Impact of urban birth and upbringing on expression of psychosis in a Chinese undergraduate population

Abstract Background Urban birth and upbringing show consistent associations with psychotic illness but the key urban exposures remain unknown. Associations with psychotic-like experiences (PEs) are inconsistent. These could be confounded by common mental disorders associated with PEs. Furthermore, associations between PEs and urban exposures may not extrapolate to psychotic disorders such as schizophrenia. Methods Annual cross-sectional surveys among first year Chinese undergraduates 2014–2019 (n = 47,004). Self-reported, hierarchical categorisation of psychosis: from psychoticism, paranoid ideation, schizotypal symptoms, nuclear syndrome using SCL-90-R, to clinical diagnosis of schizophrenia. Depressive symptoms using PHQ 9. Dissociative symptoms and posttraumatic stress disorder (PTSD) measured using PCL-C. Etiological factors of family history and childhood disadvantage. We studied effects of urban birth, urban living and critical times of exposure in childhood on psychosis phenotypes. Results Associations with urbanicity were found only after adjustments for depression. Urban birth was associated with paranoia (AOR 1.34, 1.18–1.53), schizotypal symptoms (AOR 1.59, 1.29–1.96), and schizophrenia (AOR 2.07, 1.10–3.87). The same phenotypes showed associations with urban residence > 10 years. Only schizophrenia showed an association with urban exposure birth-3 years (AOR 7.01, 1.90–25.86). Child maltreatment was associated with both psychosis and depression. Urbanicity measured across the total sample did not show any associations with demography, family history of psychosis, or child maltreatment. Sensitivity analysis additionally adjusting for dissociative symptoms and PTSD showed the same pattern of findings. Conclusions Urban birth and urban living showed a hierarchical pattern of increasing associations from paranoid ideation to schizotypal disorder to schizophrenia, confirming that associations for psychotic experiences could be extrapolated to schizophrenia, but only after adjusting for confounding from depression, dissociative symptoms and PTSD. Several etiological factors were the same for psychosis and depression. Future studies of PEs should adjust for confounding from common mental disorders and dissociative symptoms. Effects of urbanicity on psychosis were not explained by demography, family history of mental disorder, or child maltreatment.

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M132. URBANICITY AND PSYCHOSIS IN A CHINESE UNDERGRADUATE POPULATION: PRELIMINARY FINDINGS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.444 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S185-S186

Author(s):

Jeremy Coid ◽

Yamin Zhang ◽

Tao Li

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Urban Environment ◽

Family Income ◽

Common Mental Disorders ◽

Length Of Residence ◽

Etiological Factors ◽

Urban Living ◽

Increased Risk ◽

Schizotypal Symptoms

Abstract Background Urban birth and upbringing are consistently associated with schizophrenia and other psychoses but the key urban exposures remain unknown. China has previously found prevalence of psychosis higher in rural areas but has shown the largest displacement of population from rural into urban areas of any country in the world over the past 40 years. Studies of psychotic experiences (PE) show inconsistency but this may be due to confounding of PEs by depressive symptoms. This suggests the need to differentiate between PEs on a population continuum with non-affective psychosis and those secondary to common mental disorders when studying urbanicity. Our aims were to investigate effects of exposure to urban birth and upbringing on psychosis in a large Chinese undergraduate sample. Methods Cross-sectional surveys conducted annually during first year of university, 2014–2018, n=39,446. Self-reported categorical measures of psychosis included psychoticism, paranoid ideation, and schizotypal symptoms using SCL-90-R, and lifetime clinical diagnosis of schizophrenia; depressive symptoms using PHQ 9; putative etiological risk factors of family history and childhood maltreatment; urbanicity measured according to birth place in a major city (level 5 of a 5-level rural-urban scale), length of residence in urban location, and length of residence during three critical 5 year periods, birth - 15 years. We studied effects on our 4 psychosis phenotypes of (i) urban birth, (ii) urban living, (iii) critical times of exposure to urban environment, (iv) putative etiological risk factors, before and after adjusting for depression. We investigated associations between etiological risk factors and urban exposures. Results We identified 2,143 (5.4%) participants above a determined cut-off for psychoticism, 2,081 (5.3%) for paranoia, 760 (1.9%)with schizotypal symptoms, and 53 (0.1%) with schizophrenia. Effects of urban exposure on our psychosis phenotypes were only revealed following adjustments for depression in our models: Urban birth was associated with Paranoia (1.46, 1.24–1.70), schizotypal symptoms (1.90,1.48-2.42), and schizophrenia (2.30, 1.14–4.63), but not psychoticism. All four phenotypes were associated with 10–15 years of exposure to urban living, but not shorter periods. Only schizophrenia was associated with critical timings of total exposures of 1–3 years and 4–5 years during the first 5 years of life to an urban environment. There were no associations or negative associations between putative etiological factors and urban exposures. Discussion We confirmed that urban birth and living were associated with PEs and schizophrenia in this large sample of Chinese university students, but these findings only emerged after adjusting for depression. Depression is more prevalent in rural Chinese samples and previous studies may have been confounded by effects of PEs secondary to depression. There was a gradient of association between paranoia, schizotypal symptoms and schizophrenia, the latter showing strongest effects in association with urban exposures of birth and length of time in an urban environment. Only schizophrenia showed effects of critical timing of exposure to urban environment during infancy. Finally, we could not identify what exposures in the urban environment contributed to psychosis in our sample - although we could identify the etiological factors that did not. Among Sichuan students, there was no indication that urban effects were due to increased risk from demographic factors of male sex, lower family income, increased genetic risk, or child maltreatment, although these factors showed some effects on psychosis across the entire sample which included previous rural residents.

