Adult Attention-Deficit / Hyperactivity Disorder (ADHD)

MedlinePlus

Adult attention-deficit/hyperactivity disorder (ADHD) Overview Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that ... combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead ...

Diagnostic and Statistical Manual of Mental Disorders-5: implications for older adults and their families.

PubMed

Sorrell, Jeanne M

2013-03-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is targeted for publication in May 2013. Older adults and their families should be aware of the potential impact that changes in this important document may have on diagnosis and treatment of mental health concerns. Two specific changes related to a new category of Neurocognitive Disorders and a new interpretation of criteria for depression after bereavement are discussed in this article. Nurses can help older adults and their families understand the new DSM-5 terminology and encourage them to discuss risks, benefits, and likely outcomes of diagnoses, procedures, and treatments that may seem unfamiliar. Copyright 2013, SLACK Incorporated.

Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population.

PubMed

Veisani, Yousef; Mohamadian, Fathola; Delpisheh, Ali

2017-01-01

Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population. This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation. Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females. Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.

[Mental disorders and dangerous acting out].

PubMed

Bouchard, Jean-Pierre

2015-01-01

The major mental disorders which are most likely to lead to dangerous acting out are adult psychoses (schizophrenia and paranoia) and severe mood disorders (major depressive episodes and mania). Good knowledge of the symptomatology of these pathologies and their identification can help to anticipate and prevent much of the violence which people with these disorders may inflict on others or themselves. After mental assessment, those who commit wrongful and criminal acts may be ruled to be criminally irresponsible. They are then handed over to the relevant health care authorities for treatment for their mental disorders.

Social inequalities in mental disorders and substance misuse in young adults : A birth cohort study in Southern Brazil.

PubMed

Barros, Fernando C; Matijasevich, Alicia; Santos, Iná S; Horta, Bernardo L; da Silva, Bruna Gonçalves C; Munhoz, Tiago N; Fazel, Seena; Stein, Alan; Pearson, Rebecca M; Anselmi, Luciana; Rohde, Luis Augusto

2018-05-02

To investigate the association between mental disorders and substance misuse at 30 years of age with gender, socioeconomic position at birth, and family income trajectories. The 1982 Pelotas Birth Cohort was used; all 5914 children born alive at hospital were originally enrolled (99.2% of all city births). In 2012, 3701 subjects were located and interviewed (68% retention rate). Mental disorders and substance misuse were assessed, and their prevalence analysed according to gender, socioeconomic status at birth, and four different income trajectories: always poor, never poor, poor at birth/non-poor at age 30, and non-poor at birth/poor at age 30. While women presented higher prevalence of mental disorders, substance misuse was much more frequent among men. Individuals in the lowest income quintile at birth presented 2-5 times more mental disorders and substance misuse than those in the highest quintile. Young adults who were always poor or were not poor at birth but were poor at 30 years of age had a higher prevalence of mental disorders than the other groups. The high rates of mental disorders and lifetime suicide attempts in young adults, especially those who were always poor or became poor after childhood, suggest that recent socioeconomic-related stressful situations may have a higher impact on the current mental health than events earlier in life. However, we could not identify at what specific ages socioeconomic changes were more important.

Mental illness and lost income among adult South Africans.

PubMed

Lund, Crick; Myer, Landon; Stein, Dan J; Williams, David R; Flisher, Alan J

2013-05-01

Little is known regarding the links between mental disorder and lost income in low- and middle-income countries. The purpose of this study was to investigate the association between mental disorder and lost income in the first nationally representative psychiatric epidemiology survey in South Africa. A probability sample of South African adults was administered the World Health Organization Composite International Diagnostic Interview schedule to assess the presence of mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, version IV. The presence of severe depression or anxiety disorders was associated with a significant reduction in earnings in the previous 12 months among both employed and unemployed South African adults (p = 0.0043). In simulations of costs to individuals, the mean estimated lost income associated with severe depression and anxiety disorders was $4,798 per adult per year, after adjustment for age, gender, substance abuse, education, marital status, and household size. Projections of total annual cost to South Africans living with these disorders in lost earnings, extrapolated from the sample, were $3.6 billion. These data indicate either that mental illness has a major economic impact, through the effect of disability and stigma on earnings, or that people in lower income groups are at increased risk of mental illness. The indirect costs of severe depression and anxiety disorders stand in stark contrast with the direct costs of treatment in South Africa, as illustrated by annual government spending on mental health services, amounting to an estimated $59 million for adults. The findings of this study support the economic argument for investing in mental health care as a means of mitigating indirect costs of mental illness.

Adult Neurogenesis and Mental Illness

PubMed Central

Schoenfeld, Timothy J; Cameron, Heather A

2015-01-01

Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407

Attachment to employment and education before work disability pension due to a mental disorder among young adults.

PubMed

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Vahtera, Jussi; Virtanen, Marianna

2016-05-13

We examined attachment to employment and education among young adults before they were granted a fixed-term work disability pension due to psychiatric diagnosis, and the factors associated with this attachment. The data comprised all persons aged 18-34 who received a new-onset fixed-term disability pension compensation due to a mental disorder in Finland in 2008 (N = 1163). The data were derived from pension applications and the enclosed medical records, and were linked to employment records from a period of three years before the disability pension. We analysed the factors associated with attachment to employment or education with log-binomial regression analysis. Fifty percent of the participants were attached to employment or education before work disability pension. The attached were more often women; had higher basic and vocational education; had mood disorder rather than psychosis diagnosis as a primary diagnosis; and had no record of harmful alcohol use or drug use, or recorded symptoms of mental disorders already at school-age. The level of attachment to employment or education before work disability pension is low among young adults with mental disorders and several risk factors predict poor attachment; severe or comorbid mental disorder, early-life psychiatric morbidity, substance use, male sex, low basic education, and lacking vocational education.

Which Group Teaching Styles Best Promote Information Gain for Adults with Mental Disorders?

ERIC Educational Resources Information Center

Emer, Denise; McLarney, Amber; Goodwin, Melinda; Keller, Peggy

2002-01-01

Group psychoeducation formats were evaluated to determine which promoted the greatest learning and retention of therapeutically relevant information in adult clients with mental disorders. Study 1 compared lecture and interactive formats; Study 2 compared two types of interactive formats. Both studies also measured client satisfaction with the…

Diagnosis and Fluoxetine Treatment of Compulsive Behavior Disorder of Adults with Mental Retardation.

ERIC Educational Resources Information Center

Bodfish, James W.; Madison, James T.

1993-01-01

Ten adults with compulsive behavior disorder and six comparison subjects, all with mental retardation, were treated using the medication fluoxetine. Seven of the 10 experimental subjects responded favorably to fluoxetine treatment; none of the comparison subjects responded favorably to the medication. There appeared to be a relation between…

Pathways to Firesetting for Mentally Disordered Offenders: A Preliminary Examination.

PubMed

Tyler, Nichola; Gannon, Theresa A

2017-06-01

The current study aimed to investigate the specific pathways in the offence process for mentally disordered firesetters. In a previous study, an offence chain model was constructed (i.e., the Firesetting Offence Chain for Mentally Disordered Offenders, FOC-MD) using offence descriptions obtained from 23 mentally disordered firesetters, detailing the sequence of contextual, behavioural, affective, and cognitive factors that precipitate an incidence of firesetting for this population. The current study examines the prevalence of the specific pathways to firesetting for the original 23 mentally disordered firesetters and a further sample of 13 mentally disordered firesetters. Three distinct pathways to firesetting are identified within the FOC-MD: fire interest-childhood mental health, no fire interest-adult mental health, fire interest-adult mental health. In this article, we describe these three pathways in detail using illustrative case studies. The practice implications of these identified pathways are also discussed.

Psychotherapeutic and vocational interventions among young adults with work disability due to mental disorders in Finland.

PubMed

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Kivekäs, Teija; Kivimäki, Mika; Koskinen, Aki; Virtanen, Marianna

2018-05-01

Backround: Little is known about treatment and rehabilitation received and planned among young adults with work disability due to a mental disorder. To examine the implemented psychotherapeutic and vocational interventions and treatment plans among young adults with work disability due to a mental disorder. Data were collected from medical records of young Finnish adults aged 18-34 with a long-term work disability history due to a mental disorder (N = 1163). The participant characteristics associated with four types of interventions were analyzed using log-binomial regression analysis. In total, 34% had participated in a psychotherapeutic intervention. Of the non-students, 26% had participated in vocational intervention. For 46% of the non-students, neither type of intervention was planned. Both implemented and planned psychotherapeutic interventions were associated with female sex, high education, attachment to employment, and absence of substance abuse. Low education and childhood adversity were associated with implemented vocational interventions and absence of substance abuse with planned vocational interventions. There is an unmet need for psychotherapeutic interventions among men, among those with lower socio-economic status, and among those with poor attachment to labor market. In addition, there is a lack of vocational interventions for those with high education. People with substance abuse are largely excluded from both types of interventions.

Common mental disorders among adult members of 'left-behind' international migrant worker families in Sri Lanka.

PubMed

Siriwardhana, Chesmal; Wickramage, Kolitha; Siribaddana, Sisira; Vidanapathirana, Puwalani; Jayasekara, Buddhini; Weerawarna, Sulochana; Pannala, Gayani; Adikari, Anushka; Jayaweera, Kaushalya; Pieris, Sharika; Sumathipala, Athula

2015-03-28

Nearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka. A cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered. A total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group. To our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is

Associations between mental disorders and the common cold in adults: a population-based cross-sectional study.

PubMed

Adam, Yuki; Meinlschmidt, Gunther; Lieb, Roselind

2013-01-01

To investigate the association between specific mental disorders and the common cold. Negative binomial regression analyses were applied to examine cross-sectional associations of a broad range of mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) employing the standardized Munich Composite International Diagnostic Interview, with the self-reported number of occurrences of the common cold during the past 12 months in a representative population sample of 4022 German adults aged 18-65 years. After adjustment for covariates including age, gender, and marital and socioeconomic status, having any 12-month DSM-IV mental disorder (incidence rate ratio [IRR]=1.44, 95% confidence interval [CI]=1.29-1.60), any substance abuse or dependence (IRR=1.32, 95% CI=1.14-1.52), possible psychotic disorder (IRR=1.43, 95% CI=1.09-1.87), any mood disorder (IRR=1.35, 95% CI=1.16-1.56), any anxiety disorder (IRR=1.40, 95% CI=1.23-1.59), or any somatoform disorder (IRR=1.38, 95% CI=1.18-1.62) was shown to be positively associated with the number of occurrences of a cold during the past 12 months. The presence of a DSM-IV mental disorder was associated with a 44% higher risk of having experienced a cold in the past 12 months. Further studies are needed to explore potential common risk factors for incidence of mental disorders and the common cold, since the pathway connecting them has not been fully determined. Copyright © 2012 Elsevier Inc. All rights reserved.

[Prevention of mental disorders].

PubMed

Riedel-Heller, Steffi; Gühne, Uta

2013-12-01

Investment in prevention is a major public health requirement. Mental disorders are common and are associated with severe consequences. They are a major target for prevention. Based on vulnerabilitiy-stress-models the theoretical background for prevention in mental disorders is outlined. Effective strategies for children, adolescents, adults and individuals in old age do exist. Results regarding the prevention of depres-sion and psychoses are outlined and risk groups which require current actions are determined. Current activities towards a national prevention strategy in Germany are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Children with Usher syndrome: mental and behavioral disorders

PubMed Central

2012-01-01

Background Mental and behavioral disorders among adults with Usher syndrome have been discussed and reported in some case studies but no research has been reported on children with Usher syndrome. Methods This article investigates the prevalence and characteristics of mental and behavioral disorders among 26 children, 3-17 years of age, with Usher syndrome. Results Six of the 26 children were diagnosed with a mental or behavioral disorder (1 with schizophrenia and mild mental retardation, 1 with atypical autism and severe mental retardation, 1 with atypical autism and mild mental retardation, 1 with mild mental retardation, and 2 with conduct disorder). Another 3 children had had a mental or behavioral disorder previously in their childhood. Conclusion Even though vision impairment first manifests in late childhood, some children with Usher syndrome seem to develop mental and behavioral disorders during childhood. The aetiology and treatment of mental and behavioral disorders among children with Usher syndrome are discussed. Children with Usher syndrome and their parents may need clinical support during early childhood to prevent development of mental and behavioral disorders. PMID:22449032

Children with Usher syndrome: mental and behavioral disorders.

PubMed

Dammeyer, Jesper

2012-03-27

Mental and behavioral disorders among adults with Usher syndrome have been discussed and reported in some case studies but no research has been reported on children with Usher syndrome. This article investigates the prevalence and characteristics of mental and behavioral disorders among 26 children, 3-17 years of age, with Usher syndrome. Six of the 26 children were diagnosed with a mental or behavioral disorder (1 with schizophrenia and mild mental retardation, 1 with atypical autism and severe mental retardation, 1 with atypical autism and mild mental retardation, 1 with mild mental retardation, and 2 with conduct disorder). Another 3 children had had a mental or behavioral disorder previously in their childhood. Even though vision impairment first manifests in late childhood, some children with Usher syndrome seem to develop mental and behavioral disorders during childhood. The aetiology and treatment of mental and behavioral disorders among children with Usher syndrome are discussed. Children with Usher syndrome and their parents may need clinical support during early childhood to prevent development of mental and behavioral disorders.

Prevalence of Mental and Social Disorders in Adults Attending Primary Care Centers in Bosnia and Herzegovina

PubMed Central

Broers, Teresa; Hodgetts, Geoffrey; Batić-Mujanović, Olivera; Petrović, Verica; Hasanagić, Melida; Godwin, Marshall

2006-01-01

Aim To determine the prevalence of mental and social disorders in adults who attend primary care health centers in Bosnia and Herzegovina. Methods Sixty-nine family physicians from the Primary Care Research Network in Bosnia and Herzegovina each invited 20 randomly selected patients from their practices to complete the Patient Health Questionnaire (PHQ), which consists of 26-58 questions about symptoms and signs of depression, anxiety, somatization disorder, eating disorders, and alcoholism. A total of 1574 patients were invited to participate in the study. Physicians reviewed the PHQ and calculated the final score, which determined a provisional diagnosis. Definitive diagnosis was determined by further questioning and clinical knowledge of the patient. Data collection was performed between November 2003 and January 2004. Lists of non-participants were maintained by the physicians. Results The response rate was 82%. Of 1285 respondents, 61% were women. At least one type of mental or social disorder was found in 26% of the respondents, and 12% had more than one disorder. Somatization disorder, major depression syndrome, and panic syndrome were experienced by 16%, 10%, and 14% of respondents, respectively, while 5% or less were suffering from eating disorders or alcohol abuse. More women than men had somatization disorder, panic syndrome, and binge eating disorder, while more men than women reported alcohol abuse. Conclusion More than one-quarter of all adults who attended family medicine centers in Bosnia and Herzegovina presented with at least one type of mental or social disturbance. New health policies, strengthened professional training, and accessible support networks need to be developed throughout the country. PMID:16758527

Functional role of adult hippocampal neurogenesis as a therapeutic strategy for mental disorders.

PubMed

Jun, Heechul; Mohammed Qasim Hussaini, Syed; Rigby, Michael J; Jang, Mi-Hyeon

2012-01-01

Adult neurogenesis, the process of generating new neurons from neural stem cells, plays significant roles in synaptic plasticity, memory, and mood regulation. In the mammalian brain, it continues to occur well into adulthood in discrete regions, namely, the hippocampus and olfactory bulb. During the past decade, significant progress has been made in understanding the mechanisms regulating adult hippocampal neurogenesis and its role in the etiology of mental disorders. In addition, adult hippocampal neurogenesis is highly correlated with the remission of the antidepressant effect. In this paper, we discuss three major psychiatric disorders, depression, schizophrenia, and drug addiction, in light of preclinical evidence used in establishing the neurobiological significance of adult neurogenesis. We interpret the significance of these results and pose questions that remain unanswered. Potential treatments which include electroconvulsive therapy, deep brain stimulation, chemical antidepressants, and exercise therapy are discussed. While consensus lacks on specific mechanisms, we highlight evidence which indicates that these treatments may function via an increase in neural progenitor proliferation and changes to the hippocampal circuitry. Establishing a significant role of adult neurogenesis in the pathogenicity of psychiatric disorders may hold the key to potential strategies toward effective treatment.

Family of older adults with mental disorder: perception of mental health professionals.

PubMed

Saidel, Maria Giovana Borges; Campos, Claudinei José Gomes

2017-01-01

to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders. study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique. the following categories stood out: "Family exhaustion and deterioration in the perception of the healthcare professional" and "The abandonment of older adults by family members and their distancing in the perception of the healthcare professional." culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service. compreender as percepções dos profissionais do Centro de Atenção Psicossocial acerca da família do idoso em sofrimento psíquico. estudo de Caso Qualitativo conduzido com 12 profissionais de um Centro de Atenção Psicossocial com amostra composta por intencionalidade e fechada por exaustão. Realização de entrevistas semiestruturadas para coleta de dados, analisados por meio da técnica de Análise de Conteúdo. destacaram-se as categorias "O cansaço e o desgaste familiar na percepção do profissional" e "O abandono e o afastamento do idoso pela família na percepção do profissional". verificou-se a culpabilização do idoso e a penalização da família pelos profissionais. Visando à conscientização das dificuldades em aproximar a família, é necessária a criação de espaços reflexivos sobre o cuidado a essa população, bem como a superação dos desafios na construção efetiva do vínculo entre

Housing First Improves Residential Stability in Homeless Adults With Concurrent Substance Dependence and Mental Disorders

PubMed Central

Patterson, Michelle L.; Moniruzzaman, Akm; Frankish, C. James; Somers, Julian

2013-01-01

Objectives. We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study). Methods. The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence. Results. We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness. Conclusions. People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence. PMID:24148035

Young adults' recollections of parental bonds--does satisfaction with partner relationships mediate the longitudinal association with mental disorders?

PubMed

Overbeek, Geertjan; Vollebergh, Wilma; Meeus, Wim; de Graaf, Ron; Engels, Rutger C M E

2004-09-01

Recollections of cold and overprotective behaviors from parents have been hypothesized to lead to the presence of mental disorders in young adulthood through their detrimental effects on individuals' satisfaction in later partner relationships. Previous studies have not explicitly tested, however, whether partner relationship satisfaction mediates the longitudinal relationship from parental bonds to DSM-III-R disorders in young adults. We examined: (1) whether recollections of parental bonds in the first 16 years of life were related to the prevalence of DSM-III-R mental disorders in young adulthood, and (2) whether young adults' satisfaction with current partner relationships mediated these links. Data were used from 1,581 Dutch young adults aged 18-34 years, who were interviewed in three waves (1996, 1997, and 1999) of a nationwide epidemiological study. Structural Equation Models demonstrated that recollections of caring, non-intrusive parenting behaviors were significantly, negatively associated with the prevalence of mood and anxiety disorders (but not substance disorders) in young adulthood. The satisfaction with current partner relationships did not mediate these negative associations. Results replicate and extend earlier findings from the National Comorbidity Survey (Enns et al. 2002), demonstrating that mental disorders are directly related to people's recollections of parental care and overprotection. Low-quality parental bonds were only related to internalizing types of psychopathology, however, and were of a modest strength. Results may indicate that there is relatively little cross-relationship continuity in the experience of intimacy between relationships with parents and with partners.

Family Impact in Intellectual Disability, Severe Mental Health Disorders and Mental Health Disorders in ID. A Comparison

ERIC Educational Resources Information Center

Martorell, Almudena; Gutierrez-Recacha, Pedro; Irazabal, Marcia; Marsa, Ferran; Garcia, Mercedes

2011-01-01

Family impact (or family burden) is a concept born in the field of mental health that has successfully been exported to the ambit of intellectual disability (ID). However, differences in family impact associated with severe mental health disorders (schizophrenia), to ID or to mental health problems in ID should be expected. Seventy-two adults with…

Are natural disasters in early childhood associated with mental health and substance use disorders as an adult?

PubMed

Maclean, Johanna Catherine; Popovici, Ioana; French, Michael T

2016-02-01

Understanding factors that influence risk for mental health and substance use disorders is critical to improve population health and reduce social costs imposed by these disorders. We examine the impact of experiencing a natural disaster-a serious fire, tornado, flood, earthquake, or hurricane-by age five on adult mental health and substance use disorders. The analysis uses data from the 2004 to 2005 National Epidemiologic Survey of Alcohol and Related Conditions. The analysis sample includes 27,129 individuals ages 21-64 years. We also exploit information on parenting strategies to study how parents respond to natural disasters encountered by their children. We find that experiencing one or more of these natural disasters by age five increases the risk of mental health disorders in adulthood, particularly anxiety disorders, but not substance use disorders. Parents alter some, but not all, of their parenting strategies following a natural disaster experienced by their children. It is important to provide support, for example through counseling services and financial assistance, to families and children exposed to natural disasters to mitigate future mental health and substance use problems attributable to such exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

Proportion of patients without mental disorders being treated in mental health services worldwide

PubMed Central

Bruffaerts, Ronny; Posada-Villa, Jose; Al-Hamzawi, Ali Obaid; Gureje, Oye; Huang, Yueqin; Hu, Chiyi; Bromet, Evelyn J.; Viana, Maria Carmen; Hinkov, Hristo Ruskov; Karam, Elie G.; Borges, Guilherme; Florescu, Silvia E.; Williams, David R.; Demyttenaere, Koen; Kovess-Masfety, Viviane; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Ono, Yutaka; de Graaf, Ron; Browne, Mark Oakley; Bunting, Brendan; Xavier, Miguel; Haro, Josep Maria; Kessler, Ronald C.

2015-01-01

Background Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’. Aims To examine the association of past-year mental health treatment with DSM-IV disorders. Method The World Health Organization’s World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs. Results Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose-response associations were found between number of indicators of need and treatment. Conclusions The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment. PMID:25395690

Associations between mental disorders and subsequent onset of hypertension

PubMed Central

Stein, Dan J.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bruffaerts, Ronny; de Jonge, Peter; Liu, Zharoui; Caldas-de-Almeida, Jose Miguel; O’Neill, Siobhan; Viana, Maria Carmen; Al-Hamzawi, Ali Obaid; Angermeyer, Mattias C.; Benjet, Corina; de Graaf, Ron; Ferry, Finola; Kovess-Masfety, Viviane; Levinson, Daphna; de Girolamo, Giovanni; Florescu, Silvia; Hu, Chiyi; Kawakami, Norito; Haro, Josep Maria; Piazza, Marina; Wojtyniak, Bogdan J; Xavier, Miguel; Lim, Carmen C.W.; Kessler, Ronald C.; Scott, Kate

2013-01-01

Background Previous work has suggested significant associations between various psychological symptoms (e.g. depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remains unclear. Further, there is little data available on how such associations vary by gender or over life course. Methods Data from the World Mental Health Surveys (comprising 19 countries, and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated. Results After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse, and drug abuse were significantly associated with subsequent diagnosis of hypertension (with ORs ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier onset hypertension. Conclusions Depression, anxiety, impulsive eating disorders, and substance use disorders disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.. PMID:24342112

Mentalization in adults with attention deficit hyperactivity disorder: Comparison with controls and patients with borderline personality disorder.

PubMed

Perroud, Nader; Badoud, Deborah; Weibel, Sébastien; Nicastro, Rosetta; Hasler, Roland; Küng, Anne-Lise; Luyten, Patrick; Fonagy, Peter; Dayer, Alexandre; Aubry, Jean-Michel; Prada, Paco; Debbané, Martin

2017-10-01

Emotion dysregulation and interpersonal hardships constitute core features of borderline personality disorder (BPD). Research has established the link between these core dysregulations and fluctuations in the capacity to appreciate the mental states that underlie behavior (mentalizing, operationalized as reflective functioning (RF)). As emotion dysregulation and interpersonal hardships also characterize adults with attention deficit hyperactivity disorder (ADHD), this study sought to examine the potential RF impairments affecting this population. 101 adults with ADHD, 108 with BPD and 236 controls were assessed using the RF questionnaire (RFQ), evaluating how individuals employ information about mental states to better understand their own and others' behaviors. The RFQ comprises two dimensions, certainty (RF_c) and uncertainty (RF_u) about mental states. RF scores helped distinguish ADHD from controls, but also from BPD (F = 48.1 (2/441) ; p < 0.0001 for RF_c and F = 92.5 (2/441) ; p < 0.0001 for RF_u). The ADHD group showed intermediary RF scores compared to the controls (b = -0.70; p < 0.0001 and b = 0.89; p < 0.0001 for RF_c and RF_u) and BPD group (b = 0.44; p = 0.001 and b = -0.56; p = 0.001 for RF_c and RF_u). Lower RF scores correlated with poor anger control and high levels of impulsivity. Higher severity of ADHD (more attentional and hyperactive/impulsive symptoms) was correlated with RF impairments. In conclusion, RF may constitute an important process underlying attentional, hyperactive/impulsive as well as emotional symptoms in ADHD; it should therefore be considered in the assessment of these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Mental and Behavioral Disorders among People with Congenital Deafblindness

ERIC Educational Resources Information Center

Dammeyer, Jesper

2011-01-01

The population of people with congenital deafblindness faces challenges concerning communication and mobility. Due to the significance of the sensory loss it is difficult to diagnose mental and behavioral disorders. This article investigates the prevalence of mental and behavioral disorders among 95 congenitally deafblind adults. Seventy-four…

[Violence due to Armed Conflict and Prevalence of Mood Disorders, Anxiety and Mental Problems in the Colombian Adult Population].

PubMed

Gómez-Restrepo, Carlos; Tamayo-Martínez, Nathalie; Buitrago, Giancarlo; Guarnizo-Herreño, Carol Cristina; Garzón-Orjuela, Nathaly; Eslava-Schmalbach, Javier; de Vries, Esther; Rengifo, Herney; Rodríguez, Andrea; Rincón, Carlos Javier

2016-12-01

Violence in Colombia has a history of over 50 years. Between 1985 and 2012 an estimated of 220,000 Colombians have died and about 6,000,000 have been displaced by violence. To describe and compare the prevalence of some problems and mental disorders in the adult population in Colombia, taking into account the characteristics of the municipality, as regards its history of violence or armed conflict. The results for adults (over 18 years) of some problems and mental disorders were taken from the ENSM-2015. The municipalities were classified according to the presence and intensity of the conflict using the classification proposed by the CERAC. Disorders were measured using CIDI-CAPI, and problems with AUDIT, modified PCL (Post-Traumatic Stress Disorder Checklist). An estimate was also made of psychoactive substances consumption. A total of 10,870 people were interviewed, of whom 5,429 had not changed residence. There was had permanent conflict in 21.8% of the municipalities, 65.5% had a discontinued conflict, and only 12.7% had been pacified or had no conflict. The intensity of the conflict was reported as high by 31.8% of the people. Violent municipalities have a higher prevalence of anxiety disorders, depression, possible Post-Traumatic Stress Disorder, and smoking. Alcohol consumption was more common in municipalities with less intense conflict. The municipalities classified as having high levels of violence have a higher prevalence of mental disorders and the majority of the mental problems. Copyright © 2016. Publicado por Elsevier España.

Mental health literacy in korean older adults: A cross-sectional survey.

PubMed

Kim, Y S; Lee, H Y; Lee, M H; Simms, T; Park, B H

2017-09-01

WHAT IS KNOWN ON THE SUBJECT?: Mental health literacy is a fairly new concept, first introduced in 1997. It refers to what people know and believe about mental health disorders. People's knowledge and beliefs help them to recognize, manage and prevent mental disorders. Generally, older adults have lower health literacy compared to young and middle-aged adults. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This is the first study on the mental health literacy of Korean older adults. This study looks beyond peoples' ability to recognize mental health disorders and their opinions about them. It identifies factors that are associated with mental health literacy (level of education and social support, the number of people in one's social circles and how individuals rate their health). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Older adults might get more out of mental health literacy programmes in group or social settings. Programmes that use older adult peer educators/supporters, such as the "older people's champions" of the Healthy Passport programme in England, might make the programmes more effective. Mental health campaigns, such as Australia's beyondblue, might increase mental health literacy of older adults. Introduction Korea is experiencing rapid population ageing, spurring an increased need for mental health services for the elderly. Approximately one-third of Korean older adults experience depressive symptoms, and Korea has the highest elder suicide rate among 34 developed nations. Mental health literacy is an important component of promoting mental health, yet studies on the concept have been conducted in few countries. Aim This study examines the level of mental health literacy among Korean older adults and identifies factors associated with their mental health literacy. Method A cross-sectional survey was conducted with 596 community-dwelling Korean adults aged 65 and older. Andersen's Behavioral Model of Health Services Use framed the study. Results Overall

The bi-directional associations between psychotic experiences and DSM-IV mental disorders

PubMed Central

McGrath, John J.; Saha, Sukanta; Al-Hamzawi, Ali; Andrade, Laura; Benjet, Corina; Bromet, Evelyn J.; Browne, Mark Oakley; Caldas de Almeida, Jose M.; Chiu, Wai Tat; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Have, Margreet ten; Hu, Chiyi; Kovess-Masfety, Viviane; Lim, Carmen C. W.; Navarro-Mateu, Fernando; Sampson, Nancy; Posada-Villa, José; Kendler, Kenneth; Kessler, Ronald C.

2016-01-01

Objective While it is now recognized that psychotic experiences (PEs) are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of PEs and mental disorders. Methods The WHO World Mental Health (WMH) surveys assessed lifetime prevalence and age-of-onset of PEs and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries. Results Temporally primary PEs were significantly associated with subsequent first onset of 8 of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, alcohol abuse), with ORs (95%CI) ranging from 1.3 (1.2–1.5; major depressive disorder) to 2.0 (1.5–2.6; bipolar disorder). In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of PEs, with ORs (95% CI) ranging from 1.5 (1.0–2.1; childhood separation anxiety disorder) to 2.8 (1.0–7.8; anorexia nervosa). Conclusions While temporally primary PEs are associated with an elevated risk of several subsequent mental disorders, we found that most mental disorder are associated with an elevated risk of subsequent PEs. Further investigation of the underlying factors accounting for these time-order relationships might shed light on the etiology of PEs. PMID:26988628

“I was thinking too much”: experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe

PubMed Central

Kidia, Khameer; Machando, Debra; Bere, Tarisai; Macpherson, Kirsty; Nyamayaro, Primrose; Potter, Lucy; Makadzange, Tariro; Munjoma, Ronald; Marufu, Marshall; Araya, Ricardo; Safren, Steven; O'Cleirgh, Conall; Chibanda, Dixon; Abas, Melanie

2015-01-01

Objective To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. Methods In-depth qualitative interviews were conducted with 47 (female =31) HIV-positive adults who scored above the cut-point on a locally-validated scale for common mental disorders. Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. Results The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of common mental disorders (“thinking too much”, changes to appetite and sleep, “burdened heart”, and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with common mental disorders. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income generating activities, and family engagement in mental health care. Conclusions Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce common mental disorders and poor adherence to antiretroviral therapy. PMID:25754063

The quality of asthma care among adults with substance-related disorders and adults with mental illness.

PubMed

Baxter, Jeffrey D; Samnaliev, Mihail; Clark, Robin E

2009-01-01

The purpose of this study was to investigate whether the presence of substance-related disorders or mental illness may affect the quality of medication management in asthma care. Claims from 1999 for adult Medicaid patients with persistent asthma from five states were analyzed. Sample sizes ranged from 1,207 to 5,815. The adjusted odds of meeting two quality-of-care measures for asthma were calculated: the Health Effectiveness Data and Information Set (HEDIS) measure of filling a single prescription for a controller medication and a non-HEDIS measure of achieving a ratio of long-term controller medications to total asthma medications of > or = .5. Odds of achieving the HEDIS measure were lower for patients with substance-related or schizophrenia disorders in two states (range of odds ratio [OR]=.69, 95% confidence interval [CI]=.53-.90, to OR=.81, 95% CI=.69-.96), but the odds increased for patients with depressive disorders in two states (OR=1.34, CI= 1.12-1.61; OR=1.37, CI=1.05-1.77) and for patients with bipolar disorder in one state (OR=1.69, CI=1.13-2.55). Odds of achieving the ratio measure were lower for patients with substance-related disorders in four states (range of OR=.63, CI=.47-.88, to OR=.75, CI=.62-.92) and higher for patients with depressive disorders, although only in one state (OR=1.25, CI=1.03-1.53). Patients with substance-related disorders and those with schizophrenia disorders may be receiving lower-quality asthma care, whereas patients with some other forms of mental illness may be receiving higher-quality care. Further studies are needed to identify the determinants of high-quality asthma care and the validity of quality measures based on administrative data in these populations.

Major depressive disorder, suicidal behaviour, bipolar disorder, and generalised anxiety disorder among emerging adults with and without chronic health conditions.

PubMed

Ferro, M A

2016-10-01

Despite the considerable physical, emotional and social change that occurs during emerging adulthood, there is little research that examines the association between having a chronic health condition and mental disorder during this developmental period. The aims of this study were to examine the sex-specific prevalence of lifetime mental disorder in an epidemiological sample of emerging adults aged 15-30 years with and without chronic health conditions; quantify the association between chronic health conditions and mental disorder, adjusting for sociodemographic and health factors; and, examine potential moderating and mediating effects of sex, level of disability and pain. Data come from the Canadian Community Health Survey-Mental Health. Respondents were 15-30 years of age (n = 5947) and self-reported whether they had a chronic health condition. Chronic health conditions were classified as: respiratory, musculoskeletal/connective tissue, cardiovascular, neurological and endocrine/digestive. The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess the presence of mental disorder (major depressive disorder, suicidal behaviour, bipolar disorder and generalised anxiety disorder). Lifetime prevalence of mental disorder was significantly higher for individuals with chronic health conditions compared with healthy controls. Substantial heterogeneity in the prevalence of mental disorder was found in males, but not in females. Logistic regression models adjusting for several sociodemographic and health factors showed that the individuals with chronic health conditions were at elevated risk for mental disorder. There was no evidence that the level of disability or pain moderated the associations between chronic health conditions and mental disorder. Sex was found to moderate the association between musculoskeletal/connective tissue conditions and bipolar disorder (β = 1.71, p = 0.002). Exploratory analyses suggest that the levels of

Childhood adversity, early-onset depressive/anxiety disorders, and adult-onset asthma.

PubMed

Scott, Kate M; Von Korff, Michael; Alonso, Jordi; Angermeyer, Matthias C; Benjet, Corina; Bruffaerts, Ronny; de Girolamo, Giovanni; Haro, Josep Maria; Kessler, Ronald C; Kovess, Viviane; Ono, Yutaka; Ormel, Johan; Posada-Villa, José

2008-11-01

To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity. Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset (disorders, adjusting for current age, sex, country, education, and current smoking. Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49-1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67-2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43-1.91). Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

Mental Health and Substance Use Disorders among Latino and Asian American Lesbian, Gay, and Bisexual Adults

ERIC Educational Resources Information Center

Cochran, Susan D.; Mays, Vickie M.; Alegria, Margarita; Ortega, Alexander N.; Takeuchi, David

2007-01-01

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report…

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder.

PubMed

Rolin, Stephanie A; Aschbrenner, Kelly A; Whiteman, Karen L; Scherer, Emily; Bartels, Stephen J

2017-09-01

The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Three community mental health centers in New Hampshire and Massachusetts. Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization. Copyright © 2017

Subjective life satisfaction and mental disorders among older adults in UAE in general population.

