Risk Factors For Mental Disorders Research Articles

Putative risk and resiliency factors after an augmented training program for preventing posttraumatic stress injuries among public safety personnel from diverse sectors

ABSTRACT Mental health disorders are particularly prevalent among public safety personnel (PSP). Emotional Resilience Skills Training (ERST) is a cognitive behavioural training program for PSP based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (i.e. Unified Protocol). The current study was designed to assess whether ERST is associated with reduced putative risk factors for mental disorders and increased individual resilience. The PSP-PTSI Study used a longitudinal prospective sequential experimental cohort design that engaged each participant for approximately 16 months. PSP from diverse sectors (i.e. firefighters, municipal police, paramedics, public safety communicators) completed self-report measures of several putative risk variables (i.e. anxiety sensitivity, fear of negative evaluation, pain anxiety, illness and injury sensitivity, intolerance of uncertainty, state anger) and resilience at three time points: pre-training (n = 191), post-training (n = 103), and 1-year follow-up (n = 41). Participant scores were statistically compared across time points. Participants reported statistically significantly lower scores on all putative risk variables except pain anxiety, and statistically significantly higher resilience from pre- to post-training. Changes were sustained at 1-year follow-up. The results indicate that ERST is associated with reductions in several putative risk variables and improvement in resilience among PSP.

Breast Cancer and Mental Health: Incidence and Influencing Factors-A Claims Data Analysis from Germany.

With breast cancer (BC) survival improving due to optimized therapy, enhancing quality of life has become increasingly important. Both diagnosis and treatment, with their potential side effects, pose risks to mental well-being. Our study aimed to analyze the incidence and potential risk factors for mental disorders in BC patients. This retrospective analysis used claims data from AOK Baden-Wuerttemberg, including 11,553 BC patients diagnosed via ICD code C50 between 2010 and 2020 and 31,944 age-matched controls. Patients with mental disorders in the 12 months prior to diagnosis were excluded. Mental disorders were categorized into eight groups based on ICD codes: anxiety, obsessive compulsive disorder, adjustment disorder, dissociative disorder, hypochondriac disorder, affective disorder, mania, and other neuroses. Mental disorders were significantly more common in BC patients than in controls (64.2% vs. 38.1%, p < 0.01, OR 2.91, 95%CI [2.79, 3.04]). In particular, hypochondriac, anxiety, affective, and adjustment disorders occurred significantly more often in BC patients. No differences were found for mania, bipolar disease, other neuroses, obsessive compulsive-, or dissociative disorders. Furthermore, endocrine therapy was associated with psychological comorbidities (OR 1.69, p < 0.001, 95%CI [1.53, 1.86]), while primarily metastasized patients (stage C) had a lower risk than adjuvant patients in stage A (OR 0.55, p < 0.0001, 95%CI [0.49, 0.61]). Regarding surgical treatment, mastectomy patients showed lower rates of mental illnesses (61.2%) than those with breast-conserving treatment (71.6%), or especially breast reconstruction (78.4%, p < 0.01). Breast reconstruction was also associated with more hypochondriac (p < 0.01) and adjustment disorders (p < 0.01). So, BC patients experience significantly more mental disorders than controls, particularly when treated with endocrine therapy and breast reconstructive surgery.

Diagnoses of mental health disorders among Norwegian youth and young adults with immigrant parents

