International Journal of Social Psychiatry

Currently, paradoxical findings exist regarding the level of functioning in individuals with Hikikomori (prolonged social withdrawal).

This systematic review aimed to clarify the functioning, disability, and health of individuals with Hikikomori and their families in comparison to those without Hikikomori.

Relevant studies were searched from April 22 to 25, 2022, using MEDLINE, PsycINFO, Scopus, and two Japanese databases. Functions were categorized into ‘body functions”; “structure”; and “activity and participation’, which were further classified into subcategories.

Of the 8,181 studies screened, 24 studies with 1,769 individuals with Hikikomori were included. Twelve, three, and four indicators from six studies on depression and anxiety, three on addiction, and two on thought problem symptoms, respectively, were higher in the Hikikomori group than in the comparison group, with at least moderate effect sizes. Three indicators from three studies on interpersonal relationships were worse in the Hikikomori group, with at least moderate effect sizes. The meta-analyses showed that internalizing symptoms, externalizing symptoms, and thought disorders were significantly higher in the Hikikomori group than those in the comparison group with moderate-to-high effect sizes. Contrastingly, communication/interpersonal interactions were significantly lower in the Hikikomori group than those in the comparison group. No significant differences were observed in daily life/social life and the families’ communication/interpersonal interactions and relationship.

The study limitations include a high risk of bias and heterogeneity. Overall, individuals with Hikikomori often have impaired mental and interpersonal interaction functions; thus, comorbidities of this condition should be carefully assessed.

PROSPERO: CRD42022320592.

Excessive use of smartphones and the Internet can lead to addiction and may increase the risk of developing mental disorders, particularly in the context of the COVID-19 outbreak.

This systematic review and meta-analysis synthesized the existing literature reporting the impact of smartphone and Internet addiction on mental health during the COVID-19 pandemic.

A systematic search was performed on two databases, PubMed and EMBASE, following the PRISMA guidelines to identify articles conducted from December 2019 when the COVID-19 pandemic began to emerge. Studies were selected based on pre-defined criteria and assessed for quality before inclusion in the meta-analysis. The main effect estimate gathered from eligible studies was the odds ratio, which was computed using the random-effects model.

Our findings demonstrated significant associations between Internet addiction and depression (OR = 4.09, 95% CI [3.28, 5.09]), Internet addiction and anxiety (OR = 3.08, 95% CI [2.08, 4.57]), smartphone addiction and depression (OR = 3.82, 95% CI [3.31, 4.40]), and smartphone addiction and anxiety (OR = 4.81, 95% CI [3.81, 6.07]) during the COVID-19 pandemic.

This meta-analysis underscores that Internet and smartphone addiction increases the likelihood of developing mental disorders in the context of the COVID-19 pandemic. During the outbreak of infectious diseases, it is imperative for nations to not only address economic and educational challenges but also prioritize the mental well-being of their citizens.

Multidisciplinary care planning for people with intellectual disabilities who engage in behaviours of concern (BoC) is challenging and complex. Effective collaborative understanding and action planning across all stakeholders is essential. Cornwall’s Adult Community Learning Disability Team developed a care planning tool (Connect Behaviour) using contemporary evidence and best practice. Connect Behaviour is designed to facilitate care planning by collaborative and enhanced shared understanding and is also available as an interactive web-based tool.

To evaluate Connect behaviour using stakeholders’ experiences.

Family members, care providers, advocates, social workers and professionals who had attended meetings guided by the Connect Behaviour care planning tool in a 3-month period were interviewed about their experiences of those meetings. This was interpreted using inductive thematic analysis.

 Of 71 individuals identified as meeting this criterion of inclusion 61 were contactable and 27 consented to participation. These participants consisted of 17 health professionals, two parents, two social workers, three advocates, two positive behaviour support advisors within care providers, and one manager of a local care provider. The thematic analysis of participant views of connect behaviour generated five superordinate themes of ‘pragmatic’, ‘enabling’, ‘validation of effort’, ‘perceived lack of flexibility’ and ‘areas for development’. Further inquiry of themes highlighted subthemes of Connect Behaviour being ‘sensible’, ‘practical’, ‘collaborative’, ‘holistic’ and ‘action’. Conversely, some perceived a lack of flexibility in the care planning tool. Future areas for development were also identified in the data. Changes were recommended to increase the tool accessibility for people with intellectual disabilities, support stakeholders understanding of the tool, and consider utility for other clinical scenarios.

The evaluation established general feedback to continue to use the Connect Behaviour as a care planning tool. The benefits of Connect Behaviour in comparison to other care planning frameworks needs to be understood.

