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Abstract
Purpose
The purpose of this paper is to examine the preventable harm created by the adoption of austerity measures in 2010, added to the welfare reforms introduced in 2008 which, collectively, have negative implications for population mental health in the UK.
Design/methodology/approach
A critical reflection of published research papers and key policy documents in this area.
Findings
Negative mental health consequences of the combined impact of welfare reforms and austerity measures in the UK since 2010 are identified when relating to disability benefit assessments, and to the increased punitive conditionality applied to disability benefit claimants, as those in greatest need now live in fear of making a claim for financial support from the state or of losing benefits to which they are entitled.
Research limitations/implications
This paper identifies the creation of preventable harm by social policy reforms, commonly known as “welfare reforms”. The implications for social scientists are the disregard of academic peer-reviewed social policy research by policymakers, and the adoption of critically challenged policy-based research as used to justify political objectives.
Practical implications
The negative mental health impact of UK government social policy reforms has been identified and highlights the human consequences of the adoption of the biopsychosocial model of assessment.
Social implications
Reducing the numbers of sick and disabled people claiming long-term disability benefit has increased the numbers claiming unemployment benefit, with no notable increase in the numbers of disabled people in paid employment and with many service users in greatest need living in fear of the next enforced disability assessment.
Originality/value
This paper demonstrates the preventable harm created by the use of a flawed disability assessment model, together with the adoption of punitive conditionality and the increased suicides linked to UK welfare reforms which are influenced by American social policies.
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Gerretsen P, Shah P, Logotheti A, Attia M, Balakumar T, Sulway S, Ranalli P, Dillon WA, Pothier DD, Rutka JA. Interdisciplinary integration of nursing and psychiatry (INaP) for the treatment of dizziness. Laryngoscope 2019; 130:1792-1799. [DOI: 10.1002/lary.28351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/25/2019] [Accepted: 09/19/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, Campbell Mental Health Research Institute, Centre for Addiction & Mental Health Toronto Canada
- Institute of Medical ScienceUniversity of Toronto Toronto Canada
- Department of PsychiatryUniversity of Toronto Toronto Canada
- Centre for Mental HealthUniversity Health Network Toronto Canada
| | - Parita Shah
- Multimodal Imaging Group, Research Imaging Centre, Campbell Mental Health Research Institute, Centre for Addiction & Mental Health Toronto Canada
- Institute of Medical ScienceUniversity of Toronto Toronto Canada
| | - Anastasia Logotheti
- Multimodal Imaging Group, Research Imaging Centre, Campbell Mental Health Research Institute, Centre for Addiction & Mental Health Toronto Canada
| | - Mohamed Attia
- Department of PsychiatryUniversity of Toronto Toronto Canada
| | - Thushanthi Balakumar
- Multimodal Imaging Group, Research Imaging Centre, Campbell Mental Health Research Institute, Centre for Addiction & Mental Health Toronto Canada
| | - Shaleen Sulway
- Department of Otolaryngology–Head and Neck SurgeryToronto General Hospital, University of Toronto Toronto Canada
| | - Paul Ranalli
- Department of Otolaryngology–Head and Neck SurgeryToronto General Hospital, University of Toronto Toronto Canada
| | - Wanda A. Dillon
- Department of Otolaryngology–Head and Neck SurgeryToronto General Hospital, University of Toronto Toronto Canada
| | - David D. Pothier
- Department of Otolaryngology–Head and Neck SurgeryToronto General Hospital, University of Toronto Toronto Canada
| | - John A. Rutka
- Department of Otolaryngology–Head and Neck SurgeryToronto General Hospital, University of Toronto Toronto Canada
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Jao NC, Robinson LD, Kelly PJ, Ciecierski CC, Hitsman B. Unhealthy behavior clustering and mental health status in United States college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:790-800. [PMID: 30485154 PMCID: PMC6538490 DOI: 10.1080/07448481.2018.1515744] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/20/2018] [Accepted: 08/16/2018] [Indexed: 05/13/2023]
Abstract
Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781 US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.