Abstract Introduction Adolescence and early adulthood are associated with an increase in mental health problems. Migration is also a risk factor for mental disorders. Yet, there is a notable gap in research concerning the mental well-being of descendants of immigrants. This study investigates the risk of a diagnosis of a mental health disorder among those aged 16-30 years, born in Norway with at least one immigrant parent. Methods Data were sourced from the Medical Birth Registry of Norway, the Norwegian Patient Register, and Statistics Norway. Cox proportional hazard regressions were used to estimate hazard ratios (HR) of being diagnosed with different mental disorders, in total and by parental region of origin, compared to individuals of Norwegian background. Analyses were adjusted for sex, year of birth, and parental education. Results Individuals with two immigrant parents had a lower risk of most mental disorder diagnoses, while those of one immigrant parent had a higher risk. With the exception of schizophrenia, individuals with two immigrant parents had a lower risk of most mental disorder diagnoses compared to those with Norwegian-born parents. The HR for the risk of a diagnosis of anxiety for those with two immigrant parents was: 0.79 [95% CI 0.76 - 0.81], with immigrant mother: 1.07 [95% CI 1.04-1.10], with immigrant father: 1.28 [95% CI 1.24 -1.30]. Similarly, for depression, two immigrant parents: 0.85 [95% CI 0.82-0.88], immigrant mother: 1.13 [95% CI 1.09 - 1.17], immigrant father: 1.31 (95% CI 1.28-1.37). Bipolar disorders, two immigrant parents: 0.67 [95% CI 0.60-0.76], immigrant mother: 1.19 [95% CI 1.07 - 1.31], immigrant father: 1.47 [95% CI 1.35-1.61]. The pattern was relatively consistent across parental regions of origin. Conclusions Those with one immigrant parent are more likely to use specialist mental health services, while those with two immigrant parents are not. These need special attention in adulthood. Key messages • Differences in risk of diagnosis for mental disorders could be due to differences in the utilization of mental health services. • Early prevention of mental health issues seems to be especially important among children and youth raised in families with one immigrant parent.

Acculturation stress and mental health outcomes in a sample of migrant inpatients: Findings from a naturalistic study.

Migrants face numerous risk factors for mental disorders, including stressors and traumatic events during the pre-, peri-, and post-migratory phases. Acculturation stress, a significant post-migratory stressor, can adversely affect mental health during the cultural adaptation process. This study aims to assess the clinical implications of acculturation stress in migrants admitted to a psychiatric intensive care unit, with a focus on identifying predictors of acculturative stress and their impact on clinical outcomes. We conducted a retrospective study of 268 immigrant patients hospitalized between 2004 and 2019 at the psychiatric inpatient unit of the University of Foggia. We collected socio-demographic and clinical data using ad hoc schedules and validated assessment instruments, including the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF), and the Clinical Global Impression (CGI). Diagnoses were based on DSM-IV-TR/DSM-5 criteria. We analyzed associations between demographic and clinical characteristics of patients reporting acculturative stress and those not reporting it, using appropriate statistical methods. The majority of patients were diagnosed with affective (45.1%) or psychotic disorders (31.7%), with 57.1% experiencing their first psychiatric episode. Acculturation stress was reported by 51.9% of patients (N = 139), predominantly among males (71.9%), single individuals (80.9%), and those of Islamic faith (56.8%). Patients experiencing acculturation stress were more likely to be unemployed (57.6%) and without a residence permit (63.3%). This stress was particularly prevalent among patients with psychotic disorders (25.9%) and first-episode psychiatric cases (64.7%). At discharge, patients with acculturation stress showed less improvement on CGI, GAF, and BPRS scores compared to those without such stress. Acculturation stress is influenced by several socio-demographic factors and is crucial for the full symptomatic remission of migrant patients. Culturally-oriented mental health services, including language and cultural integration programs, are essential in reducing acculturative stress and improving the overall well-being of immigrants.

Self-reported workplace bullying and subsequent risk of diagnosed mental disorders and psychotropic drug prescriptions: A register-based prospective cohort study of 75,252 participants

BackgroundEvidence concerning workplace bullying as a risk factor for mental disorders is currently limited to depressive disorders and mainly based on non-clinical assessments. This study aims to examine the prospective association of self-reported workplace bullying with different types of register-based hospital-diagnosed mental disorders and redeemed psychotropic drug prescriptions. MethodsUsing a cohort study design, we examined a pooled dataset of 75,252 participants from 14 questionnaire-based surveys conducted between 2004 and 2014. In the questionnaires, workplace bullying was measured by a single item. The questionnaires were linked to Danish registers on hospital-diagnosed mental disorders and redeemed psychotropic drug prescriptions up to 2016. Data were analysed by multivariate Cox proportional hazard models, including only participants without a history of mental disorders or prescriptions since 1995. ResultsAfter adjustment for sex, age, marital and socio-economic status, workplace bullying was associated with an excess risk of any mental disorder (HR 1.37; 95 % CI: 1.17–1.59) as well as mood disorders and neurotic, stress-related, and somatoform disorders. In stratified analyses, this association were statistically significant only among women. Workplace bullying was also associated with any psychotropic drug prescription (fully-adjusted HR 1.43; 95 % CI: 1.35–1.53). This association was observed in both sexes and for all prescriptions, including anxiolytics, hypnotics and sedatives, antidepressants, and nootropics. LimitationsFirm conclusions about sex-related differences cannot be drawn. Residual confounding by unmeasured factors such as personality cannot be ruled out. ConclusionsWorkplace bullying was associated with higher risks of diagnosed mental disorders among women and psychotropic drug prescriptions in both sexes.

