Although the United States incarcerates nearly two million people, the epidemiology of psychiatric disorders in correctional populations is not well understood, and no study has examined temporal trends in psychiatric disorder prevalences within a single correctional system. This study assessed how psychiatric disorder prevalences have changed in the Texas Department of Criminal Justice (TDCJ), the largest American state prison system housing post-conviction, sentenced individuals.

This retrospective cohort study of TDCJ electronic medical record data from 1 January 2016 through 31 December 2023 included all persons incarcerated for any duration during that period. Diagnoses were based on International Classification of Disease (ICD-10) diagnostic codes. Outcomes were annual prevalences of depressive, bipolar and schizophrenia spectrum disorders stratified by age, race and sex. Cochran-Armitage Tests were used to assess temporal trends within each stratum. Two-way interactions were assessed by fitting Generalized Estimating Equations models using autoregressive correlation with repeated subjects.

The overall population ranged from 170,269 to 222,798 individuals. Approximately, one-third were White (34.5–35.4%), one-third Black (31.0–32.3%), and one-third Hispanic (32.7–33.5%). Most were aged 30–49 (52.8–57.3%), and men (88.9–90.7%) outnumbered women (9.3–11.1%). The prevalences (per 100 [95% CI]) of psychiatric disorders generally increased when comparing 2016 to 2023. Depressive disorders increased the most among those aged 30–49 (5.23 [5.10–5.35] to 6.71 [6.56–6.86]), Hispanic individuals (3.86 [3.72–4.00] to 5.72 [5.53–5.90]), and men (4.72 [4.63–4.82] to 6.53 [6.42–6.65]). Bipolar disorders increased the most among those aged ≥50 (2.57 [2.42–2.72] to 3.46 [3.29–3.63]), Hispanic individuals (1.31 [1.23–1.40] to 2.23 [2.11–2.35]), and men (2.26 [2.20–2.33] to 3.12 [3.04–3.20]). Schizophrenia spectrum disorders increased the most among those aged ≤29 (1.33 [1.24–1.42] to 2.52 [2.35–2.68]), Hispanic individuals (1.53 [1.44–1.62] to 3.21 [3.35–4.40]), and women (1.27 [1.56–1.89] to 4.24 [3.95–4.53]). When stratified by demographic variables, trend tests were significant for nearly all comparisons (P < 0.0001), and all two-way interactions were significant (P < 0.0001).

The prevalences of major psychiatric disorders in the Texas prison system increased when comparing 2016 to 2023, with certain disorders rising more rapidly than others within specific subgroups. These findings emphasize the need for expanded mental health treatment options and resources within correctional settings.

Evidence on the effects of parental Adverse Childhood Experiences (ACEs) on adolescent mental health remains limited. This study investigates the associations between parental ACEs, children’s exposure to threat- and deprivation-related ACEs, and adolescent depression and anxiety using data from the Longitudinal Study of Australian Children.

We conducted a secondary analysis of the Longitudinal Study of Australian Children (LSAC), a population-based longitudinal cohort study. Parental ACEs were retrospectively reported by caregivers. Children’s exposure to ACEs was assessed from ages 4–17 years and categorised as threat-related ACEs (e.g., bullying, hostile parenting, unsafe neighbourhoods, family violence) or deprivation-related ACEs (e.g., financial hardship, parental substance abuse, parental psychological distress, death of a family member, parental separation, parental legal problems). Depressive and anxiety symptoms were self-reported by adolescents at ages between 12 and 17 years. Modified Poisson regression models were used to examine the independent and combined associations of parental ACEs and children’s threat- and deprivation-related ACEs (assessed before ages 12, 14, and 16 years) with depression and anxiety outcomes, including tests for interaction effects.

The analysis included 3,956 children aged 12–13 years, 3,357 children aged 14–15 years, and 3,089 children aged 16–17 years. Males comprised 50.8–59.8% and females 40.2–49.2% across all ages. By the age of 17, 30.4% and 9.4% of the adolescents had depression and anxiety, respectively. Parental ACEs (≥2) were associated with increased depression risk at ages 12 to 13 years (RR = 1.42; 95% CI: 1.10–1.84) and at 16–17 years (RR = 1.19; 95% CI: 1.02–1.39). Exposure to ≥ 2 deprivation-related ACEs significantly increased the risk of depression across all ages, with relative risks ranging from 1.31 to 2.18. High threat-related ACEs (≥2) were associated with increased depression risk only at 12 to 13 years (RR = 2.01; 95% CI: 1.28–3.17). No significant interactions were observed.

The findings reinforce the ACEs model by showing that, at the population level, early identification of children exposed to early life deprivations rooted in financial crisis or familial adversities, combined with targeted interventions for both children and parents and supportive social policies, can reduce long-term mental health risks.

