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Gray J, Santos-Lozada AR, Hard G, Apsley H, O’Sullivan D, Jones AA. Serious Psychological Distress, Substance Use Disorders, and Social Issues Among Men and Women in the United States During the COVID-19 Pandemic. Am J Health Promot 2023; 37:933-939. [PMID: 37401052 PMCID: PMC10333561 DOI: 10.1177/08901171231188187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE This study assesses the association between SUD, economic hardship, gender, and related risk and protective factors on serious psychological distress (SPD) during the COVID-19 pandemic. DESIGN Quantitative cross-sectional design. SETTING National Survey on Drug Use and Health (NSDUH). SAMPLE Data were from the NSDUH (2020) N = 25,746, representing 238,677,123 US adults, who identified as 18 or older and either male or female. MEASURES SPD measured as scoring a 13 or more on the Kessler (K6) distress scale. SUDs were determined using DSM5 criteria. Sociodemographic and socioeconomic variables included in analyses. ANALYSIS Logistic regressions evaluated the association between gender, protective, and risk factors on SPD. RESULTS After controlling for sociodemographic and related factors of SPD, having a SUD was the strongest correlate of SPD. Other significant correlates of SPD included female gender and an income level at or below the federal poverty threshold. Gender stratified regressions illustrated that religiosity, self-identifying as Black, and high levels of education were protective against SPD for women but not men. Poverty level was more associated with SPD for women than men. CONCLUSION In the United States, individuals with SUDs were nearly four times more likely to report SPD than those without SUDs, controlling for economic hardship and markers of social support during 2020. Effective social interventions to reduce SPD among individuals with SUDs are needed.
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Affiliation(s)
- Joy Gray
- Department of Educational Psychology, Counseling, and Special Education College of Education, The Pennsylvania State University, University Park, PA, USA
| | - Alexis R. Santos-Lozada
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Greg Hard
- Simches Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Hannah Apsley
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Deirdre O’Sullivan
- Department of Educational Psychology, Counseling, and Special Education College of Education, The Pennsylvania State University, University Park, PA, USA
- Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA, USA
| | - Abenaa A. Jones
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA, USA
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Thomas CP, Stewart MT, Ledingham E, Adams RS, Panas L, Reif S. Quality of Opioid Use Disorder Treatment for Persons With and Without Disabling Conditions. JAMA Netw Open 2023; 6:e232052. [PMID: 36884250 PMCID: PMC9996401 DOI: 10.1001/jamanetworkopen.2023.2052] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Adverse outcomes associated with opioid use disorder (OUD) are disproportionately high among people with disabilities (PWD) compared with those without disability. A gap remains in understanding the quality of OUD treatment for people with physical, sensory, cognitive, and developmental disabilities, specifically regarding medications for OUD (MOUD), a foundation of treatment. OBJECTIVE To examine the use and quality of OUD treatment in adults with diagnosed disabling conditions, compared with adults without these diagnoses. DESIGN, SETTING, AND PARTICIPANTS This case-control study used Washington State Medicaid data from 2016 to 2019 (for use) and 2017 to 2018 (for continuity). Data were obtained for outpatient, residential, and inpatient settings with Medicaid claims. Participants included Washington State full-benefit Medicaid enrollees aged 18 to 64 years, continuously eligible for 12 months, with OUD during the study years and not enrolled in Medicare. Data analysis was performed from January to September 2022. EXPOSURES Disability status, including physical (spinal cord injury or mobility impairment), sensory (visual or hearing impairments), developmental (intellectual or developmental disability or autism), and cognitive (traumatic brain injury) disabilities. MAIN OUTCOMES AND MEASURES The main outcomes were National Quality Forum-endorsed quality measures: (1) use of MOUD (buprenorphine, methadone, or naltrexone) during each study year and (2) 6-month continuity of treatment (for those taking MOUD). RESULTS A total of 84 728 Washington Medicaid enrollees had claims evidence of OUD, representing 159 591 person-years (84 762 person-years [53.1%] for female participants, 116 145 person-years [72.8%] for non-Hispanic White participants, and 100 970 person-years [63.3%] for participants aged 18-39 years); 15.5% of the population (24 743 person-years) had evidence of a physical, sensory, developmental, or cognitive disability. PWD were 40% less likely than those without a disability to receive any MOUD (adjusted odds ratio [AOR], 0.60; 95% CI, 0.58-0.61; P < .001). This was true for each disability type, with variations. Individuals with a developmental disability were least likely to use MOUD (AOR, 0.50; 95% CI, 0.46-0.55; P < .001). Of those using MOUD, PWD were 13% less likely than people without disability to continue MOUD for 6 months (adjusted OR, 0.87; 95% CI, 0.82-0.93; P < .001). CONCLUSIONS AND RELEVANCE In this case-control study of a Medicaid population, treatment differences were found between PWD and people without these disabilities; these differences cannot be explained clinically and highlight inequities in treatment. Policies and interventions to increase MOUD access are critical to reducing morbidity and mortality among PWD. Potential solutions include improved enforcement of the Americans with Disabilities Act, workforce best practice training, and addressing stigma, accessibility, and the need for accommodations to improve OUD treatment for PWD.