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The prevalence and associated factors of common mental disorders among residents of south Gondar zone, northwest Ethiopia: A community-based, cross-sectional study

10.21203/rs.3.rs-16917/v1 ◽

2020 ◽

Author(s):

Getasew Legas ◽

Getnet Mehretie ◽

Sintayehu Asnakew ◽

Amsalu Belete ◽

Shegaye Shumet

Keyword(s):

Social Support ◽

Mental Illness ◽

Family History ◽

Mental Disorders ◽

Common Mental Disorders ◽

Cross Sectional Study ◽

Cross Sectional ◽

Poor Social Support ◽

History Of ◽

South Gondar

Abstract Background: Common mental disorders such as depression, anxiety and somatic symptoms are a public health concern. It has physical health, psychological and economic consequences. These illness is an emerging issue in Ethiopia.Therefore, this study aimed to assess the prevalence of common mental disorders and associated factors among residents of south Gondar zone 2018.Methods: In this cross-sectional study,731 respondents were recruited for interrviews using a systematic random sampling technique.The self reporting questionnaire was used to assess common mental disorders. List of Threatening Experiences, and the Oslo social support instruments were used to assess the factors. We computed bivariate and multivariable binary logistic regressions to assess factors associated with common mental disorders. Statistical significance was declared at P-value <0.05.Result: A total of 731 participants were interviewed, with a response rate of 98.5%. The prevalence of common mental disorders was 29.7% with (95% CI: 26.4-33.1).In the multivariate logistic regression,female sex (adjusted odds ratio (AOR)= 2.47, 95% CI : 1.68, 3.62),poor social support( AOR =2.34, 95% CI:1.50, 3.64), family history of mental illness(AOR =2.15, 95% CI:1.32-3.51), current use of khat(AOR =1.69, 95% CI: 1 .07, 2.64) and tobacco(AOR=1.71, 95% CI:1.04-2.84), and rural residence(AOR=2.01, 95% CI: 1.35, 3.01) were factors significantly associated with CMDs.Conclusion and recommendations: The prevalence of common mental disorders was found to be high. Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support were significantly associated with common mental disorder. Therefore; It is necessary to give emphasis to individuals with family history of mental illness, women, and history of mental illness.

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Common Mental Disorders and Substance Use in School Children of Eastern Nepal

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v8i1.26331 ◽

2019 ◽

Vol 8 (1) ◽

pp. 17-21

Author(s):

P Sharma ◽

N Thakur ◽

S Sharma ◽

M Pokharel

Keyword(s):

Mental Health ◽

Substance Use ◽

Mental Disorders ◽

Mental Health Problems ◽

Common Mental Disorders ◽

School Mental Health ◽

Prevalence Studies ◽

Common Mental Health Problems ◽

Current Scenario ◽

History Of

Introduction: School mental health is one of the important areas where early detection can lead to appropriate early intervention and burden of disease can be minimized. There is dearth of prevalence studies of common mental disorders on school going adolescents in Nepal. Considering this we aimed to study the prevalence of common mental health problems and substance use in school going adolescents. Material And Method: We evaluated 240 students for common mental disorders (depression and anxiety) using translated version of PHQ-4 and substance use single validated question after taking consent from school authorities and assent from students. Results: It was seen that 68.8 % students had psychological distress. 22.9 % and 27.5% of students had anxiety and depression respectively on screener and 23.3% students had use of substance at least once within a year. When compared male had significantly higher number of substance use as compared to female but no difference in PHQ-4 scores were seen when compared between gender and history of substance use. Conclusion: The study shows the current scenario of school going adolescents in Nepal and highlights the need of prevalence data on more generalizable setting.

