Risk of eating disorders in international adoptees: a cohort study using Swedish national population registers

Abstract Aims Compared to the general population, adoptees are more often referred to specialist psychiatric treatment, exhibit increased risk of suicide and display more symptoms of attention-deficit/hyperactivity-disorder. However, little is known about the impact of being an adoptee on the risk of developing an eating disorder. The aim of the present study was to assess whether international adoptees have a higher risk for eating disorders than native Swedes. Methods In the present retrospective cohort study, data from the Swedish total population registers on individuals born between 1979 and 2005 were used to assess whether international adoptees residing in Sweden (n = 25 287) have a higher risk for anorexia nervosa (AN) and other eating disorders (OED) than non-adoptees with Swedish-born parents from the general population (n = 2 046 835). The patterns of these results were compared to those for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety disorders to determine whether any observed effects were unique to eating disorders or reflected a more general impact on mental health outcomes. Results A survival analysis adjusting for relevant demographic covariates revealed an elevated risk of all examined psychiatric disorders in international adoptees: hazard ratios (95% confidence intervals) are 1.21 (1.04–1.41) for AN, 1.60 (1.44–1.79) for OED, 1.90 (1.81–2.00) for MDD, 1.25 (1.09–1.44) for OCD, and 1.69 (1.60–1.78) for anxiety disorders. Conclusions Elevated risk of eating disorders as well as of MDD, OCD, and anxiety disorders was found in international adoptees. A parallel pattern between AN and OCD was observed, which both display less elevated rates than the other diagnoses. A considerable number of biological, environmental, and societal factors have been suggested to explain the observed differences in mental health between adoptees and non-adoptees, but they remain primarily theoretical.

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Association of family history of schizophrenia and clinical outcomes in individuals with eating disorders

Psychological Medicine ◽

10.1017/s0033291721001574 ◽

2021 ◽

pp. 1-8

Author(s):

Ruyue Zhang ◽

Ralf Kuja-Halkola ◽

Andreas Birgegård ◽

Henrik Larsson ◽

Paul Lichtenstein ◽

...

Keyword(s):

Mental Health ◽

Eating Disorders ◽

Family History ◽

Anxiety Disorders ◽

Clinical Outcomes ◽

Suicide Attempts ◽

Compulsive Disorder ◽

First Degree Relatives ◽

Health Burden ◽

History Of

Abstract Background Familial co-aggregation studies of eating disorders (EDs) and schizophrenia reveal shared genetic and environment factors, yet their etiological and clinical relationship remains unclear. We evaluate the influence of schizophrenia family history on clinical outcomes of EDs. Methods We conducted a cohort evaluation of the association between family history of schizophrenia and ED clinical features, psychiatric comorbidities, and somatic and mental health burden in individuals born in Sweden 1977–2003 with anorexia nervosa (AN) or other EDs (OED: bulimia nervosa, binge-eating disorder, and ED not otherwise specified). Results Of 12 424 individuals with AN and 20 716 individuals with OED, 599 (4.8%) and 1118 (5.4%), respectively, had a family history of schizophrenia (in up to third-degree relatives). Among individuals with AN, schizophrenia in first-degree relatives was significantly associated with increased comorbid attention-deficit/hyperactivity disorder (ADHD) [HR(95% CI) 2.26 (1.27–3.99)], substance abuse disorder (SUD) [HR (95% CI) 1.93 (1.25–2.98)], and anxiety disorders [HR (95% CI) 1.47 (1.08–2.01)], but higher lowest illness-associated body mass index (BMI) [1.14 kg/m2, 95% CI (0.19–2.10)]. Schizophrenia in any relative (up to third-degree) in AN was significantly associated with higher somatic and mental health burden, but lower ED psychopathology scores [−0.29, 95% CI (−0.54 to −0.04)]. Schizophrenia in first-degree relatives in individuals with OED was significantly associated with increased comorbid ADHD, obsessive-compulsive disorder, SUD, anxiety disorders, somatic and mental health burden, and suicide attempts. Conclusions We observed different patterns of ED-related outcomes, psychiatric comorbidity, and illness burden in individuals with EDs with and without family histories of schizophrenia and provide new insights into the diverse manifestations of EDs.