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Affiliation(s)
- Cindy Parks Thomas
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Maureen T. Stewart
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Emily Ledingham
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Rachel Sayko Adams
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, Colorado
| | - Lee Panas
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Sharon Reif
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
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Incidence and persistence of psychological distress during the COVID-19 pandemic among individuals with and without disability. J Psychosom Res 2023; 165:111127. [PMID: 36610334 PMCID: PMC9783094 DOI: 10.1016/j.jpsychores.2022.111127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We investigated the incidence (becoming distressed at the follow-up) and persistence (distressed at the baseline and the follow-up) of psychological distress among individuals with and without disability in the period from early 2017 (before the COVID-19 pandemic) to late 2020 (the second wave of the pandemic). METHODS We analyzed the population-based FinHealth 2017 survey and its follow-up conducted in 2020 (number of individuals who participated in both surveys: n = 4881; age = 18+). Logistic regressions were applied to investigate differences in the incidence and persistence of psychological distress between people with and without disability. We also investigated whether age, quality of life at the baseline, and perceived increase in loneliness during the COVID-19 pandemic moderated the association between disability and the incidence of distress. RESULTS The incidence of psychological distress was higher (OR = 3.01, 95% CI:2.09-4.35) for people with disability (18.9%) than among those without (7.4%), being highest (31.5%) among the youngest participants with disability, aged 18 to 39. People with disability who had a poor quality of life at the baseline were particularly prone to become distressed during the follow-up. People who reported perceived increase in loneliness during the pandemic were prone to become distressed at the follow-up regardless of their disability status. The persistence of distress was more common (OR = 6.00, 95% CI:3.53-10.12) among people with disability (65.7%) than among those without (24.9%). CONCLUSION The COVID-19 pandemic had more negative mental health effects on people with disability, especially adults with disability who were young and had a low quality of life before the pandemic.
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Nicholson J, Valentine A, Ledingham E, Reif S. Peer Support at the Intersection of Disability and Opioid (Mis)Use: Key Stakeholders Provide Essential Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9664. [PMID: 35955019 PMCID: PMC9368223 DOI: 10.3390/ijerph19159664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/27/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Individuals with disabilities may experience higher rates of opioid/substance use disorders (OUD/SUD) than other individuals and are likely vulnerable to unmet treatment needs. Peer support may be beneficial to these individuals, given the evidence of benefits in target populations with similar needs and the potential for overcoming barriers to treatment suggested in the available literature. The objective of this exploratory study was to specify essential considerations in adapting peer support for this population. Diverse key stakeholders (n = 16) were interviewed to explore the experiences, needs, and available supports for individuals with disabilities and OUD/SUD. A Peer Support Work Group including members with lived experience advised each component of the study. Semi-structured interview data were content analyzed and memos generated to summarize themes related to the research question. Participants reported extensive professional and personal experience in human services, disability, and recovery. Emergent themes included the importance of accessibility and model fit, the notion of "peerness" and peer match, and essential aspects of peer recruitment, training, and support. An accessible, acceptable, effective model of peer support requires particular attention to the needs of this diverse and varied population, and the contexts in which they are identified, referred, and engaged in services.
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Affiliation(s)
- Joanne Nicholson
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Anne Valentine
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Emily Ledingham
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Sharon Reif
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
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Differences in Unfavorable Lifestyle Changes during the COVID-19 Pandemic between People with and without Disabilities in Finland: Psychological Distress as a Mediator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126971. [PMID: 35742223 PMCID: PMC9223132 DOI: 10.3390/ijerph19126971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 02/06/2023]
Abstract
We investigated whether people with disabilities—cognition, vision, hearing, mobility, or at least one of these disabilities—report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes—sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson–Holm–Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.
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Leary E, Zachary I, Kyeong NY. Regional Differences in Serious Psychological Distress and Overall Physical and Mental Health. Community Ment Health J 2022; 58:770-778. [PMID: 34455555 PMCID: PMC8403461 DOI: 10.1007/s10597-021-00882-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/18/2021] [Indexed: 11/20/2022]
Abstract
To determine regional differences in the prevalence of overall physical health, overall mental health, and serious psychological distress (SPD). Data from the 2004 to 2016 Medical Expenditure Panel Survey were used for weighted analysis across region. Relationship modifiers considered were sociodemographic factors, health factors, and measures of health expenditures. A higher burden ratio of health care expenditures is negatively associated with health outcomes, across all US regions and insurance. Compared to 2004 values, SPD, overall physical health, and mental health are significantly improved after 2014. This research supports the whole health paradigm, indicating that overall mental and physical health are closely related. The burden of health care costs is an important consideration and related to overall health outcomes, regardless of insurance status or region. These considerations are likely increasingly important to consider with recent global events.
