Association of loneliness and social isolation with excess risk of mental disorders in people with obesity: a prospective cohort study.

BackgroundObese individuals face higher degrees of loneliness and social isolation, but evidence on the association between their levels of loneliness and social isolation and the excess risk of cardiovascular disease (CVD) is lacking. Our study aimed to explore the association between the level of loneliness and social isolation and the obesity-related excess risk of CVD events.MethodsWe included 432 767 individuals from the UK Biobank at baseline (100 947 with obesity and 331 820 without obesity). The levels of loneliness and social isolation were defined by a two-item scale and a three-item scale at baseline, respectively. We ascertained CVD events, including coronary heart disease, stroke, heart failure, and CVD mortality, through linkage to inpatient records from primary and secondary health care settings and death registries.ResultsA total of 29 767 non-obese and 14 312 obese participants developed incident CVD outcomes during a median (interquartile range (IQR)) follow-up of 12.48 (11.61, 13.22) years. The excess risk of CVD events, including CVD subtypes and CVD mortality, in obese people compared to non-obese people progressively decreased with lower baseline levels of loneliness and social isolation. Specifically, the excess risk of all CVD events decreased by 29% (for loneliness) and 15% (for social isolation). The excess risk of CVD mortality decreased by 25% (for loneliness) and 52% (for social isolation), respectively.ConclusionsLower baseline levels of loneliness and social isolation were associated with lower obesity-related excess risk of CVD events. Our findings call for the integration of community engagement and social support networks into existing intervention programmes to provide more effective cardiovascular care for obese individuals.

IntroductionThe stigma towards mental disorders can limit the use and effectiveness of available mental health interventions for young people. We aim to systematically review effectiveness of interventions to reduce stigma...

Social Disconnection in Late Life Mental Illness – Commentary From the National Institute of Mental Health

Association of asthma and its genetic predisposition with the risk of severe COVID-19

Background:Both social isolation and loneliness were associated with an increased risk of all-cause mortality in general population. However, there is still limited evidence elucidating the relationship between social isolation, loneliness,...

Background:Depression and anxiety are two mental disorders that are often comorbid. However, the associations of long-term air pollution exposure with depression and anxiety remain inconclusive.Objective:We conducted a cross-sectional and prospective study to examine the associations of ambient exposure to particulate matter (PM) with a diameter of (), (), and (), nitrogen oxides (), and nitrogen dioxide () with the risk of depression and anxiety in the UK Biobank.Methods:This study included 398,241 participants from the UK Biobank, 128,456 of whom participated the 7-y online mental health survey. A total of 345,876 individuals were free of depression and anxiety at baseline; of those, 16,185 developed incident mental disorders during a median of 8.7 y of follow-up. Depression and anxiety were assessed using hospital admission records and mental health questionnaires. Associations of air pollution with prevalent and incident mental disorders were examined using logistic regression and Cox regression models, respectively.Results:Elevated levels of the five air pollutants were associated with higher odds of mental disorders at baseline. Levels of four pollutants but not were also associated with higher odds and risks of mental disorders during follow-up; specifically, hazard ratios [HR, 95% confidence interval (CI)] of an interquartile range increase in , , , and for incident mental disorders were 1.03 (95% CI: 1.01, 1.05), 1.06 (95% CI: 1.04, 1.08), 1.03 (95% CI: 1.01, 1.05), and 1.06 (95% CI: 1.04, 1.09), respectively. An air pollution index reflecting combined effects of pollutants also demonstrated a positive association with the risk of mental disorders. HR (95% CI) of incident mental disorders were 1.11 (95% CI: 1.05, 1.18) in the highest quintile group in comparison with the lowest quintile of the air pollution index. We further observed that the associations between air pollution and mental disorders differed by a genetic risk score based on single nucleotide polymorphisms previously associated with genetic susceptibility to mental disorders in the UK Biobank cohort.Discussion:To our knowledge, this research is one of the largest cohort studies that demonstrates an association between mental health disorders and exposure to long-term air pollution, which could be further enhanced by genetic predisposition. https://doi.org/10.1289/EHP10391

If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.