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A history of concussions is associated with symptoms of common mental disorders in former male professional athletes across a range of sports

The Physician and Sportsmedicine ◽

10.1080/00913847.2017.1376572 ◽

2017 ◽

Vol 45 (4) ◽

pp. 443-449 ◽

Cited By ~ 21

Author(s):

Vincent Gouttebarge ◽

Haruhito Aoki ◽

Michael Lambert ◽

William Stewart ◽

Gino Kerkhoffs

Keyword(s):

Mental Disorders ◽

Common Mental Disorders ◽

Professional Athletes ◽

History Of

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The Performance of Manic Patients on the ‘Grid Test for Schizophrenic Thought Disorder’

The British Journal of Psychiatry ◽

10.1192/bjp.118.547.671 ◽

1971 ◽

Vol 118 (547) ◽

pp. 671-673 ◽

Cited By ~ 6

Author(s):

G. W. Mellsop ◽

M. S. Spelman ◽

A. W. Harrison

Keyword(s):

Family History ◽

Clinical Diagnosis ◽

Previous History ◽

Thought Disorder ◽

Paranoid Ideation ◽

History Of ◽

Manic Patients ◽

Grid Test

It can be difficult to make a confident diagnosis and one that will stand the test of time when a person without a family history or previous history of psychosis presents as psychotic with overactivity, pressure of talk, loose association of ideas and perhaps some paranoid ideation. He may be schizophrenic or manic. The nature of the disturbance of speech, and by inference thought, may assist in making the clinical diagnosis, but standard textbooks (Slater and Roth, 1969; Freedman and Kaplan, 1967) state that pressure of speech, flight of ideas, clang associations, distractibility and inability to adhere to a line of thought are common to both conditions.

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The CCC2000 Birth Cohort Study of Register-Based Family History of Mental Disorders and Psychotic Experiences in Offspring

Schizophrenia Bulletin ◽

10.1093/schbul/sbu167 ◽

2014 ◽

Vol 41 (5) ◽

pp. 1084-1094 ◽

Cited By ~ 27

Author(s):

Pia Jeppesen ◽

Janne Tidselbak Larsen ◽

Lars Clemmensen ◽

Anja Munkholm ◽

Martin Kristian Rimvall ◽

...

Keyword(s):

Cohort Study ◽

Family History ◽

Mental Disorders ◽

Birth Cohort ◽

Birth Cohort Study ◽

Psychotic Experiences ◽

History Of

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Help-seeking behavior for problematic substance uses in Bahir Dar town, North-West Ethiopia

10.1101/363705 ◽

2018 ◽

Author(s):

Habte Belete ◽

Tesfa Mekonen ◽

Wubalem Fekadu ◽

Getasew Legas ◽

Asmamaw Getnet

Keyword(s):

Substance Use ◽

Mental Disorders ◽

Help Seeking ◽

Common Mental Disorders ◽

Bahir Dar ◽

Help Seeking Behavior ◽

Substance Users ◽

Seeking Behavior ◽

Problematic Substance ◽

History Of

AbstractBackgroundMental, neurological and substance use disorders are common, but 76% to 85% of people with those disorders in low and middle-income countries did not receive treatment.ObjectiveOur objective was to assess the level of help seeking behavior and associated factors among residents with problematic substance uses (alcohol, khat, tobacco and hashish).MethodsCommunity based cross sectional study was conducted in Bahir Dar town among total of 548 participants with problematic substance users. We had interviewed for help seeking behavior by pre-tested modified General Help Seeking Questionnaire. Logistic regression was done and p-value < 0.05 was used for declaration of significant level. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) have been used.ResultsAmong five hundred and forty-eight participants with problematic substance users, only one hundred and sixty-eight (30.7%) sought help for their substance related problems. Participants’ age above 35 years [AOR = .47 95% CI (.25, .90)], positively screened for common mental disorders [AOR = 4.12, 95% CI (2.7, 6.3)], comorbid medical [AOR = 3.0, 95% CI (1.7, 5.3)], and grand-families’ history of substance user [AOR = 2.18, 95% CI (1.4, 3.4)] found significantly associated with help seeking.ConclusionThere was low proportion of help seeking behavior among participants with problematic substance users. Advanced age was a barrier to seek help while medical illnesses, common mental disorders and history of substance use in grand families were found to enforce to seek help.