Spatial and Socioeconomic Patterns of Mental Health and Healthcare Utilization in Cologne, Germany.

Children and adolescents are significantly tied to their family's socioeconomic position and living environment. Neighbourhood and the living environment have been identified as potential risk factors for mental disorders in this age group. The aim of the study was to investigate the distribution of mental and behavioural disorders (prevalence) and the provision of mental health services for children and adolescents aged 0-19 years in the city of Cologne. In particular, the study aimed to examine the association of these factors with area deprivation and the availability of mental health services covered by statutory health insurance. Finally, possible spatial variations in these aspects were analysed. Claims data of children and adolescents aged 0 to 19 years included in four statutory health insurance of the year 2021 were analysed. A deprivation index using data on the level of the ZIP code area was calculated. Analyses were carried out descriptively, using ordinary least squares (OLS) and geographically weighted regression (GWR). The prevalence of mental and behavioural disorders in children and adolescents varied across ZIP code areas, with higher rates in the northern, southern, and eastern parts of the city. The results indicated that the use of services by male children and adolescents with a prevalent diagnosis of mental and behavioural disorders was higher in areas with a higher density of healthcare providers. However, prevalence was on the whole lower in areas with a higher density of healthcare providers. In addition, the density of health care providers was higher in the city centre with comparatively lower deprivation. These results indicate inadequate access to care for children and young people outside the city centre. However, due to the heterogeneity of the population in these areas, this study provides only preliminary insights. Data with a finer geographic resolution are needed for further research in order to analyse the association further.

Prevalence, severity and risk factors for mental disorders among sexual and gender minority young people: a systematic review of systematic reviews and meta-analyses.

Evidence suggests heightened prevalence and severity of mental disorders among sexual minority (SM) and gender minority (GM) young people. Several risk factors have been associated with these disparities. A systematic review of systematic reviews and meta-analysis was conducted to provide a comprehensive overview of the literature and to determine the field's current position. MEDLINE, PsycInfo, Scopus and Web of Science were searched in March 2022 and updated January 2024. Eligibility criteria were systematic reviews or meta-analyses assessing contemporaneous prevalence, severity and/or risk factors of mental disorders among SM or GM young people aged 25 and under. 42 reviews were included, all of which were low quality. The prevalence of depression among SM was 26% (95% CI 21-32%), and among GM was 46% (95% CI 36-56%). Greater depression severity was found among SM compared to heterosexual young people, with a significant albeit small effect size (Hedges' g = 0.38, 95% CI = 0.25 to 0.50); effect sizes were similar when separating by gender. GM also reported greater symptom severity compared to cisgender young people. Other mental disorders were more prevalent compared to those reported in the general population, and of greater severity compared to heterosexual/cisgender young people. Several proximal and distal risk factors were focused upon within the systematic reviews identified. Past systematic reviews consistently indicate a heightened risk of mental disorders among SM and GM young people. Services need to be aware of these disparities and adapt their care accordingly.

The Underestimated Role of the Sports Psychiatrist in Athletic Performance Restoration, Maintenance, and Enhancement in Sports

ABSTRACTIn competitive and elite sports, mental health and athletic performance cannot be considered separately. Mental disorders in sports are bidirectionally associated with reduced athletic performance. A decline in performance, both within and outside of sport, can be a sign of mental disorder. Additionally, poor athletic performance is a potential risk factor for mental disorders in athletes. The central role sports psychiatrists play in the mental health of athletes is well‐established. However, their role in athletic performance is less well‐described and more controversial, perhaps due to a perception that performance is purely a secondary outcome of good mental health. This paper discusses the role that sports psychiatrists can play in athletic performance within competitive and elite sports. Performance can be distinguished into three key focus areas for sports psychiatrists: (i) performance restoration, (ii) performance maintenance, and (iii) performance enhancement. These should be considered throughout the continuum of mental health care, from prevention, treatment, to ongoing care for mental disorders. When reduced performance is due to a mental disorder, psychiatric treatment should purposefully aim to restore functioning and performance as part of management. Maintenance of performance is, similarly, an important element of the prevention, psychiatric treatment, and ongoing care of mental disorders. Holistic sports psychiatrists may also choose to aim for athletic performance enhancement beyond the context of mental health symptoms and disorders, to help athletes flourish and achieve their goals.