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Affiliation(s)
- Nancy C. Jao
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611
| | - Laura D. Robinson
- University of Wollongong, School of Psychology, Building 41, Northfields Avenue, Wollongong NSW 2522, Australia
| | - Peter J. Kelly
- University of Wollongong, School of Psychology, Building 41, Northfields Avenue, Wollongong NSW 2522, Australia
| | - Christina C. Ciecierski
- Northeastern Illinois University, Department of Economics, 5500 North Saint Louis Avenue, Chicago, IL, 60625
| | - Brian Hitsman
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611
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Social exclusion of people with severe mental illness in Switzerland: results from the Swiss Health Survey. Epidemiol Psychiatr Sci 2019; 28:427-435. [PMID: 29233203 PMCID: PMC6998964 DOI: 10.1017/s2045796017000786] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIMS People with severe mental illness (SMI) have a high risk of living socially excluded from the mainstream society. Policy initiatives and health systems aim to improve the social situation of people who suffer from mental health disabilities. The aim of this study was to explore the extent of social exclusion (employment and income, social network and social activities, health problems) of people with SMI in Switzerland. METHODS Data from the Swiss Health Survey 2012 were used to compare the social exclusion magnitude of people with SMI with those suffering from severe physical illness, common mental illness and the general population. RESULTS With the exception of Instrumental Activities of Daily Living, we found a gradient of social exclusion that showed people with SMI to be more excluded than the comparison groups. Loneliness and poverty were widespread among people with SMI. Logistic regression analyses on each individual exclusion indicator revealed that people with SMI and people with severe physical illness were similarly excluded on many indicators, whereas people with common mental illness and the general population were much more socially included. CONCLUSIONS In contrast to political and health system goals, many people with SMI suffer from social exclusion. Social policy and clinical support should increase the efforts to counter exclusionary trends, especially in terms of loneliness and poverty.
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Daré LO, Bruand PE, Gérard D, Marin B, Lameyre V, Boumédiène F, Preux PM. Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis. BMC Public Health 2019; 19:304. [PMID: 30866883 PMCID: PMC6417021 DOI: 10.1186/s12889-019-6623-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
Background As the data on the association of mental disorders and chronic physical diseases in developing and emerging countries is heterogeneous, this study aims to produce the first meta-analysis of these comorbidities. Methodology The meta-analysis protocol was registered in PROSPERO (N°CRD42017056521) and was performed in accordance with PRISMA guidelines. Initially, an article search was conducted on Medline, Embase, Lilacs and the Institut d’Epidémiologie et de Neurologie Tropicale database [Institute of Epidemiology and Tropical Neurology], as well as manually, with no restriction on language or date focusing on mental disorders, chronic diseases and neurotropic diseases. Two independent investigators assessed the quality of the studies which met the inclusion criteria using the Downs and Black assessment grid. The pooled estimates were calculated out using a random-effects method with CMA software Version 3.0. A meta-regression was then performed, and the significance level was set at 0.05. Results Of the 2604 articles identified, 40 articles involving 21,747 subjects met the inclusion criteria for co-morbidities between mental disorders and chronic physical diseases. Thirty-one articles were included in the meta-analysis of prevalence studies and 9 articles in that of the analytical studies. The pooled prevalence of mental disorders in patients with chronic physical diseases was 36.6% (95% CI, 31.4–42.1) and the pooled odds ratio was 3.1 (95% CI, 1.7–5.2). There was heterogeneity in all the estimates and in some cases, this was explained by the quality of the studies. Conclusion Some estimates regarding the prevalence of mental disorders in people with chronic physical diseases living in developing and emerging countries were similar to those in developed countries. Mental disorders are a burden in these countries. In order to respond effectively and efficiently to the morbidity and mortality associated with them, mental health care could be integrated with physical care. Electronic supplementary material The online version of this article (10.1186/s12889-019-6623-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Labanté Outcha Daré
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France.
| | - Pierre-Emile Bruand
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Daniel Gérard
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Benoît Marin
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
| | - Valerie Lameyre
- Access to Medicines, SANOFI, SAG / CSVB, 82 AV Raspail, 94250, Gentilly, France
| | - Farid Boumédiène
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000, Limoges, France
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Kavalidouª K, Smith DJ, Der G, O’Connor RC. The role of physical and mental multimorbidity in suicidal thoughts and behaviours in a Scottish population cohort study. BMC Psychiatry 2019; 19:38. [PMID: 30674288 PMCID: PMC6344985 DOI: 10.1186/s12888-019-2032-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/16/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Physical illness and mental disorders play a significant role in fatal and non-fatal suicidal behaviour. However, there is no clear evidence for the effect of physical and mental illness co-occurrence (multimorbidity) in suicidal ideation and attempts. The aim of the current study was to investigate, whether physical/mental health multimorbidity predicted suicidal thoughts and behaviours as outcomes. METHODS Data from the West of Scotland Twenty-07 cohort were analysed. Twenty-07 is a multiple cohort study following people for 20 years, through five waves of data collection. Participants who responded to past-year suicidal thoughts and suicide attempt items were grouped into four distinct health-groups based on having: (1) neither physical nor mental health condition (controls); (2) one or more physical health condition; (3) one or more mental health condition and; (4) multimorbidity. The role of multimorbidity in predicting suicidal ideation and suicide attempts was tested with a generalised estimating equation (GEE) model and odds ratios (ORs) and 95% CIs are presented. Whether the effect of multimorbidity was stronger than either health condition alone was also assessed. RESULTS Multimorbidity had a significant effect on suicidal thoughts and suicide attempts, compared to the control group, but was not found to increase the risk of either suicide-related outcomes, more than mental illness alone. CONCLUSIONS We identified an effect of physical/mental multimorbidity on risk of suicidal thoughts and suicide attempts. Considering that suicide and related behaviour are rare events, future studies should employ a prospective design on the role of multimorbidity in suicidality, employing larger datasets.
