Lifetime Mood Disorders Research Articles

The mental health toll of the Great Migration: a comparison of mental health outcomes among descendants of African American migrators.

Research is beginning to examine the health outcomes of migrators of the Great Migration, a movement of up to eight million African Americans from the South to the North and West during the twentieth century. However, sparse evidence exists studying the health outcomes of the descendants of Great Migration movers. The aim for this study was to compare the lifetime prevalence of mental health disorders by migration status. We used a sample of 3183 African American adults from the National Survey of American Life (2001-2003). Using birthplaces of participants and their mothers, we classified adults as (1) Southern stayers, (2) migrators to the South, (3) migrators to the North or (4) Northern stayers. The outcomes were lifetime prevalence of any mental health, mood, anxiety, and substance use disorders. We used weighted log-Poisson regression models and adjusted for demographic characteristics and socioeconomic status. Migrators to the North and Northern stayers had higher risks of any lifetime mental health, mood, anxiety, and substance use disorders compared to Southern stayers in the adjusted models. Migrators to the North and Northern stayers were more likely to report perceived discrimination. This study suggests that migrating families to the North may have experienced mental health adversities.

Relationship between psychiatric disorders and loss weight among patients underwent metabolic and bariatric surgery: A reassessment observational study after nine years

ObjectiveTo evaluate the evolution of Psychiatric Disorders (PD) and weight loss at different postoperative intervals up to 9 years after Metabolic and Bariatric Surgery (MBS). MethodsThis is a nine-year longitudinal study conducted at a single university-based bariatric center in Brazil. The Generalized Estimating Equation (GEE) and multiple linear regression models were used to evaluate the proportion of lifetime PD according to TPS, and its relationship with weight. The Structured Clinical Interview for DSM-5 assessed the PD and the percentage of Excess Lost Weight (%EWL) for weight changes. The study included 142 participants who had undergone MBS, mostly women (82 %), mean age of 52 years. ResultsDepression and anxiety disorders were the most common PD. Regardless of the time elapsed since MBS, there was an increase of 32 % in lifetime mood disorders, bipolar disorders, and eating disorders. The average EWL for Time Post-Surgery (TPS) ≤ 24 months was 69 % and remained consistent until 72 months; after was 57 % and 58 % for ≤ 72 and 96 months, respectively. There was not a significant association between %EWL and PD when controlling for sex, age, and time post-surgery. ConclusionPsychiatric disorders can be associated and remain prevalent, regardless of time post-surgery; however, this does not significantly impact weight losss maintenance. It is recommended that individuals who have undergone MBS be monitored and supported over an extended period to address psychiatric comorbidities.

Neurocognitive risk phenotyping to predict mood symptoms in adolescence.

Predicting mood disorders in adolescence is a challenge that motivates research to identify neurocognitive predictors of symptom expression and clinical profiles. This study used machine learning to test whether neurocognitive variables predicted future manic or anhedonic symptoms in two adolescent samples risk-enriched for lifetime mood disorders (Sample 1, n = 73, ages = 13-25, M [SD] = 19.22 [2.49] years, 68% lifetime mood disorder) or familial mood disorders (Sample 2, n = 154, ages = 13-21, M [SD] = 16.46 [1.95] years, 62% first-degree family history of mood disorder). Participants completed cognitive testing and functional magnetic resonance imaging at baseline, for behavioral and neural measures of reward processing and executive functioning. Next, participants completed a daily diary procedure for 8-16 weeks. Penalized mixed-effects models identified neurocognitive predictors of future mood symptoms and stress-reactive changes in mood symptoms. Results included the following. In both samples, adolescents showing ventral corticostriatal reward hyposensitivity and lower reward performance reported more severe stress-reactive anhedonia. Poorer executive functioning behavior was associated with heightened anhedonia overall in Sample 1, but lower stress-reactive anhedonia in both samples. In Sample 1, adolescents showing ventral corticostriatal reward hypersensitivity and poorer executive functioning reported more severe stress-reactive manic symptoms. Clustering analyses identified, and replicated, five neurocognitive subgroups. Adolescents characterized by neural or behavioral reward hyposensitivities together with average-to-poor executive functioning reported unipolar symptom profiles. Adolescents showing neural reward hypersensitivity together with poor behavioral executive functioning reported a bipolar symptom profile (Sample 1 only). Together, neurocognitive phenotypes may hold value for predicting symptom expression and profiles of mood pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Time on our side: An exploratory investigation of the relationship between psychiatric disorder and time attitudes