Prevalence and correlates of mental disorders among Chinese overseas students during the COVID-19: A multi-regional cross-sectional analysis.

The global impact of the COVID-19 pandemic extends beyond physical health, significantly affecting mental health. Chinese overseas students are particularly susceptible to the adverse psychological effects of the pandemic. Understanding the prevalence and correlates of mental disorders in this population is essential for developing targeted interventions and support systems. Employing a snowball sampling technique, this study recruited Chinese overseas students from diverse regions. The 50-item Self-evaluation Table was utilized to assess the presence of mental disorders. Descriptive statistics, including percentages, 95% confidence intervals, means, and standard deviations, characterized the survey population. The chi-square test identified disparities among categorical variables, while logistic regression explored risk factors for mental disorders among Chinese overseas students. Out of the total sample size of 10,864 Chinese overseas students, a staggering 7,090 (65.4%) met the diagnostic criteria for mental disorders. Furthermore, the degree of mental disorder varied significantly across different regions (p < 0.001), education levels (p < 0.05), the duration of anti-epidemic measures (p < 0.05), and age (p < 0.05), while no significant differences were observed in terms of gender (p > 0.05). Several risk factors contributing to the mental disorder burden among Chinese overseas students during the pandemic were identified, including the seriousness of the epidemic in their residential area, the apprehension of getting infected, anxieties regarding academic performance, the infection control policies implemented by the host government, preventive measures taken locally to counter the epidemic, and challenges encountered in returning to their home country. Given the significant challenges in mental health faced by Chinese overseas students during the COVID-19 crisis, addressing their specific needs and implementing tailored measures is imperative. Future public health emergencies should consider the potential mental disorders and disease risks faced by Chinese overseas students. By providing comprehensive support and targeted interventions, policymakers, educational institutions, and healthcare providers can help mitigate the adverse psychological effects and promote the well-being of this vulnerable population.

Pathways between Child Maltreatment, Psychological Symptoms, and Life Satisfaction: A Network Analysis in Adolescent Inpatients.

Child maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, symptoms and facets of life satisfaction would be most influential in adolescent inpatients with internalizing mental disorders. N = 896 adolescent receiving inpatient psychotherapeutic treatment completed questionnaires on child maltreatment experiences, current psychopathology and subjective life satisfaction at admission and discharge (n = 765). Main diagnoses were affective (n = 322), eating (n = 447), obsessive-compulsive (n = 70) and anxiety disorders (n = 57). Network models of child maltreatment, psychopathology and life satisfaction nodes were estimated at admission and discharge and compared using network comparison tests. Potential causal shortest pathways were investigated using directed acyclic graphs.Network models were stable with no significant differences between admission and discharge. Strongest nodes of each cluster were "emotional abuse" (child maltreatment), "worthlessness", "thinking about dying" and "feeling lonely" (psychopathology) and "satisfied with life" (life satisfaction) at both admission and discharge. Emotional neglect showed direct connections to life satisfaction, indicating its relevance for therapeutic interventions. At both admission and discharge, "sexual abuse" indirectly predicted lower life satisfaction through psychological symptoms. In conclusion, child maltreatment is directly and indirectly connected to life satisfaction in adolescents with mental disorders. Emotional abuse and neglect were especially important in linking child maltreatment to life satisfaction and psychopathology.

