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The Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5) and International Classification of Diseases – 11th Revision (ICD-11) employ different post-traumatic stress disorder (PTSD) criteria, necessitating updated prevalence estimates. Most of the existing evidence is still based on ICD-Tenth Revision and DSM-Fourth Edition criteria, leading to varied estimates across populations. This study provides current PTSD prevalence rates in the German general population, comparing DSM-5 and ICD-11 criteria and examines variations by age and gender.
Methods
In a 2016 cross-sectional survey of 2404 adults (18–94 years) representative of the German general population, participants completed the Life-Events-Checklist for DSM-5 (LEC-5) for trauma exposure and the PTSD Checklist for DSM-5 (PCL-5) for PTSD symptoms. Probable PTSD diagnoses were based on DSM-5-, ICD-11-algorithms and suggested cut-off scores. Chi-square and McNemar’s tests were used to test differences in prevalence rates by diagnostic framework, age and gender.
Results
Of the total sample, 47.2% (n = 1135) reported experiencing at least one lifetime traumatic event (TE), with transportation accidents (7.3%) and life-threatening injuries (4.9%) being most common. Probable PTSD prevalence was 4.7% under both DSM-5 and ICD-11 criteria, and 2.6% based on a conservative cut-off normed for prevalence estimation. Gender and age were not significantly associated with TE exposure or PTSD prevalence, though trauma types varied: female participants more often reported sexual violence and severe suffering, while more male participants reported physical assaults and various types of accidents. DSM-5 and ICD-11 diagnostic algorithms had substantial yet not perfect agreement (κ = 0.62). Particularly within the re-experiencing symptoms, cluster agreement was only moderate (κ = 0.57). The cut-off method aligned more closely with DSM-5 (κ = 0.60) than ICD-11 algorithm (κ = 0.42).
Conclusions
This study provides updated PTSD prevalence estimates for the German general population and underscores differences between DSM-5 and ICD-11 in identifying cases, particularly with respect to re-experiencing symptoms. These findings emphasize that while overall PTSD prevalence rates under DSM-5 and ICD-11 criteria are similar, the diagnostic frameworks identify partially distinct cases, reflecting differences in symptom definitions. This highlights the need to carefully consider the impact of evolving diagnostic criteria when interpreting prevalence estimates and comparing results across studies.
Epidemiological studies on catatonia encounter several methodological challenges, and as a result, the historical epoch and clinical context must be carefully considered when estimating its incidence and prevalence. Over the past 70 years, the reported incidence and prevalence of catatonia have significantly declined, influenced by several key historical developments, including the widespread use of antipsychotic medications, shifts in diagnostic criteria, advances in psychiatric care, and changes in the clinical recognition of the disorder. The reclassification of catatonic symptoms as antipsychotic-induced motor side effects, along with the decentralization of psychiatric care and shorter patient observation periods, contributed to this decline. This chapter explores the limitations of epidemiological research on catatonia, particularly regarding its prevalence across diverse patient populations. It provides a detailed analysis of catatonia’s incidence and prevalence in different epochs, various clinical settings, considering factors such as sex ratios, age distribution, ethnicity, and recurrence rates, supported by the most recent scientific evidence.
Cross-cutting issues like nutrition have not been adequately addressed for children with severe visual impairment studying in integrated schools of Nepal. To support advocacy, this study aimed to determine the nutritional status of this vulnerable group, using a descriptive cross-sectional design involving 101 students aged 5–19 years from two integrated public schools near Kathmandu Valley and two in western Nepal. The weight-for-age z-score (WAZ), height-for-age z-score (HAZ), and body mass index-for-age z-score (BAZ) were computed and categorised using World Health Organization cut-off values (overnutrition: z-score > +2.0 standard deviations (SD), healthy weight: z-score −2.0SD to +2.0SD, moderate undernutrition: z-score ≥ −3.0SD to <−2.0SD, severe undernutrition: z-score < −3.0 SD) to assess nutritional status. A child was considered to have undernutrition for any z-scores <−2.0SD. Multivariate logistic regression was used to analyse variables linked to undernutrition. The mean age of participants was 11.86 ± 3.66 years, and the male-to-female ratio was nearly 2:1. Among the participants, 71.29% had blindness, and 28.71% had low vision. The mean BAZ and HAZ scores decreased with age. The WAZ, HAZ, and BAZ scores indicated that 6.46% were underweight, 20.79% were stunted, and 5.94% were thin, respectively. Overall, 23.76% of students had undernutrition and 7.92% had overnutrition. More than three in ten students had malnutrition and stunting was found to be prevalent. Older students and females were more likely to have undernutrition. These findings highlight the need for nutrition interventions within inclusive education settings, particularly targeting girls with visual impairments who may face compounded vulnerabilities.
