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Stickley A, Shirama A, Sumiyoshi T. Psychotic-like experiences and problem drinking among adults in Japan. Drug Alcohol Depend 2024; 260:111319. [PMID: 38788533 DOI: 10.1016/j.drugalcdep.2024.111319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) are common in the general population and have been linked to alcohol misuse and abuse. However, much of this research has been undertaken in Western countries. To address this deficit, the current study examined the association between PLEs and problem drinking in the Japanese general population. METHODS Data were used from 3717 adults (age 18-89) collected in an online survey in 2023. Information was obtained on PLEs with the PRIME Screen-Revised (PS-R), while problem drinking was assessed with the CAGE questionnaire (where a score of ≥ 2 was used to categorize cases). Logistic regression was used to examine the associations. RESULTS Problem drinking was prevalent in the study sample (12.5%). In an analysis that was adjusted for sociodemographic factors, self-rated health, smoking status and depressive symptoms, PLEs were associated with significantly higher odds for problem drinking in the total sample (OR: 1.70, 95%CI: 1.13-2.55). In a sex-stratified analysis PLEs were not linked to problem drinking in men (OR: 1.16, 95%CI 0.68-2.00), whereas women with PLEs had over 2.8 times higher odds for problem drinking (OR: 2.83, 95%CI: 1.54-5.21). CONCLUSION PLEs are associated with problem drinking in the Japanese general population and this association is especially pronounced in women. As problem drinking has been linked to a number of detrimental outcomes, future research should examine the potential effects of problem drinking in individuals with PLEs.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Japan Health Research Promotion Bureau, 1-21-1, Toyama, Shinnjiku-ku, Tokyo162-8655, Japan
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Oh H, Banawa R, Zhou S, DeVylder J, Koyanagi A. The mental and physical health correlates of psychotic experiences among US college students: Findings from the Healthy Mind Study 2020. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:834-840. [PMID: 35427464 DOI: 10.1080/07448481.2022.2058879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/15/2021] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychotic experiences have been framed as a marker of mental and physical health status; however, more research is needed to confirm these associations in university populations. METHODS We analyzed data from the Healthy Minds Survey (Fall Semester Cohort 2020), which is a non-probability sample of students attending one of 28 universities in the United States, who completed an online survey (September 2020-December 2020). We used multivariable logistic regression to examine the associations between several mental and physical health conditions and psychotic experiences, adjusting for age, gender, sexual orientation race/ethnicity, and international student status. RESULTS In terms of mental health, all conditions were associated with greater odds of having lifetime psychotic experiences. Having at least one mental health condition was associated with 2.18 times greater odds of having lifetime psychotic experiences (aOR: 2.18; 95% CI: 1.96-2.42). In terms of physical health, having at least one physical health condition was associated with 1.37 times greater odds of having lifetime psychotic experiences (aOR: 1.37; 95% CI: 1.22-1.53), but only four conditions were associated with greater odds of lifetime psychotic experiences, which were: asthma, gastrointestinal disease, HIV/AIDS, and other chronic disease. The counts of mental and physical health conditions were associated with greater odds of lifetime psychotic experiences in a dose-dependent fashion. CONCLUSION Psychotic experiences appear to be an indicator for mental health problems and some physical health problems. More research is needed to determine whether assessing for psychotic experiences broadly can help identify at-risk individuals in university settings who may benefit from targeted preventive interventions.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, CA, USA
| | - Rachel Banawa
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Sasha Zhou
- Department of Public Health, Wayne State University, Detroit, MI, USA
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, Bronx, NY, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
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Oh BH, Du J, Smith L, Koyanagi A. Psychotic experiences are associated with greater impairment among students in higher education with depression and anxiety in the United States. J Affect Disord 2024; 344:325-328. [PMID: 37838267 DOI: 10.1016/j.jad.2023.10.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Psychotic experiences are associated with depression and anxiety, but emerging research suggests that psychotic experiences are also associated with impairment within psychopathology. METHODS We analyzed a subsample from the Healthy Minds Study (2020-2021; N = 91,435) and used multivariable logistic regression to examine the associations between psychotic experiences and impairment resulting from depression and anxiety, adjusting for age, gender, and race/ethnicity. RESULTS Around one-in-five students with depression or anxiety impairment reported 12-month psychotic experiences. Psychotic experiences were associated with greater odds of depression impairment and anxiety impairment, adjusting for age, gender, race/ethnicity. Odds ratios varied depending on the type of psychotic experience and the outcomes. CONCLUSION Psychotic experiences are associated with greater odds of impairment resulting from depression and anxiety. In clinical practice, psychotic experiences may serve as a useful marker of assessing impairment resulting from psychopathology.
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Affiliation(s)
- By Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
| | - Jinyu Du
- Southern Methodist University, USA.
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
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Stickley A, Shirama A, Sumiyoshi T. Psychotic experiences, perceived stress, and suicidal ideation among the general population during the COVID-19 pandemic: Findings from Japan. Schizophr Res 2023; 260:49-55. [PMID: 37625223 DOI: 10.1016/j.schres.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/16/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Psychotic experiences (PEs) have been linked to suicidality. However, little is known about the mechanisms underlying this association. This cross-sectional study examined the role of perceived stress in the association between PEs and suicidal ideation in the general population during the COVID-19 pandemic, which has been linked to high levels of stress and an increase in suicidal behavior. METHODS Data were analyzed from an online sample of 1452 Japanese individuals aged 18 to 89 that were collected in February 2021. Information was obtained on past-year suicidal ideation and PEs, which were assessed with the PRIME Screen-Revised (PS-R). Perceived stress was measured with the Perceived Stress Scale (PSS-14). Logistic regression was used to examine associations. RESULTS In an analysis adjusted for sociodemographic factors, PEs were associated with 2.4 times higher odds for past-year suicidal ideation. However, further adjusting the analysis for mental health (depressive symptoms) attenuated the association (OR: 1.49, 95%CI: 0.76-2.93). In an analysis adjusted for mental health, individuals with PEs and perceived stress had significantly higher odds for suicidal ideation (OR: 4.77, 95%CI: 1.83-12.44), while PEs without perceived stress were not linked to suicidal thoughts (OR: 0.47, 95%Cl: 0.13-1.77). A further analysis showed that stress mediated the PEs-suicidal ideation association. CONCLUSIONS Self-perceived stress plays an important role in the association between PEs and suicidal ideation. The detection and management of stress in people with PEs may help prevent negative outcomes such as suicidal thoughts and behaviors in this population.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
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Olanrewaju O, Trott M, Smith L, López Sánchez GF, Carmichael C, Oh H, Schuch F, Jacob L, Veronese N, Soysal P, Shin JI, Butler L, Barnett Y, Koyanagi A. Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries. Qual Life Res 2023; 32:1031-1041. [PMID: 36571639 PMCID: PMC10063492 DOI: 10.1007/s11136-022-03317-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. METHODS Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0-100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations. RESULTS The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50-114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient - 5.89; 95% CI - 6.83, - 4.95), 3 (- 8.35; - 9.63, - 7.06), 4 (- 10.87; - 12.37, - 9.36), and ≥ 5 (- 13.48; - 15.91, - 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%). CONCLUSION A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.
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Affiliation(s)
- Olawale Olanrewaju
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Mike Trott
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Lee Smith
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK.
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Christina Carmichael
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, 90007, USA
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-Ro 50, Seodaemun-Gu, C.P.O Box 8044, Seoul, 03722, Republic of Korea
| | - Laurie Butler
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Yvonne Barnett
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
- ICREA, Pg, Lluis Companys 23, 08010, Barcelona, Spain
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Otieno P, Asiki G, Wekesah F, Wilunda C, Sanya RE, Wami W, Agyemang C. Multimorbidity of cardiometabolic diseases: a cross-sectional study of patterns, clusters and associated risk factors in sub-Saharan Africa. BMJ Open 2023; 13:e064275. [PMID: 36759029 PMCID: PMC9923299 DOI: 10.1136/bmjopen-2022-064275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To determine the patterns of cardiometabolic multimorbidity and associated risk factors in sub-Saharan Africa (SSA). DESIGN We used data from the WHO STEPwise approach to non-communicable disease risk factor surveillance cross-sectional surveys conducted between 2014 and 2017. PARTICIPANTS The participants comprised 39, 658 respondents aged 15-69 years randomly selected from nine SSA countries using a multistage stratified sampling design. PRIMARY OUTCOME MEASURE Using latent class analysis and agglomerative hierarchical clustering algorithms, we analysed the clustering of cardiometabolic diseases (CMDs) including high blood sugar, hypercholesterolaemia, hypertension and cardiovascular diseases (CVDs) such as heart attack, angina and stroke. Clusters of lifestyle risk factors: harmful salt intake, physical inactivity, obesity, tobacco and alcohol use were also computed. Prevalence ratios (PR) from modified Poisson regression were used to assess the association of cardiometabolic multimorbidity with sociodemographic and lifestyle risk factors. RESULTS Two distinct classes of CMDs were identified: relatively healthy group with minimal CMDs (95.2%) and cardiometabolic multimorbidity class comprising participants with high blood sugar, hypercholesterolaemia, hypertension and CVDs (4.8%). The clusters of lifestyle risk factors included alcohol, tobacco and harmful salt consumption (27.0%), and physical inactivity and obesity (5.8%). The cardiometabolic multimorbidity cluster exhibited unique sociodemographic and lifestyle risk profiles. Being female (PR=1.7, 95% CI (1.5 to 2.0), middle-aged (35-54 years) (3.9 (95% CI 3.2 to 4.8)), compared with age 15-34 years, employed (1.2 (95% CI 1.1 to 1.4)), having tertiary education (2.5 (95% CI 2.0 to 3.3)), vs no formal education and clustering of physical inactivity and obesity (2.4 (95% CI 2.0 to 2.8)) were associated with a higher likelihood of cardiometabolic multimorbidity. CONCLUSION Our findings show that cardiometabolic multimorbidity and lifestyle risk factors cluster in distinct patterns with a disproportionate burden among women, middle-aged, persons in high socioeconomic positions, and those with sedentary lifestyles and obesity. These results provide insights for health systems response in SSA to focus on these clusters as potential targets for integrated care.