Leave no one behind: Rethinking policy and practice at the national level to prevent mental disorders

The global burden of mental disorders is increasing, in line with the shift from communicable to chronic non-communicable diseases. Mental disorders affect the functioning of individuals, resulting not only in enormous emotional suffering and diminished quality of life, but also in stigma and discrimination. This burden extends to the community and society, with far-reaching economic and social consequences. Even under optimal conditions, treatment alone will never be sufficient to reduce the global burden of mental disorders, so a shift in focus from treatment to prevention of mental disorders should be promoted at the central level in the form of legislation, policy formulation and resource allocation. Universal and selective prevention programs should be prioritized nationally, as they aim to change the risk profile of the entire population and specifically target populations at risk for mental disorders, respectively. In this article, we review the key risk factors for mental disorders and the measures that can be taken at the national level to prevent them, taking into due consideration that prevention efforts can vary based on the audience they are addressing, level of intensity they are providing, and the life phase they target. By adopting a human rights perspective and placing the social determinants of health at the center of our narrative, we maintain that improving mental health cannot be achieved by strengthening health services alone. Coordination across government departments is needed to implement multi-level public health interventions across a wide range of settings, programs, and policies. Focusing on children's mental health and addressing poverty, gender inequality and social discrimination should be absolute priorities for national mental health policies and plans.

Internal migration and mental disorders among the adult population: a community-based cross-sectional study in Nepal

BACKGROUND: Mental disorders are highly prevalent globally, especially in low- and middle-income countries. Migration within a country (internal migration) may be a risk factor for mental illness due to challenges faced in a new environment. However, research on internal migration and mental health is limited, especially in Nepal. METHODS: This cross-sectional study analyzed data from the 2022 Nepal Demographic and Health Survey. Mental disorders (depression/anxiety) were the outcome. Key variables were internal migration status, demographic factors, and self-reported health status. Logistic regression identified factors associated with mental disorders. RESULTS: Among 11,976 participants, 5% reported mental disorders. In adjusted analysis, mental disorders were associated with poor self-reported health (aOR 5.74), older age (aOR 3.03 for ages 40-49 versus 15-19), and female gender (aOR 2.20). Internal migration was not independently associated with mental disorders (aOR 0.98). CONCLUSIONS: Poor health, older age, and female gender - but not internal migration - were risk factors for mental disorders in this Nepali population. Further research should explore drivers of mental illness in vulnerable groups to inform mental health interventions.

Internal migration and mental disorders among the adult population: a community-based cross-sectional study in Nepal

BACKGROUND: Mental disorders are a leading cause of years lived with disability; anxiety and depressive disorders are the most common mental disorders. Worldwide, 970 million people are suffering from mental disorders, and 82% of people with mental health conditions live in low- and middle-income countries. Of the total, 13.2% live in the South East Asia region, and 10% of adults are suffering from any type of mental disorder in Nepal. Mental health conditions are severely underserved, neglected, under-resourced, and there are research gaps all over the world. Genetic, social, behavioral, and discrimination are risk factors for mental disorders. There are limited studies focusing on internal migration, health, and healthcare service utilization. This study aims to investigate whether the condition of internal migration is independently associated with mental disorders. Thus, the study objectives are to assess the prevalence and independent risk factors for mental disorders in the Nepali adult internal migrant population. METHOD: The study will be a community-based cross-sectional study using the latest data from the Nepal Demographic and Health Survey 2022. Data were collected with computer-assisted personal interviewing (CAPI) along with validated psychometric tools, and one question related to mental health: “Ever been told by a doctor/health care worker you have: depression/anxiety?” with the response being Yes or No. The response to the question will be used to define mental disorders in the study population. Yes for both depression and anxiety or for any one yes response of depression and anxiety will be considered a mental disorder. Bivariate and multivariate logistic regression will be used to determine the independent association of potential covariates, especially internal migration, with the outcome variable. RESULTS: The results of the study will be descriptive, bivariate, and multivariate logistic regression analyses. The results will be presented in tables with frequencies, odds, and 95% confidence intervals with significance at &lt;0.05 p-value. The final report will be published in a peer-reviewed journal.

Insomnia and the incidence, recurrence and persistence of common mental disorders: Sex-differences in the general population

Insomnia is common throughout the population and thought to be a risk factor for mental disorders. We assessed the association of insomnia symptoms with incidence, recurrence and persistence of mood, anxiety and substance use disorders. In 4007 participants (55 % women, mean age 51.0 ± 12.3) of the population-based Netherlands Mental Health Survey and Incidence Study (NEMESIS), having insomnia symptoms increased the odds of developing, recurring and persisting mood disorders, mostly in men. Insomnia only associated with recurring anxiety disorders, particularly in women, and not with substance use disorders. Treating insomnia may aid recovery and prevention of mental disorders, particularly mood disorders.

