Prevalence of common mental disorders and their work consequences in France, according to occupational category

Association between 14 candidate genes, PM2.5, and affective disorders: a study of the Taiwan Biobank

BACKGROUND

Most studies have focused on the risk factors, treatment, and care of affective psychosis, and several have reported a relationship between ambient air quality and this psychosis. Although an association has been reported between psychosis and genes, studies mainly explored the associations between one type of psychosis and one gene; few have identified genes related to affective psychosis. This study investigates the genetic and environmental factors of affective psychosis.

METHODS

In this retrospective longitudinal study, 27 604 participants aged 30-70 were selected from Taiwan Biobank. The participants' propensity scores were calculated based on their demographic information, and propensity score matching was performed to divide the participants into an experimental (i.e., affective psychosis) and control group at a 1:5 ratio. Plink was used to analyze the major and minor types of gene expression related to affective psychosis, and PM2.5 exposure was incorporated into the analyses.

RESULTS

According to the generalized estimating equation analysis results, 8 single nucleotide polymorphisms (SNPs) belonging to the ANK3, BDNF, CACNA1C, and GRID1 genotypes were significantly correlated with depressive disorder (P < .001), with the majority belonging to the ANK3 and CACNA1C. A total of 5 SNPs belonging to the CACNA1C, GRID1, and SIRT1 genotypes were significantly correlated with bipolar disorder (P < .001), with the majority belonging to the CACNA1C. No significant correlation was identified between ambient air pollution and affective psychosis.

CONCLUSIONS

CACNA1C and GRID1 are common SNP genotypes for depressive disorder and bipolar disorder and should be considered associated with affective psychosis.

Psychological distress is more common in some occupations and increases with job tenure: a thirty-seven year panel study in the United States

BACKGROUND

Workers in certain occupations may have elevated risks of psychological distress. However, research is limited. For example, researchers often measure distress that may have existed before occupational exposures. We studied occupations and the development of psychological distress using national data from the United States.

METHODS

We reviewed relevant research to identify occupations with low and high risks of mental health problems. We confirmed those individual low and high risk occupations using 1981-2017 data from the Panel Study of Income Dynamics (n = 24,789). We measured new cases of distress using the Screening Scale for Psychological Distress (Kessler K6) and compared distress in the low and high risk groups, adjusted for factors associated with occupational selection and non-occupational distress risks. A subset of participants described their jobs (n = 1,484), including factors such as job demands, social support, and control over work. We examined associations of those factors with psychological distress.

RESULTS

Workers in high risk occupations had 20% higher adjusted odds of developing distress than those in low risk occupations (odds ratio, OR 1.20, 95% confidence interval, CI 1.13-1.28). Distress increased with time in a high risk occupation: ≥5 years OR 1.38 (CI 1.18-1.62), ≥ 10 years OR 1.46 (CI 1.07-1.99), and ≥ 15 years OR 1.77 (CI 1.08-2.90; p-trend = 0.0145). The most common positive participant descriptions of their jobs indicated social support (34%), sense of accomplishment (17%), and control over work (15%). Participants reporting such descriptions were significantly less likely to have a high risk occupation (OR 0.66, CI 0.46-0.94, p = 0.0195). The most common negative descriptions were excessive job demands (43%), low social support (27%), and lack of control (14%). Participants reporting such descriptions were significantly more likely to have a high risk occupation (OR 1.49, CI 1.03-2.14, p = 0.0331).

CONCLUSION

Certain occupations may have high risks of psychological distress, which may be due to characteristics of the occupations rather than employee characteristics, or in addition to them. Results were consistent with theoretical models of psychosocial work environments. Providers of health care and social services should ask patients or clients about work-related distress.

Are guided internet-based interventions for the indicated prevention of depression in green professions effective in the long run? Longitudinal analysis of the 6- and 12-month follow-up of a pragmatic randomized controlled trial (PROD-A)

OBJECTIVE

Evidence of long-term stability for positive mental health effects of internet-based interventions (IBIs) for depression prevention is still scarce. We evaluate long-term effectiveness of a depression prevention program in green professions (i.e. agriculture, horticulture, forestry).