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Are we back to normal yet? The impact of the COVID-19 pandemic on mental health with a specific focus on schizotypal traits in the general population of Germany and the UK, comparing responses from April/May vs. September/October

10.1101/2021.02.15.21251726 ◽

2021 ◽

Author(s):

Sarah Daimer ◽

Lorenz Mihatsch ◽

Lisa Ronan ◽

Graham K. Murray ◽

Franziska Knolle

Keyword(s):

Mental Health ◽

General Population ◽

Psychological Symptoms ◽

Financial Burden ◽

Psychological Impact ◽

Strong Impact ◽

Symptom Index ◽

Increased Risk ◽

The Uk ◽

The Impact

AbstractStudies reported a strong impact on mental health during the first wave of the COVID-19 pandemic in March–June, 2020. In this study, we investigated the impact of the pandemic on mental health in general and on schizoptypal traits specifically in general population samples of the UK (N 1sttimepoint=239, N 2ndtimepoint= 126) and Germany (N 1sttimepoint= 543, N 2ndtimepoint=401) over two timepoints, April/May and September/October 2020. We were able to show that whereas general psychological symptoms (global symptom index, GSI) and percentage of responders above clinical cut-off for further psychological investigation declined from the first to the second timepoint in both countries, schizotypy scores (Schizotypal Personality Questionnaire) were increased at the second timepoint. We investigated potential predictors, using regression models. For schizotypy, we detected a doubling or more of the estimated impact from the first to the second timepoint, including stronger perceived loneliness, increased use of drugs, stronger financial burden, and decreased regular exercise and sleep. These effects predicted GSI, however with a lower increase of impact from the first to the second timepoint. We furthermore found that living in the UK was a predictor for higher schizotypal scores or GSI. However, the results are highly comparable between the two countries. In conclusion, this study shows that while the general psychological impact decreases, potentially showing a normative response to an exceptional situation; schizotypy scores increase, revealing a stronger impact of loneliness, drug use, and financial burden. This development might create an increased risk for developing psychosis in some individuals. The development of the general psychological and schizotypy scores over time requires further attention and investigation.

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Incidence of COVID-19 Hospitalisation in Patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study from Denmark

Journal of Clinical Medicine ◽

10.3390/jcm10173842 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3842

Author(s):

René Cordtz ◽

Salome Kristensen ◽

Louise Plank Holm Dalgaard ◽

Rasmus Westermann ◽

Kirsten Duch ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cohort Study ◽

General Population ◽

Lupus Erythematosus ◽

Cox Regression ◽

Hazard Ratio ◽

Systemic Lupus ◽

Increased Risk ◽

Study Results ◽

The Impact

Background: Patients with systemic lupus erythematosus (SLE) have an increased risk of infections due to impaired immune functions, disease activity, and treatment. This study investigated the impact of having SLE on the incidence of hospitalisation with COVID-19 infection. Methods: This was a nationwide cohort study from Denmark between 1 March 2020 to 2 February 2021, based on the linkage of several nationwide registers. The adjusted incidence of COVID-19 hospitalisation was estimated for patients with SLE compared with the general population in Cox-regression models. Among SLE patients, the hazard ratio (HR) for hospitalisation was analysed as nested case-control study. Results: Sixteen of the 2533 SLE patients were hospitalised with COVID-19 infection. The age-sex adjusted rate per 1000 person years was 6.16 (95% CI 3.76–10.08) in SLE patients, and the corresponding hazard ratio was 2.54 (95% CI 1.55–4.16) compared with the matched general population group after adjustment for comorbidities. Among SLE patients, hydroxychloroquine treatment was associated with a HR for hospitalisation of 0.61 (95% CI 0.19–1.88), and 1.06 (95% CI 0.3–3.72) for glucocorticoid treatment. Conclusion: Patients with SLE were at increased risk of hospitalisation with COVID-19.

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Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review

Psychological Medicine ◽

10.1017/s0033291716002944 ◽

2016 ◽

Vol 47 (6) ◽

pp. 1062-1084 ◽

Cited By ~ 23

Author(s):

