Although asthma is strongly associated with elevated psychiatric morbidity, the extent to which neighbourhood deprivation is associated with psychiatric disorder risk in this population remains insufficiently understood. This study aims to examine whether neighbourhood deprivation is associated with the incidence of psychiatric disorders among adults with asthma, and whether these associations vary by sex and psychiatric disorder subtype.

Using nationwide Swedish registers (1997–2018), we identified 393,061 adults aged 25–64 years with asthma and followed them for incident psychiatric disorders. Neighbourhood deprivation was assessed at baseline and categorized into low, moderate and high levels. Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) and were stratified by sex and psychiatric disorder subtype.

During the follow-up period, 207,900 individuals (68,327 men and 139,573 women) developed psychiatric disorders. The incidence of psychiatric disorders increased progressively with higher levels of neighbourhood deprivation. In the fully adjusted models, compared with those living in low-deprivation areas, men in moderate and high deprivation areas had 11% (HR, 1.11; 95% CI, 1.08–1.13) and 31% (HR, 1.31; 95% CI, 1.27–1.35) higher hazards, respectively, while women had 10% (HR, 1.10; 95% CI, 1.08–1.11) and 22% (HR, 1.22; 95% CI, 1.19–1.25) higher hazards. Disorder-specific analyses revealed particularly strong associations for developmental delay (HR = 2.82), pervasive developmental disorder (HR = 1.96), schizophrenia (HR = 1.79) and substance use disorder (HR = 1.71). Women consistently showed higher cumulative incidence than men across all deprivation levels.

Neighbourhood deprivation was associated with higher psychiatric morbidity among individuals with asthma. These findings suggest the importance of integrating respiratory and mental healthcare with structural interventions targeting socio-economic disadvantage to help reduce inequalities in psychiatric outcomes.

Social inclusion is increasingly recognised as a key determinant of health and well-being, encompassing participation in social, economic, political and cultural life through access to resources, opportunities and relationships. Individuals with mental disorders are at increased risk of social exclusion, yet existing evidence often relies on broad population-level indicators that fail to capture the multidimensional nature of inclusion. This systematic review aimed to compare levels of social inclusion between these groups using validated psychometric instruments and to identify the dimensions in which disparities are most pronounced.

The review followed PRISMA guidelines. A two-step search strategy was conducted across PubMed, Embase, PsycINFO, Scopus, CINAHL and Web of Science. First, validated measures of social inclusion and related constructs were identified. Second, studies applying these instruments in individuals with and without mental disorders were retrieved. Eligible studies included adults with clinician-established or self-reported diagnosis of mental disorders and comparison groups from the general population. A random-effects meta-analysis was conducted to estimate standardised mean differences (SMDs) with 95% confidence intervals (CIs) between the two groups, while a thematic narrative synthesis explored domain-specific inequalities.

Ten studies met inclusion criteria, and six were included in the meta-analysis, comprising 844 individuals with mental disorders and 1086 controls. Individuals with mental disorders reported significantly lower levels of social inclusion than the general population (SMD = −0.91; 95% CI: −1.25 to −0.56). The narrative synthesis identified inequalities across several interconnected domains. Individuals with mental disorders experienced weaker social relationships, lower perceived support, reduced community participation and fewer opportunities for meaningful engagement. Marked disadvantages were also observed in employment, income, education and housing, including financial hardship, insecure living conditions and neighbourhood dissatisfaction. Several studies highlighted discrepancies between objective indicators of participation and subjective experiences of inclusion, indicating that participation alone may not reflect a sense of belonging or access to valued social roles. Socioeconomic position, gender and ethnicity appeared to intensify exclusion across domains.

Individuals with mental disorders experience substantial inequalities in social inclusion across interconnected relational, community and socioeconomic domains. These disparities are shaped by broader structural conditions and compounded by intersecting forms of disadvantage, including socioeconomic position, gender and ethnicity. The findings highlight the need for multidimensional, intersectional and person-centred approaches that recognise both the cumulative nature of exclusion and individuals’ subjective experiences of inclusion. Policies and interventions should address the social determinants that constrain opportunities for meaningful inclusion.

OSF: https://doi.org/10.17605/OSF.IO/USXWG.

