Risk Factors For Psychiatric Symptoms Research Articles

Exposure to prenatal infection and the development of internalizing and externalizing problems in children: a longitudinal population-based study.

A large body of work has reported a link between prenatal exposure to infection and increased psychiatric risk in offspring. However, studies to date have focused primarily on exposure to severe prenatal infections and/or individual psychiatric diagnoses in clinical samples, typically measured at single time points, and without accounting for important genetic and environmental confounders. In this study, we investigated whether exposure to common infections during pregnancy is prospectively associated with repeatedly assessed child psychiatric symptoms in a large population-based study. Our study was embedded in a prospective pregnancy cohort (Generation R; n = 3,598 mother-child dyads). We constructed a comprehensive prenatal infection score comprising common infections for each trimester of pregnancy. Child total, internalizing, and externalizing problems were assessed repeatedly using the parent-rated Child Behavioral Checklist (average age: 1.5, 3, 6, 10, and 14 years). Linear mixed-effects models were run adjusting for a range of confounders, including child polygenic scores for psychopathology, maternal chronic illness, birth complications, and infections during childhood. We also investigated trimester-specific effects and child sex as a potential moderator. Prenatal exposure to infections was associated with higher child total, internalizing, and externalizing problems, showing temporally persistent effects, even after adjusting for important genetic and environmental confounders. We found no evidence that prenatal infections were associated with changes in child psychiatric symptoms over time. Moreover, in our trimester-specific analysis, we did not find evidence of significant timing effects of prenatal infection on child psychiatric symptoms. No interactions with child sex were identified. Our research adds to evidence that common prenatal infections may be a risk factor for psychiatric symptoms in children. We also extend previous findings by showing that these associations are present early on, and that rather than changing over time, they persist into adolescence. However, unmeasured confounding may still explain in part these associations. In the future, employing more advanced causal inference designs will be crucial to establishing the degree to which these effects are causal.

Association between Older Age and Psychiatric Symptoms in a Population of Hospitalized Patients with COVID-19.

Increased rates of anxiety and depression have been reported for older adults during the COVID-19 pandemic. However, little is known regarding the onset of mental health morbidity during the acute phase of the disease and the role of age as potential independent risk factor for psychiatric symptoms. The cross-sectional association between older age and psychiatric symptoms has been estimated in a sample of 130 patients hospitalized for COVID-19 during the first and second wave of the pandemic. Compared to younger patients, those who were 70 years of age or older resulted at a higher risk of psychiatric symptoms measured on the Brief Psychiatric Symptoms Rating Scale (BPRS) (adjusted (adj.) odds ratio (OR) 2.36, 95% confidence interval (CI) 1.05-5.30) and delirium (adj. OR 5.24, 95% CI 1.63-16.8)). No association was found between older age and depressive symptoms or anxiety. Age was associated with psychiatric symptoms independently of gender, marital status, history of psychiatric illness, severity of disease and cardiovascular morbidity. Older adults appear at high risk of developing psychiatric symptoms related to COVID-19 disease during hospital stay. Multidisciplinary preventive and therapeutic interventions should be implemented to reduce the risk of psychiatric morbidity and related adverse health care outcomes among older hospital inpatients with COVID-19.

A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment.

Purpose of reviewCOVID-19 impacts multiple organ systems and is associated with high rates of morbidity and mortality. Pathogenesis of viral infection, co-morbidities, medical treatments, and psychosocial factors may contribute to COVID-19 related neuropsychological and psychiatric sequelae. This systematic review aims to synthesize available literature on psychiatric and cognitive characteristics of community-dwelling survivors of COVID-19 infection.Recent findingsThirty-three studies met inclusion/exclusion criteria for review. Emerging findings link COVID-19 to cognitive deficits, particularly attention, executive function, and memory. Psychiatric symptoms occur at high rates in COVID-19 survivors, including anxiety, depression, fatigue, sleep disruption, and to a lesser extent posttraumatic stress. Symptoms appear to endure, and severity of acute illness is not directly predictive of severity of cognitive or mental health issues. The course of cognitive and psychiatric sequelae is limited by lack of longitudinal data at this time. Although heterogeneity of study design and sociocultural differences limit definitive conclusions, emerging risk factors for psychiatric symptoms include female sex, perceived stigma related to COVID-19, infection of a family member, social isolation, and prior psychiatry history.SummaryThe extant literature elucidates treatment targets for cognitive and psychosocial interventions. Research using longitudinal, prospective study designs is needed to characterize cognitive and psychiatric functioning of COVID-19 survivors over the course of illness and across illness severity. Emphasis on delineating the unique contributions of premorbid functioning, viral infection, co-morbidities, treatments, and psychosocial factors to cognitive and psychiatric sequelae of COVID-19 is warranted.