METHODS

This pragmatic RCT (n = 360) compares a tailored IBI program to enhanced treatment as usual (TAU+) in green professions with at least subthreshold depression (PHQ ≥ 5). Intervention group (IG) received one of six IBIs shown previously to efficaciously reduce depressive symptoms. We report 6- and 12-month follow-up measures for depression, mental health and intervention-related outcomes. Intention-to-treat and per-protocol regression analyses were conducted for each measurement point and complemented by latent growth modeling.

RESULTS

After 6 months, depression severity (β = -0.30, 95%-CI: -0.52; -0.07), insomnia (β = -0.22, 95%-CI: -0.41; -0.02), pain-associated disability (β = -0.26, 95%-CI: -0.48; -0.04) and quality of life (β = 0.29, 95%-CI: 0.13; 0.45) in IG were superior to TAU+. Onset of possible depression was not reduced. After 12 months, no intervention effects were found. Longitudinal modeling confirmed group effects attenuating over 12 months for most outcomes. After 12 months, 55.56% of IG had completed at least 80% of their IBI.

CONCLUSIONS

Stability of intervention effects along with intervention adherence was restricted. Measures enhancing long-term effectiveness of IBIs for depression health promotion are indicated in green professions.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review

Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.

Occupational groups and its physical and mental health correlates: results from the Singapore Mental Health Study 2016

Purpose

The physical and mental wellbeing of an individual is impacted by the type occupation one does. This study aims to establish the prevalence of mental and physical disorders, the association of occupational groups and health-related quality of life, and the extent of work-loss and work-cut back in past 30 days among the employed in the Singapore resident population.

Methods

Data from a population-based, epidemiological survey of a representative sample of Singapore citizens and permanent residents aged 18 years and above were used. Lifetime diagnosis of select mental disorders was established using the World Health Organization’s Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). Data on nicotine dependence, work productivity, quality of life and socio-demographics were obtained via self-report. Ten major occupational groups based on the Singapore Standard Occupational Classification were included in the analysis.

Results

The sample comprised 4021 employed individuals who were predominantly males (54.7%) and aged 35–49 years (35.4%). ‘Service and sales workers’ (22.6%), ‘Professionals’ (17.3%) and ‘Legislators, senior officials and managers’ (16.4%) were the three largest occupational groups. Socio-demographic characteristics differed significantly (p < 0.001) across all occupational groups. Lifetime prevalence of mood disorders among the employed was 8.4% and the most prevalent physical disorder was chronic pain (18.9%). No significant differences were observed in work productivity loss across the occupational groups.

Conclusions

The disparities in the socio-demographic characteristics and prevalence of mental and physical disorders across occupational categories provide policymakers with vital information to pilot effective interventions that can improve the psychosocial and physical conditions at work.

Factors associated with hospital stay length, discharge destination, and 30-day readmission rate after primary hip or knee arthroplasty: Retrospective Cohort Study

BACKGROUND

In France and in the US, predictions for 2030 include an increased number of total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures together with an overall trend towards shorter hospital stays. Predictors of hospital length of stay (LOS) include the day of surgery, discharge destination, and patient comorbidities. Available data are conflicting, however, and to our knowledge predictors of LOS after THA or TKA have not been evaluated in France. Improved knowledge of these predictors would be expected to increase patient care efficiency. The objectives of this study were: (1) to determine whether the above-listed factors predict LOS after THA or TKA, (2) to identify predictors of discharge to a rehabilitation unit and of readmission within 30 days after surgery.

HYPOTHESIS

Both patient-related factors unamenable to modification and modifiable organisational factors are associated with LOS after THA or TKA.