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Affiliation(s)
- Peter Otieno
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Gershim Asiki
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Frederick Wekesah
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
- Lown Scholars Program, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Calistus Wilunda
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Richard E Sanya
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Welcome Wami
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Chiu CD, Chou LS, Hsieh YC, Lin CH, Li DJ. Erroneous Thought in Inpatients with Major Depressive Disorder: The Role of Psychological Trauma During Childhood and Adulthood. Neuropsychiatr Dis Treat 2023; 19:337-348. [PMID: 36778532 PMCID: PMC9910196 DOI: 10.2147/ndt.s396451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The pathogenic role of trauma in psychotic-like experiences has yet to be clarified. The aim of this study was to investigate the role of childhood and adulthood trauma on erroneous thoughts among patients with major depressive disorder. MATERIALS AND METHODS Inpatients with major depressive disorder (MDD) and healthy controls (HCs) were enrolled, and paper-and-pencil questionnaires were applied. Clinical rating and self-reported scales were used to measure levels of depression, dissociation, psychological trauma, parental maltreatment, and erroneous thoughts. Pearson's correlation analysis was conducted to explore potentially significant associations between erroneous thoughts and other independent variables, and standardized regression coefficients of hierarchical regression analysis were used to predict the significant relationships between erroneous thoughts and adulthood or childhood trauma. RESULTS A total of 99 participants were included into the analysis, of whom 59 were patients with MDD and 40 were HCs. After treatment, the patients with MDD showed significantly higher levels of depression, childhood maltreatment, interpersonal trauma and erroneous thoughts than the HCs. After estimating and verifying correlations with hierarchical regression among the patients with MDD, a link between adulthood betrayal trauma and higher level of conviction along with the number of erroneous thoughts was found. However, no significant association was identified between childhood trauma and erroneous thought. The concurrent level of depression significantly predicted a higher level of being preoccupied, along with the number of erroneous thoughts. CONCLUSION The current study fills a gap in the literature by showing a link between adulthood trauma and erroneous thoughts in non-psychotic patients. Further studies with well-controlled comparisons and prospective cohort with longer follow-up are warranted to extend the applicability and generalizability of the current study.
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Affiliation(s)
- Chui-De Chiu
- Department of Psychology, Clinical and Health Psychology Centre, and Centre for Cognition and Brain Studies, the Chinese University of Hong Kong, Sha Tin City, Hong Kong
| | - Li-Shiu Chou
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Yung-Chi Hsieh
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Ching-Hua Lin
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan
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Stickley A, Shirama A, Sumiyoshi T. Are attention-deficit/hyperactivity disorder symptoms associated with negative health outcomes in individuals with psychotic experiences? Findings from a cross-sectional study in Japan. Front Psychiatry 2023; 14:1133779. [PMID: 37205981 PMCID: PMC10188928 DOI: 10.3389/fpsyt.2023.1133779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/04/2023] [Indexed: 05/21/2023] Open
Abstract
Objective Although research has indicated that the prevalence of attention-deficit/hyperactivity disorder (ADHD) may be elevated in individuals with psychotic disorders, as yet, there has been comparatively little research on this association and its effects among adults at the subclinical level. To address this deficit, the current study examined the association between psychotic experiences (PE) and ADHD symptoms in Japanese individuals and whether the presence of ADHD symptoms increases the risk for negative health outcomes in people with PE. Method Data were analyzed from an online sample of 1,452 individuals (age 18-89; 51.5% female) collected in 2021. Information on PE was obtained with the PRIME Screen-Revised (PS-R), while the Adult ADHD Self-Report Scale (ASRS) Screener was used to measure ADHD symptoms. Information was also obtained on a number of health outcomes including anxiety and depressive symptoms and suicidal ideation. Logistic regression was used to assess associations. Results In a fully adjusted analysis PE were associated with almost three times higher odds for ADHD symptoms (OR: 2.92, 95%CI: 1.19-7.17). In an analysis that was restricted to individuals with PE, ADHD symptoms were associated with significantly increased odds for depressive symptoms, lifetime suicidal ideation, perceived stress and severe sleep problems. Conclusion ADHD symptoms are present in some individuals with PE and increase the odds for several detrimental health outcomes in this population. Identifying co-occurring PE and ADHD/ADHD symptoms may facilitate treatment options and help prevent negative health outcomes in individuals with these conditions.
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Felez-Nobrega M, Haro JM, Koyanagi A. Multimorbidity, depression with anxiety symptoms, and decrements in health in 47 low- and middle-income countries. J Affect Disord 2022; 317:176-184. [PMID: 36055525 DOI: 10.1016/j.jad.2022.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/26/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Comorbid depression and anxiety is associated with worse health outcomes compared to depression or anxiety occurring in isolation, but there is little data on its association with multimorbidity. Thus, we investigated this association across 47 low- and middle-income countries, and further explored whether having anxiety symptoms in addition to depression is associated with significant declines in health outcomes among those with multimorbidity. METHODS Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. DSM-IV depression was assessed with the Composite International Diagnostic Interview. Anxiety symptoms referred to severe/extreme problems with worry or anxiety. Ten chronic conditions and health status across five domains (cognition, interpersonal activities, sleep/energy, self-care, pain/discomfort) were assessed. Multivariable regression analyses conducted. RESULTS Data included 237,952 adults aged ≥18 years [mean age (SD) 38.4 (16.0); 50.8 % females]. Compared to no chronic conditions, 2 (OR = 6.86; 95%CI = 5.59-8.42), 3 (OR = 12.33; 95%CI = 9.72-15.63), and ≥4 (OR = 26.55; 95%CI = 20.21-35.17) chronic conditions were associated with significantly higher odds for comorbid depression/anxiety symptoms (vs. no depression or anxiety symptoms) in the multinomial logistic regression model. Among those with depression and multimorbidity, anxiety symptoms were associated with significantly worse health status across all domains. LIMITATIONS Cross-sectional design, depression and anxiety symptoms were not based on a clinical assessment. CONCLUSIONS Comorbid depression/anxiety is common in people with multimorbidity, and anxiety symptoms in people with depression and multimorbidity signify worse health status. Future studies should assess the utility of screening for and treating comorbid depression/anxiety in patients with multimorbidity in terms of clinical outcomes.
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Affiliation(s)
- M Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain.
| | - J M Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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10
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Oh H, Susser E, Volpe VV, Lui F, Besecker M, Zhou S, Anglin DM. Psychotic experiences among Black college students in the United States: The role of socioeconomic factors and discrimination. Schizophr Res 2022; 248:198-205. [PMID: 36088750 PMCID: PMC10227771 DOI: 10.1016/j.schres.2022.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/27/2022] [Accepted: 09/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Psychosis is more prevalent among Black individuals compared with White individuals. However, it is unknown whether this disparity exists among college populations in the United States, and if so, what factors contribute to the disparity. METHODS We analyzed data from Black and White young adult students using the Health Minds Study (2020-2021), which is a survey administered at 140 colleges in the U.S. Using mediation analysis, we examined the extent to which the relation between race and psychotic experiences was mediated by socioeconomic factors (past and current financial distress, food insecurity, parental education) and discrimination. RESULTS Approximately 38 % of Black students and 30 % of White students reported lifetime psychotic experiences. Including all socioeconomic factors together in the same model accounted for just over half (50.2 %) the association between race and psychotic experiences. We then conducted additional analyses examining discrimination, all the socioeconomic factors plus discrimination accounted for 81.5 % of the association between race and psychotic experiences. When disentangling the mediators, food insecurity and discrimination accounted for the largest percentages of the association. The effects of past financial distress and parental education were modified by race. CONCLUSION Black college students were more likely to report lifetime psychotic experiences than their White counterparts. Moreover, socioeconomic factors and discrimination made significant contributions to this racial difference.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States of America.
| | - Ezra Susser
- Mailman School of Public Health, Columbia University, United States of America
| | - Vanessa V Volpe
- Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC 27695
| | - Florence Lui
- Memorial Sloan Kettering Cancer Center, United States of America
| | - Megan Besecker
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States of America
| | - Sasha Zhou
- Department of Public Health, Wayne State University, United States of America
| | - Deidre M Anglin
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031, United States of America; The Graduate Center, City University of New York, 365 5th Avenue, New York, NY 10016, United States of America
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11
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Hawkins DS. "After Philando, I Had to Take a Sick Day to Recover": Psychological Distress, Trauma and Police Brutality in the Black Community. HEALTH COMMUNICATION 2022; 37:1113-1122. [PMID: 33902344 DOI: 10.1080/10410236.2021.1913838] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Unfortunately, encounters between Black Americans and law enforcement frequently feature violence, resulting in a myriad of negative health influences including increased rates of race-based mortality, chronic stress and trauma. Despite police brutality's increased media coverage, there is a dearth of empirical research surrounding violence at the hands of law enforcement and how it impacts the health of the Black community. Police departments across the country fail to release official data or information related to police brutality; however, technological advancements, such as social media and smart phones, have revolutionized information seeking and dissemination related to brutality. Drawing on Critical Race Theory (CRT), this qualitative study used phenomenological interviews to better understand how Black Americans interpret stories of police brutality and the impact such stories have on one's mental health. Analysis confirmed previous quantitative research, revealing the Black community can be traumatized by viewing graphic images or videos of police brutality. Interviewees reported a constant fear of dying, hyper alertness and lack of coping mechanisms. Findings from this study not only should be used to build health communication models that can address mental health issues, but also should be used as a blueprint to improve police-community relations. Implications are drawn from this study for addressing the issue of police violence in the Black community. Policy recommendations are suggested.