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Affiliation(s)
- Emily Leary
- School of Medicine, University of Missouri-Columbia, Columbia, MO, USA.
| | - Iris Zachary
- School of Medicine, University of Missouri-Columbia, Columbia, MO, USA
| | - Na Young Kyeong
- School of Medicine, University of Missouri-Columbia, Columbia, MO, USA
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Lundeen EA, Saydah S, Ehrlich JR, Saaddine J. Self-Reported Vision Impairment and Psychological Distress in U.S. Adults. Ophthalmic Epidemiol 2022; 29:171-181. [PMID: 33896341 PMCID: PMC10949979 DOI: 10.1080/09286586.2021.1918177] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Examine the relationship between vision impairment and psychological distress in adults ≥18 years. METHODS Using the 2016-2017 cross-sectional, U.S. National Health Interview Survey, we analyzed self-reported data (n = 57,644) on: Kessler psychological distress scores; general vision impairment (GVI), defined as difficulty seeing even when wearing glasses or contacts; and visual function impairment (VFI), measured using six visual function questions. Multinomial logistic regression was used to estimate adjusted odds ratios (aOR) for mild/moderate and serious psychological distress, by GVI and VFI status, and identify predictors of psychological distress among those with GVI or VFI. RESULTS Among adults, 10.6% (95% CI: 10.2, 11.0) had GVI; 11.6% (CI: 11.1, 12.0) had VFI. One in four adults with GVI had psychological distress (14.9% [CI: 13.8, 16.0] reported mild/moderate and 11.2% [CI: 10.2, 12.3] reported serious). Individuals with GVI, versus those without, had higher odds of mild/moderate (aOR = 2.24; CI: 2.00, 2.52) and serious (aOR = 3.41; CI: 2.96, 3.93) psychological distress; VFI had similar findings. Among adults with GVI, odds of serious psychological distress were higher for those aged 18-39 (aOR = 4.46; CI: 2.89, 6.90) or 40-64 (aOR = 6.09; CI: 4.33, 8.57) versus ≥65 years; smokers (aOR = 2.45; CI: 1.88, 3.18) versus non-smokers; physically inactive (aOR = 1.61; CI: 1.22, 2.11) versus active; and with arthritis (aOR = 2.18; CI: 1.66, 2.87) or chronic obstructive pulmonary disease (aOR = 1.65; CI: 1.15, 2.37) versus without. CONCLUSION Adults with self-reported vision impairment had higher odds of psychological distress. These findings may inform screening interventions to address psychological distress, particularly among younger working-age adults vision impairment.
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Affiliation(s)
- Elizabeth A Lundeen
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Sharon Saydah
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - Jinan Saaddine
- Division of Diabetes Translation (DDT, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Ross EJ, Cassisi JE, Joseph D, Dunn ME, Jex S. Cross-lagged analyses between gastrointestinal symptoms, psychological distress, and disability in emerging adults. Appl Psychol Health Well Being 2022; 14:920-936. [PMID: 35318797 DOI: 10.1111/aphw.12358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022]
Abstract
The gut-brain connection refers to communication between the brain and gastrointestinal (GI) system. Disorders of gut-brain interaction (DGBI) are characterized by GI symptoms that accompany distress and disability. Epidemiological research has suggested DGBI rates in emerging adults are increasing. This study investigated the relationship between GI health, distress, and disability in emerging adults across time. Emerging adults were recruited. A repeated-measure design with a 1-month time lag was used to collect data via an online survey (N = 861) across five academic semesters (Spring 2019 to Summer 2020). Measurement equivalence across time was established and a cross-lagged panel model (CLPM) was specified. Distress at Time 1 predicted GI symptoms at Time 2 (β = .206, SE = .084, p < .05). GI symptoms at Time 1 predicted disability at Time 2 (β = .117, SE = .039, p < .01). Higher disability at Time 1 predicted distress at Time 2 (β = .092, SE = .027, p < .01). The cross-lagged design offers stronger causal inferences than cross-sectional studies used to study the effects of GI symptoms. Findings provide initial evidence of a directional pathway between brain and gut rather than a bidirectional network. Findings highlight the importance of psychogastroenterology.