MATERIAL AND METHODS

This large single-centre retrospective cohort study included all adults who underwent primary THA or TKA at our university hospital between 1 January 2015 and 31 December 2016. Non-inclusion criteria were revision arthroplasty, THA with femoral or acetabular reconstruction, TKA using a constrained hinged implant, and fracture as the reason for arthroplasty. Preoperative parameters, type of arthroplasty, and postoperative care were recorded.

RESULTS

We included 938 patients with THA and 725 patients with TKA. By multivariate analysis, the likelihood of being discharged by day 5 decreased with older age (HR, 0.986; 95%CI: 0.98-0.99) and was lower by 13% in females (HR, 0,871; 95%CI: 0.77-0.986), by 39% in patients with diabetes (HR, 0.606; 95%CI: 0.5-0.73), by 68% in patients discharged to rehabilitation units (HR, 0.322; 95%CI: 0.267-0.389), and by 27% in patients who had arthroplasty on a Friday (HR, 0.733; 95%CI: 0.631-0.852). Factors predicting discharge to rehabilitation unit were older age, female gender, chronic obstructive pulmonary disease, anxiety-depressive disorder, and a history of stroke. Risk factors for 30-day readmission were male gender, obesity, and discharge to rehabilitation unit.

DISCUSSION

In this study, predictors of LOS were identified using a survival model that considered age as a continuous variable, separate comorbidities, and the discharge destination. Our findings are consistent with earlier reports and confirm the strong associations linking LOS to diabetes, day of surgery, and discharge destination in France. We also identified predictors of discharge to rehabilitation and of readmission within 30 days.

LEVEL OF EVIDENCE

IV, retrospective observational cohort study.

Prevalence of psychotic disorders and its association with methodological issues. A systematic review and meta-analyses

Objectives

The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological factors that could account for the variation in prevalence estimates.

Methods

Studies with original data related to the prevalence of psychosis (published between 1990 and 2015) were identified via searching electronic databases and reviewing manual citations. Prevalence estimates were sorted according to prevalence type (point, 12-months and lifetime). The independent association between key methodological variables and the mean effect of prevalence was examined (prevalence type, case-finding setting, method of confirming diagnosis, international classification of diseases, diagnosis category, and study quality) by meta-analytical techniques and random-effects meta-regression.

Results

Seventy-three primary studies were included, providing a total of 101 estimates of prevalence rates of psychosis. Across these studies, the pooled median point and 12-month prevalence for persons was 3.89 and 4.03 per 1000 respectively; and the median lifetime prevalence was 7.49 per 1000. The result of the random-effects meta-regression analysis revealed a significant effect for the prevalence type, with higher rates of lifetime prevalence than 12-month prevalence (p<0.001). Studies conducted in the general population presented higher prevalence rates than those carried out in populations attended in health/social services (p = 0.006). Compared to the diagnosis of schizophrenia only, prevalence rates were higher in the probable psychotic disorder (p = 0.022) and non-affective psychosis (p = 0.009). Finally, a higher study quality is associated with a lower estimated prevalence of psychotic disorders (p<0.001).

Conclusions

This systematic review provides a comprehensive comparison of methodologies used in studies of the prevalence of psychosis, which can provide insightful information for future epidemiological studies in adopting the most relevant methodological approach.

Prevalence of work-related common psychiatric disorders in primary care: The French Héraclès study

General practitioners (GP), on the frontline for individuals with mental health problems, often deal with work-related common psychiatric disorders. We aimed to determine the prevalence of work-related common psychiatric disorders in general practice and associated patients' and GPs' characteristics. HERACLES, a cross-sectional study among 2019 working patients of 121 GPs in the Nord - Pas-de-Calais region in France. Common psychiatric disorders were assessed using the MINI International Neuropsychiatric Interview, patient-perceived psychological distress and GP-diagnosed psychiatric disorders. The work-relatedness of common psychiatric disorders was ascertained by the GP and/or the patient. Prevalence rates adjusted on age were calculated by sex and associated characteristics were ascertained using multilevel Poisson regression models. The prevalence of work-related common psychiatric disorders ascertained using the MINI was estimated at 25.6% [23.7-27.5], 24.5% [22.6-26.4] for self-reported psychological distress and 25.8% [23.9-27.7] for GP-diagnosed psychiatric disorders. Age, history of psychiatric disorders, consultation for psychological purpose and GP's characteristics were associated with MINI-identified psychiatric disorders. The prevalence of work-related common psychiatric disorders among working adults seen in general practice is high but further studies are needed to support this results.