Specific phobias are common in the community, and much is known from epidemiological surveys about their subtypes and sex ratio.
Aims
To determine the subtypes and sex ratio in a treatment-seeking sample of people with a specific phobia.
Method
Patients with a specific phobia were identified by a retrospective search of clinical case records from patient notes in electronic health records at the South London and Maudsley NHS Foundation Trust (the largest secondary mental healthcare provider in Europe).
Results
We identified 1017 patients over 5 years as having a specific phobia. The adult female to male sex frequency ratio for having any specific phobia was 3.9, with the ratio of specific phobia subtypes ranging from 2.4 (natural environment) to 8.2 (animal). The child female to male ratio of specific phobia subtypes ranged from 0.7 (natural environment) to 1.8 (other subtypes). Phobia of vomiting was the most common specific phobia presenting in both adults (n = 161, 17.8% of all specific phobias) and children (n = 26, 23.4%). In adults with a phobia of vomiting, the female to male ratio was 9.1 compared with 3.4 in all other specific phobias, and 4.2 versus 0.98 for children.
Conclusions
There is a stark contrast between the apparent prevalence of phobia of vomiting in epidemiological surveys and being the most common presentation clinically. A very high female to male ratio in phobia of vomiting and animals in adults seeking treatment is also in contrast to findings in the community. This has implications for clinician training and public education.
Fasciolosis, a parasitic disease of ruminants, poses significant economic and animal-health challenges in Algeria. This study aimed to assess spatial, temporal, and species-specific patterns of fasciolosis prevalence across diverse agro-climatic zones and to estimate associated economic losses. Between 2013 and 2023, eight wilayas El-Tarf, Skikda, Jijel (Region I), Blida, Mila (Region II), and M’Sila, Medea, Laghouat (Region III) were surveyed. Systematic postmortem inspections of 1,569,392 animals (349,176 cattle; 982,669 sheep; 235,639 goats; 1,882 camels; 26 horses) were performed by qualified veterinarians, with liver and bile-duct examination for Fasciola. Data on region, species, year, and season were analyzed in R 4.4.0 using ANOVA, Kruskal–Wallis, Tukey’s post hoc tests, and principal component analysis (PCA). Economic losses were calculated from condemned liver weights in Blida, Laghouat, and Jijel, converted to USD. PCA distinguished three regional prevalence profiles, with PC1 (77.7% variance) separating overall prevalence levels. Region I exhibited the highest mean prevalence (2.47%), peaking at 3.54% in 2018 – significantly greater than Region II (1.39%) and Region III (1.96%) (p < 0.01). Cattle showed the greatest infection rate (mean 4.14%), significantly higher than sheep (1.32%; p < 0.001) and goats (0.25%; p < 0.001), while horses and camels remained uninfected. Seasonal analysis revealed highest prevalence in autumn and winter (≈2.1%) versus spring (≈1.5%). Economic losses totaled USD 10.6 million in Blida, USD 1.0 million in Laghouat, and USD 142.2 million in Jijel over the study period. Targeted control strategies, adapted to regional and seasonal risk patterns, are essential. Future work should investigate environmental and management factors driving regional differences and evaluate cost-effective interventions to mitigate fasciolosis impact in Algerian livestock.