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Affiliation(s)
- Emily Jayne Ross
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Jeffrey E Cassisi
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Dana Joseph
- Department of Management, Business Administration, University of Central Florida, Orlando, Florida, USA
| | - Michael E Dunn
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Steve Jex
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
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Grzenda A, Xu H, Miranda J, Ettner SL. Impact of the 2016 Election on the Quality of Life of Sexual and Gender Minority Adults: A Difference-in-Differences Analysis. LGBT Health 2021; 8:386-394. [PMID: 34242086 DOI: 10.1089/lgbt.2020.0334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The 2016 U.S. election significantly changed the political landscape for sexual and gender minority (SGM) individuals. The current study assessed the consequences of the election and transition to a new overtly discriminatory administration on the health-related quality of life of SGM adults compared with their cisgender and heterosexual counterparts. Methods: The study used repeated cross-sectional data from the 17 states that administered the sexual orientation and gender identity module in the 2015 and 2018 Behavioral Risk Factor Surveillance System surveys. The sample included 268,851 adult respondents: 12,006 SGM adults (5.35%) and 256,845 cisgender and heterosexual adults (94.65%). Outcomes were frequent (≥14 days in the last month) physical distress, mental distress, limited activity, and/or fair/poor general health. Difference-in-differences estimates were calculated from logistic regression models, controlling for sociodemographic, health care coverage, and chronic medical condition confounders. Results: Compared with the cisgender and heterosexual population, frequent mental distress among SGM adults increased by 5% points, corresponding to a relative increase of 32.5% (p < 0.001) from 2015. Rates of frequent physical distress, limited activity, and fair/poor general health were not significantly altered between the two populations. Gender minority adults were most negatively affected with a relative increase in frequent mental distress of 117.5% (p < 0.001). Conclusions: The 2016 U.S. election and administration changeover were associated with a substantial increase in the proportion of SGM adults reporting frequent mental distress. These data provide empirical evidence as to the psychological effects of an abrupt political realignment on SGM mental health.
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Affiliation(s)
- Adrienne Grzenda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.,Olive View-UCLA Medical Center, Sylmar, California, USA
| | - Haiyong Xu
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Jeanne Miranda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.,Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, California, USA
| | - Susan L Ettner
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.,Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, California, USA
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Williams MR, Do DP. The Compounded Burden of Poverty on Mental Health for People with Disabilities. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:419-431. [PMID: 33832403 DOI: 10.1080/19371918.2021.1905579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Using 2008-2017 National Health Interview Survey data (N = 127,973), we investigated the relationship between income and psychological distress, measured by the Kessler 6 (K6) Scale (range 0-24), net of education, employment, and other sociodemographic characteristics. Regression models allowed the association to differ by disability status and number of disabilities. Lower income predicted higher psychological distress for those with and without disabilities. However, the adverse association was stronger among people with disabilities. Compared to those with incomes at least four times the poverty threshold, poor individuals with disabilities scored 2.81 (95% CI = 2.55,3.67) points higher on the K6 Scale versus 0.58 (95% CI = 0.48,0.69) points higher for those without disabilities. Differences in associations by number of disabilities were not statistically significant. Nonetheless, those with multiple disabilities were still at increased risk of distress because they were disproportionately poor. People with disabilities who are poor are particularly disadvantaged and should be prioritized in outreach efforts.
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Affiliation(s)
- Meredith R Williams
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - D Phuong Do
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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Du W, Wang J, Zhou Q. Urgent Need of Integrated Health and Social Care to Alleviate High Psychological Distress in People with Disabilities: A Cross-Sectional National Representative Survey in Australia. Risk Manag Healthc Policy 2021; 14:1541-1550. [PMID: 33883958 PMCID: PMC8055466 DOI: 10.2147/rmhp.s291004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/27/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate factors in association with high psychological distress in people with disabilities. METHODS We used the 2015 national survey on disability in Australia to derive the representative study population of 7936 people with disabilities aged 18+ years. The Kessler Psychological Distress Scale (K10) was used to define high psychological distress (scores ≥22). The explanatory variables included socioeconomic status, physical health, social relationships and environment factors. Adjusted Odds Ratios (ORs) and 95% Confidence Intervals (CIs) were evaluated using weighted Logistic regression models with lasso techniques. RESULTS Approximately 21 in 100 study participants experienced high psychological distress. The risk of high psychological distress decreased with age and high educational attainment. Having non-English speaking background (2.31; 1.87-2.85) and need for assistance in cognitive or emotional tasks (3.25; 2.65-3.98) were independently significantly associated with high psychological distress in people with disabilities. Delay seeing a GP was associated with a 2-fold risk increase. CONCLUSION Integrated healthcare and social support are warranted with appropriate targeting to improve mental health outcomes in people with disabilities.
