Category: Mental Health Research

Refugee Children & Adolescents and PTSD

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Research Paper Title

Traumatic experiences of conditional refugee children and adolescents and predictors of post-traumatic stress disorder: data from Turkey.

Background

The researchers aimed to determine traumatic events, mental health problems and predictors of PTSD in a sample of conditional refugee children.

Methods

The sociodemographic features, chief complaints, traumatic experiences and psychiatric diagnoses according to DSM-5 were evaluated retrospectively.

Results

20.7% (n = 70) of children experienced the armed conflict or exposed to firefights at their country of origin. Most common diagnoses were anxiety disorders (n = 82, 24.3%), major depressive disorder (n = 52, 15.4%) and PTSD (n = 43, 12.7%). Age, number of traumatic experiences, explosion and sexual violence are the most important predictors for PTSD.

Conclusions

The results suggest that the number of traumas exposed as well as their nature predicted PTSD diagnosis. Refugee children have increased risk for psychiatric problems after migration and resettlement underlining the importance of an adequate follow-up for mental health and ensuring social support networks.

Reference

Yektas, C., Erman, H. & Tufan, A.E. (2021) Traumatic experiences of conditional refugee children and adolescents and predictors of post-traumatic stress disorder: data from Turkey. doi: 10.1080/08039488.2021.1880634. Online ahead of print.

Mental Health Inequalities in Non-Heterosexuals & Heterosexuals

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Research Paper Title

The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples.

Background

Evidence on inequalities in mental health in lesbian, gay, and bisexual people arises primarily from non-random samples.

The aim of this study was to use a probability sample to study change in mental health inequalities between two survey points, 7 years apart; the contribution of minority stress; and whether associations vary by age, gender, childhood sexual abuse, and religious identification.

Methods

The researchers analysed data from 10 443 people, in two English population-based surveys (2007 and 2014), on common mental disorder (CMD), hazardous alcohol use, and illicit drug use. Multivariable models were adjusted for age, gender, and economic factors, adding interaction terms for survey year, age, gender, childhood sexual abuse, and religious identification. They explored bullying and discrimination as mediators.

Results

Inequalities in risks of CMD or substance misuse were unchanged between 2007 and 2014. Compared to heterosexuals, bisexual, and lesbian/gay people were more likely to have CMD, particularly bisexual people [adjusted odds ratio (AOR) = 2.86; 95% CI 1.83-4.46], and to report alcohol misuse and illicit drug use. When adjusted for bullying, odds of CMD remained elevated only for bisexual people (AOR = 3.21; 95% CI 1.64-6.30), whilst odds of alcohol and drug misuse were unchanged. When adjusted for discrimination, odds of CMD and alcohol misuse remained elevated only for bisexual people (AOR = 2.91; 95% CI 1.80-4.72; and AOR = 1.63; 95% CI 1.03-2.57 respectively), whilst odds of illicit drug use remained unchanged. There were no interactions with age, gender, childhood sexual abuse, or religious identification.

Conclusions

Mental health inequalities in non-heterosexuals have not narrowed, despite increasing societal acceptance. Bullying and discrimination may help explain the elevated rate of CMD in lesbian women and gay men but not in bisexual people.

Reference

Pitman, A., Marston, L., Lewis, G., Semlyen, J., McManus, S. & King, M. (2021) The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples. Psychological Medicine. doi: 10.1017/S0033291721000052. Online ahead of print.

Adolescents, Depression & Low Income Countries

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Research Paper Title

Mind the brain gap: The worldwide distribution of neuroimaging research on adolescent depression.

Background

Adolescents comprise one fourth of the world’s population, with about 90% of them living in low- and middle-income countries (LMICs).

The incidence of depression markedly increases during adolescence, making the disorder a leading cause of disease-related disability in this age group.

However, most research on adolescent depression has been performed in high-income countries (HICs).

Methods

To ascertain the extent to which this disparity operates in neuroimaging research, a systematic review of the literature was performed.

Results

A total of 148 studies were identified, with neuroimaging data available for 4,729 adolescents with depression.

