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Remmerswaal KCP, Ten Have M, de Graaf R, van Balkom AJLM, Penninx BWJH, Batelaan NM. Risk factors of chronic course of anxiety and depressive disorders: a 3-year longitudinal study in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1607-1615. [PMID: 38015237 DOI: 10.1007/s00127-023-02591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Risk factors of a chronic course of anxiety and depressive disorders were previously studied using a limited definition of recovery, i.e. remission of the index disorder. However, frequently, other mental disorders are present at follow-up. Thus, the course of anxiety and depressive disorders was represented too rosy and the identified determinants may not apply when using a broader, more realistic definition. Additionally, physical health risk factors have often been ignored. METHODS Data were used from two waves of the Netherlands Mental Health Survey and Incidence Study-2 including 509 respondents with 12-month anxiety disorder (panic disorder, social phobia, agoraphobia or generalized anxiety disorder) or/and major depressive disorder at baseline. Chronic course was defined as (1) presence of index disorder; and (2) presence of any anxiety, mood or substance use disorder (overall course) during the subsequent three years. Regression models were built with sociodemographic, clinical, and lifestyle/physical health indicators. Predictive accuracy was evaluated with area under the curve (AUC). RESULTS Chronic course of the index disorder was present among 24.8% of cases, whereas 38.7% had a chronic overall course. The accuracy of prediction of chronic course of the index disorder was suboptimal (AUC = 0.68) compared to prediction of overall course (AUC = 0.75). The main risk factors were baseline number of mental disorders, neuroticism, childhood abuse, parental psychopathology and alcohol use. Lifestyle and physical health indicators were marginally relevant. CONCLUSION Transdiagnostic risk factors are important in predicting overall course of anxiety and depressive disorders but cannot accurately predict chronic course of the index disorder.
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Affiliation(s)
- Karin C P Remmerswaal
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Anton J L M van Balkom
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Amsterdam UMC, location Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health, Mental Health program and GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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Wijnen BFM, Ten Have M, de Graaf R, van der Hoek HJ, Lokkerbol J, Smit F. The economic burden of mental disorders: results from the Netherlands mental health survey and incidence study-2. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:925-934. [PMID: 37872458 DOI: 10.1007/s10198-023-01634-2] [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: 12/15/2022] [Accepted: 09/11/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Currently, there is a paucity of up-to-date estimates of the economic burden caused by mental disorders. Such information could provide vital insight into one of the most serious and costly-yet to some extent preventable-health challenges facing the world today. METHOD Data from a national psychiatric-epidemiological cohort study (NEMESIS-2, N = 6506) were used to provide reliable, relevant, and up-to-date cost estimates (in 2019 Euro) regarding healthcare costs, productivity losses, and patient and family costs associated with DSM-IV mental disorders both at individual level, but also in the general population and in the workforce of the Netherlands (per 1 million population). RESULTS In the general population, the costs of mood disorders, specifically depression, are substantial and rank above those from the anxiety disorders, whilst costs of anxiety disorders are more substantial than those stemming from substance use disorders, even when the per-person costs of drug abuse appear highest of all. In the workforce, specific and social phobias are leading causes of excess costs. The workforce has lower healthcare costs but higher productivity costs than general population. DISCUSSION The findings suggest that (preventive) healthcare interventions targeting the workforce are likely to become cost-effective and underscore the importance for employers to create healthy work environments. Overall, the results highlight the need to strengthen the role of mental health promotion and prevention of mental disorders in the social domain before people require treatment to reduce the staggering and costly burden caused by mental disorders to individuals and society.
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Affiliation(s)
- B F M Wijnen
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.
