Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are ...especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.
To investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.
Data from four population studies were used: two early adolescence studies (ages 11-13 years) and two mid-adolescence studies (ages 13-16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11-16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11-15 years.
Younger adolescents had a higher prevalence (21-23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.
Psychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
Abstract Suicide is a major public health problem in the WHO European Region accounting for over 150,000 deaths per year. Suicidal crisis Acute intervention should start immediately in order to keep ...the patient alive. Diagnosis An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. Treatment Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (CBT) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant treatment decreases the risk for suicidality among depressed patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10–14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. Treatment team Multidisciplinary treatment teams including psychiatrist and other professionals such as psychologist, social worker, and occupational therapist are always preferable, as integration of pharmacological, psychological and social rehabilitation is recommended especially for patients with chronic suicidality. Family The suicidal person independently of age should always be motivated to involve family in the treatment. Social support Psychosocial treatment and support is recommended, as the majority of suicidal patients have problems with relationships, work, school and lack functioning social networks. Safety A secure home, public and hospital environment, without access to suicidal means is a necessary strategy in suicide prevention. Each treatment option, prescription of medication and discharge of the patient from hospital should be carefully evaluated against the involved risks. Training of personnel Training of general practitioners (GPs) is effective in the prevention of suicide. It improves treatment of depression and anxiety, quality of the provided care and attitudes towards suicide. Continuous training including discussions about ethical and legal issues is necessary for psychiatrists and other mental health professionals.
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Pathological Internet use (PIU) has been conceptualized as an impulse-control disorder that shares characteristics with behavioral addiction. Research has indicated a potential link between PIU and ...psychopathology; however, the significance of the correlation remains ambiguous. The primary objective of this systematic review was to identify and evaluate studies performed on the correlation between PIU and comorbid psychopathology; the secondary aims were to map the geographical distribution of studies, present a current synthesis of the evidence, and assess the quality of available research.
An electronic literature search was conducted using the following databases: MEDLINE, PsycARTICLES, PsychINFO, Global Health, and Web of Science. PIU and known synonyms were included in the search. Data were extracted based on PIU and psychopathology, including depression, anxiety, symptoms of attention deficit and hyperactivity disorder (ADHD), obsessive-compulsive symptoms, social phobia and hostility/aggression. Effect sizes for the correlations observed were identified from either the respective publication or calculated using Cohen's d or R(2). The potential effect of publication bias was assessed using a funnel plot model and evaluated by Egger's test based on a linear regression.
The majority of research was conducted in Asia and comprised cross-sectional designs. Only one prospective study was identified. Twenty articles met the preset inclusion and exclusion criteria; 75% reported significant correlations of PIU with depression, 57% with anxiety, 100% with symptoms of ADHD, 60% with obsessive-compulsive symptoms, and 66% with hostility/aggression. No study reported associations between PIU and social phobia. The majority of studies reported a higher rate of PIU among males than females. The relative risks ranged from an OR of 1.02 to an OR of 11.66. The strongest correlations were observed between PIU and depression; the weakest was hostility/aggression.
Depression and symptoms of ADHD appeared to have the most significant and consistent correlation with PIU. Associations were reported to be higher among males in all age groups. Limitations included heterogeneity in the definition and diagnosis of PIU. More studies with prospective designs in Western countries are critically needed.