T. H. M. Moore ◽

N. Kapur ◽

K. Hawton ◽

A. Richards ◽

C. Metcalfe ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

General Population ◽

Expressive Writing ◽

Risk Of Bias ◽

Cochrane Library ◽

Post Intervention ◽

Increased Risk ◽

Cognitive Behaviour ◽

The Impact

BackgroundJob loss, debt and financial difficulties are associated with increased risk of mental illness and suicide in the general population. Interventions targeting people in debt or unemployed might help reduce these effects.MethodWe searched MEDLINE, Embase, The Cochrane Library, Web of Science, and PsycINFO (January 2016) for randomized controlled trials (RCTs) of interventions to reduce the effects of unemployment and debt on mental health in general population samples. We assessed papers for inclusion, extracted data and assessed risk of bias.ResultsEleven RCTs (n= 5303 participants) met the inclusion criteria. All recruited participants were unemployed. Five RCTs assessed ‘job-club’ interventions, two cognitive behaviour therapy (CBT) and a single RCT assessed each of emotional competency training, expressive writing, guided imagery and debt advice. All studies were at high risk of bias. ‘Job club’ interventions led to improvements in levels of depression up to 2 years post-intervention; effects were strongest among those at increased risk of depression (improvements of up to 0.2–0.3s.d.in depression scores). There was mixed evidence for effectiveness of group CBT on symptoms of depression. An RCT of debt advice found no effect but had poor uptake. Single trials of three other interventions showed no evidence of benefit.Conclusions‘Job-club’ interventions may be effective in reducing depressive symptoms in unemployed people, particularly those at high risk of depression. Evidence for CBT-type interventions is mixed; further trials are needed. However the studies are old and at high risk of bias. Future intervention studies should follow CONSORT guidelines and address issues of poor uptake.

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The Impact of Quarantine on Pain Sensation among the General Population in China during the COVID-19 Pandemic

Brain Sciences ◽

10.3390/brainsci12010079 ◽

2022 ◽

Vol 12 (1) ◽

pp. 79

Author(s):

Jie Sun ◽

Yong-Bo Zheng ◽

Lin Liu ◽

Shui-Qing Li ◽

Yi-Miao Zhao ◽

...

Keyword(s):

Mental Health ◽

General Population ◽

National Study ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Constant Pain ◽

Increased Risk ◽

Pain Symptoms ◽

The Impact

During the pandemic era, quarantines might potentially have negative effects and disproportionately exacerbate health condition problems. We conducted this cross-sectional, national study to ascertain the prevalence of constant pain symptoms and how quarantines impacted the pain symptoms and identify the factors associated with constant pain to further guide reducing the prevalence of chronic pain for vulnerable people under the pandemic. The sociodemographic data, quarantine conditions, mental health situations and pain symptoms of the general population were collected. After adjusting for potential confounders, long-term quarantine (≥15 days) exposures were associated with an increased risk of constant pain complaints compared to those not under a quarantine (Odds Ratio (OR): 1.26; 95% Confidence Interval (CI): 1.03, 1.54; p = 0.026). Risk factors including unemployment (OR: 1.55), chronic disease history (OR: 2.38) and infection with COVID-19 (OR: 2.15), and any of mental health symptoms including depression, anxiety, insomnia and PTSD (OR: 5.44) were identified by a multivariable logistic regression. Additionally, mediation analysis revealed that the effects of the quarantine duration on pain symptoms were mediated by mental health symptoms (indirect effects: 0.075, p < 0.001). These results advocated that long-term quarantine measures were associated with an increased risk of experiencing pain, especially for vulnerable groups with COVID-19 infection and with mental health symptoms. The findings also suggest that reducing mental distress during the pandemic might contribute to reducing the burden of pain symptoms and prioritizing interventions for those experiencing a long-term quarantine.

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Self-Reported Lifetime History of Eating Disorders and Mortality in the General Population: A Canadian Population Survey with Record Linkage

Nutrients ◽

10.3390/nu13103333 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3333

Author(s):

Pardis Pedram ◽

Scott B. Patten ◽

Andrew G. M. Bulloch ◽

Jeanne V. A. Williams ◽

Gina Dimitropoulos

Keyword(s):

Mental Health ◽

Eating Disorders ◽

General Population ◽

Well Being ◽

Clinical Samples ◽

Post Traumatic Stress ◽

Lifetime History ◽

National Mortality ◽

Increased Risk ◽

History Of

Eating disorders (EDs) are often reported to have the highest mortality of any mental health disorder. However, this assertion is based on clinical samples, which may provide an inaccurate view of the actual risks in the population. Hence, in the current retrospective cohort study, mortality of self-reported lifetime history of EDs in the general population was explored. The data source was the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), linked to a national mortality database. The survey sample was representative of the Canadian household population (mean age = 43.95 years, 50.9% female). The survey inquired about the history of professionally diagnosed chronic conditions, including EDs. Subsequently, the survey dataset was linked to the national mortality dataset (for the date of death) up to 2017. Cox proportional hazards models were used to explore the effect of EDs on mortality. The unadjusted-hazard ratio (HR) for the lifetime history of an ED was 1.35 (95% CI 0.70–2.58). However, the age/sex-adjusted HR increased to 4.5 (95% CI 2.33–8.84), which was over two times higher than age/sex-adjusted HRs for other mental disorders (schizophrenia/psychosis, mood-disorders, and post-traumatic stress disorder). In conclusion, all-cause mortality of self-reported lifetime history of EDs in the household population was markedly elevated and considerably higher than that of other self-reported disorders. This finding replicates prior findings in a population-representative sample and provides a definitive quantification of increased risk of mortality in EDs, which was previously lacking. Furthermore, it highlights the seriousness of EDs and an urgent need for strategies that may help to improve long-term outcomes.