| | - M Ten Have
- Department of Epidemiology, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - R de Graaf
- Department of Epidemiology, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - H J van der Hoek
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - J Lokkerbol
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Filip Smit
- Department of Epidemiology, Centre for Economic Evaluations, Trimbos-Instituut (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Academic Medical Center Amsterdam, Location VUmc, Amsterdam, The Netherlands
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Marcuzzi A, Mork PJ, Aasdahl L, Skarpsno E, Moe K, Nilsen TIL. Incidence of sick leave and disability pension in adults with musculoskeletal pain and co-occurring long-term conditions: data from the Norwegian HUNT study and national registries. BMC Musculoskelet Disord 2024; 25:273. [PMID: 38589843 PMCID: PMC11003184 DOI: 10.1186/s12891-024-07405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Musculoskeletal pain is one of the leading causes of work productivity loss. Long-term conditions (LTCs) commonly occur alongside musculoskeletal pain. However, the incidence of sick leave and disability pension according to LTC status in people with musculoskeletal pain has not been previously described. METHODS Working-age participants (20-65 years) with persistent musculoskeletal pain who participated in the HUNT3 Study (1995-97) were included. Twenty-five LTCs were classified into 8 LTC groups according to the International Classification of Diseases version 11. Data on sickness and disability benefits were obtained from the National Insurance Database and linked to the HUNT3 data using participants' personal identification number. Age-adjusted incidence rates (IRs) (per 10,000 person-years) and hazard ratios (HRs) of sick leave during 5-year follow-up and disability pension during ~ 25-year follow-up were estimated with 95% confidence intervals (CIs) and presented according to LTC status. RESULTS Overall, 11,080 participants with musculoskeletal pain were included. Of those, 32% reported one LTC and 45% reported ≥ 2 LTCs. During the follow up period, 1,312 participants (12%) received disability pension due to musculoskeletal conditions. The IR of sick leave and disability pension due to musculoskeletal conditions increased with number of LTCs. Specifically, the IR of sick leave was 720 (95% CI 672 to 768) in participants without any LTCs and 968 (95% CI 927 to 1,009) if they had ≥ 2 LTCs. The IRs of disability pension were 87 (95% CI 75 to 98) and 167 (95% CI 154 to 179) among those with no LTCs and ≥ 2 LTCs, respectively. The incidence of sick leave and disability pension due to musculoskeletal conditions was largely similar across LTCs, although the incidence of disability pension was somewhat higher among people with sleep disorders (IR: 223, 95% CI 194 to 252). CONCLUSIONS Among people with persistent musculoskeletal pain, the incidence of prematurely leaving the work force due to musculoskeletal conditions was twice as high for those with multiple LTCs compared to those without any LTCs. This was largely irrespective of the type of LTC, indicating that the number of LTCs are an important feature when evaluating work participation among people with musculoskeletal pain.
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Affiliation(s)
- Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim, Norway.
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Unicare Helsefort Rehabilitation Center, Rissa, Norway
| | - Eivind Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karoline Moe
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Ji J, Han Y, Li R, Jin H, Yin C, Niu L, Ying X, Gao Y, Ma Q. The role of effort-reward imbalance and depressive symptoms in the relationship between long working hours and presenteeism among Chinese village doctors: a moderated mediation model. BMC Psychiatry 2023; 23:497. [PMID: 37434160 DOI: 10.1186/s12888-023-04986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Long working hours and effort-reward imbalance (ERI) among medical workers may contribute to poor mental health and reduced productivity. However, the potential mechanisms among them are not well understood. This study aimed to explore the role of depressive symptoms and ERI in the relationship between long working hours and presenteeism among village doctors. METHODS We conducted a cross-sectional study in Jiangsu Province, eastern China. 705 village doctors were assessed for working hours, ERI (the Effort-Reward Imbalance Questionnaire, ERI questionnaire), presenteeism (6-item Stanford Presenteeism Scale, SPS-6 Scale), and depressive symptoms (12-item General Health Questionnaire, GHQ-12). A moderated mediation model was used to test the role of depressive symptoms (M), and ERI (W) in the relationship between long working hours (X) and presenteeism (Y). RESULTS 45.11% of the village doctors worked more than 55 h per week, and 55.89% were exposed to ERI. The prevalence of depressive symptoms among Chinese village doctors was 40.85%. Long working hours (≥ 55 h per week) were significantly associated with presenteeism behaviors (β = 2.17, P < 0.001). Mediation analysis demonstrated that depressive symptoms (GHQ score > 3) could partly mediate the relationship between long working hours and presenteeism (indirect effect β = 0.64, P < 0.001). Moderated mediation further indicated that the interaction of long working hours and ERI was significantly and positively associated with depressive symptoms, which in turn predicted elevated presenteeism behaviors. CONCLUSIONS Depressive symptoms had a mediating role in the association of long working hours with presenteeism behaviors among Chinese village doctors and ERI augment their negative effects.