Resilience and Life Expectations of Perinatally HIV-1 Infected Adolescents in France.

Background:Resilience of perinatally HIV-infected youth in European countries is poorly studied. Life satisfaction and expectations for adulthood are rarely examined.Objective:This cross-sectional, descriptive study of a French cohort of 54 perinatally HIV-infected adolescents raised in France (age 14-20 years) aimed to (1) evaluate their psychosocial adjustment, (2) identify their expectations for adulthood and (3) delineate risk and protective factors associated with mental health, life satisfaction, and HIV-1 viral load level.Method:Medical evaluation, psychological semi-structured interview, and self-report questionnaires were used.Results:All the adolescents had been receiving Highly Active Anti-Retroviral Therapy (HAART) for 9 to 11 years and 2/3 were healthy with controlled viral load (<50 copies/mL). The majority had medium to high levels of life satisfaction. They viewed HIV as having only minor impact on their current daily life and had positive expectations for adulthood. However, 46% exhibited psychiatric symptomatology. Multivariable analysis showed that having a deceased parent and current worries about HIV were substantial risk factors for psychiatric symptoms. Having two living parents and being satisfied with life were protective factors for mental health. Good quality of caregiver-adolescent relationships and high life satisfaction were significant protective factors for controlled viral load.Conclusion:These data indicate psychosocial resilience among perinatally HIV-1 infected adolescents with 10 years of HAART treatment. These findings demonstrate the influence of life satisfaction, parent’s life status and quality of caregiver-adolescent relationships on resilience and health outcomes in these patients. We conclude that healthcare providers should attend to these factors.

Exposure to interpersonal trauma, attachment insecurity, and depression severity

BackgroundExposure to traumatic events is a nonspecific risk factor for psychiatric symptoms including depression. The trauma–depression link finds support in numerous studies; however, explanatory mechanisms linking past trauma to current depressive symptoms are poorly understood. This study examines the role that attachment insecurity plays in mediating the relationship between prior exposure to trauma and current expression of depression severity. MethodsPast trauma and attachment anxiety and avoidance were assessed at baseline in a large cohort (N=705) of adults admitted to a specialized adult psychiatric hospital with typical lengths of stay ranging from 6 to 8 weeks. Depression severity was assessed at day 14 of treatment using the Beck Depression Inventory-II. ResultsInterpersonal trauma (e.g., assaults, abuse) was correlated with depression severity, whereas exposure to impersonal trauma (e.g., natural disasters, accidents) was not. Adult attachment partially mediated the relationship between past interpersonal trauma and depression severity at day 14 among psychiatric inpatients. LimitationsMeasure of trauma exposure did not systematically differentiate the age of exposure or relationship to the perpetrator. Individuals scoring high on the self-report attachment measure may be prone to over-report interpersonal traumas. ConclusionsTreatment of depression in traumatized patients should include an assessment of attachment insecurity and may be fruitful target for intervention.