PubMed

Ghubach, Rafia; El-Rufaie, Omar; Zoubeidi, Taoufik; Sabri, Sufyan; Yousif, Saeed; Moselhy, Hamdy F

2010-05-01

Life satisfaction is widely considered to be a central aspect of human welfare. Many have identified happiness with it, and some maintain that well-being consists largely or wholly in being satisfied with one's life. Empirical research on well-being relies heavily on life satisfaction studies. The aim of this study was to examine the relationships of psychiatric disorders and physical disorders on life satisfaction among Arab older adults in general population. Face-to-face interviews with Geriatric Mental State Interview (GMS-A3) were conducted with a nationwide sample of 2000 household in 2001. Total samples of 610 elders (above 60 years) were interviewed. There were 347 males (56.9%) and 263 females (43.1%). The mean age was 68.6 years (SD = 8.3). The commonest diagnoses were depression (20.2%), anxiety (5.6%), hypochondriasis (4.4%), and organic brain syndrome with or without dementia (3.6%). The findings suggest that having depressive disorder was significantly associated with less life satisfaction in the whole sample of older adults' people. In addition, anxiety, hypochondriacal disorders, and organic brain syndrome were significantly associated with low life satisfaction. Meanwhile, other psychiatric disorders e.g., phobia, Obsessive Compulsive disorder (OCD), schizophrenia were not significantly associated with life satisfaction. No significant relationship was found with any physical disorders alone. The data further reveal that low level of life satisfaction was especially significant in the age group above 85 years and people who live alone or only with wife/husband. The strong influence of psychiatric disorders e.g., depression, anxiety, organic brain syndrome, and hypochondriasis rather than physical disorders suggests that a lack of meaning and worries are more detrimental to life satisfaction than physical frailty. The findings underscore the need to develop interventions that help older people deal more effectively with psychiatric disorders and

Mental and behavioral disorders among people with congenital deafblindness.

PubMed

Dammeyer, Jesper

2011-01-01

The population of people with congenital deafblindness faces challenges concerning communication and mobility. Due to the significance of the sensory loss it is difficult to diagnose mental and behavioral disorders. This article investigates the prevalence of mental and behavioral disorders among 95 congenitally deafblind adults. Seventy-four percent were found to have a mental and/or behavioral diagnose. Mental retardation was found among 34%, psychosis among 13%. Mental and behavioral disorders, especially with symptoms of psychosis and mental retardation, are common among people with congenital deafblindness. Clinical experience is needed, as well as cross-disciplinary cooperation and specialized diagnostic methods together with a observation and intervention period in order to be able to assess and differentiate mental and behavioral symptoms from sensory deprivation in people with congenital deafblindness. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Depression and Anxiety Disorders and Associated Factors in the Adult Colombian Population, 2015 National Mental Health Survey].

PubMed

Gómez-Restrepo, Carlos; Tamayo Martínez, Nathalie; Bohórquez, Adriana; Rondón, Martín; Medina Rico, Mauricio; Rengifo, Hernet; Bautisa, Nubia

2016-12-01

Mental disorders are the first causes of disability adjusted life years (DALY), contributing with the 7.4%. This value increases as the DALYs of the transmittable diseases decrease. To determine the prevalence and associated factors of the major depressive and anxious disorders. Data obtained from the IV Mental Health Survey with representation from 5 regions. A computerised interview was conducted, focusing on the most frequent anxiety and depressive disorders, using the CIDI CAPI 3.0. A sample of 10,870 adults over 18 years old was obtained. The lifetime prevalence of any of these disorders is 10.1% (95% CI: 8.8-11.5) in the population between 18 and 44 years, and of 7.7% (95% CI: 6.5-9.1) in those older than 45 years. The prevalence in the last 12 months was 5.1% (95% CI: 4.3-6.0) in the younger group, and 2.3% (95% CI: 1.8-3.0) in the older group. Of the people with evaluated mental disorders, 17.6% (95% CI: 13.1-23.4) had 2 or more disorders, a comorbidity that is more common in the female population (20.4%, 95% CI: 14.2-28.3) than in males (13.5%, 95% CI: 7.9-22.0). Major depressive disorder is the most prevalent of the disorders, with a lifetime prevalence of 4.3% (95% CI: 3.7-5.0). After adjusting in a multivariate model, being divorced or widowed (OR=1.3), previous suicide attempt (OR=3.3), and having 6 or more features of border-line personality, were associated with an increased risk of presenting with any of the studied disorders. Anxiety and depressive mental disorders are an important health burden in Colombia. Copyright © 2016. Publicado por Elsevier España.

Mental representations of attachment in eating disorders: a pilot study using the Adult Attachment Interview.

PubMed

Barone, Lavinia; Guiducci, Valentina

2009-07-01

Mental representations of attachment in a sample of adults with Eating Disorders (ED) were assessed using the Adult Attachment Interview (AAI). Sixty subjects participated in the study: 30 non-clinical and 30 clinical. The results obtained showed a specific distribution of attachment patterns in the clinical sample: 10% Free/Autonomous (F), 47% Insecure-Dismissing (Ds), 17% Insecure-Entangled/Preoccupied (E) and about 26% disorganized (CC/U). The two samples differed in their attachment pattern distribution and were significantly different on some coding system scales. Further information was obtained by analyzing differences between the three ED subtypes considered (i.e. Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder) and by investigating the differential role of the two parental figures in the definition of attachment representations. Results showed potential benefits in using the AAI coding system scales in addition to the main classifications in order to understand better the developmental issues involved in these disorders. Implications for developmental research and clinical nosology are discussed.

Quality Group Home Care for Adults with Developmental Disabilities and/or Mental Health Disorders: Yearning for Understanding, Security and Freedom

ERIC Educational Resources Information Center

Shipton, Leah; Lashewicz, Bonnie M.

2017-01-01

Background: The purpose of this study was to uncover and understand factors influencing quality of care received by adults with developmental disabilities and/or mental health disorders living in group homes. Methods: The present authors conducted a secondary analysis of data from nine focus group discussions with adults with developmental…

Mental disorders: employment and work productivity in Singapore.

PubMed

Chong, Siow Ann; Vaingankar, Janhavi Ajit; Abdin, Edimansyah; Subramaniam, Mythily

2013-01-01

To examine the association between mental disorders and work disability in the adult resident population in Singapore. Data are from the Singapore Mental Health Study, which was a household survey of a nationally representative sample. The main instrument used was the Composite International Diagnostic Interview (CIDI). Employment-related information was collected using the modified employment module of the CIDI. A total of 6,429 respondents were included in the analysis, 71 % (n = 4,594) were employed, 24.5 % (n = 1,522) were economically inactive and 4.5 % (n = 313) were unemployed. Among the employed, 2.3 % had a 12-month prevalence of at least one mental disorder, while 5.3 % of the unemployed had at least one mental disorder. The average number of work loss days (absenteeism) per capita among those with a mental disorder was 0.5 per month that is equivalent to an annualized national projection of approximately 0.3 million productivity days. The average work-cutback days (presenteeism) were 0.4 days among this group. Of the mentally ill in the workforce, a high proportion (86.5 %) did not ever seek help for problems related to mental health. Our findings provide information on the significant consequences of mental disorders on the workforce in terms of lost work productivity, which could pave the way for a more rational allocation of scarce resources.

Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness.

PubMed

Scott, David; Burke, Karena; Williams, Susan; Happell, Brenda; Canoy, Doreen; Ronan, Kevin

2012-10-01

To compare chronic physical health disorder prevalence amongst Australian adults with and without mental illness. Total n=1,716 participants (58% female) with a mean age of 52 ± 13 years (range: 18 to 89 years) completed an online survey of Australian adults in 2010. Outcome measures including prevalence of chronic physical conditions and self-reported body mass index (BMI) in n=387 (23%) with a self-reported mental illness diagnosis were compared to respondents without mental illness. A significantly higher proportion of participants with mental illness were obese (BMI ≥ 30; 31 vs 24%, p=0.005). Adjusted odds ratios (OR) for coronary heart disease, diabetes, chronic bronchitis or emphysema, asthma, irritable bowel syndrome, and food allergies or intolerances (OR range: 1.54-3.19) demonstrated that chronic physical disorders were significantly more common in participants with a mental illness. Australian adults with a diagnosis for mental illness have a significantly increased likelihood of demonstrating chronic physical health disorders compared to persons without mental illness. Health professionals must be alert to the increased likelihood of comorbid chronic physical disorders in persons with a mental illness and should consider the adoption of holistic approaches when treating those with either a mental or physical illness. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

Lifetime mental disorders and suicidal behaviour in South Africa.

PubMed

Khasakhala, L; Sorsdahl, K R; Harder, V S; Williams, D R; Stein, D J; Ndetei, D M

2011-05-01

There is relatively little data on the relationship between lifetime mental disorders and suicidal behaviour in low and middle income countries. This study examines the relationship between lifetime mental disorders, and subsequent suicide ideation, plans, and suicide attempts in South Africa. A national survey of 4185 South African adults was conducted using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate psychiatric diagnoses and suicidal behaviour. Bivariate, multivariate and discrete-time survival analyses were employed to investigate the associations between mental disorders and subsequent suicide ideation, plans, and attempts. Sixty-one percent of people who seriously considered killing themselves at some point in their lifetime reported having a prior DSM-IV disorder. Mental disorders predict the onset of suicidal ideation, but have weaker effects in predicting suicide plans or attempts. After controlling for comorbid mental disorders, PTSD was the strongest predictor of suicidal ideation and attempts. There is a relationship between number of mental disorders and suicidal behaviour, with comorbidity having significantly sub-additive effects. Consistent with data from the developed world, mental disorders are strong predictors of suicidal behaviour, and these associations are more often explained by the prediction of ideation, rather than the prediction of attempts amongst ideators. This suggests some universality of the relevant mechanisms underlying the genesis of suicidal thoughts, and the progression to suicide attempts.

110 Teachers: Adult Education and Mentally Disordered Offenders.

ERIC Educational Resources Information Center

Lavender, Peter

1993-01-01

Recommendations of British reports on education for mentally disordered prisoners include (1) financial flexibility to purchase educational services; (2) core teams of teachers, social service providers, and solicitors; and (3) 1 full-time teacher for every 15 offenders. (SK)

Dual diagnosis of mental illness and substance use disorder and injury in adults recently released from prison: a prospective cohort study.

PubMed

Young, Jesse T; Heffernan, Ed; Borschmann, Rohan; Ogloff, James R P; Spittal, Matthew J; Kouyoumdjian, Fiona G; Preen, David B; Butler, Amanda; Brophy, Lisa; Crilly, Julia; Kinner, Stuart A

2018-05-01

People with mental illness and substance use disorder are over-represented in prisons. Injury-related mortality is elevated in people released from prison, and both mental illness and substance use disorder are risk factors for injury. Effective care coordination during the transition between criminal justice and community service providers improves health outcomes for people released from prison. However, the health outcomes and support needs of people with dual diagnosis (co-occurring mental illness and substance use disorder) released from prison are poorly understood. Here we aim to examine the association between dual diagnosis and non-fatal injury in adults released from prison. Pre-release interview data collected between Aug 1, 2008, and July 31, 2010, from a representative sample of sentenced adults (≥18 years) in Queensland, Australia, were linked, retrospectively and prospectively, to person-level, state-wide emergency department and hospital records. We identified dual diagnoses from inpatient, emergency department, and prison medical records. We modelled the association between mental health status and all injury resulting in hospital contact by fitting a multivariate Cox regression, adjusting for sociodemographic, health, and criminogenic covariates, and replacing missing covariate data by multiple imputation. In 1307 adults released from prison, there were 2056 person-years of follow-up (median 495 days, IQR 163-958). The crude injury rates were 996 (95% CI 893-1112) per 1000 person-years for the dual diagnosis group, 538 (441-657) per 1000 person-years for the mental illness only group, 413 (354-482) per 1000 person-years for the substance use disorder only group, and 275 (247-307) per 1000 person-years for the no mental disorder group. After adjusting for model covariates, the dual diagnosis (adjusted hazard rate ratio 3·27, 95% CI 2·30-4·64; p<0·0001) and mental illness only (1·87, 1·19-2·95; p=0·0071) groups were at increased risk of

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys.

PubMed

Kessler, Ronald C; McLaughlin, Katie A; Green, Jennifer Greif; Gruber, Michael J; Sampson, Nancy A; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Haro, Josep Maria; Hu, Chi-Yi; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lépine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tsang, Adley; Ustün, T Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R

2010-11-01

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients.

PubMed

Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J

2016-01-01

To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.

Quality Group Home Care for Adults with Developmental Disabilities and/or Mental Health Disorders: Yearning for Understanding, Security and Freedom.

PubMed

Shipton, Leah; Lashewicz, Bonnie M

2017-09-01

The purpose of this study was to uncover and understand factors influencing quality of care received by adults with developmental disabilities and/or mental health disorders living in group homes. The present authors conducted a secondary analysis of data from nine focus group discussions with adults with developmental disabilities and/or mental health disorders, and their family and paid caregivers (N = 52). To focus the analysis, the present authors drew on the research literature to craft a model of quality of group home care using concepts of social inclusion and self-determination, and corresponding staff approaches that include active support and person-centred care. Social inclusion and self-determination for adults in group homes are facilitated by staff approaches and manifest in residents being understood and experiencing security and freedom. The present authors offer recommendations for group home resources, training, communication and outcome measures that promote residents' being understood and experiencing security and freedom. © 2016 John Wiley & Sons Ltd.

A baseline study on mental disorders in Guiné-Bissau.

PubMed

de Jong, J T; de Klein, G A; ten Horn, S G

1986-01-01

Adults attending general health facilities in Guiné-Bissau were screened for the presence of mental disorder; minimum estimate of definite mentally ill cases was found to be 12%. The proportion correctly identified by general health workers was low: only one of every three patients with a mental disorder was recognised and of every 100 non-cases 12 patients were wrongly diagnosed by the health worker as suffering from psychiatric illness. On the basis of these results health workers are now being taught how to detect mental illness.

[Mentalization based treatment and borderline personality disorder].

PubMed

De Oliveira, C; Rahioui, H; Smadja, M; Gorsane, M A; Louppe, F

2017-08-01

The borderline personality disorder is a complex psychiatric disorder that represents a high number of patients in a psychiatric adult service. Even if some therapies have shown to be effective in the therapeutic care of the borderline personality disorder they only target certain symptoms (e.g. anxiety, sadness, self-mutilation). The aim of this paper is to introduce a therapeutic model little known in France: the mentalization based therapy (MBT) developed in 2004 by Bateman and Fonagy. This therapeutic model apprehends the borderline personality disorder in all its complexity and is based on two main concepts: Bowlby's attachment theory and the concept of mentalization. The MBT is based on the hypothesis that a deficit of mentalization leads to the development of borderline disorder. The capacity of mentalization, also known as reflexive function, is acquired in infancy through interpersonal relationships, in particular those of attachment, and is the ability to understand the mental state (emotions, needs, thoughts, etc.) of oneself and others which underlies explicit behaviour. This reflexive capacity is of a better quality when the person has a secure attachment style. Indeed, borderline patients have, mainly, a deficit of mentalization capacity associated with an insecure attachment style. Thus, the main objective of the Bateman and Fonagy approach is to develop and reinforce the mentalization capacity through a therapeutic relationship as a secure base, a group therapy and the concept of insight. Classically, MBT is structured over a period of 18 months divided into 3 distinct phases distributed in two therapeutic axes: group and individual therapy. The initial phase aims to engage the patient in the therapy by evaluating attachment style, mentalization's ability, interpersonal functioning; providing psychoeducation about borderline disorder and establishing a therapeutic contract. To evaluate attachment style, the authors strongly recommend the use of the

A prospective study of physical fitness, obesity, and the subsequent risk of mental disorders among healthy young adults in army training.

PubMed

Gubata, Marlene E; Urban, Nadia; Cowan, David N; Niebuhr, David W

2013-07-01

Mental health disorders contribute substantially to medical and occupational morbidity. The role of fitness and physical activity in the prevention of mental health disorders is not well established, but epidemiologic data suggest that physical activity can protect against anxiety and depression. The analyses presented in this report, from a prospective cohort study, evaluate the association between fitness (as measured by a 5-minute step test), and being overweight (defined as exceeding weight and body fat allowances) at military entrance, with subsequent onset of mental disorder diagnosis in the first year of service. The association between risk factors and mental disorder diagnosis was analyzed using multivariate Poisson regression with the adjusted incidence rate ratio (aIRR) as the measure of association. Among weight-qualified participants, factors associated with increased incidence of mental disorder included failing the physical fitness test (aIRR: 1.36, p<0.0001), female sex (aIRR: 2.17, p<0.0001), and smoking (aIRR: 1.49, p<0.0001). Among fit participants, being overweight was not significantly associated with mental disorder (aIRR: 1.11, p=0.1540). This test has potential military utility as an adjunct part of the medical examination process. Additional research is needed among civilians to determine if similar associations exist. If so, intervention studies should be conducted to determine if improving physical fitness reduces subsequent psychiatric disorder risk, particularly among young adults entering into stressful situations. Published by Elsevier Inc.

[Primary Prevention of Mental Disorders in Children of Mentally Ill Parents. The Kanu Programme "Canoe--Moving Jointly Forward"].

PubMed

Linthorst, K; Bauer, U; Osipov, I; Pinheiro, P; Rehder, M

2015-09-01

Children of parents who suffer from mental health disorders are more likely to develop mental disorders than children of parents not suffering from mental disorders. For children at risk, preventive strategies are hardly available and, if available, rarely supported by a scientific evaluation. "Kanu - Gemeinsam weiterkommen (canoe - moving jointly forward)" is a preventive strategy that was developed within a research project focusing on primary prevention in children who live in families with parents affected by mental disorders. The intervention is characterised by a multi-modular concept and was tested in the adult psychiatric setting. Preliminary results indicate a preventive impact of the intervention programme. © Georg Thieme Verlag KG Stuttgart · New York.

The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey

PubMed Central

Saban, Amina; Flisher, Alan J; Grimsrud, Anna; Morojele, Neo; London, Leslie; Williams, David R; Stein, Dan J

2014-01-01

Introduction Although substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population. Methods Data were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates. Data from a subset (n = 1766; aged 18 to 30 years) of the SASH sample of 4351 individuals were analysed. The Composite International Diagnostic Interview Version 3 (CIDI 3.0) was used to elicit basic demographic details and information regarding mental illness and substance use. Multiple regression analyses, adjusted for age and gender, were used to identify associations between mental disorders and substance use. Results Significant associations were found between substance use and mood and anxiety disorders, with a particularly strong relationship between cannabis use and mental disorder. Conclusion The results are consistent with those from previous studies, and reinforce the argument that comorbid substance use and mental disorders constitute a major public health burden. PMID:24624244

Physical activity and prevalence and incidence of mental disorders in adolescents and young adults.

PubMed

Ströhle, Andreas; Höfler, Michael; Pfister, Hildegard; Müller, Anne-Grit; Hoyer, Jürgen; Wittchen, Hans-Ulrich; Lieb, Roselind

2007-11-01

Although positive effects of physical activity on mental health indicators have been reported, the relationship between physical activity and the development of specific mental disorders is unclear. A cross-sectional (12-month) and prospective-longitudinal epidemiological study over 4 years in a community cohort of 2548 individuals, aged 14-24 years at outset of the study. Physical activity and mental disorders were assessed by the DSM-IV Composite International Diagnostic Interview (CIDI) with an embedded physical activity module. Multiple logistic regression analyses controlling for age, gender and educational status were used to determine the cross-sectional and prospective associations of mental disorders and physical activity. Cross-sectionally, regular physical activity was associated with a decreased prevalence of any and co-morbid mental disorder, due to lower rates of substance use disorders, anxiety disorders and dysthymia. Prospectively, subjects with regular physical activity had a substantially lower overall incidence of any and co-morbid mental disorder, and also a lower incidence of anxiety, somatoform and dysthymic disorder. By contrast, the incidence of bipolar disorder was increased among those with regular physical activity at baseline. In terms of the population attributable fraction (PAF), the potential for preventive effects of physical activity was considerably higher for men than for women. Regular physical activity is associated with a substantially reduced risk for some, but not all, mental disorders and also seems to reduce the degree of co-morbidity. Further examination of the evidently complex mechanisms and pathways underlying these associations might reveal promising new research targets and procedures for targeted prevention.

Explanations of firesetting in mentally disordered offenders: a review of the literature.

PubMed

Tyler, Nichola; Gannon, Theresa A

2012-01-01

This paper reviews current explanations of firesetting in adult mentally disordered offenders. In particular, attention is given to contemporary research that has examined developmental and background characteristics, personality and associated traits, motivation for firesetting, neurobiological explanations, psychiatric diagnoses, and frequency of self-injurious behavior, including suicide. The likelihood of recidivism and associated risk factors is also considered. Evaluation of the existing research has highlighted that even though a significant proportion has been conducted with psychiatric populations, little is understood about firesetting by mentally disordered offenders. In addition, little research has been conducted that compares mentally disordered firesetters to both other mentally disordered offenders and non-mentally disordered offenders. Recommendations are made for future research to further develop knowledge of this behavior.

Mental Health Literacy in Young Adults: Adaptation and Psychometric Properties of the Mental Health Literacy Questionnaire.

PubMed

Dias, Pedro; Campos, Luísa; Almeida, Helena; Palha, Filipa

2018-06-23

Mental health literacy (MHL) is considered a prerequisite for early recognition and intervention in mental disorders, and for this reason, it has become a focus of research over the past few decades. Assessing this construct is relevant for identifying knowledge gaps and erroneous beliefs concerning mental health issues, to inform the development of interventions aimed at promoting mental health literacy as well as the evaluation of these interventions. Recently, we developed a new self-reporting measure (MHLq) for assessing mental health literacy in young people (12⁻14 years-old), meeting the need to assess MHL from a comprehensive perspective of the construct instead of focusing on a restricted number of mental disorders or specific dimensions (e.g., knowledge concerning specific disorders; stigma). The present study aimed to adapt the MHLq for the young adult population and to examine its psychometric properties, according to the following steps: (1) item adaptation, using a think aloud procedure (n = 5); (2) data collection (n = 356, aged between 18 and 25 years old; and (3) psychometric analyses (exploratory factor analysis and internal consistency analysis). The final version of the questionnaire included 29 items (total scale α = 0.84), organized by four dimensions: (1) knowledge of mental health problems (α = 0.74); (2) erroneous beliefs/stereotypes (α = 0.72); (3) help-seeking and first aid skills (α = 0.71); and (4) self-help strategies (α = 0.60). The results suggest that the MHLq-adult form is a practical, valid, and reliable screening tool for identifying gaps in knowledge, beliefs, and behavioral intentions related to mental health and mental disorders, planning promotion programs, and evaluating intervention effectiveness.

Mental disorders among persons with arthritis: results from the World Mental Health Surveys

PubMed Central

He, Y.; Zhang, M.; Lin, E. H. B.; Bruffaerts, R.; Posada-Villa, J.; Angermeyer, M. C.; Levinson, D.; de Girolamo, G.; Uda, H.; Mneimneh, Z.; Benjet, C.; de Graaf, R.; Scott, K. M.; Gureje, O.; Seedat, S.; Haro, J. M.; Bromet, E. J.; Alonso, J.; Kovess, V.; Von Korff, M.; Kessler, R.

2009-01-01

Background Prior studies in the USA have reported higher rates of mental disorders among persons with arthritis but no cross-national studies have been conducted. In this study the prevalence of specific mental disorders among persons with arthritis was estimated and their association with arthritis across diverse countries assessed. Method The study was a series of cross-sectional population sample surveys. Eighteen population surveys of household-residing adults were carried out in 17 countries in different regions of the world. Most were carried out between 2001 and 2002, but others were completed as late as 2007. Mental disorders were assessed with the World Health Organization (WHO) World Mental Health–Composite International Diagnostic Interview (WMH-CIDI). Arthritis was ascertained by self-report. The association of anxiety disorders, mood disorders and alcohol use disorders with arthritis was assessed, controlling for age and sex. Prevalence rates for specific mental disorders among persons with and without arthritis were calculated and odds ratios (ORs) with 95% confidence intervals were used to estimate the association. Results After adjusting for age and sex, specific mood and anxiety disorders occurred among persons with arthritis at higher rates than among persons without arthritis. Alcohol abuse/dependence showed a weaker and less consistent association with arthritis. The pooled estimates of the age- and sex-adjusted ORs were about 1.9 for mood disorders and for anxiety disorders and about 1.5 for alcohol abuse/dependence among persons with versus without arthritis. The pattern of association between specific mood and anxiety disorders and arthritis was similar across countries. Conclusions Mood and anxiety disorders occur with greater frequency among persons with arthritis than those without arthritis across diverse countries. The strength of association of specific mood and anxiety disorders with arthritis was generally consistent across

Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA).

PubMed

Geue, Kristina; Brähler, Elmar; Faller, Hermann; Härter, Martin; Schulz, Holger; Weis, Joachim; Koch, Uwe; Wittchen, Hans-Ulrich; Mehnert, Anja

2018-04-12

This study provides prevalence data of mental disorders (4-week, 1-year, lifetime) and psychological distress in Adolescent and Young Adult (AYAs) with cancer. We included an AYA subsample (15 to 39 year olds; diagnosed within the last 5 years) extracted from a larger sample (4.020 cancer patients) who had been recruited for an epidemiological study across all major tumor entities. Participants were assessed with a depression screener (PHQ-9). Following that, 50% of the participants who scored below the cutoff of 9 and all patients who scored above were assessed using the Composite International Diagnostic Interview for Oncology (CIDI-O). Patients also completed an anxiety screener (GAD-7). A total of 302 AYA (167 completed CIDI-O) were identified. With regard to psychological distress, 29.5% of the AYA had increased depression symptoms (PHQ-9), and 20.8% had increased anxiety symptoms (GAD-7). Gender and age were associated with psychological distress, with women and older AYA being found to have higher distress. The 4-week prevalence of mental disorders of any kind was 46.7% (95%-CI:39%-55%). Anxiety (24.4%; 95%-CI:20%-36%) and adjustment disorders (14.1%; 95%-CI:9%-19%) had the highest prevalence rates. The lowest prevalence rates were reported for alcohol dependence (0.8%; 95%-CI:0%-2%) and somatoform disorders (3.7%; 95%-CI:1%-7%). The 1-year-prevalence was 55.4% (CI:47.36-62.64), and the lifetime-prevalence was 69.5% (CI: 62.29-77.06). Our findings may sensitize clinicians to the possible presence of mental disorders in AYA. The results indicate that there is a strong need for psycho-oncological interventions designed to improve mental health in AYAs with cancer at all stages of medical care. Copyright © 2018 John Wiley & Sons, Ltd.

Perceived stigma among individuals with common mental disorders.

PubMed

Alonso, Jordi; Buron, Andrea; Rojas-Farreras, Sonia; de Graaf, Ron; Haro, Josep M; de Girolamo, Giovanni; Bruffaerts, Ronny; Kovess, Viviane; Matschinger, Herbert; Vilagut, Gemma

2009-11-01

Severe mental disorders are associated with social distance from the general population, but there is lack of data on the stigma reported by individuals with common mental disorders. To identify the correlates and the impact of stigma among individuals with common mental disorders. Cross-sectional, household interview survey of 8796 representing the non-institutionalized adults of Belgium, France, Germany, Italy, the Netherlands and Spain. Two perceived stigma questions (embarrassment and discrimination) were asked to respondents with significant disability. Health-related quality of life measured by the SF-12, work and activity limitation and social limitation were also assessed. Among the 815 participants with a 12-month mental disorder and significant disability, 14.8% had perceived stigma. Stigma was significantly associated with low education, being married/living with someone and being unemployed. Perceived stigma was associated with decreased quality of life (SF-12 PCS score -4.65; p<0.05), higher work and role limitation and higher social limitation. Individuals with mental disorders are more likely to report stigma if they have lower education, are married, or are unemployed. Perceived stigma is associated with considerably decrease in quality of life and role functioning. Health professionals and society at large must be aware of these findings, which suggest that fighting stigma should be a public health priority.

Hierarchical screening for multiple mental disorders.

PubMed

Batterham, Philip J; Calear, Alison L; Sunderland, Matthew; Carragher, Natacha; Christensen, Helen; Mackinnon, Andrew J

2013-10-01

There is a need for brief, accurate screening when assessing multiple mental disorders. Two-stage hierarchical screening, consisting of brief pre-screening followed by a battery of disorder-specific scales for those who meet diagnostic criteria, may increase the efficiency of screening without sacrificing precision. This study tested whether more efficient screening could be gained using two-stage hierarchical screening than by administering multiple separate tests. Two Australian adult samples (N=1990) with high rates of psychopathology were recruited using Facebook advertising to examine four methods of hierarchical screening for four mental disorders: major depressive disorder, generalised anxiety disorder, panic disorder and social phobia. Using K6 scores to determine whether full screening was required did not increase screening efficiency. However, pre-screening based on two decision tree approaches or item gating led to considerable reductions in the mean number of items presented per disorder screened, with estimated item reductions of up to 54%. The sensitivity of these hierarchical methods approached 100% relative to the full screening battery. Further testing of the hierarchical screening approach based on clinical criteria and in other samples is warranted. The results demonstrate that a two-phase hierarchical approach to screening multiple mental disorders leads to considerable increases efficiency gains without reducing accuracy. Screening programs should take advantage of prescreeners based on gating items or decision trees to reduce the burden on respondents. © 2013 Elsevier B.V. All rights reserved.

Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders.

PubMed

Ströhle, Andreas

2018-03-21

Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.

Predictors of delayed social maturation and mental health disorders in young adults chronically ill since childhood.

PubMed

Kokkonen, E R; Kokkonen, J; Moilanen, I

2001-01-01

To ascertain the influence of juvenile-onset chronic physical diseases and associating factors of social environment on delayed social maturation and mental health disorders in young adults, we analysed a group of 407 (184 female, 223 male) subjects with these conditions and compared the results with those of 123 (63 female, 60 male) healthy controls studied at the age of 19-25 years. The social maturation index was formed on the basis of a demographic interview, which also reviewed the state of social development and the family situation during childhood. Mental health disorders were assessed with a Present State Examination (PSE) interview analysed with the CATEGO program. With regard to social maturation at least half of the patients and controls were doing well, whereas for 29% (CI(95), 25%-33%) of the patients and 17% (CI(95), 10%-24%) of the controls the index showed delayed maturation. Subjects with poor social maturation were found most often among the disabled patients but also among the patients without severe diseases. The prevalence of PSE-CATEGO-identified psychiatric syndromes was equal in the patients and the controls (22% versus 20%). However, the patients with severe or disabling diseases had more severe psychiatric syndromes. The prevalences of depressive syndromes were also equal, but the depression of the patients was more often a profound affective disorder. Male sex, poor scholastic and vocational success, and social problems in the family during childhood were significantly associated with poor social maturation. On the other hand, the most significant predictors of mental health problems in young adults were female sex, family distress during childhood, and a severe disease. Juvenile-onset physical disease was considered to delay social maturation in some subjects and to deepen or modulate the clinical picture of mental health disorders. It is concluded that juvenile-onset physical diseases combined with family-related factors affect in

Correlates of adverse childhood experiences among adults with severe mood disorders.

PubMed

Lu, Weili; Mueser, Kim T; Rosenberg, Stanley D; Jankowski, Mary Kay

2008-09-01

Adverse childhood experiences have been found to be associated with poor physical and poor mental health, impaired functioning, and increased substance abuse in the general adult population. The purpose of this study was to examine the clinical correlates of these experiences among adults with severe mood disorders. Adverse childhood experiences (including physical abuse, sexual abuse, parental mental illness, loss of parent, parental separation or divorce, witnessing domestic violence, and placement in foster or kinship care) were assessed retrospectively in a sample of 254 adults with major mood disorders. The relationships between cumulative exposure to these experiences and psychiatric problems, health, substance use disorders, community functioning, trauma exposure in adulthood, and high-risk behaviors were examined. Increased exposure to childhood adverse experiences was related to high-risk behaviors, diagnosis of a substance use disorder, exposure to trauma in adulthood, psychiatric problems (younger age at first hospitalization, number of suicide attempts, and diagnosis of posttraumatic stress disorder), medical service utilization, and homelessness. The findings extend research in the general population by suggesting that adverse childhood experiences contribute to worse mental and physical health and functional outcomes among adults with severe mood disorders.

The Stigma of Childhood Mental Disorders: A Conceptual Framework

ERIC Educational Resources Information Center

Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A.

2010-01-01

Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus…

Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression

PubMed Central

Alonso, Jordi; Stein, Dan J.; Kiejna, Andrzej; Aguilar-Gaxiola, Sergio; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Lepine, Jean-Pierre; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Fukao, Akira; Bunting, Brendan; Haro, Josep Maria; Posada-Villa, Jose A.; Al-Hamzawi, Ali Obaid; Medina-Mora, Maria Elena; Piazza, Marina; Hu, Chiyi; Sasu, Carmen; Lim, Carmen C. W.; Kessler, Ronald C.; Scott, Kate M.

2014-01-01

Aims/hypothesis No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes. Methods We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults (n=52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician’s diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment. Results We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment. Conclusions/interpretation Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes. PMID:24488082

Effects of Physical Limitations on Daily Activities Among Adults With Mental Health Disorders: Opportunities for Nursing and Occupational Therapy Interventions.

PubMed

Gardner, Jennifer; Swarbrick, Margaret; Ackerman, Ariane; Church, Theodora; Rios, Vanessa; Valente, Laura; Rutledge, John

2017-10-01

Individuals living with mental health disorders served by the public mental health system often face comorbid medical conditions that affect their quality of life and lifespan. The effect of physical limitations on the engagement in daily activities among individuals living with mental health disorders has not been extensively researched. Adults attending community wellness centers (N = 53) in a northeastern United State were included in a descriptive study exploring the impact of physical limitations on daily activities. The activities most frequently affected were: walking or moving around, sleeping, and finding a job. The physical limitations affecting these three activities were lack of energy and pain. Health care professionals, including mental health nurses and occupational therapy practitioners, are in an ideal position to collaborate by evaluating and offering treatment interventions that address physical limitations to positively affect occupational functioning and recovery. [Journal of Psychosocial Nursing and Mental Health Services, 55(10), 45-51.]. Copyright 2017, SLACK Incorporated.

Self-reported volitional control in adolescents and young adults from a community cohort: Associations with current, past and future mental disorders.

PubMed

Asselmann, Eva; Hilbert, Kevin; Hoyer, Jana; Wittchen, Hans-Ulrich; Lieb, Roselind; Bühringer, Gerhard; Beesdo-Baum, Katja

2017-11-21

Alterations in volitional control have been found for various mental disorders. However, it remains unclear to which degree such alterations vary by type of psychopathology and constitute preceding vulnerabilities or correlates of mental disorders. DSM-IV mental disorders were assessed among adolescents and young adults from the community at baseline (age 14-24) and in up to 3 follow-up assessments over 10 years (n = 2515) using a standardized diagnostic interview (DIA-X/M-CIDI). Self-reported volitional control was assessed at second follow-up (T2) when subjects were aged 17-28 using the German version of the Short Form of the Volitional Components Inventory. Linear regressions adjusted for sex, age and lifetime disorders revealed that anxiety and affective disorders were associated with widespread alterations in self-reported volitional control (lower self regulation, higher self inhibition and volitional inhibition), while substance use disorders were specifically associated with higher volitional inhibition. Logistic regressions adjusted for sex, age and prior lifetime psychopathology revealed that lower self-reported volitional control at T2 predicted incident panic, social phobia and substance use at T3 (follow-up interval M = 4.8 years). Findings point toward at least partly disorder-specific alterations in volitional control in mental disorders, which might be antecedent vulnerability factors and thus useful to guide early recognition and prevention. Copyright © 2017. Published by Elsevier B.V.