Associations of neighbourhood housing density with loneliness and social isolation: a cross-sectional study using UK Biobank data

Background Despite an overall decrease in cardiovascular mortality in recent decades due to effective preventive strategies, a concerning trend is emerging among young adults, with a rising incidence of myocardial infarction (MI) and its poor prognosis. Previous studies report that a significant association between mental disorders and the incidence and prognosis of MI. However, a detailed age-specific information is still lacking. Purpose We aimed to determine whether the risk of developing mental disorders after MI differs based on age and to stratify individuals at a higher risk. Methods From the UK Biobank prospective database (n=502,386), we collected data on patients with a prior MI (n=10,840) and compared them to age- and sex-matched controls (n=54,197) in a 1:5 ratio. Diagnoses of mental disorders were ascertained through linked hospital admission and mortality data, using the appropriate ICD-10-CM codes. Mental disorders were defined by at least two inpatient or outpatient claims within 1 year. The primary outcome was a composite of incident mental disorders, including depression, anxiety, stress-related, and somatoform disorders. Follow-up was done until the first diagnosis of mental disorders or the end of 2022. Results During a median follow-up of 13.7 years (interquartile range 12.8-14.5 years), the incidence rate of the primary outcome was 9.28 vs. 5.37/1,000 person-years among patients with MI and controls, respectively (p<0.001). A prior MI history demonstrated an independent association with the risk of incident mental disorders, yielding an adjusted hazard ratio (aHR) of 1.41 (95% confidence interval [CI], 1.29–1.54; p<0.001) after adjusting for confounders. This was comparable to heavy drinking and family history of depression. Notably, the risk of mental disorders attributed to previous MI was more prominent in younger individuals aged <55 years than their older counterpart (aHR 1.61 vs. 1.33) (p-for-interaction 0.020). Similar results were observed in the analysis of two important components: depression and anxiety disorder. Furthermore, in younger patients with MI (<55 years), mental disorders significantly increased the risk of mortality, while not in older patients. Conclusion MI was associated with a higher risk of incident mental disorders, resulting in poor prognosis, particularly in young individuals. Active surveillance and prevention for incident mental disorders after young MI may be beneficial.Cumulative Incidence of Mental Disorders

The epidemic of Human Immunodeficiency Virus (HIV) infection affects all social groups of the population. Biopsychosocial stressors directly related to HIV infection, such as stigma, discrimination and shame, side effects of treatment, symptoms of HIV infection, and disclosure of the diagnosis influence the deterioration of mental health of people living with HIV. Stigma and discrimination can prevent the timely seeking of psychiatric help. Social stigmatization of HIV infection may affect their adherence to antiretroviral therapy. The purpose of our study was to study the formation mechanisms of mental disorders in people living with HIV. A comprehensive examination of 118 patients diagnosed with HIV infection between the ages of 22 and 61 was conducted at the Sumy Regional Clinical Medical Center for Socially Dangerous Diseases. During the examination of each patient, a psychiatric examination was carried out, anamnestic data were collected, and questionnaires were used: the Symptom Check List90-Revised psychopathological symptoms questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI). The examined patients were diagnosed with organic mood disorders, depressive disorders, anxiety disorders; disorders related to stress and trauma. The results of the questionnaires confirm the diversity and breadth of clinical symptoms found among those examined. 55.9% of patients had severe symptoms of psychological distress. 55.9% of the examined show symptoms of depression of varying severity. As a result of the study, the main parameters that influence the formation of mental disorders in people living with HIV were formed: socioeconomic factors, which are primarily represented by a low level of education and a fairly high level of unemployment, social isolation and the absence of family support, fear of stigmatization, the presence of harmful habits and stressful events and factors related to the detection of HIV infection. Keywords: antiretroviral therapy, depression, neuroinflammation, psychosocial factors.

