Suicidal thoughts and behaviours (STB) are common in Australia, yet many individuals do not seek clinical care. Evidence on STB and help-seeking among culturally and linguistically diverse (CALD) populations is limited. This study examined the prevalence of suicide ideation and attempts by region of birth, and patterns of formal and informal help-seeking. This study used data from the National Study of Mental Health and Wellbeing (2020–2022; N = 15,893). Prevalence of lifetime suicide ideation and attempts was estimated by region of birth. Latent class analysis identified patterns of help-seeking, and regression models examined associations between cultural factors and class membership. Overall, 16.4
This study examines how genetic liability for Attention-Deficit/Hyperactivity Disorder (ADHD), measured using a polygenic index (ADHD-PGI), relates to both objective and subjective socio-economic outcomes in the general population. We studied six Finnish population-based cohorts (1992–2017; N = 20,121), linking genetic, registry and survey data. Probit and ordered probit models estimated associations between ADHD-PGI and sequential socio-economic outcomes: educational attainment, employment, occupational selection, income and economic satisfaction. Higher ADHD-PGI was strongly associated with lower educational attainment (P < 0.001); individuals in the top ADHD-PGI quintile were 9.2
Caregiving for individuals diagnosed with fully dependent schizophrenia is a multidimensional process that extends far beyond providing physical assistance. It profoundly influences caregivers’ emotional, physical, social, and economic well-being. Understanding these experiences is essential for developing holistic and sustainable care models that support both patients and caregivers. This study aimed to explore and interpret the lived experiences of caregivers providing continuous care to fully dependent individuals diagnosed with schizophrenia, with a focus on the emotional, social, and systemic dimensions of caregiving. A qualitative research design based on the phenomenological approach was adopted. The study was conducted at the Psychiatry Outpatient Clinic of Sakarya University Training and Research Hospital between January and April 2025. Eighteen adult caregivers who had provided care for at least six months were recruited using purposive sampling until data saturation was achieved. Data were collected through semi-structured in-depth interviews and analyzed using Colaizzi’s seven-step phenomenological method. Five main themes were identified: (1) Diagnosis and Initial Reactions, (2) Care Responsibilities and Daily Routines, (3) Effects of Caregiving on the Caregiver, (4) Relations with Society and the Social Environment, and (5) Perceptions of Systemic and Institutional Support. The findings revealed that caregiving leads to emotional exhaustion, social isolation, and physical fatigue. Religious beliefs and meaning-making processes acted as important coping mechanisms. Additionally, participants reported significant economic difficulties, insufficient institutional support, and experiences of social stigma. Positive views on Community Mental Health Centers (CMHC) were expressed, though accessibility remained unequal across regions. Caring for fully dependent individuals with schizophrenia represents a complex and lifelong responsibility that reshapes caregivers’ personal, emotional, and social lives. The findings highlight the necessity of structured psychosocial support programs, improved accessibility to community-based mental health services, and stigma reduction initiatives. Family physicians, through their continuity, comprehensiveness, and person-centered approach, are in a key position to identify caregiver burnout, coordinate multidisciplinary support, and strengthen the integration between primary and psychiatric care systems.
Emerging adults experience the highest rates of mental health problems but the lowest rates of treatment engagement among U.S. adults. Stigma is a well-known barrier to care, undermining outcomes along the mental health treatment cascade from symptom recognition to treatment seeking. In the present study, we examine differences in experiences of stigma among emerging adults based on the presence, recognition, and/or diagnosis of mental health problems. The Voices for Well-Being (Project VOW) is a 12-wave longitudinal study of stigma and mental health in emerging adults (ages 18–21) recruited nationally via snowball and convenience sampling, surveyed quarterly for three years. Using baseline data, we classified participants into four groups: (1) no mental health problem history (n = 608); (2) recognized and diagnosed (n = 2566); (3) recognized and undiagnosed (n = 1417) and (4) unrecognized mental health problem (n = 91). We examined demographic profiles and compared groups across stigma mechanisms (stereotypes, prejudice, discrimination, perceived, anticipated, experienced, and internalized stigma) using ANCOVA models. The Project VOW Cohort is demographically diverse with a high mental health burden; 54.4
Exposure to war and terrorism increases the risk of mental health problems and often leads to economic hardship, which can further heighten psychological distress. This longitudinal study examined the extent of economic hardship experienced during the Israel–Hamas war following the October 7th terrorist attack, the severity of mental health symptoms over the first year of the war, and the associations and temporal directionality between economic hardship and mental health. A representative sample of Jewish Israeli adults (N = 1,035) completed surveys at four time points: two weeks, and two, six, and 12 months after the attack. Participants reported economic hardship events (e.g., job loss, reduced income, unpaid leave, increased expenses, business losses) and symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Psychological symptoms remained elevated throughout the year, declining from two weeks to two and six months after the attack, but rising again by 12 months. Economic hardship was prevalent and consistently associated with worse mental health outcomes. Longitudinal analyses showed a dynamic pattern: in the early stage of the war, poorer mental health predicted subsequent economic hardship, whereas later in the year, economic hardship predicted increases in depression, anxiety, and PTSD symptoms. Psychological distress and economic hardship mutually influence one another across different stages of prolonged mass trauma. Integrating economic assistance with psychological support may help reduce long-term mental health impacts.