Health Promotion for Young Adults With Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Scherer, Emily A.; Pratt, Sarah I.; Bartels, Stephen J.

2017-01-01

Objective Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21–30) compared with participants over age 30. Methods Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Results Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a non-significant difference between age groups). Conclusions Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group. PMID:27799016

Health Promotion for Young Adults With Serious Mental Illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; Pratt, Sarah I; Bartels, Stephen J

2017-02-01

Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21-30) compared with participants over age 30. Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a nonsignificant difference between age groups). Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group.

Young adults' perceptions of GPs as a help source for mental distress: a qualitative study

PubMed Central

Biddle, Lucy; Donovan, Jenny L; Gunnell, David; Sharp, Debbie

2006-01-01

Background Few young adults with mental disorder seek help from a GP. Aim To explore young adults' perceptions of GPs as a source of help for mental distress. Design of study Qualitative interviews. Setting Bristol and surrounding areas, UK. Method Males and females aged 16–24 years screened as ‘cases’ with probable mental disorder (GHQ [General Health Questionnaire]-12 score≥4) or describing past episodes of mental disorder (n = 23) were sampled purposively according to help-seeking behaviour. Semi-structured interviews explored help-seeking choices. Transcripts were analysed using thematic, constant comparison and case study analysis. Results Most young adults did not value or recognise GPs as a source of help for mental disorder or distress. They thought that GPs deal exclusively with physical illness, lack training in mental health, are unable to provide ‘talking’ therapy, and may be dismissive of those consulting with mental distress. A prescription for antidepressants was seen as the most likely outcome of a consultation, but young adults wished to avoid this and so rarely consulted. Encounters with GPs could challenge or reinforce these perceptions. Conclusion Negative perceptions about the value of consulting a GP for mental distress may explain low rates of help-seeking among young adults, including those with severe distress. Young people require a better understanding of GPs' role. It is also necessary to address evidence reported elsewhere that some GPs also experience uncertainties about what they can offer within the constraints of primary care. PMID:17132380

The Meaning of Stigma for People with Mental Disorders in Brazil.

PubMed

Vedana, Kelly Graziani Giacchero; Silva, Dayane Rosa Alvarenga; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; Borges, Tatiana Longo

2017-12-01

To understand the meaning of stigma for people with mental disorders. A qualitative study with 46 Brazilian adults with mental disorders. Data were collected through semistructured interviews and nonparticipant observation and submitted for a thematic analysis with symbolic interactionism. Stigma was considered as an experience of incomprehension and suffering. The society has difficulty in empathizing, respecting differences and understanding the extent of the suffering of people with mental disorders. Participants recommended anti-stigma strategies that included promoting knowledge and respecting differences. The present study contributes new insights to be addressed in interventions to reduce the suffering and impact of stigma.

[Poverty and Mental Disorders in the Colombian Population: National Mental Health Survey 2015].

PubMed

Quitian, Hoover; Ruiz-Gaviria, Rafael E; Gómez-Restrepo, Carlos; Rondón, Martin

2016-12-01

Poverty has been associated in some studies with poorer outcomes in mental problems and disorders. A circular relationship has been considered in which poverty fosters the appearance of mental illness and this facilitates greater poverty. There are no studies in Colombia on this subject. To describe the association between mental problems and disorders and poverty according to the Multidimensional Poverty Index (MPI) in Colombia. Using the 2015 National Mental Health Survey, adjusted with the expansion factors for the population. The prevalences of mental problems and disorders obtained through semi-structured interviews employing the instruments SRQ-20, AUDIT C and A, modified PCL, familiar APGAR and CIDI CAPI. The poverty status was determined by the MPI. A total of 13,200 households were interviewed, of which 13.5% were classified as in a poverty condition, 6.3% of the adolescents of poor households reported a life-time prevalence of any mental disorder, and 4.6% in the last 12 months. On the other hand, the prevalences for the same age group not in a poverty condition were 7.2% and 3.3%, respectively. For adults in poverty, the prevalence of life-time mental disorders were 9.2%, with 4.3% in the last year, while those not considered poor showed prevalences of 9.1% and 3.9% for the same time periods. For the population of Colombia, there is a relationship between not being able to access the basic basket of goods and the presence of mental diseases, although there does not seems to be an association between an increase in poverty and the deterioration of mental health. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Prevalence of self-management versus formal service use for common mental disorders in Australia: findings from the 2007 National Survey of Mental Health and Wellbeing.

PubMed

Olesen, Sarah C; Butterworth, Peter; Leach, Liana

2010-09-01

To determine the proportion of Australian adults who use non-practitioner led support services and self-management strategies for common mental disorders. Data were drawn from the 2007 National Survey of Mental Health and Wellbeing, a representative survey of 8841 Australian adults aged 16 to 85 years. This survey included the Composite International Diagnostic Instrument to obtain diagnosis of International Classification of Diseases (Version 10; ICD-10) mental disorders. Information about consultations with health professionals for mental health problems and the use of support services and self-management strategies was also collected. Half of all adults who met the criteria for an affective or anxiety disorder in the last 12 months reported using non-practitioner led support services and/or self-management strategies for their mental health problems. Six per cent used support services, including Internet and non-online support groups and telephone counselling, and 51.9% used self-management strategies such as doing 'more of the things you enjoy' to 'help deal with' their mental health problems. Of people with a 12-month common mental disorder, 24% used support services and/or self-management strategies without additional formal services; 29.3% used both. Of adults with a 12-month affective or anxiety disorder, 37% used neither formal services nor self-management strategies. A substantial proportion of people who reported using self-management strategies for their mental health did not have a diagnosable affective or anxiety disorder. The use of non-practitioner led support services and self-management strategies for mental health problems, with and without adjunct use of formal health services, is widespread in Australia. Future research is needed to investigate why people may select these strategies over formal services, or whether self-management reflects the presence of barriers to use of formal services.

[Homicide and major mental disorder: what are the social, clinical, and forensic differences between murderers with a major mental disorder and murderers without any mental disorder?].

PubMed

Richard-Devantoy, S; Chocard, A-S; Bourdel, M-C; Gohier, B; Duflot, J-P; Lhuillier, J-P; Garré, J-B

2009-09-01

To establish the social, clinical, and forensic differences between murderers suffering from a major mental disorder and murderers without any psychiatric disorder and, in particular, to compare their respective records of psychiatric symptoms and their respective relationship with their victims. We studied 210 forensic examinations of murderers, the offences related to the murders, and the social and clinical information collected from psychiatric court reports on persons convicted of homicide. Firstly, we identified the socio-demographic, clinical and criminological profiles of 210 murderers from which were distinguished murderers with major mental disorder. Then, we compared the profiles of murderers suffering from a major mental disorder with those of murderers without any mental disease. In other words, we compared 37 persons affected with major mental disorder (schizophrenia, paranoiac delusional disorder, and affective disorder) with 73 persons without any mental disorder. We deliberately excluded subjects with personality disorder or abuse of/dependency on drugs, mental retardation or dementia. With the exception of certain variables, murderers with major mental disorder have the same characteristics as others murderers: young man, living alone, with psychiatric and offence records and substance abuse. Murderers with major mental disorder are older (37.8 versus 31.7 years old) than perpretators without any mental disorder, and the former have a psychiatric record more often than the latter (81 versus 32.9%). In addition, contrary to the latter, the former show clinical symptoms of a psychopathological process. Depression, delusional and suicidal ideas are frequent among murderers with a major mental disorder, whereas the persons without mental disorder quarrel or have a row with their victim just before their crime. The victim was known to the perpetrator significantly more often in the major mental disorder group than in the no mental disorder group (94

Mental health, concurrent disorders, and health care utilization in homeless women.

PubMed

Strehlau, Verena; Torchalla, Iris; Kathy, Li; Schuetz, Christian; Krausz, Michael

2012-09-01

This study assessed lifetime and current prevalence rates of mental disorders and concurrent mental and substance use disorders in a sample of homeless women. Current suicide risk and recent health service utilization were also examined in order to understand the complex mental health issues of this population and to inform the development of new treatment strategies that better meet their specific needs. A cross-sectional survey of 196 adult homeless women in three different Canadian cities was done. Participants were assessed using DSM-IV-based structured clinical interviews. Current diagnoses were compared to available mental health prevalence rates in the Canadian female general population. Current prevalence rates were 63% for any mental disorder, excluding substance use disorders; 17% for depressive episode; 10% for manic episode; 7% for psychotic disorder; 39% for anxiety disorders, 28% for posttraumatic stress disorder; and 19% for obsessive-compulsive disorder; 58% had concurrent substance dependence and mental disorders. Lifetime prevalence rates were notably higher. Current moderate or high suicide risk was found in 22% of the women. Participants used a variety of health services, especially emergency rooms, general practitioners, and walk-in clinics. Prevalence rates of mental disorders among homeless participants were substantially higher than among women from the general Canadian population. The percentage of participants with moderate or high suicide risk and concurrent disorders indicates a high severity of mental health symptomatology. Treatment and housing programs need to be accompanied by multidisciplinary, specialized interventions that account for high rates of complex mental health conditions.

[Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy].

PubMed

Taubner, Svenja; Volkert, Jana; Gablonski, Thorsten-Christian; Rossouw, Trudie

2017-07-01

Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.

[Assessment and treatment of developmental disorder traits in adult mental disorder: from the viewpoint of maladjustment in a company and university].

PubMed

Fukuda, Shinya

2013-01-01

This paper discusses the maladjustment reaction of adults with autism spectrum disorders such as Asperger syndrome to a working environment or university setting, from the viewpoint of a psychiatrist seeing them in areas of occupational and college mental health. The author is in charge of a day care program for company workers, called "The Return-to-Work Support Course", at a mental clinic. A total of 176 patients attended the program and most of them were originally diagnosed with depression and/or adjustment disorder. The author noted that five of them showed some traits of developmental disorder. They initially had been capable specialists at work, but started showing mental and psychosocial dysfunction as they received promotions and became team leaders or managers. It seems that changes in their work environment involving their superiors, co-workers, the organization, etc., easily affected their work performance and triggered their maladjustment, and finally caused their leave of absence. The author also works in a university student counseling room, and noted that some students started to show maladjustment in the course of writing their graduation thesis or applying for jobs, although they previously had performed fairly well at university. They could not maintain good communication with thesis advisers, could not perform adequately during a group discussion at a job interview, or could not cope with personnel offices appropriately. After being interviewed, they were diagnosed with Asperger syndrome. Not only child psychiatrists but all psychiatrists should have a sufficient knowledge of developmental disorders, and they need to be cautious when they diagnose patients and inform them.

Emerging adults' perspectives on their relationships with mothers with mental illness: implications for caregiving.

PubMed

Abraham, Kristen M; Stein, Catherine H

2012-10-01

Guided by a life course perspective, the current study examined whether emerging adults with and without mothers with affective disorders viewed their relationships with their mothers differently, and whether aspects of the emerging adult-mother relationship were associated with reports of caregiving for mothers. Reports from emerging adults with mothers with affective disorders (n = 46) were compared to reports from emerging adults with mothers without mental illness (n = 64). Results indicated that emerging adults with mothers with affective disorders reported significantly lower levels of affection, felt obligation, reciprocity, and future caregiving intentions, and significantly higher levels of role reversal in their relationships with their mothers. Reported current caregiving levels did not differ between emerging adults with and without mothers with affective disorders. Hierarchical multiple regression analyses generally indicated higher levels of felt obligation were associated with higher levels of caregiving, regardless of maternal mental health status. Results and future research directions are discussed from a life course perspective. © 2012 American Orthopsychiatric Association.

Mental health service use among South Africans for mood, anxiety and substance use disorders.

PubMed

Seedat, Soraya; Williams, David R; Herman, Allen A; Moomal, Hashim; Williams, Stacey L; Jackson, Pamela B; Myer, Landon; Stein, Dan J

2009-05-01

Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. A nationally representative survey of 4351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) diagnoses, severity, and service utilisation were determined using the World Health Organization Composite International Diagnostic Interview (CIDI). Twelve-month treatment was categorised by sector and province. South Africans in households and hostel quarters were interviewed between 2002 and 2004 in all nine provinces. 4 317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender. Of respondents with a mental disorder, 25.2% had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders, and among those with a mental disorder it varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment, and this was largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder. There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need.

Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study.

PubMed

Crump, Casey; Sundquist, Kristina; Winkleby, Marilyn A; Sundquist, Jan

2013-03-04

To determine the risk of people with mental disorders being victims of homicide. National cohort study. Sweden. Entire adult population (n = 7,253,516). Homicidal death during eight years of follow-up (2001-08); hazard ratios for the association between mental disorders and homicidal death, with adjustment for sociodemographic confounders; potential modifying effect of comorbid substance use. 615 homicidal deaths occurred in 54.4 million person years of follow-up. Mortality rates due to homicide (per 100,000 person years) were 2.8 among people with mental disorders compared with 1.1 in the general population. After adjustment for sociodemographic confounders, any mental disorder was associated with a 4.9-fold (95% confidence interval 4.0 to 6.0) risk of homicidal death, relative to people without mental disorders. Strong associations were found irrespective of age, sex, or other sociodemographic characteristics. Although the risk of homicidal death was highest among people with substance use disorders (approximately ninefold), the risk was also increased among those with personality disorders (3.2-fold), depression (2.6-fold), anxiety disorders (2.2-fold), or schizophrenia (1.8-fold) and did not seem to be explained by comorbid substance use. Sociodemographic risk factors included male sex, being unmarried, and low socioeconomic status. In this large cohort study, people with mental disorders, including those with substance use disorders, personality disorders, depression, anxiety disorders, or schizophrenia, had greatly increased risks of homicidal death. Interventions to reduce violent death among people with mental disorders should tackle victimisation and homicidal death in addition to suicide and accidents, which share common risk factors.

Mental health implications for older adults after natural disasters--a systematic review and meta-analysis.

PubMed

Parker, Georgina; Lie, David; Siskind, Dan J; Martin-Khan, Melinda; Raphael, Beverly; Crompton, David; Kisely, Steve

2016-01-01

Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.

Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder.

PubMed

Kelleher, I; Ramsay, H; DeVylder, J

2017-03-01

Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale.

PubMed

Préville, Michel; Mechakra Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

2015-01-01

To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population. Cross-sectional survey. Primary medical health services clinics. Probabilistic sample of older adults aged 65 years and over waiting for medical services in the general medical sector (n = 1765). Perceived social stigma against people with a mental health problem was measured using the STIG scale composed of seven indicators. A second-order measurement model of perceived social stigma fitted adequately the observed data. The reliability of the STIG scale was 0.83. According to our results, 39.6% of older adults had a significant level of perceived social stigma against people with a mental health problem. RESULTS showed that the perception of social stigma against mental health problems was not significantly associated with a respondent gender and age. RESULTS also showed that the perception of social stigma against the mental health problems was directly associated with the respondents' need for improved mental health (b = -0.10) and indirectly associated with their use of primary medical health services for psychological distress symptoms (b = -0.07). RESULTS lead us to conclude that social stigma against mental disorders perceived by older adults may limit help-seeking behaviours and warrants greater public health and public policy attention. Also, results lead us to conclude that physicians should pay greater attention to their patients' attitudes against mental disorders in order to identify possible hidden mental health problems.

Association of Mental Disorders With Subsequent Chronic Physical Conditions

PubMed Central

Scott, Kate M.; Lim, Carmen; Al-Hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; Florescu, Silvia; de Girolamo, Giovanni; Hu, Chiyi; de Jonge, Peter; Kawakami, Norito; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; O’Neill, Siobhan; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C.

2017-01-01

IMPORTANCE It is clear that mental disorders in treatment settings are associated with a higher incidence of chronic physical conditions, but whether this is true of mental disorders in the community, and how generalized (across a range of physical health outcomes) these associations are, is less clear. This information has important implications for mental health care and the primary prevention of chronic physical disease. OBJECTIVE To investigate associations of 16 temporally prior DSM-IV mental disorders with the subsequent onset or diagnosis of 10 chronic physical conditions. DESIGN, SETTING, AND PARTICIPANTS Eighteen face-to-face, cross-sectional household surveys of community-dwelling adults were conducted in 17 countries (47 609 individuals; 2 032 942 person-years) from January 1, 2001, to December 31, 2011. The Composite International Diagnostic Interview was used to retrospectively assess the lifetime prevalence and age at onset of DSM-IV–identified mental disorders. Data analysis was performed from January 3, 2012, to September 30, 2015. MAIN OUTCOMES AND MEASURES Lifetime history of physical conditions was ascertained via self-report of physician’s diagnosis and year of onset or diagnosis. Survival analyses estimated the associations of temporally prior first onset of mental disorders with subsequent onset or diagnosis of physical conditions. RESULTS Most associations between 16 mental disorders and subsequent onset or diagnosis of 10 physical conditions were statistically significant, with odds ratios (ORs) (95% CIs) ranging from 1.2 (1.0–1.5) to 3.6 (2.0–6.6). The associations were attenuated after adjustment for mental disorder comorbidity, but mood, anxiety, substance use, and impulse control disorders remained significantly associated with onset of between 7 and all 10 of the physical conditions (ORs [95% CIs] from 1.2 [1.1–1.3] to 2.0 [1.4–2.8]). An increasing number of mental disorders experienced over the life course was significantly

The Autism Mental Status Exam: Sensitivity and Specificity Using DSM-5 Criteria for Autism Spectrum Disorder in Verbally Fluent Adults

ERIC Educational Resources Information Center

Grodberg, David; Weinger, Paige M.; Halpern, Danielle; Parides, Michael; Kolevzon, Alexander; Buxbaum, Joseph D.

2014-01-01

The phenotypic heterogeneity of adults suspected of autism spectrum disorder (ASD) requires a standardized diagnostic approach that is feasible in all clinical settings. The autism mental status exam (AMSE) is an eight-item observational assessment that structures the observation and documentation of social, communicative and behavioral signs and…

The ICD‐11 developmental field study of reliability of diagnoses of high‐burden mental disorders: results among adult patients in mental health settings of 13 countries

PubMed Central

Reed, Geoffrey M.; Sharan, Pratap; Rebello, Tahilia J.; Keeley, Jared W.; Elena Medina‐Mora, María; Gureje, Oye; Luis Ayuso‐Mateos, José; Kanba, Shigenobu; Khoury, Brigitte; Kogan, Cary S.; Krasnov, Valery N.; Maj, Mario; de Jesus Mari, Jair; Stein, Dan J.; Zhao, Min; Akiyama, Tsuyoshi; Andrews, Howard F.; Asevedo, Elson; Cheour, Majda; Domínguez‐Martínez, Tecelli; El‐Khoury, Joseph; Fiorillo, Andrea; Grenier, Jean; Gupta, Nitin; Kola, Lola; Kulygina, Maya; Leal‐Leturia, Itziar; Luciano, Mario; Lusu, Bulumko; Nicolas, J.; Martínez‐López, I.; Matsumoto, Chihiro; Umukoro Onofa, Lucky; Paterniti, Sabrina; Purnima, Shivani; Robles, Rebeca; Sahu, Manoj K.; Sibeko, Goodman; Zhong, Na; First, Michael B.; Gaebel, Wolfgang; Lovell, Anne M.; Maruta, Toshimasa; Roberts, Michael C.; Pike, Kathleen M.

2018-01-01

Reliable, clinically useful, and globally applicable diagnostic classification of mental disorders is an essential foundation for global mental health. The World Health Organization (WHO) is nearing completion of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD‐11). The present study assessed inter‐diagnostician reliability of mental disorders accounting for the greatest proportion of global disease burden and the highest levels of service utilization – schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear‐related disorders, and disorders specifically associated with stress – among adult patients presenting for treatment at 28 participating centers in 13 countries. A concurrent joint‐rater design was used, focusing specifically on whether two clinicians, relying on the same clinical information, agreed on the diagnosis when separately applying the ICD‐11 diagnostic guidelines. A total of 1,806 patients were assessed by 339 clinicians in the local language. Intraclass kappa coefficients for diagnoses weighted by site and study prevalence ranged from 0.45 (dysthymic disorder) to 0.88 (social anxiety disorder) and would be considered moderate to almost perfect for all diagnoses. Overall, the reliability of the ICD‐11 diagnostic guidelines was superior to that previously reported for equivalent ICD‐10 guidelines. These data provide support for the suitability of the ICD‐11 diagnostic guidelines for implementation at a global level. The findings will inform further revision of the ICD‐11 diagnostic guidelines prior to their publication and the development of programs to support professional training and implementation of the ICD‐11 by WHO member states. PMID:29856568

The ICD-11 developmental field study of reliability of diagnoses of high-burden mental disorders: results among adult patients in mental health settings of 13 countries.

PubMed

Reed, Geoffrey M; Sharan, Pratap; Rebello, Tahilia J; Keeley, Jared W; Elena Medina-Mora, María; Gureje, Oye; Luis Ayuso-Mateos, José; Kanba, Shigenobu; Khoury, Brigitte; Kogan, Cary S; Krasnov, Valery N; Maj, Mario; de Jesus Mari, Jair; Stein, Dan J; Zhao, Min; Akiyama, Tsuyoshi; Andrews, Howard F; Asevedo, Elson; Cheour, Majda; Domínguez-Martínez, Tecelli; El-Khoury, Joseph; Fiorillo, Andrea; Grenier, Jean; Gupta, Nitin; Kola, Lola; Kulygina, Maya; Leal-Leturia, Itziar; Luciano, Mario; Lusu, Bulumko; Nicolas, J; Martínez-López, I; Matsumoto, Chihiro; Umukoro Onofa, Lucky; Paterniti, Sabrina; Purnima, Shivani; Robles, Rebeca; Sahu, Manoj K; Sibeko, Goodman; Zhong, Na; First, Michael B; Gaebel, Wolfgang; Lovell, Anne M; Maruta, Toshimasa; Roberts, Michael C; Pike, Kathleen M

2018-06-01

Reliable, clinically useful, and globally applicable diagnostic classification of mental disorders is an essential foundation for global mental health. The World Health Organization (WHO) is nearing completion of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). The present study assessed inter-diagnostician reliability of mental disorders accounting for the greatest proportion of global disease burden and the highest levels of service utilization - schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress - among adult patients presenting for treatment at 28 participating centers in 13 countries. A concurrent joint-rater design was used, focusing specifically on whether two clinicians, relying on the same clinical information, agreed on the diagnosis when separately applying the ICD-11 diagnostic guidelines. A total of 1,806 patients were assessed by 339 clinicians in the local language. Intraclass kappa coefficients for diagnoses weighted by site and study prevalence ranged from 0.45 (dysthymic disorder) to 0.88 (social anxiety disorder) and would be considered moderate to almost perfect for all diagnoses. Overall, the reliability of the ICD-11 diagnostic guidelines was superior to that previously reported for equivalent ICD-10 guidelines. These data provide support for the suitability of the ICD-11 diagnostic guidelines for implementation at a global level. The findings will inform further revision of the ICD-11 diagnostic guidelines prior to their publication and the development of programs to support professional training and implementation of the ICD-11 by WHO member states. © 2018 World Psychiatric Association.

Common mental disorders and the built environment in Santiago, Chile.

PubMed

Araya, Ricardo; Montgomery, Alan; Rojas, Graciela; Fritsch, Rosemarie; Solis, Jaime; Signorelli, Andres; Lewis, Glyn

2007-05-01

There is growing research interest in the influence of the built environment on mental disorders. To estimate the variation in the prevalence of common mental disorders attributable to individuals and the built environment of geographical sectors where they live. A sample of 3870 adults (response rate 90%) clustered in 248 geographical sectors participated in a household cross-sectional survey in Santiago, Chile. Independently rated contextual measures of the built environment were obtained. The Clinical Interview Schedule was used to estimate the prevalence of common mental disorders. There was a significant association between the quality of the built environment of small geographical sectors and the presence of common mental disorders among its residents. The better the quality of the built environment, the lower the scores for psychiatric symptoms; however, only a small proportion of the variation in common mental disorder existed at sector level, after adjusting for individual factors. Findings from our study, using a contextual assessment of the quality of the built environment and multilevel modelling in the analysis, suggest these associations may be more marked in non-Western settings with more homogeneous geographical sectors.

Mental disorders and subsequent educational attainment in a US national sample.

PubMed

Breslau, Joshua; Lane, Michael; Sampson, Nancy; Kessler, Ronald C

2008-07-01

As part of a larger investigation of the adverse effects of mental disorders on role functioning, we examined the associations of early-onset mental disorders with subsequent educational attainment in a large nationally representative survey of the US adult population. Diagnoses and age of onset for each of 17 DSM-IV disorders were assessed through retrospective self-report with the fully structured WHO Composite International Diagnostic Instrument (CIDI). Survival analysis was used to examine the associations between early-onset DSM-IV/CIDI disorders and subsequent termination of schooling with controls for socio-demographic characteristics and childhood adversities (i.e. childhood traumatic events, childhood neglect, parental mental illness, family disruption, and low parental educational attainment). Mental disorders were found to be significantly associated with termination of schooling prior to completion of each of four educational milestones (primary school graduation, high school graduation, college entry, college graduation), with odds ratios in the range of 1.3-7.0. The proportion of school terminations attributable to mental disorders was largest for high school graduation (10.2%) but also meaningful for primary school graduation (3.8%), college entry (4.4%) and college graduation (2.6%). These results add to a growing body of evidence documenting a wide variety of adverse life course effects of mental disorders.

Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS).

PubMed

Ten Have, Margreet; de Graaf, Ron; Monshouwer, Karin

2011-11-01

To establish associations between physical exercise during leisure time and prevalence, incidence and course of mental disorders. Data were derived from the Netherlands Mental Health Survey and Incidence Study, a 3-wave cohort study in a representative sample (N=7,076) of Dutch adults. Mental disorders were assessed with the Composite International Diagnostic Interview. Physical activity was established by the number of hours per week people spent on taking physical exercise. Physical exercise was negatively associated with presence and first-onset of mood and anxiety disorders after adjustment for confounders. Evidence for a dose-response relationship between exercise levels and mental health was not found. Among those with mental disorder at baseline, exercise participants were more likely to recover from their illness (OR=1.47) compared to their counterparts who did not take exercise. Physical exercise is beneficial to mental health, but it remains uncertain whether this association truly reflects a causal effect of exercise. 2011 Elsevier Inc. All rights reserved.

Caring for juveniles with mental disorders in adult corrections facilities.

PubMed

Wills, Cheryl D

2017-02-01

Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.

Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics

PubMed Central

2011-01-01

Background Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital. Methods From among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis. Results Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services. Conclusion The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of

Sub-clinical psychosis symptoms in young adults are risk factors for subsequent common mental disorders.

PubMed

Rössler, Wulf; Hengartner, Michael P; Ajdacic-Gross, Vladeta; Haker, Helene; Gamma, Alex; Angst, Jules

2011-09-01

Not all persons identified in the early stages to be at risk for psychosis eventually cross the threshold for a psychotic illness. However, sub-clinical symptoms may not only indicate a specific risk but also suggest a more general, underlying psychopathology that predisposes one to various common mental disorders. Analyzing data from the prospective Zurich Cohort Study, we used two psychosis subscales - "schizotypal signs" and "schizophrenia nuclear symptoms" - derived from the SCL-90-R checklist that measured sub-clinical psychosis symptoms in 1979. We also assessed 10 different diagnoses of common mental disorders through seven interview waves between 1979 and 2008. This 30-year span, covering participant ages of 19/20 to 49/50, encompasses the period of highest risk for the occurrence of such disorders. Both psychosis scales from 1979, but especially "schizotypal signs", were significantly correlated with most mental disorders over the subsequent test period. Higher values on both subscales were associated with an increasing number of co-occurring disorders. Our data demonstrate that sub-clinical psychosis generally represents a risk factor for the development of common mental disorders and a liability for co-occurring disorders. This refers in particular to dysthymia, bipolar disorder, social phobia, and obsessive-compulsive disorder. Proneness to psychosis could signal a fundamental tendency toward common mental disorders. Copyright © 2011 Elsevier B.V. All rights reserved.

Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.

PubMed

Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa

2017-08-01

A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs

Mental disorders are not brain disorders.

PubMed

Banner, Natalie F

2013-06-01

As advances in neuroscience and genetics reveal complex associations between brain structures, functions and symptoms of mental disorders, there have been calls for psychiatric classifications to be reconfigured, to conceptualize mental disorders as disorders of the brain. In this paper, I argue that this view is mistaken, and that the level at which we identify mental disorders is, and should be, the person, not the brain. This is not to deny physicalism or argue that the mental realm is somehow distinct from the physical, but rather to suggest the things that are going 'wrong' in mental disorder are picked out at the person-level: they are characterized by breaches in epistemic, rational, evaluative, emotional, social and moral norms. However, as our scientific understanding of the brain becomes advanced, what makes an identified neurobiological difference in brain structure or functioning indicative of pathology is its association with these behaviours at the person-level. Instead of collapsing psychiatry into biomedicine, biomedicine may benefit from drawing closer to the expertise of psychiatry, as it is able to accommodate social, psychological and biological explanations while focusing on the person, within their environment. © 2013 John Wiley & Sons Ltd.

Mental Health and Mental Disorder Recommendation Programs.

PubMed

Ruchiwit, Manyat

2017-12-01

The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environ-ment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and tar-get groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults

PubMed Central

Cochran, Susan D.; Mays, Vickie M.; Alegria, Magarita; Ortega, Alexander N.; Takeuchi, David

2009-01-01

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. We report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. PMID:17907860

Mental Disorders among Persons with Heart Disease - Results from the World Mental Health Surveys

PubMed Central

Ormel, Johan; Von Korff, Michael; Burger, Huibert; Scott, Kate; Demyttenaere, Koen; Huang, Yue-qin; Posada-Villa, José; Lepine, Jean Pierre; Angermeyer, Matthias C.; Levinson, Daphna; de Girolamo, Giovanni; Kawakami, Norito; Karam, Elie; Medina-Mora, María Elena; Gureje, Oye; Williams, David; Haro, Josep Maria; Bromet, Evelyn J.; Alonso, Jordi; Kessler, Ron

2007-01-01

Objective While in western countries depression and heart disease often co-occur, less is known about the association of anxiety and alcohol use disorders with heart disease and about the cross-cultural consistency of these associations. Consistency across emotional disorders and cultures would suggest that relatively universal mechanisms underlie the association. Method Surveys in 18 random population samples of household-residing adults in 17 countries in Europe, the Americas, the Middle East, Africa, Asia and the South Pacific. Medically recognized heart disease was ascertained by self-report. Mental disorders were assessed with the WMH-CIDI, a fully structured diagnostic interview. Results Specific mood and anxiety disorders occurred among persons with heart disease at higher rates than among persons without heart disease. Adjusted for gender and age, the pooled odds ratios (95% CI) were 2.1 (1.9,2.5) for mood disorders, 2.2 (1.9,2.5) for anxiety disorders, and 1.4 (1.0,1.9) for alcohol abuse/dependence among persons with versus without heart disease. This pattern was similar across countries. Conclusions An excess of anxiety disorders, as well as mood disorders, is found among persons with heart disease. These associations hold across countries despite substantial between-country differences in culture and mental disorder prevalence rates. These results suggest that similar mechanisms underlie the associations and that a broad spectrum of mood-anxiety disorders should be considered in research on the comorbidity of mental disorders and heart disease. PMID:17591509

Psychiatric service use and psychiatric disorders in adults with intellectual disability.

PubMed

Bhaumik, S; Tyrer, F C; McGrother, C; Ganghadaran, S K

2008-11-01

UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric disorders in this population. A cross-sectional study was carried out on all adults with ID using specialist services in Leicestershire and Rutland, UK, between 2001 and 2006. Characteristics of individuals seen by psychiatric services and the nature and prevalence of psychiatric disorders were investigated. Of 2711 adults identified, 1244 (45.9%) accessed specialist psychiatric services at least once during the study period. Individuals attending psychiatric services were more likely to be older and to live in residential settings; they were less likely to be south Asian or to have mild/moderate ID. The prevalence of psychiatric disorders among the total study population was 33.8%; the most common disorders were behaviour disorder (19.8%) and autistic spectrum disorders (8.8%). Epilepsy was highly prevalent (60.8%) among those attending psychiatric services without a mental health diagnosis. Behaviour disorders and autistic spectrum disorders were more common in men and in adults with severe/profound ID, whereas schizophrenia and organic disorders were more common in women and in adults with mild/moderate ID. Depression was also more common in women with ID. Psychiatric disorders and specialist health problems are common among adults with ID and the profile of psychiatric disorders differs from that found in general psychiatry. Close collaboration between general and specialist service providers is needed if the current move towards use of general psychiatric services in this population is to be achieved. The measures should include a clear care pathway for people with ID and mental health problems to facilitate the smooth transfer of

Patterns of Heterotypic Continuity Associated With the Cross-Sectional Correlational Structure of Prevalent Mental Disorders in Adults

PubMed Central

Lahey, Benjamin B.; Zald, David H.; Hakes, Jahn K.; Krueger, Robert F.; Rathouz, Paul J.

2014-01-01

Importance Mental disorders predict future occurrences of both the same disorder (homotypic continuity) and other disorders (heterotypic continuity). Heterotypic continuity is inconsistent with a view of mental disorders as fixed entities. In contrast, hierarchical-dimensional conceptualizations of psychopathology, in which each form of psychopathology is hypothesized to have both unique and broadly shared etiologies and mechanisms, predict both homotypic and heterotypic continuity. Objective To test predictions derived from a hierarchical-dimensional model of psychopathology that (a) heterotypic continuity is widespread, even controlling for homotypic continuity, and (b) the relative magnitudes of heterotypic continuities recapitulate the relative magnitudes of cross-sectional correlations among diagnoses at baseline. Design Assess 10 prevalent diagnoses in the same persons 3 years apart. Setting Representative sample of adults in the United States. Participants The 28,958 participants in the National Epidemiologic Study of Alcohol and Related Condition aged 18–64 years who were assessed in both waves. Main Outcome Measure Diagnoses from reliable and valid structured interviews. Results Bivariate associations of all pairs of diagnoses from wave 1 to wave 2 exceeded chance levels for all homotypic (tetrachoric ρ = 0.41 – 0.79, median = 0.54) and for nearly all heterotypic continuities (tetrachoric ρ = 0.07 – 0.50, median = 0.28), adjusted for sex and age. Significant heterotypic continuity was widespread even when all other wave 1 diagnoses (including the same diagnosis) were simultaneous predictors of each wave 2 diagnosis. The rank correlation between age and sex adjusted tetrachoric ρs for cross-sectional associations among wave 1 diagnoses and heterotypic associations from wave 1 to wave 2 diagnoses was ρ = .86. Conclusions and Relevance For these prevalent mental disorders, heterotypic continuity was nearly universal and not an artifact of failure to

Age of onset of life-time mental disorders and treatment contact.