Childhood maltreatment and adolescent mental health problems are unequally distributed, with the highest burdens among marginalised groups including females and those experiencing socioeconomic disadvantage. However, little is known about how the psychological consequences of maltreatment vary across intersecting social positions (e.g., socioeconomically disadvantaged females). Prior quantitative work has largely focused on average differences across a limited number of groups, obscuring non-additive intersectional patterning. Because social realities are structured by overlapping systems of privilege and oppression (e.g., relating to gender, socioeconomic position, ethnicity, age, and place), we leveraged recent methodological advances to address this gap. Accordingly, this study aimed to (i) map inequalities in adolescent emotional problems and the effects of maltreatment across intersectional positions; and (ii) describe the extent to which inequalities in emotional problems reflect additive and non-additive (intersectional) effects.

Data were analysed from 19 590 students aged 11–16 years who participated in the OxWell 2023 Student Survey in England, United Kingdom. Within a random-coefficient Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA), individuals were nested in 180 intersectional strata defined by combinations of social positions relating to gender, ethnicity, household poverty, school year group, and school-level deprivation (also entered as additive main effects). Emotional problems (Revised Child Depression and Anxiety Scale; RCADS-11) were regressed on maltreatment exposure (Short Childhood Maltreatment Questionnaire) as the primary effect of interest. Stratum-specific predicted emotional problems and maltreatment effects were estimated, and between-stratum variance was partitioned into additive and residual non-additive components.

Maltreatment was associated with higher levels of emotional problems, with stratum-specific increases ranging from +3.20 to +6.14 scale points. Socioeconomically disadvantaged females and individuals who selected ‘other’ or ‘prefer not to say’ for gender showed the highest levels of emotional problems and among the strongest maltreatment effects. Between-stratum inequalities in emotional problems were largely accounted for by maltreatment exposure and the additive contributions of the included social positions. However, residual non-additive effects were also evident, particularly among individuals exposed to maltreatment, where 5.25% of between-stratum variance remained unaccounted for by additive effects (compared with 3.46% among those not exposed).

In this large community sample of adolescents in England, the detrimental effects of maltreatment on emotional problems appear pervasive but not uniform across intersectional social positions. Applying an intersectional MAIHDA framework suggests that inequalities in adolescent emotional problems largely reflect additive social patterning, with additional non-additive contributions suggestive of intersectional dynamics that are more pronounced with maltreatment exposure. These findings motivate deeper investigation into the social-structural mechanisms that shape vulnerability and resilience in adolescence, and support the need for trauma-informed, equity-focused interventions and policy action to reduce unequal exposure to maltreatment and the contexts that amplify its harms.

Depression in cancer patients is a common condition that poses significant challenges for prognosis, treatment adherence, and quality of life. Its onset reflects the interplay of diverse biological, psychological, and social factors, which has been the focus of numerous studies.

We identified both systematic and non-systematic reviews examining cross-sectional or prospective studies reporting associations between DAFs and depression. We extracted data relative to DAFs, as well as the direction and statistical significance of the reported association. Consistency of findings was assessed by estimating the proportion of concordant studies (PCS) for each DAF. Methodological quality and risk of bias were assessed using a standardized tool.

We identified 73 reviews (26 systematic and/or meta-analyses, 47 narrative) encompassing 514 unique primary studies, reporting the associations between depression and 198 distinct DAFs. DAFs were grouped into six domains (sociodemographic, cancer-related, somatic, psychological, biological-genetic, and other). The strongest associations (PCS ≥ 75% and ≥5 studies) were observed for sociodemographic factors (e.g., high social support, being unmarried), inflammatory markers (IL-6, TNF-α, CRP), psychological factors (e.g., history of depression, distress, anxiety), and somatic factors (e.g., fatigue, low functional status, malnutrition). When restricting analyses to prospective studies, consistent associations emerged for cancer-related physical symptoms and time dedicated to patient communication.

Depression in cancer is multifactorial, with physical and psychosocial factors likely iteracting dynamically. Prospective studies are still greatly needed. Further research on risk and protective factors may facilitate risk stratification, early diagnosis and patient management.

Although often associated with ageing, disability is becoming increasingly prevalent among young adults. While disability can pose a substantial psychological burden for young adults on critical pathways to establish the foundations for their future, the mental health risks faced by this population remain underexplored.

This study aimed to (1) assess the association between disability – including its presence, severity and type – and the risk of depressive and anxiety disorders, and (2) examine whether this association varies across sociodemographic factors, health behaviours and comorbidities in a young adult population.

We conducted a population-based cohort study using linked data from the National Disability Registry and the National Health Insurance Database of South Korea. A total of 6,058,290 individuals aged 20–39 years who underwent health check-ups between 2009 and 2012 were followed through 2022. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for depressive and anxiety disorders.