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Affiliation(s)
- Katerina Kavalidouª
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK. .,Hull York Medical School, University of Hull, Hull, HU6 7RX, UK.
| | - Daniel J. Smith
- 0000 0001 2193 314Xgrid.8756.cInstitute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Geoff Der
- 0000 0001 2193 314Xgrid.8756.cMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rory C. O’Connor
- 0000 0001 2193 314Xgrid.8756.cSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Judkins J, Laska I, Paice J, Kumthekar P. Quality of Life of Family Caregivers of Patients With Cancer in Korçe, Albania. J Palliat Care 2018; 34:118-125. [PMID: 30465470 DOI: 10.1177/0825859718812432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: The primary objective of this study was to quantify cancer family caregiver (FCG) quality of life (QOL) in a Southern Albanian population and to determine whether differences exist between 4 domains of QOL (physical, psychological, social, and spiritual). This study also sought to compare QOL in our cohort to QOL in historical studies that used the same survey instrument, and to examine correlations between demographic characteristics and QOL to identify any high-risk groups. METHODS: A sample of 40 FCGs was recruited at the Mary Potter Palliative Care Clinic in Korçe, Albania. Each participant completed the City of Hope Quality of Life (Family Version), a validated 37-question instrument that measures caregiver well-being in 4 domains: physical, psychological, social, and spiritual well-being. RESULTS: There were no significant differences between the composite scores of the 4 QOL domains in our study. However, there were differences when comparing self-reported QOL between domains ("Rate your overall physical/psychological/social/spiritual well-being"). The QOL measured in our study was significantly lower than in 3 studies from the United States that used the same questionnaire. There were no significant correlations between demographic groups and QOL. CONCLUSIONS: This study examines the impact that the paucity of palliative services has on the QOL of Albanian cancer FCGs. Although there were no domains of QOL or demographic groups identified in our study that were faring significantly worse than others, the poor overall QOL provides further evidence to support the continued development of palliative services for both patients and family members in Albania.
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Affiliation(s)
- Jonathon Judkins
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Irena Laska
- 2 Mary Potter Palliative Care Clinic, Korçe, Albania
| | - Judith Paice
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Priya Kumthekar
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Blomqvist M, Ivarsson A, Carlsson IM, Sandgren A, Jormfeldt H. Health Risks among People with Severe Mental Illness in Psychiatric Outpatient Settings. Issues Ment Health Nurs 2018; 39:585-591. [PMID: 29446657 DOI: 10.1080/01612840.2017.1422200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital.
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Affiliation(s)
- Marjut Blomqvist
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
| | - Andreas Ivarsson
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
| | | | - Anna Sandgren
- b Linnaeus University, Center for Collaborative Palliative Care , Department of Health and Caring Sciences , Växjö , Sweden
| | - Henrika Jormfeldt
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
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Abstract
Purpose
The purpose of this paper is to assess food security as a risk factor in the development of poor mental health among younger populations in the USA over an eight-year period using a nationally representative cross-sectional sample.
Design/methodology/approach
Using data from individuals who participated in the National Health and Nutrition Examination Survey between 2005 and 2012, respondents were classified as either having “poor mental health” or “good mental health.” Multivariate logistic regression models based on this dichotomy are employed to estimate the odds ratios in the association of household food security and mental health using three cut-off points that correspond to these models.
Findings
Respondents from very low food security had higher odds (OR=2.06, p<0.0001; OR=1.98, p<0.0001; OR=1.94, p=0.01) of suffering from poor mental health compared with participants from fully food secure households. These findings indicate the robustness of the results across all three separate regression models.
Research limitations/implications
Causality cannot be determined from the cross-sectional design. Although potential endogeneity could invalidate the conclusions, these findings inform public policy that food security is a contributory factor in the development of poor mental health at an early age. It suggests that interventions to alleviate food insecurity could improve mental health among younger populations in the USA.