The hypothesis that the S allele of the 5-HTTLPR serotonin transporter promoter region is associated with increased risk of depression, but only in individuals exposed to stressful situations, has ...generated much interest, research and controversy since first proposed in 2003. Multiple meta-analyses combining results from heterogeneous analyses have not settled the issue. To determine the magnitude of the interaction and the conditions under which it might be observed, we performed new analyses on 31 data sets containing 38 802 European ancestry subjects genotyped for 5-HTTLPR and assessed for depression and childhood maltreatment or other stressful life events, and meta-analysed the results. Analyses targeted two stressors (narrow, broad) and two depression outcomes (current, lifetime). All groups that published on this topic prior to the initiation of our study and met the assessment and sample size criteria were invited to participate. Additional groups, identified by consortium members or self-identified in response to our protocol (published prior to the start of analysis) with qualifying unpublished data, were also invited to participate. A uniform data analysis script implementing the protocol was executed by each of the consortium members. Our findings do not support the interaction hypothesis. We found no subgroups or variable definitions for which an interaction between stress and 5-HTTLPR genotype was statistically significant. In contrast, our findings for the main effects of life stressors (strong risk factor) and 5-HTTLPR genotype (no impact on risk) are strikingly consistent across our contributing studies, the original study reporting the interaction and subsequent meta-analyses. Our conclusion is that if an interaction exists in which the S allele of 5-HTTLPR increases risk of depression only in stressed individuals, then it is not broadly generalisable, but must be of modest effect size and only observable in limited situations.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
•Mental health was associated with low-grade inflammation in the general population.•Lifestyles largely explained the association with depressive symptoms.•Platelet distribution width was positively ...associated with depressive symptoms.•Neutrophil-to-lymphocyte ratio was negatively associated with mental wellbeing.
Mental health modulates the risk of common chronic conditions. Although inflammation is thought to partly explain this link, its relation with mental health is still unclear and largely unexplored.
We investigated three scales assessing psychological resilience (CD-RISC), depression symptoms (PHQ9-6) and mental wellbeing (SF36-MCS) in an Italian adult population cohort (Nmax = 16,952). This showed a slightly higher frequency of men, more educated and younger participants, compared to samples with incomplete questionnaires. We performed stepwise generalized linear models to test the association between each scale and INFLA-score, a composite blood-based inflammation index. At each step, a class of potential mediators was included in the model, namely health conditions, lifestyle factors, or both (full model). Full model analysis was also conducted on single blood markers involved in the inflammatory process.
In the baseline model, we observed significant associations of PHQ9-6 (standardized β(SE) = 0.024(0.009), p = 8.9 × 10−3) and SF36-MCS (β(SE) = −0.021(0.008), p = 7 × 10−3) with INFLA-score. These associations survived adjustment for health conditions but not for lifestyle factors, which explained 81% and 17% of the association with PHQ9-6 and SF36-MCS. Significant associations (p < 4.2 × 10−3) after mediator adjustment were observed for single low-grade inflammation markers, including platelet distribution width (with PHQ9-6 and CD-RISC), granulocyte- and neutrophil-to-lymphocyte ratios, monocyte and lymphocyte fractions (with SF36-MCS). After imputation of missing data, we observed substantially consistent associations.
These findings suggest that the relationship between mental health and low-grade inflammation is largely influenced by lifestyle. However, the associations with specific biomarkers related to inflammation are partly independent and might be explained by biological factors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction Adequate sleep is essential for good health. Several research show that sleep problems may increase risk to develop different disorders. In particular, the high prevalence and ...comorbidity of anxiety and sleep problems suggest an important relationship between these two disorders. Importantly, there is evidence that sleep complaints are more common in suicidal patients. Indeed, poor sleep and sleep disturbances are common in depressive disorders and other psychopathological conditions potentially associated with suicidal risk. Sleep problems in children and adolescents are common, and sleep disruption is associated with a wide range of behavioral, cognitive, and mood impairments, including hyperactivity, lower school grades, and depression. Objectives increasing the knowledge about the relationship between sleep problems, anxiety and depression disorders and mental health disorders in young. Through the new knowledge to develop strategies in order to prevent the risk conditions among young. Aims improve mental health among young. Methods A cross-sectional analysis of the correlation between number of hours of sleep per night by the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel suicidal Scale (PSS) and the Strengths and difficulties questionnaire (SDQ) was performed on 11,788 students (mean age: 14.9±0.9 M/F: 5181/6552) from 11 different European countries involved in the SEYLE project (Saving and Empowering Young Lives in Europe). Conclusions . Sleep problems are very common among adolescents and often, as other at-risk behaviors, occur with some types of psychological distress. It's important to identify strategies of interventions that pay more attention of unhealthy sleep patterns