PubMed

Vaingankar, Janhavi Ajit; Rekhi, Gurpreet; Subramaniam, Mythily; Abdin, Edimansyah; Chong, Siow Ann

2013-05-01

Early onset of mental disorders is a major social and public health concern as it affects individuals in their most formative years. The impact is more pronounced when early onset is also associated with treatment delay. Little is known about the age of onset (AOO) for mental disorders and its predictors in Singapore. A national mental health survey was conducted among adult residents aged 18 years and above in Singapore. The composite international diagnostic interview (CIDI 3.0) was used to establish the life-time diagnosis of major depressive disorder (MDD), dysthymia, bipolar disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol abuse and dependence, and the age of onset as well as any subsequent treatment contact. A total of 6,616 respondents (mean age of 43.9 years) participated in the survey giving a response rate of 75.9 %. The median AOO for having any one of the mental disorders was 22 years with variation among the different disorders. Predictors for AOO varied across the mental disorders. Only 8 % had sought any treatment in the first year after onset. Males, those belonging to Malay and Indian ethnicities and 50+ age cohorts were less likely to have made treatment contact in the year of onset. Nearly half of the respondents with any life-time mental disorder would have its onset by age of 22 years, and very few had sought treatment within the first year from onset. The study also identified socio-demographic predictors associated with AOO for mental disorders and delayed treatment contact, thus highlighting a vulnerable subpopulation that can be targeted for outreach and early interventions.

Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults.

PubMed

Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet

2013-06-01

Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups. Copyright © 2013 John Wiley & Sons, Ltd.

Mental disorders across the adult life course and future coronary heart disease: evidence for general susceptibility

PubMed Central

Gale, Catharine R; Batty, G David; Osborn, David P J; Tynelius, Per; Rasmussen, Finn

2014-01-01

Background Depression, anxiety and psychotic disorders have been associated with an increased risk of coronary heart disease (CHD). It is unclear whether this association between mental health and CHD is present across a wider range of mental disorders. Methods and Results Participants were 1,107,524 Swedish men conscripted at mean age 18.3 years. Mental disorders were assessed by psychiatric interview on conscription and data on hospital admissions for mental disorder and CHD were obtained from national registers during 22.6 years of follow-up. Increased risk of incident CHD was evident across a range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.30 (1.05, 1.60) (depressive disorders) to 1.92 (1.60, 2.31) (alcohol-related disorders). The equivalent figures according to diagnoses during hospital admission ranged from 1.49 (1.24, 1.80) (schizophrenia) to 2.82 (2.53, 3.13) (other substance use disorders). Associations were little changed by adjustment for parental socioeconomic status, or body mass index, diabetes and blood pressure measured at conscription, but were partially attenuated by adjustment for smoking, alcohol intake, and intelligence measured at conscription, and for education and own socioeconomic position. Conclusions Increased risk of incident CHD is present across a range of mental disorders and is observable when disorders are diagnosed at a young age. PMID:24190959

Visual Arts in Counselling Adults with Depressive Disorders

ERIC Educational Resources Information Center

Lee, Khai Ling; Mustaffa, M. S.; Tan, S. Y.

2017-01-01

This study provides a better understanding of using visual arts in counselling adults with depressive disorders. Three in-depth case studies were conducted in the counselling unit of a mental health hospital in Malaysia. Both qualitative and quantitative research methods were applied to explore three adult participants' counselling experiences.…

Psychotherapeutic and work-oriented interventions: employment outcomes among young adults with work disability due to a mental disorder.

PubMed

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Koskinen, Aki; Tuisku, Katinka; Ervasti, Jenni; Virtanen, Marianna

2016-01-01

We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder. Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18‒34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years. Forty-six percent had no proposal for psychotherapy or a work-oriented intervention in their treatment and rehabilitation plan, 22 % had a plan for only a psychotherapeutic intervention, 23 % had a plan for only a work-oriented intervention, and 10 % had both types of interventions planned. Having a planned psychotherapeutic intervention (HR = 1.35, 95 % CI 1.07-1.69) and of the work-oriented interventions, planned rehabilitative courses and training (HR = 1.34, 95 % CI 1.03-1.70) predicted quicker entry into competitive employment. Having a plan for both a psychotherapeutic and work-oriented intervention was associated with being employed at the end of the follow-up (OR = 1.77, 95 % CI 1.07-2.95). Young adults with a long-term psychiatric work disability episode rarely have a recorded plan for rehabilitation in their treatment and rehabilitation plan although psychotherapeutic interventions and a combination of a psychotherapeutic and work-oriented intervention might help them gain employment.

Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders.

PubMed

Mojtabai, Ramin; Chen, Lian-Yu; Kaufmann, Christopher N; Crum, Rosa M

2014-02-01

Barriers to both mental health and substance use disorder treatments have rarely been examined among individuals with comorbid mental health and substance use disorders. In a sample of 393 adults with 12-month major depressive episodes and substance use disorders, we compared perceived barriers to these two types of treatments. Data were drawn from the 2005-2011 U.S. National Surveys on Drug Use and Health. Overall, the same individuals experienced different barriers to mental health treatment versus substance use disorder treatment. Concerns about negative views of the community, effects on job, and inconvenience of services were more commonly reported as reasons for not receiving substance use disorder treatment. Not affording the cost of care was the most common barrier to both types of treatments, but more commonly reported as a barrier to mental health treatment. Improved financial access through the Affordable Care Act and parity legislation and integration of mental health and substance use disorder services may help to reduce treatment barriers among individuals with comorbid mental health and substance disorders. © 2013.

War and first onset of suicidality: the role of mental disorders

PubMed Central

Karam, E. G.; Salamoun, M. M.; Mneimneh, Z. N.; Fayyad, J. A.; Karam, A. N.; Hajjar, R.; Dimassi, H.; Nock, M. K.; Kessler, R. C.

2014-01-01

Background Suicide rates increase following periods of war; however, the mechanism through which this occurs is not known. The aim of this paper is to shed some light on the associations of war exposure, mental disorders, and subsequent suicidal behavior. Method A national sample of Lebanese adults was administered the Composite International Diagnostic Interview to collect data on lifetime prevalence and age of onset of suicide ideation, plan, and attempt, and mental disorders, in addition to information about exposure to stressors associated with the 1975–1989 Lebanon war. Results The onset of suicide ideation, plan, and attempt was associated with female gender, younger age, post-war period, major depression, impulse-control disorders, and social phobia. The effect of post-war period on each type of suicide outcome was largely explained by the post-war onset of mental disorders. Finally, the conjunction of having a prior impulse-control disorder and either being a civilian in a terror region or witnessing war-related stressors was associated with especially high risk of suicide attempt. Conclusions The association of war with increased risk of suicidality appears to be partially explained by the emergence of mental disorders in the context of war. Exposure to war may exacerbate disinhibition among those who have prior impulse-control disorders, thus magnifying the association of mental disorders with suicidality. PMID:22370047

War and first onset of suicidality: the role of mental disorders.

PubMed

Karam, E G; Salamoun, M M; Mneimneh, Z N; Fayyad, J A; Karam, A N; Hajjar, R; Dimassi, H; Nock, M K; Kessler, R C

2012-10-01

Suicide rates increase following periods of war; however, the mechanism through which this occurs is not known. The aim of this paper is to shed some light on the associations of war exposure, mental disorders, and subsequent suicidal behavior. A national sample of Lebanese adults was administered the Composite International Diagnostic Interview to collect data on lifetime prevalence and age of onset of suicide ideation, plan, and attempt, and mental disorders, in addition to information about exposure to stressors associated with the 1975-1989 Lebanon war. The onset of suicide ideation, plan, and attempt was associated with female gender, younger age, post-war period, major depression, impulse-control disorders, and social phobia. The effect of post-war period on each type of suicide outcome was largely explained by the post-war onset of mental disorders. Finally, the conjunction of having a prior impulse-control disorder and either being a civilian in a terror region or witnessing war-related stressors was associated with especially high risk of suicide attempt. The association of war with increased risk of suicidality appears to be partially explained by the emergence of mental disorders in the context of war. Exposure to war may exacerbate disinhibition among those who have prior impulse-control disorders, thus magnifying the association of mental disorders with suicidality.

Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

PubMed

Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie

2015-03-01

Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Prevalence of mental disorders among Māori in Te Rau Hinengaro: the New Zealand Mental Health Survey.

PubMed

Baxter, Joanne; Kingi, Te Kani; Tapsell, Rees; Durie, Mason; McGee, Magnus A

2006-10-01

To describe the prevalence of mental disorders (period prevalence across aggregated disorders, 12 month and lifetime prevalence) among Māori in Te Rau Hinengaro: The New Zealand Mental Health Survey. Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken between 2003 and 2004, was a nationally representative face-to-face household survey of 12,992 New Zealand adults aged 16 years and over, including 2,595 Māori. Ethnicity was measured using the 2001 New Zealand census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0), was used to measure disorder. The overall response rate was 73.3%. This paper presents selected findings for the level and pattern of mental disorder prevalence among Māori. Māori lifetime prevalence of any disorder was 50.7%, 12 month prevalence 29.5% and 1 month prevalence 18.3%. The most common 12 month disorders were anxiety (19.4%), mood (11.4%) and substance (8.6%) disorders and the most common lifetime disorders were anxiety (31.3%), substance (26.5%) and mood (24.3%) disorders. Levels of lifetime comorbidity were high with 12 month prevalence showing 16.4% of Māori with one disorder, 7.6% with two disorders and 5.5% with three or more disorders. Twelve-month disorders were more common in Māori females than in males (33.6%vs 24.8%) and in younger age groups: 16-24 years, 33.2%; 25-44 years, 32.9%; 45-64 years, 23.7%; and 65 years and over, 7.9%. Disorder prevalence was greatest among Māori with the lowest equivalized household income and least education. However, differences by urbanicity and region were not significant. Of Māori with any 12 month disorder, 29.6% had serious, 42.6% had moderate and 27.8% had mild disorders. Mental disorders overall and specific disorder groups (anxiety, mood and substance) are common among Māori and measures of severity indicate that disorders

The Mental Health of Older LGBT Adults.

PubMed

Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

2016-06-01

There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

MEMENTA-'Mental healthcare provision for adults with intellectual disability and a mental disorder'. A cross-sectional epidemiological multisite study assessing prevalence of psychiatric symptomatology, needs for care and quality of healthcare provision for adults with intellectual disability in Germany: a study protocol.

PubMed

Koch, Andrea; Vogel, Anke; Holzmann, Marco; Pfennig, Andrea; Salize, Hans Joachim; Puschner, Bernd; Schützwohl, Matthias

2014-05-20

The study 'Mental healthcare provision for adults with intellectual disability and a mental disorder' (MEMENTA) is a cross-sectional epidemiological study carried out in three different regions of Germany. Its main aim is to assess the prevalence of mental disorders in adults with intellectual disability (ID) as well as quality of mental healthcare for this population. The target population are persons aged between 18 and 65 years with a mild or moderate ID. The study population will be recruited through service providers. A representative sample is realised by two-stage sampling. First, institutions providing services for people with ID (sheltered workshops) are selected in a stratified cluster sampling, with strata being (1) types of service-providing non-governmental organisations and (2) sizes of their sheltered workshops. Then persons working in selected sheltered workshops are selected by simple random sampling. An estimated number of 600 adults with ID will be included. Information will be obtained from the group leaders in the sheltered workshops, informal carers or staff members in sheltered housing institutions and the person with ID. Besides the main outcome parameter of psychiatric symptomatology and problem behaviour, other outcome parameters such as needs for care, quality of life, caregiver burden, health services utilisation and costs for care are assessed using well-established standardised instruments. If a comorbid mental disorder is diagnosed, quality of mental healthcare will be assessed with open questions to all interview partners and, in addition, problem-focused interviews with a small subgroup. Analyses will be carried out using quantitative and qualitative methods. Approval of all three local ethics committees was obtained. Research findings will add much needed empirical information in order to improve services provided to this vulnerable group of patients. NCT01695395. Published by the BMJ Publishing Group Limited. For permission to

Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Nunes, Maria A; Pinheiro, Andréa P; Bessel, Marina; Brunoni, André R; Kemp, Andrew H; Benseñor, Isabela M; Chor, Dora; Barreto, Sandhi; Schmidt, Maria I

2016-01-01

To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score ≥ 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. CMD (CIS-R score ≥ 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address health inequities related to mental disorders.

Gender, Traumatic Events, and Mental Health Disorders in a Rural Asian Setting*

PubMed Central

Axinn, William G.; Ghimire, Dirgha J.; Williams, Nathalie E.; Scott, Kate M.

2014-01-01

Research shows a strong association between traumatic life experience and mental health and important gender differences in that relationship in the Western European Diaspora, but much less is known about these relationships in other settings. We investigate these relationships in a poor rural Asian setting that recently experienced a decade-long armed conflict. We use data from 400 adult interviews in rural Nepal. The measures come from World Mental Health survey instruments clinically validated for this study population to measure Depression, Post Traumatic Stress Disorder (PTSD), and Intermittent Explosive Disorder (IED). Our results demonstrate that traumatic life experience significantly increases the likelihood of mental health disorders in this setting and that these traumatic experiences have a larger effect on the mental health of women than men. These findings offer important clues regarding the potential mechanisms producing gender differences in mental health in many settings. PMID:24311755

Civilians in World War II and DSM-IV mental disorders: results from the World Mental Health Survey Initiative.

PubMed

Frounfelker, Rochelle; Gilman, Stephen E; Betancourt, Theresa S; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bromet, Evelyn J; Bruffaerts, Ronny; de Girolamo, Giovanni; Gluzman, Semyon; Gureje, Oye; Karam, Elie G; Lee, Sing; Lépine, Jean-Pierre; Ono, Yutaka; Pennell, Beth-Ellen; Popovici, Daniela G; Ten Have, Margreet; Kessler, Ronald C

2018-02-01

Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7). Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.

Civilians in World War II and DSM-IV mental disorders: Results from the World Mental Health Survey Initiative

PubMed Central

Frounfelker, Rochelle; Gilman, Stephen E.; Betancourt, Theresa S.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bromet, Evelyn J.; Bruffaerts, Ronny; de Girolamo, Giovanni; Gluzman, Semyon; Gureje, Oye; Karam, Elie G.; Lee, Sing; Lépine, Jean-Pierre; Ono, Yutaka; Pennell, Beth-Ellen; Popovici, Daniela G.; Have, Margreet ten; Kessler, Ronald C.

2018-01-01

Purpose Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods Adults (n= 3,370)who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders. (OR 0.4, 95% CI 0.2, 0.7). Conclusions Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders. PMID:29119266

[Application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment].

PubMed

Pang, Yan-Xia; Zhang, Jian; Yang, Cheng-Long; Cang, Yong; Wang, Xue-Ling

2011-06-01

Study on the application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment. Mental impairment assessment cases between July 2009 and March 2011 in judicial appraisal institute of Taizhou University were collected. Assessment results obtained with the WAIS-RC short forms and adult intelligence disability scale were compared with the experts assessing conclusions and analyzed using SPSS 11.5 software. Assessment results with the two scales did not fully comply with the expert's conclusions, with reliability coefficient were 0.785 and 0.940 respectively, correlation coefficient were 0.850 and 0.922 respectively. The intelligence assessment was influenced by many factors. When the appraised individuals had nerve dysfunction and mild intelligence disability or mental disorders, the two scales should be used together. When the appraised individuals had moderate intelligence disability or mental disorders, adult intelligence disability scale had advantage.

Adult mental health needs and expenditure in Australia.

PubMed

Burgess, Philip; Pirkis, Jane; Buckingham, Bill; Burns, Jane; Eagar, Kathy; Eckstein, Gary

2004-06-01

Relatively little international work has examined whether mental health resource allocation matches need. This study aimed to determine whether adult mental health resources in Australia are being distributed equitably. Individual measures of need were extrapolated to Australian Areas, and Area-based proxies of need were considered. Particular attention was paid to the prevalence of mental health problems, since this is arguably the most objective measure of need. The extent to which these measures predicted public sector, private sector and total adult mental health expenditure at an Area level was examined. In the public sector, 41.6% of expenditure variation was explained by the prevalence of affective disorders, personality disorders, cognitive impairment and psychosis, as well as the Area's level of economic resources and State/Territory effects. In the private sector, 72.4% of expenditure variation was explained by service use and State/Territory effects (with an alternative model incorporating service use and State/Territory supply of private psychiatrists explaining 69.4% of expenditure variation). A relatively high proportion (58.7%) of total expenditure variation could be explained by service utilisation and State/Territory effects. For services to be delivered equitably, the majority of variation in expenditure would have to be accounted for by appropriate measures of need. The best model for public sector expenditure included an appropriate measure of need but had relatively poor explanatory power. The models for private sector and total expenditure had greater explanatory power, but relied on less appropriate measures of need. It is concluded that mental health services in Australia are not yet being delivered equitably.

Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review

PubMed Central

Eichert, Hans-Christoph; Riper, Heleen

2017-01-01

Background Many studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions). Objective The aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness. Methods Studies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions (“inpatient,” “outpatient,” “face-to-face,” or “residential treatment”), which were combined with terms indicating Internet treatment (“internet,” “online,” or “web”) and terms indicating mental disorders (“mental health,” “depression,” “anxiety,” or “substance abuse”). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse). Results We identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions. Conclusions Several studies have shown that, for common mental health disorders, blended interventions are feasible and can be

Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review.

PubMed

Erbe, Doris; Eichert, Hans-Christoph; Riper, Heleen; Ebert, David Daniel

2017-09-15

Many studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions). The aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness. Studies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions ("inpatient," "outpatient," "face-to-face," or "residential treatment"), which were combined with terms indicating Internet treatment ("internet," "online," or "web") and terms indicating mental disorders ("mental health," "depression," "anxiety," or "substance abuse"). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse). We identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions. Several studies have shown that, for common mental health disorders, blended interventions are feasible and can be more effective compared with no treatment controls. However, more RCTs on effectiveness and

'I was thinking too much': experiences of HIV-positive adults with common mental disorders and poor adherence to antiretroviral therapy in Zimbabwe.

PubMed

Kidia, Khameer; Machando, Debra; Bere, Tarisai; Macpherson, Kirsty; Nyamayaro, Primrose; Potter, Lucy; Makadzange, Tariro; Munjoma, Ronald; Marufu, Marshall; Araya, Ricardo; Safren, Steven; O'Cleirigh, Conall; Chibanda, Dixon; Abas, Melanie

2015-07-01

To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. In-depth qualitative interviews were conducted with 47 (female = 31) HIV-positive adults who scored above the cut-point on a locally validated scale for common mental disorders (CMDs). Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of CMDs ('thinking too much', changes to appetite and sleep, 'burdened heart' and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with CMDs. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income-generating activities and family engagement in mental health care. Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce CMDs and poor adherence to antiretroviral therapy. © 2015 John Wiley & Sons Ltd.

Spino-Cerebellar Degeneration, Hormonal Disorder, Hypogonadism, Deaf Mutism and Mental Deficiency

ERIC Educational Resources Information Center

Sylvester, P. E.

1972-01-01

Post mortem examinations were done on two adult siblings (one female and one male) who had been clinically described as suffering from mental handicap, deaf mutism, ataxia, hypogonadism, and hormonal disorders. (DB)

Patterns of heterotypic continuity associated with the cross-sectional correlational structure of prevalent mental disorders in adults.

PubMed

Lahey, Benjamin B; Zald, David H; Hakes, Jahn K; Krueger, Robert F; Rathouz, Paul J

2014-09-01

Mental disorders predict future occurrences of both the same disorder (homotypic continuity) and other disorders (heterotypic continuity). Heterotypic continuity is inconsistent with a view of mental disorders as fixed entities. In contrast, hierarchical-dimensional conceptualizations of psychopathology, in which each form of psychopathology is hypothesized to have both unique and broadly shared etiologies and mechanisms, predict both homotypic and heterotypic continuity. To test predictions derived from a hierarchical-dimensional model of psychopathology that (1) heterotypic continuity is widespread, even controlling for homotypic continuity, and that (2) the relative magnitudes of heterotypic continuities recapitulate the relative magnitudes of cross-sectional correlations among diagnoses at baseline. Ten prevalent diagnoses were assessed in the same person twice (ie, in 2 waves separated by 3 years). We used a representative sample of adults in the United States (i.e., 28,958 participants 18-64 years of age in the National Epidemiologic Study of Alcohol and Related Conditions who were assessed in both waves). Diagnoses from reliable and valid structured interviews. Adjusting for sex and age, we found that bivariate associations of all pairs of diagnoses from wave 1 to wave 2 exceeded chance levels (P < .05) for all homotypic (median tetrachoric correlation of ρ = 0.54 [range, 0.41-0.79]) and for nearly all heterotypic continuities (median tetrachoric correlation of ρ = 0.28 [range, 0.07-0.50]). Significant heterotypic continuity was widespread even when all wave 1 diagnoses (including the same diagnosis) were simultaneous predictors of each wave 2 diagnosis. The rank correlation between age- and sex-adjusted tetrachoric correlation for cross-sectional associations among wave 1 diagnoses and for heterotypic associations from wave 1 to wave 2 diagnoses was ρ = 0.86 (P < .001). For these prevalent mental disorders, heterotypic continuity was

Prevention of mental and behavioural disorders: implications for policy and practice.

PubMed

Saxena, Shekhar; Jané-Llopis, Eva; Hosman, Clemens

2006-02-01

There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice.

Prevention of mental and behavioural disorders: implications for policy and practice

PubMed Central

SAXENA, SHEKHAR; JANÉ-LLOPIS, EVA; HOSMAN, CLEMENS

2006-01-01

There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice. PMID:16757984

Psychoneuroimmunology of mental disorders.

PubMed

Soria, Virginia; Uribe, Javiera; Salvat-Pujol, Neus; Palao, Diego; Menchón, José Manuel; Labad, Javier

The immune system is a key element in the organism's defence system and participates in the maintenance of homeostasis. There is growing interest in the aetiopathogenic and prognostic implications of the immune system in mental disorders, as previous studies suggest the existence of a dysregulation of the immune response and a pro-inflammatory state in patients with mental disorders, as well as an increased prevalence of neuropsychiatric symptoms in patients suffering from autoimmune diseases or receiving immune treatments. This study aims to conduct a narrative review of the scientific literature on the role of Psychoneuroimmunology in mental disorders, with special focus on diagnostic, prognostic and therapeutic issues. The development of this body of knowledge may bring in the future important advances in the vulnerability, aetiopathogenic mechanisms, diagnosis and treatment of some mental disorders. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Insurance Financing Increased For Mental Health Conditions But Not For Substance Use Disorders, 1986-2014.

PubMed

Mark, Tami L; Yee, Tracy; Levit, Katharine R; Camacho-Cook, Jessica; Cutler, Eli; Carroll, Christopher D

2016-06-01

This study updates previous estimates of US spending on mental health and substance use disorders through 2014. The results reveal that the long-term trend of greater insurance financing of mental health care continued in recent years. The share of total mental health treatment expenditures financed by private insurance, Medicare, and Medicaid increased from 44 percent in 1986 to 68 percent in 2014. In contrast, the share of spending for substance use disorder treatment financed by private insurance, Medicare, and Medicaid was 45 percent in 1986 and 46 percent in 2014. From 2004 to 2013, a growing percentage of adults received mental health treatment (12.6 percent and 14.6 percent, respectively), albeit only because of the increased use of psychiatric medications. In the same period, only 1.2-1.3 percent of adults received substance use disorder treatment in inpatient, outpatient, or residential settings, although the use of medications to treat substance use disorders increased rapidly. Project HOPE—The People-to-People Health Foundation, Inc.

Gendered mental disorders: masculine and feminine stereotypes about mental disorders and their relation to stigma.

PubMed

Boysen, Guy; Ebersole, Ashley; Casner, Robert; Coston, Nykhala

2014-01-01

Research indicates that stereotypes can intersect. For example, the intersection of stereotypes about gender and mental disorders could result in perceptions of gendered mental disorders. In the current research, Studies 1 and 2 showed that people view specific disorders as being masculine or feminine. The masculine stereotype included antisocial personality disorder, addictions, and paraphilias. The feminine stereotype included eating disorders, histrionic personality disorder, body dysmorphia, and orgasmic disorder. In both studies, the perception of disorders as masculine was positively correlated with stigma. Study 3 showed that the positive correlation between masculinity and stigma also occurred when examining specific symptoms rather than full mental disorders. The findings provide further evidence for the intersection of stereotypes and indicate a novel factor in the understanding of stigma.

Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges.

PubMed

Sowers, Jo-Ann; Swank, Paul

2017-01-01

The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.

Obesity and mental disorders in the general population: results from the world mental health surveys.

PubMed

Scott, K M; Bruffaerts, R; Simon, G E; Alonso, J; Angermeyer, M; de Girolamo, G; Demyttenaere, K; Gasquet, I; Haro, J M; Karam, E; Kessler, R C; Levinson, D; Medina Mora, M E; Oakley Browne, M A; Ormel, J; Villa, J P; Uda, H; Von Korff, M

2008-01-01

(1) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (2) to establish whether demographic variables (sex, age, education) moderate any associations observed. Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Household residing adults, 18 years and over (n=62 277). DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.5) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population.

The mental health of individuals referred for assessment of autism spectrum disorder in adulthood: A clinic report.

PubMed

Russell, Ailsa J; Murphy, Clodagh M; Wilson, Ellie; Gillan, Nicola; Brown, Cordelia; Robertson, Dene M; Craig, Michael C; Deeley, Quinton; Zinkstok, Janneke; Johnston, Kate; McAlonan, Grainne M; Spain, Deborah; Murphy, Declan Gm

2016-07-01

Growing awareness of autism spectrum disorders has increased the demand for diagnostic services in adulthood. High rates of mental health problems have been reported in young people and adults with autism spectrum disorder. However, sampling and methodological issues mean prevalence estimates and conclusions about specificity in psychiatric co-morbidity in autism spectrum disorder remain unclear. A retrospective case review of 859 adults referred for assessment of autism spectrum disorder compares International Classification of Diseases, Tenth Revision diagnoses in those that met criteria for autism spectrum disorder (n = 474) with those that did not (n = 385). Rates of psychiatric diagnosis (>57%) were equivalent across both groups and exceeded general population rates for a number of conditions. The prevalence of anxiety disorders, particularly obsessive compulsive disorder, was significantly higher in adults with autism spectrum disorder than adults without autism spectrum disorder. Limitations of this observational clinic study, which may impact generalisability of the findings, include the lack of standardised structured psychiatric diagnostic assessments by assessors blind to autism spectrum disorder diagnosis and inter-rater reliability. The implications of this study highlight the need for careful consideration of mental health needs in all adults referred for autism spectrum disorder diagnosis. © The Author(s) 2015.

Associations between DSM-IV mental disorders and subsequent non-fatal, self-reported stroke.

PubMed

Swain, Nicola R; Lim, Carmen C W; Levinson, Daphna; Fiestas, Fabian; de Girolamo, Giovanni; Moskalewicz, Jacek; Lepine, Jean-Pierre; Posada-Villa, Jose; Haro, Josep Maria; Medina-Mora, María Elena; Xavier, Miguel; Iwata, Noboru; de Jonge, Peter; Bruffaerts, Ronny; O'Neill, Siobhan; Kessler, Ron C; Scott, Kate M

2015-08-01

To examine the associations between a wide range of mental disorders and subsequent onset of stroke. Lifecourse timing of stroke was examined using retrospectively reconstructed data from cross-sectional surveys. Data from the World Mental Health Surveys were accessed. This data was collected from general population surveys over 17 countries of 87,250 adults. The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of DSM-IV mental disorders. A weighted subsample (n=45,288), was used for analysis in the present study. Survival analyses estimated associations between first onset of mental disorders and subsequent stroke onset. Bivariate models showed that 12/16 mental disorders were associated with subsequent stroke onset (ORs ranging from 1.6 to 3.8). However, after adjustment for mental disorder comorbidity and smoking, only significant relationships between depression and stroke (OR 1.3) and alcohol abuse and stroke (OR 1.5) remained. Among females, having a bipolar disorder was also associated with increased stroke incidence (OR 2.1). Increasing number of mental disorders was associated with stroke onset in a dose-response fashion (OR 3.3 for 5+ disorders). Depression and alcohol abuse may have specific associations with incidence of non-fatal stroke. General severity of psychopathology may be a more important predictor of non-fatal stroke onset. Mental health treatment should be considered as part of stroke risk prevention. Limitations of retrospectively gathered cross sectional surveys design mean further research on the links between mental health and stroke incidence is warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders.

PubMed

Wu, Nancy S; Schairer, Laura C; Dellor, Elinam; Grella, Christine

2010-01-01

This study describes the prevalence of childhood traumatic events (CTEs) among adults with comorbid substance use disorders (SUDs) and mental health problems (MHPs) and assesses the relation between cumulative CTEs and adult health outcomes. Adults with SUDs/MHPs (N=402) were recruited from residential treatment programs and interviewed at treatment admission. Exposures to 9 types of adverse childhood experiences were summed and categorized into 6 ordinal levels of exposure. Descriptive analyses were conducted to assess the prevalence and range of exposure to CTEs in comparison with a sample from primary health care. Logistic regression analyses were conducted to examine the association between the cumulative exposure to CTEs and adverse health outcomes. Most of the sample reported exposure to CTEs, with higher exposure rates among the study sample compared with the primary health care sample. Greater exposure to CTEs significantly increased the odds of several adverse adult outcomes, including PTSD, alcohol dependence, injection drug use, tobacco use, sex work, medical problems, and poor quality of life. Study findings support the importance of early prevention and intervention and provision of trauma treatment for individuals with SUDs/MHPs.

Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study.

PubMed

Kivimäki, Mika; Lawlor, Debbie A; Singh-Manoux, Archana; Batty, G David; Ferrie, Jane E; Shipley, Martin J; Nabi, Hermann; Sabia, Séverine; Marmot, Michael G; Jokela, Markus

2009-10-06

To examine potential reciprocal associations between common mental disorders and obesity, and to assess whether dose-response relations exist. Prospective cohort study with four measures of common mental disorders and obesity over 19 years (Whitehall II study). Civil service departments in London. 4363 adults (28% female, mean age 44 years at baseline). Common mental disorder defined as general health questionnaire "caseness;" overweight and obesity based on Word Health Organization definitions. In models adjusted for age, sex, and body mass index at baseline, odds ratios for obesity at the fourth screening were 1.33 (95% confidence interval 1.00 to 1.77), 1.64 (1.13 to 2.36), and 2.01 (1.21 to 3.34) for participants with common mental disorder at one, two, or three preceding screenings compared with people free from common mental disorder (P for trend<0.001). The corresponding mean differences in body mass index at the most recent screening were 0.20, 0.31, and 0.50 (P for trend<0.001). These associations remained after adjustment for baseline characteristics related to mental health and exclusion of participants who were obese at baseline. In addition, obesity predicted future risk of common mental disorder, again with evidence of a dose-response relation (P for trend=0.02, multivariable model). However, this association was lost when people with common mental disorder at baseline were excluded (P for trend=0.33). These findings suggest that in British adults the direction of association between common mental disorders and obesity is from common mental disorder to increased future risk of obesity. This association is cumulative such that people with chronic or repeat episodes of common mental disorder are particularly at risk of weight gain.

Life stress and mental disorders in the South African Stress and Health study

PubMed Central

Seedat, Soraya; Stein, Dan J; Jackson, Pamela B; Heeringa, Steven G; Williams, David R; Myer, Landon

2011-01-01

Background Although stressful life events (SLEs) are associated with psychopathology, the contribution from distal and proximal events and the specificity of their association with common mental disorders require further exploration. We examined the association of recent life events and past adversities to mood, anxiety, substance use and impulse control disorders in South Africa. Methods Data were analysed from the South African Stress and Health study, a population-based study of mental disorders in a nationally representative sample of 4 351 adults. Psychiatric disorders were assessed with the Composite International Diagnostic Interview (CIDI). This included questions covering early and later SLEs (negative life events, relationship stress, partner violence, social strain and adverse events during childhood) and various socio-demographic variables. Logistic regression models were constructed for 3 957 respondents (2 371 female, 1 586 male) with no missing covariate data, to assess life stress and socio-demographic predictors of 12-month and lifetime disorder. Results Recent negative life events and relationship problems were significant predictors of any 12-month disorder and any lifetime disorder. Physical partner violence predicted any lifetime disorder. There was evidence of specificity for the prediction of mood versus anxiety disorders, with childhood adversity specifically associated with mood disorders but not anxiety disorders. Single marital status was the strongest socio-demographic predictor of any 12-month and any lifetime disorder. Conclusions Stressful life events, distal and proximal, contribute significantly and independently to the prediction of major psychiatric disorders among South Africans, underscoring the importance of screening adversities in adults with common mental disorders, and of providing appropriate adjunctive interventions. PMID:19588801

The relationship between religion and mental disorders in a Korean population.

PubMed

Park, Jong-Ik; Hong, Jin Pyo; Park, Subin; Cho, Maeng-Je

2012-03-01

The question of whether religion has beneficial or detrimental effects on the mental well-being of the adult individual is debatable. Because most Korean citizens are free to select their own religion, there is a higher proportion of non-believers than believers among the Korean population. The aim of this research was to investigate the association between spiritual values and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders in Korea across all types of belief systems, including Koreans not affiliated with a particular religion. The Korean version of the Composite International Diagnostic Interview 2.1 was used to interview 6,275 people across South Korea in 2001. While controlling for age and sex, we used logistic regression to analyze the relationship between mental disorders (both current and past) and the types of religion and spiritual values. Strong spiritual values were positively associated with increased rates of current depressive disorder and decreased rates of current alcohol use disorder. Using "atheist" as the reference category, Catholics had higher lifetime odds of single episodes of depression whilst Protestants had higher lifetime odds of anxiety disorder and lower lifetime odds of alcohol use disorders. The results of this study suggest that depressive episodes often lead to a search for spirituality and that religion may be helpful in overcoming depression or becoming less vulnerable to relapsing. The associations between religion, spiritual values, and mental health have not been fully elucidated and warrant further exploration.

The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based, longitudinal cohort study.

PubMed

Moran, Paul; Romaniuk, Helena; Coffey, Carolyn; Chanen, Andrew; Degenhardt, Louisa; Borschmann, Rohan; Patton, George C

2016-07-01

Existing knowledge about the consequences of personality disorders is substantially derived from the study of clinical populations. To gain a fuller understanding of the disease burden associated with personality disorders, we report their long-term mental health and social consequences in a large population-based sample of young adults. We used data from a population-based, ten-wave cohort study of a stratified random sample of non-treatment-seeking young adults recruited from Victoria, Australia, between Aug 20, 1992, and March 3, 2014. The population sample was originally recruited in adolescence: here we report the analysis of data collected from wave 8 (participants aged 24-25 years) and wave 10 (participants aged 34-35 years). Presence and severity of personality disorder were assessed at age 24 years with a semi-structured, informant-based interview (the Standardised Assessment of Personality). At age 35 years, participants were assessed on the occurrence of the following outcomes: major depressive disorder, anxiety disorder, smoking and alcohol consumption, illicit substance use, ever having separated from a long-term partner or been divorced, not currently in a relationship, not currently in paid employment, and in receipt of government welfare. We used multiple imputation to address potentially biased estimates resulting from the reduction of the analysis sample to participants who had completed both survey waves. The imputation dataset contained 1635 individuals. For the 1520 participants in wave 8, 1145 (75%) informant interviews for personality disorder in these participants took place. At age 24 years, 305 (27%) of the observed sample had either personality difficulties or personality disorder. At age 24 years, in the imputed analysis sample, the severity of personality disorder was associated with the absence of a degree or vocational qualification (adjusted odds ratio [aOR] for the effect of complex and severe personality disorder vs no personality

A psychological model of mental disorder.

