scholarly journals Traumatic Events, Social Adversity and Discrimination as Risk Factors for Psychosis - An Umbrella Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Leonie Varchmin ◽  
Christiane Montag ◽  
Yvonne Treusch ◽  
Jakob Kaminski ◽  
Andreas Heinz

Exposure to childhood trauma is a well-known risk factor for severe mental disorders including schizophrenia and other non-affective psychoses. Beyond childhood trauma, there is increasing evidence that bullying, social exclusion, and discrimination during adolescence and adulthood may increase the risk of developing a psychotic disorder, and that such forms of traumatization may also underlie the elevated psychosis risk among migrants or persons with a visible minority status. In this umbrella review, we systematically assess meta-analyses regarding trauma and social adversity. A systematic literature review yielded 11 meta-analyses that met inclusion criteria and could be summarized quantitatively with a random effect model. Furthermore, six meta-analyses were evaluated qualitatively. Heterogeneity and publication bias were apparent in several meta-analyses. We observed that most significant social risk factors for psychosis were vulnerability for racist discrimination [OR = 3.90 (3.25–4.70)], migration [OR = 2.22 (1.75–2.80)], and childhood adversities [OR = 2.81 (2.03–3.83)]. Furthermore, social factors increasing the risk for psychosis were variation/impairment of parental communication, aversive adult life events, bullying, and factors associated with social isolation and discrimination. In spite of these environmental risk factors, there is a lack of evidence regarding treatment of trauma and psychosis, although some psychotherapeutic and art therapy approaches appear to be promising. Beyond individual interventions, stigmatization, racism, and other forms of discrimination need to be targeted to increase solidarity and communal support.

2010 ◽  
Vol 12 (3) ◽  
pp. 305-315 ◽  

Major advances have been made in our understanding of the epidemiology of schizophrenia. We now know that the disorder is more common and severe in young men, and that the incidence varies geographically and temporally. Risk factors have been elucidated; biological risks include a family history of the disorder, advanced paternal age, obstetric complications, and abuse of drugs such as stimulants and cannabis. In addition, recent research has also identified social risk factors such as being born and brought up in a city, migration, and certain types of childhood adversity such as physical abuse and bullying, as well as social isolation and adverse events in adult life. Current research is focussing on the significance of minor psychotic symptoms in the general population, gene-environmental interaction, and how risk factors impact on pathogenesis; perhaps all risk factors ultimately impact on striatal dopamine as the final common pathway.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0244346
Author(s):  
Svenn-Erik Mamelund ◽  
Clare Shelley-Egan ◽  
Ole Rogeberg

Background The objective of this study is to document whether and to what extent there is an association between socioeconomic status (SES) and disease outcomes in the last five influenza pandemics. Methods/principle findings The review included studies published in English, Danish, Norwegian and Swedish. Records were identified through systematic literature searches in six databases. We summarized results narratively and through meta-analytic strategies. Only studies for the 1918 and 2009 pandemics were identified. Of 14 studies on the 2009 pandemic including data on both medical and social risk factors, after controlling for medical risk factors 8 demonstrated independent impact of SES. In the random effect analysis of 46 estimates from 35 studies we found a pooled mean odds ratio of 1.4 (95% CI: 1.2–1.7, p < 0.001), comparing the lowest to the highest SES, but with substantial effect heterogeneity across studies,–reflecting differences in outcome measures and definitions of case and control samples. Analyses by pandemic period (1918 or 2009) and by level of SES measure (individual or ecological) indicated no differences along these dimensions. Studies using healthy controls tended to document that low SES was associated with worse influenza outcome, and studies using infected controls find low SES associated with more severe outcomes. A few studies compared severe outcomes (ICU or death) to hospital admissions but these did not find significant SES associations in any direction. Studies with more unusual comparisons (e.g., pandemic vs seasonal influenza, seasonal influenza vs other patient groups) reported no or negative non-significant associations. Conclusions/significance We found that SES was significantly associated with pandemic influenza outcomes with people of lower SES having the highest disease burden in both 1918 and 2009. To prepare for future pandemics, we must consider social vulnerability. The protocol for this study has been registered in PROSPERO (ref. no 87922) and has been published Mamelund et al. (2019).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shasha Guo ◽  
Qiang Sun ◽  
Xinyang Zhao ◽  
Liyan Shen ◽  
Xuemei Zhen

Abstract Background Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. Results Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. Conclusion The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.


Author(s):  
John F. Steiner ◽  
Glenn K. Goodrich ◽  
Kelly R. Moore ◽  
Spero M. Manson ◽  
Laura M. Gottlieb ◽  
...  

Innova ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 33-38
Author(s):  
Владимир Игоревич Тимошилов ◽  
◽  
Альберт Генрихович Ластовецкий

Period 2014-2019 characterized by a certain increase in social instability in Russia, which led to an increase of social risk factors for drug addiction. In the Kursk region, at the same time, there have been changes in the regulation of anti-drug prevention, a large number of specialists have been trained, and a movement of competent volunteers has developed. In this regard, the epidemiological data for 2014-2019 are of particular interest. For the period from 2005 to 2019 the primary incidence of alcohol use disorders in Russia decreased from 147.4 to 48.3, in the Kursk region – from 106 to 53.5 cases per 100 000 population per year. Of the adjacent regions in 2019, a lower incidence rate than in the Kursk region was noted only in the Belgorod region – 39.4 cases per 100,000 population. Primary incidence of disorders associated with the use of narcotic active substances, during 2014-2019 in Russia as a whole decreased from 15 to 9.8, in the Kursk region – from 11.3 to 4 new cases per 100 000 inhabitants per year. In 2019, the detection rate of primary incidence of drug addiction and substance abuse was significantly higher than in the Kursk region in Bryansk and Lipetsk. Despite favorable trends, it was noted that the coronavirus pandemic and the restrictions introduced to combat it can have a significant impact on the risk factors for drug addiction, which requires the adaptation of preventive programs to new conditions.


2021 ◽  
pp. 003435522110432
Author(s):  
Areum Han

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.


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