Data on the infection of Middendorffʼs eelpout, Hadropareia middendorffii, by metacercariae of the trematodes Cryptocotyle lingua Creplin, 1825 and Liliatrema skrjabini Gubanov, 1953, which are causative agents of black spot disease, is provided here for the first time for Taui Bay, Sea of Okhotsk. The prevalence of infection of fish by larvae of C. lingua reached 79%, while the intensity of infection varied from one to 278 individuals (with an average of 53). The prevalence of infection by L. skrjabini was lower (40%), with an intensity from one to 22 larvae (on average, eight). Metacercariae of both trematode species were surrounded by two envelopes: an outer, connective tissue capsule formed by the host’s cells, and an inner cyst formed by the parasite. The examined metacercariae were found in all regions of the fish’s body (head, trunk, and fins), with approximately equal numbers of individuals of both species found in tissues of the head and trunk regions. Metacercariae of C. lingua were localised in the fishes’ muscles, not only immediately under the skin but also in deeper layers. The capsules formed around metacercariae of both trematode species were dominated by fibroblasts and collagen fibres and did not show pronounced signs of inflammation. Studying the distribution of black spot disease and its effects on fish is crucial for understanding disease patterns in relation to fish population dynamics. It may also inform the development of effective anthelmintic treatments for use in aquaculture farms.
Population dynamics of aquatic parasites respond to factors like host availability, habitat age and quality. Amphipods are intermediate hosts for Acanthocephala, a widespread group of parasitic worms. Acanthocephalan infections of amphipods can easily be detected, and the widespread occurrence of amphipods makes their infection status an attractive potential proxy for the ecological status of their aquatic environment, including stressors introduced by urbanization. This study investigated the prevalence and the species-level and genetic diversity of Acanthocephala in the stream amphipod Gammarus fossarum. The study streams cross forested, agricultural and urban landscapes in the eastern foothills of the European Alps. Parasite prevalence ranged from 0% to 8.8% and increased towards downstream reaches independent of surrounding land use. Oxford Nanopore Technology was used to sequence the mitochondrial cytochrome oxidase I barcoding locus to identify parasite species and assess their genetic diversity. The majority of the parasites were Pomphorhynchus tereticollis, which use fish as definitive hosts. Despite their relative abundance in the studied streams, their genetic diversity was low and the most common haplotype was found at all sampling sites, which might indicate population expansion. Amphipods also hosted P. laevis and Polymorphus sp. type 1, the first evidence of this cryptic species within Polymorphus cf. minutus in Austria. Genetic diversity was high in Polymorphus sp. type 1, possibly reflecting a large effective population size due to gene flow maintained by the avian final hosts. The low and downstream-biased prevalence suggests that definitive hosts may be a limiting factor for Acanthocephala populations in small streams.
Accumulating evidence shows that an increasing number of children and young people (CYP) are reporting mental health problems.
Aims
To investigate emotional disorders (anxiety or depression) among CYP in England between 2004 and 2017, and to identify which disorders and demographic groups have experienced the greatest increase.
Method
Repeated cross-sectional, face-to-face study using data from the Mental Health of Children and Young People surveys conducted in 2004 and 2017, allowing use of nationally representative probability samples of CYP aged 5–16 years in England. A total of 13 561 CYP were included across both survey waves (6898 in 2004 and 6663 in 2017). We assessed the prevalence of any emotional, anxiety and depressive disorder assessed using the Development and Well-Being Assessment and classified according to ICD-10 criteria.
Results
The prevalence of emotional disorders increased from 3.9% in 2004 to 6.0% in 2017, a relative increase of 63% (relative ratio 1.63, 95% CI 1.38, 1.91). This was largely driven by anxiety disorders, which increased from 3.5 to 5.4% (relative ratio 1.63, 95% CI 1.37, 1.93). The largest relative changes were for panic disorder, separation anxiety, social phobia and post-traumatic stress disorder. Changes were similar for different genders and socioeconomic groups, but differed by ethnicity: the most pronounced increase was among White CYP (relative ratio 1.88, 95% CI 1.59, 2.24), compared with no clear change for Black and minority ethnic CYP (relative ratio 0.85, 95% CI 0.52, 1.39). Comorbid psychiatric conditions were present in over a third of CYP with emotional disorders, with the most common being conduct disorder.