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Affiliation(s)
- Wei Du
- School of Public Health, Southeast University, Nanjing, People’s Republic of China
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Jiali Wang
- Research School of Finance, Actuarial Studies & Statistics, Australian National University, Canberra, Australia
- Massachusetts Eye and Ear Institute, Harvard University, Cambridge, USA
| | - Qingsheng Zhou
- Faculty of Health Science, University of Sydney, Sydney, Australia
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Lennon O, Ryan C, Helm M, Moore K, Sheridan A, Probst M, Cunningham C. Psychological Distress among Patients Attending Physiotherapy: A Survey-Based Investigation of Irish Physiotherapists' Current Practice and Opinions. Physiother Can 2020; 72:239-248. [PMID: 35110792 DOI: 10.3138/ptc-2019-0010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The primary purpose of this study was to investigate the current practice and opinions of members of the Irish Society of Chartered Physiotherapists (ISCP) with respect to the care of patients in psychological distress. Method: This was a cross-sectional, survey-based investigation of Irish physiotherapists. An electronic survey was sent by email to the ISCP membership. It consisted of closed- and open-ended questions, as well as opinion questions with Likert scale responses. Results: More than 80% of the respondents reported that they encountered patients with psychological distress at least once a week. A lack of education in the area of mental health emerged as a predominant theme. Reflecting on current practice, many discussed the importance of addressing underlying psychological issues before or in tandem with physical issues. Respondents who had engaged in further education in mental health, psychology, or both rated their confidence in recognizing the signs and symptoms of psychological distress higher (p < 0.001). Moreover, a greater proportion of these respondents routinely assessed for psychological distress in their clinical practice (p < 0.001). Conclusion: Physiotherapists regularly encounter patients whom they perceive to have high levels of psychological distress. Irish physiotherapists displayed positive attitudes toward patients' psychological well-being. However, additional education in mental health was a recognized need in the profession.
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Affiliation(s)
- Olive Lennon
- School of Public Health, Physiotherapy and Sports Science
| | - Cormac Ryan
- School of Public Health, Physiotherapy and Sports Science
| | - Maggie Helm
- School of Public Health, Physiotherapy and Sports Science
| | - Katrina Moore
- School of Public Health, Physiotherapy and Sports Science
| | - Ann Sheridan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Michel Probst
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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Weinberger AH, Pacek LR, Sheffer CE, Budney AJ, Lee J, Goodwin RD. Serious psychological distress and daily cannabis use, 2008 to 2016: Potential implications for mental health? Drug Alcohol Depend 2019; 197:134-140. [PMID: 30825793 PMCID: PMC6440801 DOI: 10.1016/j.drugalcdep.2019.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/14/2018] [Accepted: 01/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Daily cannabis use is increasing in the United States (US). Yet, it is not known whether daily cannabis use is disproportionately common, or whether it has increased differentially over time, by mental health status. This study estimated the prevalence of daily cannabis use among adults in the US with and without past-month serious psychological distress (SPD; measured by the Kessler Psychological Distress Scale (K6)) in 2016 and estimated trends in daily cannabis use by past-30-day SPD status from 2008 to 2016. METHODS Data were drawn from adults age 18 and older in the 2008-2016 National Survey on Drug Use and Health (combined total analytic sample n = 356,413). Linear time trends of daily cannabis use, stratified by SPD status, were assessed using logistic regression models with continuous year as the predictor. RESULTS In 2016, past-month daily cannabis use was significantly more common among those with past-month SPD (8.07%), compared to those without past-month SPD (2.66%). Daily cannabis use increased significantly from 2008 to 2016 among those both with and without SPD although use among those with SPD was persistently higher than use among those without SPD over the time period studied. CONCLUSIONS Daily cannabis use is significantly more common among persons with serious psychological distress and is increasing in this group, as well as among those without. Given this increase and the high prevalence of cannabis use among those with SPD, it may be important to consider potential consequences of this increased use for those with mental health vulnerabilities.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Yeshiva University Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA.
| | - Alan J Budney
- Geisel School of Medicine at Dartmouth, Center for Technology and Behavioral Health, Lebanon, NH, USA.
| | - Joun Lee
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Renee D Goodwin
- Institute for Implementation Science and Population Health, CUNY School of Public Health and Health Policy, New York, NY, USA; Department of Epidemiology and Biostatistics, CUNY School of Public Health, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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14
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Chanti-Ketterl M, Gamaldo A, Andel R, Thorpe RJ. The Association Between Lipoproteins, Disability, and Physical Function Among Older Costa Rican Adults. J Aging Health 2018; 30:758-777. [PMID: 28553801 PMCID: PMC5538937 DOI: 10.1177/0898264317690866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the relationship between total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) with disability and physical performance. METHOD Wave 1 data were from Costa Rican Longevity and Healthy Aging Study ( n = 2,827). Lipoprotein profiles were measured using blood samples. Disability and physical functioning were measured with activities of daily living/instrumental activities of daily living (ADLs/IADLs) and objective assessment of physical performance. RESULTS Lower HDL-C was associated with greater ADL disability, and lower TC with longer time to pick-a-pencil and Time-Up-Go (TUG) test. Age interacted between (a) TG and lung function, chair stands, and pick-a-pencil, and (b) HDL-C and TUG. Stratification showed lower TG and longer time picking up a pencil only for those above 84 years. Based on significant interactions with sex, lower TC was associated with slower chair stand time in women and higher HDL-C with slower chair stand time in men. DISCUSSION Lower levels of lipoproteins may suggest worse physical function, but the association may differ by sex.