Originality/value
Several cut-off points are developed to distinguish between “poor” and “good” mental health to assess the robustness of the findings. This approach has the potential to minimize the misclassification of mental health outcomes. Very low food security is a strong predictor of poor mental health regardless of the cut-off point used.
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Jansen L, van Schijndel M, van Waarde J, van Busschbach J. Health-economic outcomes in hospital patients with medical-psychiatric comorbidity: A systematic review and meta-analysis. PLoS One 2018; 13:e0194029. [PMID: 29534097 PMCID: PMC5849295 DOI: 10.1371/journal.pone.0194029] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 02/23/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hospital inpatients often experience medical and psychiatric problems simultaneously. Although this implies a certain relationship between healthcare utilization and costs, this relationship has never been systematically reviewed. OBJECTIVE The objective is to examine the extent to which medical-psychiatric comorbidities relate to health-economic outcomes in general and in different subgroups. If the relationship is significant, this would give additional reasons to facilitate the search for targeted and effective treatments for this complex population. METHOD A systematic review in Embase, Medline, Psycinfo, Cochrane, Web of Science and Google Scholar was performed up to August 2016 and included cross-references from included studies. Only peer-reviewed empirical studies examining the impact of inpatient medical-psychiatric comorbidities on three health-economic outcomes (length of stay (LOS), medical costs and rehospitalizations) were included. Study design was not an exclusion criterion, there were no restrictions on publication dates and patients included had to be over 18 years. The examined populations consisted of inpatients with medical-psychiatric comorbidities and controls. The controls were inpatients without a comorbid medical or psychiatric disorder. Non-English studies were excluded. RESULTS From electronic literature databases, 3165 extracted articles were scrutinized on the basis of title and abstract. This resulted in a full-text review of 86 articles: 52 unique studies were included. The review showed that the presence of medical-psychiatric comorbidity was related to increased LOS, higher medical costs and more rehospitalizations. The meta-analysis revealed that patients with comorbid depression had an increased mean LOS of 4.38 days compared to patients without comorbidity (95% CI: 3.07 to 5.68, I2 = 31%). CONCLUSIONS Medical-psychiatric comorbidity is related to increased LOS, medical costs and rehospitalization; this is also shown for specific subgroups. This study had some limitations; namely, that the studies were very heterogenetic and, in some cases, of poor quality in terms of risk of bias. Nevertheless, the findings remain valid and justify the search for targeted and effective interventions for this complex population.
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Affiliation(s)
- Luc Jansen
- Erasmus MC, University Medical Center Rotterdam, Department of Psychiatry, Rotterdam, the Netherlands
- Zilveren Kruis Achmea, Department of Health Procurement, Leusden, the Netherlands
| | - Maarten van Schijndel
- Erasmus MC, University Medical Center Rotterdam, Department of Psychiatry, Rotterdam, the Netherlands
- Rijnstate Hospital, Department of Psychiatry, Arnhem, the Netherlands
| | - Jeroen van Waarde
- Rijnstate Hospital, Department of Psychiatry, Arnhem, the Netherlands
| | - Jan van Busschbach
- Erasmus MC, University Medical Center Rotterdam, Department of Psychiatry, Rotterdam, the Netherlands
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Starace F, Mungai F, Baccari F, Galeazzi GM. Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register. Soc Psychiatry Psychiatr Epidemiol 2018; 53:249-257. [PMID: 29273912 DOI: 10.1007/s00127-017-1468-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 12/03/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE People with mental disorders show mortality rates up to 22.2 times higher than that of the general population. In spite of progressive increase in life expectancy observed in the general population, the mortality gap of people suffering from mental health problems has gradually widened. The aim of this paper was to study mortality rates in people suffering from mental illness in a cohort of people (16,981 subjects) in the local mental health register of the province of Modena during the decade 2006-2015. METHODS Standardized Mortality Ratios (SMRs) were calculated to compare the mortality of people with mental disorders to the mortality of people living in the province of Modena and the excess of mortality was studied in relation to the following variables: gender, age group, diagnosis and causes of death. In addition, Poisson regression analysis was performed to study the association between patient characteristics and mortality. RESULTS An overall excess mortality of 80% was found in subjects under the care of mental health services as compared to the reference population (SMR = 1.8, 95% CI 1.7-1.9). Subjects in the 15-44 year group presented the highest SMR (9.2, 95% CI 6.9-11.4). The most prevalent cause of death was cancer (28.1% of deaths). At the Poisson regression, the diagnosis "Substance abuse and dependence" showed the highest relative risk (RR) (4.00). Moreover, being male, single, unemployed and with a lower qualification was associated with higher RRs. CONCLUSIONS Our study confirms that subjects with mental illness have higher SMR. Noteworthy, the overall higher risk of mortality was observed in the younger age group.