Individuals with disabilities had significantly higher risks of depressive (aHR: 1.58, 95% CI: 1.55–1.60) and anxiety disorders (aHR: 1.50, 95% CI: 1.42–1.59). Increased risks were consistently observed across various disability types with the highest risk observed for mental health-related disabilities in depression (aHR: 4.98, 95% CI 4.62–5.37) and epilepsy-related disabilities in anxiety disorders (aHR: 12.05, 95% CI 8.73–16.63). Subgroup analyses revealed stronger associations among individuals in their 20s, low-income groups, non-smokers and those abstaining from alcohol, compared to their respective counterparts.

Young adults with disabilities, a population that has been relatively overlooked in policy discussions, warrant greater policy attention in relation to their mental health.

Loneliness is a global public health concern that has been widely associated with a variety of mental health impairments. Two dimensions of loneliness have been differentiated, that is, social loneliness (the perceived absence or inadequacy of a broader social network) and emotional loneliness (the perceived absence of a close, intimate relationship or emotional support from a significant person). The present study aimed to test the hypothesis that both dimensions of loneliness are differentially associated with mental health outcomes.

Altogether, 3275 individuals (aged 45.2 ± 15.7 years, 47.9% men), enrolled from the general population, were assessed at two waves spanning 6 to 7 months. Social and emotional loneliness were quantified using the 11-item De Jong Gierveld Loneliness Scale. Social isolation was assessed with the six-item Lubben Social Network Scale, depressive symptoms with the Patient Health Questionnaire-9, generalised anxiety with the Generalised Anxiety Disorder-7, social anxiety with the Social Interaction Anxiety Scale, and paranoid ideation with the Revised Green et al. Paranoid Thoughts Scale. The data were analysed using a cross-lagged panel network model. Covariates included age, gender, education, employment status, place of residence, monthly income, the history of psychiatric treatment and substance use.

Both dimensions of loneliness were bidirectionally associated and were found to have the highest overall weight of outcoming network connections. Emotional loneliness was bidirectionally and positively associated with all measures of mental health. In turn, social loneliness predicted higher levels of social anxiety but was not associated with other mental health outcomes. It was bidirectionally associated with social isolation.

The findings imply the relevance of differentiating social and emotional dimensions of loneliness in the assessment of its underlying mechanisms and consequences for mental health. Emotional loneliness might show a greater importance in the development of psychopathological symptoms compared to its social dimension.

Although extensive research has been conducted on the impact of the COVID-19 pandemic on global mental health, a systematic synthesis of the cross-time dynamics of suicidal ideation (SI) remains lacking. This study aims to systematically synthesise the global aggregated prevalence of SI before and after the pandemic, investigate the potential association between pandemic exposure and the SI risk through meta-regression analysis of longitudinal studies, and explore key moderating factors.

A systematic search was conducted in Web of Science, PubMed, PsycINFO and ProQuest databases up to August 2025. Observational studies were included if they employed cross-sectional or longitudinal designs and reported the prevalence of SI before and after the pandemic across global regions.

The analysis included 354 cross-sectional studies (N = 8,247,875) and 27 longitudinal studies. In cross-sectional studies, the pooled prevalence of SI was 13.20% [95% CI 12.06%–14.42%]. Pre-pandemic prevalence was 12.52% [95% CI 8.46%–18.14%], and post-pandemic prevalence was 13.24% [95% CI 12.07%–14.50%], with no significant difference. Meta-regression analysis identified three moderators. Specifically, larger sample sizes (n) were associated with lower prevalence (β = −0.232, P < 0.0001); higher study quality predicted lower prevalence (β = −0.278, P < 0.001); and studies on adults reported significantly lower prevalence than adolescents (β = −0.366, P < 0.05). Conversely, time progression during the pandemic, development level, geographical area, gender and measurement method did not show significant independent effects. Interaction analyses also found no significant moderating effect of economic development level or geographical area on the temporal trend of SI prevalence. Longitudinal analysis found no significant increase in prevalence from the pre-pandemic to the post-pandemic period (P = 0.101). However, a small but significant increase occurred between early and late stages within the pandemic (β = 0.265, P = 0.021). Subgroup analyses showed no significant moderation of these temporal changes.

The COVID-19 pandemic’s impact on SI was dynamic. While no significant prevalence change was found between pre- and post-pandemic periods, a significant increase occurred as the crisis progressed. This deteriorating trend was more pronounced in adolescents, identifying them as a key vulnerable group. Methodologically, findings were moderated by the measurement instrument, study quality and sample size, with evidence suggesting potential small-study effects. These findings underscore the need for robust mental health surveillance and targeted interventions for at-risk populations during prolonged public health crises.