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Affiliation(s)
| | | | - Ross Andel
- University of South Florida, FL, USA
- St. Anne’s University Hospital, Brno, Czech Republic
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15
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Johnsen NF, Davidsen M, Michelsen SI, Juel K. Health profile for Danish adults with activity limitation: a cross-sectional study. BMC Public Health 2017; 18:46. [PMID: 28738796 PMCID: PMC5525283 DOI: 10.1186/s12889-017-4532-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 06/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies have indicated that people with disabilities die earlier and may experience a poorer health than the general population. This study investigated 31 factors related to health and well-being, health behaviour and social relations among Danish adults with activity limitation (AL). METHODS This study was based on data from the Danish Health and Morbidity Survey (DHMS) 2013 where 25,000 men and women aged 16 years or older were selected randomly from the adult Danish population. A total of 14,265 individuals answered the self-administered questionnaire including 100 questions on health-related quality of life, health behaviour, morbidity, consequences of illness and social relations. Based on an international standard question on AL, 888 individuals (6%) were defined as having profound AL and 4180 (29%) as having some AL. Multiple logistic regression analyses were used to analyse the associations between activity limitation and 31 indicators of health. The results were presented as relative risks 95% confidence intervals. RESULTS Twenty-eight of 31 indicators showed consistently poorer health and well-being, health behaviour and social relations among individuals with AL as compared to individuals without AL. The increased relative risks were in a range of 7-661% the risk among individuals without AL. An example is obesity where RR (95% CI) was 2.07 (1.82-2.37). Only contact with internet friends was significantly higher among individuals with AL as compared to individuals with no AL. There was no association between alcohol and AL and no association between fast food and some AL. CONCLUSION Danish adults with AL experience a poorer health and well-being, and have an unhealthier lifestyle and poorer social relations than adults without AL. People with activity limitation should be prioritized in public health and efforts done to secure availability and flexibility of health care services and primary prevention programs. Policies should address accessibility, availability and affordability of health care and health behaviour among people with activity limitation.
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Affiliation(s)
- Nina Føns Johnsen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen K, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen K, Denmark
| | - Susan Ishøy Michelsen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen K, Denmark
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen K, Denmark
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16
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Okoro CA, Dhingra SS, Li C. A triple play: psychological distress, physical comorbidities, and access and use of health services among U.S. adults with disabilities. J Health Care Poor Underserved 2014; 25:814-36. [PMID: 24858888 PMCID: PMC8246314 DOI: 10.1353/hpu.2014.0103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Among adults with disabilities, we examined whether increasing levels of psychological distress were associated with higher estimated prevalences of chronic conditions, obesity, health care access, and use of preventive services. METHODS We analyzed data from the 2007 Behavioral Risk Factor Surveillance System. The Kessler-6 scale was used to assess psychological distress. RESULTS Increasing levels of psychological distress were associated with an increased prevalence of chronic diseases and conditions, and decreased access to health care and utilization of preventive services in keeping with what has been established for non-disabled populations. Among adults with disabilities, aged 18-64 years and 65 years or older, increasing levels of distress were also associated with increased receipt of mental health treatment. However, compared to adults aged 18-64 years, larger proportions of older adults reported non-receipt of mental health treatment (mild to moderate psychological distress: 58.0% versus 70.6%; serious psychological distress: 40.5% versus 54.5%). CONCLUSIONS While adults with disabilities who had increased levels of psychological distress were more likely to receive mental health services, they also had higher estimated prevalences of chronic conditions, barriers to health care, and non-receipt of preventive cancer screenings.
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Okoro CA, Stoodt G, Rohrer JE, Strine TW, Li C, Balluz LS. Physical activity patterns among U.S. adults with and without serious psychological distress. Public Health Rep 2014; 129:30-8. [PMID: 24381357 DOI: 10.1177/003335491412900106] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE A physically active lifestyle is recommended for overall health--both physical and mental. Serious psychological distress (SPD) is associated with adverse health behaviors. We compared patterns of physical activity (PA) among adults with and without SPD using current public health guidelines for PA and examined whether adults with SPD were physically active at recommended levels. METHODS We used data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to assess SPD using the Kessler 6 (K6) scale of nonspecific psychological distress and PA categories based on the 2008 U.S. Department of Health and Human Services guidelines. Complete data were available for 78,886 adults in 16 states that used an optional BRFSS mental illness and stigma module containing the K6 scale. We performed multiple logistic regression analyses to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS The unadjusted prevalence of SPD was 3.9% (95% CI 3.6, 4.2), and the age-adjusted prevalence of SPD was 3.8% (95% CI 3.5, 4.1). After adjusting for age, sex, race/ethnicity, education, employment, body mass index, smoking status, and heavy drinking, adults with SPD were significantly less likely to be physically active at recommended levels than adults without SPD. PRs were attenuated but remained significant after further adjustment for limitations to PA. CONCLUSION Adults with SPD are less likely to meet current PA recommendations than adults without SPD, highlighting the need for targeted interventions.