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Affiliation(s)
- Jingya Ji
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
- Department of Health Management, Affiliated Hospital of Nantong University, Nantong, China
| | - Yarong Han
- Nantong Center for Disease Control and Prevention, Nantong, China
| | - Ruyu Li
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
| | - Hui Jin
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
| | - Chengjie Yin
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
| | - Luyao Niu
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
| | - Xinyu Ying
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China
| | - Yuexia Gao
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China.
- Institute for Health and Development, Nantong University, Nantong, China.
| | - Qiang Ma
- Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, China.
- Department of Health Management, Affiliated Hospital of Nantong University, Nantong, China.
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de Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:167-193. [PMID: 36376610 PMCID: PMC9663290 DOI: 10.1007/s40258-022-00761-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mental health disorders in the workplace have increasingly been recognised as a problem in most countries given their high economic burden. However, few reviews have examined the relationship between mental health and worker productivity. OBJECTIVE To review the relationship between mental health and lost productivity and undertake a critical review of the published literature. METHODS A critical review was undertaken to identify relevant studies published in MEDLINE and EconLit from 1 January 2008 to 31 May 2020, and to examine the type of data and methods employed, study findings and limitations, and existing gaps in the literature. Studies were critically appraised, namely whether they recognised and/or addressed endogeneity and unobserved heterogeneity, and a narrative synthesis of the existing evidence was undertaken. RESULTS Thirty-eight (38) relevant studies were found. There was clear evidence that poor mental health (mostly measured as depression and/or anxiety) was associated with lost productivity (i.e., absenteeism and presenteeism). However, only the most common mental disorders were typically examined. Studies employed questionnaires/surveys and administrative data and regression analysis. Few studies used longitudinal data, controlled for unobserved heterogeneity or addressed endogeneity; therefore, few studies were considered high quality. CONCLUSION Despite consistent findings, more high-quality, longitudinal and causal inference studies are needed to provide clear policy recommendations. Moreover, future research should seek to understand how working conditions and work arrangements as well as workplace policies impact presenteeism.
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Affiliation(s)
- Claire de Oliveira
- Centre for Health Economics, University of York, York, UK.
- Hull York Medical School, Hull and York, UK.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | | | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
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Volz HP, Bartečků E, Bartova L, Bessa J, De Berardis D, Dragasek J, Kozhuharov H, Ladea M, Lazáry J, Roca M, Usov G, Wichniak A, Godman B, Kasper S. Sick leave duration as a potential marker of functionality and disease severity in depression. Int J Psychiatry Clin Pract 2022; 26:406-416. [PMID: 35373692 DOI: 10.1080/13651501.2022.2054350] [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] [Indexed: 10/18/2022]
Abstract
Objective: To discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression.Methods: Our review was based on a literature search and expert opinion that emerged during a virtual meeting of European psychiatrists that was convened to discuss this topic.Results: Current evidence demonstrates that depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions. A wide variety of pharmacological and non-pharmacological treatments and work-based interventions are effective in reducing depression-related sick leave duration and/or facilitating return to work. Recent real-world evidence showed that patients treated with antidepressant monotherapy appear to recover their working life faster than those receiving combination therapy. Although depression-related sick leave duration was found to correlate with severity of depressive symptoms, it cannot be used alone as a viable marker for disease severity.Conclusions: Given its multifactorial nature, depression-related sick leave duration is not on its own a viable outcome measure of depression severity but could be used as a secondary outcome alongside more formal severity measures and may also represent a useful measure of functionality in depression. Key pointsDepression in the working population and depression-related sick leave have a profound economic impact on societyDepression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditionsA wide variety of pharmacological and non-pharmacological treatments and work-based interventions have been shown to be effective in reducing depression-related sick leave duration and/or facilitating return to workIn terms of pharmacological intervention, recent real-world evidence has shown that patients treated with antidepressant monotherapy are able to recover their working life faster than those treated with combination therapyAlthough depression-related sick leave duration has been shown to correlate with severity of depressive symptoms, it is not a viable outcome measure of depression severity on its own, but could be used as secondary outcome alongside more formal clinician- and patient-rated severity measuresDepression-related sick leave duration may, however, represent a viable outcome for measuring functionality in depression.