Time attitudes indicate how individuals feel about the past, present, and future. A growing body of research has demonstrated that scores on the Adolescent and Adult Time Inventory-Time Attitudes Scale relate meaningfully to a variety of measures of well-being and psychiatric symptomatology. To date, no study has examined how (if at all) Time Attitudes scores relate to psychiatric disorder. The present study used an existing clinical cohort (N = 68) and assessed the associations among time attitudes, lifetime disorder, and a retrospective measure of childhood trauma. Preliminary analyses revealed that mean scores of the six time attitudes in the present study did not differ substantially from scores reported in a recent meta-analysis. Correlations between time attitude scores and retrospective trauma scores were particularly large for past negative and past positive. Individuals with no past or current disorder reported substantially higher positive attitudes and substantially lower negative attitudes than those without a disorder across all three time periods with interpretable effect sizes. Finally, past negative time attitudes scores were significantly associated with lifetime mood or anxiety disorder, prior to adjustment for scores on self-reported childhood trauma. These results suggest that time attitudes could be a variable of consequence beyond feelings of general well-being and beyond psychiatric symptoms. More studies with larger sample sizes are required in order to examine the relationship between time attitudes and psychiatric disorder.

Abstract 16179: Psychiatric Status in Young Adults With Surgically Corrected D-Transposition of the Great Arteries (d-TGA) -The Boston Circulatory Arrest Study

Background: The Boston Circulatory Arrest Study (BCAS) is a longitudinal investigation of neurodevelopmental and mental health (MH) outcomes of newborns with d-TGA who underwent the arterial switch operation. Goal: We describe current and lifetime MH outcomes in this now adult cohort. Methods: We enrolled 88/149 surviving and eligible infant BCAS study participants (29±1.3 yrs; 73% male) between 2017 and 2021; 77 were evaluated prior to the COVID-19 pandemic. The Structured Clinical Interview for DSM-5 Disorders - Research Version, which includes modules exploring anxiety, mood, externalizing, trauma and stress-related, and substance use disorders, as well as suicidality, was administered and captured lifetime (any point in life) and current (within the last 1-12 months) diagnoses. Results: One participant was not interviewed and was referred for further care after endorsing current suicidal ideation. Of 87 interviewees, 62 (71%) met criteria for ≥1 lifetime psychiatric disorder, with 41% diagnosed with lifetime mood disorder and 25% with lifetime anxiety disorder. In addition, 37% noted lifetime substance use disorders, most commonly with alcohol use. Four (5%) had a lifetime history of post-traumatic stress disorder. For comparison, general US similar age population prevalence of lifetime mood, anxiety, and substance use disorders were 21-24%, 30-35% and 17-18% respectively. Forty (46%) participants met criteria for ≥1 current disorder, with 11% diagnosed with mood disorders and 16% with anxiety disorders and 22% with substance use disorders. Further, 31% of participants had a history of suicidal ideation, 10% of non-suicidal self-injury, and 6% of suicide attempt compared to 5%, 1% and 0.4% respectively in a similar age general US population. Conclusions: MH disorders are common in young adults with d-TGA, with almost three-quarters meeting criteria for a psychiatric disorder by age 35. Mood and anxiety disorders are particularly common, and almost one-third endorse a history of suicidal ideation. Substance use is also common and warrants inclusion in history-taking of adolescent and adult CHD patients. Ongoing surveillance to identify patients with MH disorders in order to initiate treatment is vital for young adults with CHD.

