Adolescent life events and adult mental health 5–9 years after referral for acute psychiatric outpatient treatment

Knowledge is needed of mental health in relation to life events of former acute child and adolescent outpatients at risk of suicide. The present study describes the long‐term mental health outcome of young adults who as children or adolescents were referred to outpatient psychiatry for mental health problems, and identifies putative mental health statistical outcome predictors at follow‐up, with focus on life events. One hundred patients referred to treatment at child and adolescent outpatient clinics in Nordland County, Norway, during 1990–1994 were interviewed face to face, 5–9 years after referral. At follow‐up, life events at young age were associated with the mental health status in spite of referral and acute psychotherapeutic intervention. There was a general effect of life events at young age, affecting a large number of mental health variables. Childhood and adolescence difficulties were highly correlated, indicating a possible continuation of effects from childhood to adolescence. Copyright © 2004 John Wiley & Sons, Ltd.     

The health status and life satisfaction of first-year medical students

The self-reported health status and life satisfaction of 286 first-year Duke University medical students in four consecutive classes were measured at the beginning and end of the school year and compared statistically with relevant sociodemographic and behavioral factors. Health status, quantitated in terms of Duke Health Profile scores, was generally lower for women than for men. Although there was a definite trend of worsening along all parameters of health and satisfaction during the year for both women and men, the most marked change was the increase in depressive symptoms. The students who were very satisfied with life had fewer symptoms of depression and anxiety; higher self-esteem, better physical, mental, and social health; stronger social ties; more physical activity; more sleep; and fewer stressful life events. Strong social ties was the factor most positively related to better health and life satisfaction.     

Association Between Perceived Health Care Stigmatization and BMI Change

Background/AimsThis study examined the association between experiences of health care stigmatization and BMI changes in men and women with normal weight and obesity in Sweden.MethodsThe participants were drawn from a population-based survey in Sweden (1996-2006), and data on their perceived health care stigmatization were measured in 2008. They were categorized in individuals with normal weight (n = 1,064), moderate obesity (n = 1,273), and severe obesity (n = 291). The main outcome measure was change in BMI.ResultsIndividuals with severe obesity experiencing any health care stigmatization showed a BMI increase by 1.5 kg/m² more than individuals with severe obesity with no such experience. For individuals with moderate obesity, insulting treatment by a physician and avoidance of health care were associated with a relative BMI increase of 0.40 and 0.75 kg/m², respectively, compared with their counterparts who did not experience stigmatization in these areas. No difference in experience of any form of health care stigmatizing associated BMI change was observed for men and women with normal weight.ConclusionIn this large, population-based study, perceived health care stigmatization was associated with an increased relative BMI in individuals with severe obesity. For moderate obesity, the evidence of an association was inconclusive.Key Words: Obesity, Prejudice, Primary health care, Gender identity, Body weight changes     

聋生与健全学生心理健康状况及相关因素的比较研究

目的探讨聋生与健全学生心理健康状况及影响因素的差异,为聋人高职院校心理健康教育及管理工作提供科学依据。方法选取某职业技术学院聋生103人和该校健全学生180人作为调查对象,采用症状自评量表(SCL-90)、青少年生活事件(ASLEC)、艾森克个性问卷(EPQ)、社会支持量表(SSRS)和简易应对方式问卷(SCSQ),分别对两组人员进行评定和统计分析。结果聋生组SCL-90各因子总分、总均分、焦虑、躯体化、抑郁、偏执、精神病性各因子均高于健全学生组,差异有显著意义;EPQ的精神质、神经质、掩饰;SSRS总分、主观支持、对支持的利用度;应对方式问卷的积极应对、消极应对与健全学生对照组相比均有显著差异(P<0.05);而两组青年生活事件(ASLEC)评定结果除其它因子外,聋生组的生活事件总分、人际关系因子、学习压力因子、受惩罚因子、丧失因子、健康适应因子均显著高于对照组。多元逐步回归分析表明,生活事件量表总分、消极应对、神经质、内外倾向、精神质是影响聋生心理健康的主要因素。结论聋生心理健康水平低于健全学生,其原因与生活事件、人格因素、社会支持、应对方式有关,提示应关注聋生心理健康状况,加强聋生心理健康教育和心理咨询...     