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Affiliation(s)
- Hans-Peter Volz
- Department of Psychotherapy and Psychosomatic Medicine, Hospital for Psychiatry, Werneck, Germany
| | - Elis Bartečků
- Department of Psychiatry, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy (Division of General Psychiatry), Medical University of Vienna, Vienna, Austria
| | - João Bessa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
| | - Jozef Dragasek
- First Department of Psychiatry, Pavol Jozef Šafárik University and University Hospital, Košice, Slovakia
| | - Hristo Kozhuharov
- Department of Psychiatry, University Hospital, "St. Marina", Varna, Bulgaria
| | - Maria Ladea
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Judit Lazáry
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Miquel Roca
- School of Medicine, Son Espases University Hospital, IUNICS/IDISBA, University of Balearic Islands, Palma de Mallorca, Spain
| | | | - Adam Wichniak
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK.,School of Pharmacy, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, United Arab Emirates
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy (Division of General Psychiatry), Medical University of Vienna, Vienna, Austria.,Center for Brain Research, Medical University of Vienna, Vienna, Austria
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Bozzatello P, Giordano B, Montemagni C, Rocca P, Bellino S. Real-World Functioning in Psychiatric Outpatients: Predictive Factors. J Clin Med 2022; 11:4400. [PMID: 35956015 PMCID: PMC9369214 DOI: 10.3390/jcm11154400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/17/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Investigations on predictors of real-world functioning were mainly performed in patients with schizophrenia, while fewer studies have been conducted in other psychiatric disorders. OBJECTIVE Our objective was to identify clinical, socio-demographic, and illness-related predictors of real-world functioning during 12 months of standard treatments in outpatients with different diagnoses. METHODS Outpatients (n = 1019) with schizophrenia (SZ), major depressive disorder (MDD), bipolar disorder (BD), and borderline personality disorder (BPD) were evaluated with the following tools: SCID-5-CV and SCID-5-PD, CGI-S, SAT-P, DAI-10, and PSP. Change of PSP (ΔPSP) between baseline and 12 months was used as the dependent variable in multiple regression analysis. RESULTS Higher PSP score at baseline and the achievement of main milestones predicted better functioning after follow-up in all subgroups of patients, with the exception of BD. In the total sample, ΔPSP was related to age of onset, treatments, and quality of life, and inversely related to psychiatric anamnesis, antidepressants, and global symptoms. In SZ, ΔPSP was related to adherence and quality of life. In MDD, ΔPSP was related to psychotherapy and quality of life, and inversely related to antidepressants and global symptoms. In BD, ΔPSP was related to age of onset, antipsychotics, and quality of life, while it was inversely related to psychiatric anamnesis. In BPD, antipsychotics, mood stabilizers, psychotherapy, and quality of life were directly related to ΔPSP, while suicidal attempts and global symptoms had an inverse relation. Conclusions: Several socio-demographic and illness-related variables predicted improvement of real-world functioning, besides psychopathology and severity of the disease.
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Affiliation(s)
- Paola Bozzatello
- Department of Neuroscience, University of Turin, 10126 Turin, Italy; (B.G.); (C.M.); (P.R.); (S.B.)
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Madi HI, Ismael NT, Hamaideh SH, Jaber AF. Occupational performance and satisfaction of individuals with mental disorders in Jordan: A cross-sectional study. Br J Occup Ther 2022. [DOI: 10.1177/03080226221089853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Individuals with mental disorders face challenges while performing occupations. Existing evidence is limited to Western countries and certain daily life occupations that do not explore all factors related to occupational performance. This study aimed to explore occupational performance and satisfaction in individuals with mental disorders, explore the challenging occupations, investigate the relationship between demographic characteristics to occupational performance and satisfaction, and investigate the factors affecting the occupational performance of individuals with mental disorders. Methods: This was a descriptive correlational cross-sectional study that used the convenience sampling method. It included 95 individuals with mental disorders that had a mean age of (34.46 ± 12.22) years, and were from different mental health care facilities. Additionally, this study used the Canadian Occupational Performance Measure instrument. Results: Individuals with mental disorders had a low mean occupational performance and satisfaction scores (5.8 ± 1.7), (5.2 ± 2.0), respectively. Instrumental Activities of Daily Living were the most reported challenging occupations. There was a relationship between work status and both occupational performance and satisfaction (r = 0.243, p = 0.018), (r = 0.239, p = 0.020), respectively. Also, there was a relationship between the diagnosis and occupational performance (r =0.219, p = 0.033), and work status predicted occupational performance (α ≤ 0.05). Work status is a predictor of occupational performance in individuals with mental disorders.