Utrecht grief rumination scale (UGRS): Psychometric study of validation of the Portuguese version

Grief rumination is characterized by recurring, repetitive, self-focused thoughts about the causes and consequences of loss and loss-related emotions. This cognitive process is a transdiagnostic risk factor for mental disorders, such as prolonged grief. The aim of this study was to analyze the psychometric properties of the Portuguese version of the Utrecht Grief Rumination Scale (UGRS). The sample consists of 242 bereaved adult participants with Portuguese nationality. Confirmatory Factor Analysis showed that the hierarchical model showed a better fit to the data. Average Variance Extracted was also calculated to measure convergent and divergent validity. Test-criterion validity was investigated by analyzing associations between grief rumination and measures of posttraumatic stress, prolonged grief, anxiety, and depression. Using McDonald’s Omega and Cronbach’s Alpha, all subscales showed adequate reliability. The UGRS showed acceptable psychometric properties, standing out as a valid instrument for practice and research in psychology in the area of ​​bereavement.

Thought Believability and Anxious Feelings about COVID-19: A Case-Control Study in Northeastern Iran.

Believability and thoughts are considered as the pillars of behaviors over time, and anxious feelings are a risk factor for mental disorders, especially during the coronavirus disease (COVID-19) pandemic. This study aimed to explore the thought believability and anxious feelings of COVID-19 among infected and healthy families. In this hospital-based matched case-control study, health surveillance files of COVID-19 patients were collected from January to June 2021 and were analyzed statistically. In this study, two questionnaires of demographic characteristics and the Believability of Anxious Feelings and Thoughts (BAFT) were used. Data were analyzed using the One-way ANOVA. Of 600 participants, 300 (50%) were PCR-confirmed and 300 (50%) were non-infected. Overall, 163 (54.33%) of infected people were male, 146 (48.67%) single, and 156 (52.00%) government employees. The results showed that the mean scores of physical anxiety (PA) and negative evaluation (NE) in the case group is significantly higher than the control group (P = 0.001); while emotional regulation (ER) in the control group was significantly higher than the case group (P = 0.001). Having high believability to the risks of COVID-19 may be a predictor of preventive behaviors in individuals. Worrying about COVID-19 can increase the perceived risk of a pandemic in societies and consequence, increase the general public health.

Risk of mental disorders and malnutrition in elderly COVID-19 survivors: An observational study

Background: The incidence rate of COVID-19 is around 11-15% in the elderly. The case fatality rate (CFR) of COVID-19 in the elderly is around 8.9% and increases with age. The risk of mental disorders and malnutrition is increased in COVID-19 survivors. Continuous inflammatory conditions result in a state of hypercatabolism that can disrupt brain neuroendocrine and protein consumption for the formation of acute-phase reactant proteins. Mental disorders and malnutrition can lead to fragility. The aim of this study was to assess the risk of mental disorders and malnutrition in elderly survivors of COVID-19. Methods: This research was a cross-sectional study. The results of the research on age, disease symptoms, and comorbidities have proven that they are risk factors for mental disorders and malnutrition in elderly COVID-19 survivors. This study used total sampling and included 100 study subjects. The research was conducted in Depok for two months; data was collected directly through shared questionnaires and direct anthropometric measurements. The questionnaires used were the SRQ-20 tool for mental disorder screening and MNA for malnutrition screening. Results: The risk factors for mental disorders were age over 70 years old OR 3 (CI 1.0-8.8), severe COVID-19 symptoms OR 4.5 (CI 1.2-16.17), and multi-comorbidity OR 2.3 (CI 0.6-8.8). The risk factors for malnutrition were age higher than 70 years old OR 2.5 (CI 0.8-7.9), moderate COVID-19 symptoms OR 6.3 (CI 2.0-19.81), and multi-comorbidity OR 6.6 (CI 1.5-28.5). Conclusions: Those infected with COVID-19 have a risk of mental disorders and malnutrition, especially in geriatrics, and this risk increases with age.

The association between short-term exposure to nitrogen dioxide and hospital admission for schizophrenia: A systematic review and meta-analysis.