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12
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Smith L, Oh H, Jacob L, López-Sánchez GF, Veronese N, Soysal P, Shin JI, Schuch F, Tully MA, Butler L, Barnett Y, Koyanagi A. Sleep problems and subjective cognitive complaints among middle-aged and older adults in 45 low- and middle-income countries. Aging Clin Exp Res 2022; 34:1285-1293. [PMID: 34985716 DOI: 10.1007/s40520-021-02052-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Currently, a small body of evidence suggests that sleep problems are positively associated with subjective cognitive complaints (SCC). However, no studies on this topic exist from low- and middle-income countries (LMICs). Thus, we investigated the association between sleep problems and SCC in a large sample of middle-age and older adults from 45 LMICs. METHODS Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. Sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days were self-reported. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression was conducted to explore the association between sleep problems (exposure) and SCC (outcome). RESULTS Data on 60,228 adults aged ≥ 50 years were analyzed [mean (SD) age 61.4 (9.9) years; 53.9% females]. After adjustment for potential confounders, compared to those without sleep problems, the mean SCC score for the multivariable model was 13.32 (95% CI 12.01, 14.63), 19.46 (95% CI 17.95, 20.98), 24.17 (95% CI 22.02, 26.33), and 31.39 (95% CI 28.13, 34.65) points higher for mild, moderate, severe, and extreme sleep problems, respectively. Similar results were found for analyses stratified by age and country-income level. CONCLUSION Sleep problems were positively associated in a dose-response manner with SCC among middle-aged and older adults in multiple LMICs. Addressing sleep problems may aid in the prevention of SCC and ultimately dementia, pending future longitudinal research.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Guillermo F López-Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, 30100, Espinardo, Murcia, Spain.
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, İstanbul, Turkey
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, BT37 0QB, Northern Ireland, UK
| | - Laurie Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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13
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Oh H, DeVylder JE, Koyanagi A. Psychotic experiences as a health indicator: A provisional framework. Int J Soc Psychiatry 2022; 68:244-252. [PMID: 33554709 DOI: 10.1177/0020764021992809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
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14
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Endo K, Yamasaki S, Nakanishi M, DeVylder J, Usami S, Morimoto Y, Stanyon D, Suzuki K, Miyashita M, Arai M, Fujikawa S, Kanata S, Ando S, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Psychotic experiences predict subsequent loneliness among adolescents: A population-based birth cohort study. Schizophr Res 2022; 239:123-127. [PMID: 34875510 DOI: 10.1016/j.schres.2021.11.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/14/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cross-sectional studies have suggested that the occurrence of psychotic experiences is associated with loneliness in the general adolescent population. However, there has been a scarcity of prospective longitudinal studies on this topic. METHODS We investigated the longitudinal association between the presence of psychotic experiences and loneliness among adolescents using data from a population-based birth cohort study (Tokyo Teen Cohort; N = 3171). Psychotic experiences and loneliness were assessed at three timepoints with two-year intervals through early adolescence (age 10, 12, and 14). RESULTS After adjusting for demographic characteristics and potential confounding factors, linear regression analyses showed a significant longitudinal association between psychotic experiences and subsequent loneliness (for age 10 to 12: B = 0.041, 95% CI: 0.009-0.074, p = .013; for age 12 to 14: B = 0.061, 95% CI: 0.026-0.096, p = .001). The reverse association, between preceding loneliness and later psychotic experiences, was not significant (for age 10 to 12: B = 0.003, 95% CI: -0.052-0.057, p = .926; for age 12 to 14: B = -0.028, 95% CI: -0.088-0.032, p = .355). DISCUSSION Loneliness could be a sign of underlying psychotic experiences among adolescents but does not appear to be antecedent to these symptoms. Clinicians and teachers should assess for the presence of psychotic experiences in young adolescents who report loneliness. Future studies capturing PEs and loneliness at narrower time intervals, and including other potential mediators and confounders, may be insightful.
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Affiliation(s)
- Kaori Endo
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Japan
| | - Syudo Yamasaki
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Japan.
| | - Miharu Nakanishi
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Japan
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, United States of America
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychology, Ube Frontier University, Japan
| | - Daniel Stanyon
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Japan
| | - Kazuhiro Suzuki
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Makoto Arai
- Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan
| | - Sho Kanata
- Graduate School of Medicine, Teikyo University, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan
| | | | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes of Advanced Study (UTIAS), Japan
| | - Atsushi Nishida
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Japan
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15
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Coid JW, Zhang Y, Zeng J, Li X, Lv Q, Tang W, Wang Q, Deng W, Guo W, Zhao L, Ma X, Meng Y, Li M, Wang H, Chen T, Yang M, Li T. Testing extra-linearity across a psychosis continuum. BMC Psychiatry 2021; 21:574. [PMID: 34784908 PMCID: PMC8594101 DOI: 10.1186/s12888-021-03498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/27/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND It is unclear whether psychotic experiences (PEs) gradually merge into states of clinical psychosis along a continuum which correspond to a dimensional classification or whether latent classes appear above a certain severity threshold which correspond better to diagnostic categories of psychosis. METHODS Annual cross-sectional surveys, 2014-19, among Chinese undergraduates (N = 47,004) measured PEs, depression and etiological risk factors using standardized self-report instruments. We created a psychosis continuum with five levels and tested linear and extra-linear contrasts in associated etiological risk factors, before and after adjustment for depression. We carried out latent class analysis. RESULTS Categorical expression of psychosis, including hallucinations and delusions, nuclear symptoms, and nuclear symptoms and depression were found at severe level 5. Etiological risk factors which impacted linearly across the continuum were more common for depression. Child maltreatment impacted extra-linearly on both psychosis and depression. Family history of psychosis impacted linearly on psychosis; male sex and urban birth impacted extra-linearly and were specific for psychosis. Four latent classes were found, but only at level 5. These corresponded to nuclear schizophrenia symptoms, nuclear schizophrenia and depressive symptoms, severe depression, and an unclassified category with moderate prevalence of PEs. CONCLUSION Quantitative and qualitative changes in the underlying structure of psychosis were observed at the most severe level along a psychosis continuum, where four latent classes emerged. These corresponded to existing categorical classifications but require confirmation with clinical interview. PEs are non-specific and our findings suggest some are on a continuum with depression, whilst others are on a continuum with non-affective psychosis. Differing patterns of impact from etiological risk factors across the spectrum of psychopathology determine outcome at the most severe level of these continua.
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Affiliation(s)
- Jeremy W. Coid
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Yamin Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Jinkun Zeng
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Xiaojing Li
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Qiuyue Lv
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Wanjie Tang
- grid.13291.380000 0001 0807 1581Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581Centre for Psychological Educational and Consultation, Sichuan University, Chengdu, Sichuan China
| | - Qiang Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Wei Deng
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China ,grid.469604.90000 0004 1765 5222Hangzhou Seventh People’s Hospital, Affiliated Mental Health Center, Zhejiang University School of Medicine, Hang zhou, Zhejiang China
| | - Wanjun Guo
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Liansheng Zhao
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Xiaohong Ma
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Yajing Meng
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Mingli Li
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Huiyao Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Ting Chen
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan China
| | - Min Yang
- grid.13291.380000 0001 0807 1581Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan China
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China. .,Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, Zhejiang University School of Medicine, Hang zhou, Zhejiang, China.