Bereavement an independent risk factor for psychiatric symptoms in young people

Bereavement an independent risk factor for psychiatric symptoms in young people

Perinatal Risk and Psychiatric Outcome in Adolescents Born Preterm With Very Low Birth Weight or Term Small for Gestational Age

To study perinatal risk factors for psychiatric symptoms in adolescents born preterm with very low birth weight or at term, but small for gestational age (GA). Mental health was assessed in 65 adolescents born with very low birth weight (VLBW) (birth weight < or = 1500 g), 59 born term small for GA (birth weight <10th centile) and 81 control adolescents using Schedule for Affective Disorders and Schizophrenia for School-Age Children, Children's Global Assessment Scale, Autism Spectrum Screening Questionnaire, Attention-Deficit Hyperactivity Disorder-Rating Scale IV and Achenbach System of Empirically Based Assessment. Perinatal data included birth weight, GA, head circumference, Apgar scores, intraventricular hemorrhage, days in neonatal intensive care unit, and days on mechanical ventilation. In the very low birth weight group, lower birth weight was associated with inattention (p < .01), psychiatric diagnoses, and reduced psychosocial function (p < or = .05). Intraventricular hemorrhage increased the risk for a high inattention score (odds ratio = 7.5; 95% confidence intervals: 1.2-46.8). Lower Apgar score at 1 min was associated with a high Autism Spectrum Screening Questionnaire score and lower Apgar score at 5 min with a high internalizing score (p < or = .05). In the subgroup born appropriate for GA, internalizing symptoms were also associated with lower GA. In the term small for GA group, perinatal events were not associated with psychiatric problems. In contrast, low socioeconomic status was associated with externalizing symptoms. Lower birth weight, shorter gestation, and intraventricular hemorrhage were risk factors for psychiatric problems in the very low birth weight group. Lower Apgar score increased the risk for autism spectrum symptoms and internalizing symptoms. Among adolescents born term small for GA, the main risk factor for psychiatric symptoms was low socioeconomic status.

Schizophrenia risk factors constitute general risk factors for psychiatric symptoms in the population

BackgroundThe presence of a psychosis continuum is suggested by studies showing that schizophrenia and non-clinical psychotic symptoms in the general population share the same risk factors. However, to our knowledge no large-scale studies have been conducted which examine the specificity of these risk factors in the general population. AimTo investigate whether socio-demographic characteristics associated with non-clinical psychotic symptoms are also associated with other psychiatric symptoms. And secondly, to examine to what extent concomitant psychiatric symptoms explain the relationship between socio-demographic characteristics and non-clinical psychotic symptoms. MethodsIn a general population sample of 4894 subjects (mean age 39years, 45% men) from the Utrecht Health Project we investigated the associations of socio-demographical characteristics with non-clinical psychotic symptoms and other psychiatric symptoms by using the SCL-90. We examined these associations using multivariable logistic regression analyses with and without controlling for the presence of other psychiatric symptoms. ResultsParticipants with non-clinical psychotic symptoms had an 89% probability of concomitant depressive, anxiety or phobic anxiety symptoms, compared to 11% in participants without psychotic symptoms. The risk profiles for non-clinical psychotic symptoms and other psychiatric symptoms were largely similar. Non-Dutch ethnicity was most strongly associated with non-clinical psychotic symptoms. Adjusting for other psychiatric symptoms did not increase the specificity of the risk factors. ConclusionSocio-demographic risk factors for non-clinical psychotic symptoms in the general population are also risk factors for other psychiatric symptoms. The relationship between these risk factors and psychotic symptoms are for a substantial part explained by an increase in other psychiatric symptoms.

Psychiatric symptoms in Ground Zero ironworkers in the aftermath of 9/11: prevalence and predictors

Aims and MethodTo establish the prevalence of, and risk factors for, psychiatric symptoms in Ground Zero ironworkers. Questionnaires commonly used to screen for psychiatric symptoms were completed by 124 workers.ResultsWe have established the prevalence of screening positive for symptoms of post-traumatic stress disorder, panic attacks, generalised anxiety, depression and alcohol misuse. Among the risk factors were alcohol misuse, injury to or death of a family member, friend or co-worker at Ground Zero and one or more adverse life events since 9/11.Clinical ImplicationsIronworkers at Ground Zero tend to have significant psychiatric symptoms likely to be associated with the traumatic experience of working there during the clean-up operation. Risk factors for psychiatric symptoms were established.