Eating disorders (EDs) have traditionally been studied among heterosexual cisgender women, but recent research highlights a higher prevalence in LGBTQIA+ individuals.

This study aims (1) to investigate the association between different groups based on gender identity and sexual orientation (GISO) and experiencing eating symptoms, and (2) to explore the extent to which self-perceived discrimination and adverse conditions explain this association.

We administered an online survey to assess eating symptoms using the Eating Disorder Examination Questionnaire (EDE-Q 6.0) and measures of self-perceived discrimination and adverse conditions. Multistep logistic regressions were employed to analyze the associations between GISO and eating symptoms, initially unadjusted, then adjusted for sociodemographic variables, and finally adjusted for self-perceived discrimination and/or adverse conditions.

A total of 560 adults aged 30 ± 10.9 years old were included. After adjusting for socio-demographics all groups were more likely to experience eating symptoms compared to heterosexual men, with odds ratios (ORs) of 5.7 [95% CI: 1.3, 24.3] for cisgender heterosexual women, 6.7 [95% CI: 1.5, 29.8] for cisgender non-heterosexual women, and 9.3 [95% CI: 1.8, 47.5] for non-cisgender individuals. After adjusting for self-perceived discrimination and adverse conditions, the associations for women were attenuated, while the associations for non-cisgender individuals were no longer significant.

This study (1) confirms that sexual and gender minorities may be at higher risk for EDs, and (2) suggests that discrimination and adverse conditions may contribute to the higher prevalence of eating symptoms in this population. Additional research is needed to investigate these minority stressors as they may represent targets for effective interventions to prevent eating symptoms in the LGBTQIA+ community.

Both the symptoms and diagnoses of mental health disorders affect individuals’ occupational status and income. However, studies that compare the impact of differences between symptoms and diagnoses on occupational outcomes are lacking.

This study aimed to compare labour market attachment and income until midlife between individuals with different histories of mental disorder symptoms and diagnoses.

Utilizing the Northern Finland Birth Cohort 1966 with linkages to national registers and self-reported mental disorder symptoms at the age of 31, we compared labour market attachment and income until midlife among individuals with neither mental disorder symptoms nor a diagnosis (reference group), symptomatic undiagnosed mental disorder, asymptomatic diagnosed mental disorder, and with symptomatic diagnosed mental disorder by using cross-tabulations and regression analyses. We stratified our analysis by sex.

Compared to the reference group, males but not females with symptomatic undiagnosed mental disorder had an increased risk for poor labour market attachment, with Odds Ratios (95% Confidence intervals) 2.26 [1.41, 3.63] and 0.87 [0.63, 1.19], respectively. The analogous risk was heightened for both males and females with asymptomatic diagnosed mental disorders or symptomatic diagnosed mental disorders. Regarding income, having mental disorder symptoms, a diagnosis, or both was associated with lower earnings irrespective of sex.

Mental disorder symptoms and diagnoses are differently associated with labour market attachment and income. Our findings suggest that interventions should be offered not only based on diagnoses but also based on symptoms as they may serve as predictors of future challenges related to work careers.

This paper aims to explore the intricacies of cross-sectoral collaboration in mental health care, focusing on the perspectives of health professionals across various disciplines. It seeks to understand how collaboration can enhance service delivery and patient outcomes while identifying existing challenges.

The evolving healthcare landscape emphasizes the importance of integrating services across sectors, particularly in mental health care, to improve continuity and efficiency of care.

The study utilizes qualitative methods to investigate health professionals’ experiences with cross-sectoral collaboration in mental health services.

Purposive sampling was used to select 21 health professionals for focus group discussions held at a mental health center in Region Zealand, Denmark. Data was collected through these discussions, and content analysis was performed to extract key themes. The data collection took place in 2022.

Health professionals recognized the potential benefits of cross-sectoral collaboration, such as enhanced service delivery and improved patient outcomes. However, significant barriers were identified, including bureaucratic obstacles, communication gaps, and insufficient organizational support.

Cross-sectoral collaboration in mental health care offers significant advantages, but challenges must be addressed to fully realize its potential. Efforts should focus on policy reforms, organizational support, and fostering interdisciplinary communication to improve care delivery.

Conflict-induced displacement is a greater risk factor for mental health challenges, especially in countries where people have limited access to mental health services. This study examined the prevalence of mental distress, post-traumatic stress disorder (PTSD), and their relationship with key demographic variables and psychological capital among conflict-induced Internally Displaced People (IDP) in the Wag-Hemra Zone, Amhara Region, Ethiopia.