Conclusions
Between 2004 and 2017, the increase in emotional disorders among CYP in England was largely driven by anxiety disorders. Socioeconomic inequalities did not narrow. Disaggregating by ethnicity, change was evident only in White CYP, suggesting differential trends in either risk exposure, resilience or reporting by ethnicity.
Many marine invertebrates are intermediate hosts to parasites. As some of these parasites may influence host behaviour and act as cryptic agents involved in mass mortality, knowledge of their presence, dynamics, and life cycles is important. Our aim with the present study is to provide a survey of parasites in subtidal cockles in the Limfjorden (Denmark), to examine their influence on cockles, and to assess their possible role in the surfacing of cockles, as this phenomenon is considered a prelude to mortality. The trematode fauna of the studied subtidal population was poor in species, but about 19% of the examined cockles in late summer and autumn were infected by Monorchis parvus – a species not previously reported from cockles in Danish waters. Heavily infected cockles were filled with small, undulating, worm-like sporocysts, each filled with metacercariae. From August to November, the number of metacercariae in sporocysts increased, and at a certain point, the growing stock of sporocysts is supposed to reach a level where the cockle is unable to perform vital life functions. Our data show that infected individuals exhibit less annual shell growth than uninfected ones. There was no significant difference in the prevalence of M. parvus between unburied and buried cockles. Cockle-eating fish from the family Sparidae are known as final hosts to M. parvus, but these fish do not occur in Danish waters. Therefore, the record-high presence of M. parvus in cockles from the Limfjorden is surprising, and we consider alternative life cycle options for this trematode.
Opioid use disorder (OUD) is a medical condition associated with problematic opioid use, leading to addiction and severe life impairments. This research delivers an in-depth evaluation of OUD burden and trends at global, regional and national levels.
Methods
This study analysed the global burden of OUD from 1990 to 2021 using data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study. Key metrics included age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs), disaggregated by gender, age, region, country and socio-demographic index (SDI) quintiles. The average annual percentage change described trends, while the age-period-cohort model evaluated age, period and cohort effects. A Bayesian Age-period-cohort model predicted future OUD trends from 2022 to 2040.
Results
In 2021, the global burden of OUD remained substantial, with a total of 16,164,876 cases and a prevalence of 154.59 cases per 100,000 population (95% uncertainty interval [UI]: 131.06–181.26). In 2021, the global incidence of OUD reached 1,942,525 cases (95% UI: 1,643,342–2,328,363), and its global mortality reached 99,555 deaths (95% UI: 92,948–108,050), with DALYs amounting to 11,218,519 (95% UI: 9,188,658–13,159,551). Regionally, high SDI regions, particularly in the High-income North America, exhibited the greatest burden. Among countries, the United States faced the most severe burden and increase, with the highest prevalence (2014.62 per 100,000), incidence (151.84 per 100,000), mortality (15.37 per 100,000) and DALYs (1594.63 per 100,000), and all APPC values exceeding 5%. Males aged 20–39 years were the most affected demographic. However, forecasts indicate that the OUD burden among females will significantly increase over the next 20 years, with the prevalence and incidence expected to rise by 39% and 49%, respectively.
Conclusions
The global burden of OUD has statistically significantly increased from 1990 to 2021. There are marked disparities across regions, countries and SDI levels. High-SDI regions, particularly High-income North America, bear the heaviest burden, with young males (aged 20–39 years) being the most affected groups. However, caution should be exercised regarding the female population, as the number of affected individuals is rapidly increasing.
On February 6, 2023, seismic activity struck Kahramanmaraş, with earthquakes of magnitudes 7.7 and 7.6. The study aimed to determine the effect of the presence of PTSD and its scores on hygiene behaviors.