Death or illness of a family member,violence, interpersonal conflict,and financial difficulties as predictors of sickness absence: longitudinal cohort study on psychological and behavioral links

OBJECTIVE: Although an association between stressful life events and health problems has been demonstrated, the underlying mechanisms have remained unclear. We examined whether psychological problems and health-risk behaviors underpin the health effects of different event categories. METHOD: The initially healthy participants were 2991 (796 men, 2195 women) municipal employees who had taken no sick leave in 1995. In 1997, they completed a questionnaire requesting information on recent life events and psychological and behavioral factors. The outcome was recorded sickness absences in 1998. RESULTS: In men, the death or serious illness of a family member, violence, and financial difficulties increased the risk of later sickness absence. According to structural equation modeling, violence and financial difficulties also induced psychological problems such as anxiety, mental distress, and lowered sense of coherence. Psychological problems were associated with heightened cigarette and alcohol consumption, which in turn increased sickness absence. A corresponding structural model did not fit the data in relation to death or serious illness of a family member. In women, life events were associated with psychological problems and smoking but not sickness absence. CONCLUSIONS: Longitudinal evidence suggests that increased psychological problems and behaviors involving risk to health partially mediate the effect of stressful life events on health, as indicated by sickness absence. This model received support among men and for the event categories of violence and financial difficulties. Women were less affected by stressful life events than men.     

Obesity and health‐related quality of life: Does social support moderate existing associations?

Objectives Obesity has been shown to be negatively related to physical health‐related quality of life (HQOL) much more strongly than mental HQOL. This is remarkable given findings on obesity‐related social stigmata and associations with depression. Considering obesity as a stressor, this study tests for a moderating role of social support for obesity/HQOL associations among women and men. Design Data come from N=2,732 participants aged 35–74 years in a 2004–2005 general population survey in the Augsburg region, Germany. Methods Body weight and height were assessed by anthropometric measurements (classified by body mass index using WHO standards), social support by the Social Support Questionnaire 14‐item Short‐Form (F‐SozU‐K14) and HQOL by the 12‐item Short‐Form Health Survey (SF‐12). In multiple regression and general linear models, age, education, family status, health insurance, and place of residence were adjusted for. Results Among both genders, obesity was associated with reduced physical but not mental HQOL. Among men reporting strong social support, physical HQOL was impaired neither in the moderately nor the severely obese group (compared with normal weight), while it was given less social support. Among women, poor physical HQOL was associated with obesity regardless of social support. Conclusions In this adult population sample, no association was found for obesity with mental HQOL. In contrast, a negative association with physical HQOL exists for all subgroups except men with strong social support, indicating that social support buffers obesity‐related impairments in physical HQOL in men but not in women. This suggests that obese women and men with strong social support represent distinct populations, with possible implications for obesity care.     

Association between the scores on the general health questionnaire-28 and the saliva levels of 3-methoxy-4-hydroxyphenylglycol in normal volunteers

To access the saliva level of 3-methoxy-4-hydroxy-phenylglycol (sMHPG) as an index of mental health in normal volunteers, we investigated the relationship between the sMHPG and the scores on the general health questionnaire-28 (GHQ-28). A total of 270 normal volunteers answered the GHQ-28 and the sMHPG levels were determined. The sMHPG levels in women and men were comparable. There was a significant negative correlation between the social dysfunction score on the GHQ-28 and sMHPG levels in women (P=0.0035), but not in men. Moreover, the sMHPG levels also correlated with the total GHQ-28 score (P=0.0205), the anxiety and the insomnia score (P=0.0306) in women. These data indicate a high social dysfunction score on the GHQ-28 to be associated with a reduced noradrenergic neuronal tone thus possibly reflecting psychomotor retardation in women.     