Common mental disorders in medical students: A repeated cross-sectional study over six years

Summary Introduction: Becoming a medical doctor is a very complex process. Factors related to the student’s personality, the educational process and the daily experience with death contribute to peculiar psycho-emotional experiences, not always properly investigated during medical training. Objective: To estimate the prevalence of common mental disorders (CMD) and associated factors, over six years of medical undergraduate course among all students of a class at a public university in Brazil. Method: Cross-sectional study based on repeated surveys. All 40 students enrolled in 2006 in the first year of our medical school were included and evaluated annually until 2011 using the SRQ-20 and a structured questionnaire prepared by the authors on sociodemographic, personal and educational aspects. We performed logistic regression and correspondence analysis. Results: The 40 freshmen in the first evaluation had a mean age of 20 years (SD=2.4), 57.5% were female, and 41% were approved after taking their third entrance exam. The prevalence of CMD increased over the years: from 12.5% in the first year to 43.2% in the fifth. The following variables were potentially associated with CMD: female sex (PR=1.38), originating from capital cities (PR=1.97), the program was less than they expected (PR=3.20), discomfort with program activities (PR=2.10), dissatisfaction with teaching strategies (PR=1.38), and feeling that the program is not a source of pleasure (PR=2.06), being R2=28.8% and AIC=60.04. Conclusion: The factors potentially associated with the high prevalence of CMD were those related to medical training, showing that it is necessary to implement preventive measures and review the educational process in order to reduce the damages caused by the development of CMD.

Men, Work, and Mental Health: A Systematic Review of Depression in Male-dominated Industries and Occupations

Among men, depression is often unrecognised and untreated. Men employed in male-dominated industries and occupations may be particularly vulnerable. However, efforts to develop tailored workplace interventions are hampered by lack of prevalence data. A systematic review of studies reporting prevalence rates for depression in male dominated workforce groups was undertaken. Studies were included if they were published between 1990 - June 2012 in English, examined adult workers in male-dominated industries or occupations (> 70% male workforce), and used clinically relevant indicators of depression. Twenty studies met these criteria. Prevalence of depression ranged from 0.0% to 28.0%. Five studies reported significantly lower prevalence rates for mental disorders among male-dominated workforce groups than comparison populations, while six reported significantly higher rates. Eight studies additionally found significantly higher levels of depression in male-dominated groups than comparable national data. Overall, the majority of studies found higher levels of depression among workers in male-dominated workforce groups. There is a need to address the mental health of workers in male-dominated groups. The workplace provides an important but often overlooked setting to develop tailored strategies for vulnerable groups.

Good work ability despite multisite musculoskeletal pain? A study among occupationally active Finns

AIM

Although multisite pain (MSP) often threatens work ability (WA), some of those with MSP retain good WA. Our aim was to identify factors associated with good WA among subjects with MSP.

METHODS

A nationally representative sample (the Health 2000-Study, response rate 87%) comprising 3884 occupationally active Finns aged 30-64 years. Data on WA, musculoskeletal pain, physical and psychosocial working conditions, chronic diseases, lifestyle and domestic situation were gathered by questionnaire, interview and clinical examination. Good current WA compared with the lifetime best was defined as ⩾9 on a 0-10 scale. Musculoskeletal pain in 18 body locations was combined into four sites, and thereafter pain in two or more sites was defined as MSP (N=1351). Poisson regression analysis was used to obtain prevalence rate ratios (PRR).

