiety, depression, and stress. We also gave the Mindful Attention Awareness Scale and Life-Orientation Test-Revised to assess mindfulness and optimism.

RESULTS

The results revealed that the prevalence rates for anxiety and depression were 62.5% and 45.3%, respectively. Multivariate analyses showed that several nonmodifiable factors, such as those who were students, unmarried and females, and those living in the Northern region (Rajshahi and Mymensingh division) and dwelling in the rural areas, suffered from worse mental health (accounted for 5%-23% of the variances in the mental health outcome scores). Modifiable factors accounted for an additional 10%-25% of the variances in the same outcome variables. Adults with higher mindfulness and optimism, living in the country's Southern region (Chattogram division) and those who took both vaccine doses and had no history of mental illness reported better mental health.

CONCLUSION

Anxiety, depression, and stress remained high in Bangladeshi adults after one year of the pandemic. The community-based interventions should aim to increase the mindfulness and optimism levels among the sufferers. More accelerated vaccination programs across the country could protect people from suffering from overall mental distress.

Small-scale urban design interventions: A framework for deploying cities as resource for mental health and mental health literacy

With roughly half of the global population living in cities, urban environments become central to public health often perceived as health risk factors. Indeed, mental disorders show higher incidences in urban contexts compared to rural areas. However, shared urban environments also provide a rich potential to act as a resource for mental health and as a platform to increase mental health literacy. Based on the concepts of salutogenesis and restorative environments, we propose a framework for urban design interventions. It outlines (a) an output level, i.e., preventive and discursive potentials of such interventions to act as biopsychosocial resources, and (b) a process level, i.e., mechanisms of inter- and transdisciplinary collaboration of researchers and citizens in the design process. This approach aims at combining evidence-based, salutogenic, psychosocially-supportive design with a focus on mental health. Implementing low-threshold, resource-efficient options in the existing urban context brings this topic to the public space. Implications for the implementation of such interventions for citizens, researchers, and municipality stakeholders are discussed. This illustrates new directions of research for urban person-environment interactions, public health, and beyond.

Common Mental Disorders in Smart City Settings and Use of Multimodal Medical Sensor Fusion to Detect Them

Cities have undergone numerous permanent transformations at times of severe disruption. The Lisbon earthquake of 1755, for example, sparked the development of seismic construction rules. In 1848, when cholera spread through London, the first health law in the United Kingdom was passed. The Chicago fire of 1871 led to stricter building rules, which led to taller skyscrapers that were less likely to catch fire. Along similar lines, the COVID-19 epidemic may have a lasting effect, having pushed the global shift towards greener, more digital, and more inclusive cities. The pandemic highlighted the significance of smart/remote healthcare. Specifically, the elderly delayed seeking medical help for fear of contracting the infection. As a result, remote medical services were seen as a key way to keep healthcare services running smoothly. When it comes to both human and environmental health, cities play a critical role. By concentrating people and resources in a single location, the urban environment generates both health risks and opportunities to improve health. In this manuscript, we have identified the most common mental disorders and their prevalence rates in cities. We have also identified the factors that contribute to the development of mental health issues in urban spaces. Through careful analysis, we have found that multimodal feature fusion is the best method for measuring and analysing multiple signal types in real time. However, when utilizing multimodal signals, the most important issue is how we might combine them; this is an area of burgeoning research interest. To this end, we have highlighted ways to combine multimodal features for detecting and predicting mental issues such as anxiety, mood state recognition, suicidal tendencies, and substance abuse.

Come gli stati psichici si traducono in molecole biologiche e come questo cambia la medicina e la psicologia

Nell'aprile del 2022 abbiamo pubblicato, su invito di una rivista internazionale di biologia molecolare, un'ampia review che riporta le principali evidenze scientifiche sul tema delle relazioni tra vita psichica e biologia, traendone alcune conclusioni di carattere generale sulla psicologia e la medicina (Bottaccioli, Bologna & Bottaccioli, 2022). Il presente articolo riprende alcuni dei passaggi fondamentali presentati in quella review e si collega a un precedente articolo pubblicato sul n. 4/2014 di Psicoterapia e Scienze Umane (Bottaccioli, 2014b), di cui rappresenta un aggiornamento. Dalla pubblicazione di quell'articolo le evidenze sperimentali e cliniche sull'influenza della psiche sui sistemi biologici si sono moltiplicate. Al tempo stesso, conosciamo meglio le vie e i meccanismi con cui gli stati psichici si traducono in biologia.