The study used a cross-sectional quantitative design, and simple random sampling was used to recruit 367 IDPs from the Weleh IDP camp in Sekota town. The Psychological Capital Questionnaire (PCQ 12), Kessler Psychological Distress Scale (K 10), and Post-traumatic Stress Disorder–Civilian Version (PCL-C) scales were used to collect data. STATA version 2021 was used to analyze data.

The prevalence of mental distress and posttraumatic stress disorder (PTSD) was 63% and 48 %, respectively. Mental distress and PTSD were higher among female participants (M = 27.4, 45.7), those who experienced rape (M = 32.6, 55.5), witnessed murder (M = 25.2, 46.1), widowed (M = 30.9, 44.9), illiterate (M = 28.1%, 47.2), and adolescents (M = 27.6, 45.5). Stepwise regression analysis indicated that psychological capital is a significant negative predictor of mental distress and PTSD (p = .000), with 26% mental distress and 20.9% variance in PTSD accounting for psychological capital, with self-efficacy being the strongest predicting component of psychological capital.

The study underlined that mental health efforts should target enhancing psychological capital as the critical element in mitigating the psychological impacts of war and displacement. Training on improving self-efficacy, utilizing the solid spiritual and religious base of the IDP community to raise hope and optimism, and leveraging the communal culture to foster resilience could help reduce mental distress and the effects of PTSD among IDPs in the study area.

Adverse childhood experiences (ACE) are pivotal precursors to poor mental health outcomes. However, studies focusing on the Arab/Islamic population, including Oman, are scarce. This cross-sectional study investigated the association between ACE and mental health outcomes (e.g., depression, anxiety, suicidal ideation) among Omani adults.

A total sample of 1,648 adults were recruited from a university-affiliated hospital in Oman using convenient sampling technique. Adverse Childhood Experience International Questionnaire (ACE-IQ) was utilized to measure ACEs while CDC Health Appraisal Questionnaire (HAQ) was used to measure the mental health outcomes.

The results show that 88% of participants suffered at least from one ACE in their childhood. The prevalence of mental health outcomes as follow: anxiety (10.32%), depression (6.10%), and suicidal ideation (4.61%). ACE level significantly correlated with depression (p < .001), anxiety (p < .001), and suicidal ideation (p = .001). Participants with four ACEs or more have higher odds ratio for depression (10.03), anxiety (3.44), and suicidal ideation (3.93). Demographic factors (except education level) showed significant associations with all mental health outcomes.

This study highlights a substantial association between ACE and mental health disorders among Omani adults, underscoring the need for targeted interventions to address ACE’s enduring impact on adult mental health in Omani society

Receiving a formal diagnosis for a depressive disorder is a prerequisite for getting treatment, yet the illness inherently complicates care-seeking. Thus, understanding the process from depression symptoms to diagnosis is crucial.

This study aims to disentangle (1) risk factors for depression symptoms from (2) facilitators and barriers to receiving a diagnosis after experiencing depression symptoms.

We used data from the German Socio-Economic Panel. Within a sample of 40,238 individuals, we investigated factors predicting depression symptoms, assessed with the SF-12 Mental Component Summary score. Additionally, within a subsample of 3,444 individuals with depression symptoms, we analyzed factors associated with receiving a first-ever diagnosis in the subsequent year. These factors included health status, demographics, socioeconomic characteristics, personality traits, and health infrastructure.

Depression symptoms were associated with chronic physical conditions, female gender, middle age, living alone, fewer close friends, being unemployed or not working, lower income, lower agreeableness, conscientiousness, or extraversion, and higher neuroticism. Additionally, poorer overall mental and physical health, female gender, older age, unemployment, and neuroticism were positively associated with receiving a formal diagnosis. Access to general practitioners and psychotherapists was not associated with receiving a formal diagnosis.

Our results replicated previous research on risk factors for depression symptoms. Moreover, some risk factors for experiencing symptoms (female gender, middle age, unemployment, and higher neuroticism) subsequently also facilitated receiving a formal depression diagnosis. Thus, this study underscores the importance of considering the chronological sequence in the process from depression symptoms to diagnosis.

Individuals living with severe mental illness (SMI) are at higher risk of being overweight and obese. In addition to medication side effects, poor dietary habits are considered as modifiable factors. However, individuals with SMI face a variety of barriers to healthy eating, and it is still unclear which dietary strategies are best.

The current study aimed to examine the course of dietary habits in dieting and non-dieting patients treated at a psychiatric day clinic.