Survey of Physician Well-Being and Health Behaviors at an Academic Medical Center

Purpose: The study aims were to ascertain, among attending and house staff at a single academic medical center, the prevalence of and risk factors for psychiatric symptoms and disorders and for personal health behaviors.Methods: A self-administered, anonymous 72-item survey of physicians was conducted in February 2003.Results: Response rate was 37.6%. The prevalence of current depressive symptoms was 29%. AUDIT scores consistent with high likelihood of harmful alcohol consumption were prevalent in 6%. Almost 5% acknowledged use of sedatives or hypnotics without a prescription in the prior 12 months. Characteristics independently associated with current depressive symptoms included: living alone, full time salaried faculty status, not having a primary care physician, female sex, and age < 50 years. Factors associated with high risk of harmful alcohol consumption included: male sex, house staff status, and not being exclusively heterosexual.Conclusions: The prevalence of recent depressive symptoms among responding physicians was nearly 30%. Interventions to engage physicians in primary care relationships and social support to confidentially disclose potentially stigmatizing characteristics may facilitate earlier case finding of those at risk for depression, suicide, and substance abuse

Relationship of bone and blood lead levels to psychiatric symptoms: the normative aging study.

Blood and bone lead levels were used to investigate lead's potential effect on psychiatric symptoms among middle-aged to elderly men from the Normative Aging Study. Symptoms were assessed using the Brief Symptom Inventory (BSI) and analyzed as individual outcomes as well as a measure that combined anxiety, depression, and phobic anxiety. Blood and bone lead averaged 6.3 microg/dL (standard deviation [SD] = 4.16), 21.9 microg/g (SD = 13.5), and 32.1 microg/g (SD = 19.8) for blood, tibia, and patella lead, respectively. In logistic regression models that adjusted for age, alcohol intake, employment status, and education status, we found that patella bone lead was significantly associated with an increased risk of phobic anxiety and the combined outcome measure at the P </= 0.05 level. Tibia and blood lead had similar associations. We conclude that cumulative lead exposure, which bone lead levels reflect, could be a risk factor for psychiatric symptoms even at modest levels of exposure.

Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees

Each refugee group experiences specific migration and resettlement experiences. There are no epidemiological data on risk factors for psychiatric symptoms among adult Somalis in the UK. We interviewed a community sample of 180 Somalis. We assessed the relationship between symptoms of psychosis (BPRS), anxiety and depression (SCL-90) and suicidal thinking (BDI) and migration-related experiences such as traumatic events, immigration difficulties, employment and income. Anxiety and depression was incrementally more common with each pre-migration traumatic event (OR per trauma event = 1.31, 1.06-1.62, p = 0.01). Shortages of food, being lost in a war situation, and being close to death and suffering serious injury were each related to specific psychiatric symptoms. Suicidal thinking was more common among Somalis who were unemployed before migration and those using qat in the UK. War-related experiences, occupational status before migration and current Qat use are risk factors for psychiatric symptoms among Somali refugees.

Housework, paid work and psychiatric symptoms.

To evaluate the hypothesis that work burden, the simultaneous engagement in paid work and unpaid family housework, is a potential risk factor for psychiatric symptoms among women. A cross-sectional study was carried out with 460 women randomly selected from a poor area of the city of Salvador, Brazil. Women between 18 to 70 years old, who reported having a paid occupation or were involved in unpaid domestic activities for their families, were eligible. Work burden-related variables were defined as: a) double work shift, i.e., simultaneous engagement in a paid job plus unpaid housework; and b) daily working time. Psychiatric symptoms were collected through a validated questionnaire, the QMPA. Positive, statistically significant associations between high (>7 symptoms) QMPA scores and either double work shift (prevalence ratio - PR=2.04, 95% confidence interval - CI: 1.16, 2.29) or more than 10 hours of daily work time (PR=2.29, 95% CI: 1.96, 3.43) were found after adjustment for age, marital status and number of pre-school children. Major correlates of high QMPA scores are work burden variables. Being married or having pre-school children are also associated with high QMPA scores only when associated with work burden.