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16
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Coid JW, Zhang Y, Sun H, Yu H, Wei W, Li X, Lv Q, Tang W, Wang Q, Deng W, Guo W, Zhao L, Ma X, Meng Y, Li M, Wang H, Chen T, Li T. Impact of urban birth and upbringing on expression of psychosis in a Chinese undergraduate population. BMC Psychiatry 2021; 21:493. [PMID: 34625040 PMCID: PMC8501541 DOI: 10.1186/s12888-021-03475-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 09/16/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Urban birth and upbringing show consistent associations with psychotic illness but the key urban exposures remain unknown. Associations with psychotic-like experiences (PEs) are inconsistent. These could be confounded by common mental disorders associated with PEs. Furthermore, associations between PEs and urban exposures may not extrapolate to psychotic disorders such as schizophrenia. METHODS Annual cross-sectional surveys among first year Chinese undergraduates 2014-2019 (n = 47,004). Self-reported, hierarchical categorisation of psychosis: from psychoticism, paranoid ideation, schizotypal symptoms, nuclear syndrome using SCL-90-R, to clinical diagnosis of schizophrenia. Depressive symptoms using PHQ 9. Dissociative symptoms and posttraumatic stress disorder (PTSD) measured using PCL-C. Etiological factors of family history and childhood disadvantage. We studied effects of urban birth, urban living and critical times of exposure in childhood on psychosis phenotypes. RESULTS Associations with urbanicity were found only after adjustments for depression. Urban birth was associated with paranoia (AOR 1.34, 1.18-1.53), schizotypal symptoms (AOR 1.59, 1.29-1.96), and schizophrenia (AOR 2.07, 1.10-3.87). The same phenotypes showed associations with urban residence > 10 years. Only schizophrenia showed an association with urban exposure birth-3 years (AOR 7.01, 1.90-25.86). Child maltreatment was associated with both psychosis and depression. Urbanicity measured across the total sample did not show any associations with demography, family history of psychosis, or child maltreatment. Sensitivity analysis additionally adjusting for dissociative symptoms and PTSD showed the same pattern of findings. CONCLUSIONS Urban birth and urban living showed a hierarchical pattern of increasing associations from paranoid ideation to schizotypal disorder to schizophrenia, confirming that associations for psychotic experiences could be extrapolated to schizophrenia, but only after adjusting for confounding from depression, dissociative symptoms and PTSD. Several etiological factors were the same for psychosis and depression. Future studies of PEs should adjust for confounding from common mental disorders and dissociative symptoms. Effects of urbanicity on psychosis were not explained by demography, family history of mental disorder, or child maltreatment.
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Affiliation(s)
- Jeremy W. Coid
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Yamin Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Huan Sun
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Hua Yu
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Wei Wei
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Xiaojing Li
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Qiuyue Lv
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Wanjie Tang
- grid.13291.380000 0001 0807 1581Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581Centre for Psychological Educational and Consultation, Sichuan University, Chengdu, Sichuan China
| | - Qiang Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Wei Deng
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China ,grid.13402.340000 0004 1759 700XHangzhou Seventh People’s Hospital, Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Wanjun Guo
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Liansheng Zhao
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Xiaohong Ma
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Yajing Meng
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Mingli Li
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Huiyao Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Ting Chen
- grid.412901.f0000 0004 1770 1022Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041 Sichuan China
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 28 Dianxin South street, Chengdu, 610041, Sichuan, China. .,Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Jacob L, Shin JI, Oh H, López-Sánchez GF, Smith L, Haro JM, Koyanagi A. Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries. BMJ Open Diabetes Res Care 2021; 9:9/1/e002514. [PMID: 34620622 PMCID: PMC8499266 DOI: 10.1136/bmjdrc-2021-002514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/26/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Previous studies on the diabetes-edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs). RESEARCH DESIGN AND METHODS Data from the World Health Survey were used for this cross-sectional study (2002-2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models. RESULTS There were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only. CONCLUSIONS Diabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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18
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Prados-Ojeda JL, Luque-Luque R, Gordillo-Urbano RM, Guler I, López-Medina C, Collantes-Estévez E, Escudero-Contreras A. Assessment of Subclinical Psychotic Symptoms in Patients with Rheumatoid Arthritis and Spondyloarthritis. J Clin Med 2021; 10:jcm10163461. [PMID: 34441756 PMCID: PMC8396915 DOI: 10.3390/jcm10163461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
Inflammatory and autoimmune processes have been associated with the onset of depressive and psychotic symptoms. Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are rheumatic diseases with an inflammatory etiology. A high prevalence of depressive and anxiety-related comorbidity has been reported for both diseases, with no evidence of a greater prevalence of psychosis. The objective of the present study was to evaluate for the first time subclinical psychotic symptoms in patients with RA and SpA. This is a cross-sectional, single-center study including RA and SpA patients, as well as healthy controls. Abnormal psychotic experiences (positive, negative, and depressive symptoms) were evaluated using the Community Assessment of Psychic Experiences (CAPE-42). Functional capacity was evaluated using the Short-Form Health Survey SF-12. We compared the CAPE and SF-12 scores between the three groups. We recruited 385 individuals: 218 with RA, 100 with SpA, and 67 healthy controls. According to the CAPE scale, the frequency of subclinical psychotic symptoms was greater in patients than in healthy controls (RA, 1.90 vs. 1.63, p < 0.001; SpA, 1.88 vs. 1.63, p = 0.001). Distress was also greater in patients than in controls owing to the presence of symptoms. No differences were observed between the three groups for the mental dimension scores in the SF-12 Health Survey (43.75 in RA, 45.54 in SpA, and 43.19 in healthy controls). Our findings point to a greater prevalence of subclinical psychotic symptoms in patients with RA and patients with SpA than in the general population. The results suggest an association between inflammation and depression/subclinical psychotic symptoms.
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Affiliation(s)
- Juan L. Prados-Ojeda
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
- Morphological and Socio-Sanitary Sciences, University of Cordoba, 14004 Cordoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Rogelio Luque-Luque
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
- Morphological and Socio-Sanitary Sciences, University of Cordoba, 14004 Cordoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Rafael M. Gordillo-Urbano
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
| | - Ipek Guler
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Clementina López-Medina
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
- Correspondence:
| | - Eduardo Collantes-Estévez
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
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Shoham N, Eskinazi M, Hayes JF, Lewis G, Theodorsson M, Cooper C. Associations between psychosis and visual acuity impairment: A systematic review and meta-analysis. Acta Psychiatr Scand 2021; 144:6-27. [PMID: 34028803 PMCID: PMC8504204 DOI: 10.1111/acps.13330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Several theories propose that visual acuity impairment is associated with psychosis. Visual impairment could lead to psychosis or the converse, or they may share underlying pathology or risk factors. In the first evidence synthesis in this area for over 25 years, we collated studies measuring the association between visual acuity impairment and psychosis. METHODS We searched the MEDLINE, EMBASE, PsycINFO, and Web of Science databases for studies published from 1992 to 2020, using the Newcastle Ottawa Scale to assess risk of bias. We narratively synthesized findings and meta-analyzed sufficiently homogenous results. RESULTS We included 40 papers, which reported on 31 studies. Evidence from seven cohort studies was inconsistent, which precluded meta-analysis of this study design. These contradictory results also made it difficult to draw conclusions regarding a temporal association. We found evidence for an association from eight cross-sectional studies treating visual acuity impairment as the exposure and psychosis as the outcome [pooled odds ratio (OR) =1.76, 95% confidence interval (CI): 1.34-2.31], and four with the reverse exposure and outcome (OR: 1.85, 95% CI: 1.17-2.92). Seven case-control studies with mixed findings were found, but only two primarily addressed our research question, and these findings were mixed. CONCLUSIONS Although evidence supports a cross-sectional association between visual acuity impairment and psychosis, further research is needed to clarify the temporal direction, given the mixed findings in cohort studies. Understanding the association may give insights into prevention strategies for people at risk of visual acuity impairment and psychosis.
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Affiliation(s)
- Natalie Shoham
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Michelle Eskinazi
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Joseph F. Hayes
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Gemma Lewis
- Division of PsychiatryUniversity College LondonLondonUK
| | | | - Claudia Cooper
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052439. [PMID: 33801381 PMCID: PMC7967573 DOI: 10.3390/ijerph18052439] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 01/02/2023]
Abstract
Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38-4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14-3.22), 4.71 (95%CI = 3.67-6.11), 6.96 (95%CI = 4.95-9.87), 10.59 (95%CI = 7.10-15.80), and 19.89 (95%CI = 11.13-35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.
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Bhavsar V, Dorrington S, Morgan C, Hatch SL, McGuire P, Fusar-Poli P, Mills J, MacCabe JH, Hotopf M. Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London. Psychol Med 2021; 51:147-157. [PMID: 31713511 PMCID: PMC7116680 DOI: 10.1017/s0033291719003106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Co-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health. METHODS We linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions. RESULTS In all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49-3.27] and 3.46 (95% CI 1.52-7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15-1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22-20.44) among those with PTSD with psychotic experiences. CONCLUSIONS Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.
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Affiliation(s)
- Vishal Bhavsar
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sarah Dorrington
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Stephani L. Hatch
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - John Mills
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - James H. MacCabe
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
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Felez-Nobrega M, Olaya B, Haro JM, Stubbs B, Smith L, Koyanagi A. Associations between sedentary behavior and happiness: An analysis of influential factors among middle-aged and older adults from six low- and middle-income countries. Maturitas 2020; 143:157-164. [PMID: 33308622 DOI: 10.1016/j.maturitas.2020.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/21/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Higher levels of sedentary behavior (SB) may be associated with decreased happiness but there are no studies on this topic. Thus, we investigated this association, and its influential factors among middle-aged and older adults using nationally representative datasets from six low- and middle-income countries (LMICs). STUDY DESIGN Community-based cross-sectional data from the Global Ageing and Adult Health study were analyzed. SB was assessed with the Global Physical Activity Questionnaire. Multivariable ordinal logistic regression and mediation analyses were performed. MAIN OUTCOME MEASURES Happiness was assessed with a cross-culturally validated single-item question (5-point scale) with higher scores indicating higher levels of happiness. RESULTS The final sample included 34,129 adults aged 50 years or more (mean age = 62.4 ± SD 16 years; 51.9 % female). After adjusting for multiple confounders, increased time spent in SB (hours/day) was associated with lower happiness levels (OR = 0.96; 95 % CI = 0.94-0.98). Mobility limitations, cognitive complaints, pain/discomfort, sleep problems and disability explained the largest proportion of the association between SB and happiness. CONCLUSIONS SB was linked with lower levels of happiness in middle-aged and older adults from LMICs, although a high level of between-country heterogeneity was observed. Longitudinal and interventional studies among older people in LMICs are warranted to assess directionality and the potential for reduction in SB to improve mental well-being in this population.