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Affiliation(s)
- Hanan I Madi
- Lab Instructor and Clinical Supervisor, Physical and Occupational Therapy Department, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa’a, Jordan
| | - Noor T Ismael
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, The Jordan University of Science and Technology, Irbid, Jordan
| | - Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa’a, Jordan
| | - Ala’a F Jaber
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, The Jordan University of Science and Technology, Irbid, Jordan
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La Marca R, Pallich G, Holtforth MG, Hochstrasser B. Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Depression is one of the most prevalent mental disorders, with treatment outcomes generally being unsatisfactory. The identification of outcome predictors could contribute to improving diagnosis, treatment, and outcome. Heart rate variability (HRV), an index of cardiovagal activity, has been proposed as a potential correlate of depression as well as a predictor of treatment effectiveness. The aim of the present study was to examine if HRV at baseline could predict the outcome of inpatient treatment for stress-related depressive disorder (SRDD). Depressive symptoms of n = 57 inpatients with an SRDD, who were treated in a specialized burnout ward, were assessed using the Beck Depression Inventory (BDI) at the beginning, the end of treatment, and at 3-month follow-up. HRV (i.e., RMSSD, the root mean square of successive RR interval differences) was determined from a five-minute measurement in the supine position. RMSSD was not significantly associated with the BDI score at the beginning, end, and follow-up. Higher RMSSD was revealed to be a significant predictor of a stronger decrease in depressive severity from the beginning to the end of the treatment. Thereby, the regression model explained 7.6% of the total variance in the BDI decrease. The results revealed initial HRV to predict a larger decrease in depressive severity. Therefore, resting HRV represents a physiological resource and index of successful neurovisceral interaction, which supports inpatients in benefitting from specialized treatment.
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Affiliation(s)
- Roberto La Marca
- Centre for Stress-Related Disorders, Clinica Holistica Engiadina SA, Susch, Switzerland
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
| | - Gianandrea Pallich
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Private Hospital Meiringen, Switzerland
| | - Martin grosse Holtforth
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Missmer SA, Tu F, Soliman AM, Chiuve S, Cross S, Eichner S, Antunez Flores O, Horne A, Schneider B, As-Sanie S. Impact of endometriosis on women's life decisions and goal attainment: a cross-sectional survey of members of an online patient community. BMJ Open 2022; 12:e052765. [PMID: 35477879 PMCID: PMC9047767 DOI: 10.1136/bmjopen-2021-052765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 03/28/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine women's perceptions of endometriosis-associated disease burden and its impact on life decisions and goal attainment. DESIGN An anonymous online survey was distributed in October 2018 through the social media network MyEndometriosisTeam.com. PARTICIPANTS Women aged 19 years and older living in several English-speaking countries who self-identified as having endometriosis. OUTCOME MEASURES Patients' perspectives on how endometriosis has affected their work, education, relationships, overall life decisions and attainment of goals. Subanalyses were performed for women who identified as 'less positive about the future' (LPAF) or had 'not reached their full potential' (NRFP) due to endometriosis. RESULTS 743 women completed the survey. Women reported high levels of pain when pain was at its worst (mean score, 8.9 on severity scale of 0 (no pain) to 10 (worst imaginable pain)) and most (56%, n=415) experienced pain daily. Women reported other negative experiences attributed to endometriosis, including emergency department visits (66%, n=485), multiple surgeries (55%, n=406) and prescription treatments for symptoms of endometriosis (72%, n=529). Women indicated that they believed endometriosis had a negative impact on their educational and professional achievements, social lives/relationships and overall physical health. Most women 'somewhat agreed'/'strongly agreed' that endometriosis caused them to lose time in life (81%, n=601), feel LPAF (80%, n=589) and feel they had NRFP (75%, n=556). Women who identified as LPAF or NRFP generally reported more negative experiences than those who were non-LPAF or non-NRFP. CONCLUSIONS Women who completed this survey reported pain and negative experiences related to endometriosis that were perceived to negatively impact major life-course decisions and attainment of goals. Greater practitioner awareness of the impact that endometriosis has on a woman's life course and the importance of meaningful dialogue with patients may be important for improving long-term management of the disease and help identify women who are most vulnerable.