RESULTS

Good WA was reported by 48% of the women and 37% of the men with MSP. In a multivariable model good WA was associated with younger age, female gender, physically non-strenuous work (PRR 1.3, 95% CI 1.1-1.5), low job strain (1.2, 1.0-1.4), high supervisor support (1.2, 1.0-1.4), and not having musculoskeletal diseases (1.3, 1.1-1.5), mental disorders (1.4, 1.1-1.9), daytime tiredness (1.4, 1.2-1.7) or economic troubles (1.5, 1.1-1.9). Age-stratified analyses revealed also associations with high coworker support (1.2, 1.0-1.4) and strenuous leisure-time physical exercise (1.2, 1.0-1.4) in those aged 30-44 and low alcohol consumption (1.8, 1.2-2.6) in the age-group 45-64.

CONCLUSIONS

Several potentially modifiable factors related to health, work, and lifestyle were associated with good WA among occupationally active subjects with MSP.

Educational inequalities in major depressive and generalized anxiety disorders: results from the French national SIP study

OBJECTIVES

Social inequalities in mental disorders have been reported; the lower the social position, the higher the prevalence of mental disorders. However, these inequalities have not always been observed and results may vary according to the indicator of social position, mental health outcome and population studied. The objective of this study was to examine the association between social position (educational level) and two mental disorders (major depressive disorder-MDD and general anxiety disorder-GAD), measured using a structured diagnostic interview (MINI), and to evaluate the contribution of work status in the explanation of this association.

METHODS

The study was based on a national representative sample of the French general population of 11,777 people including 8,072 workers. All analyses were done using weighted data. Bivariate Rao-Scott Chi-square tests were conducted, and multivariate analysis was performed using weighted logistic regression analysis with adjustment for age.

RESULTS

The prevalences of MDD/GAD and of less educated people were lower in the working population than in the non-working population. Educational inequalities were observed for MDD and GAD in the general population. Non-working status contributed to explain these inequalities by 23-28 % for MDD and by 23-37 % for GAD when the less educated group was considered. Non-working status was strongly associated with both disorders.

CONCLUSION

These results may improve our knowledge on educational inequalities in mental health and help to understand the discrepancies in the literature. Effort to preserve jobs and facilitate the return to employment may help to reduce social inequalities in mental health.

[Work-related disability among postal employees: incidence, duration, and social security costs in 2008]

This study analyzed the characteristics of Brazilian postal workers that received sick leave benefits in 2008. The databases were from the Unified Benefits System (SUB) and the National Registry of Social Information (CNIS). The incidence rate was 556.5 benefits per 10,000 employees, and the leading causes of work-related sick leave were injuries, musculoskeletal disorders, and mental disorders. Areas most frequently reported in injuries were knees and legs, wrists and hands, ankles and feet, and shoulders and arms, with higher incidence rates in men. Women were more affected by musculoskeletal disorders and mental disorders. Average sick leave lasted longer in men, and the incidence of benefits increased with age. The States with the highest incidence rates were Mato Grosso do Sul, Goiás, and Santa Catarina, and security benefits averaged BRL 1,847.00. Postal work may involve additional risk of injuries to the limbs, due to the long distances carrying heavy weight, assault, and dog bites.

Sickness benefit claims due to mental disorders in Brazil: associations in a population-based study

This study aims to determine the prevalence and duration of sickness benefit claims due to mental disorders and their association with economic activity, sex, age, work-relatedness and income replacement using a population-based study of sickness benefit claims (> 15 days) due to mental disorders in Brazil carried out in 2008. The prevalence of mental disorders was 45.1 claims per 10,000 workers. Prevalence and duration of sickness benefit claims due to mental disorder were higher and longer in workers aged over 40 years. Prevalence of claims was 73% higher in women but duration of sickness benefit claims was longer in men. Prevalence rates for claims differed widely according to economic activity, with sewage, residential care and programming and broadcasting activities showing the highest rates. Claims were deemed to be work-related in 8.5% of cases with mental disorder showing low work-relatedness in Brazil. A wide variation of prevalence and duration between age, economic activity and work-relatedness was observed, suggesting that working conditions are a more important factor in mental disorder work disability than previously assumed.