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Affiliation(s)
- Catherine A Okoro
- Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services, Public Health Surveillance & Informatics Program Office, Division of Behavioral Surveillance, Atlanta, GA
| | - Georjean Stoodt
- Walden University, College of Health Sciences, School of Health Sciences, Minneapolis, MN
| | - James E Rohrer
- Walden University, College of Health Sciences, School of Health Sciences, Minneapolis, MN
| | - Tara W Strine
- Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, Atlanta, GA
| | - Chaoyang Li
- Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services, Public Health Surveillance & Informatics Program Office, Division of Behavioral Surveillance, Atlanta, GA
| | - Lina S Balluz
- Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services, Public Health Surveillance & Informatics Program Office, Division of Behavioral Surveillance, Atlanta, GA
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18
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Dallo FJ, Kindratt TB, Snell T. Serious psychological distress among non-Hispanic whites in the United States: the importance of nativity status and region of birth. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1923-30. [PMID: 23661150 DOI: 10.1007/s00127-013-0703-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 04/29/2013] [Indexed: 01/28/2023]
Abstract
PURPOSE Serious psychological distress (SPD) is an understudied health topic. When studied, estimates for minority groups are compared to that of non-Hispanic whites. Non-Hispanic whites are heterogeneous, and comprise individuals from Europe, North Africa or the Middle East. The objectives of this study are to estimate and compare the sex- and age-adjusted prevalence of SPD first by nativity status and then by region of birth (Europe, Middle East and Russia) while controlling for potential confounders. METHODS The sample consisted of 196,483 participants, 18 years of age or older in the National Health Interview Survey (2000-2010). To measure SPD, Kessler's K6 Likert scale was used. Individuals with scores greater than or equal to 13 were considered to have SPD. RESULTS The age- and sex- adjusted prevalence of SPD was 3 % for foreign-born non-Hispanic whites. Of this, estimates were 6 % for those from the Middle East, 3 % for Europe and 2 % for Russia (p = 0.00). In the fully adjusted multivariable model, foreign-born non-Hispanic whites from the Middle East were more likely (OR = 1.76; 95 % CI = 1.01, 3.04) to report SPD when compared to US-born non-Hispanic whites. Within the foreign-born population, non-Hispanic whites from the Middle East were more than twice as likely to report SPD (OR = 2.43; 95 % CI = 1.15, 5.14) compared to foreign-born non-Hispanic whites from Europe after controlling for confounders. CONCLUSIONS This study's findings will help researchers understand which subgroups within non-Hispanic whites suffer most from SPD, which will facilitate tailored prevention intervention efforts.
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Affiliation(s)
- Florence J Dallo
- Wellness, Health Promotion and Injury Prevention, School of Health Sciences, Oakland University, Rochester, MI, 48309-4428, USA,
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Theis KA, Murphy L, Hootman JM, Wilkie R. Social participation restriction among US adults with arthritis: a population-based study using the International Classification of Functioning, Disability and Health. Arthritis Care Res (Hoboken) 2013; 65:1059-69. [PMID: 23401463 PMCID: PMC4466902 DOI: 10.1002/acr.21977] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/29/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine arthritis impact among US adults with self-reported doctor-diagnosed arthritis using the International Classification of Functioning, Disability and Health (ICF) framework (including the impairments, activity limitations, environmental, and personal factors domains and social participation restriction [SPR] as the outcome) overall and among those with and without SPR, and to identify the correlates of SPR. METHODS Cross-sectional 2009 National Health Interview Survey data were analyzed to examine the distribution of the ICF domain components. Unadjusted and multivariable-adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated to identify the correlates of SPR. Analyses using SAS, version 9.2 survey procedures accounted for the complex sample design. RESULTS SPR prevalence was 11% of adults with arthritis (5.7 million). After initial multivariable adjustment by ICF domain, serious psychological distress (impairments domain; PR 2.5 [95% CI 2.0-3.2]), ≥5 medical office visits (environmental domain; PR 3.4 [95% CI 2.5-4.4]), and physical inactivity (personal domain; PR 4.8 [95% CI 3.6-6.4]) were most strongly associated with SPR. A combined measure (key limitations [walking, standing, or carrying]; PR 31.2 [95% CI 22.3-43.5]) represented the activity limitations domain. After final multivariable adjustment incorporating all ICF domains simultaneously, the strongest associations with SPR were key limitations (PR 24.3 [95% CI 16.8-35.1]), ≥9 hours of sleep (PR 1.6 [95% CI 1.3-2.0]), and income-to-poverty ratio <2.00 and severe joint pain (PR 1.4 [95% CI 1.2-1.6] for both). CONCLUSION SPR affects 1 of 9 adults with arthritis. This study is the first to use the ICF framework in a population-based sample to identify specific functional activities, pain, sleep, and other areas as priorities for intervention to reduce negative arthritis impacts on disability, including SPR. Increased use of existing clinical and public health interventions is warranted.