Urbanization and depressive symptoms among middle-aged and older adults in China

Aims

Urbanization plays an important role in individuals' health. However, it is difficult to isolate healthy migrant effect between urbanization and health. This study examined the effects of urbanization on depressive symptoms and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration.

Methods

Using the baseline survey of the China Health and Retirement Longitudinal Study, this study compared the depressive symptoms among three groups (urbanized rural residents, rural non-migrants and urban non-migrants). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms. Logistic regression models and Structural Equation Model (SEM) were applied to examine the association between urbanization and depressive symptoms and the corresponding potential mechanisms.

Results

Our final sample contained 11,156 respondents with an average age of 58.91 (SD = 9.48), with 5,142 males (46.09%) and 6,014 females (53.91%). Compared with urbanized rural residents, rural residents were more likely to have depressive symptoms (OR = 1.19, 95% CI = 1.07, 1.32), and urban residents were associated with a decreased risk of depressive symptoms (OR = 0.81, 95% CI: 0.70, 0.94). A large proportion of the association between urbanization and depressive symptoms were mainly mediated by social participation, income and living conditions.

Conclusions

Planned urbanization had an independent impact on decreased depressive symptoms. Improvements in social participation, income and living conditions are the main drivers behind this relationship. Additionally, urbanization compensates for the negative impact of depressive symptoms from disadvantaged early life conditions, but it cannot eliminate the gap between urbanized rural people and urban non-migrants.

BOAM: A Visual, Explanatory Diagnostic and Psychoeducation System Used in Collaboration with Families-Feasibility and Acceptability for Children Who Are Non-Responsive to Treatment as Usual

Many children referred to mental health services have neurodevelopmental problems, which are not always recognized because the resulting emotional and behavioral problems dominate diagnosis and treatment. BOAM (Basic needs, Order, Autonomy and Meaning) is a new diagnostic system consisting of imaginative models that explain the complexity of symptoms and underlying neuropsychological problems in a simple way. It is designed to be used in a transparent, collaborative process with families, so that family members can better understand the nature of mental health problems, thus increasing self-knowledge and mutual understanding. In this study, the feasibility of the BOAM diagnostic trajectory and subsequent treatment informed by this trajectory are evaluated clinically in 34 children who have not responded to or relapsed after treatment as usual (TAU). Parents completed questionnaires pre-test, post-test and at a 3-month follow-up. The treatment drop-out rate was 2.9%. Post-test, parents rated the BOAM trajectory positively. The questionnaires (measuring child psychopathology, attention, executive functioning, family functioning, partner relationships and parenting stress) demonstrated sensitivity to change, and therefore, seems appropriate for a future effectiveness study. A limitation was the high percentage of missing measurements both post-test (41%) and at the follow-up (41%). The BOAM diagnostic trajectory and subsequent treatment may be a feasible alternative for children who do not respond to or relapse after TAU.

A Novel Affective Analysis System Modeling Method Integrating Affective Cognitive Model and Bi-LSTM Neural Network

The severity of mental health issues among college students has increased over the past few years, having a significant negative impact on not only their academic performance but also on their families and even society as a whole. Therefore, one of the pressing issues facing college administrators right now is finding a method that is both scientific and useful for determining the mental health of college students. In pace with the advancement of Internet technology, the Internet has become an important communication channel for contemporary college students. As one of the main forces in the huge Internet population, college students are at the stage of growing knowledge and being most enthusiastic about new things, and they like to express their opinions and views on study life and social issues and are brave to express their emotions. These subjective text data often contain some affective tendencies and psychological characteristics of college students, and it is beneficial to dig out their affective tendencies to further understand what they think and expect and to grasp their mental health as early as possible. In order to address the issue of assessing the mental health of college students, this study makes an effort to use public opinion data from the university network and suggests a college student sentiment analysis model based on the OCC affective cognitive model and Bi-LSTM neural network. In order to label three different types of positive, negative, and neutral sentiment on the microblog text of college network public opinion, we first design a sentiment rule system based on the OCC affective cognition elicitation mechanism. In order to effectively and automatically identify the sentiment state of college students in the network public opinion, this study uses a Bi-LSTM neural network to classify the preprocessed college network public opinion data. Finally, this study performs comparison experiments to confirm the validity of the Bi-LSTM neural network sentiment recognition algorithm and the accuracy of the OCC sentiment rule labeling system. The findings show that the college student sentiment recognition effect of the model is significantly enhanced when the OCC sentiment rule system is used to label the college network public opinion data set as opposed to the naturally labeled data set. In contrast to SVM and other classification models like CNN and LSTM, the Bi-LSTM neural network-based classification model achieves more satisfactory classification results in the recognition of college opinion sentiment.