Screening is essential to bridge the significant care gap that exists for depression. PHQ-9 is a brief, valid, and reliable questionnaire, making it a valuable tool for detecting depression in both clinical and community settings. However, there is a lack of culturally and contextually appropriate local language versions of the PHQ-9, especially in India. This study aims to culturally adapt the existing Marathi version of the PHQ-9 for a rural Marathi-speaking population and evaluate its diagnostic accuracy and psychometric properties for detecting depression. We followed the World Health Organization’s guidelines for the cultural adaptation of the PHQ-9, followed by the assessment of criterion, construct, and convergent and divergent validity, as well as reliability. We compared the performance of the Marathi version of the PHQ-9 with that of the semi-structured diagnostic interview. We also assessed test-retest and inter-rater reliability by estimating the Intraclass Correlation Coefficient (ICC) and internal consistency by calculating Cronbach’s alpha. For the Marathi version of PHQ-9, Area Under the Curve (AUROC) was 0.88 (95
To estimate the pooled mean severity of nomophobia and describe associated sociodemographic patterns among university students through a systematic review with meta-analysis and meta-regression. A systematic review of observational studies was conducted and registered in PROSPERO (CRD420261320594). Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and ERIC up to February 28, 2026. Studies including adult university students (≥ 18 years) and assessing nomophobia using the Nomophobia Questionnaire (NMP-Q) were eligible. Pooled mean nomophobia scores were estimated using random-effects models. Heterogeneity was assessed using the I2 statistic and explored through subgroup analyses and meta-regression according to age, sex, and country income level. Nineteen observational studies comprising 12,079 university students from 11 countries were included. The pooled mean nomophobia score was 75.74 (95
Many caregivers of people with psychosis are at risk of distress, which can have negative consequences for well-being and service user outcomes. A number of appraisals of caregiving and avoidant coping styles have been associated with caregiver burden, burnout and distress, but understanding how these co-occur might further identify those at risk of poorer outcomes. To determine if there are distinct caregiver profiles of appraisals and avoidant coping in early psychosis (EP). Further aims were to understand whether there are sociodemographic differences in the identified profiles. The study analysed data collected from 254 caregivers within a London-based Early Intervention Service (EIS). Appraisals, beliefs and avoidant coping style measured using self-report questionnaires were entered into Latent Profile Analysis (LPA). Relationships between identified profiles and sociodemographics were assessed via chi-square tests. LPA identified three caregiving profiles which were defined as: (i) Engagement and Rewarding (21.3
Social exclusion encompasses multiple domains, material, digital, relational, political, and structural. These may have different impacts on an individual’s mental health. We evaluated associations between domains of social exclusion and mental health problems in a sample of English adults. Using data from Understanding Society, we analysed social exclusion exposures and mental health outcomes at Wave 11 (2019-21) among 34,403 adults. We generated standardised domain scores and an overall social exclusion measure using principal component analysis. Mental health was assessed using the General Health Questionnaire (GHQ-12) continuous symptom scores (range 0–36). We used survey-weighted linear regression models adjusted for age, sex, and ethnicity. Each standard deviation increase in overall social exclusion was associated with 1.28-point increase in GHQ-12 symptoms (95 β =1.34, 95 β =1.37, 95 β =0.15 to 0.37). Associations did not differ by sex and remained robust when examining mental health caseness as a binary outcome. Social exclusion was associated with worse mental health, with strongest effects for relational and material domains. Policies targeting these domains may have the largest impact on population mental health.