The protocol was registered on PROSPERO (CRD42024603151).

The environment shapes the risk of psychosis. In particular, urbanicity, deprivation or inequality, migrant density and cannabis availability may not only influence psychosis incidence, but also the characteristics of individuals who arrive at clinical services. This study examined how socioeconomic factors influence the incidence and characteristics of cases of First-Episode Psychosis (FEP).

We analysed prospective data collected from the FEP early detection programme of Emilia-Romagna, a high-income Italian region. Participants were 1240 individuals aged 18–35 years, who presented at the public healthcare services for a FEP. Exposures were derived from area-level data of 331 municipalities. We used population density, socioeconomic deprivation, educational deprivation, economic inequality, migrant density (proportion of migrants), frequent cannabis use (proportion of people aged 15–19 years old who reported frequent cannabis use). Outcome measures were FEP incidence (cases/100 000 inhabitants at risk per year) and characteristics (age of onset, migrant status, unemployment, substance use, treatment lag [DUP], family and resource problems). We reviewed pertinent literature, and formulated a Directed Acyclic Graph to present causal assumptions and provide adjustment sets for Bayesian spatial and multilevel models of social causation. To compare the effects of different exposures, we computed Average Marginal Effects and report the outcome changes that correspond to one standard deviation change of the exposure, incidence rate ratios (IRR) or odds ratios (OR).

The exposures and incidence of FEP displayed heterogeneous spatial distribution, with no spatially organized pattern. Accordingly, incidence and characteristics were best modelled as non-spatial, three-level hierarchical models. The incidence of FEP was influenced by population density (IRR, 1.14; 95% CrI, 1.03; 1.29), educational deprivation (IRR, 1.15; 95% CrI, 1.02; 1.31) and frequent cannabis use (IRR, 1.31; 95% CrI, 0.98; 1.82), more than socioeconomic deprivation. Higher migrant density in an area shortened the DUP on average by 3.4 months (95% CrI, −1.122; 0.76), while an increase of cannabis use of one standard deviation increased the DUP of 12.9 months (95% CrI, −2.86; 6229). Socioeconomic deprivation increased the likelihood of FEP cases being substance users (OR, 1.12; 95% CrI, 1.01; 1.26), while population density decreased it (OR, 0.91; 95% CrI, 0.83; 1.00).

Area-level socioeconomic features affect both the incidence and the characteristics of FEP, including the probability of individual being migrants, substance users or having a different DUP. Educational deprivation may function as a proxy for culture- or cognitive-related factors. Area-level socioeconomic data may inform public healthcare strategies for early identification and availability of tertiary clinical services.

The associations of prior homelessness with current health are unknown. Using nationally representative data collected in private households in England, this study aimed to examine Common Mental Disorders (CMDs), physical health, alcohol/substance dependence, and multimorbidities in people who formerly experienced homelessness compared to people who never experienced homelessness.

This cross-sectional study utilised data from the 2007 and 2014 Adult Psychiatric Morbidity Surveys. Former homelessness and current physical health problems were self-reported. Current CMDs, alcohol dependence and substance dependence were ascertained using structured validated scales. Survey-weighted logistic regression was used to compare multimorbidities (conditions in combination) for participants who formerly experienced homelessness with those who had never experienced homelessness, adjusting for sociodemographic characteristics, smoking status and adverse experiences. Population attributable fractions (PAFs) were calculated.

Of 13,859 people in the sample, 535 formerly experienced homelessness (3.6%, 95% CI 3.2–4.0). 44.8% of people who formerly experienced homelessness had CMDs (95% CI 40.2–49.5), compared to 15.0% (95% CI 14.3–15.7) for those who had never experienced homelessness. There were substantial associations between prior homelessness and physical multimorbidity (adjusted odds ratio [aOR] 1.98, 95% CI 1.53–2.57), CMD–physical multimorbidity (aOR 3.43, 95% CI 2.77–4.25), CMD–alcohol/substance multimorbidity (aOR 3.53, 95% CI 2.49–5.01) and trimorbidity (CMD–alcohol/substance–physical multimorbidity) (aOR 3.26, 95% CI 2.20–4.83), in models adjusting for sociodemographic characteristics and smoking. After further adjustment for adverse experiences, associations attenuated but persisted for physical multimorbidity (aOR 1.40, 95% CI 1.10–1.79) and CMD–physical multimorbidity (aOR 1.55, 95% CI 1.20–2.00). The largest PAFs were observed for CMD–alcohol/substance multimorbidity (17%) and trimorbidity (16%).