Social inequalities in mental health: results from the EU contribution to the World Mental Health Surveys Initiative

PURPOSE

The objective of the present study was to provide updated data from nine European countries about the impact of social inequalities in the prevalence of common mental disorders.

METHODS

Cross-sectional household survey of a representative sample of the adult general population of Belgium, Bulgaria, Germany, Italy, The Netherlands, Northern Ireland, Portugal, Romania and Spain. In total, 34,395 individuals were included. Social inequalities in 12-month mood, anxiety and alcohol-related disorders were evaluated.

RESULTS

In Europe, income seems not to be related to the prevalence of mental disorders. Unemployment and disablement are associated with mental disorders. Lower educational level augments the risk for mood disorders. Living in small (rural) areas decreases the risk for mood disorders and living in urban settings increases it. Northern Ireland, Portugal and Belgium are the countries with the highest risks for mental disorders.

CONCLUSIONS

Despite some contradictions with previous literature, in Europe there are social inequalities in the prevalence of mental disorders. However, income showed not to be associated with inequalities in mental health. Being younger, unemployed or disabled, with no education or incomplete primary studies, living in urban settings, and in Northern Ireland, Portugal or Belgium were associated to an augmented prevalence of mental disorders. Policy makers could focus on mental health promotion and mental disorders prevention programmes for risk groups such as unemployed/disabled individuals. Support to vulnerable groups (unemployed or those with less education) and mental health literacy can improve European citizens' mental health.

Occupation and the prevalence of current depression and frequent mental distress, WA BRFSS 2006 and 2008

BACKGROUND

Workers with depression and frequent mental distress (FMD) have lost work productivity. Limited systematic comparisons exist for the prevalence of depression and FMD across occupational groups.

METHODS

Using a state-added question for occupation coupled to measures of depression and FMD on the Washington State (WA) 2006 and 2008 Behavioral Risk Factor Surveillance System survey, we estimated the prevalence and odds ratios (ORs) among the 20,560 WA workers.

RESULTS

The prevalences of current depression and FMD were 5.2% and 7.5%, respectively. The prevalence varied considerably across occupations. Compared with Management occupation, Truck drivers had significantly increased odds for both current depression [OR = 6.18, 95% confidence interval (CI): 2.52-15.16] and FMD (OR = 1.85, 95% CI: 1.01-3.41). Cleaning/Building services (OR = 1.95, 95% CI: 1.11-3.40) and Protective services (OR = 1.97, 95% CI: 1.19-3.27) were associated with increased FMD.

CONCLUSIONS

These findings demonstrate the need for research on possible sources of the differences for current depression and FMD across occupations.

The prevalence of common mental disorders among hospital physicians and their association with self-reported work ability: a cross-sectional study

Background

We studied the prevalence of common mental disorders among Dutch hospital physicians and investigated whether the presence of a mental disorder was associated with insufficient self-reported work ability.

Methods

A questionnaire was sent to all (n = 958) hospital physicians of one academic medical center, using validated scales to assess burnout, work-related fatigue, stress, posttraumatic stress disorder (PTSD), anxiety and depression. Furthermore, respondents were asked to rate their current work ability against the work ability in their own best period (adapted version of the first WAI item). The prevalence of each common mental disorder was calculated. In addition, odds ratios of reporting insufficient work ability for subjects with high complaint scores compared to physicians with low complaint scores were calculated for each mental disorder.

Results

The response rate was 51%, and 423 questionnaires were eligible for analysis. The mental disorder prevalence rates were as follows: work-related fatigue 42%, depression 29%, anxiety 24%, posttraumatic stress complaints 15%, stress complaints 15% and burnout 6%. The mean score for self-reported work ability was 8.1 (range 0–10), and 4% of respondents rated their own work ability as insufficient. Physicians with high mental health complaints were 3.5- for fatigue, 5.6- for PTSD, 7.1- for anxiety, 9.5- for burnout, 10.8- for depression and 13.6-fold for stress more likely to report their work ability as insufficient.