Sex/gender differences in the associations between adverse childhood experiences and intimate partner violence with mental disorders

Sex and gender differences exist in mental and substance use disorders (MSUDs). Studies examining the moderating effects of sex/gender on MSUDs may help understand these differences. This national study explored whether sex/gender moderated (1) the associations between adverse childhood experience (ACEs; i.e., child abuse, child neglect, and child household dysfunction) and intimate partner violence (IPV) with MSUDs and (2) more associations with past year than lifetime MSUDs or mental (i.e., mood disorder, anxiety disorder, and posttraumatic stress disorder) than substance use disorders (i.e., alcohol use disorder and nicotine dependence). Data was used from participants in the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression tested the main effects of ACEs, IPV, and sex/gender on five, past-year and lifetime MSUDs along with the ACE-sex/gender and IPV-sex/gender interactions. Sex/gender moderated 60% of the ACEs-MSUD and IPV-MSUD associations and more associations with lifetime (54%) than past year MSUDs (46%) and substance use (94%) than mental disorders (38%). For nearly half of the moderated associations, ACEs and IPV were associated with greater odds of MSUDs for males. Males who experienced IPV had greater odds of lifetime mood, anxiety, and alcohol use disorders than females. This study advances sex and gender informed research.

Specificity of affective dynamics of bipolar and major depressive disorder.

Here, we examine whether the dynamics of the four dimensions of the circumplex model of affect assessed by ecological momentary assessment (EMA) differ among those with bipolar disorder (BD) and major depressive disorder (MDD). Participants aged 11-85years (n=362) reported momentary sad, anxious, active, and energetic dimensional states four times per day for 2weeks. Individuals with lifetime mood disorder subtypes of bipolar-I, bipolar-II, and MDD derived from a semistructured clinical interview were compared to each other and to controls without a lifetime history of psychiatric disorders. Random effects from individual means, inertias, innovation (residual) variances, and cross-lags across the four affective dimensions simultaneously were derived from multivariate dynamic structural equation models. All mood disorder subtypes were associated with higher levels of sad and anxious mood and lower energy than controls. Those with bipolar-I had lower average activation, and lower energy that was independent of activation, compared to MDD or controls. However, increases in activation were more likely to perpetuate in those with bipolar-I. Bipolar-II was characterized by higher lability of sad and anxious mood compared to bipolar-I and controls but not MDD. Compared to BD and controls, those with MDD exhibited cross-augmentation of sadness and anxiety, and sadness blunted energy. Bipolar-I is more strongly characterized by activation and energy than sad and anxious mood. This distinction has potential implications for both specificity of intervention targets and differential pathways underlying these dynamic affective systems. Confirmation of the longer term stability and generalizability of these findings in future studies is necessary.

The default mode network and rumination in individuals at-risk for depression.

The default mode network (DMN) is a network of brain regions active during rest and self-referential thinking. Individuals with Major Depressive Disorder (MDD) show increased or decreased DMN activity, relative to controls. DMN activity has been linked to a tendency to ruminate in MDD. It is unclear if individuals who are at-risk for, but who have no current or past history of depression, also show differential DMN activity associated with rumination. We investigated whether females with high levels of neuroticism with no current or lifetime mood or anxiety disorders (n=25) show increased DMN activation, specifically when processing negative self-referential information, compared with females with average levels of neuroticism (n=28). Participants heard criticism and praise during functional MRI scans in a 3T Siemens Prisma scanner. The at-risk group showed greater activation in two DMN regions, the medial prefrontal cortex (MPFC) and the inferior parietal lobule (IPL), after hearing criticism, but not praise (relative to females with average levels of neuroticism). Criticism-specific activation in the IPL was significantly correlated with rumination. Individuals at-risk for depression therefore may have an underlying neurocognitive vulnerability to use a brain network typically involved in thinking about oneself to preferentially ruminate about negative, rather than positive, information.