Methods
This cross-sectional study was conducted in Adıyaman, Türkiye, between September and October 2023. The study population comprised individuals aged 18 and above who had experienced the earthquake. The PTSD Checklist-Civilian (PCL-C) scale was used to evaluate PTSD, and the Hygiene Inventory was used to evaluate the participants’ hygiene behaviors.
Results
Females, those with lower levels of education, the unemployed, singles, those living in tents, individuals who lost a loved one in the earthquake, and those with PTSD had worse hygiene behaviors compared to other groups. In the multivariate model of linear regression analysis of hygiene total score, only the PTSD score retained its predictive significance for hygiene behavior. More than 50% of the participants had scores meeting PTSD. The total PTSD score and the prevalence of PTSD among women was notably greater.
Conclusions
Mental health plays a pivotal role in shaping individuals’ hygiene practices and behavior patterns post-disaster. Swift implementation of mental health interventions is crucial for the prevention of behavioral pathologies.
Energy drinks (ED) can cause cardiovascular, gastrointestinal and other health disorders. These effects are particularly pronounced in youth. The aim of this study was to systematically review the literature on the consumption of ED in European countries.
Design:
A systematic bibliographic search was performed in November 2024 in EMBASE, MEDLINE (Ovid), Scopus and Cochrane databases with no restrictions on country, study period, study design and language.
Setting:
ED are beverages high in caffeine, sugar and other stimulants.
Participants:
A total of 2008 studies were identified and reviewed by four researchers. Ninety-four met the inclusion criteria and were extracted in a table designed ad hoc.
Results:
The included studies showed differences regarding their design, definition of consumption and time frame under study. The most studied frequency of ED consumption was weekly consumption, and the most studied population was school students. An increase in the prevalence of consumption was observed when tracking ED consumption over time. Variables most related to consumption were low socio-economic status, alcohol and tobacco consumption, physical activity, age and sex.
Conclusions:
It is difficult to have a clear picture of the extent of ED consumption in Europe, mainly due to differences in the design of the studies and the lack of periodicity of the estimates in different countries. However, given the health problems that have been associated with ED consumption, regulation of these beverages is essential, especially in youth.
Many consultations in primary care involve patients with mental health problems, and primary care is typically the place where many such patients initially seek help. While considerable research has examined the prevalence of mental health disorders in primary care, relatively few papers have examined this issue in recent years. This study aims to address this gap by reviewing contemporary literature from 2014 to 2024 on the prevalence of mental health disorders among general practice patients.
Methods:
A comprehensive search across PubMed, PsycINFO, and Google Scholar was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for article selection and assessment, examining the prevalence of mental health disorders in general practice.
Results:
Studies varied in methodologies and healthcare settings, with reported prevalence rates of mental health disorders ranging from 2.4% to 56.3%. Demographic characteristics (female gender, older age) were associated with a higher prevalence of mental health disorders in the studies identified. Studies based on patient interviews reported broader prevalence (2.4–56.3%) compared to studies using electronic medical record reviews (12–38%). Prevalence also varied between countries. Notably, there has been a lack of post-COVID-19 studies, especially within Europe, examining the prevalence of mental health prevalence in primary care.
Conclusions:
Mental health problems are still common among patients attending general practice; the approach to data collection (i.e., prospective interviews with patients), female gender and older age appear to be correlates of higher estimates. Further research involving a large-scale study with multiple sites is a priority.
Eating disorders and psychotic disorders represent two of the most serious psychiatric conditions. Emerging lines of evidence from genetic and epidemiological studies suggest that these disorders may commonly co-occur. This systematic review investigated the association between these disorders across community and clinical populations.
Method
A systematic review was preregistered (CRD42021231771) and conducted according to PRISMA guidelines. Web of Science, PsycINFO and Medline were searched for articles on the association and comorbidity between psychosis and eating disorders up to the 26th February 2024. A random effects meta-analysis was conducted for studies reporting comorbidity of eating disorders and psychotic disorders based on clinical diagnosis or interview measures, to estimate prevalence of the comorbidity between these disorders. A narrative synthesis was conducted for all other studies and grouped by sample (general population, eating disorders or psychotic disorders).