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Affiliation(s)
- Mireia Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
| | - Beatriz Olaya
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Oh H, Waldman K, Stickley A, DeVylder JE, Koyanagi A. Psychotic experiences and physical health conditions in the United States. Compr Psychiatry 2019; 90:1-6. [PMID: 30639892 DOI: 10.1016/j.comppsych.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/08/2018] [Accepted: 12/15/2018] [Indexed: 01/23/2023] Open
Abstract
AIMS Psychotic experiences are associated with physical health conditions, though the associations have not always been consistent in the literature. The current study examines the associations between psychotic experiences and several physical health conditions across four racial groups in the United States. METHODS We analyzed data from the Collaborative Psychiatric Epidemiology Surveys to examine the associations between psychotic experiences and physical health conditions across four racial groups (White, Black, Asian, Latino). We used multivariable logistic regression to calculated adjusted odds ratios and 95% Confidence Intervals. RESULTS Psychotic experiences were significantly associated with several physical health conditions depending on the condition and the racial group being examined. Further, the number of physical health conditions was associated with increasingly greater risk for psychotic experiences in a linear fashion. CONCLUSIONS Psychotic experiences may serve as useful markers for physical health conditions and overall physical health status. Future studies should examine the underlying mechanisms between psychotic experiences and health, and explore the clinical utility of psychotic experiences for preventive interventions.
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Affiliation(s)
- H Oh
- University of Southern California, School of Social Work, 669 W. 34th St., University of Southern California, Los Angeles, CA 90089 - 0411, United States of America.
| | - K Waldman
- University of Southern California, School of Social Work, 669 W. 34th St., University of Southern California, Los Angeles, CA 90089 - 0411, United States of America
| | - A Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
| | - J E DeVylder
- Fordham University, Graduate School of Social Service, 113 W 60th Street, New York, NY 10023, United States of America.
| | - A Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
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24
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Oh H, Waldman K, Stubbs B, Koyanagi A. Psychotic experiences in the context of mood and anxiety disorders and their associations with health outcomes among people of color in the United States. J Psychosom Res 2019; 118:27-33. [PMID: 30782351 DOI: 10.1016/j.jpsychores.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Psychotic experiences appear to increase risk for health outcomes above and beyond mood/anxiety disorders. However, existing studies that have found this association were conducted mostly in low- and middle-income countries, calling for more studies to explore the association in other contexts, such as the U.S., where people of color face considerable health disparities. MATERIALS/METHODS Data from the National Latino and Asian American Survey, and the National Survey of American Life were analyzed. After restricting the analytic sample to individuals with at least one mood or anxiety disorder (N = 2929), multivariable logistic regression was used to examine the associations between psychotic experiences and health outcomes, disabilities, and help-seeking behaviors, adjusting for socio-demographic characteristics and psychiatric disorders. RESULTS Among people of color with mood/anxiety disorders, 16.58% (n = 519) of the weighted analytic sample reported psychotic experiences. Psychotic experiences were associated with 1.75 times greater odds (95% CI: 1.24-2.47) for reporting a lifetime health condition, with varying odds depending on the specific conditions (e.g. arthritis, heart disease, ulcers, and asthma), and specific disabilities (e.g. cognition, mobility, social interaction, and time out of role). Psychotic experiences were associated with 1.66 times the odds of seeking any treatment (95% CI: 1.20-2.29), and the perceived need for help among people who did not seek treatment (e.g. feeling the need for treatment, being encouraged to seek treatment by others). CONCLUSIONS Mental health practitioners serving people of color who have mood/anxiety disorders should routinely screen for psychotic experiences, which may suggest health problems and disabilities that warrant integrated healthcare.
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Affiliation(s)
- Hans Oh
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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25
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Psychotic experiences as indicators of risk for cardiovascular disease. Schizophr Res 2018; 202:281-283. [PMID: 29880454 DOI: 10.1016/j.schres.2018.05.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/29/2018] [Indexed: 11/23/2022]
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26
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DeVylder JE, Kelleher I, Koyanagi A. Urbanicity and Psychosis-Reply. JAMA Psychiatry 2018; 75:1301-1302. [PMID: 30208376 DOI: 10.1001/jamapsychiatry.2018.2352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, New York
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons, Dublin, Ireland
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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DeVylder JE, Jun HJ, Fedina L, Coleman D, Anglin D, Cogburn C, Link B, Barth RP. Association of Exposure to Police Violence With Prevalence of Mental Health Symptoms Among Urban Residents in the United States. JAMA Netw Open 2018; 1:e184945. [PMID: 30646377 PMCID: PMC6324385 DOI: 10.1001/jamanetworkopen.2018.4945] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health. OBJECTIVE To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. Participants were identified through Qualtrics panels, an internet-based survey administration service using quota sampling. EXPOSURES Past 12-month exposure to police violence, assessed using the Police Practices Inventory. Subtypes of violence exposure were coded according to the World Health Organization domains of violence (ie, physical, sexual, psychological, and neglectful). MAIN OUTCOMES AND MEASURES Current Kessler Screening Scale for Psychological Distress (K6) score, past 12-month psychotic experiences (World Health Organization Composite International Diagnostic Interview), and past 12-month suicidal ideation and attempts. RESULTS Of 1221 eligible participants, there were 1000 respondents (81.9% participation rate). The sample matched the adult population of included cities on race/ethnicity (non-Hispanic white, 339 [33.9%]; non-Hispanic black/African American, 390 [39.0%]; Hispanic/Latino, 178 [17.8%]; other, 93 [9.3%]), age (mean [SD], 39.8 [15.2] years), and gender (women, 600 [60.0%]; men, 394 [39.4%]; transgender, 6 [0.6%]) within 10% above or beyond 2010 census distributions. Twelve-month prevalence of police violence was 3.2% for sexual violence, 7.5% for physical violence without a weapon, 4.6% for physical violence with a weapon, 13.2% for psychological violence, and 14.9% for neglect. Police violence exposures were higher among men, people of color, and those identified as homosexual or transgender. Respondents reported suicidal ideation (9.1%), suicide attempts (3.1%), and psychotic experiences (20.6%). The mean (SD) K6 score was 5.8 (6.1). All mental health outcomes were associated with police violence exposure in adjusted logistic regression analyses. Physical violence with a weapon and sexual violence were associated with greater odds of psychotic experiences (odds ratio [95% CI]: 4.34 [2.05-9.18] for physical violence with a weapon; 6.61 [2.52-17.36] for sexual violence), suicide attempts (odds ratio [95% CI]: 7.30 [2.94-18.14] for physical violence with a weapon; 6.63 [2.64-16.64] for sexual violence), and suicidal ideation (odds ratio [95% CI]: 2.72 [1.30-5.68] for physical violence with a weapon; 3.76 [1.72-8.20] for sexual violence). CONCLUSIONS AND RELEVANCE Police violence was commonly reported, especially among racial/ethnic and sexual minorities. Associations between violence and mental health outcomes did not appear to be explained by confounding factors and appeared to be especially pronounced for assaultive forms of violence.
