Twelve-Month Suicidal Symptoms and Use of Services Among Adolescents: Results From the National Comorbidity Survey

Objective The study assessed the prevalence of suicidal ideation, suicide plans, and suicide attempts as well as patterns of mental health service use among adolescents. Methods Data came from the National Comorbidity Survey–Adolescent Supplement, a nationally representative sample of 10,123 adolescents aged 13 to 18 years who participated in computer-assisted, face-to-face interviews between February 2001 and January 2004. Prevalences of suicidal thoughts and behaviors in the past year were determined. Past-year use of any mental health treatment and receipt of four or more visits from one provider among youths with suicidal ideation, plans, or attempts were also assessed. Associations were evaluated by using logistic regression. Results During the course of 12 months, 3.6% of adolescents reported suicidal ideation without a plan or attempt, .6% reported a suicide plan without an attempt, and 1.9% made a suicide attempt. Overall, two-thirds of adolescents with suicidal ideation (67.3%) and half of those with a plan (54.4%) or attempt (56.9%) did not have any contact with a mental health specialist in the past year. Different predictors of use of care were identified for each group. Conclusions Adolescent suicidality often is untreated in the United States. Increased outreach efforts to improve treatment access for youths with suicidal ideation and attempts are needed.Psycholog

Compr Psychiatry

BACKGROUND: Post-traumatic stress disorder (PTSD) is associated with significant personal and societal burden. The present study examines the gender-specific differences in this burden in terms of the co-occurrence of psychiatric disorders and medical conditions with PTSD in the general population of France. METHODS: The study is based on a cross-sectional general population survey of 21,879 adults. Trained interviewers used a computer-assisted telephone interviewing system to administer the Composite International Diagnostic Interview-Short Form to screen for psychiatric disorders and medical conditions in the previous 12months. RESULTS: One third of those with moderately severe PTSD (35.3%) and half of those with severe PTSD (54.2%) suffered from comorbid depression. The prevalence of anxiety disorders and substance use disorders was also greater among severe cases of PTSD. Chronic back or neck problems, frequent or severe headaches, arthritis or rheumatism and hypertension were highly prevalent among adults with PTSD. Adjusting for gender, age, education, employment and marital status, moderately severe and severe PTSD diagnoses were associated with significantly greater odds of comorbid psychiatric disorders and medical conditions. With few exceptions, the pattern of gender differences in psychiatric and medical morbidity among those with moderate or severe PTSD were similar to differences observed among those without PTSD. CONCLUSIONS: The findings highlight the burden of co-occurring psychiatric and medical conditions among PTSD sufferers in France and suggest the need for careful consideration of comorbidity in the assessment and service planning for PTSD

J Trauma Stress

Exposure to potentially traumatic events (PTEs) increases an individual's risk of suffering from psychiatric disorders. However, only a small proportion of individuals exposed to PTEs use health care services (HCS). Few studies have examined how exposure to different types of PTEs affect the odds an individual will suffer from a psychiatric disorder and access HCS. The present study aimed to examine the associations among lifetime exposure to sexual and nonsexual violence, psychiatric disorder presence, and utilization of HCS. Data were drawn from a large cross-sectional survey (N = 19,958) representative of four regions of France. Lifetime occurrence of traumatic events, past-year DSM-IV Axis I psychiatric disorders, and past-year use of HCS were assessed using the CIDI-SF. Lifetime exposure to violence, particularly sexual violence, was associated with significantly higher odds of suffering from common psychiatric disorders in the past year, including major depression, aOR = 1.70, 95%CI [1.34, 2.17], which was present among 36.9% of participants who reported sexual violence exposure, 20.9% of those who reported exposure to nonsexual violence, and 7.1% of those exposed to neither. Compared to participants who were not exposed to sexual violence, victims of sexual violence were more likely to have contacted health care professionals due to a mental health problem and to have received psychotropic medication. However, a significant portion of individuals with psychiatric disorders did not report receiving potentially beneficial HCS. The present findings highlight the need to identify victims of violence and improve access to appropriate services for this population

Mental imagery in bipolar disorder: A PRISMA-compliant systematic review of its characteristics, content and relation to emotion