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Affiliation(s)
- Fabrizio Starace
- Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Francesco Mungai
- Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy.
| | - Flavia Baccari
- Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Gian Maria Galeazzi
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
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Abstract
SummaryDiabetes is an increasingly common health problem, especially in the West, where there is an emerging epidemic of type 2 diabetes, closely related to the epidemic of obesity. Many people with diabetes struggle to optimise their diabetes control, often because they also have mental illnesses or psychological and social problems. Poor diabetes control has significant consequences for the individual, and if not addressed will result in complications that include blindness, kidney failure and even amputations. There are also consequences for health services resulting from increased admissions and emergency department presentations with diabetes-related difficulties. In the long-term, the costs associated with complications such as renal failure and amputation are high. Addressing the psychiatric and psychological barriers to good glucose control can help reduce the burden of diabetes and its complications on both the individual and the health service.
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Ehrlich C, Chester P, Kisely S, Crompton D, Kendall E. Making sense of self-care practices at the intersection of severe mental illness and physical health-An Australian study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e47-e55. [PMID: 28685496 DOI: 10.1111/hsc.12473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 06/07/2023]
Abstract
The poor physical health of people who experience severe mental illness (SMI) is an important public health issue that has been acknowledged, yet not properly addressed. People who live with SMI perform a myriad of complex tasks in order to take care of their physical health, while receiving unpredictable levels of support and assistance from health professionals. In this qualitative study, we aimed to uncover the kinds of work people with SMI do in order to look after their physical health. In a metropolitan area in Queensland, Australia, 32 people with lived experience of SMI participated in semi-structured, face-to-face interviews. Data were digitally recorded, transcribed verbatim and open coded. They were then themed using a constant comparative process. We found that people with SMI were engaged in a "rhythm of life with illness" that consisted of relatively short, acute and chaotic cycles of mental and physical illness, accompanied by much longer mental and physical illness recovery cycles. Participants engaged in three specific types of health-related work to manage these cycles: discovery work (and the associated role of the health professional); sense-making work to meaningfully interpret health and illness; and embedding work to become engaged self-managers of illness and producers of health. We discuss how varying levels of support from health professionals impact consumers' self-management of their physical and mental health; how health professionals influence consumers' experience of treatment burden; and implications for practice.
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Affiliation(s)
- Carolyn Ehrlich
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
| | - Polly Chester
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, Queensland, Australia
| | - David Crompton
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
- Metro South Addiction and Mental Health Services, Upper Mount Gravatt, Queensland, Australia
| | - Elizabeth Kendall
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Hopkins Centre, Menzies Health Institute, Griffith University, Meadowbrook, Queensland, Australia
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Lavelle M, Attoe C, Tritschler C, Cross S. Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study. NURSE EDUCATION TODAY 2017; 59:103-109. [PMID: 28968516 DOI: 10.1016/j.nedt.2017.09.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 08/18/2017] [Accepted: 09/11/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND In the UK, people with severe mental illness die up to 20years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness. OBJECTIVES To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings. Investigating the impact of training on: 1. Participants' knowledge, confidence, and attitudes towards managing medical deterioration; and 2. Incident reporting, as an objective index of incident management. Participants' perceptions of the impact on their practice were qualitatively explored. DESIGN This evaluation employed a mixed-methods pre-post intervention design. PARTICIPANTS & SETTINGS Fifty-three healthcare professionals participated including: mental health nurses, psychiatrists, healthcare assistants, and activity co-ordinators from two busy psychiatric triage wards in South London, UK. METHODS The intervention comprised eight half-day sessions delivered weekly across two wards. Structured surveys assessed participants' knowledge, confidence, and attitudes towards medical deterioration pre and post training. Participants' experience of training was qualitatively captured through post-course surveys and focus groups three months post training. Incident reporting rates for seven-month periods pre and post training were compared. RESULTS Following training, participants showed significant improvement in knowledge (p<0.001), confidence (p<0.001), and attitudes towards (p<0.02) managing medical deterioration. Incident reporting increased by 33% following training. Participants' reported improved confidence in managing medical deterioration, better understanding of effective communication, improved self-reflection and team working, and an increased sense of responsibility for patients' physical health. CONCLUSIONS Interprofessional, in situ simulation training for medical deterioration yielded promising outcomes for individuals and teams. Simulation is an under-used training modality in mental health, offering a holistic training approach with the potential to provide educational and clinical benefits while supporting workforce resilience.