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Affiliation(s)
- Jordan E. DeVylder
- Graduate School of Social Service, Fordham University, New York, New York
| | - Hyun-Jin Jun
- School of Social Work, University of Maryland, Baltimore
| | - Lisa Fedina
- School of Social Work, University of Maryland, Baltimore
- School of Social Work, University of Michigan, Ann Arbor
| | - Daniel Coleman
- Graduate School of Social Service, Fordham University, New York, New York
| | | | | | - Bruce Link
- School of Public Policy, University of California Riverside, Riverside
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Koyanagi A, Oh H, Stickley A, Stubbs B, Veronese N, Vancampfort D, Haro JM, DeVylder JE. Sibship size, birth order and psychotic experiences: Evidence from 43 low- and middle-income countries. Schizophr Res 2018; 201:406-412. [PMID: 29929772 DOI: 10.1016/j.schres.2018.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/08/2018] [Accepted: 06/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sibship size and birth order may be contributing factors to the multifactorial etiology of psychosis. Specifically, several studies have shown that sibship size and birth order are associated with schizophrenia. However, there are no studies on their association with psychotic experiences (PE). METHODS Cross-sectional, community-based data from 43 low- and middle-income countries which participated in the World Health Survey were analyzed. The Composite International Diagnostic Interview was used to identify four types of past 12-month PE. The association of sibship size and birth order with PE was assessed with multivariable logistic regression. RESULTS The final sample consisted of 212,920 adults [mean (SD) age 38.1 (16.0) years; 50.7% females]. In the multivariable analysis, compared to individuals with no siblings, the OR increased linearly from 1.26 (95%CI = 1.01-1.56) to 1.72 (95%CI = 1.41-2.09) among those with 1 and ≥ 9 siblings, respectively. Compared to the first-born, middle-born individuals were more likely to have PE when having a very high number of siblings (i.e. ≥9). CONCLUSIONS Future studies should examine the environmental and biological factors underlying the association between sibship size/birth order and PE. Specifically, it may be important to examine the unmeasured factors, such as childhood infections and adversities that may be related to both family structure and PE.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Hans Oh
- University of Southern California, School of Social Work, CA, USA
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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Insomnia, negative affect, and psychotic experiences: Modelling pathways over time in a clinical observational study. Psychiatry Res 2018; 269:673-680. [PMID: 30216919 PMCID: PMC6215774 DOI: 10.1016/j.psychres.2018.08.090] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/09/2018] [Accepted: 08/24/2018] [Indexed: 01/10/2023]
Abstract
Insomnia has been shown to contribute to the development of psychotic experiences, predominantly via increasing negative affect. However, the role of insomnia in the persistence of psychotic experiences is yet to be investigated in a clinical population. Furthermore, other plausible influences, such as psychotic experiences contributing to insomnia, remain to be evaluated. This study tests the role of insomnia as a predictor of persistence of psychotic experiences versus other potential causal routes. Twenty-nine patients aged 18-30 with non-affective psychosis completed three assessments over three months of their insomnia, negative affect, and psychotic experiences. Mixed effect models allowed comparisons between hypothesis-based models (comprising insomnia as predictor, negative affect as mediator, and psychotic experiences as outcome) and oppositional models, where relationships were reversed. The results supported the hypothesised mediation model above models where negative affect was primary. Insomnia was also found to be a stronger predictor of later hallucinations than vice versa, although a bidirectional relationship was indicated between insomnia and paranoia. In conclusion, insomnia predicts persistence of psychotic experiences over time to the same or greater extent than psychotic experiences contribute to insomnia. This supports insomnia as a potential intervention target in psychosis.
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Abstract
BACKGROUND The anticipation of threat or victimization is a core feature of paranoia. Cognitive theories of paranoia suggest that paranoid thoughts may arise as a psychological response to trauma exposure, which likewise may lead to greater anticipation of subsequent victimization. Little is known, however, about the relation between paranoid beliefs and anticipated victimization when accounting for past victimization experience. The present study aimed to address whether the experiences of past victimization contribute to the link between paranoid beliefs and the anticipation of threat or victimization, with a particular focus on exposure to police violence. METHODS Data were collected through the Survey of Police-Public Encounters (N=1615), a cross-sectional, general population survey study conducted in four Eastern U.S. cities. Associations between paranoia and anticipated victimization were assessed using linear regression models, with and without adjustment for past victimization exposure. RESULTS Paranoid beliefs were positively associated with police victimization expectations (β=0.19, p<0.001), but these associations were statistically better explained by past exposures to similar victimization such that paranoia was no longer associated with anticipated victimization in adjusted models (β=0.02, p=0.451). To assess for the specificity of past exposures to victimization, adjusting for past exposure to intimate partner violence (as a control condition) did not eliminate the association between paranoia and expected police victimization. CONCLUSIONS The overall findings are consistent with cognitive theories of paranoia in which paranoid beliefs may be a severe but normative reaction to past victimization exposures in some cases.
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Stubbs B, Vancampfort D, Thompson T, Veronese N, Carvalho AF, Solmi M, Mugisha J, Schofield P, Matthew Prina A, Smith L, Koyanagi A. Pain and severe sleep disturbance in the general population: Primary data and meta-analysis from 240,820 people across 45 low- and middle-income countries. Gen Hosp Psychiatry 2018; 53:52-58. [PMID: 29807277 DOI: 10.1016/j.genhosppsych.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/19/2018] [Accepted: 05/20/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Pain and sleep disturbances are widespread, and are an important cause of a reduced quality of life. Despite this, there is a paucity of multinational population data assessing the association between pain and sleep problems, particularly among low- and middle-income countries (LMICs). Therefore, we investigated the relationship between pain and severe sleep disturbance across 45 LMICs. METHOD Community-based data on 240,820 people recruited via the World Health Survey were analyzed. Multivariable logistic regression analyses adjusted for multiple confounders were performed to quantify the association between pain and severe sleep problems in the last 30 days. A mediation analysis was conducted to explore potential mediators of the relationship between pain and severe sleep disturbance. RESULTS The prevalence of mild, moderate, severe, and extreme levels of pain was 26.0%, 16.2%, 9.1%, and 2.2% respectively, whilst 7.8% of adults had severe sleep problems. Compared to those with no pain, the odds ratio (OR, 95% CI) for severe sleep problems was 3.65 (3.24-4.11), 9.35 (8.19-10.67) and 16.84 (13.91-20.39) for those with moderate, severe and extreme pain levels respectively. A country wide meta-analysis adjusted for age and sex demonstrated a significant increased OR across all 45 countries. Anxiety, depression and stress sensitivity explained 12.9%, 3.6%, and 5.2%, respectively, of the relationship between pain and severe sleep disturbances. CONCLUSION Pain and sleep problems are highly co-morbid across LMICs. Future research is required to better understand this relationship. Moreover, future interventions are required to prevent and manage the pain and sleep disturbance comorbidity.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Andre F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy; Department of Neurosciences, University of Padova, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - A Matthew Prina
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédicaen Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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DeVylder JE, Oh HY, Kelleher I. Commentary on Degenhardt et al. (2018): Cause or consequence? Disentangling the relationship between psychosis and substance use. Addiction 2018; 113:935-936. [PMID: 29638033 DOI: 10.1111/add.14186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Hans Y Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ian Kelleher
- Royal College of Surgeons in Ireland, Department of Psychiatry, Dublin 2, Ireland
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Intimate partner violence and psychotic experiences in four U.S. cities. Schizophr Res 2018; 195:506-512. [PMID: 28935168 DOI: 10.1016/j.schres.2017.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/07/2017] [Accepted: 09/13/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND A large body of research has established a relationship between trauma exposure, particularly during childhood, and psychotic experiences. Yet, there remains a general lack of research on adult trauma exposure, including intimate partner violence (IPV), as a risk factor for psychotic experiences. The purpose of this study is to investigate the association between IPV and psychotic experiences in U.S. cities. METHODS Data were collected from 1615 participants in four U.S. cities. Psychotic experiences were assessed through the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) psychosis screen along with adapted IPV measures. RESULTS Findings revealed that experiencing at least one form of IPV was significantly associated with each of the four psychotic experiences assessed for both men and women. The strongest associations were found for threatening and sexual IPV; physical IPV was not significantly associated with psychotic experiences. Exposure to IPV was associated with more than a tripling of the odds of reporting at least one psychotic experience as opposed to none. Among those exposed to IPV there was between three- to five times the odds of reporting specific subtypes of psychotic experiences. CONCLUSION The results expand on prior findings linking psychotic experiences and childhood trauma exposure to include intimate adult exposures. Emotional and sexual IPV appear to be associated with elevated risk for psychotic experiences in adulthood. Even though IPV is more commonly reported by women in the U.S., such victimization appears to have similar associations with psychotic experiences regardless of gender.