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Affiliation(s)
- Stacey A Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Boston Center for Endometriosis, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Grand Rapids, Michigan, USA
| | - Frank Tu
- Department of Obstetrics and Gynecology, NorthShore University Health System, Evanston, Illinois, USA
- Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Evanston, Illinois, USA
| | | | | | | | | | | | - Andrew Horne
- Medical Research Council Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
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Parsley IC, Dale AM, Fisher SL, Mintz CM, Hartz SM, Evanoff BA, Bierut LJ. Association Between Workplace Absenteeism and Alcohol Use Disorder From the National Survey on Drug Use and Health, 2015-2019. JAMA Netw Open 2022; 5:e222954. [PMID: 35297970 PMCID: PMC8931561 DOI: 10.1001/jamanetworkopen.2022.2954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
IMPORTANCE Alcohol use disorder (AUD) is common and associated with increased morbidity. The degree to which AUD currently factors into workplace absenteeism needs further characterization in the US. OBJECTIVE To examine the association between AUD and workplace absenteeism in a nationally representative sample. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from a nationally representative sample of noninstitutionalized US residents from the 2015-2019 National Survey on Drug Use and Health to examine the association of AUD with workplace absenteeism. Eligible respondents were aged 18 years and older who reported full-time employment. Data were analyzed from March to September 2021. MAIN OUTCOMES AND MEASURES Primary outcomes were markers of workplace absenteeism as defined by the number of days missed from work because of illness or injury and days skipped from work in the last 30 days. Descriptive statistics, prevalence ratios, and logistic regression analyses were performed to assess the association between AUD and absenteeism. RESULTS A total of 110 701 adults aged 18 years and older reported current full-time employment (58 948 [53.2%] men, 51 753 [46.8%] women; 12 776 [11.5%] Black, 18 096 [16.3%] Hispanic, and 69 506 [62.8%] White respondents). Weighted prevalence of AUD in this sample of working adults was 9.3% (95% CI, 9.0%-9.5%); 6.2% (95% CI, 6.0%-6.4%) of respondents met criteria for mild AUD, 1.9% (95% CI, 1.7%-2.0%) for moderate AUD, and 1.2% (95% CI, 1.1%-1.3%) for severe AUD. Mean days missed from work annually increased in a stepwise fashion with increasing AUD severity (no AUD, 13.0 days; 95% CI, 12.7-13.2 days; mild AUD, 17.7 days; 95% CI, 16.4-19.1 days; moderate AUD, 23.6 days; 95% CI, 21.5-25.7 days; severe AUD, 32.3 days; 95% CI, 27.5-37.0 days). People with AUD represented 9.3% of the full-time workforce and contributed to 14.1% of total reported workplace absences. CONCLUSIONS AND RELEVANCE In this cross-sectional study, AUD was disproportionately associated with an increased prevalence of workplace absenteeism, with individuals with AUD contributing over 232 million missed workdays annually. These results provide economic incentive for increased investment in AUD prevention and treatment, both for employers and policy makers.
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Affiliation(s)
- Ian C. Parsley
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Ann Marie Dale
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Sherri L. Fisher
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Carrie M. Mintz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Sarah M. Hartz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Bradley A. Evanoff
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Laura J. Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
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Leung N, Bernacki SE, Kalia N, Bernacki EJ, Almeida JRC. Long-Term Healthcare Utilization and the Cost of Bipolar Disorder Among Participants in a Large Employer's Health Benefit Plan. J Occup Environ Med 2022; 64:e124-e130. [PMID: 34935680 DOI: 10.1097/jom.0000000000002465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) is a chronic illness with recurrent exacerbations. The objective was to evaluate longitudinal costs related to BD in an employer-sponsored medical plan. METHODS This analysis utilized 5 years of administrative claims data. Claimants with a diagnosis of BD were matched to plan members (1:5) based on age, sex, and years of follow-up. RESULTS Medical costs for hospitalized BD members were 3.5 times more expensive than the general population (BDhosp = $92.2K vs General population = $26.8K). Average 5-year paid costs among hospitalized members with BD was $107K, $105.4K with cancer, and $103.3K with myocardial infarction (MI). CONCLUSIONS Hospitalized BD plan members consumed more than 3.5 times the medical resources and were similar in longitudinal costs when compared with members with other costly conditions. These findings highlight the need for novel employer-sponsored programs to help manage BD.