云南少数民族地区贫困大学生心理健康的相关研究

目的通过对云南少数民族地区贫困大学生的心理健康与生活事件的相互关系的研究,以便为他们心理健康的维护及进行有效的干预提供依据与新思路。方法以青少年生活事件量表、症状自评量表随机抽取932名大学生进行团体施测。结果贫困生与非贫困生心理健康各因子及总分差异显著,贫困生生活压力比非贫困生大,主要的应激事件是经济困难、学习压力、人际关系、适应、就业;贫困大学生的心理健康状况与生活事件有非常显著的正相关。结论贫困生的心理健康水平明显低于非贫困生,他们的心理问题主要表现在强迫、抑郁、人际关系敏感、焦虑等方面。     

强迫症患者生活质量及相关因素分析

目的:了解强迫症患者生活质量的现状,探讨其相关影响因素。方法:采用自编一般情况调查表、健康状况问卷(SF-36),Yale-Brown强迫量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD),对60例强迫症患者进行调查。结果:除外生理健康和疼痛,强迫症患者总体生活质量其它各维度均低于中国常模(P<0.001);强迫症患者汉密尔顿抑郁分、强迫症严重程度分、强迫思维分与SF-36各维度均相关(P<0.05,或P<0.01);而强迫行为仅与SF-36中的社会功能、情感职能、精神健康和精力四个维度相关;就业状况与生理职能相关;合并躯体疾病的患者在一般健康、社会功能和精神健康维度得分更低,合并其它精神障碍的患者在疼痛、一般健康、社会功能和精神健康维度得分更低。结论:强迫症患者的生活质量明显低于正常人群,强迫的严重程度,尤其是强迫思维、同时是否合并其它躯体和精神障碍及就业状况对患者的生活质量有很大的影响。     

Adolescent mental health consumers' self‐stigma: associations with parents' and adolescents' illness perceptions and parental stigma

Currently, little is known about adolescents' self‐stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH problems? (b) to what extent do illness perceptions (adolescents and parents) and parents' own stigma experiences relate to adolescents' self‐stigmatization? The results, based on data from separate interviews with a voluntary sample of 60 adolescent–parent dyads, clients of MH wraparound services, suggest that approximately 20% of adolescents and parents reported significant concerns related to self‐stigmatization. Using multivariate analyses, we found that the three most prominent factors associated with adolescents' self‐stigma ratings included adolescents' perceptions of social skill deficits and trauma as causal factors pertaining to their mental health challenges, as well as parents' inclination to conceal their child's MH problems from others. © 2010 Wiley Periodicals, Inc.     

527名大学生心理健康状况及相关因素调查

目的 :了解大学生心理健康状况与负性生活事件、应对方式、社会支持等各种因素之间的关系。方法 :用SCL - 90、青少年生活事件量表 (ASLEC)、简易应对方式问卷、社会支持评定量表 (SSRS)等工具对 5 2 7名大学生进行调查。结果 :(1)影响大学生心理健康的因素依次是 :负性生活事件、消极应对方式、丧失因子、受惩罚因子、对支持的利用度。 (2 )负性生活事件与SCL - 90总分间有显著正相关 ;消极应对与SCL - 90总分间相关极其显著 ;社会支持总分及其各因子与SCL - 90总分间呈显著负相关。结论 :负性生活事件、消极应对等是影响大学生心理健康状况的重要因素     

Life Events,Emotions, and Immune Function: Evidence from Whitehall II Cohort Study