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Introduction Internet currently has 513 million users worldwide and the young continue to be one of the highest users of the Internet. Often the young choose to use the media for get answers to their ...questions and also for search for mental healthrelated information. The researches show a rapid growth of mental disorders among young that often co-occurs with risk behaviours, such as suicide, which is one of the leading cause of death among young ages 15–34. Therefore it's necessary to use some tools that can promote mental health getting to young lives such as Internet and media. Objectives increasing the knowledge on the use of internet and media in order to promote the mental health and to prevent at-risk behaviors among young. Aims The main expected outcome is to improve mental health among young. Methods SUPREME - Suicide Prevention by Internet and Media Based Mental Health Promotion, European Project for the prevention of risk behaviours and mental health promotion through the use of mass media and Internet. The Project, financed by EACH and DG SANCO EU Public Health is developed by a consortium of 7 European countries. The intervention comprise of a highly interactive website targeted at young. In each participating country, a sample of 300 pupils have been selected and randomized in one of three different intervention arms. Conclusions Internet and media can be used how efficient instruments to spread information among adolescents and to promote programs aimed to improve their mental health and well-being.
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9.
Controlling access to suicide means Sarchiapone, Marco; Mandelli, Laura; Iosue, Miriam ...
International journal of environmental research and public health,
12/2011, Volume:
8, Issue:
12
Journal Article
Peer reviewed
Open access
Restricting access to common means of suicide, such as firearms, toxic gas, pesticides and other, has been shown to be effective in reducing rates of death in suicide. In the present review we aimed ...to summarize the empirical and clinical literature on controlling the access to means of suicide.
This review made use of both MEDLINE, ISI Web of Science and the Cochrane library databases, identifying all English articles with the keywords "suicide means", "suicide method", "suicide prediction" or "suicide prevention" and other relevant keywords.
A number of factors may influence an individual's decision regarding method in a suicide act, but there is substantial support that easy access influences the choice of method. In many countries, restrictions of access to common means of suicide has lead to lower overall suicide rates, particularly regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging, by introducing "safe rooms" in prisons and hospitals. Moreover, decline in prescription of barbiturates and tricyclic antidepressants (TCAs), as well as limitation of drugs pack size for paracetamol and salicylate has reduced suicides by overdose, while increased prescription of SSRIs seems to have lowered suicidal rates.
Restriction to means of suicide may be particularly effective in contexts where the method is popular, highly lethal, widely available, and/or not easily substituted by other similar methods. However, since there is some risk of means substitution, restriction of access should be implemented in conjunction with other suicide prevention strategies.
There is no health without mental health. This WHO slogan symbolizes that that any health promotion should include mental health components. It is evident that effective mental health promotion ...techniques are successful in increasing improved mental health and well-being among adolescents. Research has demonstrated that the Internet and the media are effective tools to disseminate mental health information and education to adolescents; however, fundamental issues still remain in this procedure. If used improperly, the information disseminated on the Internet can result in serious detrimental consequences on adolescents’ mental health and well-being. On the other hand, if the information is supportive, informative and educational, the effects can be positive. Many adolescents that suffer from social isolation reach out on the Internet as a way to cope with feelings of loneliness and social exclusion. Therefore, there is a unique opportunity to utilize the Internet as a means of communication to reach vulnerable adolescents who suffer from social exclusion, in which cases otherwise go undetected. Moreover, given that Europe, as a whole, is an extensive multicultural environment, requires considerable thought in preparing and adapting culturally-specific interventions that can be implemented in each respective European country. For this reason, resources used in a mental health intervention across Europe necessitate a culturally diverse partnership for materials to be translated and culturally adapted to the respective European region or area.
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