Smaller cornu ammonis (CA3) as a potential risk factor for suicidal behavior in mood disorders

Mood disorders and suicidal behavior have moderate heritability and familial transmission, and are associated with smaller hippocampal volumes. However, it is unclear whether hippocampal alterations reflect heritable risk or epigenetic effects of childhood adversity, compensatory mechanisms, illness-related changes, or treatment effects. We sought to separate the relationships of hippocampal substructure volumes to mood disorder, suicidal behavior, and risk and resilience to both by examining high familial risk individuals (HR) who have passed the age of greatest risk for psychopathology onset. Structural brain imaging and hippocampal substructure segmentation quantified Cornu Ammonis (CA1-4), dentate gyrus, and subiculum gray matter volumes in healthy volunteers (HV, N = 25) and three groups with one or more relatives reporting early-onset mood disorder and suicide attempt: 1. Unaffected HR (N = 20); 2. HR with lifetime mood disorder and no suicide attempt (HR-MOOD, N = 25); and 3. HR with lifetime mood disorder and a previous suicide attempt (HR-MOOD + SA, N = 18). Findings were tested in an independent cohort not selected for family history (HV, N = 47; MOOD, N = 44; and MOOD + SA, N = 21). Lower CA3 volume was found in HR (vs. HV), consistent with the direction of previously published findings in MOOD+SA (vs. HV and MOOD), suggesting the finding reflects a familial biological risk marker, not illness or treatment-related sequelae, of suicidal behavior and mood disorder. Familial suicide risk may be mediated in part by smaller CA3 volume. The structure may serve as a risk indicator and therapeutic target for suicide prevention strategies in high-risk families.

The relationship between suicidal thoughts and well-being among individuals with a history of depression and cardiovascular risk.

Prior work demonstrates a relationship between suicidal behavior and mood disorders, as well as between suicidal behavior and cardiovascular risk. When cardiovascular risk and mood disorders co-occur, people with these comorbid conditions tend to experience worse outcomes than people with only one of these conditions. As such, given the relevance of suicidal thoughts and behaviors among those with cardiovascular risk and mood disorders, suicidal thoughts and behaviors may be of particular concern in the comorbid population. However, the factors that differentiate those with or without suicidal thoughts or behaviors are unknown. Self-reported well-being is one factor that is shown to hold a relationship with suicidal risk, and may be relevant in the comorbid population. Thus, we evaluated whether different levels of well-being relate to suicidal thoughts and behaviors among individuals (N = 340) with lifetime mood disorders and cardiovascular risk who participated in a 16-week online exercise study. Participants completed self-report assessments of lifetime (per the MINI International Neuropsychiatric Interview) and current (per the Patient Health Questionnaire-9) suicidal thoughts and behaviors, as well as a self-report assessment of well-being (per the WHO-5 Well-Being Index). We found that individuals with lifetime and current suicidal thinking had lower total WHO-5 scores over the study period. These data suggest that, among those with a history of depression and who have or are at-risk for cardiovascular disease, the risk of current or lifetime suicidal thoughts and behaviors may be increased for those who experience decreased well-being.

The role of mood disorders in the progression of and recovery from alcohol and drug use problems: A latent transition analysis