In this longitudinal observational study, symptom severity, dietary habits, and other health-risk behaviors of n = 53 psychiatric outpatients with a primary ICD-10 diagnosis (85% F3 and 15% F2) were assessed at the start of treatment in a psychiatric day clinic and after 3 months using semi-structured interview data and anthropometric measurements.

Patients’ mental health improved after 3 months of treatment (e.g. lower scores on a modified Global Assessment of Functioning Scale (m-GAF) and on the 9-item Patient Health Questionnaire (PHQ-D)). However, BMI and lifestyle behaviors (e.g. diet quality, physical activity, and smoking) remained unchanged. Fewer depressive symptoms and dieting were even associated with weight gain over the 3 months (+1.7 kg). Compared with non-dieters, dieters had higher levels of neuroticism and ambivalence about eating, were more likely to overeat and were more dissatisfied with their body weight.

The group of dieters may benefit from professional support to achieve a healthier lifestyle.

Amidst increasing occurrences of disasters and traumatic events, there is growing concern about the declining mental health of young adults, who are facing rising societal pressures and uncertainty about their futures.

This study investigates the interplay between collective trauma, anxiety, and resilience among young adults in the Korean context. Based on survey data collected in 2023 from 323 Korean young adults aged 18 to 34 years, a multiple linear regression and independent t-tests were used to examine their experiences of collective trauma, collective anxiety, and resilience, taking gender differences into account.

Collective anxiety was associated with resilience, but collective trauma was not. Gender differences were observed: competition- and security-related anxiety, education, and income were positively associated with resilience only for men, while fairness-related anxiety was negatively associated only with women’s resilience. Adaptation-related anxiety was a significant factor for both groups.

Certain types of collective anxiety and socioeconomic status may act as protective factors against trauma. Gender should be considered when designing mental health assessments and services for young adults to address the unique needs and challenges in building resilience and managing anxiety.

Effective mental health systems depend on the functioning of a variety of factors that can be systematically monitored across countries. Macro-level assessments are needed to identify potential areas for improvement in the health sector, particularly in countries that face significant access barriers such as Greece.

To analyze Greece’s mental health-related indicators in comparison to countries with similar socioeconomic contexts and geography and identify priority areas for the national mental health system.

Data was sourced from the Global Mental Health Countdown 2030, an initiative gathering 48 indicators from 193 countries, classifying metrics into four domains: mental health system performance, determinants of mental health, factors influencing the demand for care, and wellbeing. We analyzed 39 indicators available for Greece to perform a comparative analysis with three groups of countries (27 European Union, 55 high-income, and 52 upper-middle income nations). We employed content analysis to organize mental health system indicators into a framework to inform policy and practice.

Greece exhibited low performance in several indicators related to mental health provision, with four metrics falling below the 12.5th centile for all comparative groups (‘interventions in primary care’, ‘policy implementation’, ‘promotion and prevention’, and ‘frequency of collection of data’). A content-analysis framework grouped indicators into categories related to the mental health system, with low-scoring metrics clustering around ‘policy and planning’, ‘affordability of care’, ‘coordination of services’, and ‘data collection and quality assessment’.

This analysis provides a contextualized overview of Greece’s mental health system, identifying areas for improvement based on a panel of evidence-based indicators. Priority policy actions should focus on enhancing mental health insurance coverage and freely-available mental health services, organizing provision into a stepped-care and coordinated service network, and establishing systematic data monitoring mechanisms with unified electronic registers.

To date, most large surveys on the mental health of children under 11 years old have relied exclusively on data collected from parents and teachers, with no information from children themselves. However, these children are valuable informants despite their young age.

To evaluate the effects of adding young children’s self-evaluation of internalizing disorders to a combined teacher/parent-based algorithm using data from a European survey carried out in Italy, Bulgaria, and in the Netherlands.

Comparing concordances with the Development and Well-Being Assessment (DAWBA; considered as the gold standard) of a Strengths and Difficulties Questionnaire’s (SDQ) parent/teacher-based predictive algorithm, with and without integrating a child self-evaluation. The child self-evaluation was using the Dominic Interactive (DI), a computerized, pictorial, self-administered questionnaire for young children, which followed DSM 5 diagnoses definitions for internalized disorders. The concordance comparisons concerned 238 children, 5 to 12 years old from out-patient clinics, double evaluated, using kappa concordance test . Subsequent variations in disorder prevalence were evaluated in cross-sectional surveys in the general populations of the three study countries (n = 3,442).