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Affiliation(s)
- Nina Leung
- Department of Population Health (Dr Leung); Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Leung, Dr Kalia, Dr Bernacki); Texas Mutual Insurance Company (Dr Leung); Campbell University School of Osteopathic Medicine, North Carolina (Dr Bernacki); General Electric, Cinncinati, Ohio (Dr Kalia); Department of Psychiatry and Behavior Sciences (Dr Almeida), Department of Population Health (Dr Leung, Dr Bernacki), Dell Medical School, the University of Texas at Austin, Austin, Texas
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Osei-Nimo S, Millman C, Aboagye-Nimo E. The Interplay of Alcohol and Wellbeing in the Workplace: Combining Soft Systems Methodology and Foucauldian Approach. SYSTEMIC PRACTICE AND ACTION RESEARCH 2022. [DOI: 10.1007/s11213-022-09591-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractThis paper focuses on the topic of alcohol and wellbeing in contemporary work organisations. It explores the relationship between stakeholders’ viewpoints regarding alcohol in the workplace and how they have shaped organisational practices regarding wellbeing. The work of Michel Foucault is used to explore these issues. The notions of power, knowledge and discipline are identified as key Foucauldian themes that offer an alternative understanding of how discourses on alcohol are shaped in the United Kingdom workplace. The paper combines certain stages of Checkland’s Soft Systems Methodology and Foucault’s Poststructuralist approach in addressing the topic. Foucault’s method of analysis, particularly archaeology and genealogy, is used to explore how and why certain discourses surrounding alcohol in the workplace become dominant over time. Qualitative cases with semi-structured interviews in knowledge-intensive firms were adopted to capture contrasting, varied experiences and perceptions of these organisational actors and shed light on alcohol and wellbeing and its relationships with the power dimension.
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Effectiveness of a return to work intervention after occupational disability retirement due to depression and anxiety. PSYCHOL HEALTH MED 2022; 28:1387-1398. [PMID: 35045781 DOI: 10.1080/13548506.2022.2029505] [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] [Indexed: 10/19/2022]
Abstract
Depression and anxiety disorders are the most common cause for disability retirement among people of middle age. The following social disintegration can have an additional detrimental effect on subjects' psychological well-being, which further reduces their chances for recovery. Long-term disability could be avoidable in many cases as depression and anxiety disorders don't have an etiology that makes permanent loss of function inevitable. This prospective cohort study tests the long-term effects of an intervention addressed at these young disablement retirees. Forty-one subjects each in the experimental and control group were followed-up on over a period of 24 months. The intervention had positive effects on psychological well-being. More subjects returned to work than controls. The effects were still present at one year follow-up. These findings show that an individually tailored return-to-work intervention is a useful, sustainable and economically advantageous therapeutic tool to get out of disability retirement due to mental illness even after all other therapeutic tools have failed.
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Safi F, Aniserowicz AM, Colquhoun H, Stier J, Nowrouzi-Kia B. Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol. J Eat Disord 2022; 10:7. [PMID: 35033207 PMCID: PMC8760832 DOI: 10.1186/s40337-021-00525-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. METHODS Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. DISCUSSION This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. TRIAL REGISTRATION The registration number for this systematic review on PROSPERO is CRD42021255055.
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Affiliation(s)
- Fatima Safi
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Anna M Aniserowicz
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Heather Colquhoun
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Jill Stier
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
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Gantner M, Jarzcok MN, Schneider J, Brandner S, Gündel H, von Wietersheim J. Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data. Front Psychiatry 2022; 13:838823. [PMID: 35401269 PMCID: PMC8987373 DOI: 10.3389/fpsyt.2022.838823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Psychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start. METHODS Routine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression. RESULTS Eighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences. CONCLUSIONS PSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.