Even in people currently rehoused, marked inequities across multimorbidities remained evident, highlighting the need for longer-term integrated support for people who have previously experienced homelessness.

Humanitarian migrants are at increased risk of post-traumatic stress disorder (PTSD) and elevated psychological distress. However, men and women often report varying degrees of stress and experience different challenges during migration. While studies have explored PTSD, psychological distress, gender, and resettlement stressors, they have not explored the interplay between these factors. This study aims to address that gap by investigating gender disparities in PTSD and psychological distress among humanitarian migrants in Australia, with a focus on the moderating role of socioeconomic factors.

This study used data from five waves of the Building a New Life in Australia (BNLA) survey, a longitudinal study of 2,399 humanitarian migrants who arrived in Australia in 2013. PTSD and psychological distress were measured using the PTSD-8 and Kessler-6 (K6) scales, respectively. We conducted generalised linear mixed-effect logistic regression analyses stratified by gender.

Female humanitarian migrants exhibited a significantly higher prevalence of PTSD and psychological distress than males over five years of resettlement in Australia. Women facing financial hardship, unemployment, or residing in short-term housing reported greater levels of PTSD and distress compared to men.

Women facing financial hardship, inadequate housing, and unemployment exhibit higher rates of PTSD and psychological distress, underscoring the significant impact of socioeconomic factors. Addressing these challenges at both individual and systemic levels is essential for promoting well-being and managing mental health among female humanitarian migrants.

While factors such as age and education have been associated with persistent differences in functional cognitive decline, they do not fully explain observed variations particularly those between different racial/ethnic and sex groups. The aim of this study was to explore the association between allostatic load (AL) and cognition in a racially diverse cohort of young adults.

Utilizing Wave V of the National Longitudinal Study of Adolescent to Adult Health – a nationally representative, longitudinal survey of adults aged 34–44, this study utilized primary data from 10 immune, cardiovascular, and metabolic biomarkers to derive an AL Index. Cognition was previously recorded through word and number recall scores. Regression analysis evaluated the association between cognitive recall, AL, age, sex, and race/ethnicity.

Regression results indicated statistically higher AL scores among Blacks (IRR = 1.09, CI = 1.01, 1.19) compared to Whites and lower AL score among females compared to males (IRR = 0.76, CI = 0.72, 0.81). At zero AL, Blacks (IRR = 1.2399, CI = 1.2398, 1.24) and Other races (IRR = 1.4523, CI = 1.452, 1.4525) had higher recall while Hispanics (IRR = 0.808, CI = 0.8079, 0.8081) had lower recall compared to Whites. Relative to males, females had higher number recall (IRR = 1.1976, CI = 1.1976, 1.1977). However, at higher, positive levels of AL, Blacks (IRR = 0.9554, CI = 0.9553, 0.9554), Other races (IRR = 0.9479, CI = 0.9479, 0.9479) and females (IRR = 0.9655, CI = 0.9655, 0.9655) had significantly lower number recall than Whites and males respectively.

Race and sex differences were observed in recall at different levels of AL. Findings demonstrate the need for further exploration of cognition in young adults across diverse populations that includes examination of AL.

Refugees are at an elevated risk of some mental disorders with studies highlighting the contributing role of post-migration factors. Studies of migrant groups show neighborhood social composition, such as ethnic density, to be important. This is the first longitudinal study to examine this question for refugees and uses a novel quasi-experimental design.

We followed a cohort of 44 033 refugees from being first assigned housing under the Danish dispersal policy, operating from 1986 to 1998, until 2019. This comprised, in effect, a natural experiment whereby the influence of assigned neighborhood could be determined independently of endogenous factors. We examined three aspects of neighborhood social composition: proportion of co-nationals, refugees, and first-generation migrants; and subsequent incidence of different mental disorders.

Refugees assigned to neighborhoods with fewer co-nationals (lowest v. highest quartile) were more likely to receive a subsequent diagnosis of non-affective psychosis, incident rate ratio (IRR) 1.25 (95% confidence interval (CI) 1.06–1.48), and post-traumatic stress disorder (PTSD), IRR 1.21 (95% CI I.05–1.39). A comparable but smaller effect was observed for mood disorders but none observed for stress disorders overall. Neighborhood proportion of refugees was less clearly associated with subsequent mental disorders other than non-affective psychosis, IRR 1.24 (95% CI 1.03–1.50). We found no statistically significant associations with proportion of migrants.

For refugees, living in a neighborhood with a lower proportion of co-nationals is related to subsequent increased risk of diagnosed mental disorders particularly non-affective psychosis and PTSD.