Abstract

Stressful life events have been shown to increase vulnerability to infections. However, the effects may be dependent on specific emotional responses associated with these events. In general, negative emotions are thought to exacerbate and positive emotions to protect from the adverse effects of stressors on health. In this study, we adopted an evolutionary and functionalist perspective on emotions and hypothesized that both positive and negative emotions in response to stressful events are protective, whereas absence of emotional reactions exacerbates vulnerability to infections. We assessed immune function using lymphocytes to white blood cells ratio as a proxy for current viral infection in 3,008 British civil workers (30% women). No main effect of stressful life events or emotions on lymphocyte ratio was observed in either sex. However, in men, there was an interaction of life events with both positive and negative emotions as well as a combined measure of general affect. Supporting our hypothesis, stressful life events were associated with impaired immune function in men who reported very low levels of both positive and negative emotions but not in others. We discuss potential benefits of negative and positive emotions in the context of stress and immunity.     

Sexual orientation and mental health in a birth cohort of young adults

BACKGROUND: This paper sought to examine the relationship between sexual orientation and mental health in a New Zealand birth cohort studied to age 25 years. METHOD: The analysis is based on a sample of 967 participants (469 males; 498 females) in the Christchurch Health and Development Study. As part of this study information was gathered on: (a) measures of sexual orientation, same-sex behaviour and sexual attraction obtained at ages 21 and 25 years; (b) measures of mental disorders and suicidal behaviours over the interval 21-25 years; (c) measures of childhood and family background. RESULTS: Latent class analysis was used to combine indicators of sexual orientation, same sex behaviour and attraction to form an empirically based classification of sexual orientation. The best-fitting model classified the sample into three groups: exclusively heterosexual orientation (87.6%); predominantly heterosexual but with same-sex inclinations or experience (9.6%); predominantly homosexual (2.8%). Proportionately more women than men were classified as predominantly heterosexual (14.2% v. 4.8% respectively) or predominantly homosexual (3.9% v. 1.5% respectively). Cohort members with a predominantly homosexual orientation had rates of mental disorder and suicidal behaviours that were between 1.5 and 12 times higher than for those with an exclusively heterosexual orientation. These associations persisted after adjustment for confounding. The associations between sexual orientation and mental health were more marked for males than females. CONCLUSIONS. The findings suggest a continuum of sexual preferences amongst young adults. Variations in sexual orientation were clearly associated with mental health. These associations tended to be stronger for males.     

新训学员心理健康状况与生活事件影响研究

目的探讨新训学员心理健康状况及生活事件对新训学员心理卫生状况的影响程度。方法对2002级500名学员进行测定,采用症状自评量表和自编军校学员生活事件问卷施测．应用SPSS软件统计分析。结果16．98％的学员存在中度以上心理问题,新训学员心理卫生水平要优于军校学员常模。新训学员主要生活事件为：军人角色的适应问题。心理健康阳性分数者和阴性分数者在某些生活事件上有显著差异。结论应有针对性地做好新训学员的管理教育和心理健康工作。     

The impact of a violent community on mental health and the benefits of a sport program for social development

The aim of the present study was to evaluate the impact of a violent environment on mental health and the impact of a sport for social development (SSD) program on quality of life, mental distress symptoms, and heart rate variability (HRV). HRV and psychometric data were measured from 20 men professional athletes assisted by the SSD and 20 men living in the same violent community. The comparison of groups revealed greater sympathetic parameters of HRV, positive affect, and quality of life in the SSD group. Multiple regression analysis showed that the quality of life in the SSD group was positively predicted by positive affect, while in the control group the quality of life was negatively predicted by their history of traumatic events. Both groups reported high levels of exposure to traumatic events and posttraumatic stress symptoms. However, this study demonstrates the benefits of SSD programs in mental health.     

Life events, social problems and physical health status as predictors of emotional distress in men and women in a community setting

The main aim of this study was to construct logistic models of emotional distress (defined as a GHQ-30 score of 6 or greater) in a community sample of 226 men and 225 women. The independent variables included were: sociodemographic characteristics, physical health status, social problems and undesirable life events. Univariate comparisons showed that in both sexes undesirable life events and social problems were associated with emotional distress; in men the presence of physical symptoms and widowed, separated or divorced status also showed such an association. Separate logistic regression models for men and women confirmed the importance of undesirable life events and social problems as predictors for emotional distress. In women there was also a significant interaction effect between the two variables on emotional distress. Sociodemographic characteristics and physical health status did not exert a statistically significant effect in these models.     