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Sex Differences in Anxiety Disorders

The Oxford Handbook of Evolutionary Psychology and Behavioral Endocrinology ◽

10.1093/oxfordhb/9780190649739.013.21 ◽

2019 ◽

pp. 404-432

Author(s):

Teresa A. Piggott ◽

Alexandra N. Duran ◽

Isha Jalnapurkar ◽

Tyler Kimm ◽

Stephanie Linscheid ◽

...

Keyword(s):

Sex Differences ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Stress Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Considerable Research ◽

Psychosocial Influences ◽

Psychiatric Conditions ◽

The Impact

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

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Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

Public Health Nutrition ◽

10.1017/s1368980021001592 ◽

2021 ◽

pp. 1-25

Author(s):

Qionggui Zhou ◽

Xuejiao Liu ◽

Yang Zhao ◽

Pei Qin ◽

Yongcheng Ren ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Normal Weight ◽

Sensitivity Analyses ◽

Hypertension Status ◽

Moderation Effect ◽

Increased Risk ◽

All Cause Mortality ◽

Chinese Cohort ◽

The Impact

Abstract Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort Participants: 17,262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the HRs (95% CI) for mortality in normotensive participants were 1.92 (1.23-3.00), 1.44 (1.01-2.05), 1.14 (0.82-1.58), 0.96 (0.70-1.31), 0.96 (0.65-1.43), 1.32 (0.81-2.14), and 1.32 (0.74-2.35) respectively, and in hypertensive participants were 1.85 (1.08-3.17), 1.67 (1.17-2.39), 1.29 (0.95-1.75), 1.20 (0.91-1.58), 1.10 (0.83-1.46), 1.10 (0.80-1.52), and 0.61 (0.40-0.94) respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity versus normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

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Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001622 ◽

2020 ◽

pp. bmjmilitary-2020-001622 ◽

Cited By ~ 1

Author(s):

Dominic Murphy ◽

C Williamson ◽

J Baumann ◽

W Busuttil ◽

N T Fear

Keyword(s):

Mental Health ◽

Social Support ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Increased Risk ◽

Mental Health Difficulties ◽

Post Traumatic ◽

The Impact

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

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Real-world safety of palbociclib in breast cancer patients in the United States: a new user cohort study

BMC Cancer ◽

10.1186/s12885-021-07790-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel C. Beachler ◽

Cynthia de Luise ◽

Aziza Jamal-Allial ◽

Ruihua Yin ◽

Devon H. Taylor ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Pulmonary Embolism ◽

Cohort Study ◽

Real World ◽

The United States ◽

Elevated Risk ◽

Breast Cancer Patients ◽

Increased Risk ◽

Serious Infections

Abstract Background There is limited real-world safety information on palbociclib for treatment of advanced stage HR+/HER2- breast cancer. Methods We conducted a cohort study of breast cancer patients initiating palbociclib and fulvestrant from February 2015 to September 2017 using the HealthCore Integrated Research Database (HIRD), a longitudinal claims database of commercial health plan members in the United States. The historical comparator cohort comprised patients initiating fulvestrant monotherapy from January 2011 to January 2015. Propensity score matching and Cox regression were used to estimate hazard ratios for various safety events. For acute liver injury (ALI), additional analyses and medical record validation were conducted. Results There were 2445 patients who initiated palbociclib including 566 new users of palbociclib-fulvestrant, and 2316 historical new users of fulvestrant monotherapy. Compared to these historical new users of fulvestrant monotherapy, new users of palbociclib-fulvestrant had a greater than 2-fold elevated risk for neutropenia, leukopenia, thrombocytopenia, stomatitis and mucositis, and ALI. Incidence of anemia and QT prolongation were more weakly associated, and incidences of serious infections and pulmonary embolism were similar between groups after propensity score matching. After adjustment for additional ALI risk factors, the elevated risk of ALI in new users of palbociclib-fulvestrant persisted (e.g. primary ALI algorithm hazard ratio (HR) = 3.0, 95% confidence interval (CI) = 1.1–8.4). Conclusions This real-world study found increased risks of several adverse events identified in clinical trials, including neutropenia, leukopenia, and thrombocytopenia, but no increased risk of serious infections or pulmonary embolism when comparing new users of palbociclib-fulvestrant to fulvestrant monotherapy. We observed an increased risk of ALI, extending clinical trial findings of significant imbalances in grade 3/4 elevations of alanine aminotransferase (ALT).

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