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Koyanagi A, Stubbs B, Vancampfort D. Correlates of low physical activity across 46 low- and middle-income countries: A cross-sectional analysis of community-based data. Prev Med 2018; 106:107-113. [PMID: 29066372 DOI: 10.1016/j.ypmed.2017.10.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022]
Abstract
Physical inactivity accounts for 5.5% of all avoidable global deaths. However, a paucity of multinational studies, particularly in low- and middle-income countries (LMICs), has investigated correlates of physical activity (PA). Thus, we assessed the correlates of PA using cross-sectional, community-based data of the World Health Survey including 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those who do (≥150min moderate-vigorous PA per week) and do not (<150min=low PA) comply with the World Health Organization (WHO) PA recommendations. Multivariable logistic regression was used to assess the PA correlates. The prevalence of low PA in 206,356 persons (mean age 38.4years; 49.6% males) was 29.2% (95%CI=28.3%-30.0%). In the overall sample, female sex, not married/cohabiting, high education and wealth, unemployment, and urban setting were significant sociodemographic correlates of low PA. In terms of other correlates, inadequate fruit and vegetable intake, subsyndromal depression, worse sleep/energy and cognition, visual impairment, hearing problems and asthma were associated with not meeting the WHO recommendations. There were some variations in the correlates depending on age and sex. Interventions should be developed that operate at multiple levels of influence and take into account age- and gender-related PA patterns in order to assist people in LMICs to comply with the WHO PA recommendations. Researchers, funding bodies, practitioners and policymakers in education, mental and physical health, and urban planning have a critical role to play.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
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Stubbs B, Vancampfort D, Veronese N, Thompson T, Fornaro M, Schofield P, Solmi M, Mugisha J, Carvalho AF, Koyanagi A. Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. Psychol Med 2017; 47:2906-2917. [PMID: 28637534 DOI: 10.1017/s0033291717001477] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs. METHODS Community-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted. RESULTS The prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83-2.55], 1.45 (95% CI 1.22-1.73), and 2.11 (95% CI 1.87-2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54-4.37). CONCLUSION Depression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill, London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven,Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division,Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - T Thompson
- Faculty of Education and Health,University of Greenwich,London,UK
| | - M Fornaro
- New York Psychiatric Institute,Columbia University,New York, NY,USA
| | - P Schofield
- Faculty of Health,Social Care and Education,Anglia Ruskin University,Chelmsford,UK
| | - M Solmi
- Institute of clinical Research and Education in Medicine (IREM),Padova,Italy
| | | | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group,Faculty of Medicine,Federal University of Ceará,Fortaleza, CE,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Koyanagi A, Vancampfort D, Carvalho AF, DeVylder JE, Haro JM, Pizzol D, Veronese N, Stubbs B. Depression comorbid with tuberculosis and its impact on health status: cross-sectional analysis of community-based data from 48 low- and middle-income countries. BMC Med 2017; 15:209. [PMID: 29179720 PMCID: PMC5704363 DOI: 10.1186/s12916-017-0975-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/09/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Depression in tuberculosis increases the risk for adverse health outcomes. However, little is known about comorbid depression and tuberculosis in the general population. Thus, we assessed the association between depression and tuberculosis, and the decrements in health status associated with this comorbidity in 48 low- and middle-income countries. METHODS Cross-sectional, community-based data from the World Health Survey on 242,952 individuals aged ≥ 18 years were analyzed. Based on the World Mental Health Survey version of the Composite International Diagnostic Interview, past 12-month depression was categorized into depressive episode, brief depressive episode, subsyndromal depression, and no depression. Health status across six domains (cognition, interpersonal activities, sleep/energy, self-care, mobility, pain/discomfort) was assessed. Multivariable logistic and linear regression analyses were performed to assess the associations. RESULTS The prevalence of depressive episode among those with and without tuberculosis was 23.7% and 6.8%, respectively (P < 0.001). Tuberculosis was associated with a 1.98 (95% CI 1.47-2.67), 1.75 (95% CI 1.26-2.42), and 3.68 (95% CI 3.01-4.50) times higher odds for subsyndromal depression, brief depressive episode, and depressive episode, respectively. Depressive episode co-occurring with tuberculosis was associated with significantly worse health status across all six domains compared to tuberculosis alone. Interaction analysis showed that depression significantly amplifies the association between TB and difficulties in self-care but not in other health domains. CONCLUSIONS Depression is highly prevalent in adults with tuberculosis, and is associated with worse health status compared to tuberculosis without depression. Public health efforts directed to the recognition and management of depression in people with tuberculosis may lead to better outcomes.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain. .,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Jordan E DeVylder
- Fordham University, Graduate School of Social Service, New York, NY, USA
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Damiano Pizzol
- Operation Research Unit, Doctors with Africa, Maputo, Mozambique
| | - Nicola Veronese
- Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy.,National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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Psychotic-like experiences and happiness in the English general population. J Affect Disord 2017; 222:211-217. [PMID: 28711798 DOI: 10.1016/j.jad.2017.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) have been associated with a variety of adverse outcomes but how they affect happiness in individuals with PLE is unknown. Thus, the aim of the study was to assess the association between PLEs and happiness, and the factors that may influence this association. METHODS Nationally representative data from the 2007 Adult Psychiatric Morbidity Survey including adults aged ≥ 16 years was analyzed. The Psychosis Screening Questionnaire was used to assess past 12-month PLE. Individuals who endorsed at least one of the following were considered to have any PLE: thought control, paranoia, strange experiences, auditory hallucinations. Happiness (3-point scale) was assessed with a validated question with higher scores indicating lower levels of happiness. The association between PLE and happiness was assessed by multivariable ordinal logistic regression. Mediation analysis was also performed. RESULTS Among the 7363 individuals included in the analysis, the prevalence of any PLE increased with decreasing levels of happiness [very happy (2.3%), fairly happy (5.4%), not too happy (14.9%)]. This was also shown in the multivariable analysis adjusted for sociodemographic factors and stressful life events (from very happy to not too happy: OR = 2.41; 95%CI = 1.86-3.12). Mediation analysis showed that anxiety disorders explained the largest proportion of the association (38.8%) followed by depressive episode (28.5%), insomnia (21.9%), disability (16.5%), pain (12.5%), social support (10.0%), and physical health conditions (6.0%). LIMITATIONS The cross-sectional design limits causal inference. CONCLUSION Interventions to identify and address conditions that may have a negative impact on happiness in individuals with PLE may be important to improve their well-being.
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Stubbs B, Vancampfort D, Veronese N, Kahl KG, Mitchell AJ, Lin PY, Tseng PT, Mugisha J, Solmi M, Carvalho AF, Koyanagi A. Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries. Psychol Med 2017; 47:2107-2117. [PMID: 28374652 DOI: 10.1017/s0033291717000551] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs). METHOD Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity. RESULTS Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98-3.57). CONCLUSIONS Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust,Denmark Hill,London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division, Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy,Hannover Medical School,Hannover,Germany
| | - A J Mitchell
- Department of Cancer and Molecular Medicine,University of Leicester,Leicester,UK
| | - P-Y Lin
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - P-T Tseng
- Department of Psychiatry,Tsyr-Huey Mental Hospital,Kaohsiung Jen-Ai's Home,Taiwan
| | | | - M Solmi
- Department of Neurosciences,University of Padova,Padova,Italy
| | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine,Federal University of Ceará,Fortaleza, CE 60430-040,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Stubbs B, Veronese N, Vancampfort D, Thompson T, Kohler C, Schofield P, Solmi M, Mugisha J, Kahl KG, Pillinger T, Carvalho AF, Koyanagi A. Lifetime self-reported arthritis is associated with elevated levels of mental health burden: A multi-national cross sectional study across 46 low- and middle-income countries. Sci Rep 2017; 7:7138. [PMID: 28769081 PMCID: PMC5541038 DOI: 10.1038/s41598-017-07688-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022] Open
Abstract
Population-based studies investigating the relationship of arthritis with mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). We investigated the relationship between arthritis and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress) across community-dwelling adults aged ≥18 years across 46 countries from the World Health Survey. Symptoms of psychosis and depression were established using questions from the Mental Health Composite International Diagnostic Interview. Severity of anxiety, sleep problems, and stress sensitivity over the preceding 30 days were self-reported. Self-report lifetime history of arthritis was collected, including presence or absence of symptoms suggestive of arthritis: pain, stiffness or swelling of joints over the preceding 12-months. Multivariable logistic regression analyses were undertaken. Overall, 245,706 individuals were included. Having arthritis increased the odds of subclinical psychosis (OR = 1.85; 95%CI = 1.72–1.99) and psychosis (OR = 2.48; 95%CI = 2.05–3.01). People with arthritis were at increased odds of subsyndromal depression (OR = 1.92; 95%CI = 1.64–2.26), a brief depressive episode (OR = 2.14; 95%CI = 1.88–2.43) or depressive episode (OR = 2.43; 95%CI = 2.21–2.67). Arthritis was also associated with increased odds for anxiety (OR = 1.75; 95%CI = 1.63–1.88), sleep problems (OR = 2.23; 95%CI = 2.05–2.43) and perceived stress (OR = 1.43; 95%CI = 1.33–1.53). Results were similar for middle-income and low-income countries. Integrated interventions addressing arthritis and mental health comorbidities are warranted to tackle this considerable burden.
