This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL).

Results are based on a nationally representative sample (DEGS1-MH; n = 4483 aged 18–79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4 weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (= active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (= unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12 months (= non-active cases [NAC]; partially or fully remitted).

In comparison to UAI (mean: 1.9), AC reveals a 2–3 fold disability days/month (5.4, P < .001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P < .001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P < .001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases.

By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.

Previous research has suggested an association between the use of social networking sites (SNSs) and mental health problems such as psychological distress, suicidal ideation and attempts in adolescents. However, little is known about the factors that might mediate these relationships. The present study examined the link between the use of social networking sites and psychological distress, suicidal ideation and suicide attempts, and tested the mediating role of cyberbullying victimization on these associations in adolescents.

The sample consisted of a group of 11-to-20-year-old individuals (n = 5126, 48% females; mean ± SD age: 15.2 ± 1.9 years) who completed the mental health portion of the Ontario Student Drug Use and Health Survey (OSDUHS) in 2013. Multiple logistic regression analyses were used to test the mediation models.

After adjustment for age, sex, ethnicity, subjective socioeconomic status (SES), and parental education, use of SNSs was associated with psychological distress (adjusted odds ratio, 95% confidence interval = 2.03, 1.22–3.37), suicidal ideation (3.44, 1.54–7.66) and attempts (5.10, 1.45–17.88). Cyberbullying victimization was found to fully mediate the relationships between the use of SNSs with psychological distress and attempts; whereas, it partially mediated the link between the use of SNSs and suicidal ideation.

Findings provide supporting evidence that addressing cyberbullying victimization and the use of SNSs among adolescents may help reduce the risk of mental health problems.

Mother–daughter relationship was the focus of studies on the development of eating disorders (ED) for many years. This study aimed to examine the association between the father–daughter relationship and ED and depressive symptoms.

Fifty-three women diagnosed with ED were compared to a psychiatric control group (n = 26) and to healthy participants (n = 60) regarding their perception of their fathers and the relationship with them. Assessments were done using the Parental Bonding Instrument, the Eating Disorders Questionnaire, the Body Shape Questionnaire, the Eating Attitude Test, and the Beck Depression Inventory as well as narrative-based methods.

Fathers’ negative attributes were significantly associated with ED and depressive symptom. Two profiles of father–daughter relationship were found, the “caring and benevolent” relationship and the “overprotective and avoidant” one. In the latter, patients displayed significantly higher levels of food-restraint, more concerns about eating and about their body shape and appearance, and higher levels of depression.

Negative perception of the father's parenting style as well as the quality of the relationship with him are crucial for the understanding of the development and persistence of ED. Therapeutic programs for ED should focus not only on the relationship with the mother but must also address the relationship with the father.

To study the impact of chronic, life-threatening stressors in the form of daily missile attacks, for five consecutive years, on pregnancy outcomes.

Charts of deliveries from two neighboring towns in the south of Israel, covering the years 2000 and 2003–2008, were reviewed retrospectively. One city had been exposed to missile attacks, while the other was not. For each year, 100 charts were chosen at random.

Significant association was found between exposure to stress and frequency of pregnancy complications (P = 0.047) and premature membrane rupture (P = 0.029). A more detailed analysis, based on dividing the stressful years into three distinct periods: early (2003–2004), intermediate (2005–2006) and late (2007–2008), revealed that preterm deliveries were significantly more frequent (P = 0.044) during the intermediate period, as was premature membrane rupture during the late period (P = 0.014).

Exposure to chronic life-threatening stress resulted in more pregnancy complications and in particular more premature membrane ruptures. The impact was most significant during the middle period of the 5-year-exposure to the stressor. Hence it seems that factors of duration and habituation may play a role in the impact of chronic, life-threatening stressors on pregnancy.

The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness.

We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose).

The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P = 0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P = 0.086). However, the BMI decreased significantly more in the CG, by 0.26 kg/m2 (95%CI: 0.02 to 0.51; P = 0.038), than in the IG. There were no significant differences in the WC.

The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters.

Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).

Anorexia nervosa (AN) may be associated with impaired decision-making. Cognitive processes underlying this impairment remain unclear, mainly because previous assessments of this complex cognitive function were completed with a single test. Furthermore, clinical features such as mood status may impact this association. We aim to further explore the hypothesis of altered decision-making in AN.

Sixty-three adult women with AN and 49 female controls completed a clinical assessment and were assessed by three tasks related to decision-making [Iowa Gambling Task (IGT), Balloon Analogue Risk Task (BART), Probabilistic Reversal Learning Task (PRLT)].

