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Background: Examine the onset of a clinical diagnosis of mood (major depression, dysthymia and bipolar disorder)- and anxiety disorders (panic disorder, agoraphobia without panic disorder, social phobia, specific phobia and generalized anxiety disorder) by Body Mass Index levels at baseline in the general adult population over three years. Methods: Data are from NEMESIS-2, a representative psychiatric cohort study in the Netherlands. A total of 5303 subjects aged 18–64 were interviewed with the CIDI (3.0 based on DSM-IV) in two waves, with an interval of three years. The first wave was performed from November 2007 to July 2009, the second wave from November 2010 to June 2012. Results: Persons with obesity at baseline had a significantly increased risk of the onset of any mood -or anxiety disorder adjusting for covariates compared to persons with a normal Body Mass Index (OR = 1.71; 95% CI: 1.11–2.62). The odds ratio of the underweight category was non-significant. A dose–response effect of the continuous BMI scores on the onset of any mood or anxiety disorder was found (OR = 1.06; 95% CI: 1.02 = 1.10; p < 0.01). Conclusions: Obesity at baseline is a risk for the onset of mood -and anxiety disorders at three year follow up. [ABSTRACT FROM AUTHOR]

Hypotheses about the link between cannabis use and psychosis apply to the within-person level but have been tested mostly at the between-person level. We used a within-person design, in which a person serves as his own control, thus removing the need to consider confounding by any fixed (genetic and nongenetic) characteristic to study the prospective association between cannabis use and the incidence of attenuated psychotic experiences, and vice versa, adjusted for time-varying confounders. We combined 2 general population cohorts (at baseline: Early Developmental Stages of Psychopathology Study, n = 1395; Netherlands Mental Health Survey and Incidence Study-2, n = 6603), which applied a similar methodology to study cannabis use and attenuated psychotic experiences with repeated interviews (T0, T1, T2, and T3) over a period of approximately 10 years. The Hausman test was significant for the adjusted models, indicating the validity of the fixed-effects model. In the adjusted fixed-effects model, prior cannabis use was associated with psychotic experiences (aOR = 7.03, 95% CI: 2.39, 20.69), whereas prior psychotic experiences were not associated with cannabis use (aOR = 0.59, 95% CI: 0.21, 1.71). Longitudinal studies applying random-effects models to study associations between risk factors and mental health outcomes, as well as reverse causality, may not yield precise estimates. Cannabis likely impacts causally on psychosis but not the other way round. [ABSTRACT FROM AUTHOR]

The polygenic risk score (PRS) allows for quantification of the relative contributions of genes and environment in population-based studies of mental health. We analyzed the impact of transdiagnostic schizophrenia PRS and measures of familial and environmental risk on the level of and change in general mental health (Short-Form-36 mental health) in the Netherlands Mental Health Survey and Incidence Study-2 general population sample, interviewed 4 times over a period of 9 years, yielding 8901 observations in 2380 individuals. Schizophrenia PRS, family history, somatic pain, and a range of environmental risks and social circumstances were included in the regression model of level of and change in mental health. We calculated the relative contribution of each (group of) risk factor(s) to the variance in (change in) mental health. In the combined model, familial and environmental factors explained around 17% of the variance in mental health, of which around 5% was explained by age and sex, 30% by social circumstances, 16% by pain, 22% by environmental risk factors, 24% by family history, and 3% by PRS for schizophrenia (PRS-SZ). Results were similar, but attenuated, for the model of mental health change over time. Childhood trauma and gap between actual and desired social status explained most of the variance. PRS for bipolar disorder, cross-disorder, and depression explained less variance in mental health than PRS-SZ. Polygenic risk for mental suffering, derived from significance-testing in massive samples, lacks impact in analyses focusing on prediction in a general population epidemiological setting. Social-environmental circumstances, particularly childhood trauma and perceived status gap, drive most of the attributable variation in population mental health. [ABSTRACT FROM AUTHOR]

Purpose: Limited longitudinal population-based research exists on the bidirectional association between loneliness and common mental disorders (CMDs). Using 3-year follow-up data, this study examined whether loneliness among adults increases the risk for onset and persistence of mild-moderate or severe CMD; and whether mild-moderate or severe CMD is a risk factor for onset and persistence of loneliness.Methods: Data were used from the second ('baseline') and third (3-year follow-up) waves of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults aged 18-64 years. Twelve-month CMDs and their severity were assessed with the Composite International Diagnostic Interview 3.0, and current loneliness using the De Jong Gierveld Loneliness Scale. Multivariate analyses were controlled for several potential confounders.Results: Loneliness predicted onset of severe CMD at follow-up in adults without CMDs at baseline, and increased risk for persistent severe CMD at follow-up in those with CMD at baseline. Conversely, severe CMD predicted onset of loneliness at follow-up in non-lonely adults at baseline, but was not associated with persistent loneliness at follow-up in lonely adults at baseline. Observed associations remained significant after controlling for perceived social support at baseline, except for the relationship between loneliness and persistent severe CMD. No longitudinal relationships were observed between loneliness and mild-moderate CMD.Conclusions: Attention should be paid to loneliness, both in adults with and without CMD. Further research is needed to better understand the mechanisms underlying the observed associations between loneliness and CMDs to develop successful interventions. [ABSTRACT FROM AUTHOR]

Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration). Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio. Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other. Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation. [ABSTRACT FROM AUTHOR]

The enormous societal and individual consequences of mental health disorders and detrimental health behaviours in the general population are of paramount concern. Many argue that 'prevention is the best cure', pushing for the implementation of early (preventive) interventions. Key questions regarding early interventions include which population segment to target for screenings and what information these screenings should focus on. In line with previous efforts, this study aimed to identify which population segment holds the majority (≥ 80 %) of different economically costly outcomes in society, and whether child abuse before the age of 16 years predicts being part of that population segment. Epidemiological cohort study. This study used the Netherlands Mental Health Survey and Incidence Study-2, a Dutch epidemiological cohort study including 6646 adults aged 18–64 years at baseline, spanning four timepoints from 2007 to 2018. Cumulative distributions were computed to identify high-cost population segments of economically costly outcomes in adulthood (i.e., mental and physical health [behaviours], unemployment and work absenteeism). Child abuse was examined as a potential predictor of these segments and the risk of multiple high-cost population segment membership was investigated by conducting Poisson regressions. A 20 % population segment carried between 42 % and 100 % of economically costly outcomes. Being exposed to more child abuse predicted being in a high-cost population segment, albeit with small effect sizes. Being exposed to more child abuse also predicted belonging to multiple high-cost population segments across different economically costly outcomes. The study findings have implications for policy makers. Emphasis should be placed on prevention aimed at identifying potential members of multiple high-cost population segments. [ABSTRACT FROM AUTHOR]

Pain might be an important risk factor for common mental disorders. Insight into the longitudinal association between pain and common mental disorders in the general adult population could help improve prevention and treatment strategies. Data were used from the first 2 waves of the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among the Dutch general population aged 18 to 64 years at baseline (N = 5303). Persons without a mental disorder 12 months before baseline were selected as the at-risk group (n = 4974 for any mood disorder; n = 4979 for any anxiety disorder; and n = 5073 for any substance use disorder). Pain severity and interference due to pain in the past month were measured at baseline using the Short Form Health Survey. DSM-IV mental disorders were assessed at both waves using the Composite International Diagnostic Interview version 3.0. Moderate to very severe pain was associated with a higher risk of mood (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.33-3.29) or anxiety disorders (OR = 2.12, 95% CI = 1.27-3.55). Moderate to very severe interference due to pain was also associated with a higher risk of mood (OR = 2.14, 95% CI = 1.30-3.54) or anxiety disorders (OR = 1.92, 95% CI = 1.05-3.52). Pain was not significantly associated with substance use disorders. No interaction effects were found between pain severity or interference due to pain and a previous history of mental disorders. Moderate to severe pain and interference due to pain are strong risk factors for first-incident or recurrent mood and anxiety disorders, independent of other mental disorders. Pain management programs could therefore possibly also serve as a preventative program for mental disorders. [ABSTRACT FROM AUTHOR]

Background: Little is known about the associations between common mental disorders and sexual dissatisfaction in the general population., Aims: To assess the associations between the presence of 12-month and remitted (lifetime minus 12-month) mood, anxiety and substance use disorders and sexual dissatisfaction in the general population of The Netherlands., Method: A total of 6646 participants, aged 18-64, took part in a face-to-face survey using the Composite International Diagnostic Interview 3.0. Childhood trauma, somatic disorders and sexual dissatisfaction were also assessed in an additional questionnaire. Associations were assessed with multivariate regression analyses., Results: In total, 29% reported some sexual dissatisfaction. Controlling for demography, somatic disorders and childhood trauma, significant associations with 12-month mood disorder (B = 0.31), substance use disorder (B = 0.23) and anxiety disorder (B = 0.16) were found. Specifically, relatively strong associations were found for alcohol dependence (B = 0.54), bipolar disorder (B = 0.45) and drug dependence (B = 0.44). The association between remitted disorders and sexual dissatisfaction showed significance for the category substance use disorder., Conclusions: People with mood, anxiety and substance use disorders show elevated scores on sexual dissatisfaction, even when relevant confounders are controlled for. Sexual satisfaction appears to be reduced most by alcohol and drug dependence and bipolar disorder. Once remitted, substance use disorder shows a persisting association with present sexual dissatisfaction., (Royal College of Psychiatrists.)