Conclusions

The prevalence of common mental disorders among hospital physicians varied from 6% for burnout to 42% for work-related fatigue. Those physicians with high complaints had significantly 4- to 14 times increased odds of reporting their own work ability as insufficient. This work suggests that to ensure future workers health and patients safety occupational health services should plan appropriate intervention strategies.

Imprisonment, alcohol dependence and risk of delusional disorder: a cross-sectional study

BACKGROUND

Compared to the general population, an excess of psychotic illnesses, major depression and dependence disorders among prisoners has been reported. However, the impact of prison on detainees' psychopathology has rarely been studied.

OBJECTIVE

To determine the mental disorders liable to develop or regress on entry into prison and over time.

METHOD

Two samples of French prisoners detained in local prisons were interviewed using the same methodology. The first sample consisted of 267 new arrivals. The second was a random sample of 450 prisoners. Diagnoses were assessed using a thorough methodology: each prisoner was interviewed for approximately 2 hours by two clinicians. One of the clinicians used a structured clinical interview, which generates DSM IV diagnoses (MINI plus v 5.0); the second completed the procedure with an open clinical interview. The final DSM IV diagnoses were obtained as a consensus between the two approaches. Multilevel logistic regressions were used to take into account potential confounders.

RESULTS

Prevalence rates of mental disorders were substantially higher in prison even for the sample of newcomers (major depression disorder: 24.7%, substance dependence: 17.6% and schizophrenia: 4.1%). Alcohol dependence disorder was significantly more frequent in the sample of newcomers (OR 1.84 [1.01-3.51]). No significant difference was evidenced between samples for substance dependence disorder. Psychotic disorders were significantly less frequent at entry into prison, particularly delusional disorder (OR 0.29 [0.08-0.98]).

CONCLUSION

This study shows the contrasted potential effects of prison on psychopathology: alcohol dependence disorders were significantly more frequent for the newcomers, while the frequency of delusional disorders was lower. This evidence is arguing in favour of the validity of the old concept: prison psychosis. Moreover, prisoners should receive relevant help from clinicians to cope with these disorders.

Surveillance Programme of Work-related Diseases (WRD) in France

The surveillance programme of work-related diseases (WRD) is based on a network of occupational physicians who notify all WRD diagnosed during a two-week observation period. The aims are mainly to estimate the prevalence of non-compensated WRD in the working population according to socio economic factors; to determine new indicators of occupational health; to update the lists of compensable occupational diseases; to understand and assess under-compensation and under-notification. The participation rate for occupational physicians is around 33% in 2008. The main WRD are the musculoskeletal disorders, followed by the mental disorders. This 2-week protocol, repeated regularly, provides useful data on frequency of pathologies linked to employment as well as an estimate of unreported WRD subject to compensation or non-compensated WRDs, and the trends of WRDs over the time.

Incidence of work and non-work related disability claims in Brazil

BACKGROUND

Sickness benefit claims are an important economic burden to society. This study aims to determine the incidence of sickness benefit claims in Brazil in 2008, exploring the role of economic activity.

METHODS

Population-based study on sickness claims lasting longer than 15 days of sickness absence granted to private sector employees. Data on gender, age, economic activity, diagnosis, and work-relatedness were collected.

RESULTS

The annual incidence of sickness benefits was 421.8/10,000 jobs, 435.4 for males and 452.0 for females. There were 3.5 times more non-work-related than work-related claims. The main diagnoses were injuries, musculoskeletal disorders, and mental disorders. Rates increased with age up to 59 years. Economic activity 37-Sewage had the highest incidence of non-work-related and work-related claims.

CONCLUSION

The incidence of sickness benefits is higher among female and older workers. Economic activities show great variability of sickness benefit rates, work-relatedness, diagnostic categories, and gender.