A growing emphasis on autonomy, manifest through the influence of recovery orientations, user involvement, and the broader shift towards patient-centered healthcare, has significantly influenced mental health care. The Convention on the Rights of Persons with Disabilities (CRPD) is a pivotal development in this regard, challenging longstanding practices in mental health care and particularly involuntary care. This study examined how European mental health legislation seeks to promote the autonomy of those subjected to involuntary care, by analyzing laws from 27 jurisdictions. Data was collected via a comprehensive survey between July 2023 and September 2024, completed by country representatives from the EU COST Action FOSTREN network. We examined the letter of the law as regards 16 autonomy-promoting provisions including the principle of least restriction, capacity-based criteria, supported decision-making, advance healthcare directives, treatment plans, rights to appeal, legal aid, advocacy services, and oversight mechanisms. Most laws across the 27 jurisdictions were amended in the last eight years. All legislations included at least one measure related to the principle of least restriction, the right to appeal against involuntary status, and support to do so, such as legal aid. In contrast, mechanisms designed to support autonomous decision-making, such as Advance Healthcare Directives and Supported Decision-Making, were less frequently included as a right. While procedural legal safeguards are well established, there is significant variation in the adoption of other legal mechanisms to afford statutory rights to individuals in line with autonomy promoting approaches, including the CRPD.
Family structure transitions affect adolescents’ mental health, yet uncertainty remains about their type, frequency, and timing effects. This longitudinal study examines these transitions and their association with early adolescents’ internalizing and externalizing problems. Using data from the French EDEN cohort, a Sequence Analysis was performed to cluster participating mothers (n = 1,915) according to changes in family structure over time, defined as transitions between living with the child’s biological father, alone, with a new partner or with other adults. Among adolescents with available outcomes at age 11, assessed using the CBCL and SDQ (n = 538), associations of resulting sequence clusters, transition number, and timing of the first transition, with CBCL/SDQ scores were examined by multivariate regression analyses adjusted for relevant child, maternal, and family characteristics at baseline. Three clusters were identified: Largely stable cohabitation (86.2
Previous studies have confirmed the individual heterogeneity of post-stroke fatigue (PSF). However, the transition of PSF categories over time has not been thoroughly explored. The main purpose of this study was to identify the latent profiles of PSF during acute hospitalization (T1) and three months post-discharge (T2) and to describe the latent transition patterns among these profiles. The secondary objective was to identify factors potentially associated these transition patterns. A prospective observational study was conducted between September 2022 and July 2023 in the neurology department of a general hospital in southeast China. Data collection occurred at T1 and T2, with 310 stroke patients completing follow-up. Data were gathered using the 10-item Connor-Davidson Resilience Scale and the Fatigue Severity Scale. Latent transition analysis was employed to examine the transition patterns of PSF from T1 to T2. Three subgroups exhibiting varying degrees of fatigue were identified both at T1 and T2, designated respectively as the mild fatigue group, moderate fatigue group, and severe fatigue group. The longitudinal stability range for fatigue severity categories was between 29.3
To investigate the association between social determinants of health (SDoH), mental health history, and the propensity of firearm usage in suicide in the United States from 2003 to 2022. Using retrospective data from the National Violent Death Reporting System, we analyzed 348,112 suicide deaths, identifying differences in circumstantial, sociodemographic and mental health characteristics across those who used firearms versus other lethal methods. Documentation of any adverse health care access SDoH or adverse social context-related SDoH was significantly associated with increased odds of suicide by firearm (adjusted odds ratio [aOR] = 1.88 and 1.45, respectively) while any adverse neighborhood and built environment SDoH was inversely associated (aOR = 0.49). Decedents of suicide by firearm were less likely to have documented mental health problems (aOR = 0.83), to have recently received mental health treatment or have a prior suicide attempt (aOR = 0.50) compared to non-firearm suicides, though rates of depressed mood were similar (32.86
When a psychiatric disorder emerges during adolescence, it can affect the daily functioning and well-being of the entire family, including siblings. This study aimed to explore the impact of having a sibling with psychiatric disorders, regardless of the specific diagnosis, on well-being and perceived social support of young adults. A total of 86 participants (mean age 23 ± 2.59 and 80
To analyze temporal trends in suicidal ideation and planning among adolescents from 2006 to 2022, and to assess the association between intersectional inequalities and these outcomes. A repeated cross-sectional study was conducted using data from four nationally representative epidemiological surveys (2006, 2011, 2016, and 2022), comprising 21,019 high school students aged 14–19 years. The Jeopardy Index was used to quantify cumulative social disadvantage based on sex, race/ethnicity, and maternal education. Suicidal ideation and planning were the primary outcomes, each categorized dichotomously, and analyzed using survey-weighted logistic regression models. Suicidal behaviors increased significantly over the study period: ideation rose from 11.2