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Affiliation(s)
- Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom. .,Institute of clinical Research and Education in Medicine (IREM), Padova, Italy. .,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.,Institute of clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Cristiano Kohler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Marco Solmi
- KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.,Department of Neurosciences, University of Padova, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover Medical School, Hannover, Germany
| | - Toby Pillinger
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain.,Instituto de Salud Carlos III, Centro de InvestigaciónBiomédicaenRed de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid, 28029, Spain
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Stubbs B, Koyanagi A, Schuch F, Firth J, Rosenbaum S, Gaughran F, Mugisha J, Vancampfort D. Physical Activity Levels and Psychosis: A Mediation Analysis of Factors Influencing Physical Activity Target Achievement Among 204 186 People Across 46 Low- and Middle-Income Countries. Schizophr Bull 2017; 43:536-545. [PMID: 27562855 PMCID: PMC5464271 DOI: 10.1093/schbul/sbw111] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) can help reduce cardiovascular disease and premature mortality in people with psychosis. However, there is a paucity of representative data on PA in people with psychosis, especially from low- and middle-income countries (LMICs). Moreover, data on subclinical psychosis and PA is absent. This study explored whether complying with PA recommendations of 150 minutes of moderate-vigorous PA per week is related to: (1) psychotic symptoms without a psychosis diagnosis (subclinical psychosis); and (2) clinical psychosis (psychosis diagnosis). A total of 204 186 participants aged 18-64 years from 46 LMICs recruited via the World Health Survey were subdivided into those with (1) no psychosis diagnosis and no psychotic symptoms in the past 12 months (controls); (2) subclinical psychosis; and (3) psychosis diagnosis. People with a psychosis diagnosis had significantly higher odds for low PA in the overall sample (OR = 1.36; 95% CI = 1.04-1.78; P = .024) and among males (OR = 2.29; 95% CI = 1.57-3.34; P < .0001) but not females (OR = 0.93; 95% CI = 0.67-1.30; P = .6712). No difference was found among those with subclinical psychosis vs controls. Mediation analyses demonstrated that mobility difficulties explained the largest amount of low PA among males (18.5%) followed by self-care difficulties (16.3%), depression (16.1%), cognition (11.8%), pain and discomfort (11.4%), interpersonal activities (8.6%), sleep and energy (7.2%), and vision (3.0%). The results from the largest dataset on PA and psychosis and first in LMICs, found that psychosis diagnosis (especially among males) but not subclinical psychosis, is associated with physical inactivity. Population level interventions seeking to increase PA among people with psychosis may help improve health outcomes.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK;,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain;,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;,Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - James Mugisha
- Kyambogo University, Kampala, Uganda;,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium;,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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41
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Vancampfort D, Koyanagi A, Hallgren M, Probst M, Stubbs B. The relationship between chronic physical conditions, multimorbidity and anxiety in the general population: A global perspective across 42 countries. Gen Hosp Psychiatry 2017; 45:1-6. [PMID: 28274332 DOI: 10.1016/j.genhosppsych.2016.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/25/2016] [Accepted: 11/07/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This cross-sectional study assessed the association of chronic physical conditions and multimorbidity with anxiety among community-dwelling adults in 42 countries. METHOD Data were analyzed from the World Health Survey including 181,845 adults aged ≥18years. Anxiety in the past 30days and nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problem, tuberculosis, and visual impairment) were assessed. Multivariable logistic regression analyses were conducted to explore the associations between chronic physical conditions or the number of them and anxiety. RESULTS After adjustment for confounders, most of the individual chronic physical conditions were significantly associated with anxiety. Compared to those with no physical health conditions, one condition was associated with an almost twofold increased odds of anxiety symptoms (OR=1.94; 95%CI=1.76-2.13), while this figure rose to 5.49 (3.73-8.09) in those with ≥5 conditions. CONCLUSIONS Our data suggest that increasing numbers of chronic physical conditions are associated with higher odds for anxiety. Health care providers should consider the presence of anxiety symptoms especially in individuals with physical multimorbidity.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Michel Probst
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
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42
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Koyanagi A, Oh H, Stubbs B, Haro JM, DeVylder JE. Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries. Psychol Med 2017; 47:531-542. [PMID: 27786151 DOI: 10.1017/s0033291716002750] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions. METHOD Cross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed. RESULTS The crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3-2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07-1.59, p = 0.0086); angina 1.40 (95% CI 1.18-1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21-2.26, p = 0.0017). CONCLUSIONS The prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.
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Affiliation(s)
- A Koyanagi
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - H Oh
- University of California Berkeley School of Public Health,Berkeley,CA,USA
| | - B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK
| | - J M Haro
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - J E DeVylder
- School of Social Work,University of Maryland,Baltimore, MD,USA
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43
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Vancampfort D, Koyanagi A, Ward PB, Rosenbaum S, Schuch FB, Mugisha J, Richards J, Firth J, Stubbs B. Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries. Int J Behav Nutr Phys Act 2017; 14:6. [PMID: 28100238 PMCID: PMC5241915 DOI: 10.1186/s12966-017-0463-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/05/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There are no nationally representative population-based studies investigating the relationship between physical activity, chronic conditions and multimorbidity (i.e., two or more chronic conditions) in low- and middle-income countries (LMICs), and studies on a multi-national level are lacking. This is an important research gap, given the rapid increase in the prevalence of chronic diseases associated with lifestyle changes in these countries. This cross-sectional study aimed to assess the association between chronic conditions, multimorbidity and low physical activity (PA) among community-dwelling adults in 46 LMICs, and explore the mediators of these relationships. METHODS World Health Survey data included 228,024 adults aged ≥18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ). Nine chronic physical conditions (chronic back pain, angina, arthritis, asthma, diabetes, hearing problems, tuberculosis, visual impairment and edentulism) were assessed. Multivariable logistic regression and mediation analyses were used to assess the association between chronic conditions or multimorbidity and low PA. RESULTS Overall, in the multivariable analysis, arthritis (OR = 1.12), asthma (1.19), diabetes (OR = 1.33), edentulism (OR = 1.46), hearing problems (OR = 1.90), tuberculosis (OR = 1.24), visual impairment (OR = 2.29), multimorbidity (OR = 1.31; 95% CI = 1.21-1.42) were significantly associated with low PA. More significant associations were observed in individuals aged ≥50 years. In older adults, depression mediated between 5.1% (visual impairment) to 23.5% (angina) of the association between a chronic condition and low PA. Mobility difficulties explained more than 25% of the association for seven of the eight chronic conditions. Pain was a strong mediator for angina (65.9%) and arthritis (64.9%), while sleep problems mediated up to 43.7% (angina) of the association. CONCLUSIONS In LMICs, those with chronic conditions and multimorbidity are significantly less physically active (especially older adults). Research on the efficacy and effectiveness of PA in the management of chronic diseases in LMICs is urgently needed. Targeted promotion of physical activity to populations in LMICs experiencing chronic conditions may ameliorate associated depression, mobility difficulties and pain that are themselves important barriers for initiating or adopting an active lifestyle.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Leuven, 3001 Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, Kortenberg, 3070 Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 0883 Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid, 28029 Spain
| | - Philip B. Ward
- School of Psychiatry, UNSW, Sydney, Australia
- Schizophrenia Research Institute, Ingham Institute of Applied Medical Research, Liverpool, NSW Australia
| | - Simon Rosenbaum
- Exercise Physiology Department, School of Medical Sciences, UNSW Australia, Sydney, Australia
| | - Felipe B. Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Mugisha
- Kyambogo University, Kampala, Uganda
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Justin Richards
- School of Public Health & Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Joseph Firth
- School of Health Sciences, Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Box SE5 8AF, De Crespigny Park, London, UK
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44
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Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N, Solmi M, Mugisha J, Vancampfort D. Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries. Acta Psychiatr Scand 2016; 134:546-556. [PMID: 27704532 DOI: 10.1111/acps.12654] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors. METHOD Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression. RESULTS Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42; 95% CI = 1.24-1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%). CONCLUSION Individuals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - F B Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - J Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - S Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - N Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy, Institute of clinical Research and Education in Medicine (IREM), Padova, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - J Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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45
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Stubbs B, Koyanagi A, Veronese N, Vancampfort D, Solmi M, Gaughran F, Carvalho AF, Lally J, Mitchell AJ, Mugisha J, Correll CU. Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries. BMC Med 2016; 14:189. [PMID: 27871281 PMCID: PMC5118890 DOI: 10.1186/s12916-016-0734-z] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/26/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In people with psychosis, physical comorbidities, including cardiovascular and metabolic diseases, are highly prevalent and leading contributors to the premature mortality encountered. However, little is known about physical health multimorbidity in this population or in people with subclinical psychosis and in low- and middle-income countries (LMICs). This study explores physical health multimorbidity patterns among people with psychosis or subclinical psychosis. METHODS Overall, data from 242,952 individuals from 48 LMICs, recruited via the World Health Survey, were included in this cross-sectional study. Participants were subdivided into those (1) with a lifetime diagnosis of psychosis ("psychosis"); (2) with more than one psychotic symptom in the past 12 months, but no lifetime diagnosis of psychosis ("subclinical psychosis"); and (3) without psychotic symptoms in the past 12 months or a lifetime diagnosis of psychosis ("controls"). Nine operationalized somatic disorders were examined: arthritis, angina pectoris, asthma, diabetes, chronic back pain, visual impairment, hearing problems, edentulism, and tuberculosis. The association between psychosis and multimorbidity was assessed by multivariable logistic regression analysis. RESULTS The prevalence of multimorbidity (i.e., two or more physical health conditions) was: controls = 11.4% (95% CI, 11.0-11.8%); subclinical psychosis = 21.8% (95% CI, 20.6-23.0%), and psychosis = 36.0% (95% CI, 32.1-40.2%) (P < 0.0001). After adjustment for age, sex, education, country-wise wealth, and country, subclinical psychosis and psychosis were associated with 2.20 (95% CI, 2.02-2.39) and 4.05 (95% CI, 3.25-5.04) times higher odds for multimorbidity. Moreover, multimorbidity was increased in subclinical and established psychosis in all age ranges (18-44, 45-64, ≥ 65 years). However, multimorbidity was most evident in younger age groups, with people aged 18-44 years with psychosis at greatest odds of physical health multimorbidity (OR = 4.68; 95% CI, 3.46-6.32). CONCLUSIONS This large multinational study demonstrates that physical health multimorbidity is increased across the psychosis-spectrum. Most notably, the association between multimorbidity and psychosis was stronger among younger adults, thus adding further impetus to the calls for the early intervention efforts to prevent the burden of physical health comorbidity at later stages. Urgent public health interventions are necessary not only for those with a psychosis diagnosis, but also for subclinical psychosis to address this considerable public health problem.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK. .,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, UK.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid, 28029, Spain
| | - Nicola Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Padova, Italy.,Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy.,Department of Neurosciences, University of Padova, Padova, Italy.,Local Health Unit ULSS 17, Mental Health Department, Monselice, Padova, Italy
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - André F Carvalho
- Department of Psychiatry and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK.,Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alex J Mitchell
- Department of Cancer and Molecular Medicine, University of Leicester, Leicester, UK
| | - James Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Christoph U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA.,Hofstra Northwell School of Medicine, Hempstead, New York, USA
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