Results
In total 43 studies met inclusion criteria for the systematic review and 16 were included in the meta-analysis. Findings suggest substantial comorbidity between eating disorders and psychotic disorders, with a pooled comorbidity prevalence of 8% (CI: 3, 14) based on clinical diagnosis or interview measures. Studies using self-report questionnaires also highlight the association between eating disorders and psychosis across clinical and community populations.
Conclusions
Eating disorders and psychotic disorders frequently co-occur. Further research should investigate the temporal order of symptom development and consider the need for novel interventions targeted at overlapping psychotic and eating disorder symptoms and associated phenomena.
Personality disorders, characterised by pervasive emotional and interpersonal dysfunction, are integral to psychiatric practice. This service review estimated the prevalence of personality disorders in a psychiatric inpatient setting and looked at various clinical and demographic factors of interest.
Methods:
Data were retrospectively collected from 526 patients discharged from St Patrick’s University Hospital in 2019–2020 under the care of two consultant-led teams. Demographic and clinical data such as age of first mental health contact, number of previous admissions, and risk history were recorded as well as the use of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD).
Results:
37% of the sample had at least one personality disorder, with borderline (24.9%), avoidant (13.3%) and obsessive-compulsive (7.6%) being the most common subtypes. Notably, in 72.1% of cases the diagnosis was new. High comorbidity was observed, particularly with affective (47.7%) and anxiety disorders (28.4%). Patients with personality disorders exhibited high rates of self-harm (45%) and suicide attempts (40%).
Discussion:
The review highlighted potential delays in diagnosis, with an average of 15 years of mental health service contact prior to diagnosis. The findings underscore the need for specialised services and further research to better understand and manage personality disorders in the Irish psychiatric setting. Limitations include the specific sample from a private mental health facility and the high use of structured interviews, which may affect the generalisability of the results to other settings. This review contributes valuable data to the limited research on personality disorder prevalence in Irish psychiatric services.
When students are asked about the difficulties they experience in their epidemiology classes, one of the biggest barriers they report is the language their teachers use to describe the concepts being explained (note, it is the language rather than the concepts themselves). And here’s the thing: it is epidemiologists who are largely to blame, not the teachers! Being a relatively young discipline, it is not unusual to come across different words being used to describe the same concept, or the same word being used to describe different concepts – sometimes fundamentally different. Confusing, right?
Since cannabis was legalized in Canada in 2018, its use among older adults has increased. Although cannabis may exacerbate cognitive impairment, there are few studies on its use among older adults being evaluated for cognitive disorders.
Methods:
We analyzed data from 238 patients who attended a cognitive clinic between 2019 and 2023 and provided data on cannabis use. Health professionals collected information using a standardized case report form.
Results:
Cannabis use was reported by 23 out of 238 patients (9.7%): 12 took cannabis for recreation, 8 for medicinal purposes and 3 for both purposes. Compared to non-users, cannabis users were younger (mean ± SD 62.0 ± 7.5 vs 68.9 ± 9.5 years; p = 0.001), more likely to have a mood disorder (p < 0.05) and be current or former cigarette smokers (p < 0.05). There were no significant differences in sex, race or education. The proportion with dementia compared with pre-dementia cognitive states did not differ significantly in users compared with non-users. Cognitive test scores were similar in users compared with non-users (Montreal Cognitive Assessment: 20.4 ± 5.0 vs 20.7 ± 4.5, p = 0.81; Folstein Mini-Mental Status Exam: 24.5 ± 5.1 vs 26.0 ± 3.6, p = 0.25). The prevalence of insomnia, obstructive sleep apnea, anxiety disorders, alcohol use or psychotic disorders did not differ significantly.
Conclusion:
The prevalence of cannabis use among patients with cognitive concerns in this study was similar to the general Canadian population aged 65 and older. Further research is necessary to investigate patients’ motivations for use and explore the relationship between cannabis use and mood disorders and cognitive decline.
Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.