Mental imagery is often described as “seeing with the mind's eye” as it refers to perceptual experiences of sensory information in the absence of external sensory input (Kosslyn, Ganis, & Thompson, 2001). Mental imagery is known to be strongly related to emotion and is used in the context of therapy for the treatment of mood disorders, in particular in Imagery-focused Cognitive Therapy. Due to the predominance of emotional dysfunction in bipolar disorder (BD), mental imagery may be helpful in providing a better characterization of the illness. This systematic review aimed at extracting data about mental images’ (a) clinical characteristics (frequency, vividness and likelihood), (b) contents and (c) relation to emotion in individuals with BD. Authors performed the systematic review following the PRISMA statement. Among the 81 articles screened, 55 were assessed for eligibility after the removal of duplicates. A total of 5 studies met inclusion criteria, and covered a total of 298 unique participants. Differences in the clinical characteristics of mental imagery were found in individuals with BD as compared to healthy controls. The contents of images in BD appeared to be related to individuals’ current preoccupations and seemed to push them to take action, with high associated emotional ratings. The level of evidence remains limited due to the designs of the included studies. Additional research is needed to characterize mental imagery during thymic phases of BD. Such studies may potentially identify markers of the transition from one thymic phase to the next

J Affect Disord

Exposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence. The study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year. Data were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year. At baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses. Retrospective report of CA exposure, and low baseline response rate. Using a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.Harcèlement et médias sociaux chez les jeunes: une étude longitudinale de leur impact sur la santé mentale, le bien-être et la réussite scolaire des adolescent

Journal of Affective Disorders

Background We aimed to determine the prevalence of past-year health service use for mental health reasons in a French representative sample of adults overall and in those reporting suicidal ideation in the past year and assess the factors associated with health service use according Andersen's model of healthcare seeking behaviors. Methods Data were drawn from the 2017 Health Barometer survey a large computer-assisted telephone survey on a representative sample of the general population aged 18–75 years living in France (n = 25,319). Logistic regression analyses were used to study past-year health service use for mental health reasons as a function of predisposing, enabling and need factors. Analyses were stratified according to suicidal ideation and sex. Results Among individuals with suicidal ideation, 45.1 % of adults, 50.4 % of females and 37.6 % of males, reported past-year health service use for a mental health reason. Increased odds of health service use were observed regarding predisposing (female sex, younger age, higher education), enabling (income level), and need factors (prior suicide attempts, role impairment and major depression). Among males, the only significant factors included age 65–75 (aOR = 0.16, 95%CI = 0.03–0.84) and major depression (aOR = 2.79, 95%CI = 1.79–4.36). Limitations Self-reported service utilization. Cross-sectional survey. Conclusions In a country with a high level of medical coverage, further research is needed to identify sex-specific socio-demographic, economic and clinical differences in the use of different types of health services as well as perceived need for care, structural and attitudinal barriers to treatment

Research on Posttraumatic Stress Disorder in the Context of the COVID-19 Pandemic: A Review of Methods and Implications in General Population Samples

Increasing concern about the mental health sequelae to the COVID-19 pandemic has prompted a surge in research and publications on the prevalence of posttraumatic stress disorder in general population samples in relation to the pandemic. We examined how posttraumatic stress disorder in the context of the COVID-19 pandemic has been studied to date and found three general themes: (1) assessment of posttraumatic stress disorder and posttraumatic stress disorder symptoms relied on self-report measures and often did not determine direct trauma exposure as required by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criterion A to diagnose posttraumatic stress disorder; (2) inadequate assessment of pre-existing mental disorders and co-occurring stress; and (3) the use of cross-sectional designs in most studies, often relying on snowball sampling strategies to conduct online surveys. Notwithstanding these methodological limitations, these studies have reported moderate to severe posttraumatic symptoms in 25.8% of the general population on average in relation to the pandemic (ranging from 4.6% to 55.3%). Opportunities for advancing future research that will inform public health planning are discussed

