The social determinants of mental health and disorder: evidence, prevention and recommendations

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(1), P. 58 - 90

Published: Jan. 12, 2024

People exposed to more unfavourable social circumstances are vulnerable poor mental health over their life course, in ways that often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage health. Addressing these challenges is an imperative matter justice. In this paper we provide a roadmap address the determinants cause ill Relying as far possible on high-quality evidence, first map out literature supports causal link between later outcomes. Given breadth topic, focus most pervasive across those common major disorders. We draw primarily available evidence from Global North, acknowledging other global contexts will face both similar unique sets require equitable attention. Much our focuses groups who marginalized, thus multitude intersecting risk factors. These include refugees, asylum seekers displaced persons, well ethnoracial minoritized groups; lesbian, gay, bisexual, transgender queer (LGBTQ+) living poverty. then introduce preventive framework for conceptualizing disorder, can guide much needed primary prevention strategies capable reducing inequalities improving population Following this, review concerning candidate intervene interventions fall broadly within scope universal, selected indicated strategies, but also briefly important secondary tertiary promote recovery with existing Finally, seven key recommendations, framed around justice, constitute action research, policy public Adoption recommendations would opportunity advance efforts modifiable affect

Language: Английский

---

Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management

World Psychiatry, Journal Year: 2023, Volume and Issue: 22(3), P. 366 - 387

Published: Sept. 15, 2023

Populations with common physical diseases – such as cardiovascular diseases, cancer and neurodegenerative disorders experience substantially higher rates of major depressive disorder (MDD) than the general population. On other hand, people living MDD have a greater risk for many diseases. This high level comorbidity is associated worse outcomes, reduced adherence to treatment, increased mortality, health care utilization costs. Comorbidity can also result in range clinical challenges, more complicated therapeutic alliance, issues pertaining adaptive behaviors, drug‐drug interactions adverse events induced by medications used mental disorders. Potential explanations prevalence above involve shared genetic biological pathways. These latter include inflammation, gut microbiome, mitochondrial function energy metabolism, hypothalamic‐pituitary‐adrenal axis dysregulation, brain structure function. Furthermore, several antecedents related social factors (e.g., socioeconomic status), lifestyle variables activity, diet, sleep), stressful live childhood trauma). Pharmacotherapies psychotherapies are effective treatments comorbid MDD, introduction interventions well collaborative models digital technologies provide promising strategies improving management. paper aims detailed overview epidemiology specific including bidirectional risk; pathways potentially implicated pathogenesis diseases; socio‐environmental that serve both protective factors; management prevention treatment. We conclude future directions emerging research optimal

Language: Английский

---

Is There a Burnout Epidemic among Medical Students? Results from a Systematic Review

Medicina, Journal Year: 2024, Volume and Issue: 60(4), P. 575 - 575

Published: March 30, 2024

Background and Objectives: Medical students represent the ideal target group for promoting mental health wellbeing, being exposed to specific risk factors, such as content of medical training, exposure sickness death, a stressful academic routine. report high levels cynicism emotional exhaustion, which two essential features burnout syndrome. In this systematic review, studies assessing among through validated tools worldwide were analyzed. Materials Methods: A review has been performed in order identify studies: (1) focusing on samples students; (2) evaluating syndrome using tools; (3) providing prevalence data burnout; (4) written English. Results: Out 5547 papers initially obtained, 64 finally included analysis. The sample sizes ranged from 51 2682 participants. Almost all had cross-sectional design; Maslach Burnout Inventory its related versions most frequently used assessment tools. burnout, was stratified based gender stage, 5.6 88%. mostly predicted by thoughts stopping education, negative life events, lack support, dissatisfaction, poor motivation. Conclusions: is quite heterogeneous, reaching peak 88% some countries. However, several predictors have identified, including events or These findings highlight need develop preventive interventions targeting future generation doctors, improve their coping strategies resilience styles.