PubMed

Kinderman, Peter

2005-01-01

A coherent conceptualization of the role of psychological factors is of great importance in understanding mental disorder. Academic articles and professional reports alluding to psychological models of the etiology of mental disorder are becoming increasingly common, and there is evidence of a marked policy shift toward the provision of psychological therapies and interventions. This article discusses the relationship between biological, social, and psychological factors in the causation and treatment of mental disorder. It argues that simple biological reductionism is not scientifically justified, and also that the specific role of psychological processes within the biopsychosocial model requires further elaboration. The biopsychosocial model is usually interpreted as implying that biological, psychological, and social factors are co-equal partners in the etiology of mental disorder. The psychological model of mental disorder presented here suggests that disruption or dysfunction in psychological processes is a final common pathway in the development of mental disorder. These processes include, but are not limited to, cognitive processes. The model proposes that biological and social factors, together with a person's individual experiences, lead to mental disorder through their conjoint effects on those psychological processes. Implications for research, interventions, and policy are discussed.

[Mental Health, Emotional Suffering, Mental Problems and Disorders in Indigenous Colombians. Data From the National Mental Health Survey 2015].

PubMed

Gómez-Restrepo, Carlos; Rincón, Carlos Javier; Urrego-Mendoza, Zulma

2016-12-01

Indigenous people represent 5% of the world population and one-third of the poor ones. Alcoholism rates, substance abuse problems, and mental disorders are shown to be higher than the general population. An analysis was made of the data from the National Mental Health Survey 2015. In this survey, it was asked if self-recognition as a native was according to the culture, the people, or physical features. A total of 902 indigenous people were surveyed, corresponding to 8.3% of the surveyed adult population. The majority (39.5%) lived in the Pacific region, with 23.7% Atlantic region, and 20% in the Eastern region. More than one-quarter (26.6%) reported a status of poverty, 31.7% spoke the language of their people, and 17.8% reported displacement due to violence. Mental health was defined as, "having good physical health, to eat, sleep and rest, by 42.9%. As regards problems and mental disorders, 8% reported excessive consumption and 7.9% a risk consumption of alcohol. As regards general psychopathology, measured by the (Self-reporting questionnaire) SRQ, 8.1% of the population had symptoms. The life prevalences of anxiety and depressive mental disorders were reported by 6.7% women and 8.4% men, and the associated risk factors that show higher risk were: aged between 18 to 44 years, not speaking the language of their people, living in Bogota, living in urban areas, and consuming psychoactive substances and tobacco. People who recognised themselves as indigenous have higher rates of displacement by violence, report problems and common mental disorders that are associated with factors consistent with loss of cultural characteristics. Copyright © 2016. Publicado por Elsevier España.

Police officers' perceptions and experiences with mentally disordered suspects.

PubMed

Oxburgh, Laura; Gabbert, Fiona; Milne, Rebecca; Cherryman, Julie

Despite mentally disordered suspects being over-represented within the criminal justice system, there is a dearth of published literature that examines police officers' perceptions when interviewing this vulnerable group. This is concerning given that police officers are increasingly the first point of contact with these individuals. Using a Grounded Theory approach, this study examined 35 police officers' perceptions and experiences when interviewing mentally disordered suspects. Current safeguards, such as Appropriate Adults, and their experiences of any training they received were also explored. A specially designed questionnaire was developed and distributed across six police forces in England and Wales. Nine conceptual categories emerged from the data that highlighted how police officers' level of experience impacted upon their perceptions when dealing with this cohort. As a consequence, a new model grounded within Schema Theory has emerged termed Police Experience Transitional Model. Implications include the treatment and outcome of mentally disordered suspects being heavily dependent on whom they encounter within the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental health nurses' attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review.

PubMed

Dickens, Geoffrey L; Lamont, Emma; Gray, Sarah

2016-07-01

To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Systematic, integrative literature review. Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working

Obesity and Mental Disorders in the General Population: Results from the World Mental Health Surveys

PubMed Central

Scott, Kate M.; Bruffaerts, Ronny; Simon, Gregory E.; Alonso, Jordi; Angermeyer, Matthias; de Girolamo, Giovanni; Demyttenaere, Koen; Gasquet, Isabelle; Haro, Josep Maria; Karam, Elie; Kessler, Ronald C.; Levinson, Daphna; Mora, Maria Elena Medina; Browne, Mark Oakley; Ormel, J. Hans; Villa, Jose Posada; Uda, Hidenori; Von Korff, Michael

2009-01-01

Objectives (i) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (ii) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects Household residing adults, 18 years and over (n = 62,277). Measurements DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m2 or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2–1.4) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. Conclusions The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population. PMID:17712309

A cross-sectional study about associations between personality characteristics and mental health service utilization in a Korean national community sample of adults with psychiatric disorders.

PubMed

Park, Subin; Lee, Yeeun; Seong, Su Jeong; Chang, Sung Man; Lee, Jun Young; Hahm, Bong Jin; Hong, Jin Pyo

2017-05-05

Personality traits are not only associated with psychiatric symptoms, but also with treatment seeking behavior. Our purpose was to examine the relationship between mental health service utilization and personality characteristics in a nationwide community sample of Korean adults. Of the 6022 subjects aged 18-74 years who participated in the Korean Epidemiologic Catchment Area study, 1544 (25.6%) with a lifetime diagnosis of any DSM-IV psychiatric disorder were analyzed. Diagnostic assessments were based on the Composite International Diagnostic Interview and personality constructs were measured by Big Five Personality Inventory-10. Of the 1544 participants, 275 (17.8%) had used mental health services. Multivariate analyses revealed positive associations between mental health service utilization and both neuroticism and openness, and an inverse association between mental health service utilization and agreeableness. These findings suggest that specific personality traits may have a role in treatment-seeking behaviors for mental health problems independent of the psychiatric disorder.

The impact of adverse child and adult experiences on recovery from serious mental illness.

PubMed

Stumbo, Scott P; Yarborough, Bobbi Jo H; Paulson, Robert I; Green, Carla A

2015-12-01

The purpose of this study was to compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a 2-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia, or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Child and adult exposures to adverse experiences were high, at 91% and 82%, respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning and social functioning and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. (c) 2015 APA, all rights reserved).

The Impact of Adverse Child and Adult Experiences on Recovery from Serious Mental Illness

PubMed Central

Stumbo, Scott P.; Yarborough, Bobbi Jo H.; Paulson, Robert I.; Green, Carla A.

2015-01-01

Objective To compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. Methods As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a two-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Results Child and adult exposures to adverse experiences were high, at 91% and 82% respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning, social functioning, and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Conclusions and Implications for Practice Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. PMID:26053533

Cross-national associations between gender and mental disorders in the WHO World Mental Health Surveys

PubMed Central

Seedat, Soraya; Scott, Kate Margaret; Angermeyer, Matthias C.; Berglund, Patricia; Bromet, Evelyn J.; Brugha, Traolach S.; Demyttenaere, Koen; de Girolamo, Giovanni; Haro, Josep Maria; Jin, Robert; Karam, Elie G.; Kovess-Masfety, Viviane; Levinson, Daphna; Mora, Maria Elena Medina; Ono, Yutaka; Ormel, Johan; Pennell, Beth-Ellen; Posada-Villa, Jose; Sampson, Nancy A.; Williams, David; Kessler, Ronald C.

2009-01-01

Context Gender differences in mental disorders, including more anxiety-mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The “gender roles” hypothesis suggests that these differences should narrow as the roles of women and men become more equal. Objective To study time-space (i.e., cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the WHO World Mental Health (WMH) Survey Initiative and determine if this variation is significantly related to time-space variation in female gender role traditionality (GRT) as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Design/Setting and Participants Face-to face household surveys of 72,933 community-dwelling adults in Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Main Outcomes The WHO Composite International Diagnostic Interview (CIDI) assessed lifetime prevalence and age-of-onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in Female:Male (F:M) odds-ratios (ORs) of these disorders across cohorts defined by age ranges 18–34, 35–49, 50–64, and 65+. Structural equation analysis examined predictive effects of variation in GRT on these ORs. Results Women had more anxiety-mood disorders than men and men more externalizing-substance disorders than women in all cohorts and countries. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder (MDD) and substance disorders. This narrowing was significantly related to temporal (MDD) and spatial (substance disorders) variation in GRT. Conclusion While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial inter-cohort narrowing of

Mental disorder and victimisation in prison: Examining the role of mental health treatment.

PubMed

Daquin, Jane C; Daigle, Leah E

2018-04-01

There is evidence that people with mental disorders are at increased risk of victimisation in prison. It is unclear whether this risk of victimisation varies across types of disorders or symptoms and what role mental health treatment has on victimisation risk in this context. To examine the relationship between specific mental disorders, psychiatric symptoms, and victimisation in prison and the effect of treatment for the disorders on victimisation risk. Using a nationally-representative sample of prisoners, path analyses were conducted to examine the relationship between mental disorder and victimisation. The analyses also examined whether receiving mental health treatment in prison affected any such relationship. Victimisation risk varied with the type of mental disorder or symptoms. Depression, personality disorder, hopelessness, paranoia, and hallucinations were associated with increased victimisation risk. Psychotic illnesses were otherwise negatively associated with victimisation. Receiving mental health treatment in prison was associated with greater risk of victimisation there. Receiving treatment appeared to mediate the relationship between mental disorders, symptoms, and victimisation. The findings suggest that not all inmates with mental disorders are at an increased risk of victimisation. Further, mental health treatment in prison also appears to be a risk factor of victimisation. More research is needed to further elucidate the relationship between mental disorders, treatment, and victimisation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults.

PubMed

Marino, Leslie; Wissow, Lawrence S; Davis, Maryann; Abrams, Michael T; Dixon, Lisa B; Slade, Eric P

2016-12-01

To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults. Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated . Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P < 0.01 and OR = 0.36, P < 0.01, respectively). In addition, those who utilized any outpatient public mental health services during the 180 days prior to their index hospitalization (N = 625, 55.4%) were more likely to have a follow-up visit than those without prior outpatient use (OR = 2.45, P < 0.01). Prior Medicaid-reimbursed primary care visits were not significantly associated with follow-up. In this predominantly urban, low-income statewide sample of young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans. © 2015 Wiley Publishing Asia Pty Ltd.

Self-Management Training of Mentally Retarded Adults with Chronic Conduct Difficulties. RT11.

ERIC Educational Resources Information Center

Cole, Christine L.; And Others

Six mildly and moderately mentally retarded adults with chronic and severe emotional/behavioral problems participated in a study of the assumption that aggression and conduct disorders reflected self-managed coping skills deficits. The study was conducted in a vocational training workshop setting located in the Waisman Center on Mental Retardation…

Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees.

PubMed

Torvik, Fartein Ask; Reichborn-Kjennerud, Ted; Gjerde, Line C; Knudsen, Gun Peggy; Ystrom, Eivind; Tambs, Kristian; Røysamb, Espen; Østby, Kristian; Ørstavik, Ragnhild

2016-08-03

Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment

Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia.

PubMed

Fekadu, Abebaw; Hanlon, Charlotte; Gebre-Eyesus, Emebet; Agedew, Melkamu; Solomon, Haddis; Teferra, Solomon; Gebre-Eyesus, Tsehaysina; Baheretibeb, Yonas; Medhin, Girmay; Shibre, Teshome; Workneh, Abraham; Tegegn, Teketel; Ketema, Alehegn; Timms, Philip; Thornicroft, Graham; Prince, Martin

2014-08-20

The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule. We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness. Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.

Child Physical Abuse and Adult Mental Health: A National Study

PubMed Central

Sugaya, Luisa; Hasin, Deborah S.; Olfson, Mark; Lin, Keng-Han; Grant, Bridget F.; Blanco, Carlos

2013-01-01

This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000–2001 and 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16–2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention. PMID:22806701

Child physical abuse and adult mental health: a national study.

PubMed

Sugaya, Luisa; Hasin, Deborah S; Olfson, Mark; Lin, Keng-Han; Grant, Bridget F; Blanco, Carlos

2012-08-01

This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000-2001 and 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16-2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention. Copyright © 2012 International Society for Traumatic Stress Studies.

Discrimination, Mental Health, and Substance Use Disorders Among Sexual Minority Populations.

PubMed

Lee, Ji Hyun; Gamarel, Kristi E; Bryant, Kendall J; Zaller, Nickolas D; Operario, Don

2016-08-01

Sexual minority (lesbian, gay, bisexual) populations have a higher prevalence of mental health and substance use disorders compared to their heterosexual counterparts. Such disparities have been attributed, in part, to minority stressors, including distal stressors such as discrimination. However, few studies have examined associations between discrimination, mental health, and substance use disorders by gender among sexual minority populations. We analyzed data from 577 adult men and women who self-identified as lesbian, gay, or bisexual and participated in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Six questions assessed discrimination due to sexual orientation. Weighted multivariable logistic regression examined associations between experiences of sexual orientation discrimination and both mental health and substance use disorders. Analyses were conducted separately for sexual minority men and women, adjusting for sociodemographic covariates. Sexual minority men who ever experienced discrimination (57.4%) reported higher odds of any lifetime drug use disorder and cannabis use disorder compared to sexual minority men who never experienced discrimination. Sexual minority women who ever experienced discrimination (42.9%) reported higher odds of any lifetime mood disorder and any lifetime anxiety disorder compared to sexual minority women who never experienced discrimination. The findings suggest that discrimination is differentially associated with internalizing (mental health) and externalizing (substance use) disorders for sexual minority men and women. These findings indicate a need to consider how homophobia and heteronormative discrimination may contribute to distinct health outcomes for lesbian and bisexual women compared with gay and bisexual men.

The Relationship between Religion and Mental Disorders in a Korean Population

PubMed Central

Park, Jong-Ik; Hong, Jin Pyo; Park, Subin

2012-01-01

Objective The question of whether religion has beneficial or detrimental effects on the mental well-being of the adult individual is debatable. Because most Korean citizens are free to select their own religion, there is a higher proportion of non-believers than believers among the Korean population. The aim of this research was to investigate the association between spiritual values and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders in Korea across all types of belief systems, including Koreans not affiliated with a particular religion. Methods The Korean version of the Composite International Diagnostic Interview 2.1 was used to interview 6,275 people across South Korea in 2001. While controlling for age and sex, we used logistic regression to analyze the relationship between mental disorders (both current and past) and the types of religion and spiritual values. Results Strong spiritual values were positively associated with increased rates of current depressive disorder and decreased rates of current alcohol use disorder. Using "atheist" as the reference category, Catholics had higher lifetime odds of single episodes of depression whilst Protestants had higher lifetime odds of anxiety disorder and lower lifetime odds of alcohol use disorders. Conclusion The results of this study suggest that depressive episodes often lead to a search for spirituality and that religion may be helpful in overcoming depression or becoming less vulnerable to relapsing. The associations between religion, spiritual values, and mental health have not been fully elucidated and warrant further exploration. PMID:22396682

Free will and mental disorder: Exploring the relationship

PubMed Central

2010-01-01

A link between mental disorder and freedom is clearly present in the introduction of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It mentions “an important loss of freedom” as one of the possible defining features of mental disorder. Meanwhile, it remains unclear how “an important loss of freedom” should be understood. In order to get a clearer view on the relationship between mental disorder and (a loss of) freedom, in this article, I will explore the link between mental disorder and free will. I examine two domains in which a connection between mental disorder and free will is present: the philosophy of free will and forensic psychiatry. As it turns out, philosophers of free will frequently refer to mental disorders as conditions that compromise free will and reduce moral responsibility. In addition, in forensic psychiatry, the rationale for the assessment of criminal responsibility is often explained by referring to the fact that mental disorders can compromise free will. Yet, in both domains, it remains unclear in what way free will is compromised by mental disorders. Based on the philosophical debate, I discuss three senses of free will and explore their relevance to mental disorders. I conclude that in order to further clarify the relationship between free will and mental disorder, the accounts of people who have actually experienced the impact of a mental disorder should be included in future research. PMID:20931360

Adult head-banging and stereotypic movement disorders.

PubMed

Mendez, M F; Mirea, A

1998-09-01

Stereotypic movement disorders (SMD) such as head-banging, which are common among children with mental retardation or pervasive developmental disorders, may also occur in intellectually normal adults. We report a 27-year history of daily head-banging with self-injury in a 49-year-old man with normal cognition. The patient had no personal or family history of Tourette's syndrome, tic disorder, obsessive-compulsive disorder (OCD), or mental retardation. The frequency of his stereotypical head-banging increased with anxiety, loud noises with startle, and boredom. He reported a sense of pleasure from his head-banging, and the frequency of this behavior decreased when he was treated with the opioid antagonist naltrexone. Although not diagnostic, the self-stimulatory or pleasurable component of head-banging, body-rocking, thumb-sucking, and other SMD may help distinguish them from tics, Tourette's syndrome, OCD, and deliberate self-harming behavior. This report reviews the disorders associated with SMD and discusses the potential mechanisms for these behaviors. The treatment of SMD includes drugs that work through opioid, serotonergic, or dopaminergic systems.

Mental disorders induced by carbamazepine.

PubMed

Mizukami, K; Naito, Y; Yoshida, M; Nakanishi, T; Koizumi, J

1990-03-01

We present here a case with various physical and neuropsychiatric symptoms caused by the administration of carbamazepine. The patient suffering from right ophthalmic neuralgia showed fever, eczema, erythema, lymphoadenopathy, eosinophilia, vomiting, headache, dizziness, nystagmus, and various mental disorders which consisted of emotional instability, personality change, delusions of reference and persecution, depressive state, and hyperventilation syndrome during the administration of carbamazepine. The physical symptoms in the present case were conformable to the side effect of carbamazepine. The mental disorders appeared in a few days from the start of carbamazepine administration and disappeared after the discontinuation of the administration of this drug without antipsychotic therapy and have never relapsed until now. The mental disorders and the physical symptoms were in parallel with their clinical course. This kind of mental disorders induced by carbamazepine has not yet been reported.

The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample.

PubMed

Afifi, Tracie O; Boman, Jonathan; Fleisher, William; Sareen, Jitender

2009-03-01

To determine how the experiences of child abuse and parental divorce are related to long-term mental health outcomes using a nationally representative adult sample after adjusting for sociodemographic variables and parental psychopathology. Data were drawn from the National Comorbidity Survey (NCS, n=5,877; age 15-54 years; response rate 82.4%). Logistic regression models were used to determine the odds of experiencing lifetime psychiatric disorders and suicidal ideation and attempts. Parental divorce alone was associated with some psychiatric disorders after adjusting for sociodemographic variables (AOR ranging from 1.30 to 2.37), while child abuse alone was associated with psychiatric disorders (AOR ranging from 1.39 to 6.07) and suicidal ideation (AOR=2.08; 95% CI=1.57-2.77) and attempts (AOR=1.54; 95% CI=1.02-2.31) after adjusting for sociodemographic variables. However, having experienced both parental divorce and child abuse together resulted in significantly increased odds for lifetime PTSD (AOR=9.87; 95% CI=6.69-14.55), conduct disorder (AOR=4.01; 95% CI=2.92-5.51) and suicide attempts (AOR=2.74; 95% CI=1.84-4.08) compared to having experienced either parental divorce or child abuse alone. These results were attenuated when further adjusting for parental psychopathology. When the experience of parental divorce is accompanied with child abuse, the associations with some poor mental health outcomes are significantly greater compared to the impact of either parental divorce or child abuse on its own. Therefore, parental divorce is an additional childhood adversity that significantly contributes to poor mental health outcomes especially when in combination with child abuse. Parental psychopathology attenuated these relationships suggesting that it may be one possible mechanism to explain the relationships between child abuse, parental divorce, and psychiatric disorders and suicide attempts.

Associations between subjective social status and DSM-IV mental disorders: Results from the World Mental Health Surveys

PubMed Central

Scott, Kate M.; Al-Hamzawi, Ali Obaid; Andrade, Laura H.; Borges, Guilherme; Caldas-de-Almeida, Jose Miguel; Fiestas, Fabian; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kawakami, Norito; Lee, Sing; Levinson, Daphna; Lim, Carmen C.W.; Navarro-Mateu, Fernando; Okoliyski, Michail; Posada-Villa, Jose; Torres, Yolanda; Williams, David R.; Zakhozha, Victoria; Kessler, Ronald C.

2017-01-01

Importance The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures such as education, income and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture perception of relative social status, but to date there are no studies of associations between SSS and mental disorders. Objective To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS. Design; Setting; Participants Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, the Middle East (n= 56,085). SSS was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, education and occupation. Scores on the 1–10 SSS scale were categorised into four categories: low (scores 1–3); low-mid (scores 4 and 5); high-mid (scores 6 and 7); high (scores 8–10). OSS was assessed with a wide range of fine-grained objective indicators of income, education and occupation. Main Outcome Measures The Composite International Diagnostic Interview assessed 12-month prevalence of 16 DSM-IV mood, anxiety and impulse control disorders. Results Graded, inverse associations were found between SSS and all 16 mental disorders. Gross odds-ratios (lowest versus highest SSS categories) in the range 1.8–9.0 were attenuated but remained significant for all 16 disorders (ORs: 1.4–4.9) after adjusting for OSS indicators. The pattern of inverse association between SSS and mental disorders was significant in 14/18 individual countries, and in low, middle and high income country groups, but was significantly stronger in higher versus lower income countries

Mental Disorders in Deaf and Hard of Hearing Adult Outpatients: A Comparison of Linguistic Subgroups.

PubMed

Øhre, Beate; Volden, Maj; Falkum, Erik; von Tetzchner, Stephen

2017-01-01

Deaf and hard of hearing (DHH) individuals who use signed language and those who use spoken language face different challenges and stressors. Accordingly, the profile of their mental problems may also differ. However, studies of mental disorders in this population have seldom differentiated between linguistic groups. Our study compares demographics, mental disorders, and levels of distress and functioning in 40 patients using Norwegian Sign Language (NSL) and 36 patients using spoken language. Assessment instruments were translated into NSL. More signers were deaf than hard of hearing, did not share a common language with their childhood caregivers, and had attended schools for DHH children. More Norwegian-speaking than signing patients reported medical comorbidity, whereas the distribution of mental disorders, symptoms of anxiety and depression, and daily functioning did not differ significantly. Somatic complaints and greater perceived social isolation indicate higher stress levels in DHH patients using spoken language than in those using sign language. Therefore, preventive interventions are necessary, as well as larger epidemiological and clinical studies concerning the mental health of all language groups within the DHH population. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

External built residential environment characteristics that affect mental health of adults.

PubMed

Ochodo, Charles; Ndetei, D M; Moturi, W N; Otieno, J O

2014-10-01

External built residential environment characteristics include aspects of building design such as types of walls, doors and windows, green spaces, density of houses per unit area, and waste disposal facilities. Neighborhoods that are characterized by poor quality external built environment can contribute to psychosocial stress and increase the likelihood of mental health disorders. This study investigated the relationship between characteristics of external built residential environment and mental health disorders in selected residences of Nakuru Municipality, Kenya. External built residential environment characteristics were investigated for 544 residents living in different residential areas that were categorized by their socioeconomic status. Medically validated interview schedules were used to determine mental health of residents in the respective neighborhoods. The relationship between characteristics of the external built residential environment and mental health of residents was determined by multivariable logistic regression analyses and chi-square tests. The results show that walling materials used on buildings, density of dwelling units, state of street lighting, types of doors, states of roofs, and states of windows are some built external residential environment characteristics that affect mental health of adult males and females. Urban residential areas that are characterized by poor quality external built environment substantially expose the population to daily stressors and inconveniences that increase the likelihood of developing mental health disorders.

Suicide Ideation in Older Adults: Relationship to Mental Health Problems and Service Use

ERIC Educational Resources Information Center

Corna, Laurie M.; Cairney, John; Streiner, David L.

2010-01-01

Purpose: To assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use. Design and Methods: We use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of…

Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care.

PubMed

Jimenez, Daniel E; Bartels, Stephen J; Cardenas, Veronica; Alegría, Margarita

2013-10-01

The current study applies the perceived stigma framework to identify differences in attitudes toward mental health and mental health treatment among various racial/ethnic minority older adults with common mental health problems including depression, anxiety disorders, or at-risk alcohol use. Specifically, this study examines to what extent race/ethnicity is associated with differences in (1) perceived stigma of mental illness and (2) perceived stigma for different mental health treatment options. Analyses were conducted using baseline data collected from participants who completed the SAMHSA Mental Health and Alcohol Abuse Stigma Assessment, developed for the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) study, a multisite randomized trial for older adults (65+ years) with depression, anxiety, or at-risk alcohol consumption. The final sample consisted of 1247 non-Latino Whites, 536 African-Americans, 112 Asian-Americans, and 303 Latinos. African-Americans and Latinos expressed greater comfort in speaking to primary care physicians or mental health professionals concerning mental illness compared with non-Latino Whites. Asian-Americans and Latinos expressed greater shame and embarrassment about having a mental illness than non-Latino Whites. Asian-Americans expressed greater difficulty in seeking or engaging in mental health treatment. Racial/ethnic differences exist among older adults with mental illness with respect to stigmatizing attitudes toward mental illness and mental health treatment. Results of this study could help researchers and clinicians educate racial/ethnic minority older adults about mental illness and engage them in much needed mental health services. Copyright © 2013 John Wiley & Sons, Ltd.

Stigmatizing Attitudes towards Mental Illness among Racial/Ethnic Older Adults in Primary Care

PubMed Central

Jimenez, Daniel E.; Bartels, Stephen J.; Cardenas, Veronica; Alegría, Margarita

2013-01-01

Objective The current study applies the perceived stigma framework to identify differences in attitudes toward mental health and mental health treatment among various racial/ethnic minority older adults with common mental health problems including depression, anxiety disorders, or at-risk alcohol use. Specifically, this study examines to what extent race/ethnicity is associated with differences in: (1) perceived stigma of mental illness; and (2) perceived stigma for different mental health treatment options. Methods Analyses were conducted using baseline data collected from participants who completed the SAMHSA Mental Health and Alcohol Abuse Stigma Assessment, developed for the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) study, a multi-site randomized trial for older adults (65+) with depression, anxiety, or at-risk alcohol consumption. The final sample consisted of 1247 non-Latino Whites, 536 African-Americans, 112 Asian-Americans, and 303 Latinos. Results African-Americans and Latinos expressed greater comfort in speaking to primary care physicians or mental health professionals concerning mental illness compared to non-Latino Whites. Asian-Americans and Latinos expressed greater shame and embarrassment about having a mental illness than non-Latino Whites. Asian-Americans expressed greater difficulty in seeking or engaging in mental health treatment. Conclusions Racial/ethnic differences exist among older adults with mental illness with respect to stigmatizing attitudes towards mental illness and mental health treatment. Results of this study could help researchers and clinicians educate racial/ethnic minority older adults about mental illness and engage them in much needed mental health services. PMID:23361866

Prevalence and determinants of common mental illness among adult residents of Harari Regional State, Eastern Ethiopia

PubMed Central

Hunduma, Gari; Girma, Mulugeta; Digaffe, Tesfaye; Weldegebreal, Fitsum; Tola, Assefa

2017-01-01

Introduction Common mental disorders include depression, anxiety and somatoform disorders are a public health problem in developed as well as developing countries. It represents a psychiatric morbidity with significant prevalence, affecting all stages of life and cause suffering to the individuals, their family and communities. Despite this fact, little information about the prevalence of common mental illness is available from low and middle-income countries including Ethiopia. The aim of this study was to determine the magnitude of common mental disorders and its associated factors among adult residents of Harari Region. Methods Comparative cross-sectional, quantitative community-based survey was conducted From February 1, 2016 to March 30, 2016 in Harari Regional State using multi-stage sampling technique. A total of 968 residents was selected using two stage sampling technique. Of this 901 were participated in the study. Validated and Pretested Self reported questionnaire (SQR_20) was used to determine the maginitude of common mental disorders. Data was entered and analyzed using Epi-info version 3.5.1 and SPSS-17 for windows statistical packages. Univirate, Bi-variate and multivariate logistic regression analysis with 95% CI was employed in order to infer associations. Results The prevalence of common mental illnesses among adults in our study area was 14.9%. The most common neurotic symptoms in this study were often head ache (23.2%), sleep badly (16%) and poor appetite (13.8%). Substance use like Khat chewing (48.2%), tobacco use (38.2%) and alcohol use (10.5%) was highly prevalent health problem among study participant. In multivariate logistic regression analysis, respondents age between 25-34 years, 35-44 years, 45-54 years and above 55years were 6.4 times (AOR 6.377; 95% CI: 2.280-17.835), 5.9 times (AOR 5.900; 95% CI: 2.243-14.859), 5.6 times (AOR 5.648; 95% CI: 2.200-14.50) and 4.1 times (AOR 4.110; 95% CI: 1.363-12.393) more likely having common

The role of comorbid major depressive disorder in the clinical presentation of adult ADHD.

PubMed

Fischer, Aline G; Bau, Claiton H D; Grevet, Eugenio H; Salgado, Carlos A I; Victor, Marcelo M; Kalil, Katiane L S; Sousa, Nyvia O; Garcia, Christiane R; Belmonte-de-Abreu, Paulo

2007-12-01

Most adults with attention-deficit/hyperactivity disorder (ADHD) are not recognized and remain untreated, although a large fraction of these individuals are diagnosed and treated for other comorbid mental disorders, such as major depressive disorder (MDD). The fact that MDD is one of the most commonly occurring mental disorders with high comorbidity with adult ADHD raises the question whether such comorbidity is associated with differences in the clinical picture of ADHD. Three hundred and twenty adult ADHD outpatients were evaluated. Diagnoses followed DSM-IV criteria. Interviews to evaluate ADHD and oppositional defiant disorder (ODD) were performed based on the Portuguese version of K-SADS-E. Psychiatric comorbidities were investigated using SCID-IV and MINI. Regression models were applied to test MDD association with clinical and demographic outcomes. Subjects presenting ADHD and MDD had a higher frequency of generalized anxiety disorder and social phobia and a lower frequency of substance dependence, grade repetition and school suspensions, when compared to subjects with ADHD without MDD. Furthermore, adults presenting ADHD and MDD reported higher demand for psychotherapy and pharmacological treatment prior to enrollment in the study when compared to ADHD subjects free of MDD. However, contrary to what could be expected based on these data, the presence of MDD was not associated with an earlier ADHD diagnosis. These results point to the need for research and medical education into an earlier and more efficient ADHD diagnosis in patients who search for mental health care.

The Take-Up of Employer-Sponsored Insurance Among Americans with Mental Disorders: Implications for Health Care Reform.

PubMed

Zuvekas, Samuel H

2015-07-01

Little is known about how take-up of private health insurance coverage differs between those with and without mental disorders. This study seeks to fill this gap by using data from the 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and take-up of employer-sponsored insurance (ESI) among adults aged 27-54. Little evidence that mental disorders are associated with take-up of offers of ESI coverage was found. This suggests that take-up rates in the Affordable Care Act (ACA) marketplaces by those with and without mental disorders may be similar. The ACA is especially important to Americans with mental disorders, many of whom lack access to ESI coverage to pay for mental health treatment either through their own job or through a spouse's job.

Early intervention for substance abuse among youth and young adults with mental health conditions: an exploration of community mental health practices.

PubMed

Anthony, Elizabeth K; Taylor, Sarah A; Raffo, Zulma

2011-05-01

This mixed method study examined current practices and barriers for screening and assessing substance use among youth/young adults in community mental health systems. Substance use rates remain high among youth/young adults in the general population and substance use disorders are prevalent among young people involved in public service systems such as mental health. In an effort to understand the dynamics for early intervention, 64 case managers and/or clinical directors from children's mental health systems in two states participated in an online survey or focus group in fall 2008. Quantitative survey questions and qualitative focus group questions explored attitudes and perspectives about screening and early intervention for substance use among youth/young adults involved in the mental health system and current agency practices. Mixed method results suggest a number of barriers to substance use screening and early intervention and point to innovations that could be more effectively supported.

Promotion of mental health in children of parents with a mental disorder.

PubMed

Verrocchio, Maria Cristina; Ambrosini, Alessandra; Fulcheri, Mario

2013-01-01

Mental disorders are associated with many difficulties in the activities of daily living, work, relationships and family, and they determine high social and economic costs that represent an important public health problem. The literature has shown that children of parents with mental disorders grow up in environments that are potentially harmful to their mental health and are at risk of neglect and maltreatment. Interventions to prevent mental disorders and psychological symptoms of children of parents with mental disorders are effective but supporting these families is a complex task which requires both cooperation between departments and an interdisciplinary knowledge. A greater knowledge of the responses provided to assist families with dependent children and a mentally ill parent, could stimulate reflections on critical issues and government actions aimed at promoting and protecting the mental health of children.

Prevalence and early determinants of common mental disorders in the 1982 birth cohort, Pelotas, Southern Brazil

PubMed Central

Anselmi, Luciana; Barros, Fernando C; Minten, Gicele C; Gigante, Denise P; Horta, Bernardo L; Victora, Cesar G

2009-01-01

OBJECTIVE To estimate the prevalence of common mental disorders and assess its association with risk factors in a cohort of young adults. METHODS Cross-sectional study nested in a 1982 birth cohort study conducted in Pelotas, Southern Brazil. In 2004-5, 4,297 subjects were interviewed during home visits. Common mental disorders were assessed using the Self-Report Questionnaire. Risk factors included socioeconomic, demographic, perinatal, and environmental variables. The analysis was stratified by gender and crude and adjusted prevalence ratios were estimated by Poisson regression. RESULTS The overall prevalence of common mental disorders was 28.0%; 32.8% and 23.5% in women and men, respectively. Men and women who were poor in 2004-5, regardless of their poor status in 1982, had nearly 1.5-fold increased risk for common mental disorders (p≤0.001) when compared to those who have never been poor. Among women, being poor during childhood (p≤0.001) and black/mixed skin color (p=0.002) increased the risk for mental disorders. Low birth weight and duration of breastfeeding were not associated to the risk of these disorders. CONCLUSIONS Higher prevalence of common mental disorders among low-income groups and race-ethnic minorities suggests that social inequalities present at birth have a major impact on mental health, especially common mental disorders. PMID:19142342

Discrimination, Mental Health, and Substance Use Disorders Among Sexual Minority Populations

PubMed Central

Lee, Ji Hyun; Gamarel, Kristi E.; Bryant, Kendall J.; Zaller, Nickolas D.

2016-01-01

Abstract Purpose: Sexual minority (lesbian, gay, bisexual) populations have a higher prevalence of mental health and substance use disorders compared to their heterosexual counterparts. Such disparities have been attributed, in part, to minority stressors, including distal stressors such as discrimination. However, few studies have examined associations between discrimination, mental health, and substance use disorders by gender among sexual minority populations. Methods: We analyzed data from 577 adult men and women who self-identified as lesbian, gay, or bisexual and participated in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Six questions assessed discrimination due to sexual orientation. Weighted multivariable logistic regression examined associations between experiences of sexual orientation discrimination and both mental health and substance use disorders. Analyses were conducted separately for sexual minority men and women, adjusting for sociodemographic covariates. Results: Sexual minority men who ever experienced discrimination (57.4%) reported higher odds of any lifetime drug use disorder and cannabis use disorder compared to sexual minority men who never experienced discrimination. Sexual minority women who ever experienced discrimination (42.9%) reported higher odds of any lifetime mood disorder and any lifetime anxiety disorder compared to sexual minority women who never experienced discrimination. Conclusion: The findings suggest that discrimination is differentially associated with internalizing (mental health) and externalizing (substance use) disorders for sexual minority men and women. These findings indicate a need to consider how homophobia and heteronormative discrimination may contribute to distinct health outcomes for lesbian and bisexual women compared with gay and bisexual men. PMID:27383512

38 CFR 4.125 - Diagnosis of mental disorders.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency shall...

Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

PubMed

Jurewicz, Izabela

2015-04-01

In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults. © 2015 Royal College of Physicians.