When stratified by income group, 122 (82%) studies originated from HICs, while 26 (18%) were conducted in LMICs, for a total of 3,705 and 1,024 adolescents with depression respectively.

A positive Spearman rank correlation was observed between country per capita income and sample size (rs=0.673, p = 0.023).

Conclusions

The results support the previous reports showing a large disparity between the number of studies and the adolescent population per world region.

Future research comparing neuroimaging findings across populations from HICs and LMICs may provide unique insights to enhance our understanding of the neurobiological processes underlying the development of depression.

Reference

Battel, L., Cunegatto, F., Viduani, A., Fisher, H.L., Kohrt, B.A., Mondelli, V., Swartz, J.R. & Kieling, C. (2021) Mind the brain gap: The worldwide distribution of neuroimaging research on adolescent depression. Neuroimage. doi: 10.1016/j.neuroimage.2021.117865. Online ahead of print.

PHQ-9 & GAD-7 Data in a National Survey about COVID-19 Restrictions in Australia

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Research paper Title

Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) data contributed by 13,829 respondents to a national survey about COVID-19 restrictions in Australia.

Background

While the Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) are frequently used in mental health research, few studies have reported comprehensive data on these measures from population or community samples.

The aim of this study was to describe gender- and age-specific PHQ-9 and GAD-7 item and summary data contributed by those who completed this survey.

Methods

The PHQ-9 and GAD-7 were used as indicators of symptoms of depression and anxiety in a national online anonymous survey to assess the mental health of adults in Australia during the COVID-19 restrictions.

Data were analysed descriptively.

Results

Complete survey responses were contributed by 13,829 people.

For both measures, item-by-item results, summary statistics (mean, standard deviation, minimum, maximum, median and interquartile range) and prevalence of severity categories are reported for the whole sample, and disaggregated by gender and age groups.

Conclusions

These comprehensive data provide a useful point of comparison for future COVID-19-related or other research among population or community samples.

Other researchers are encouraged to report detailed PHQ-9 and GAD-7 data in the future, to enable and promote relevant between-group comparisons.

Reference

Stocker, R., Tran, T., Hammarberg, K., Nguyen, H., Rowe, H. & Fisher, J. (2021) Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) data contributed by 13,829 respondents to a national survey about COVID-19 restrictions in Australia. Psychiatry Research. doi: 10.1016/j.psychres.2021.113792. Online ahead of print.

Is There Value in Targeted Screening & Intervention Programmes of Anxiety in Young Adult Offspring with Parental Mental Health Problems?

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Research Paper Title

Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study.

Background

Epidemiological studies indicate that children of parents with mental health problems are at an increased risk of developing anxiety disorders.

Few studies have investigated this relationship in young adults.

Methods

Participants were from the Raine Study, which is a multi-generational birth cohort study in Australia. Maternal anxiety and depression in late childhood were assessed using the Depression, Anxiety, and Stress Scale (DASS-42), and paternal lifetime mental health problems were assessed using a self-reported questionnaire.

The short form of DASS-42 (DASS-21) was used to assess anxiety symptoms among offspring at age 20. Negative binomial regression model was used to quantify the association. Data were available for 1,220 mother-offspring and 1,190 father-offspring pairs.

Results

After adjusting for potential confounders, the researchers found an increased risk of anxiety in young adult offspring exposed to maternal anxiety in late childhood and paternal lifetime mental health problems. However, they observed no increased risks of anxiety in offspring exposed to maternal depressive symptoms. Their sensitivity analysis based on the log-binomial model (binary outcome) as well as the linear model (log-transformed data) confirmed the robustness of the main results.

Conclusions

The findings suggest there can be value to consider and apply targeted screening and intervention programmes of anxiety in the young adult offspring with parental mental health problems.

Reference

Ayano, G., Betts, K., Lin, A., Tait, R. & Alati, R. (2021) Associations of maternal and paternal mental health problems with offspring anxiety at age 20 years: Findings from a population-based prospective cohort study. Psychiatry Research. doi: 10.1016/j.psychres.2021.113781. Online ahead of print.