Fundam Clin Pharmacol

This study assessed in depth the use of first‐ and second‐generation antipsychotic (FGAP/SGAP) drugs in France. A 1/97th random sample of beneficiaries affiliated to the French Health Insurance system—Echantillon Généraliste des Bénéficiaires (EGB)—was used: (i) 621 662 persons in 2015 among which 11 319 had an antipsychotic (AP) prescription; (ii) a sample of first AP prescriptions concerning 5 935 patients in 2013 and 2014 (no AP in the last 6 months of 2012) for whom diagnosis was available in 40% of cases. In 2015, AP prevalence was 21.9/1 000. SGAP/FGAP ratio was 1.02. Long‐lasting prescriptions were rare: 1.79/1 000 for FGAP and 1.38/1 000 for SGAP. FGAP first prescriptions were higher than SGAP for each age class, except for <18 aged patients; 2.85% had both generations; 50.7% of the patients had another psychotropic. GPs prescribed more FGAPs than SGAPs, psychiatrists prescribed more SGAPs and hospital‐based practitioners prescribed both generations equally, and these patterns changed across age ranges: For the elderly, GPs are the more frequent prescribers. SGAP/FGAP ratio is different by diagnostic categories. In France, FGAPs are largely prescribed by GPs mainly for the elderly, but young and adult patients are concerned as well. Inappropriate antipsychotic consumption through off‐label use, which adds to the co‐prescription, especially in vulnerable population groups, mainly concerns FGAP prescriptions by GPs who do not have psychiatric training and limited contact with psychiatrists. Attention should then be brought to the regulatory advisory agencies in order to better inform and train the prescribers

Differential Associations Between Excess Body Weight and Psychiatric Disorders in Men and Women

peer reviewedBACKGROUND: The current investigation is the first large-scale population-based study from France that documents the association between excess body weight and common psychiatric disorders, and examines the influence of gender on the association between excess body weight and these disorders. A recent plan has been implemented in France to treat the rising rate of those who are overweight or obese, and we seek to demonstrate whether integrated treatment of excess weight and psychiatric conditions appears as indicated. MATERIALS AND METHODS: Data were drawn from a cross-sectional general population survey of 17,237 adults. Past-year psychiatric disorders were assessed using the Composite International Diagnostic Interview-Short Form. Body mass index was used to determine excess weight status. RESULTS: Overall, 3.7% of the sample were underweight, 57% were normal weight, 28% were overweight (35% of men, 22% of women), and 11% were obese (11% of men, 11% of women). Being overweight was more common in men than women, although obesity did not differ by gender. Sociodemographic variables significantly associated with weight status included, age, marital status, education, employment status, income level, and population density. Adjusting for these variables, being overweight was associated with major depression and other disorders among women and inversely associated with drug abuse and dependence among men. Obesity was associated with major depression, panic disorder, agoraphobia, social phobia, specific phobia, and obsessive-compulsive disorder among women. Only generalized anxiety was associated with obesity among men. CONCLUSION: Past year, mental disorders were more likely associated with being overweight or obese among women as compared with men. The prevalence of these co-occurring psychiatric disorders in the context of the rising rate of obesity in France indicates a clear need for psychiatric assessment and treatment in caring for those with excess weight, especially women. Preliminary reports suggest this need is unmet within the otherwise progressive move in France to assist those struggling with excess weight

Differential Associations Between Excess Body Weight and Psychiatric Disorders in Men and Women.

peer reviewedBACKGROUND: The current investigation is the first large-scale population-based study from France that documents the association between excess body weight and common psychiatric disorders, and examines the influence of gender on the association between excess body weight and these disorders. A recent plan has been implemented in France to treat the rising rate of those who are overweight or obese, and we seek to demonstrate whether integrated treatment of excess weight and psychiatric conditions appears as indicated. MATERIALS AND METHODS: Data were drawn from a cross-sectional general population survey of 17,237 adults. Past-year psychiatric disorders were assessed using the Composite International Diagnostic Interview-Short Form. Body mass index was used to determine excess weight status. RESULTS: Overall, 3.7% of the sample were underweight, 57% were normal weight, 28% were overweight (35% of men, 22% of women), and 11% were obese (11% of men, 11% of women). Being overweight was more common in men than women, although obesity did not differ by gender. Sociodemographic variables significantly associated with weight status included, age, marital status, education, employment status, income level, and population density. Adjusting for these variables, being overweight was associated with major depression and other disorders among women and inversely associated with drug abuse and dependence among men. Obesity was associated with major depression, panic disorder, agoraphobia, social phobia, specific phobia, and obsessive-compulsive disorder among women. Only generalized anxiety was associated with obesity among men. CONCLUSION: Past year, mental disorders were more likely associated with being overweight or obese among women as compared with men. The prevalence of these co-occurring psychiatric disorders in the context of the rising rate of obesity in France indicates a clear need for psychiatric assessment and treatment in caring for those with excess weight, especially women. Preliminary reports suggest this need is unmet within the otherwise progressive move in France to assist those struggling with excess weight