IntroductionLongitudinal research assessing whether mood disorders predict substance use behaviors is limited. We extend our prior work evaluating transition patterns with alcohol use to assess patterns with alcohol and drug use problems. MethodUsing National Epidemiologic Survey on Alcohol and Related Conditions prospective data, waves 1 and 2, we completed latent class analyses to empirically define classes of alcohol and drug problems from DSM disorder criteria. Latent transition analyses were used to assess associations of lifetime mood disorders at baseline with transitions across classes of alcohol and drug problems during follow-up. ResultsA three-class model of alcohol and drug problems was identified (No problems, Alcohol Problems Only, and Alcohol and Drug Problems) for males and females. Females with mood disorders were over two times more likely to transition from No Problems, and Alcohol Problems Only at baseline to having both Alcohol and Drug Problems at follow-up relative to those without mood disorders (aOR=2.30, 95 % CI=1.31–4.05, p = 0.004, and aOR=2.64, CI=1.24–5.62, p = 0.011, respectively). Furthermore, females with mood disorders were significantly less likely to recover from baseline Alcohol and Drug Problems to Alcohol Problems Only at follow-up (aOR=0.35, CI=0.12–0.98, p = 0.047) relative to those without mood disorders. There were no significant findings for males. DiscussionOur study provides evidence that mood disorders impact transitions through classes of alcohol and drug problems among females. The findings emphasize the need for ongoing evaluation of substance use among those with mood conditions, and recognition and treatment of mood disorders among those recovering from substance use problems.

Ventral prefrontal serotonin 1A receptor binding: a neural marker of vulnerability for mood disorder and suicidal behavior?

Mood disorders and suicidal behavior have moderate heritability and are associated with altered corticolimbic serotonin 1A receptor (5-HT1A) brain binding. However, it is unclear whether this reflects genetic effects or epigenetic effects of childhood adversity, compensatory mechanisms, or illness stress-related changes. We sought to separate such effects on 5-HT1A binding by examining high familial risk individuals (HR) who have passed through the age of greatest risk for psychopathology onset with and without developing mood disorder or suicidal behavior. PET imaging quantified 5-HT1A binding potential BPND using [11C]CUMI-101 in healthy volunteers (HV, N = 23) and three groups with one or more relatives manifesting early-onset mood disorder and suicide attempt: 1. unaffected HR (N = 23); 2. HR with lifetime mood disorder and no suicide attempt (HR-MOOD, N = 26); and 3. HR-MOOD with previous suicide attempt (HR-MOOD + SA, N = 20). Findings were tested in an independent cohort not selected for family history (HV, MOOD, and MOOD + SA, total N = 185). We tested for regional BPND differences and whether brain-wide patterns distinguished between groups. Low ventral prefrontal 5-HT1A BPND was associated with lifetime mood disorder diagnosis and suicide attempt, but only in subjects with a family history of mood disorder and suicide attempt. Brain-wide 5-HT1A BPND patterns including low ventral prefrontal and mesiotemporal cortical binding distinguished HR-MOOD + SA from HV. A biological endophenotype associated with resilience was not observed. Low ventral prefrontal 5-HT1A BPND may reflect familial mood disorder and suicide-related pathology. Further studies are needed to determine if higher ventral prefrontal 5-HT1A BPND confers resilience, reducing risk of suicidal behavior in the context of familial risk, and thereby offer a potential prevention target.

Experience of Intimate Partner Violence and Associated Psychiatric, Neurobehavioral, and Functional Burden in Male and Female Veterans: Implications for Treatment

ABSTRACT Intimate partner violence (IPV) is prevalent among Veterans. Injuries to head, neck, and face are frequent and elevate risk for traumatic brain injury (TBI). IPV also increases risk for mental health morbidity. A better understanding of IPV’s impact on health and functioning is needed among Veterans to inform assessment and intervention. This study identified lifetime IPV in post-9/11 Veterans and examined the associations between lifetime IPV and health and functioning. A sample of 813 post-9/11 Veterans completed a comprehensive assessment of psychiatric, neurobehavioral and functional outcomes. Thirty-eight percent of female and 22% of male Veterans experienced IPV during their lifetime. Veterans with IPV experience had higher prevalence of TBI, pain, and psychiatric conditions (posttraumatic stress disorder [PTSD], mood, anxiety, substance use). Lifetime IPV experience, PTSD, mood disorder, and pain were significantly associated with functional disability in men and women (β’s = .12–.44; ps < .05); the effect was larger for women. Given the clinical complexity of Veterans with a history of IPV, we propose the need for novel, transdiagnostic treatments. The STEP-Home workshop is a skills-based intervention with preliminary effectiveness in treating combat-related TBI and commonly co-occurring psychiatric disorders in post-9/11 Veterans that could expand evidence-based treatments for IPV.