Linking Age, COVID-19 & First Episodes Psychosis

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Research Paper Title

Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, Italy.

Background

The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms.

The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalised in the first four months since lockdown in Milan.

Methods

The researchers recruited sixty-two patients hospitalised between 08 March to 08 July 2020 versus those first hospitalised in the same period in 2019.

The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes.

Results

Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse.

Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019.

Conclusions

These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.

Reference

Esposito, C.M., D’Agostino, A., Osso, B.D., Fiorentini, A., Prunas, C., Callari, A., Oldani, L., Fontana, E., Gargano, G., Viscardi, B., Giordano, B., D’Angelo, S., Widenmann, F., Macellaro, M., Giorgetti, F., Turtulici, N., Gambini, O. & Brambilla, P. (2021) Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, Italy. Psychiatry Research. doi: 10.1016/j.psychres.2021.113802. Online ahead of print.

Linking Depressive Symptoms & Academic Achievement in UK Adolescents

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Research Paper Title

Depressive symptoms and academic achievement in UK adolescents: a cross-lagged analysis with genetic covariates.

Background

The relationship between adolescent depressive symptoms and academic achievement remains poorly understood. The aim of this study was to help clarify the nature and directionality of this association.

Methods

The researchers used a sample of 13,599 British adolescents (main sample of N=3,809 participants). They fitted cross-lagged panel models using four repeated measures of self-reported depressive symptoms and four measures of academic achievement based on British national records between 11-18 years, separately for male and female adolescents and considering polygenic risk scores (PRS) for educational attainment and depression, alongside other child and parental covariates.

Observational design, variation around measurement times, missing data.

Results

The researchers found evidence of an overall negative association that was stronger in boys (R=-0.21, 95% CI -0.31 to -0.11) than in girls (-0.13, -0.31 to 0.05). Higher depressive symptoms were associated with lower academic achievement at a later stage up to the end of compulsory education (16 years), when the direction of the association reversed, although girls with lower achievement also appeared vulnerable to depressive symptoms at previous stages. The genetic variables derived for this study showed stronger associations for academic achievement, but the PRS for depression also showed a negative association with academic achievement in girls. Child intelligence quotient and peer victimisation also showed relevant associations.

Conclusions

Depressive symptoms and academic achievement should be considered jointly when designing school-based programmes for children and adolescents, alongside gender, child ability and school experience. Including genetic information in research can help to disentangle average from time-varying effects.

Reference

Lopez-Lopez, J.A., Kwong, A.S.F., Washbrook, L., Tilling, K., Fazel, M.S. & Pearson, R.M. (2021) Depressive symptoms and academic achievement in UK adolescents: a cross-lagged analysis with genetic covariates. Journal of Affective Disorders. 284, pp.104-113. doi: 10.1016/j.jad.2021.01.091. Online ahead of print.

Linking Depression & Internet Gaming Disorder

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Research Paper Title

Depressive symptoms and depression in individuals with internet gaming disorder: A systematic review and meta-analysis.

Background

Although depression has frequently been associated with Internet Gaming Disorder (IGD), its epidemiological impact on this emerging condition has not been systematically assessed. In this study, the researchers aimed to synthesize the available evidence focusing on depression and depressive symptoms in individuals with IGD.

Methods

The researchers searched PubMed, Embase, PsycINFO, GreyLit, OpenGrey, and ProQuest up to March 2020 for observational studies focusing on depression-related outcomes in IGD. They conducted random-effects meta-analyses on 1) rate of comorbid depression in IGD; 2) severity of depressive symptoms in IGD participants without depression.

Results

The researchers identified 92 studies from 25 different countries including 15,148 participants. 21 studies (n = 5025 participants) provided data for the first analysis, resulting in a pooled event rate of depression of 0.32 (95% Confidence Interval 0.21-0.43). The pooled Beck Depression Inventory scores in individuals without depression were suggestive of mild severity (13 studies, n = 508; 10.3, 95% Confidence Interval 8.3-12.4).