Self-reported utilization of mental health services in the adult German population--evidence for unmet needs? Results of the DEGS1-Mental Health Module (DEGS1-MH).

PubMed

Mack, Simon; Jacobi, Frank; Gerschler, Anja; Strehle, Jens; Höfler, Michael; Busch, Markus A; Maske, Ulrike E; Hapke, Ulfert; Seiffert, Ingeburg; Gaebel, Wolfgang; Zielasek, Jürgen; Maier, Wolfgang; Wittchen, Hans-Ulrich

2014-09-01

This paper provides up-to-date data on service use for mental health problems and disorders among adults aged 18-79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH; N=4483). Data are based exclusively on self-report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA-X/M-CIDI to assess diagnoses according to the criteria of DSM-IV-TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12-month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio-demographic characteristics. Lowest 12-month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self-reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS-MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type

Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

PubMed

Lin, Yu-Ju; Yang, Li-Kuang; Gau, Susan Shur-Fen

2016-06-01

We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental

Absence of sex differences in mental rotation performance in autism spectrum disorder.

PubMed

Rohde, Melanie S; Georgescu, Alexandra L; Vogeley, Kai; Fimmers, Rolf; Falter-Wagner, Christine M

2017-08-01

Mental rotation is one of the most investigated cognitive functions showing consistent sex differences. The 'Extreme Male Brain' hypothesis attributes the cognitive profile of individuals with autism spectrum disorder to an extreme version of the male cognitive profile. Previous investigations focused almost exclusively on males with autism spectrum disorder with only limited implications for affected females. This study is the first testing a sample of 12 female adults with high-functioning autism spectrum disorder compared to 14 males with autism spectrum disorder, 12 typically developing females and 14 typically developing males employing a computerised version of the mental rotation test. Reaction time and accuracy served as dependent variables. Their linear relationship with degree of rotation allows separation of rotational aspects of the task, indicated by slopes of the psychometric function, and non-rotational aspects, indicated by intercepts of the psychometric function. While the typical and expected sex difference for rotational task aspects was corroborated in typically developing individuals, no comparable sex difference was found in autism spectrum disorder individuals. Autism spectrum disorder and typically developing individuals did not differ in mental rotation performance. This finding does not support the extreme male brain hypothesis of autism.

Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.

PubMed

Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

2016-01-01

The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51), unemployment (1.36; 1.18-1.56), single status (1.34; 1.23-1.45), and Wealth Index middle class (1.20; 1.08-1.32) or poor (1.33; 1.21-1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89). Single (1.50; 1.26-1.78), unemployed (1.39; 1.07-1.80) and inactive respondents (1.42; 1.10-1.83) had a higher odds of chronic anxiety or depression than married individuals, or those with partner, and employed persons. Those with perceived

Mental Disorders and Suicidal Intention.

ERIC Educational Resources Information Center

Litman, Robert E.

1987-01-01

Explores use of psychological autopsies to clarify intention in suicide. Compares clinical experience with courtroom experience. Discusses the "decriminalization" of suicide and insurance concerns, mental disorders, and intention to commit suicide. Notes that capacity to have the intent to commit suicide is lost due to mental disorders only under…

The Impact of Comorbid Mental Health Disorders on Complications Following Adult Spinal Deformity Surgery with Minimum 2-Year Surveillance.

PubMed

Diebo, Bassel G; Lavian, Joshua D; Murray, Daniel P; Liu, Shian; Shah, Neil V; Beyer, George A; Segreto, Frank A; Bloom, Lee; Vasquez-Montes, Dennis; Day, Louis M; Hollern, Douglas A; Horn, Samantha R; Naziri, Qais; Cukor, Daniel; Passias, Peter G; Paulino, Carl B

2018-02-06

Retrospective analysis OBJECTIVE.: To compare long-term outcomes between patients with and without mental health comorbidities who are undergoing surgery for adult spinal deformity (ASD). Recent literature reveals that one in three patients admitted for surgical treatment for ASD has comorbid mental health disorder. Currently, impacts of baseline mental health status on long-term outcomes following ASD surgery have not been thoroughly investigated. Patients admitted from 2009-2013 with diagnoses of ASD who underwent ≥4-level thoracolumbar fusion with minimum two-year follow-up were retrospectively reviewed using New York State's Statewide Planning and Research Cooperative System (SPARCS). Patients were stratified by fusion length (Short: 4-8-level; Long: ≥9 level). Patients with comorbid mental health disorder (MHD) at time of admission were selected for analysis (MHD) and compared against those without MHD (no-MHD). Univariate analysis compared demographics, complications, readmissions and revisions between cohorts for each fusion length. Multivariate binary logistic regression models identified independent predictors of outcomes (covariates: fusion length, age, female gender, and Deyo score). 6,020 patients (MHD: n = 1,631; no-MHD: n = 4,389) met inclusion criteria. Mental health diagnoses included disorders of depression (59.0%), sleep (28.0%), anxiety (24.0%), and stress (2.3%). At two-year follow-up, MHD patients with short fusion had significantly higher complication rates (p = 0.001). MHD patients with short or long fusion also had significantly higher rates of any readmission and revision (all p ≤ 0.002). Regression modeling revealed that comorbid MHD was a significant predictor of any complication (OR: 1.17, p = 0.01) and readmission (OR: 1.32, p < 0.001). MHD was the strongest predictor of any revision (OR: 1.56, p < 0.001). Long fusion most strongly predicted any complication (OR: 1.87, p < 0.001). ASD patients with

Prevalence and correlates of eating disorders among young adults in Finland.

PubMed

Lähteenmäki, Sini; Saarni, Suoma; Suokas, Jaana; Saarni, Samuli; Perälä, Jonna; Lönnqvist, Jouko; Suvisaari, Jaana

2014-04-01

This study investigated the epidemiology of eating disorders in a population-based sample of young adults. A mental health questionnaire was sent to a nationally representative two-stage cluster sample of 1863 Finns aged 20-35 years. All screen-positives and a random sample of screen-negatives were invited to participate in a Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. Case records from all lifetime mental health treatments were also obtained and were used to complement the diagnostic assessment. The lifetime prevalence of anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified and any eating disorder among women were 2.1%, 2.3%, 2.0% and 6.0%, respectively, while there was only one man with an eating disorder. Unlike other mental disorders, they are associated with high education. Of women diagnosed with lifetime eating disorder, 67.9% had at least one comorbid Axis I psychiatric disorder, most commonly depressive disorder. While 79.3% of women with lifetime eating disorder had had a treatment contact, only one third of persons with current eating disorder had a current treatment contact. Women whose eating disorder had remitted still experienced more psychological distress and had lower psychosocial functioning that women without lifetime Axis I disorders. Eating disorders are the fourth largest group of mental disorders among young women. They tend to be comorbid, often remain untreated and are associated with residual symptoms after the remission of eating disorder symptoms.

Pediatric-Onset and Adult-Onset Separation Anxiety Disorder Across Countries in the World Mental Health Survey

PubMed Central

Silove, Derrick; Alonso, Jordi; Bromet, Evelyn; Gruber, Mike; Sampson, Nancy; Scott, Kate; Andrade, Laura; Benjet, Corina; de Almeida, Jose Miguel Caldas; De Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Fiestas, Fabian; Florescu, Silvia; Gureje, Oye; He, Yanling; Karam, Elie; Lepine, Jean-Pierre; Murphy, Sam; Villa-Posada, Jose; Zarkov, Zahari; Kessler, Ronald C.

2016-01-01

Objective The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data. Method The sample included 38,993 adults in 18 countries in the World Health Organization (WHO) World Mental Health Surveys. The WHO Composite International Diagnostic Interview was used to assess a range of DSM-IV disorders that included an expanded definition of separation anxiety disorder allowing onsets in adulthood. Analyses focused on prevalence, age at onset, comorbidity, predictors of onset and persistence, and separation anxiety-related role impairment. Results Lifetime separation anxiety disorder prevalence averaged 4.8% across countries (interquartile range [25th–75th percentiles]=1.4%–6.4%), with 43.1% of lifetime onsets occurring after age 18. Significant time-lagged associations were found between earlier separation anxiety disorder and subsequent onset of internalizing and externalizing DSM-IV disorders and conversely between these disorders and subsequent onset of separation anxiety disorder. Other consistently significant predictors of lifetime separation anxiety disorder included female gender, retrospectively reported childhood adversities, and lifetime traumatic events. These predictors were largely comparable for separation anxiety disorder onsets in childhood, adolescence, and adulthood and across country income groups. Twelve-month separation anxiety disorder prevalence was considerably lower than lifetime prevalence (1.0% of the total sample; interquartile range=0.2%–1.2%). Severe separation anxiety-related 12-month role impairment was significantly more common in the presence (42.4%) than absence (18.3%) of 12-month comorbidity. Conclusions Separation anxiety disorder is a common and highly comorbid disorder that can have onset across the lifespan. Childhood adversity and lifetime trauma are

Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group

PubMed Central

Mohlman, Jan; Bryant, Christina; Lenze, Eric J.; Stanley, Melinda A.; Gum, Amber; Flint, Alastair; Beekman, Aartjan T. F.; Wetherell, Julie Loebach; Thorp, Steven R.; Craske, Michelle G.

2014-01-01

Background Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders. Methods This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee. Results Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health. Conclusions DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults. PMID:21773996

Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group.

PubMed

Mohlman, Jan; Bryant, Christina; Lenze, Eric J; Stanley, Melinda A; Gum, Amber; Flint, Alastair; Beekman, Aartjan T F; Wetherell, Julie Loebach; Thorp, Steven R; Craske, Michelle G

2012-06-01

Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders. This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee. Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health. DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults. Copyright © 2011 John Wiley & Sons, Ltd.

Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

PubMed

McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

2012-06-01

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Post-Traumatic Stress Disorder and other mental disorders in the general population after Lorca's earthquakes, 2011 (Murcia, Spain): A cross-sectional study.

PubMed

Navarro-Mateu, Fernando; Salmerón, Diego; Vilagut, Gemma; Tormo, Mª José; Ruíz-Merino, Guadalupe; Escámez, Teresa; Júdez, Javier; Martínez, Salvador; Koenen, Karestan C; Navarro, Carmen; Alonso, Jordi; Kessler, Ronald C

2017-01-01

To describe the prevalence and severity of mental disorders and to examine differences in risk among those with and without a lifetime history prior to a moderate magnitude earthquake that took place in Lorca (Murcia, Spain) at roughly the mid-point (on May 11, 2011) of the time interval in which a regional epidemiological survey was already being carried out (June 2010 -May 2012). The PEGASUS-Murcia project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia. Main outcome measures are prevalence and severity of anxiety, mood, impulse and substance disorders in the 12 months previous to the survey, assessed using the Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic variables, prior history of any mental disorder and earthquake-related stressors were entered as independent variables in a logistic regression analysis. A total number of 412 participants (response rate: 71%) were interviewed. Significant differences in 12-month prevalence of mental disorders were found in Lorca compared to the rest of Murcia for any (12.8% vs 16.8%), PTSD (3.6% vs 0.5%) and other anxiety disorders (5.3% vs 9.2%) (p≤ 0.05 for all). No differences were found for 12-month prevalence of any mood or any substance disorder. The two major predictors for developing a 12-month post-earthquake mental disorder were a prior mental disorder and the level of exposure. Other risk factors included female sex and low-average income. PTSD and other mental disorders are commonly associated with earthquake disasters. Prior mental disorders and the level of exposure to the earthquakes are the most important for the development of a consequent mental disorder and this recognition may help to identify those individuals that may most benefit from specific therapeutic intervention.

Serious mental illness and negative substance use consequences among adults on probation.

PubMed

Rossheim, Matthew E; Livingston, Melvin D; Lerch, Jennifer A; Taxman, Faye S; Walters, Scott T

2018-03-22

Adults on probation are at greater risk of both using substances and having a mental disorder compared to the general population. Several theories explain the relationship between substance use and poor mental health. However, the interaction between substance use, mental health, and substance-related consequences is not well understood. A better understanding of this relationship may help treatment programs become more responsive to people with serious mental illness (SMI). The current study used interview data from 313 adults on probation who reported recent substance use. We examined associations between SMI risk, substance use, and substance use consequences. A substantial proportion of the sample (37.5%) screened at risk of having a SMI. Adjusting for type and amount of substance use, those who screened at risk of having a SMI reported more negative substance use consequences. Significant interaction effects were observed between use of alcohol or opiates and SMI risk. Alcohol use was associated with more negative substance use consequences among those at risk of SMI, while opiate use was associated with more consequences among those not at risk. Programs are sorely needed to identify and treat adults with comorbid substance use and mental health symptoms, particularly for adults in the justice system. Clinicians should carefully consider how mental health may interact with substance use to exacerbate consequences.

Chronic illness histories of adults entering treatment for co-occurring substance abuse and other mental health disorders.

PubMed

Chesher, Nicholas J; Bousman, Chad A; Gale, Maiken; Norman, Sonya B; Twamley, Elizabeth W; Heaton, Robert K; Everall, Ian P; Judd, Patricia A

2012-01-01

Little is known about the medical status of individuals entering treatment for co-occurring substance abuse and other mental disorders (COD). We analyzed the medical histories of 169 adults entering outpatient treatment for CODs, estimating lifetime prevalence of chronic illness and current smoking, comparing these rates to the general population, and examining psychiatric and substance-related correlates of chronic illness. Results revealed significantly higher prevalence of hypertension, asthma, arthritis, and smoking compared to the general US population, and showed an association between chronic illness and psychiatric symptom distress and substance use severity. Findings support integration of chronic illness management into COD treatment.  Copyright © American Academy of Addiction Psychiatry.

Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys.

PubMed

Seedat, Soraya; Scott, Kate Margaret; Angermeyer, Matthias C; Berglund, Patricia; Bromet, Evelyn J; Brugha, Traolach S; Demyttenaere, Koen; de Girolamo, Giovanni; Haro, Josep Maria; Jin, Robert; Karam, Elie G; Kovess-Masfety, Viviane; Levinson, Daphna; Medina Mora, Maria Elena; Ono, Yutaka; Ormel, Johan; Pennell, Beth-Ellen; Posada-Villa, Jose; Sampson, Nancy A; Williams, David; Kessler, Ronald C

2009-07-01

Gender differences in mental disorders, including more anxiety and mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The gender roles hypothesis suggests that these differences narrow as the roles of women and men become more equal. To study time-space (cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the World Health Organization World Mental Health Survey Initiative and to determine if this variation is significantly related to time-space variation in female gender role traditionality as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Face-to-face household surveys. Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Community-dwelling adults (N = 72,933). The World Health Organization Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in female to male odds ratios of these disorders across cohorts defined by the following age ranges: 18 to 34, 35 to 49, 50 to 64, and 65 years and older. Structural equation analysis examined predictive effects of variation in gender role traditionality on these odds ratios. In all cohorts and countries, women had more anxiety and mood disorders than men, and men had more externalizing and substance disorders than women. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder and substance disorders. This narrowing was significantly related to temporal (major depressive disorder) and spatial (substance disorders) variation in gender role traditionality. While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied

Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.

PubMed Central

Biddle, Lucy; Gunnell, David; Sharp, Debbie; Donovan, Jenny L

2004-01-01

BACKGROUND: Young adults, especially men, are among those least likely to consult healthcare professionals when mentally distressed or suicidal. AIMS: To investigate the help-seeking behaviours of mentally distressed young adults. Design of study: Cross-sectional survey. SETTING: Bristol and surrounding areas, including inner-city, suburban and urban locations. METHOD: A questionnaire was sent to a sample of 3004 young adults aged 16-24 years. This assessed probable mental disorder (using the 12-item general health questionnaire [GHQ-12]), suicidal thoughts (GHQ-28 suicide subscale), and help-seeking behaviours. RESULTS: Most responders who were assessed as having probable mental disorders (GHQ "cases") had not sought help. Help seeking was more common in female GHQ cases than male cases (34.8% and 21.8%,respectively; P = 0.003) and women with suicidal thoughts more commonly sought help than men with suicidal thoughts (41.6% and 30.9%, respectively; P = 0.15). Small proportions of male and female GHQ cases (7.5% and 8.9%, respectively; P = 0.6), and less than one in five responders with suicidal thoughts, had consulted a general practitioner. In more female than male cases, help was sought from family and friends (30.7% and 18.4%, respectively; P = 0.004). GHQ score was the strongest predictor of help seeking. Men had a higher threshold of severity at which they would seek help than women. Recent experience of suicidal thoughts appeared to be a stronger predictor of formal help seeking in mentally distressed women than mentally distressed men. CONCLUSION: Distressed young adults are reluctant to seek help. Men are particularly unlikely to do so unless severely distressed and tend not to seek lay support. Sex differences in help seeking may be important in understanding the high suicide rate for men. PMID:15113490

Mental disorder comorbidity in Te Rau Hinengaro: the New Zealand Mental Health Survey.

PubMed

Scott, Kate M; McGee, Magnus A; Oakley Browne, Mark A; Wells, J Elisabeth

2006-10-01

To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.

The longitudinal relationship between flourishing mental health and incident mood, anxiety and substance use disorders.

PubMed

Schotanus-Dijkstra, Marijke; Ten Have, Margreet; Lamers, Sanne M A; de Graaf, Ron; Bohlmeijer, Ernst T

2017-06-01

High levels of mental well-being might protect against the onset of mental disorders but longitudinal evidence is scarce. This study examines whether flourishing mental health predicts first-incidence and recurrent mental disorders 3 years later. Data were used from 4482 representative adults participating in the second (2010-12) and third wave (2013-15) of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental well-being was assessed with the Mental Health Continuum-Short Form (MHC-SF) at the second wave. The classification criteria of this instrument were used to classify participants as having flourishing mental health: high levels of both hedonic well-being (life-satisfaction, happiness) and eudaimonic well-being (social contribution, purpose in life, personal growth). DSM-IV mood, anxiety and substance use disorders were measured with the Composite International Diagnostic Interview (CIDI) 3.0 at all waves. Odds ratios of (first and recurrent) incident disorders were estimated, using logistic regression analyses adjusting for potential confounders. Flourishing reduced the risk of incident mood disorders by 28% and of anxiety disorders by 53%, but did not significantly predicted substance use disorders. A similar pattern of associations was found for either high hedonic or high eudaimonic well-being. Significant results were found for substance use disorders when life-events and social support were removed as covariates. This study underscores the rationale of promoting mental well-being as a public mental health strategy to prevent mental illness. In wealthy European nations it seems fruitful to measure and pursuit a flourishing life rather than merely high levels of hedonic well-being. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Mental-Physical Comorbidity in Korean Adults: Results from a Nationwide General Population Survey in Korea.

PubMed

Kim, Ji-Hyun; Chang, Sung Man; Bae, Jae Nam; Cho, Seong-Jin; Lee, Jun-Young; Kim, Byung-Soo; Cho, Maeng Je

2016-09-01

The aims of this study were to estimate the prevalence of mental-physical comorbidity and health-threatening risk factors in subjects with mental disorders, and the risks of mental disorders in those with physical diseases for the last 12 months in the general Korean population. Korean Epidemiologic Catchment Area study replication (KECA-R) was conducted for 6,510 adults between August 2006 and April 2007. The Korean version of Composite International Diagnostic Interview 2.1 (K-CIDI) was used in the survey. Prevalence of mental and physical disorders, and risk factors for physical health were calculated, and their associations were evaluated with adjustment for age and sex. Subjects with any mental disorder showed significantly higher prevalence of chronic physical conditions (adjusted odds ratio, AOR=1.5 to 2.8, p<0.001) and medical risk factors including smoking, heavy drinking, overweight, and hypertension (AOR=1.5 to 4.0, p<0.001). Of those with chronic physical conditions, 21.6% had one or more comorbid mental disorder compared with 10.5% of the subjects without chronic physical disorders (AOR=2.6, p<0.001). Contrary to expectations, depressive disorders did not show significant association with hypertension and prevalence of obesity was not influenced by presence of mental disorders. Further studies should assess these findings. This is the first identification of significant mental-physical comorbidity in the general Korean population. Clinicians and health care officials should keep in mind of its potential adverse effects on treatment outcome and aggravated disease-related socioeconomic burden.

History of foster care among homeless adults with mental illness in Vancouver, British Columbia: a precursor to trajectories of risk.

PubMed

Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2015-02-26

It is well documented that a disproportionate number of homeless adults have childhood histories of foster care placement(s). This study examines the relationship between foster care placement as a predictor of adult substance use disorders (including frequency, severity and type), mental illness, vocational functioning, service use and duration of homelessness among a sample of homeless adults with mental illness. We hypothesize that a history of foster care predicts earlier, more severe and more frequent substance use, multiple mental disorder diagnoses, discontinuous work history, and longer durations of homelessness. This study was conducted using baseline data from two randomized controlled trials in Vancouver, British Columbia for participants who responded to a series of questions pertaining to out-of-home care at 12 months follow-up (n = 442). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; vocational functioning; and service use. In multivariable regression models, a history of foster care placement independently predicted incomplete high school, duration of homelessness, discontinuous work history, less severe types of mental illness, multiple mental disorders, early initiation of drug and/or alcohol use, and daily drug use. This is the first Canadian study to investigate the relationship between a history of foster care and current substance use among homeless adults with mental illness, controlling for several other potential confounding factors. It is important to screen homeless youth who exit foster care for substance use, and to provide integrated treatment for concurrent disorders to homeless youth and adults who have both psychiatric and substance use problems. Both trials are registered with the International Standard Randomized Control Trial Number Register and were assigned ISRCTN57595077 (Vancouver At Home Study: Housing First plus

Departure scripts and life review of parents living with abusive adult children with mental disorder.

PubMed

Avieli, Hila; Smeloy, Yael; Band-Winterstein, Tova

2015-08-01

Increasing numbers of aging parents are finding themselves in the role of caregiver for their mentally ill adult child due to global deinstitutionalization policy. The aim of this article is to explore preparations for the end of life in light of the life review process among old parents of abusive children with mental disorder. Data collection was performed through in-depth semi-structured interviews with 20 parents, followed by phenomenological analysis. Five different types of departure scripts emerged: a pragmatic departure script, a burned-out departure script, a dead-end departure script, an optimistic departure script, and a violent departure script. The parents in this study tended to interpret events in their past to fit their perception of the current relationship with their child, thus connecting past, present, and future into one coherent picture. Years of extended care have led to a unique aging process which does not allow separation from the child or the development of a sense of closure that characterizes the aging process. This calls for better insights and deeper understanding in regard to intervention with such families. Copyright © 2015. Published by Elsevier Inc.

A retrospective study of nursing diagnoses, outcomes, and interventions for patients with mental disorders.

PubMed

Escalada-Hernández, Paula; Muñoz-Hermoso, Paula; González-Fraile, Eduardo; Santos, Borja; González-Vargas, José Alonso; Feria-Raposo, Isabel; Girón-García, José Luis; García-Manso, Manuel

2015-05-01

The aim of this study is to describe the most frequent NANDA-I nursing diagnoses, NOC outcomes, and NIC interventions used in nursing care plans in relation to psychiatric diagnosis. Although numerous studies have described the most prevalent NANDA-I, NIC and NOC labels in association with medical diagnosis in different specialties, only few connect these with psychiatric diagnoses. This multicentric cross-sectional study was developed in Spain. Data were collected retrospectively from the electronic records of 690 psychiatric or psychogeriatric patients in long and medium-term units and, psychogeriatric day-care centres. The most common nursing diagnoses, interventions and outcomes were identified for patients with schizophrenia, organic mental disorders, mental retardation, affective disorders, disorders of adult personality and behavior, mental and behavioural disorders due to psychoactive substance use and neurotic, stress-related and somatoform disorders. Results suggest that NANDA-I, NIC and NOC labels combined with psychiatric diagnosis offer a complete description of the patients' actual condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Medication use in US youth with mental disorders.

PubMed

Merikangas, Kathleen R; He, Jian-ping; Rapoport, Judith; Vitiello, Benedetto; Olfson, Mark

2013-02-01

To evaluate the prevalence, demographic and clinical correlates, and specificity of classes of psychotropic medications indicated for mental disorders. Cross-sectional survey. Direct household interviews of combined household and school samples representative of the general population of adolescents in the United States. Ten thousand one hundred twenty-three adolescents aged 13 to 18 years who participated in the National Comorbidity Survey Adolescent Supplement. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) mental disorders and neurodevelopmental disorders. Psychotropic medication use in the past 12 months. Among youth with any DSM-IV mental disorder, 14.2% reported that they had been treated with a psychotropic medication in the past 12 months. Strong associations emerged between specific disorders and classes of medications with evidence for efficacy. Antidepressants were most frequently used among those with primary mood disorders (14.1%); stimulant use was most common among those with attention-deficit/hyperactivity disorder (20.4%); and antipsychotic use was infrequent and mostly seen among those with serious developmental disorders. Less than 2.5% of adolescents without a 12-month mental disorder had been prescribed psychotropic medications, and most had evidence of psychological distress or impairment reflected in a previous mental disorder, subthreshold condition, or developmental disorder. Appropriate medication use was significantly more frequent among those in treatment in the mental health specialty sector than general medicine or other settings. These findings challenge recent concerns over widespread overmedication and misuse of psychotropic medications in US youth. In fact, these data highlight the need for greater recognition and appropriate treatment of youth with mental health disorders.

Supplemental Security Income Benefits for Mental Disorders.

PubMed

Perrin, James M; Houtrow, Amy; Kelleher, Kelly; Hoagwood, Kimberly; Stein, Ruth E K; Zima, Bonnie

2016-07-01

The Supplemental Security Income Program (SSI) provides financial support to low-income households with children and youth with severe disabilities. The program included children when it began in the early 1970s. The numbers of children receiving SSI benefits increased substantially in the early 1990s, in part through an expansion of the listings of mental health conditions with which children could become eligible. Over the past 20 years, larger numbers of children have received SSI benefits for mental disorders, and these increases have led to questions from the press and Congress regarding these numbers. Do they indicate more of an increase in mental disorders among SSI children than in the general population? The National Academy of Medicine (NAM; formerly the Institute of Medicine) convened a study panel to examine what is known about mental disorders among the child SSI population and how that compares with evidence about mental disorders in children in general. The NAM report provides detailed information about how SSI works, about the changing numbers of children receiving SSI for mental disorders, and some comparisons with other evidence about rising rates of mental disorders in the general population and especially among children living in poverty. The report indicates that increasing numbers of children with mental disorders in SSI mirror similar increases in the population in general. This article summarizes key evidence from the NAM report and suggests the implications for pediatricians. Copyright © 2016 by the American Academy of Pediatrics.

38 CFR 4.127 - Mental retardation and personality disorders.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.127 Mental retardation and personality disorders. Mental retardation and personality disorders are not diseases or injuries... from them may not be service-connected. However, disability resulting from a mental disorder that is...

Mental disorders among college students in the WHO World Mental Health Surveys

PubMed Central

Auerbach, Randy P.; Alonso, Jordi; Axinn, William G.; Cuijpers, Pim; Ebert, David D.; Green, Jennifer Greif; Hwang, Irving; Kessler, Ronald C.; Liu, Howard; Mortier, Philippe; Nock, Matthew K.; Pinder-Amaker, Stephanie; Sampson, Nancy A.; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H.; Benjet, Corina; Caldas-de-Almeida, José Miguel; Demyttenaere, Koen; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Karam, Elie G.; Kiejna, Andrzej; Kovess-Masfety, Viviane; Lee, Sing; McGrath, John J.; O’Neill, Siobhan; Pennell, Beth-Ellen; Scott, Kate; ten Have, Margreet; Torres, Yolanda; Zaslavsky, Alan M.; Zarkov, Zahari; Bruffaerts, Ronny

2016-01-01

Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Methods The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1,572) and nonstudents in the same age range (18–22; n = 4,178), including nonstudents who recently left college without graduating (n = 702) based on surveys in 21 countries (4 low/lower-middle income, 5 upper middle-income, 1 lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioural and substance disorders were assessed with the Composite International Diagnostic Interview. Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders. 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning. PMID:27484622

12-MONTH PREVALENCE AND TREATMENT OF MENTAL DISORDERS IN LEBANON

PubMed Central

Karam, Elie G.; Mneimneh, Zeina N.; Karam, Aimee N.; Fayyad, John A.; Nasser, Soumana C.; Chatterji, Somnath; Kessler, Ronald C.

2007-01-01

SUMMARY Background: Mental disorders are thought to account for a significant portion of disease burden throughout the world. However, no national studies have been conducted to assess this assumption in the Arab world. Methods: As part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey of n = 2857 adults (ages 18+) was carried out in Lebanon (the Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation: LEBANON). Twelve-month prevalence and severity of DSM-IV disorders and treatment were assessed with the WHO Composite International Diagnostic Interview (CIDI, Version 3.0). Information was also obtained about socio-demographics and exposure to traumatic events in the Lebanon wars. Findings: One-sixth (17.0%) of respondents met criteria for at least one 12-month DSM-IV/CIDI disorder, 27.0% of whom were classified serious and an additional 36.0% moderate. Nearly half of respondents had a history of exposure to war-related traumatic events. Significantly elevated odd-ratios (OR) of mood, anxiety and impulse-control disorders were associated with two (OR = 2.0-3.6) or more (OR = 2.2-9.1) war-related traumatic events, resulting in substantially higher proportions of moderate or severe 12-month mental disorders among respondents exposed to multiple war-related traumata (16.8-20.4%) than other respondents (3.3-3.5%). Only 10.9% of respondents with 12-month disorders obtained treatment. Two-thirds of treatment was provided in the general medical sector. Interpretation: Mental disorders are common in Lebanon. Prevalence is similar to WMH surveys in Western Europe. Unmet need for treatment is considerably higher in Lebanon than in Western countries. PMID:16564362

Long-Term Effects of Mental disorders on Employment In the National Comorbidity Survey Ten-Year Follow-up

PubMed Central

Mojtabai, Ramin; Stuart, Elizabeth A.; Hwang, Irving; Susukida, Ryoko; Eaton, William W.; Sampson, Nancy; Kessler, Ronald C.

2015-01-01

Purpose Although significant negative associations of mental disorders with employment have been documented in epidemiological research, much of this research was based on cross-sectional samples and focused only on severe and persistent mental disorders. The present study examined the longitudinal associations of more common mental disorders with employment. Methods Data on the associations of common mental disorders with employment are presented here from 4,501 respondents in the National Comorbidity Survey panel study, a two-wave community epidemiological survey of respondents aged 15-54 at baseline (1990-1992) who were re-interviewed in 2001-2003 and were employed, unemployed in the labor force or student at baseline. Lifetime mental disorders at baseline and disorders with onset after baseline were assessed with the Composite International Diagnostic Interview, a fully-structured interview that assessed lifetime prevalence of internalizing fear disorders (panic, phobias), anxiety/misery disorders (major depression, generalized anxiety disorder, post-traumatic stress disorder), externalizing disorders (conduct disorder, alcohol and illicit drug abuse-dependence), and bipolar disorder. Results Both baseline lifetime disorders and disorders with onsets after baseline were associated with significantly reduced odds of subsequent employment among respondents who were either employed or students at baseline. Population projections based on the assumption that these associations represented causal effects suggest that the mental disorders considered here were associated with 1.7-3.2 million adults being unemployed in the US population at follow-up. Conclusions Expanded access to treatment among current employees and students with mental disorders might lead to improved employment outcomes in these segments of the population. PMID:26211661

The Structure of Diagnostic and Statistical Manual of Mental Disorders (4th Edition, Text Revision) Personality Disorder Symptoms in a Large National Sample

PubMed Central

Trull, Timothy J.; Vergés, Alvaro; Wood, Phillip K.; Jahng, Seungmin; Sher, Kenneth J.

2013-01-01

We examined the latent structure underlying the criteria for DSM–IV–TR (American Psychiatric Association, 2000, Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.) personality disorders in a large nationally representative sample of U.S. adults. Personality disorder symptom data were collected using a structured diagnostic interview from approximately 35,000 adults assessed over two waves of data collection in the National Epidemiologic Survey on Alcohol and Related Conditions. Our analyses suggested that a seven-factor solution provided the best fit for the data, and these factors were marked primarily by one or at most two personality disorder criteria sets. A series of regression analyses that used external validators tapping Axis I psychopathology, treatment for mental health problems, functioning scores, interpersonal conflict, and suicidal ideation and behavior provided support for the seven-factor solution. We discuss these findings in the context of previous studies that have examined the structure underlying the personality disorder criteria as well as the current proposals for DSM-5 personality disorders. PMID:22506626

The structure of Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision) personality disorder symptoms in a large national sample.

PubMed

Trull, Timothy J; Vergés, Alvaro; Wood, Phillip K; Jahng, Seungmin; Sher, Kenneth J

2012-10-01

We examined the latent structure underlying the criteria for DSM-IV-TR (American Psychiatric Association, 2000, Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.) personality disorders in a large nationally representative sample of U.S. adults. Personality disorder symptom data were collected using a structured diagnostic interview from approximately 35,000 adults assessed over two waves of data collection in the National Epidemiologic Survey on Alcohol and Related Conditions. Our analyses suggested that a seven-factor solution provided the best fit for the data, and these factors were marked primarily by one or at most two personality disorder criteria sets. A series of regression analyses that used external validators tapping Axis I psychopathology, treatment for mental health problems, functioning scores, interpersonal conflict, and suicidal ideation and behavior provided support for the seven-factor solution. We discuss these findings in the context of previous studies that have examined the structure underlying the personality disorder criteria as well as the current proposals for DSM-5 personality disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Church-based health programs for mental disorders among African Americans: a review.

PubMed

Hankerson, Sidney H; Weissman, Myrna M

2012-03-01

African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.

Mental Disorder or "Normal Life Variation"? Why It Matters

ERIC Educational Resources Information Center

Jacobs, David H.

2014-01-01

"Diagnostic and Statistical Manual of Mental Disorders, fifth edition" ("DSM-5") promises a refined definition of mental disorder, which is tantamount to acknowledging that prior "DSM" definitions have failed to clarify what mental disorder is and why a person should be considered mentally disordered. Since the…

Post-Traumatic Stress Disorder and other mental disorders in the general population after Lorca’s earthquakes, 2011 (Murcia, Spain): A cross-sectional study

PubMed Central

Salmerón, Diego; Vilagut, Gemma; Tormo, Mª José; Ruíz-Merino, Guadalupe; Escámez, Teresa; Júdez, Javier; Martínez, Salvador; Koenen, Karestan C.; Navarro, Carmen; Alonso, Jordi; Kessler, Ronald C.