The prevalence of psychiatric morbidity and its associated factors in general health care in Taiwan

BACKGROUND: This paper reports the prevalence, disability, sociodemographic and clinical association of psychiatric morbidity among attenders in general health care in Taiwan where, as in the rest of non-Western countries, few studies have been carried out. METHODS: A cross-sectional survey with a two-phase design was carried out at out-patient clinics of three health stations and a general hospital. RESULTS: A total of 990 patients completed the brief screen in the first phase, 486 of whom completed the independent assessment in the second phase. The proportion of screening positives was 46.0% and the weighted prevalence of definite psychiatric disorder was 38.2%. Common mental disorders were associated with female gender and unemployment. Housewives, students and patients with higher educational attainment were at lower risk of having alcohol use disorders. Patients with common mental disorders were more likely to present with psychological complaints, to attribute their illness to psychosocial causes and to perceive their mental and physical health as poor. Psychiatric morbidity was associated with excess life events. Common mental disorders, particularly depressive disorders, were significantly associated with self-reported disability. CONCLUSIONS: Psychiatric morbidity is a major health problem in general health care in Taiwan. Physicians should be aware of these health problems.     

Stressful life‐events exposure is associated with 17‐year mortality,but it is health‐related events that prove predictive

Objectives Despite the widely‐held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life‐events exposure and death. The present analyses examined the association between overall life‐events stress load, health‐related and health‐unrelated stress, and subsequent all‐cause mortality. Design This study employed a prospective longitudinal design incorporating time‐varying covariates. Methods Participants were 968 Scottish men and women who were 56 years old. Stressful life‐events experience for the preceding 2 years was assessed at baseline, 8–9 years and 12–13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time‐varying covariates were applied. We adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure. Results Overall life‐events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17‐year mortality. Health‐related event numbers and impact scores were strongly predictive of mortality. This was not the case for health‐unrelated events. Conclusions The frequency of life‐events and the stress load they imposed were associated with all‐cause mortality. However, it was the experience and impact of health‐related, not health‐unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.     

The assessment of life change stress: a comparative and methodological inquiry

A comprehensive life events questionnaire was administered to 416 men. Total life change scores were computed from published normative weights and from individuals' own ratings of events that occurred. The results showed that the rank order of life events was highly correlated between our sample and the original normative groups. However, in the population of men we studied, there were significant differences between the total life event scores derived by summing the published normative weights and the total adjustment or distress reported by those men who experienced the events. Other results indicated that life event scores based on normative weights reflect more on the number of life events that are experienced, whereas life change scores based on individuals' ratings may better reflect on the potential impact of life change. Finally, the psychometric properties of several life change inventories are poor.     

医学中专生焦虑与生活事件相关性研究

目的探讨医学中专生的焦虑情绪与具体生活事件的关系,为医学中专生的心理健康教育提供更具针对性的理论依据。方法用儿童焦虑性情绪障碍筛查表,青少年生活事件量表,一般情况调查表,对随机抽取的沈阳医学院附属卫生学校在校的389名中专生进行调查。结果有焦虑情绪41人,占总人数的10.5%,其中男20人（10.5%）,女21人（10.6%）,两者比较无显著差异（P〉0.05）。相关分析发现焦虑情绪与生活事件各因子之间除社交恐怖和简明焦虑与丧失和健康适应因子之间无显著相关外,其余各因子之间均呈显著正相关（P〈0.01～0.05）;逐步回归分析发现影响焦虑情绪的生活事件依次为不喜欢上学、被人误会和错怪、升学压力、择业压力、家庭内部矛盾。结论影响医学中专生焦虑的因素较多,他们的焦虑障碍应引起重视。