Mental health-related stigma among healthcare professionals and trainees remains a significant barrier to high-quality, person-centred care. Educational interventions are frequently proposed to reduce stigma; however, their effectiveness across professional groups and outcome domains remains uncertain. This review evaluated the effectiveness of educational interventions in reducing mental health stigma among healthcare professionals and trainees. A systematic review and meta-analysis were conducted. Searches of CENTRAL, PubMed, EMBASE, PsycINFO, and CINAHL were completed up to 1 July 2025. Randomised controlled trials evaluating educational interventions aimed at reducing stigma among healthcare professionals or trainees were included. Primary outcomes were changes in attitudes, knowledge, affective responses, and behaviourally related indicators. Certainty of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Nineteen reports (including 21 studies) were included. Educational interventions significantly reduced explicit negative attitudes towards people with mental illness immediately post-intervention among both healthcare professionals and trainees (SMD = − 0.38; 95
Individuals diagnosed with schizophrenia often experience challenges with social connection, leading to diminished community functioning and quality of life. Psychosocial interventions address these challenges through training the mental processes that guide interpretation of social interactions (social cognition) or strengthening the conversational and paralinguistic techniques needed to navigate social situations (social skills). While social cognition and social skills are integral to social connection, questions remain about their interrelation and influence on treatment outcomes. This study sought to examine the latent structure and interrelatedness of social skills and social cognition to better understand their influence on psychosocial functioning. A total of 194 outpatients with schizophrenia from a multisite comparative effectiveness study of two psychosocial interventions were assessed pre-treatment on an array of social functioning, social skills, and social cognitive measures. Exploratory factor analysis was conducted to examine overlap of social cognitive and social skills dimensions, and resulting composite factors were incorporated within multivariate regression models predicting psychosocial functioning. A 3-factor solution was identified, with social cognition retained within an emotion management factor, while social skills separated into two factors assessing conversational engagement and coherence of communication. Social cognition and social skill factors predicted improved interpersonal and motivational domains of psychosocial functioning while the social cognition factor uniquely predicted improved role performance/instrumental functioning. Social cognition and social skills, while distinct constructs, demonstrate similar influence on psychosocial functioning, particularly social connection. Interventions that incorporate both constructs as treatment targets may prove effective in addressing a wide range of functional outcomes.
Matching intensity to people’s needs and circumstances requires rethinking traditional care pathways and aligning them with personal recovery goals by reducing dependency on professionals where possible. Social support is recognized as a crucial factor in mental healthcare usage, and this study examined its role in how the intensity of mental healthcare is adjusted. We analyzed data from a four-year naturalistic cohort study of Dutch individuals with mental disorders (n = 293). The Social Network Map was employed to assess social support. The Mental Healthcare Intensity Scale measured healthcare usage. A linear mixed-effects model was utilized to explore the relationship between social support and healthcare intensity, while controlling for demographic variables and healthcare usage one year earlier. Previous levels of social support significantly influenced the intensity of mental healthcare. Participants with little support saw minimal changes in the intensity of the care they received. However, those with more support experienced dynamic changes, which differed significantly from those in the previous year. This effect was both positive and negative. It showed that social support acts as a catalyst by either escalating or deescalating the intensity of care needed. Social support plays a vital role in adjustments in the intensity of mental healthcare. This underscores the need for mental health professionals to incorporate social support assessments into clinical evaluations and be aware of this effect when deciding on the intensity of mental healthcare needed for people with a mental illness.
Depression and anxiety are a major contributor to the global burden of mental disorders, disproportionately affecting women of reproductive age (15–49 years). This study examined the global trends for depression and anxiety in women of reproductive age, allowing for the variation in social development, profiles of risk factors, and public policies. We analyzed Global Burden of Disease Study (1990–2021) data, estimating age-standardized rates (ASRs) and applying age-period-cohort (APC) analysis to assess trends in depressive and anxiety disorders by sociodemographic index (SDI). We also calculated the slope index of inequality (SII) to measure disparities in disability-adjusted life years (DALYs) and examined correlations with policy performance indicators. From 1990 to 2021, the global age-standardized prevalence of depressive and anxiety disorders rose from 55.98 (95