Long-term follow-up assessment of opioid use outcomes among individuals with comorbid mental disorders and opioid use disorder treated with buprenorphine or methadone in a randomized clinical trial.

To investigate whether reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders. In a randomized controlled trial, adults with OUD were randomized to 24weeks of either BUP or MET treatment and were followed up in 3-yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments. The outcome measure was the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: life-time mood disorder (n=302), life-time mental disorder other than mood disorder (n=114) and no mental disorder (n=181). Medication treatment (BUP, MET, no treatment) during the follow-up period was a time-varying predictor. Based on zero-inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP [odds ratio (OR)=0.12, 95% confidence interval (CI)=0.07-0.21 for any use; risk ratio (RR)=0.77, 95% CI=0.66-0.89 for days of use] and by MET [OR=0.33, 95% CI=0.25-0.45 for any use; RR=0.78, 95% CI=0.72-0.84 for days of use]. Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR=0.52, 95% CI=0.36-0.74) and for participants without mental disorder (OR= 0.37, 95% CI=0.21-0.66) and fewer number of days using opioids (RR=0.37, 95% CI=0.25-0.56) among participants with other mental disorders. Among adults with comorbid opioid use disorder and mental disorders, treatment with buprenorphine-naloxone produced greater reductions in opioid use than treatment with methadone.

Chronic Pain and Mood Disorders in Asian Americans.

Purpose: Pain and mood disorder frequently coexist. Yet, for Asian Americans (AAs), scant information about pain and mood disorder is available. Our aims were to compare (1) the rates of pain and mood disorders and (2) the magnitude of associations between pain and mood disorders between AAs and European Americans (EAs), and across different Asian subgroups.Methods: An analytical data was constructed from the Collaborative Psychiatric Epidemiology Studies (CPES), a representative sample of community-residing U.S. adults (n = 9,871). Pain morbidity was assessed by self-report. Mood disorders, including major depression and anxiety disorders, were assessed using the diagnostic interview. Analysis included descriptive statistics and multivariate logistic regression modeling. All analyses were weighted to approximate the U.S. populations, and controlled for sociodemographic and immigration characteristics.Results: Greater proportion of EAs, compared to AAs, endorsed lifetime pain (56.8% vs. 35.8%). Having life pain disorders elevated the likelihood of lifetime mood disorder by more than 2-folds (weight adjusted odds ratio (WAOR): 2.12, 95% CI: 1.77, 2.55). Having pain disorders over the past 12 months elevated the likelihood of mood disorder in the same time period by more than 3-folds (WAOR: 3.29, 95% CI: 2.02, 5.37) among AAs. The magnitude of the association between pain and psychiatric morbidity were greater in Vietnamese Americans compared to other AAs and EAs.Discussion: The conventional belief that rates of pain and mood disorders are greater in AAs than EAs may need to be further examined. Vietnamese Americans may be particularly vulnerable for experience of comorbid pain and mood disorders.

Prevalence and course of mood and anxiety disorders, and correlates of symptom severity in adolescents with type 1 diabetes: Results from diabetes LEAP.