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Affiliation(s)
- Mary Lavelle
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, WC2R 2LS, UK
| | - Chris Attoe
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, Lambeth Hospital, SW9 9NT, UK.
| | - Christina Tritschler
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, Lambeth Hospital, SW9 9NT, UK
| | - Sean Cross
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, Lambeth Hospital, SW9 9NT, UK
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Hahn C, Oh JH, Joo SH, Jeong JE, Chae JH, Lee CU, Kim TS. Association between mental health status and bone mineral density: Analysis of the 2008-2010 Korea national health and nutrition examination survey. PLoS One 2017; 12:e0187425. [PMID: 29131866 PMCID: PMC5683604 DOI: 10.1371/journal.pone.0187425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/19/2017] [Indexed: 02/03/2023] Open
Abstract
The current study aimed to investigate the association between mental health status and bone mineral density (BMD) using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2010. We enrolled 15,876 South Korean participants (4,010 postmenopausal females, 4,836 premenopausal females, and 7,016 males, all aged 20 years or older). BMD was measured using dual-energy radiography absorptiometry at the femoral neck (NK), lumbar spine (LSP), and total femur (TFM). Mental health status data were obtained from a self-report questionnaire that assessed psychological stress, depressed mood, and suicidal ideation. Psychological stress was negatively correlated with BMD in the LSP, NK, and TFM for the male group. Depressed mood was associated with lower BMD in the LSP, NK and TFM for the premenopausal female group, and in the LSP for the male group. Suicidal ideation was associated with lower BMD in the NK and TFM for the male group. Mental health problems were associated with lower BMD, especially in premenopausal females and males. Future investigations should focus on the shared pathophysiology between mental health problems and BMD, and the interrelationship between increased BMD and recovery from mental health problems.
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Affiliation(s)
- Changtae Hahn
- Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Deajeon, Republic of Korea
| | - Ji Hoon Oh
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo-Hyun Joo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jo-Eun Jeong
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang-Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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Surkan PJ, Sakyi KS, Christian P, Mehra S, Labrique A, Ali H, Ullah B, Wu L, Klemm R, Rashid M, West KP, Strobino DM. Risk of Depressive Symptoms Associated with Morbidity in Postpartum Women in Rural Bangladesh. Matern Child Health J 2017; 21:1890-1900. [PMID: 28766094 PMCID: PMC5693766 DOI: 10.1007/s10995-017-2299-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives Depression following pregnancy is common, but its extent and association with maternal morbidity in the first 6 months postpartum have not been well described in low resource settings such as rural Bangladesh. Methods We used data from a population-based, community trial of approximately 39,000 married rural Bangladeshi women aged 13-44 between 2001 and 2007 to examine the relation between women's reported morbidity symptoms from childbirth to 3 months postpartum, and subsequent depressive symptoms assessed at 6 months postpartum. We calculated crude and adjusted risk ratios for depressive symptoms following women's reports of reproductive, urinary, neurologic, nutrition and other illness measures constructed based on symptomatic reporting. Results In models adjusted for sociodemographic factors and co-morbidities, all postpartum illnesses were associated with an increased relative risk [RR, with 95% confidence intervals (CI) excluding 1] of depressive symptoms by 6 months postpartum. These morbidities included uterine prolapse (RR 1.20, 95% CI 1.04-1.39), urinary tract infection (RR 1.24, 95% CI 1.11-1.38), stress related incontinence (SRI) (RR 1.49, 95% 1.33-1.67), simultaneous SRI and continuously dripping urine (RR 1.60-2.96), headache [RR 1.20 (95% CI 1.12-1.28)], convulsions (RR 1.67, 95%CI 1.36-2.06), night blindness (RR 1.33, 95% CI 1.19-1.49), anemia (RR 1.38, 95% CI 1.31-1.46), pneumonia (RR 1.24, 95% CI 1.12-1.37), gastroenteritis (RR 1.24, 95% CI 1.17-1.31) and hepatobiliary disease (RR 2.10, 96% CI 1.69-2.60). Conclusions for Practice Illnesses during the first three postpartum months were risk factors for depressive symptoms, with the strongest associations noted for convulsions and hepatobiliary disease. Symptoms of depression may be of particular concern among women suffering from physical illnesses. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT0019882.
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Affiliation(s)
- Pamela J Surkan
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA.