Adding self-evaluated child DI-based ‘probable’ internalizing disorder diagnoses to the SDQ parent/teacher algorithm increased concordance with gold standard: kappa increased from .25 (.14–.37) to .36 (.23–.49). In terms of population-based data, this addition increased the prevalence of ‘probable’ emotional disorders from 2.00 % (1.56–2.53) to 3.63 % (3.03–4.31) and revealed an expected gender difference.

The inclusion of young children’s self-reported data on internalizing disorders is a valuable addition to the generally used combined parent/teacher-based SDQ algorithm, and therefore better reflects the true prevalence of these disorders in these children. Further evaluation on larger validation samples is required.

There has been significant reduction in inpatient beds for people with intellectual disability and/or autism (PwID/A) in the UK in the last decade following high profile national scandals in specialist psychiatric hospitals. To reduce inappropriate admissions a new strategy (Blue-Light, an emergency multi-disciplinary meeting to prevent admission to hospital) was introduced. However, there is no research on the influence of Blue-Light on crisis management for PwID/A.

To assess Blue-Light’s impact on PwID/A’s crisis presentations

Co-produced with experts-by-experience, a mixed methods approach using a 13 question Likert based survey of health and social-care professionals along with semi-structured interviews of carers involved with consecutive Blue-Light patient reviews was undertaken in Cornwall UK (population: 538,000). Patient data was accessed to understand the patient journey. All data analysis was descriptive in nature. Semi-structured interviews were transcribed and thematically analysed using Braun and Clarke’s six-step process.

Ten patient journeys were examined. Staff interviewed had a good understanding of the Blue-Light process, Blue-Light activation practical challenges and considered Blue-Light reactive. Nearly half wanted ID/A specialist beds recommissioned. A majority wanted improved supervision and standards for third sector providers. Semi-structured interviews of 10 patient-carers identified a lack of consistency from professionals, limited infrastructure provision, the prolongation of crises and a lack of definition of crisis as carers did not feel supported by services.

Current crisis support systems are not standardised and often leave carers feeling unsupported in crises. An evidence-based debate of crisis support and the inpatient role for PwID/A is required.

Homelessness is a deeply ingrained aspect of our culture. It has a detrimental influence on people of all ages’ physical and mental well-being, child development, academic success and the establishment and upkeep of families. Homelessness and mental illness have a reciprocal relationship that makes them two interrelated social issues that affect people’s ability to function and communities all over the world.

The study followed a Quasi-experimental research design – Pre and Post without control group, conducted in an urban rehabilitation center. A basic random sampling technique was used to select a sample of the respondents. All eligible participants who gave their consent were given the WHO Disability Assessment Schedule (WHODAS 2.0) and a semi-structured interview schedule. Statistics procedures used frequency distribution and inferential statistics such as t-tests, chi-square and correlation.

The results of the study show that the majority of the respondents (60.00%) were in the age group 20 to 40 years, 73.3% were male, 50% were married, 62.7% had no children and their educational status shows that the majority of them (63.3%) were literate 56.7% were unemployed prior to institutionalisation. The mean percentage of disability of the respondents followed by the intervention (30.9 ± 16.4) was found to be significantly lesser than (t = 11.6, df = 29, p < .001) their level of disability (52.7 ± 17.8) before the psychosocial intervention. A significant negative correlation exists between disability and income (r = −.48, p < .01).

Psychosocial intervention plays an essential role in enhancing functionality among homeless persons with mental illness in terms of self-help skills, social skills development, casework, group work, working with family and community and networking with community-based organisations to develop a support system. The present study revealed a significant negative correlation between disability and income.

In the earthquake of magnitude 7.7 and 7.6 in Turkey on February 6, 2023, many buildings collapsed and many people suffered emotional and spiritual damage. It is important to understand the situations experienced by people who experienced the earthquake and to plan strategies according to these views in the future.

The aim of the study is to examine the preparations of people living in Hatay province before the earthquake, their experiences during the earthquake and their experiences after the earthquake in a qualitative design. Twenty-eight individuals (14 women and 14 men) between the ages of 18 and 65 years, who experienced the earthquake in Hatay, Turkey, participated in the study.

Participants were asked nine questions about before, during and after the earthquake using a semi-structured interview method. It was found that 32.1% of the participants made any preparations before the earthquake, all of them experienced the feeling of fear the most, 82.1% of them used prayer behavior instead of protective strategies during the earthquake, all of them were affected psychologically, socially, and economically, and 35.7% were physically affected.

As a result of the analysis of participant opinions, it was seen that pre-earthquake preparation processes were insufficient, behaviors during the earthquake were not protective, and individuals and their environment were negatively affected after the earthquake.