There is a substantial body of literature on environmental risk associated with schizophrenia. Most research has largely been conducted in Europe and North America, with little representation of the rest of the world; hence generalisability of findings is questionable. For this reason, we performed a mapping review of studies on environmental risk for schizophrenia spectrum disorders, recording the country where they were conducted, and we linked our findings with publicly available data to identify correlates with the uneven global distribution. Our aim was to evaluate how universal is the ‘common knowledge’ of environmental risk for psychosis collating the availability of evidence across different countries and to generate suggestions for future research identifying gaps in evidence.

We performed a systematic search and mapping of studies in the PubMed and PsycINFO electronic databases reporting on exposure to environmental risk for schizophrenia including obstetric complications, paternal age, migration, urbanicity, childhood trauma, and cannabis use and subsequent onset of schizophrenia spectrum disorders. This search focused on articles published from the date of the first available publication until 31 May 2023. We recorded the country where they were conducted. We downloaded publicly available data on population size, measures of wealth, medical provisions, research investment, and of quality research outputs per country and performed regression analyses of each predictor with the number of studies and recruited cases in each country.

We identified 308 publications that included a sample size of 445,000 patients with schizophrenia spectrum disorders. The majority were conducted in northern Europe and North America, with large parts of the world totally unrepresented. In the associations between the number of environmental risk studies for schizophrenia with potential predictors, we found that neither population nor wealth or research investment were strong predictors of research outputs in the field. Interestingly, the stronger correlations were found for number of researchers per population and for indicators of top-end scientific achievements, such as number of Nobel laureates per country.

Our results demonstrate a gap of knowledge due to the underrepresentation of studies on environmental risk of schizophrenia spectrum disorders in large parts of the world. This has implications not only in the generalisability of any findings from research conducted in the Northern hemisphere but also in our ability to progress in efforts to make causal inferences about biological pathways to schizophrenia. These findings reinforce the need to focus research on populations that are underrepresented in research and underserved in health care.

Suicide rates in the United States have been increasing, necessitating an understanding of demographic variations by ethnicity, age, sex and method to inform effective prevention strategies.

To dissect suicide rates in the US population from 2001 to 2023 by age, sex, ethnicity, and method.

This retrospective observational study utilized suicide data and population statistics from the CDC’s WISQARS database for the years 2001 (n = 30,418), 2018 (n = 48,132), 2020 (n = 45,721) and 2023 (n = 49,014). Cases were stratified by age, sex, ethnicity, and suicide method to assess trends and demographic differences.

From 2001 to 2023, the overall US suicide rate rose from 10.7 to 14.6 per 100,000, with a temporary decrease in 2019 and 2020 (14.4 and 13.8, respectively). The primary driver of the increase was firearm-related suicides among White males, contributing 25.8% of the rise from 2001 to 2018 and 51.6% from 2020 to 2023. Decline between 2018 and 2020 was mainly due to reductions in firearm and drug-related suicides among White males, but firearm suicides surged again from 2020 to 2023. Additionally, firearm suicides among ethnic minorities, especially Black/African-American males, accounted for 14.0% of the increase during 2020–2023. Drug-related suicides also increased by 8.6% among White females aged 45 and older in the same period.

Firearm suicides are the leading factor in the changing suicide rates in the United States from 2001 to 2023, alongside rising drug-related suicides among White females. These trends highlight the necessity for targeted prevention efforts that consider demographic-specific factors and method accessibility.

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 British Paediatric Surveillance Unit of the UK Royal College of Paediatrics and Child Health contacts participating consultant paediatricians each month to survey whether particular rare conditions or events have been seen in their services. This national surveillance of rare paediatric events has allowed a large amount of research into multiple paediatric conditions. In 2009, the Royal College of Psychiatrists established a similar system – the Child and Adolescent Psychiatry Surveillance System (CAPSS) – to survey consultant psychiatrists in UK and Ireland. Since many conditions involve mental and physical health features, seven studies have been run using reporting to both systems, with simultaneous surveillance across both paediatricians and psychiatrists. Given the desire by policymakers, commissioners and clinicians for well-integrated physical and mental healthcare (‘joined-up working’), and if the surveillance systems were functioning well, the CAPSS Executive expected high rates of parallel reporting of individual patients to the two systems. The current study synthesises the rates of parallel reporting of cases to those two systems. We assimilate rates of parallel reporting across the seven studies using figures that have already been published, and by contacting contributing research groups directly where the relevant figures are not currently published. No new primary data were collected.

Of the 1211 confirmed cases, 47 (3.9%) were reported by both psychiatrists and paediatricians. No parallel reporting occurred in four of the seven studies.

Our findings raise questions about whether joined-up working in mental and physical healthcare is happening in practice. Research into challenges to obtaining comprehensive surveillance will help epidemiologists improve their use of surveillance and control for biases.