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA.
| | - Kwame S Sakyi
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Parul Christian
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- Nutrition|Global Development, Bill and Melinda Gates Foundation, Seattle, WA, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Sucheta Mehra
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Alain Labrique
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Hasmot Ali
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Barkat Ullah
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
| | - Lee Wu
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Rolf Klemm
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Mahbubur Rashid
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205-2179, USA
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Xing C, Zhang X, Cheng ST. Would more social partners leads to enhanced health? The paradox between quantity and quality. Psych J 2017; 6:219-227. [DOI: 10.1002/pchj.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 05/22/2017] [Accepted: 06/28/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Cai Xing
- Department of Psychology and Research Center for Social Psychology and Brain Sciences; Renmin University of China; Beijing China
| | - Xin Zhang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health; Peking University; Beijing China
| | - Sheung-Tak Cheng
- Department of Health and Physical Education; The Education University of Hong Kong; New Territories Hong Kong, China
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Fernando A, Attoe C, Jaye P, Cross S, Pathan J, Wessely S. Improving Interprofessional Approaches to Physical and Psychiatric Comorbidities Through Simulation. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2016.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang L, Palmer AJ, Cocker F, Sanderson K. Multimorbidity and health-related quality of life (HRQoL) in a nationally representative population sample: implications of count versus cluster method for defining multimorbidity on HRQoL. Health Qual Life Outcomes 2017; 15:7. [PMID: 28069026 PMCID: PMC5223532 DOI: 10.1186/s12955-016-0580-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background No universally accepted definition of multimorbidity (MM) exists, and implications of different definitions have not been explored. This study examined the performance of the count and cluster definitions of multimorbidity on the sociodemographic profile and health-related quality of life (HRQoL) in a general population. Methods Data were derived from the nationally representative 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841). The HRQoL scores were measured using the Assessment of Quality of Life (AQoL-4D) instrument. The simple count (2+ & 3+ conditions) and hierarchical cluster methods were used to define/identify clusters of multimorbidity. Linear regression was used to assess the associations between HRQoL and multimorbidity as defined by the different methods. Results The assessment of multimorbidity, which was defined using the count method, resulting in the prevalence of 26% (MM2+) and 10.1% (MM3+). Statistically significant clusters identified through hierarchical cluster analysis included heart or circulatory conditions (CVD)/arthritis (cluster-1, 9%) and major depressive disorder (MDD)/anxiety (cluster-2, 4%). A sensitivity analysis suggested that the stability of the clusters resulted from hierarchical clustering. The sociodemographic profiles were similar between MM2+, MM3+ and cluster-1, but were different from cluster-2. HRQoL was negatively associated with MM2+ (β: −0.18, SE: −0.01, p < 0.001), MM3+ (β: −0.23, SE: −0.02, p < 0.001), cluster-1 (β: −0.10, SE: 0.01, p < 0.001) and cluster-2 (β: −0.36, SE: 0.01, p < 0.001). Conclusions Our findings confirm the existence of an inverse relationship between multimorbidity and HRQoL in the Australian population and indicate that the hierarchical clustering approach is validated when the outcome of interest is HRQoL from this head-to-head comparison. Moreover, a simple count fails to identify if there are specific conditions of interest that are driving poorer HRQoL. Researchers should exercise caution when selecting a definition of multimorbidity because it may significantly influence the study outcomes.
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Affiliation(s)
- Lili Wang
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Fiona Cocker
- Monash Centre for Occupation and Environmental Health (MonCOEH), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. .,School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
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71
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Möller-Leimkühler AM, Möller HJ, Maier W, Gaebel W, Falkai P. EPA guidance on improving the image of psychiatry. Eur Arch Psychiatry Clin Neurosci 2016; 266:139-54. [PMID: 26874959 DOI: 10.1007/s00406-016-0678-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
Abstract
This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength.