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Affiliation(s)
- K A Theis
- Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Pan HJ, Cole BM, Geliebter A. The benefits of body weight loss on health-related quality of life. J Chin Med Assoc 2011; 74:169-75. [PMID: 21463847 PMCID: PMC3835351 DOI: 10.1016/j.jcma.2011.01.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 11/30/2010] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Obesity is a worldwide public health issue, and the prevalence of obesity is also increasing steadily in Taiwan. Obesity leads to several chronic diseases. Often, impaired quality of life is a consequence of obesity. The aim of this study was to determine if body weight-loss could improve health-related quality of life (HRQOL) in Taiwan. METHODS The cutoff for obesity is body mass index (BMI) = 27 as compared with 30 in US and Europe. We enrolled 67 participants with BMI ≥ 27 and more than one criterion of the metabolic syndrome, who underwent 3 months of body weight-loss intervention by diet control and regular exercise. We performed anthropometric measurements and blood tests, and administered the WHOQOL-BREF questionnaire Taiwanese version to assess HRQOL before and after the weight loss intervention. This is the first study using the WHOQOL-BREF to examine HRQOL in Taiwan. The questionnaire included D1 physical, D2 psychological, D3 social relationships and D4 environmental domains; each was scored from 4 to 20. RESULTS Obese subjects had lower D1 and D2 scores as compared with the Taiwan healthy population reference group at baseline. In this study, 38 participants completed the 3-month intervention program and 29 participants dropped out. Twenty-five participants reached the 5% of initial BMI goal. Among them, significant statistical improvements were found both in medical comorbidities and in the four domains of the HRQOL questionnaire. CONCLUSION Obesity can cause impaired HRQOL, which can be improved through BMI intervention. In addition to the benefits of biomedical aspect, this could be an incentive goal for keeping body weight control.
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Affiliation(s)
- Hsiang-Ju Pan
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
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Chittleborough CR, Winefield H, Gill TK, Koster C, Taylor AW. Age differences in associations between psychological distress and chronic conditions. Int J Public Health 2010; 56:71-80. [PMID: 20886258 DOI: 10.1007/s00038-010-0197-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 07/27/2010] [Accepted: 09/12/2010] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine associations between psychological distress (PD) and chronic health conditions among different age groups in a representative population sample. METHODS PD measured by the Kessler-10, and the presence of diagnosed chronic conditions were self-reported by respondents aged 18 years and over in a South Australian continuous computer-assisted telephone interviewing surveillance system from July 2002 to June 2007 (n = 26,376). RESULTS The overall prevalence of PD was 9.8% (95% CI 9.5-10.2). In age-specific adjusted multivariate models, arthritis and mental health conditions remained significantly associated with PD for all age groups, cardiovascular disease was significantly associated with PD among those aged 35 years and over, asthma was associated with PD for respondents aged 50 years and over, and osteoporosis was associated with PD for 50-64 year olds. Being born outside of Australia, United Kingdom or Ireland, current smoking, low level of education, and low income also remained significantly associated with PD for all age groups. CONCLUSIONS Young people experience a higher prevalence of PD than older age groups, irrespective of the presence of chronic conditions.
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Affiliation(s)
- Catherine R Chittleborough
- Population Research and Outcome Studies Unit, SA Health, Level 8, CitiCentre Building, 11 Hindmarsh Square, Adelaide, SA, 5000, Australia
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Bellin MH, Zabel TA, Dicianno BE, Levey E, Garver K, Linroth R, Braun P. Correlates of depressive and anxiety symptoms in young adults with spina bifida. J Pediatr Psychol 2009; 35:778-89. [PMID: 19880443 PMCID: PMC2908707 DOI: 10.1093/jpepsy/jsp094] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Based on social ecological theory, this study was designed to examine the unique relationships between multi-level ecological factors and psychological symptoms in young adults with spina bifida (SB). METHOD A sample of 61 individuals with SB, 18-25 years of age, completed standardized self-report measures of attitude toward SB, satisfaction with family functioning, Chronic Care Model (CCM) services, and depressive and anxiety symptoms. A chart review yielded SB clinical data. RESULTS High rates of depressive and anxiety symptoms were found. Hierarchical regression analysis identified the proximal individual (attitude toward SB) and family (satisfaction with family functioning) factors as more strongly related to depressive symptoms than the distal healthcare system factor (CCM services). Self-reported pain was the only ecological factor associated with anxiety symptoms. CONCLUSIONS Study findings provide a potential foundation for multi-factor screening of young adults with SB at risk for psychological symptoms.
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Affiliation(s)
- Melissa H Bellin
- University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA.
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