Mental disorders can be triggered by genetic and environmental risk factors. Limited studies have explored the effects of long-term exposure to air pollution on mental disorders, and most of the studies have focused on individual air pollutants. This study aimed to examine the relationship between long-term exposure to multiple air pollutants and incident mental disorders, including depression, anxiety, and schizophrenia, and whether the associations were affected by genetic susceptibility. Participants in the UK Biobank with no history of mental disorders were followed from baseline (2006 to 2010) to October 31st, 2022. Cox regression was applied to evaluate the correlation between PM2.5 absorbance, PM2.5, PM2.5-10, PM10, NO2, and NOx and any or specific mental disorders. Additive and multiplicative scales were used to measure the interaction between air pollution and schizophrenia polygenic risk score (PRS), depression PRS, or anxiety PRS on specific mental diseases. After a median of 13.36years of follow-up on 252,376 participants, we observed per interquartile increase of PM2.5 absorbance (0.32per meter), PM2.5 (1.28μg/m3), NO2 (10.08μg/m3), and NOx (16.78μg/m3) were related to a 2-6% higher risk of incident mental disorders. The HR (95% CI) of incident mental disorder for the 2nd, 3rd, and 4th quartile of the air pollution score were 1.05 (1.01-1.18), 1.13 (1.09-1.18), and 1.14 (1.09-1.19), respectively, in comparison to the lowest level of the score. Per interquartile increase in the air pollution score was associated with a 6%, 24%, 4%, and 6% higher risk of incident mental disorders, schizophrenia, depression, and anxiety, respectively. No interaction between air pollution and genetic risk of schizophrenia, depression or anxiety on corresponding incident disorders was observed. These findings emphasize the importance of implementing air pollution control standards to decrease the burden of mental disorders.

Social Isolation, Loneliness, and Risk of Microvascular Complications Among Individuals With Type 2 Diabetes Mellitus

BackgroundThere is paucity of data regarding the prevalence of common mental disorders (CMDs) in people living with HIV (PLHIV) in Ekurhuleni Health District (EHD), South Africa. Also, there is an association between CMDs and poor HIV treatment outcomes. Guidelines therefore recommend that healthcare practitioners screen for CMDs in PLHIV.AimTo determine the prevalence and correlates of CMDs in PLHIV in primary health care facilities in Ekurhuleni district.SettingSeven primary health facilities in Ekurhuleni district.MethodsA cross-sectional study was conducted in which data were collected from 403 randomly selected participants, using a questionnaire that incorporated the scores of the Patient Health Questionnaire (PHQ)-9, generalised anxiety disorder (GAD)-7 and substance use disorder (SUD) criteria of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). The proportion screening positive for CMDs was calculated. ‘R’ statistical software was used for univariate and multivariate analysis, with a confidence interval (CI) of 95%.ResultsMost participants (63%) were female and the mean age was 43 ± 11 years. Forty per cent of participants screened positive for CMDs, 16.6%, 15.1% and 24.1% screened positive for depression, GAD and SUD, respectively. Common mental disorders were associated with poor adherence and HIV non-suppression, while increasing age and being female were associated with reduced risk of CMDs. The risk of severe SUDs in males was 11 times compared to females. During assessment, clinicians screened only 16%, 14% and 40% of the cohort for depression, GAD and SUDs, respectively.ConclusionThe prevalence of CMDs remains high. Adherence to recommendations to screen for CMDs in PLHIV is low.ContributionThis study reveals a low CMD screening rate, estimates the prevalence of CMDs in PLHIV in Ekurhuleni district, and its impact.

Long-term mental health disorders and suicidal behaviors linked to excessive vomiting during pregnancy: Evidence from the UK biobank.

BackgroundUnderstanding the mental health consequences of child maltreatment at different life stages is important in accurately quantifying the burden of maltreatment. This study investigated the association between child maltreatment and incident mental disorders in middle and older age as well as the potential mediators and moderators.MethodsThis is a retrospective cohort study of 56,082 participants from UK Biobank. Child maltreatment was recalled using the Childhood Trauma Screener. Incident mental disorders, including depressive, anxiety and affective disorders, behavioural syndromes, post-traumatic stress disorder (PTSD), schizophrenia, substance abuse, and dementia, after baseline assessment were ascertained through linkage to primary care records.FindingsThere was a dose-response relationship between child maltreatment and mental disorder. Those who experienced three or more maltreatment types had the highest risk of all mental disorders (HR 1.85, 95% CI: 1.67-2.06) followed by those who experienced two (HR 1.48, 95% CI: 1.35-1.63) and then one (HR 1.26, 95% CI: 1.19-2.35). Child maltreatment was most strongly associated with PTSD (HR 1.59, 95% CI: 1.20-2.10 P=0.001). The excess risk was largely unexplained by the included mediators. The association between child maltreatment and all mental disorders were stronger among participants who binge drank (Pinteraction=0.003) or had few social visits (Pinteraction=0.003).InterpretationThe mental health consequence of child maltreatment could last decades, even among those who had no recorded mental disorders in early adulthood. In the absence of strong mediators, prevention of child maltreatment remains the priority.FundingWellcome Trust Institutional Strategic Support Fund