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Affiliation(s)
- A M Möller-Leimkühler
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - H-J Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - W Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Bergische Landstraße 2, 40629, Düsseldorf, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany
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Hsu YH, Cheng JS, Ouyang WC, Lin CL, Huang CT, Hsu CC. Lower Incidence of End-Stage Renal Disease but Suboptimal Pre-Dialysis Renal Care in Schizophrenia: A 14-Year Nationwide Cohort Study. PLoS One 2015; 10:e0140510. [PMID: 26469976 PMCID: PMC4607300 DOI: 10.1371/journal.pone.0140510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 09/25/2015] [Indexed: 01/21/2023] Open
Abstract
Schizophrenia is closely associated with cardiovascular risk factors which are consequently attributable to the development of chronic kidney disease and end-stage renal disease (ESRD). However, no study has been conducted to examine ESRD-related epidemiology and quality of care before starting dialysis for patients with schizophrenia. By using nationwide health insurance databases, we identified 54,361 ESRD-free patients with schizophrenia and their age-/gender-matched subjects without schizophrenia for this retrospective cohort study (the schizophrenia cohort). We also identified a cohort of 1,244 adult dialysis patients with and without schizophrenia (1:3) to compare quality of renal care before dialysis and outcomes (the dialysis cohort). Cox proportional hazard models were used to estimate the hazard ratio (HR) for dialysis and death. Odds ratio (OR) derived from logistic regression models were used to delineate quality of pre-dialysis renal care. Compared to general population, patients with schizophrenia were less likely to develop ESRD (HR = 0.6; 95% CI 0.4–0.8), but had a higher risk for death (HR = 1.2; 95% CI, 1.1–1.3). Patients with schizophrenia at the pre-ESRD stage received suboptimal pre-dialysis renal care; for example, they were less likely to visit nephrologists (OR = 0.6; 95% CI, 0.4–0.8) and received fewer erythropoietin prescriptions (OR = 0.7; 95% CI, 0.6–0.9). But they had a higher risk of hospitalization in the first year after starting dialysis (OR = 1.4; 95% CI, 1.0–1.8, P < .05). Patients with schizophrenia undertaking dialysis had higher risk for mortality than the general ESRD patients. A closer collaboration between psychiatrists and nephrologists or internists to minimize the gaps in quality of general care is recommended.
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Affiliation(s)
- Yueh-Han Hsu
- Department of Public Health and Department of Health Services Administration, China Medical University, Taichung City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
- Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan
| | - Jur-Shan Cheng
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Chen Ouyang
- Department of Psychiatry, Changhua Christian Hospital and Changhua Christian Healthcare System, Changhua, Taiwan
- Lutung Christian Hospital, Changhua, Taiwan
- Department of Nursing, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Psychiatry, Kaohsiung Medicine University, Kaohsiung, Taiwan
| | - Chen-Li Lin
- Taipei City Hospital Fuyou Branch; Taipei, Taiwan
| | - Chi-Ting Huang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
- Department of Health Services Administration, China Medical University, Taichung City, Taiwan
- * E-mail:
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Association between mental health and comorbid obesity and hypertension among children and adolescents in the US. Eur Child Adolesc Psychiatry 2015; 24:497-502. [PMID: 25146327 DOI: 10.1007/s00787-014-0598-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 08/06/2014] [Indexed: 01/24/2023]
Abstract
This paper examines the association between mental health and comorbid obesity and hypertension among US children and adolescents using data from the National Health and Nutritional Examination Survey (NHANES). Questionnaires from NHANES were used to assess mental health during the previous 30 days. Respondents were then categorized into two groups namely "poor mental health" and "good mental health" based on their responses to these survey questions. Three multiple logistic regression models, based on these categories, are estimated to compute the odds ratios and 95% confidence intervals in the association of obesity and hypertension and mental health. As a select example, the results of Model 2 reveal that compared with respondents who are not obese, obese respondents have increased odds (OR = 1.24; P < 0.0001) of poor mental health. Furthermore compared with non-hypertensive respondents, hypertensive respondents have higher odds (OR = 2.96; P < 0.0001) of poor mental health. These findings have important implications for mental health management in younger populations. It brings into focus the maintenance of a healthy body mass index and hypertension control in mitigating poor mental health.
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[Comorbid somatic illnesses in psychiatric inpatients - an analysis of administrative data]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2015; 29:71-6. [PMID: 25676286 DOI: 10.1007/s40211-015-0135-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE This study intended to analyze the prevalence of physical diagnoses at psychiatric inpatient hospital wards. METHODS For this purpose we used partially aggregated administrative data from routine diagnostic documentation of Austrian hospitals. All psychiatric and physical main and secondary diagnoses according to ICD-10 of all psychiatric inpatient units in Austria of the years 2007 were used. RESULTS Of 79,027 psychiatric hospital admissions 75,224 received a psychiatric and 3803 a somatic main diagnosis at discharge. Diseases of the vascular system (20 %) were the most frequent somatic diagnoses, followed by endocrine and metabolic diseases (16.4 %) and neurological diseases (14.4 %). Among patients suffering from schizophrenia, the most frequent physical diagnoses were endocrine and metabolic diseases. Among those with affective disorders, vascular diseases as well as endocrine and metabolic diseases were found most often. CONCLUSIONS Physical diagnoses are very common among psychiatric inpatients. Mass screening and specialized prevention programs should be evaluated regarding their effectiveness for this population.
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