Language: Английский

---

The lived experience of mental disorders in adolescents: a bottom‐up review co‐designed, co‐conducted and co‐written by experts by experience and academics

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(2), P. 191 - 208

Published: May 10, 2024

We provide here the first bottom-up review of lived experience mental disorders in adolescents co-designed, co-conducted and co-written by experts academics. screened first-person accounts within outside medical field, discussed them collaborative workshops involving numerous - representing different genders, ethnic cultural backgrounds, continents their family members carers. Subsequently, material was enriched phenomenologically informed perspectives shared with all collaborators. The inner subjective is described for mood disorders, psychotic attention-deficit/hyperactivity disorder, autism spectrum anxiety eating externalizing self-harm behaviors. recollection individuals' past histories also indexes prodromal (often transdiagnostic) features predating psychiatric diagnosis. wider society respect to family, school peers, social context. Furthermore, health care receiving a diagnosis accessing support, psychopharmacological treatment, psychotherapy, experiencing peer support activism, achieving recovery. These findings can impact clinical practice, research, whole society. hope that this journey help us maintain our commitment protecting adolescents' fragile health, develop into healthy, fulfilling contributing adult life.

Language: Английский

---

Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders

JAMA Psychiatry, Journal Year: 2025, Volume and Issue: 82(3), P. 246 - 246

Published: Jan. 2, 2025

In the Netherlands, a growing group of young people request medical assistance in dying based on psychiatric suffering (MAID-PS). Little is known about this group, their characteristics, and outcomes. To assess proportion requests for deaths by MAID-PS among patients, outcomes application assessment procedures, characteristics those patients who died either MAID or suicide. This retrospective cohort study included Dutch individuals younger than 24 years requesting between January 1, 2012, June 30, 2021, whose patient file had been closed December 2022, at Expertisecentrum Euthanasie, specialized health care facility providing consultation care. Outcomes procedure (discontinued, rejected, MAID-PS) clinical The 397 processed applications submitted 353 (73.4% female; mean [SD] age, 20.84 [1.90] years). Between 2012 first half number increased from 10 to 39. most likely outcome was retracted (188 [47.3%]) followed rejected (178 [44.8%]). For 12 (3.0%), MAID. Seventeen (4.3%) were stopped because suicide during process 2 (0.5%) after they voluntarily eating drinking. All (n = 29) multiple diagnoses (most frequently major depression, autism spectrum disorder, personality disorders, and/or trauma-related disorder) extensive treatment histories. Twenty-eight these (96.5%) history suicidality that attempts prior application. Among 17 suicide, 13 14 (92.9%) crisis-related hospital admission, 9 (75.0%) self-harm. found Netherlands requested 2021 most. Those mostly female long histories prominent suicidality. These findings suggest there an urgent need more knowledge persistent death wishes effective prevention strategies high-risk group.

Language: Английский

---

Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

The Lancet Public Health, Journal Year: 2023, Volume and Issue: 8(11), P. e889 - e898

Published: Oct. 26, 2023

BackgroundAssessing the prevalence of clinically relevant depressive symptoms and their possible variation by country over time could be a valuable resource to inform development public health policies preventive resources reduce mental burden. We aimed assess cross-national differences in point Europe 2018–20, evaluate between countries 2013–15 2018–20.MethodsIn this population-based study, data from participants second third waves European Health Interview Survey (EHIS-2 2013 2015 EHIS-3 2018 2020) 30 were used (n=542 580). From total sample, 283 692 belonging included study (52·4% women 47·5% men). The non-response ranged country, 12% 78%. Point was evaluated using cutoff score 10 or more for 8-item version Patient Questionnaire. Crude ratios adjusted (aPRs) obtained within countries.FindingsThe 2018–20 6·54% (95% CI 6·34–6·73), ranging across 1·85% (1·53–2·17) Greece 10·72% (10·04–11·40) Sweden. Compared with other countries, those lowest aPRs Greece, Serbia, Cyprus highest Belgium, Slovenia, Croatia. A small but significant increase EHIS-2 observed (aPR 1·11 [1·07–1·14]). wide variability observed, an aPR 0·63 (0·54–0·74) Hungary 1·88 (1·53–2·31) Slovenia.InterpretationThis based on large representative datasets valid reliable screening tool assessment depression, indicates that 2020 remains relatively stable, countries. These findings considered baseline monitoring Europe, policy strategies depression both at level.FundingCenter Biomedical Research Epidemiology Public Network AGAUR.