Conclusions

The considerable inconsistency of methods employed across studies limits the transferability of these findings to clinical practice.

The prevalence of depression in individuals with IGD varied considerably across studies, affecting approximately one out of three participants overall. Furthermore, a globally major severity of depressive symptoms was found in those without a clinical diagnosis of depression, compared to the general population.

These findings confirm a relevant impact of mood disturbances in IGD.

Reference

Ostinelli, E.G., Zangani, C., Giordano, B., Maestri, D., Gambini, O., D’Agostino, A., Furukawa, T.A. & Purgato, M. (2021) Depressive symptoms and depression in individuals with internet gaming disorder: A systematic review and meta-analysis. Journal of Affective Disorders. doi: 10.1016/j.jad.2021.02.014. Online ahead of print.

Deprescribing & Antidepressant Use in Older Adults

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Research Paper Title

Long term antidepressant use in a cohort of older people.

Background

Depression is the most common mental health problem in older adults and untreated is associated with significant burden of illness for patients. This study aimed to examine longitudinal patterns of antidepressant use in older adults and determine which factors were associated with changes in use.

Methods

Adults aged 50 and over, from the Irish Longitudinal Study on Ageing, who participated at any one of the four TILDA waves (n = 8,175) were included in the analysis. Repeated measures latent class analysis (RMLCA) is the model-based approach we used to identify underlying subgroups in a population.

Results

The researchers found antidepressant use ranged from 6% to 10%, over a 6-year period. RMLCA identified three distinct classes of anti-depressant use. Notably, 6% of older adults were categorised in a ‘long-term antidepressant use’ class, with consistent use across all four waves, and 6% were categorised in an ‘Intermittent/ Developing Use’ class. We found long-term antidepressant use to be a characteristic of older adults with chronic conditions at baseline of study and striking low uptake of psychological and psychiatric services.

Conclusions

These findings provide evidence of the complex presentations of depression with comorbidities in long-term antidepressant users. While prolonged use of antidepressants in an older cohort is often rationalised due to recurrent depression and comorbidities, this study suggests little deprescribing of antidepressants and a need for greater access and provision of psychological services tailored to later life seem necessary to improve management of this condition.

Reference

O’Neill, A., McFarland, J. & Kelly, D. (2021) Long term antidepressant use in a cohort of older people. International Journal of Geriatric Psychiatry. doi: 10.1002/gps.5518. Online ahead of print.

Interoceptive Impairment & Non-Suicidal Self-Injury

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Research Paper Title

A multi-measure examination of interoception in people with recent nonsuicidal self-injury.

Background

Self-injurious behaviors (SIB) are highly dangerous, yet prediction remains weak. Novel SIB correlates must be identified, such as impaired interoception. This study examined whether two forms of interoceptive processing (accuracy and sensibility) for multiple sensations (general, cardiac, and pain) differed between people with and without recent nonsuicidal self-injury (NSSI).

Methods

Participants were adults with recent (n = 48) NSSI and with no history of SIBs (n = 55). Interoceptive sensibility was assessed with self-reports. Interoceptive accuracy for cardiac sensations was assessed using the heartbeat tracking task. Interoceptive accuracy for pain was assessed with a novel metric that mirrored the heartbeat tracking test.

Results

Participants with recent NSSI reported significantly lower interoceptive sensibility for general sensations relative to people without SIBs. Groups did not differ on interoceptive sensibility for cardiac sensations or pain. Groups also did not differ on interoceptive accuracy for cardiac sensations. The NSSI group exhibited significantly lower interoceptive accuracy for pain compared with the No SIB group.

Conclusions

Interoceptive impairment in people with NSSI may vary by interoceptive domain and sensation type. Diminished interoceptive accuracy for sensations relevant to the pathophysiology of self-injury may be a novel SIB correlate.

Reference

Forrest, L.N. & Smith, A.R. (2021) A multi-measure examination of interoception in people with recent nonsuicidal self-injury. Suicide & Life-Threatening Behaviour. doi: 10.1111/sltb.12732. Online ahead of print.