ObjectivesWe aim to determine the prevalence and the course of anxiety and mood disorders in Dutch adolescents (12–18 years old) with type 1 diabetes, and to examine correlates of symptom severity, including parental emotional distress.MethodsParticipants were 171 adolescents and 149 parents. The Diagnostic Interview Schedule for Children‐IV was used to assess current, past year and lifetime anxiety and mood disorders in adolescents. Symptom severity and diabetes distress were measured with validated questionnaires. Correlates of these symptoms were examined using hierarchical regression analyses and included demographics (adolescent sex and age), clinical factors (diabetes duration, treatment modality, most recent glycated hemoglobin A1c; all extracted from medical charts), adolescent diabetes distress, and parent emotional distress.ResultsTwenty‐four (14%) adolescents met the criteria for ≥1 disorder(s) in the previous 12 months. Anxiety disorders were more prevalent than mood disorders (13% vs. 4%). Lifetime prevalence of anxiety and mood disorders was 29% (n = 49). The presence of any of these disorders earlier in life (from 5 years old up to 12 months prior to assessment) was associated with disorders in the past 12 months (OR = 4.88, p = 0.001). Higher adolescent diabetes distress was related to higher symptoms of anxiety (b = 0.07, p = 0.001) and depression (b = 0.13, p = 0.001), while demographics, clinical characteristics, and parental emotional distress were not related.ConclusionsAnxiety and mood disorders are common among adolescents and related to earlier disorders. Higher diabetes distress was related to higher symptom severity. Clinicians are advised to address past psychological problems and remain vigilant of these problems.

The long-lasting impact of childhood trauma on adult chronic physical disorders

BackgroundIt is unclear if childhood trauma (CT) is an independent risk factor of adult chronic physical disorders or whether its impact is (also) due to underlying poorer mental health. MethodsData were obtained from baseline measurements among 13,489 respondents of the Netherlands Mental Health Survey and Incidence Study-1 and -2, cohort studies of the Dutch general population aged 18–64 years. We used a childhood trauma questionnaire measuring emotional, psychological, physical or sexual trauma before the age of 16. Lifetime mood, anxiety and substance use disorders were assessed with the Composite International Diagnostic Interview version 1.1 and 3.0. A standard self-report checklist was used to assess a broad range of chronic physical disorders treated by a medical doctor in the previous 12 months. ResultsRespondents with a history of CT (N = 4054) suffered significantly more often from digestive (OR: 1.89–2.95), musculoskeletal (OR: 1.21–1.75) and respiratory disorders (OR: 1.39–1.91) and migraine (OR: 1.42–1.66). We found indirect associations between CT and digestive, musculoskeletal and respiratory disorders through lifetime mood (54%, 52% and 48% respectively), anxiety (44%, 55% and 44% respectively) and substance use disorders (33%, 23% and 38% respectively). Mood (69%) and anxiety disorders (67%) also impacted the relationship with migraine. ConclusionsCT predicts the development of adult physical disorders, even after controlling for sociodemographic and lifestyle factors. This association is substantially influenced by mental health disorders. Treatment programs for CT should include interventions aimed at enhancing both mental and physical health.

Thirty-day suicidal thoughts and behaviors among hospital workers during the first wave of the Spain COVID-19 outbreak.

BackgroundHealthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID‐19 outbreak (March–July 2020).MethodsData come from the baseline assessment of a cohort of Spanish hospital workers (n = 5450), recruited from 10 hospitals just after the height of the coronavirus disease 2019 (COVID‐19) outbreak (May 5–July 23, 2020). Web‐based self‐report surveys assessed 30‐day STB, individual characteristics, and potentially modifiable contextual factors related to hospital workers' work and financial situation.ResultsThirty‐day STB prevalence was estimated at 8.4% (4.9% passive ideation only, 3.5% active ideation with or without a plan or attempt). A total of n = 6 professionals attempted suicide in the past 30 days. In adjusted models, 30‐day STB remained significantly associated with pre‐pandemic lifetime mood (odds ratio [OR] = 2.92) and anxiety disorder (OR = 1.90). Significant modifiable factors included a perceived lack of coordination, communication, personnel, or supervision at work (population‐attributable risk proportion [PARP] = 50.5%), and financial stress (PARP = 44.1%).Conclusions and RelevanceThirty‐day STB among hospital workers during the first wave of the Spain COVID‐19 outbreak was high. Hospital preparedness for virus outbreaks should be increased, and strong governmental policy response is needed to increase financial security among hospital workers.