Language: Английский

---

Validity of the five‐item mental health inventory for screening current mood and anxiety disorders in the general population

International Journal of Methods in Psychiatric Research, Journal Year: 2024, Volume and Issue: 33(3)

Published: July 2, 2024

Abstract Objectives The Mental Health Inventory (MHI‐5) is frequently used as a screener for mood and anxiety disorders. However, few population‐based studies have validated it against diagnostic instrument assessing disorders following current criteria. Methods Within the third Netherlands Survey Incidence Study (NEMESIS‐3), representative study of adults ( N = 6194; age: 18–75 years), MHI‐5 was to measure general mental ill‐health in past month. Presence (major depressive disorder, persistent or bipolar disorder) (panic agoraphobia, social phobia, generalized month assessed with slightly modified version Composite International Diagnostic Interview 3.0 per Statistical Manual disorders‐5. Results good excellent at distinguishing people without an any disorder. cut‐off value associated highest sensitivity specificity disorder ≤68, ≤76 Conclusions can identify individuals high risk population when interviews are too time consuming.

Language: Английский

---

Immuno-metabolic depression: from concept to implementation

The Lancet Regional Health - Europe, Journal Year: 2024, Volume and Issue: 48, P. 101166 - 101166

Published: Dec. 18, 2024

Language: Английский

---

Measuring Self-Referent Memory Bias as Marker for Depression: Overview, New Insights, and Recommendations

Journal of Psychopathology and Behavioral Assessment, Journal Year: 2025, Volume and Issue: 47(1)

Published: Jan. 13, 2025

Abstract Negative self-referent memory bias (the preferential for negative information) is a well-known symptom of depression and risk factor its development, maintenance, recurrence. Evidence shows potential as an add-on tool in clinical practice. However, it unclear which measure(s) could be clinically relevant. Here, first step, we investigate measures best differentiate current status track depressive severity most closely. The total sample ( N = 956) from three (naturalistic) psychiatric cohorts with matched controls was divided into depression, remitted non-disordered control group. Self-referent task were calculated the drift diffusion model (DDM) applied to assess underlying components cognitive decision making process. Measures compared between groups linear regression models their association severity. number endorsed words differentiated while combination positive words, bias, rate strongly associated Our results give direction implementation this task. Its value assessing, monitoring, predicting state trait settings requires further investigation.

Language: Английский

---

Specialized mental healthcare use for common mental disorders and prescription of antidepressants before and during the COVID-19 pandemic among working-age refugees and Swedish-born individuals – a nationwide register-based study

BMC Public Health, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 3, 2025

Abstract Background It is known that refugees have an elevated risk of common mental disorders (CMDs, including depression, anxiety, and stress-related disorders). The effect the coronavirus disease pandemic on healthcare use due to CMDs in yet unknown, especially socioeconomically deprived groups. We conducted a population-wide study comparing specialized for antidepressant prescriptions before during Swedish-born, investigated differences by labor market marginalization education. Methods An interrupted time series analysis quarterly cohorts (2018.01.01–2021.12.31) all aged 19 65 was applied. Information outcome measures covariates were linked individually from administrative registers. applied estimated incidence rate ratios (IRR) rates (IR) their corresponding confidence intervals (CI) pandemic. Results A total 4,932,916 individuals, whom 488,299 (9.9%) refugees, included at baseline. observed 3% (95% CI: 1%, 5%) increase trends but no changes Swedish-born individuals. IRRs larger whose position marginalized (IRR: 6%, (3%, 9%)), with low education level 4% (1%, 7%)). There substantial prescription. Conclusion Refugees, those already position, had increased CMD-related Strategies meet health care needs are outmost public importance.

Language: Английский

---