Ambient air pollution has been identified as a primary risk factor for mental disorders. In recent years, the relationship between exposure to ambient nitrogen dioxide (NO2) and the risk of hospital admissions (HAs) for schizophrenia has garnered increasing scientific interest, but evidence from epidemiological studies has been inconsistent. Therefore, a systematic review and meta-analysis were conducted to comprehensively identify potential correlations. A literature search in 3 international databases was conducted before December 31, 2022. Relative risk (RR) and corresponding 95% confidence intervals (CI) were calculated to evaluate the strength of the associations. Summary effect sizes were calculated using a random-effects model due to the expected heterogeneity (I2 over 50%). A total of ten eligible studies were included in the meta-analysis, including 1,412,860 participants. The pooled analysis found that an increased risk of HAs for schizophrenia was associated with exposure to each increase of 10 μg/m3 in NO2 (RR = 1.029, 95% CI = 1.016-1.041, P < .001). However, the heterogeneity was high for the summary estimates, reducing the credibility of the evidence. In 2-pollutant models, results for NO2 increased by 0.3%, 0.2% and 2.3%, respectively, after adjusting for PM2.5, PM10 and SO2. This study provides evidence that NO2 exposure significantly increases the risk of hospital admission for schizophrenia. Future studies are required to clarify the potential biological mechanism between schizophrenia and NO2 exposure to provide a more definitive result.

Construction of a risk prediction model for detecting postintensive care syndrome-mental disorders.

Postintensive care syndrome (PICS) has adverse multidimensional effects on nearly half of the patients discharged from ICU. Mental disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are the most common psychological problems for patients with PICS with harmful complications. However, developing prediction models for mental disorders in post-ICU patients is an understudied problem. To explore the risk factors of PICS mental disorders, establish the prediction model and verify its prediction efficiency. In this cohort study, data were collected from 393 patients hospitalized in the ICU of a tertiary hospital from April to September 2022. Participants were randomly assigned to modelling and validation groups using a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to select the predictors, multiple logistic regression analysis was used to establish the risk prediction model, and a dynamic nomogram was developed. The Hosmer-Lemeshow (HL) test was performed to determine the model's goodness of fit. The area under the receiver operating characteristic (ROC) curve was used to evaluate the model's prediction efficiency. The risk factors of mental disorders were Sepsis-related organ failure assessment (SOFA) score, Charlson comorbidity index (CCI), delirium duration, ICU depression score and ICU sleep score. The HL test revealed that p = .249, the area under the ROC curve = 0.860, and the corresponding sensitivity and specificity were 84.8% and 71.0%, respectively. The area under the ROC curve of the verification group was 0.848. A mental disorders dynamic nomogram for post-ICU patients was developed based on the regression model. The prediction model provides a reference for clinically screening patients at high risk of developing post-ICU mental disorders, to enable the implementation of timely preventive management measures. The dynamic nomogram can be used to systematically monitor various factors associated with mental disorders. Furthermore, nurses need to develop and apply accurate nursing interventions that consider all relevant variables.

The relationship of posttraumatic stress disorder and developmental trauma disorder with childhood psychopathology: A network analysis

ObjectivePotentially traumatic experiences are a major risk factor for mental disorders in children and adolescents. Posttraumatic psychopathology includes trauma-specific disorders such as posttraumatic stress disorder (PTSD) as well as other psychiatric disorders. Developmental Trauma Disorder (DTD) has been proposed as a developmentally sensitive diagnosis. We aimed to further illuminate the co-occurrence of psychiatric conditions with DTD and PTSD. MethodIn a convenience sample of families of 507 children and adolescents (mean age = 12.11 years old, SD = 2.92; 48.5% female), we assessed DTD, PTSD, and screened for psychiatric disorders. We estimated network models including DTD, PTSD and ten psychiatric conditions. ResultsWe found that DTD and PTSD share both common and differential comorbidity features on disorder-, domain-, and symptom-level. The differential comorbidity patterns of the DTD and PTSD domains placed DTD close to both externalizing and internalizing psychopathology while PTSD was primarily linked to internalizing conditions. ConclusionsOur study provides evidence for the complex clinical presentation of posttraumatic psychopathology over and above PTSD in children. DTD and PTSD provide useful and distinct diagnostic categories for children who are also experiencing internalizing conditions, and DTD may be especially relevant for children who are experiencing externalizing psychopathology.