2017-01-01

Aims To describe the prevalence and severity of mental disorders and to examine differences in risk among those with and without a lifetime history prior to a moderate magnitude earthquake that took place in Lorca (Murcia, Spain) at roughly the mid-point (on May 11, 2011) of the time interval in which a regional epidemiological survey was already being carried out (June 2010 –May 2012). Methods The PEGASUS-Murcia project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia. Main outcome measures are prevalence and severity of anxiety, mood, impulse and substance disorders in the 12 months previous to the survey, assessed using the Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic variables, prior history of any mental disorder and earthquake-related stressors were entered as independent variables in a logistic regression analysis. Findings A total number of 412 participants (response rate: 71%) were interviewed. Significant differences in 12-month prevalence of mental disorders were found in Lorca compared to the rest of Murcia for any (12.8% vs 16.8%), PTSD (3.6% vs 0.5%) and other anxiety disorders (5.3% vs 9.2%) (p≤ 0.05 for all). No differences were found for 12-month prevalence of any mood or any substance disorder. The two major predictors for developing a 12-month post-earthquake mental disorder were a prior mental disorder and the level of exposure. Other risk factors included female sex and low-average income. Conclusions PTSD and other mental disorders are commonly associated with earthquake disasters. Prior mental disorders and the level of exposure to the earthquakes are the most important for the development of a consequent mental disorder and this recognition may help to identify those individuals that may most benefit from specific therapeutic intervention. PMID:28723949

Impact of common mental disorders during childhood and adolescence on secondary school completion

PubMed Central

Myer, Landon; Stein, Dan J; Jackson, Pamela B; Herman, Allen A; Seedat, Soraya; Williams, David R

2011-01-01

There are few data from South Africa and other low- and middle-income countries on how mental disorders in childhood and adolescence may influence different aspects of socio-economic position, including educational attainment. We examined the association between early-onset disorders and subsequent educational achievement in a nationally representative sample of 4 351 South African adults. After adjusting for participant demographic characteristics and traumatic life events, post-traumatic stress disorder, major depressive disorder and substance-related disorders were each associated with increased odds of failing to complete secondary education (odds ratios and 95% confidence intervals 2.3, 1.0 – 5.1; 1.7, 1.2 – 2.5, and 1.7, 1.2 – 2.5, respectively). These data point to the role that early-life mental disorders may play in educational achievement and subsequent socio-economic position over the life course. PMID:19588798

[Mental disorders and female infertility].

PubMed

Schweiger, U; Wischmann, T; Strowitzki, T

2012-11-01

Approximately 5-10% of women in the reproductive years are affected by infertility which is associated with depression, anxiety and disturbed eating behavior. Part of this association can be explained by the emotional stress resulting from infertility. As mental disorders, such as depressive disorder or eating disorders are also prospectively associated with infertility, a bidirectional relationship is assumed. A special relationship exists between mental disorders and the main causes of ovulatory infertility, hypothalamic amenorrhea and polycystic ovary disease. The results of pilot studies support the assumption that psychotherapy may constitute an important component of the treatment of infertility.

Attitudes towards mental health, mental health research and digital interventions by young adults with type 1 diabetes: A qualitative analysis.

PubMed

Clarke, Janine; Proudfoot, Judy; Vatiliotis, Veronica; Verge, Charles; Holmes-Walker, Deborah J; Campbell, Lesley; Wilhelm, Kay; Moravac, Catherine; Indu, Pillaveetil S; Bridgett, Madeleine

2018-06-01

Young people with type 1 diabetes are at increased risk of mental disorders. Whereas treatment need is high, difficulty recruiting young people with type 1 diabetes into psychosocial studies complicates development, testing and dissemination of these interventions. Interviews with young adults with type 1 diabetes were conducted to examine attitudes towards mental health and mental health research, including barriers and motivators to participation in mental health studies and preferred sources of mental health support. The interviews were audio-taped, transcribed and evaluated via thematic analysis. Young adults with type 1 diabetes were recruited via social media channels of 3 advocacy organizations. A total of 31 young adults (26 females and 5 males) with an average age of 22 years were interviewed between October 2015 and January 2016. Participants were largely unaware of their increased vulnerability to common mental health problems and knew little about mental health research. Major barriers to participation included perceived stigma and lifestyle issues and low levels of trust in researchers. Opportunities to connect with peers and help others were described as key motivators. Psychological distress was considered normal within the context of diabetes. A need for some level of human contact in receiving psychosocial support was expressed. Findings provide valuable insights into the complex dynamics of engaging young adults with type 1 diabetes in mental health studies. Interviewees provided practical suggestions to assist investigation and delivery of psychosocial interventions for this vulnerable group. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Stressors and common mental disorder in informal carers--an analysis of the English Adult Psychiatric Morbidity Survey 2007.

PubMed

Stansfeld, Stephen; Smuk, Melanie; Onwumere, Juliana; Clark, Charlotte; Pike, Cleo; McManus, Sally; Harris, Jenny; Bebbington, Paul

2014-11-01

This study investigates potential explanations of the association between caring and common mental disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring--such as domestic violence and debt--and if so whether this explains their elevated rates of mental disorder. We analysed differences between carers and non-carers in common mental disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR=1.64 95% CI 1.37-1.97), suicidal thoughts in the last week (OR=2.71 95% CI 1.31-5.62) and fatigue (OR=1.33 95% CI 1.14-1.54) was increased in carers. However, caring remained independently associated with CMD (OR=1.58 1.30-1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Co-occurring mental illness and health care utilization and expenditures in adults with obesity and chronic physical illness.

PubMed

Shen, Chan; Sambamoorthi, Usha; Rust, George

2008-06-01

The objectives of the study were to compare health care expenditures between adults with and without mental illness among individuals with obesity and chronic physical illness. We performed a cross-sectional analysis of 2440 adults (older than age 21) with obesity using a nationally representative survey of households, the Medical Expenditure Panel Survey. Chronic physical illness consisted of self-reported asthma, diabetes, heart disease, hypertension, or osteoarthritis. Mental illness included affective disorders; anxiety, somatoform, dissociative, personality disorders; and schizophrenia. Utilization and expenditures by type of service (total, inpatient, outpatient, emergency room, pharmacy, and other) were the dependent variables. Chi-square tests, logistic regression on likelihood of use, and ordinary least squares regression on logged expenditures among users were performed. All regressions controlled for gender, race/ethnicity, age, martial status, region, education, employment, poverty status, health insurance, smoking, and exercise. All analyses accounted for the complex design of the survey. We found that 25% of adults with obesity and physical illness had a mental illness. The average total expenditures for obese adults with physical illness and mental illness were $9897; average expenditures were $6584 for those with physical illness only. Mean pharmacy expenditures for obese adults with physical illness and mental illness and for those with physical illness only were $3343 and $1756, respectively. After controlling for all independent variables, among adults with obesity and physical illness, those with mental illness were more likely to use emergency services and had higher total, outpatient, and pharmaceutical expenditures than those without mental illness. Among individuals with obesity and chronic physical illness, expenditures increased when mental illness is added. Our study findings suggest cost-savings efforts should examine the reasons for

Mental disorders and employment status in the São Paulo Metropolitan Area, Brazil: gender differences and use of health services.

PubMed

França, Mariane Henriques; Barreto, Sandhi Maria; Pereira, Flavia Garcia; Andrade, Laura Helena Silveira Guerra de; Paiva, Maria Cristina Alochio de; Viana, Maria Carmen

2017-10-09

Mental disorders are associated with employment status as significant predictors and as consequences of unemployment and early retirement. This study describes the estimates and associations of 12-month DSM-IV prevalence rates of mental disorders and use of health services with employment status by gender in the São Paulo Metropolitan Area, Brazil. Data from the São Paulo Megacity Mental Health Survey was analyzed (n = 5,037). This is a population-based study assessing the prevalence and determinants of mental disorders among adults, using the Composite International Diagnostic Interview. The associations were estimated by odds ratios obtained through binomial and multinomial logistic regression. This study demonstrates that having mental disorders, especially mood disorders, is associated with being inactive or unemployed among men and inactive among women, but only having a substance use disorder is associated with being unemployed among women. Among those with mental disorders, seeking health care services is less frequent within unemployed.

Clinical Study of the Effects of Age on the Physical Health of Adults with Mental Retardation.

ERIC Educational Resources Information Center

Cooper, Sally-Ann

1998-01-01

Physical disorders and pharmacotherapy for 134 people with mental retardation (ages 65 years and older) living in the United Kingdom were compared to 73 younger adults with mental retardation. Results showed the older group had higher rates of urinary incontinence, immobility, hearing impairments, arthritis, hypertension, and cerebrovascular…

Food insecurity and mental health problems among a community sample of young adults.

PubMed

Pryor, Laura; Lioret, Sandrine; van der Waerden, Judith; Fombonne, Éric; Falissard, Bruno; Melchior, Maria

2016-08-01

Food insecurity has been found to be related to anxiety and depression; however, the association with other psychiatric disorders, particularly among young adults, is not well known. We examined whether food insecurity is independently associated with four common mental health problems among a community sample of young adults in France. Data are from the TEMPO longitudinal cohort study. In 1991, participants' parents provided information on health and family socioeconomic characteristics. In 2011, participants' (18-35 years) reported food insecurity, mental health symptoms, and socioeconomic conditions (n = 1214). Mental health problems ascertained included major depressive episode, suicidal ideation, attention deficit and hyperactivity disorder, and substance abuse and/or dependence (nicotine, alcohol and cannabis). Cross-sectional associations between food insecurity and mental health problems were tested using modified Poisson regressions, weighted by inverse probability weights (IPW) of exposure. This makes food insecure and not food insecure participants comparable on all characteristics including socioeconomic factors and past mental health problems. 8.5 % of young adults were food insecure. In IPW-controlled analyses, food insecurity was associated with increased levels of depression (RR = 2.01, 95 % CI 1.01-4.02), suicidal ideation (RR = 3.23, 95 % CI 1.55-6.75) and substance use problems (RR = 1.68, 95 % CI 1.15-2.46). Food insecurity co-occurs with depression, suicidal ideation and substance use problems in young adulthood. Our findings suggest that reductions in food insecurity during this important life period may help prevent mental health problems. Policies aiming to alleviate food insecurity should also address individuals' psychiatric problems, to prevent a lifelong vicious circle of poor mental health and low socioeconomic attainment.

The effect of social networks and social support on common mental disorders following specific life events.

PubMed

Maulik, P K; Eaton, W W; Bradshaw, C P

2010-08-01

This study examined the association between life events and common mental disorders while accounting for social networks and social supports. Participants included 1920 adults in the Baltimore Epidemiologic Catchment Area Cohort who were interviewed in 1993-1996, of whom 1071 were re-interviewed in 2004-2005. Generalized estimating equations were used to analyze the data. Social support from friends, spouse or relatives was associated with significantly reduced odds of panic disorder and psychological distress, after experiencing specific life events. Social networks or social support had no significant stress-buffering effect. Social networks and social support had almost no direct or buffering effect on major depressive disorder, and no effect on generalized anxiety disorder and alcohol abuse or dependence disorder. The significant association between social support and psychological distress, rather than diagnosable mental disorders, highlights the importance of social support, especially when the severity of a mental health related problem is low.

Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders.

PubMed

Muroff, Jordana; Robinson, Winslow; Chassler, Deborah; López, Luz M; Gaitan, Erika; Lundgren, Lena; Guauque, Claudia; Dargon-Hart, Susan; Stewart, Emily; Dejesus, Diliana; Johnson, Kimberly; Pe-Romashko, Klaren; Gustafson, David H

2017-01-01

Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. The evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to

Neurocognitive impairment in a large sample of homeless adults with mental illness.

PubMed

Stergiopoulos, V; Cusi, A; Bekele, T; Skosireva, A; Latimer, E; Schütz, C; Fernando, I; Rourke, S B

2015-04-01

This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. A total of 1500 homeless adults with mental illness enrolled in the At Home Chez Soi study completed neuropsychological measures assessing speed of information processing, memory, and executive functioning. Sociodemographic and clinical data were also collected. Linear regression analyses were conducted to examine factors associated with neurocognitive performance. Approximately half of our sample met criteria for psychosis, major depressive disorder, and alcohol or substance use disorder, and nearly half had experienced severe traumatic brain injury. Overall, 72% of participants demonstrated cognitive impairment, including deficits in processing speed (48%), verbal learning (71%) and recall (67%), and executive functioning (38%). The overall statistical model explained 19.8% of the variance in the neurocognitive summary score, with reduced neurocognitive performance associated with older age, lower education, first language other than English or French, Black or Other ethnicity, and the presence of psychosis. Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Poverty and common mental disorders in developing countries.

PubMed

Patel, Vikram; Kleinman, Arthur

2003-01-01

A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.

Poverty and common mental disorders in developing countries.

PubMed Central

Patel, Vikram; Kleinman, Arthur

2003-01-01

A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment. PMID:14576893

Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders.

PubMed

Wahlbeck, Kristian; Westman, Jeanette; Nordentoft, Merete; Gissler, Mika; Laursen, Thomas Munk

2011-12-01

People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision. To evaluate trends in health outcomes of people with serious mental disorders. We examined nationwide 5-year consecutive cohorts of people admitted to hospital for mental disorders in Denmark, Finland and Sweden in 1987-2006. In each country the risk population was identified from hospital discharge registers and mortality data were retrieved from cause-of-death registers. The main outcome measure was life expectancy at age 15 years. People admitted to hospital for a mental disorder had a two- to threefold higher mortality than the general population in all three countries studied. This gap in life expectancy was more pronounced for men than for women. The gap decreased between 1987 and 2006 in these countries, especially for women. The notable exception was Swedish men with mental disorders. In spite of the positive general trend, men with mental disorders still live 20 years less, and women 15 years less, than the general population. During the era of deinstitutionalisation the life expectancy gap for people with mental disorders has somewhat diminished in the three Nordic countries. Our results support further development of the Nordic welfare state model, i.e. tax-funded community-based public services and social protection. Health promotion actions, improved access to healthcare and prevention of suicides and violence are needed to further reduce the life expectancy gap.

Predictors of young adults' amphetamine use and disorders: a prospective study.

PubMed

Hayatbakhsh, Mohammad R; Najman, Jake M; Bor, William; Williams, Gail M

2009-05-01

Understanding the risk factors that predict amphetamine use and development of amphetamine abuse or dependence (disorder) may help guide preventive interventions. This study aimed to investigate the correlates and predictors of young adults' amphetamine use and use disorders. Prospective cohort, population-based study which started in Brisbane, South East Queensland (Australia) in 1981. The study participants were a cohort of 2042 young adults, followed up from birth to young adulthood. At the 21-year follow-up, amphetamine use was assessed via a self-report questionnaire, and amphetamine use disorder (AUD) was assessed using the Composite International Diagnostic Interview (CIDI-Auto). Potential predictors (15 risk factors) were assessed between baseline (antenatal visit) and the 21-year follow-up. These included participant's gender, mother's age and education, maternal marital status and quality of marital relationship, maternal tobacco and alcohol consumption, mother-child communication, child mental health and problem behaviours, child smoking and alcohol consumption and child school performance. Young adult amphetamine users were more likely to have concurrent symptoms of mental illness and problem behaviours and to use or abuse cigarettes, cannabis, or other illicit drugs. In multivariate analyses, young adults' amphetamine use and disorder were disproportionately more common among males and those who have prospectively reported aggression/delinquency or smoking at 14 years, or who have experienced childhood sexual abuse. Our findings suggest that problem behaviours, smoking and childhood sexual abuse are predictors of initiation to use of amphetamines and development of amphetamine abuse and dependence.

Childhood adversity and adult depressive disorder: a case-controlled study in Malaysia.

PubMed

Loh, S F; Maniam, T; Tan, S M K; Badi'ah, Y

2010-06-01

To describe the association between childhood adversity and depression in adult depressed patients in a Malaysian population. Fifty-two patients, who met the criteria for major depressive disorder or dysthymia according to the Structured Clinical Interview based on the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders, were used as cases and compared with 52 controls matched for age and sex. Cases and controls were assessed using a sexual and physical abuse questionnaire and a Parental Bonding Instrument. There was a positive relationship between childhood abuse in general and childhood physical abuse with adult depressive disorder in particular. Nearly a quarter (23%) of depressed patients reported being abused in childhood compared with none in the control group. There was no significant association between childhood loss and depression in adulthood. Low level of parental care during childhood was significantly correlated with adult depressive disorder. Clinicians should assiduously seek a history of childhood adversities in adult patients with depression. This information can influence clinical management by way of implementing secondary preventive measures. In all depressed patients, mental health professionals also need to look out for their poor attachment with parents during childhood. This may enable interventions directed at parenting skills and improved attachment relationships with their own children. These types of interventions together with pharmacotherapy may provide the optimal approach to the management of depression in adults and help prevent the cycle of depression perpetuating itself in the next generation.

Associations between DSM-IV mental disorders and subsequent COPD diagnosis.

PubMed

Rapsey, Charlene M; Lim, Carmen C W; Al-Hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas-de-Almeida, J M; Florescu, Silvia; de Girolamo, Giovanni; Hu, Chiyi; Kessler, Ronald C; Kovess-Masfety, Viviane; Levinson, Daphna; Medina-Mora, María Elena; Murphy, Sam; Ono, Yutaka; Piazza, Maria; Posada-Villa, Jose; ten Have, Margreet; Wojtyniak, Bogdan; Scott, Kate M

2015-11-01

COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders. Data were collected using population surveys of 19 countries (n=52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis. COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5-3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7-3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6-1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime. Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs. Copyright © 2015 Elsevier Inc. All rights reserved.

Associations between DSM-IV mental disorders and subsequent COPD diagnosis

PubMed Central

Rapsey, Charlene M.; Lim, Carmen C.W.; Al-Hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas-de-Almeida, J.M.; Florescu, Silvia; de Girolamo, Giovanni; Hu, Chiyi; Kessler, Ronald C.; Kovess-Masfety, Viviane; Levinson, Daphna; Elena Medina-Mora, María; Murphy, Sam; Ono, Yutaka; Piazza, Maria; Posada-Villa, Jose; ten Have, Margreet; Wojtyniak, Bogdan; Scott, Kate M.

2016-01-01

Objectives COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders. Methods Data were collected using population surveys of 19 countries (n = 52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis. Results COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5–3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7–3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6–1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime. Conclusions: Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs. PMID:26526305

Narcissistic Personality Disorder and the Structure of Common Mental Disorders.

PubMed

Eaton, Nicholas R; Rodriguez-Seijas, Craig; Krueger, Robert F; Campbell, W Keith; Grant, Bridget F; Hasin, Deborah S

2017-08-01

Narcissistic personality disorder (NPD) shows high rates of comorbidity with mood, anxiety, substance use, and other personality disorders. Previous bivariate comorbidity investigations have left NPD multivariate comorbidity patterns poorly understood. Structural psychopathology research suggests that two transdiagnostic factors, internalizing (with distress and fear subfactors) and externalizing, account for comorbidity among common mental disorders. NPD has rarely been evaluated within this framework, with studies producing equivocal results. We investigated how NPD related to other mental disorders in the internalizing-externalizing model using diagnoses from a nationally representative sample (N = 34,653). NPD was best conceptualized as a distress disorder. NPD variance accounted for by transdiagnostic factors was modest, suggesting its variance is largely unique in the context of other common mental disorders. Results clarify NPD multivariate comorbidity, suggest avenues for classification and clinical endeavors, and highlight the need to understand vulnerable and grandiose narcissism subtypes' comorbidity patterns and structural relations.

[Perioperative disorders of mental functions].

PubMed

Tonković, Dinko; Adam, Visnja Nesek; Kovacević, Marko; Bogović, Tajana Zah; Drvar, Zeljko; Baronica, Robert

2012-03-01

Mental disorders are characterized by disturbances of thought, perception, affect and behavior, which occur as a result of brain damage. Recognizing and treating these conditions is necessary not only for psychiatrists but for all physicians. Disorder of mental function is one of the most common associated conditions in intensive care unit (ICU) patients. However, disturbances of mental function often remain unrecognized. In ICU patients, different types of mental function disorders may develop. They range from sleep disorders, severe depression, anxiety, posttraumatic stress disorder (PTSD) to cognitive disorders including delirium. The causes of mental dysfunction in ICU patients can be divided into environmental and medical. Cognitive disorders are related to mental processes such as learning ability, memory, perception and problem solving. Cognitive disorders are usually not prominent in the early postoperative period and in many cases are discovered after hospital discharge because of difficulties in performing everyday activities at home or at work. The etiology of postoperative cognitive impairment is unclear. Older age, previous presence of cognitive dysfunction, severity of disease, and polypharmacy with more than four drugs are some of the risk factors identified. Delirium is a multifactorial disorder. It is an acute confusional state characterized by alteration of consciousness with reduced ability to focus, sustain, or shift attention. It is considered as the most common form of mental distress in ICU patients. Nearly 30% of all hospitalized patients pass through deliriant phase during their hospital stay. Delirium can last for several days to several weeks. Almost always it ends with complete withdrawal of psychopathological symptoms. Sometimes it can evolve into a chronic brain syndrome (dementia). The causes are often multifactorial and require a number of measures to ease the symptoms. Delirious patient is at risk of complications of immobility and

Assessment of Generalized Anxiety Disorder Diagnostic Criteria in the National Comorbidity Survey and Virginia Adult Twin Study of Psychiatric and Substance Use Disorders

ERIC Educational Resources Information Center

Kubarych, Thomas S.; Aggen, Steven H.; Hettema, John M.; Kendler, Kenneth S.; Neale, Michael C.

2008-01-01

The authors investigated measurement properties of the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition," generalized anxiety disorder (GAD) criteria in the National Comorbidity Survey and the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD). The two studies used different widely used…

Prolonged internal displacement and common mental disorders in Sri Lanka: the COMRAID study.

PubMed

Siriwardhana, Chesmal; Adikari, Anushka; Pannala, Gayani; Siribaddana, Sisira; Abas, Melanie; Sumathipala, Athula; Stewart, Robert

2013-01-01

Evidence is lacking on the mental health issues of internally displaced persons, particularly where displacement is prolonged. The COMRAID study was carried out in year 2011 as a comprehensive evaluation of Muslims in North-Western Sri Lanka who had been displaced since 1990 due to conflict, to investigate the prevalence and correlates of common mental disorders. A cross-sectional survey was carried out among a randomly selected sample of internally displaced people who had migrated within last 20 years or were born in displacement. The total sample consisted of 450 adults aged 18-65 years selected from 141 settlements. Common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) prevalences were measured using the Patient Health Questionnaire and CIDI sub-scale respectively. The prevalence of any CMD was 18.8%, and prevalence for subtypes was as follows: somatoform disorder 14.0%, anxiety disorder 1.3%, major depression 5.1%, other depressive syndromes 7.3%. PTSD prevalence was 2.4%. The following factors were significantly associated with CMDs: unemployment (odds ratio 2.8, 95% confidence interval 1.6-4.9), widowed or divorced status (4.9, 2.3-10.1) and food insecurity (1.7, 1.0-2.9). This is the first study investigating the mental health impact of prolonged forced displacement in post-conflict Sri Lanka. Findings add new insight in to mental health issues faced by internally displaced persons in Sri Lanka and globally, highlighting the need to explore broader mental health issues of vulnerable populations affected by forced displacement.

Shared reality of the abusive and the vulnerable: the experience of aging for parents living with abusive adult children coping with mental disorder.

PubMed

Band-Winterstein, Tova; Smeloy, Yael; Avieli, Hila

2014-11-01

Increasing numbers of aging parents are finding themselves in the role of caregiver for their mentally ill adult child due to global deinstitutionalization policy. The aim of this paper is to describe the daily aging experience of parents abused by an adult child with mental disorder and the challenges confronting them in this shared reality. Data collection was performed through in-depth semi-structured interviews with 16 parents, followed by content analysis. Three major themes emerged: (a) old age as a platform for parent's vulnerability facing ongoing abuse; (b) "whose needs come first?" in a shared reality of abusive and vulnerable protagonists; (c) changes in relationship dynamics. Old age becomes an arena for redefined relationships combining increased vulnerability, needs of both sides, and its impact on the well-being of the aging parents. This calls for better insights and deeper understanding in regard to intervention with such families.

Temporal comorbidity of mental disorder and ulcerative colitis.

PubMed

Cawthorpe, David; Davidson, Marta

2015-01-01

Ulcerative colitis is an inflammatory bowel disease that rarely exists in isolation in affected patients. We examined the association of ulcerative colitis and International Classification of Diseases mental disorder, as well as the temporal comorbidity of three broad International Classification of Diseases groupings of mental disorders in patients with ulcerative colitis to determine if mental disorder is more likely to occur before or after ulcerative colitis. We used physician diagnoses from the regional health zone of Calgary, Alberta, for patient visits from fiscal years 1994 to 2009 for treatment of any presenting concern in that Calgary health zone (763,449 patients) to identify 5113 patients age younger than 1 year to age 92 years (2120 males, average age = 47 years; 2993 females, average age = 48 years) with a diagnosis of ulcerative colitis. The 16-year cumulative prevalence of ulcerative colitis was 0.0058%, or 58 cases per 10,000 persons (95% confidence interval = 56-60 per 10,000). Although the cumulative prevalence of mental disorder in the overall sample was 5390 per 10,000 (53.9%), we found that 4192 patients with ulcerative colitis (82%) also had a diagnosis of a mental disorder. By annual rate of ulcerative colitis, patients with mental disorder had a significantly higher annual prevalence. The mental disorder grouping neuroses/depressive disorders was most likely to arise before ulcerative colitis (odds ratio = 1.87 for males; 2.24 for females). A temporal association was observed between specific groups of International Classification of Diseases mental disorder and ulcerative colitis, indicating a possible etiologic relationship between the disorders or their treatments, or both.

HIV Risk, Substance Use, and Personality Characteristics among Adults with History of Serious Mental Illness.

PubMed

Mainville, Cathryn H; Richardson, Mark A; Brady, Stephen M; Berger-Greenstein, Jori; Bacic, Janine

2017-01-01

The present study examined the relationship between characteristics associated with personality disorders, substance use, and HIV risk among adults with a history of serious mental illness. Participants included 103 adults with antisocial or borderline personality disorder, serious mental illness, and recent HIV risk behavior. The sample was predominately male (64%), diverse (42% African American and 13% Hispanic), and homeless/marginally housed (76%). In order to examine the relationship between personality characteristics and risk we constructed a risk index comprising key symptoms of antisocial and borderline personality disorders, namely; impulsivity, affective instability, and disregard for safety of self/others. Contrary to our primary hypotheses, risk index scores did not predict HIV risk behavior and substance abuse did not mediate this risk. Exploratory analyses did reveal that women engaged in significantly more risk behaviors than their male counterparts and that risk scores were a significant predictor of total sex acts for women but not men. In addition, increased emotional dysregulation was a significant predictor of condomless sex acts for women but not men. Finally, recent alcohol use and increased impulsivity was associated with more condomless oral sex for men and women. These results suggest the relationship among serious mental illness, personality disorder, substance abuse, and gender is complex and merits further study.

Association between personality traits and mental health outcomes in older adults with lifetime trauma exposure: a nationwide community sample.

PubMed

Park, Jee Eun; Suk, Hye Won; Seong, Su Jeong; Sohn, Ji Hoon; Hahm, Bong-Jin; Lee, Dong-Woo; Cho, Maeng Je

2016-09-01

This study evaluated the impacts of earlier traumatic events on the mental health of older adults, in terms of mental disorders and mental well-being, according to sociodemographic variables, trauma-related characteristics, and personality traits in a nationally representative sample of older Koreans. A total of 1,621 subjects aged 60 to 74 years from a Korean national epidemiological survey of mental disorders responded face-to-face interviews. The Korean Composite International Diagnostic Interview was used to investigate lifetime trauma exposure (LTE) and psychiatric diagnoses. The EuroQol health classification system and life satisfaction scale were used to assess quality of life (QoL), and the Big Five Inventory-10 (BFI-10) to measure personality traits. Five-hundred and seventy-seven subjects (35.6%) reported a history of LTE (mean age at trauma, 30.8 years old). Current mental disorders were more prevalent in elderly people with LTE, while better current QoL was more frequent in those without LTE. Among older people with LTE, lower extraversion and higher neuroticism increased the risk of current mood or anxiety disorders, whereas higher extraversion increased the probability of experiencing mental well-being after adjusting for sociodemographic and trauma-related variables. Personality traits, especially extraversion, and neuroticism, may be useful for predicting the mental health outcomes of LTE in older adults. Further longitudinal studies investigating the relationship between traumatic events and mental health outcomes are needed.

[image omitted] Review of five instruments for the assessment of Asperger's Disorder in adults.

PubMed

Stoesz, Brenda M; Montgomery, Janine M; Smart, Sherri L; Hellsten, Laurie-Ann M

2011-04-01

Due to the recent inclusion of Asperger's Disorder (AD) in the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) and the International Classification of Diseases (WHO, 1993), concerns regarding diagnosis of AD, particularly in adults, are emerging. Many existing instruments used to assess Pervasive Developmental Disorder are more appropriate for identifying Autistic Disorder (AU) in children, and their usefulness for assessing AD in adults is questionable. We describe and critically review five instruments created specifically for identifying AD in adults. Overall, the normative information provided is limited and evidence of the reliability and validity for each instrument is relatively poor. Further research and development is required before we would recommend one instrument over another for the assessment of AD in adults.

Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders.

PubMed

Raposo, Sarah M; Mackenzie, Corey S; Henriksen, Christine A; Afifi, Tracie O

2014-11-01

We aimed to examine the prevalence of several types of childhood adversity across adult cohorts, whether age moderates the effect of childhood adversity on mental health, the relationship between childhood adversity and psychopathology among older adults, the dose-response relationship between number of types of childhood adversities and mental disorders in later life, and whether lifetime mental health treatment reduces the odds of psychopathology among older survivors of childhood adversity. In a population-based, cross-sectional study on a nationally representative U.S. sample, we studied 34,653 community-dwelling Americans 20 years and older, including 7,080 adults 65 years and older from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Trained lay interviewers assessed past-year mood and anxiety disorders and lifetime personality disorders. Participants self-reported childhood adversity based on questions from the Adverse Childhood Experiences Study. Childhood adversity was prevalent across five age cohorts. In our adjusted models, age did not moderate the effect of childhood adversity on mental disorders. Older adults who experienced childhood adversity had higher odds of having mood (odds ratio: 1.73; 95% confidence interval: 1.32-2.28), anxiety (odds ratio: 1.48; 95% confidence interval: 1.20-1.83), and personality disorders (odds ratio: 2.11; 95% confidence interval: 1.75-2.54) after adjusting for covariates. An increasing number of types of childhood adversities was associated with higher odds of personality disorders and somewhat higher odds of anxiety disorders. Treatment-seeking was associated with a reduced likelihood of anxiety and, especially, mood disorders in older adult childhood adversity survivors. These results emphasize the importance of preventing childhood adversity and intervening once it occurs to avoid the negative mental health effects that can last into old age. Copyright © 2014 American Association for

IRRITABLE MOOD IN ADULT MAJOR DEPRESSIVE DISORDER: RESULTS FROM THE WORLD MENTAL HEALTH SURVEYS

PubMed Central

Kovess-Masfety, Viviane; Alonso, Jordi; Angermeyer, Matthias; Bromet, Evelyn; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia E.; Gruber, Michael J.; Gureje, Oye; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Jin, Robert; Lépine, Jean-Pierre; Levinson, Daphna; McLaughlin, Katie A.; Medina-Mora, María E.; O’Neill, Siobhan; Ono, Yutaka; Posada-Villa, José A.; Sampson, Nancy A.; Scott, Kate M.; Shahly, Victoria; Stein, Dan J.; Viana, Maria C.; Zarkov, Zahari; Kessler, Ronald C.

2014-01-01

Background Although irritability is a core symptom of DSM-IV major depressive disorder (MDD) for youth but not adults, clinical studies find comparable rates of irritability between nonbipolar depressed adults and youth. Including irritability as a core symptom of adult MDD would allow detection of depression-equivalent syndromes with primary irritability hypothesized to be more common among males than females. We carried out a preliminary examination of this issue using cross-national community-based survey data from 21 countries in the World Mental Health (WMH) Surveys (n = 110,729). Methods The assessment of MDD in the WHO Composite International Diagnostic Interview includes one question about persistent irritability. We examined two expansions of the definition of MDD involving this question: (1) cases with dysphoria and/or anhedonia and exactly four of nine Criterion A symptoms plus irritability; and (2) cases with two or more weeks of irritability plus four or more other Criterion A MDD symptoms in the absence of dysphoria or anhedonia. Results Adding irritability as a tenth Criterion A symptom increased lifetime prevalence by 0.4% (from 11.2 to 11.6%). Adding episodes of persistent irritability increased prevalence by an additional 0.2%. Proportional prevalence increases were significantly higher, but nonetheless small, among males compared to females. Rates of severe role impairment were significantly lower among respondents with this irritable depression who did not meet conventional DSM-IV criteria than those with DSM-IV MDD. Conclusion Although limited by the superficial assessment in this single question on irritability, results do not support expanding adult MDD criteria to include irritable mood. PMID:23364997

Multidisciplinary Treatment for Adults with Autism Spectrum Disorder and Co-Occurring Mental Health Disorders: Adapting Clinical Research Tools to Everyday Clinical Practice

ERIC Educational Resources Information Center

Battaglia, Maurizio; Detrick, Susan; Fernandez, Anna

2016-01-01

In California, individuals with autism and co-occurring mental disorders, and their families, face two serious barriers when attempting to access the mental health services they need. The first is that the State Mental Health Specialty Service guidelines specifically exclude autism as a qualifying primary diagnosis for eligibility for mental…

Substance use and mental health disorders are linked to different forms of intimate partner violence victimisation.

PubMed

Salom, Caroline L; Williams, Gail M; Najman, Jakob M; Alati, Rosa

2015-06-01

Substance and mental health disorders convey significant health burdens and impair interpersonal relationships. We tested associations between comorbid substance and mental health disorders and different forms of intimate partner violence (IPV) experienced by young adults. Mothers (n = 6703) were recruited during pregnancy to the longitudinal Mater-University of Queensland Study of Pregnancy. Mother/offspring dyads were followed up from birth to 21 years. Offspring with complete psychiatric data at 21 years who reported having had an intimate partnership were included (n = 1781). Participants' experiences of psychological, physical and severe combined IPV were assessed at 21 years using a summarised form of the Composite Abuse Scale. We used the Composite International Diagnostic Interview to obtain lifetime diagnoses of mental health and substance disorders. Multivariable logistic regression models of each IPV form were adjusted for individual, family and neighbourhood factors during adolescence, and for other forms of IPV. We have shown specific links between different forms of IPV experienced and individual substance and mental health disorders. Mental health disorders were related to all three forms of IPV, while alcohol disorders were linked to psychological IPV (ORAUD = 1.86; 1.21-2.86) and illicit substance disorders to physical IPV (ORSUD = 2.07; 1.25-3.43). The co-occurrence of related disorders was strongly linked to psychological and physical IPV. Intimate partner violence was experienced by both men and women. Substance and mental health disorders were associated with specific forms of IPV victimisation, suggesting that screening IPV clients and mental health/substance disorder patients for the converse problems may be important for intervention planning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A multinational study of mental disorders, marriage, and divorce.

PubMed

Breslau, J; Miller, E; Jin, R; Sampson, N A; Alonso, J; Andrade, L H; Bromet, E J; de Girolamo, G; Demyttenaere, K; Fayyad, J; Fukao, A; Gălăon, M; Gureje, O; He, Y; Hinkov, H R; Hu, C; Kovess-Masfety, V; Matschinger, H; Medina-Mora, M E; Ormel, J; Posada-Villa, J; Sagar, R; Scott, K M; Kessler, R C

2011-12-01

Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46,128) and age at first divorce in a subset of 12 countries (n = 30,729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. © 2011 John Wiley & Sons A/S.