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Help-seeking behavior of individuals with schizophrenia in the general population of Hunan, China

10.21203/rs.3.rs-20778/v1 ◽

2020 ◽

Author(s):

Jing Ma ◽

Qiongjuan Zheng ◽

Yun Zhang ◽

Chunyu Liu ◽

Xuefei Tian ◽

...

Keyword(s):

Family History ◽

Mental Disorders ◽

Help Seeking ◽

Hunan Province ◽

Help Seeking Behavior ◽

First Choice ◽

Education Levels ◽

Seeking Behavior ◽

History Of ◽

Seeking Help

Abstract Purpose : This study aims to know the seeking help behavior (including seeking help or not, first choice, influential factors and barriers in seeking help) of individuals with SZ in Hunan province of China. Methods : The participants are from a larger epidemiological study of severe mental disorders in Hunan province of China. Self-made questionnaires were used to collect relative information. Results : 1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n=163) pursued professional psychiatric services and 30.8% (n=78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. 2) The help-seeking behavior ratio (seeking help individuals/total sample size) is significantly lower in the illiterate group than in other education levels. Those with a family history of mental disorders tend to have a higher help-seeking behavior ratio. And the first choice of help is largely related to education level. 3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). Conclusion : About one third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospital and relatives as their first choice. A family history of mental disorders and higher education levels are meaningfully associated with help-seeking behavior, and individuals with more education tend to seek for professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etc.

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Help-Seeking Behavior of Individuals With Schizophrenia in the General Population of Hunan, China

10.21203/rs.3.rs-20778/v2 ◽

2020 ◽

Author(s):

Jing Ma ◽

Qiongjuan Zheng ◽

Yun Zhang ◽

Chunyu Liu ◽

Xuefei Tian ◽

...

Keyword(s):

Family History ◽

Mental Disorders ◽

Help Seeking ◽

Hunan Province ◽

Help Seeking Behavior ◽

First Choice ◽

Education Levels ◽

Seeking Behavior ◽

History Of ◽

Seeking Help

Abstract Background This study aims to know the seeking help behavior (including seeking help or not, first choice, influential factors and barriers in seeking help) of individuals with SZ (Schizophrenia) in Hunan province of China. Methods The participants are from a larger epidemiological study of severe mental disorders in Hunan province of China. Self-made questionnaires were used to collect relative information. Results (1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n=163) pursued professional psychiatric services and 30.8% (n=78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. (2) The help-seeking behavior ratio (seeking help individuals/total sample size) is significantly lower in the illiterate group than in other education levels. Those with a family history of mental disorders tend to have a higher help-seeking behavior ratio. And the first choice of help is largely related to education level. (3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). Conclusions About one third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospital and relatives as their first choice. A family history of mental disorders and higher education levels are meaningfully associated with help-seeking behavior, and individuals with more education tend to seek for professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etcTrial registration This study is approved by ‘the ethics committee of the Brain Hospital of Hunan Province’,the committee’s reference numberis ‘Z2019045’.

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Help-seeking Behavior of Individuals with Schizophrenia in the General Population of Hunan, China

10.21203/rs.3.rs-20778/v3 ◽

2021 ◽

Author(s):

Jiawen Hu ◽

Qiongjuan Zheng ◽

Yun Zhang ◽

Chunyu Liu ◽

Xuefei Tian ◽

...

Keyword(s):

Family History ◽

Mental Disorders ◽

Help Seeking ◽

Hunan Province ◽

Help Seeking Behavior ◽

First Choice ◽

Education Levels ◽

Seeking Behavior ◽

History Of ◽

Seeking Help

Abstract PurposeThis study aims to know the seeking help behavior of individuals with SZ (Schizophrenia) in Hunan province of China. MethodsThe participants are from a larger epidemiological study of severe mental disorders in Hunan province of China. Self-made questionnaires were used to collect relative information. Results1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n=163) pursued professional psychiatric services and 30.8% (n=78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. 2) The help-seeking behavior ratio is significantly lower in the illiterate group than in other education levels. Those with a family history of mental disorders tend to have a higher help-seeking behavior ratio. 3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services（47.0%）.ConclusionAbout one third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospital and relatives as their first choice. A family history of mental disorders and higher education levels are meaningfully associated with help-seeking behavior, and individuals with more education tend to seek for professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etc.

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