The Prevalence of Depression Symptoms and Their Socioeconomic and Health Predictors in a Local Community with a High Deprivation: A Cross-Sectional Studies

Depression is a heterogeneous and etiologically complex psychiatric syndrome thatshows a strong sexual dimorphism and often impacts people with a low socioeconomic status (SES). The aim of the study was to estimate the occurrence of depression symptoms in a local community with a high deprivation rate, the example being the inhabitants of the JanówLubelski County in eastern Poland. A cross-sectional study was carried out on 3752 people aged between 35 and 64. The prevalence of depression symptoms was assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. In the screening for depression symptoms in the entire population we studied, the risk of depression symptoms was 16.1% (n = 605), with women having a significantly higher mean score than men (p < 0.001). Significant predictors associated with the achievement of 10 points and more in the PHQ-9 assessment in the case of women and men were: living alone, education and having comorbidities. Moreover, female participants living in rural areas were significantly more likely to exhibit depression symptoms, whereas smoking was a significant predictor of depressive symptoms in men. It was observed that in the case of obese women, the chance of being in the higher category of the PHQ-9 assessment was 1.41 times higher than in women with normal body weight. However, in the case of men, an increase in age by one year increased the chance of being in a higher category by 1.02 times. Moreover, the odds of falling into a higher category, as assessed by the PHQ-9 questionnaire, among men who drink alcohol more than once a week was 1.7 times higher than in men who do not drink or consume alcohol occasionally. Summarising the results of studies conducted in a local community characterised by a high deprivation rate, socioeconomic and health variables related to SES significantly impacted the incidence of depression, but they differ in terms of gender.

The central role of self-esteem in the quality of life of patients with mental disorders

In psychiatry, recent years have seen a change of focus from a clinician- to a patient-centered perspective that emphasizes quality of life as a treatment target. As a complex construct, quality of life is composed of multiple dimensions that interact with one-another (e.g. physical and psychological well-being, relationships, autonomy, self-esteem). Here, we used data from the REHABase cohort, which includes N = 2180 patients from 15 psychosocial rehabilitation centers in France, to explore networks of quality-of-life dimensions among six psychiatric disorders: schizophrenia, neurodevelopmental, bipolar, depressive, anxiety, and personality disorders. Stronger connections (edges) involved the Self-Esteem dimension, such as Self-Esteem–Physical Well-Being, Self-Esteem–Autonomy, Self-Esteem–Psychological Well-Being, and Self-Esteem–Resilience. Self-esteem was also consistently retrieved as the most central node (the dimension with the most connections within each network). Between-group tests did not reveal any differences regarding network structure, overall connectivity, edge-weights, and nodes’ centrality. Despite presenting with different symptom profiles, various psychiatric disorders may demonstrate similar inter-relationships among quality-of-life dimensions. In particular, self-esteem may have a crucial inter-connecting role in patients’ quality of life. Our findings could support treatment programmes that specifically target self-esteem to improve patients’ quality of life in a cost-effective way.

The mental health of children and young people living in big cities in a revolving postpandemic world

PURPOSE OF REVIEW

The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings.

RECENT FINDINGS

Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action.

SUMMARY

Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.

Psychic Life-Biological Molecule Bidirectional Relationship: Pathways, Mechanisms, and Consequences for Medical and Psychological Sciences-A Narrative Review

Today, it is possible to investigate the biological paths and mechanisms that link mental life to biological life. Emotions, feelings, desires, and cognitions influence biological systems. In recent decades, psychoneuroendocrinoimmunology research has highlighted the routes linking the psyche-brain-immune systems. Recently, epigenetics research has shown the molecular mechanisms by which stress and mental states modulate the information contained in the genome. This research shapes a new paradigm considering the human being as a whole, integrating biology and psychology. This will allow us to progress towards personalized precision medicine, deeply changing medical and psychological sciences and clinical practice. In this paper, we recognize leading research on both bidirectional relations between the psyche-brain-immunity and molecular consequences of psychological and mental states.