A multinational study of mental disorders, marriage, and divorce

PubMed Central

Breslau, J.; Miller, E.; Jin, R.; Sampson, N. A.; Alonso, J.; Andrade, L. H.; Bromet, E. J.; de Girolamo, G.; Demyttenaere, K.; Fayyad, J.; Fukao, A.; Gălăon, M.; Gureje, O.; He, Y.; Hinkov, H. R.; Hu, C.; Kovess-Masfety, V.; Matschinger, H.; Medina-Mora, M. E.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K. M.; Kessler, R. C.

2014-01-01

Objective Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Method Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46 128) and age at first divorce in a subset of 12 countries (n = 30 729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Results Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. Conclusion This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. PMID:21534936

Mental Health Disorder Therapeutic Modalities Modified for the GMS.

PubMed

Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

2017-12-01

Mental health disorders can affect physical and psychological behaviors. The people of the Greater Mekong Subregion (GMS) have a high risk of mental health disorders, such as depression, stress, and substance abuse be-cause the people in this region are trafficked for forced sex work and various forms of forced labor. In these situations, vic-tims often endure violence and abuse from trafficking recruiters, employers, and other individuals. The purposes of this study were to identify the elements characterizing mental health disorders, especially in terms of depression, stress, and sub-stance abuse, and to identify the treatment modalities for mental health disorders in the GMS. The researcher undertook a comparative analysis of the literature, reviews of epidemiological studies and mental disorder therapies, and overviews of previous research studies, were used to generate a synthesis of the existing knowledge of the mental disorder therapeutic modalities. Regarding the search methods, the data from the electronic databases PubMed, PsycINFO, Dynamed and ScienceDirect were supplemented with a manual reference search covering relevant studies from 2005 to 2016. Thirty-one papers were included in the review of elements characterizing mental health disorders, especially in terms of depression, stress, and substance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Nine papers defined characterizing mental health disorders, in terms of depression, stress, and substance abuse. Twenty-two papers showed the treatment modalities for mental health disorders that the treatment was effective, these in-cluded pharmacological treatments and psychological treatments, such as mindfulness-based cognitive therapy, biofeedback, and music therapy. Useful guidance can be provided for the prevention and treatment of mental health disorders, and for the care of people in the Greater Mekong Subregion. The finding of this review confirms the

The cross-national structure of mental disorders: results from the World Mental Health Surveys.

PubMed

de Jonge, Peter; Wardenaar, Klaas J; Lim, Carmen C W; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Bunting, Brendan; Chatterji, Somnath; Ciutan, Marius; Gureje, Oye; Karam, Elie G; Lee, Sing; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C; Scott, Kate

2017-12-19

The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure. We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA). A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor. These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.

Executive functioning in older adults with hoarding disorder.

PubMed

Ayers, Catherine R; Wetherell, Julie Loebach; Schiehser, Dawn; Almklov, Erin; Golshan, Shahrokh; Saxena, Sanjaya

2013-11-01

Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear. The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy older adult comparison group (n = 25). We hypothesized that older adults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] ( Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]). Older adults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, older adults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group. Compared with demographically-matched controls, older adults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for older adults with HD. Copyright © 2013 John Wiley & Sons, Ltd.

Patterns of justice involvement among adults with schizophrenia and bipolar disorder: key risk factors.

PubMed

Robertson, Allison G; Swanson, Jeffrey W; Frisman, Linda K; Lin, Hsiuju; Swartz, Marvin S

2014-07-01

Adults with serious mental illness have a relatively high risk of criminal justice involvement. Some risk factors for justice involvement are known, but the specific interaction of these risk factors has not been examined. This study explored the interaction of gender, substance use disorder, and psychiatric diagnosis among patients with schizophrenia or bipolar disorder to identify subgroups at higher risk of justice involvement. Administrative service records of 25,133 adults with schizophrenia or bipolar disorder who were clients of Connecticut's public behavioral health system during 2005-2007 were merged with state records of criminal convictions, incarceration, and other measures of justice involvement. The main effects and the effects of interactions of gender, substance use disorder, and psychiatric diagnosis on risk of justice involvement ("offending") were estimated by using multivariable logistic regression. Men with bipolar disorder and co-occurring substance use disorder had the highest absolute risk of offending in every category of justice involvement. For both men and women, bipolar disorder was associated with an increased risk of offending versus schizophrenia, but the increase was significantly greater for women. Substance use disorder also increased risk of offending more among women than men, especially among those with schizophrenia. Men and women with bipolar disorder and substance use disorders have much higher risk of justice involvement than those with schizophrenia, especially those without a substance use disorder. Research is needed to validate these effects in other populations and specify risk factors for justice involvement among adults with mental illness.

Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

PubMed

Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

2016-05-01

Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

[Facts visualized through job support activities for mentally disordered persons--what is the objective of medical treatment for mental disorder?].

PubMed

Tagawa, Seiji

2014-01-01

According to a recent investigation by the Public Employment Security Office, the rate of employing mentally disordered persons is increasing. In the report, it was predicted that the number of employed mentally disordered persons will exceed the number of physically disordered persons within a few years, and will become the highest of the main three disabled types. Despite the strong desire of mentally disordered persons to work, supporting systems have been inadequate. In 2007, mental clinic doctors in Osaka took the lead and established the NPO Osaka Job Support Network for Mentally Disordered Persons (JSN) to support their employment persons. We aimed to establish a support system for mentally disordered persons who have a strong will to work, stating "I would like to work" to their family doctors, who introduce JSN to the patients, and then the family doctors and JSN cooperate to support the patients to realize the desire to "work". Since April 2013, 49 persons have found a job and "graduated" from JSN. Over 6 years until the end of March, 2013, a total of 154 persons found jobs and "graduated" from JSN. From now on, it is expected that around 50 persons will find jobs and "graduate" from JSN every year. It is definitely insufficient just to repeat "temporary" medical treatment for mental disorders with a long course like schizophrenia. A care management view that values the hopes and dreams of patients is required in psychiatric treatment.

Impact of different approaches of primary care mental health on the prevalence of mental disorders.

PubMed

Moscovici, Leonardo; de Azevedo-Marques, Joao Mazzoncini; Bolsoni, Lívia Maria; Rodrigues-Junior, Antonio Luiz; Zuardi, Antonio Waldo

2018-05-01

AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

Lifetime Prevalence of Mental Disorders in Lebanon: First Onset, Treatment, and Exposure to War

PubMed Central

Karam, Elie G; Mneimneh, Zeina N; Dimassi, Hani; Fayyad, John A; Karam, Aimee N; Nasser, Soumana C; Chatterji, Somnath; Kessler, Ronald C

2008-01-01

Background There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset of mental disorders, and their relationship to war in Lebanon. Methods and Findings The Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation study was carried out on a nationally representative sample of the Lebanese population (n = 2,857 adults). Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) disorder was 25.8%. Anxiety (16.7%) and mood (12.6%) were more common than impulse control (4.4%) and substance (2.2%) disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays (6 to 28 y) between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.5–14.1), mood (OR 3.32, 95% CI 2.0–5.6), and impulse control disorders (OR 12.72, 95% CI 4.5–35.7). Conclusions About one-fourth of the sample (25.8%) met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders. PMID:18384228

[Vocational rehabilitation in mental disorders].

PubMed

Tuisku, Katinka; Juvonen-Posti, Pirjo; Härkäpää, Kristiina; Heilä, Hannele; Vainiemi, Kirsi; Ropponen, Tapio

2013-01-01

Supporting the working careers of patients having mental disorders is in the best interest of the individual, the community and the society. In mental disorders, recovery to be able to work is more challenging than in other disease groups. Vocational rehabilitation yields the best results when implemented early enough and in close association with work. Work trial and preparation for work are among the most common means of rehabilitation supporting mental patients' return to work. Collaboration with the workplace is needed when the work and working hours are adapted to the needs of the rehabilitee. Supported employment helps even the severely ill to be able to return to work.

Exposure to Interparental Conflict and Psychological Disorder among Young Adults

ERIC Educational Resources Information Center

Turner, Heather A.; Kopiec, Kathleen

2006-01-01

This article examines the effect of exposure to interparental conflict on the mental health of young adults. Based on a diverse sample of 649 students from three New England colleges, the authors investigate the association between nonviolent interparental conflict during childhood, subsequent distress and disorder, and identified factors that…

Annual Research Review: Hoarding Disorder-- Potential Benefits and Pitfalls of a New Mental Disorder

ERIC Educational Resources Information Center

Mataix-Cols, David; Pertusa, Alberto

2012-01-01

Background: The inclusion of a new mental disorder in the nomenclature is not a trivial matter. Many have highlighted the risks of an ever-increasing number of mental disorders and of overpathologizing human behaviour. Given the proposed inclusion of a new hoarding disorder (HD) in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders,…

Transdiagnostic Factors and Mediation of the Relationship Between Perceived Racial Discrimination and Mental Disorders.

PubMed

Rodriguez-Seijas, Craig; Stohl, Malki; Hasin, Deborah S; Eaton, Nicholas R

2015-07-01

Multivariable comorbidity research indicates that many common mental disorders are manifestations of 2 latent transdiagnostic factors, internalizing and externalizing. Environmental stressors are known to increase the risk for experiencing particular mental disorders, but their relationships with transdiagnostic disorder constructs are unknown. The present study investigated one such stressor, perceived racial discrimination, which is robustly associated with a variety of mental disorders. To examine the direct and indirect associations between perceived racial discrimination and common forms of psychopathology. Quantitative analysis of 12 common diagnoses that were previously assessed in a nationally representative sample (N = 5191) of African American and Afro-Caribbean adults in the United States, taken from the National Survey of American Life, and used to test the possibility that transdiagnostic factors mediate the effects of discrimination on disorders. The data were obtained from February 2001 to March 2003. Latent variable measurement models, including factor analysis, and indirect effect models were used in the study. Mental health diagnoses from reliable and valid structured interviews and perceived race-based discrimination. While perceived discrimination was positively associated with all examined forms of psychopathology and substance use disorders, latent variable indirect effects modeling revealed that almost all of these associations were significantly mediated by the transdiagnostic factors. For social anxiety disorder and attention-deficit/hyperactivity disorder, complete mediation was found. The pathways linking perceived discrimination to psychiatric disorders were not direct but indirect (via transdiagnostic factors). Therefore, perceived discrimination may be associated with risk for myriad psychiatric disorders due to its association with transdiagnostic factors.

Misophonia: A new mental disorder?

PubMed

Taylor, Steven

2017-06-01

Misophonia, a phenomenon first described in the audiology literature, is characterized by intense emotional reactions (e.g., anger, rage, anxiety, disgust) in response to highly specific sounds, particularly sounds of human origin such as oral or nasal noises made by other people (e.g., chewing, sniffing, slurping, lip smacking). Misophonia is not listed in any of the contemporary psychiatric classification systems. Some investigators have argued that misophonia should be regarded as a new mental disorder, falling within the spectrum of obsessive-compulsive related disorders. Other researchers have disputed this claim. The purpose of this article is to critically examine the proposition that misophonia should be classified as a new mental disorder. The clinical and research literature on misophonia was examined and considered in the context of the broader literature on what constitutes a mental disorder. There have been growing concerns that diagnostic systems such as DSM-5 tend to over-pathologize ordinary quirks and eccentricities. Accordingly, solid evidence is required for proposing a new psychiatric disorder. The available evidence suggests that (a) misophonia meets many of the general criteria for a mental disorder and has some evidence of clinical utility as a diagnostic construct, but (b) the nature and boundaries of the syndrome are unclear; for example, in some cases misophonia might be simply one feature of a broader pattern of sensory intolerance, and (c) considerably more research is required, particularly work concerning diagnostic validity, before misophonia, defined as either as a disorder or as a key feature of some broader syndrome of sensory intolerance, should be considered as a diagnostic construct in the psychiatric nomenclature. A research roadmap is proposed for the systematic evaluation as to whether misophonia should be considered for future editions of DSM or ICD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Likelihood and predictors of detention in patients with personality disorder compared with other mental disorders: A retrospective, quantitative study of Mental Health Act assessments.

PubMed

Olajide, Kike; Tyrer, Peter; Singh, Swaran P; Burns, Tom; Rugkåsa, Jorun; Thana, Lavanya; Paul, Moli; Islam, Zoebia; Crawford, Mike J

2016-08-01

The UK guidelines on the treatment of personality disorder recommend avoiding compulsory treatment except in extreme situations. Little is known about how often patients with personality disorder are detained or how this compares with the treatment of other mental disorders. Our aim is to test the hypothesis that people with personality disorder are infrequently detained under the Mental Health Act (MHA) and that risk factors associated with detention are the same as those for people with other mental disorders. We used a retrospective, quantitative study of MHA assessments. Of the 2 087 assessments undertaken, 204 (9.8%) patients had a diagnosis of personality disorder; 40.7% of assessments in the personality disorder group resulted in detention, as did 69.7% of patients with other mental disorders. A higher proportion of people with personality disorder received no intervention following assessment compared with those with other mental disorders (20.6% vs. 4.7%, p < 0.001). Study centre and a history of admission were risk factors for detention in both groups. Risk was a predictor of detention in those with other mental disorders. Detention rates in patients with personality disorder are lower than those for other disorders but are still substantial. Risk factors for detention in patients with personality disorder differ from those with other mental disorders. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Childhood family wealth and mental health in a national cohort of young adults.

PubMed

Lê-Scherban, Félice; Brenner, Allison B; Schoeni, Robert F

2016-12-01

Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. We used prospectively collected data from 2060 young adults aged 18-27 in 2005-2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale) and childhood average household wealth during ages 0-18 years (net worth in 2010 dollars). In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to below-median wealth, prevalence ratio (PR) = 0.56 (0.36-0.87) for 3 rd quartile and PR = 0.46 (0.29-0.73) for 4 th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness.

Mental Health Disorder Therapeutic Modalities Modified for the GMS

PubMed Central

Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

2017-01-01

Background: Mental health disorders can affect physical and psychological behaviors. The people of the Greater Mekong Subregion (GMS) have a high risk of mental health disorders, such as depression, stress, and substance abuse be-cause the people in this region are trafficked for forced sex work and various forms of forced labor. In these situations, vic-tims often endure violence and abuse from trafficking recruiters, employers, and other individuals. The purposes of this study were to identify the elements characterizing mental health disorders, especially in terms of depression, stress, and sub-stance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Methods: The researcher undertook a comparative analysis of the literature, reviews of epidemiological studies and mental disorder therapies, and overviews of previous research studies, were used to generate a synthesis of the existing knowledge of the mental disorder therapeutic modalities. Regarding the search methods, the data from the electronic databases PubMed, PsycINFO, Dynamed and ScienceDirect were supplemented with a manual reference search covering relevant studies from 2005 to 2016. Results: Thirty-one papers were included in the review of elements characterizing mental health disorders, especially in terms of depression, stress, and substance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Nine papers defined characterizing mental health disorders, in terms of depression, stress, and substance abuse. Twenty-two papers showed the treatment modalities for mental health disorders that the treatment was effective, these in-cluded pharmacological treatments and psychological treatments, such as mindfulness-based cognitive therapy, biofeedback, and music therapy. Useful guidance can be provided for the prevention and treatment of mental health disorders, and for the care of people in the Greater Mekong Subregion. Conclusion: The

How primary care can contribute to good mental health in adults.

PubMed

Gupta, Sunjai; Jenkins, Rachel; Spicer, John; Marks, Marina; Mathers, Nigel; Hertel, Lise; Calamos Nasir, Laura; Wright, Fiona; Ruprah-Shah, Baljeet; Fisher, Brian; Morris, David; Stange, Kurt C; White, Robert; Giotaki, Gina; Burch, Tony; Millington-Sanders, Catherine; Thomas, Steve; Banarsee, Ricky; Thomas, Paul

2018-01-01

The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.

[Effects of social mobility on adult mental health:a systematic review of the literature].

PubMed

de Quadros, Lenice de Castro Muniz; Laura, Helen Castillo; Quevedo, Luciana de Avila; Gigante, Denise Petrucci

2016-02-01

The scope of this study was to identify longitudinal studies evaluating the relationship between social mobility and mental disorders in adults. An electronic review of the literature was conducted in the PubMed/Medline and PsycINFO databases. The bibliographic references of the articles selected for analysis were also examined for eligibility. Cohort studies were selected taking social mobility as exposure category and mental health-related disorders as the outcome. Seven studies were reviewed and their definition and categorization of exposure and outcome were found to be heterogeneous, thus rendering analysis and comparison of the results found in the various studies difficult. Mental health-related disorders were more common in individuals belonging to lower socio-economic classes, regardless of having upward, stable or downward social mobility. Moreover, the influence of individual socio-economic conditions, assessed in adulthood, appears to be greater than the effect of parental economic status on the mental health of individuals. This review indicates that it is possible to find a relationship between socio-economic status during the course of life and mental health in adulthood. However, the direction taken by this relationship remains unclear.

The Mental Health of Individuals Referred for Assessment of Autism Spectrum Disorder in Adulthood: A Clinic Report

ERIC Educational Resources Information Center

Russell, Ailsa J.; Murphy, Clodagh M.; Wilson, Ellie; Gillan, Nicola; Brown, Cordelia; Robertson, Dene M.; Craig, Michael C.; Deeley, Quinton; Zinkstok, Janneke; Johnston, Kate; McAlonan, Grainne M.; Spain, Deborah; Murphy, Declan G. M.

2016-01-01

Growing awareness of autism spectrum disorders has increased the demand for diagnostic services in adulthood. High rates of mental health problems have been reported in young people and adults with autism spectrum disorder. However, sampling and methodological issues mean prevalence estimates and conclusions about specificity in psychiatric…

Kant on mental disorder. Part 1: an overview.

PubMed

Frierson, Patrick

2009-09-01

This paper sets out Kant's anthropological account of mental disorder. I begin with a discussion of the nature of Kant's 'pragmatic anthropology' and the implications of the fact that his discussion of mental disorder takes place in that context. I then set out Kant's taxonomy of the mind and discuss the various disorders affecting the cognitive faculty and the faculties of feeling and desire. I end with a brief discussion of Kant's views on the causes, preventions, and treatments of mental disorder.

[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

PubMed

González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

2016-12-01

Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Mental health promotion and the prevention of mental disorders in South Africa.

PubMed

Petersen, I; Bhana, A; Swartz, L

2012-11-01

The need for greater attention to mental health promotion and the prevention of mental disorders in South Africa is highlighted by the cycle of poverty and mental ill-health, the potential for social gains, the question of affordability of treatment in the face of the increasing burden of mental disorders, and the limitations of existing treatment methods. This article, which provides a desk review of the current status of mental health promotion and prevention of mental disorders in South Africa, suggests that South Africa has a number of policies that bode well for promoting mental health from infancy through to old age. There is, however, a need for programmatic interventions to promote resilience in vulnerable populations. Of note, is the need for programmes to address maternal depression and strengthen attachment and psychosocial stimulation during infancy, strengthen families, promote health enhancing school environments, and address intimate partner violence and build health enhancing social capital. Given the multifaceted nature of risk and protective influences, the need for a multi-sectoral plan of action is highlighted.

Mental disorders among college students in the World Health Organization World Mental Health Surveys.

PubMed

Auerbach, R P; Alonso, J; Axinn, W G; Cuijpers, P; Ebert, D D; Green, J G; Hwang, I; Kessler, R C; Liu, H; Mortier, P; Nock, M K; Pinder-Amaker, S; Sampson, N A; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Benjet, C; Caldas-de-Almeida, J M; Demyttenaere, K; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; Karam, E G; Kiejna, A; Kovess-Masfety, V; Lee, S; McGrath, J J; O'Neill, S; Pennell, B-E; Scott, K; Ten Have, M; Torres, Y; Zaslavsky, A M; Zarkov, Z; Bruffaerts, R

2016-10-01

Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

“Church-Based Health Programs for Mental Disorders among African Americans: A Review

PubMed Central

Hankerson, Sidney H.; Weissman, Myrna M.

2014-01-01

Objective African Americans, compared to White Americans, underutilize traditional mental health services. A systematic review is presented of studies involving church-based health promotion programs (CBHPP) for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. Methods A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980 and December 31, 2009. Inclusion criteria included the following: studies were conducted in a church; primary objective(s) involved assessment, perceptions/attitudes, education, prevention, group support, or treatment for Diagnostic and Statistical Manual-IV mental disorders or their correlates; number of participants was reported; qualitative and/or quantitative data were reported; and African Americans were the target population. Results Of 1,451 studies identified, 191 studies were eligible for formal review. Only eight studies met inclusion criteria for this review. The majority of studies focused on substance related disorders (n=5), were designed to assess the effects of a specific intervention (n=6), and targeted adults (n=6). One study focused on depression and was limited by a small sample size of seven participants. Conclusion Although CBHPP have been successful in addressing racial disparities for several chronic medical conditions, the published literature on CBHPP for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans. PMID:22388529

'Mind the gap'--mapping services for young people with ADHD transitioning from child to adult mental health services.

PubMed

Hall, Charlotte L; Newell, Karen; Taylor, John; Sayal, Kapil; Swift, Katie D; Hollis, Chris

2013-07-10

Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. We report the findings of a survey of 96 healthcare professionals working in children's (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management.

[Service use patterns among adults with mental health problems in Chile].

PubMed

Vicente, Benjamín; Kohn, Robert; Saldivia, Sandra; Rioseco, Pedro; Torres, Silverio

2005-01-01

To describe the patterns in the use of general health services and specialized health services among adults with mental health problems in Chile, as well as those persons' level of satisfaction with the services. The overall objective was to optimize the use of the limited resources available for mental health care in the countries of the Americas, especially Chile. The diagnoses and the patterns of use of mental health services were obtained from the Chilean Study of Psychiatric Prevalence (Estudio Chileno de Prevalencia Psiquiátrica). That representative research on the adult population of Chile was based on a stratified random sample of 2,987 people 15 years old and older, done over the period of 1992 to 1999. The psychiatric diagnoses were obtained using the Composite International Diagnostic Interview (CIDI). The interviewees were also asked about their use of general health care services and of mental health services in the preceding six months, as well as any barriers to accessing the services. More than 44% of the interviewees had had contact with some type of health service during the six months prior to the study, but only 5.6% received specialized care. Those who presented with a diagnosis of obsessive-compulsive disorder or of panic disorder consulted more frequently, but not in specialized centers. Consumption of substances such as alcohol and drugs as well as antisocial personality disorder were associated with a low level of consultation. When asked about sources of assistance for mental health problems, the majority of the interviewees mentioned only the formal health care system. More than 75% of the interviewees said that they were satisfied or very satisfied with the care that they had received. Our results confirm the existence of a wide gap between the need for care and the treatment that is actually received. The informal and folkloric alternative resources (priests, family members, healers, herbalists, etc.) were used less frequently than is

Influence of perceived and actual neighbourhood disorder on common mental illness.

PubMed

Polling, C; Khondoker, M; Hatch, S L; Hotopf, M

2014-06-01

Fear of crime and perceived neighbourhood disorder have been linked to common mental illness (CMI). However, few UK studies have also considered the experience of crime at the individual and neighbourhood level. This study aims to identify individual and local area factors associated with increased perceived neighbourhood disorder and test associations between CMI and individuals' perceptions of disorder in their neighbourhoods, personal experiences of crime and neighbourhood crime rates. A cross-sectional survey was conducted of 1,698 adults living in 1,075 households in Lambeth and Southwark, London. CMI was assessed using the Revised Clinical Interview Schedule. Data were analysed using multilevel logistic regression with neighbourhood defined as lower super output area. Individuals who reported neighbourhood disorder were more likely to suffer CMI (OR 2.12) as were those with individual experience of crime. These effects remained significant when individual characteristics were controlled for. While 14 % of the variance in perceived neighbourhood disorder occurred at the neighbourhood level, there was no significant variance at this level for CMI. Perceived neighbourhood disorder is more common in income-deprived areas and individuals who are unemployed. Worry about one's local area and individual experience of crime are strongly and independently associated with CMI, but neighbourhood crime rates do not appear to impact on mental health.

Effects of common mental disorders and physical conditions on role functioning in Spain.

PubMed

Barbaglia, Gabriela; Duran, Núria; Vilagut, Gemma; Forero, Carlos García; Haro, Josep Maria; Alonso, Jordi

2013-01-01

To examine the effects of common mental disorders and physical conditions on role functioning in Spain. Cross-sectional study of the general adult population of Spain (n = 2,121). Non-psychotic mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0) and physical conditions with a checklist. The role functioning dimension of the WHO-Disability Assessment Schedule (WHODAS) was used to asses the number of days in the past month in which respondents were fully or partially limited to perform daily activities. Generalized linear models were used to estimate individual-level associations of specific conditions and role functioning, controlling for co-morbidity. Societal level estimates were calculated using population attributable risk proportions (PARP). Mental disorders and physical conditions showed similar number of days with full role limitation (about 20 days per year); in contrast mental disorders were responsible for twice as many days with partial role limitation than physical conditions (42 vs 21 days, respectively). If the population were entirely unexposed to mental and physical conditions, days with full limitation would be reduced by 73% and days with partial limitation by 41%. Common health conditions in Spain are associated with considerably more days with role limitation than other Western countries. There is need of mainstreaming disability in the Spanish public health agenda in order to reduce role limitation among individuals with common conditions. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Why mental disorders are just mental dysfunctions (and nothing more): some Darwinian arguments.

PubMed

De Block, Andreas

2008-09-01

Mental disorders are often thought to be harmful dysfunctions. Jerome Wakefield has argued that such dysfunctions should be understood as failures of naturally selected functions. This suggests, implicitly, that evolutionary biology and other Darwinian disciplines hold important information for anyone working on answering the philosophical question, 'what is a mental disorder?'. In this article, the author argues that Darwinian theory is not only relevant to the understanding of the disrupted functions, but it also sheds light on the disruption itself, as well as on the harm that attends the disruption. The arguments advanced here are partially based on the view that a core feature of Darwinism is that it stresses the environmental relativity of functions and dysfunctions. These arguments show a very close empirical connection between social judgments (values) and dysfunctions (psychopathology), which is of interest for psychiatric theory. Philosophically, they lead to the conclusion that the concept of mental disorder is identical to the concept of mental dysfunction. Consequently, it is both misleading and redundant to conceptualize mental disorders as 'harmful dysfunctions', and not simply as 'mental dysfunctions'.

Family relations, social connections, and mental health among Latino and Asian older adults.

PubMed

Guo, Man; Li, Shijian; Liu, Jinyu; Sun, Fei

2015-02-01

Using a nationally representative sample, we compared Latino and Asian older adults in terms of lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, anxiety and mood disorders. Given the strong family norms and collectivist cultures shared by the two groups, we also examined whether 12-month prevalence rates were associated with various family relation and social connection variables. The findings showed that older Latinos were almost twice as likely as older Asians to have any anxiety or mood disorders in their lifetime (34.5% vs. 17.7%) and in the past year (14.3% vs. 7.4%). Logistic regressions revealed different predictors of anxiety and mood disorders in the two groups: Family cultural conflict was associated with a higher prevalence of anxiety disorders, whereas family cohesion was associated with a lower prevalence of mood disorders. We argue that more research is needed on negative family interactions and their implications for the mental health of older ethnic minorities. © The Author(s) 2014.

Prevalence Rates of Mental Disorders in Chilean Prisons

PubMed Central

Mundt, Adrian P.; Alvarado, Rubén; Fritsch, Rosemarie; Poblete, Catalina; Villagra, Carolina; Kastner, Sinja; Priebe, Stefan

2013-01-01

Objective High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. Method A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population. Results Prevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05) and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001). Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05), simple (3.3% vs. 11.5%, Z=-3.13, p<0.001) and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05) were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05) and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001) were less prevalent in the male prison population than in the general population. Conclusions Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders. PMID:23894415

Social determinants of mental health: a Finnish nationwide follow-up study on mental disorders.

PubMed

Paananen, Reija; Ristikari, Tiina; Merikukka, Marko; Gissler, Mika

2013-12-01

Most mental disorders start in childhood and adolescence. Risk factors are prenatal and perinatal, genetic as well as environmental and family related. Research evidence is, however, insufficient to explain the life-course development of mental disorders. This study aims to provide evidence on factors affecting mental health in childhood and adolescence. The 1987 Finnish Birth Cohort covers all children born in Finland in 1987 (N=59 476) who were followed up until the age of 21 years. The study covers detailed health, social welfare and sociodemographic data of the cohort members and their parents from Finnish registers. Altogether, 7578 (12.7%) cohort members had had a diagnosed mental disorder. Several prenatal, perinatal and family-related risk factors for mental disorders were found, with sex differences. The main risk factors for mental disorders were having a young mother (OR 1.30 (1.16 to 1.47)), parents' divorce (OR 1.33 (1.26 to 1.41)), death of a parent (OR 1.27 (1.16 to 1.38)), parents' short education (OR 1.23(1.09 to 1.38)), childhood family receiving social assistance (OR 1.61 (1.52 to 1.71)) or having a parent treated at specialised psychiatric care (OR 1.47 (1.39 to 1.55)). Perinatal problem (OR 1.11 (1.01 to 1.22)) and prenatal smoking (OR 1.09 (1.02 to 1.16)) were risk factors for mental disorders, even after controlling for background factors. Elevated risk was seen if the cohort member had only basic education (OR 3.37 (3.14 to 3.62)) or had received social assistance (OR 2.45 (2.30 to 2.60)). Mental disorders had many social risk factors which are interlinked. Although family difficulties increased the risk for mental disorders, they were clearly determined by the cohort member's low education and financial hardship. This study provides evidence for comprehensive preventative and supporting efforts. Families with social adversities and with parental mental health problems should be supported to secure children's development.

Prevalence and clinical profile of chronic pain and its association with mental disorders.

PubMed

Pereira, Flávia Garcia; França, Mariane Henriques; Paiva, Maria Cristina Alochio de; Andrade, Laura Helena; Viana, Maria Carmen

2017-11-17

To identify the prevalence of 12-month self-reported pain and chronic pain in a general population and to describe their clinical profile to assess if chronic pain is associated with 12-month mental disorders. The data used comes from the São Paulo Megacity Mental Health Survey, a population-based study assessing adult (≥ 18 years) residents of the São Paulo metropolitan area, Brazil. We have assessed the respondents (n = 5,037) using the Composite International Diagnostic Interview (CIDI 3.0), with a global response rate of 81.3%. Descriptive analyses have been performed, and crude and adjusted odds ratios (OR) have been calculated with logistic and multinomial regression and presented with respective 95% confidence intervals (95%CI). The prevalence of pain and chronic pain in the past 12 months were 52.6% (95%CI 50.3-54.8) and 31.0% (95%CI 29.2-32.7), respectively. Joints (16.5%, 95%CI 15.4-17.5) and back or neck (15.5%, 95%CI 14.2-16.9) were the most frequently reported anatomical sites of chronic pain. On a 10-point analogue scale, the mean intensity of the worst pain was 7.7 (95%CI 7.4-7.8), and the mean average pain was 5.5 (95%CI 5.2-5.6); the mean treatment response was 6.3 (95%CI 6.0-6.6). Mean pain duration was 16.1 (95%CI 15.6-17.0) days a month and 132 (95%CI 126-144) minutes a day. Chronic pain was associated with 12-month DSM-IV mental disorders (OR = 2.7, 95%CI 2.3-3.3), anxiety disorders (OR = 2.1, 95%CI 1.9-3.0), and mood disorders (OR = 3.3, 95%CI 2.4-4.1). A high prevalence of chronic pain in multiple sites is observed among the general adult population, and associations between chronic pain and mental disorders are frequent.

Family structure and childhood mental disorders: new findings from Australia.

PubMed

Perales, Francisco; Johnson, Sarah E; Baxter, Janeen; Lawrence, David; Zubrick, Stephen R

2017-04-01

Many children now live in non-traditional families-including one-parent, blended, and step families. While a substantial body of international evidence indicates that these children display poorer cognitive and socio-emotional outcomes than children living in traditional families, research on childhood mental disorders is scarce. This report provides new evidence of the relationships between family structure and childhood mental disorders in an under-researched context, Australia. We use recent, nationally representative data on children aged 4-17 from Young Minds Matter, the second Australian Child and Adolescent Survey of Mental Health and Well-being (N = 6310). Mental disorders were assessed using the Diagnostic Interview Schedule for Children-Version IV and included social phobia, separation anxiety disorder, generalised anxiety disorder, obsessive-compulsive disorder, major depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Compared to children living in original families, children in one-parent, blended, and step families experienced a higher prevalence of mental disorders. Amongst children whose parents separated, the time since separation was not statistically significantly related to the prevalence of mental disorders. Although we are unable to assess causality, our findings highlight the strength of the association between family structure and child and adolescent mental health. They also stress the need for programs to support children, parents, and families in non-traditional family types to reduce mental health inequalities in childhood and later life.

Ethnic comparisons of the 12 month prevalence of mental disorders and treatment contact in Te Rau Hinengaro: the New Zealand Mental Health Survey.

PubMed

Baxter, Joanne; Kokaua, Jesse; Wells, J Elisabeth; McGee, Magnus A; Oakley Browne, Mark A

2006-10-01

To compare ethnic groups for the 12 month prevalence of mental disorders and 12 month treatment contact in Te Rau Hinengaro: The New Zealand Mental Health Survey. Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken in 2003 and 2004, was a nationally representative face-to-face household survey of 12,992 New Zealand adults aged 16 years and over, including Māori (n = 2595), Pacific people (n = 2236) and a composite Other ethnic group (predominantly European) (n = 8161). Ethnicity was measured using the 2001 census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used to measure disorder. The overall response rate was 73.3%. The 12 month prevalence of any mental disorder was highest in Māori (29.5%; 26.6, 32.4), followed by Pacific people (24.4%; 21.2, 27.6) and Others (19.3%; 18.0, 20.6). Adjustment for age, sex, education and household income reduced differences: Māori (23.9%; 21.3, 26.4), Pacific (19.2%; 16.4, 22.1) and Other (20.3%; 18.9, 21.6). A similar pattern was seen for serious disorder and most individual disorders or disorder groups. After adjustment, Māori were most different from Pacific people and Others for substance use disorder. Both Māori and Pacific people had a higher prevalence of bipolar disorder than Others. Pacific people had the lowest prevalence of major depressive disorder. Among those with disorder, the proportion with a visit for mental health problems to any service was highest among Others (41.1%; 38.1, 44.1), with Māori (32.5%; 28.3, 36.7) intermediate and Pacific (25.4%, 19.4, 31.4) lowest. Adjustment did not alter ethnic differences in service contact. Māori, and to a lesser extent Pacific people, have a higher prevalence of 12 month mental disorders than Others. Differences are reduced after adjusting for sociodemographic correlates. Relative to need

The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services.

PubMed

Belling, Ruth; McLaren, Susan; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P

2014-07-01

To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services in four English NHS Mental Health Trusts and voluntary organisations. Data were analysed thematically using a structured framework. Findings revealed a lack of clarity on service availability and the operation of different eligibility criteria between child and adult mental health services, with variable service provision for young people with attention deficit hyperactivity disorder, autism spectrum disorders and learning disabilities. High workloads and staff shortages were perceived to influence service thresholds and eligibility criteria. A mutual lack of understanding of services and structures together with restrictive eligibility criteria exacerbated by perceived lack of resources can impact negatively on the transition between CAMHS and AMHS, disrupting continuity of care for young people. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.