People with AN had poorer performance on the IGT and made less risky choices on the BART, whereas performances were not different on PRLT. Notably, AN patients with a current major depressive disorder showed similar performance to those with no current major depressive disorder.

These results tend to confirm an impaired decision making-process in people with AN and suggest that various cognitive processes such as inhibition to risk-taking or intolerance of uncertainty may underlie this condition Furthermore, these impairments seem unrelated to the potential co-occurent major depressive disorders.

Over the last 50 years, several studies have provided estimates of the prevalence of transsexualism. The variation in reported prevalence is considerable and may be explained by factors such as the methodology and diagnostic classification used and the year and country in which the studies took place. Taking these into consideration, this study aimed to critically and systematically review the available literature measuring the prevalence of transsexualism as well as performing a meta-analysis using the available data.

Databases were systematically searched and 1473 possible studies were identified. After initial scrutiny of the article titles and removal of those not relevant, 250 studies were selected for further appraisal. Of these, 211 were excluded after reading the abstracts and a further 18 after reading the full article. This resulted in 21 studies on which to perform a systematic review, with only 12 having sufficient data for meta-analysis. The primary data of the epidemiological studies were extracted as raw numbers. An aggregate effect size, weighted by sample size, was computed to provide an overall effect size across the studies. Risk ratios and 95% confidence intervals (CIs) were calculated. The relative weighted contribution of each study was also assessed.

The overall meta-analytical prevalence for transsexualism was 4.6 in 100,000 individuals; 6.8 for trans women and 2.6 for trans men. Time analysis found an increase in reported prevalence over the last 50 years.

The overall prevalence of transsexualism reported in the literature is increasing. However, it is still very low and is mainly based on individuals attending clinical services and so does not provide an overall picture of prevalence in the general population. However, this study should be considered as a starting point and the field would benefit from more rigorous epidemiological studies acknowledging current changes in the classification system and including different locations worldwide.

Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care.

We used data from the French cohort Étude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses.

Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad.

Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics.

Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority.

The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders.

Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students’ Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents.

Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect.

The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents.

Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized that co-morbid anxiety disorders would be particularly predictive for early relapse, but not late relapse.

In a prospective design, male alcohol dependent patients (n = 189) were recruited from an inpatient detoxification clinic. Psychiatric diagnoses and personality traits were assessed using the Mini International Neuropsychiatric Interview for psychiatric disorders and the Temperament and Character Inventory. The addiction severity index was used to assess addiction severity and follow-up.

One year after detoxification, 81 patients (53%) relapsed and nine patients (7%) were deceased, due to alcohol related causes. Co-morbid anxiety disorder, marital status, addiction severity, in particular legal problems, and harm avoidance predicted relapse. Anxiety disorders specifically predicted early relapse.

Alcohol dependence is a severe mental disorder, with high relapse rates and high mortality. Alcohol dependent patients with co-morbid anxiety disorders are particularly prone to relapse during the first three months of treatment. These patients may therefore require additional medical and psychological attention.

Numerous treatment guidelines recommend that long-term use of benzodiazepines (BZD) should be avoided primarily due to development of tolerance and a risk for BZD dependence. Despite this, long-term BZD use remains a controversial subject in clinical patient care with “for and against” debates. However, there is no explicit understanding of what is meant by long-term BZD use in real world. The aim of this study was to assess different definitions, usage patterns, prevalence and other characteristics of long-term BZD use based on published register-based studies. Synthesis of these characteristics is essential to derive a meaningful definition of long-term BZD.

Systematic review of register-based studies on long-term BZD use published in 1994–2014.

Fourty-one studies met our predetermined inclusion criteria. The length of BZD use defined as “long-term” varied in these studies ranging from one month to several years. The most common definition was six months or longer during a year. The prevalence of long-term BZD use in the general population was estimated to be about 3%. The relative proportion of long-term BZD users (all definitions) in adult BZD users ranged from 6% to 76% (mean 24%; 95% CL 13–36%). The estimates were higher in studies only on the elderly (47%; 95% CL 31–64%). Long-term use involved typically steady treatment with low BZD doses. However, in elderly patients long-term BZD use and exceeding recommended doses was relatively common. Several characteristics associated with long-term use were found.

Long-term BZD use is common and a clinical reality. Uniform definitions for “long-term”, which is in line with population-based evidence, is needed to have more comparable results between studies. Our systematic review suggests that duration of BZD treatment over six months, the most common definition for long-term BZD use in the included studies. As also recommended previously, it is a useful starting point for further analyses on disadvantages but also potential advantages associated with long-term BZD use.