Is the Black-White mental health paradox consistent across age, gender, and psychiatric disorders?

Objectives The Black-White mental health epidemiological paradox (i.e. Black Americans’ lower or similar rates of mental disorder relative to Whites) characterizes the literature on race and mental health. Yet, research has generally paid less attention to how such findings may vary across other social statuses that shape mental health. This study assessed whether the Black-White paradox is consistent across gender, age groups, and psychiatric disorders, including lifetime mood, anxiety, and substance use disorders. Method We used data from the National Comorbidity Survey-Replication (NCS-R) and National Survey of American Life (NSAL), 2001–2003 (N = 4,591 African Americans; 6,668 non-Hispanic Whites). Psychiatric disorders were measured with the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI). Binary logistic regression models were conducted to assess racial patterns of lifetime mental disorders across age and gender. Wald tests were performed to assess age and gender group differences in Black-White patterns of mental disorder. Results The Black-White mental health paradox generally extends across lifetime mood, anxiety, and substance use disorders and is consistent across age and gender groups. One exception is middle-aged (45–64 years) Black men, who had higher odds of lifetime substance use disorder relative to their White male middle-aged peers. This difference is no longer statistically significant after accounting for education and employment. We also found more similarity in mental disorders between older Blacks and Whites relative to their younger counterparts, suggesting that Black-White mental health differences are most pronounced among younger age groups. Conclusion Our findings contribute to the broader literature on the Black-White mental health paradox by demonstrating that this epidemiological pattern persists across various mental disorder types and, at times, depends on age group and gender. Given that Black-Whte differences are less pronounced among older adults, future research should consider the ways life course theory might inform our understanding of the paradox. Findings also suggest that substance use services are critical to address the needs of middle-aged Black men of lower socioeconomic status who are disproportionately affected by substance use disorder, yet have relatively lower mental health care utilization rates.

Burden of cannabis use and disorder in the U.S. veteran population: Psychiatric comorbidity, suicidality, and service utilization

BackgroundCannabis use is associated with psychiatric illness and suicidality, which are prevalent among U.S. military veterans. However, the psychiatric burden of cannabis use and cannabis use disorder (CUD) among veterans is unclear. Using data from a nationally representative sample of veterans, we evaluated associations of lifetime cannabis use and CUD with psychiatric problems, suicidality, and treatment utilization. MethodsParticipants were 3,157 veterans aged 21 to 96 years from the National Health and Resilience in Veterans Study (NHRVS). Cannabis use and CUD were assessed using the Mini International Neuropsychiatric Interview. Psychiatric morbidities, suicidal ideation and attempts, and treatment utilization were assessed and compared between three cannabis groups: [1] no lifetime cannabis use (never-use); [2] lifetime cannabis use but never met criteria for CUD (non-CUD cannabis use); [3] lifetime CUD (CUD). ResultsRelative to the never-use group, veterans who used cannabis had elevated odds of current and lifetime posttraumatic stress disorder (PTSD), mood, anxiety, and substance use disorders, current suicidal ideation, lifetime suicide attempts, and current and lifetime mental health treatment utilization [odds ratios (ORs)=1.5-8.3]. Veterans with CUD had higher odds of current and lifetime PTSD, mood, and anxiety disorders, lifetime nicotine and alcohol dependence, and current suicidal ideation, relative to veterans who used cannabis but never met criteria for CUD (ORs=1.6-2.7). LimitationsThe cross-sectional design of this study precludes causal inference. ConclusionsCannabis use and CUD are associated with substantial psychiatric and suicide-related burden among veterans, highlighting the need for screening, education, and treatment to mitigate potential cannabis-related harm.