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Affiliation(s)
- Melanie Gantner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | - Marc Nicolas Jarzcok
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | | | | | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
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França MH, Pereira FG, Wang YP, Andrade LH, Alonso J, Viana MC. Individual and population level estimates of work loss and related economic costs due to mental and substance use disorders in Metropolitan São Paulo, Brazil. J Affect Disord 2022; 296:198-207. [PMID: 34610514 DOI: 10.1016/j.jad.2021.09.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/04/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND We estimate work loss and economic costs due to mental and substance use disorders in the economically active population of the São Paulo Metropolitan Area, Brazil. METHODS The São Paulo Megacity Mental Health Survey assessed a population-based sample of 3,007 economically active residents using the Composite International Diagnostic Interview 3.0 and the World Health Organization Disability Assessment Schedule 2 to investigate, respectively, 12-month psychiatric disorders, work performance, and economic costs. RESULTS Absenteeism over the past 12 months was reported by 12.6%, and presenteeism by 14.7% (qualitative loss) and 13.1% (quantitative loss). Having any mental disorder was associated with 17.6 days of absenteeism and 37.7 days of reduced-qualitative and/or quantitative functioning. Fourteen mental disorders were significantly associated with work loss, with odds ratios ranging from 2.3 for adult separation anxiety to 40.4 for oppositional defiant disorder. At a population-level, oppositional defiant disorder, panic disorder, attention deficit disorder, and dysthymia contributed to the largest costs. The total annual economic costs were USD $83.2 billion/year, representing 6.1% of Brazil's Gross Domestic Product in 2007. LIMITATIONS Diagnosis of mental disorders was based on self-reported symptoms. Work loss assessment was restricted to 30 days before the interview and may not fully represents the annual real experience and symptoms of the respondents which would lead to an overestimation of the burden. CONCLUSIONS Mental disorders impose a great negative impact on work performance and functioning, with a consequent high economic burden, pointing to the need of implementing cost-effective interventions to prevent work loss.
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Affiliation(s)
| | - Flavia Garcia Pereira
- Post graduate Program in Public Health, Federal University of Espirito Santo, Brazil
| | - Yuan-Pang Wang
- Instituto and Departamento de Psiquiatria (LIM-23), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo SP, Brazil
| | - Laura Helena Andrade
- Section of Psychiatric Epidemiology - LIM 23, Department and Institute of Psychiatry, University of São Paulo, Medical School, São Paulo, SP- Brazil
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Carmen Viana
- Department of Social Medicine, Federal University of Espirito Santo, Brazil. Av. Marechal Campos 1468; Vitória/ES - Brazil; Post graduate Program in Public Health, Federal University of Espirito Santo, Brazil
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Small SP, de Boer C, Swab M. Barriers to and facilitators of labor market engagement for individuals with chronic physical illnesses in their experiences with work disability policy: a qualitative systematic review. JBI Evid Synth 2021; 20:348-536. [PMID: 34669686 DOI: 10.11124/jbies-20-00482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to identify and synthesize the best available evidence to address two questions. From the perspectives of individuals with chronic physical illnesses: i) what are barriers in work disability policies with respect to labor market engagement? and ii) what are facilitators in work disability policies with respect to labor market engagement? INTRODUCTION Chronic physical illnesses have a high and increasing prevalence worldwide and are associated with significant disability in the working-age population. Individuals with chronic illnesses and disability have low employment and high unemployment rates, and low wages. Work disability policies have important role in reducing negative labor market impacts, but inadequate policies may also pose barriers to work engagement. INCLUSION CRITERIA This review included studies of individuals who were of working age, had one or more chronic physical illness, and had experience relevant to disability policy and work engagement. The phenomena of interest were perceived barriers and perceived facilitators in work disability policies with respect to labor market engagement. The context was any study setting globally. Studies considered for this review had qualitative data from a variety of methodologies. METHODS This review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. A literature search involved academic databases (ie, CINAHL Plus, MEDLINE, PsycINFO, AgeLine, SocINDEX, Social Work Abstracts, Sociological Abstracts, Social Services Abstracts) for published studies; gray literature sources (ie, ProQuest Dissertations and Theses, MedNar, Google Scholar, OpenGrey, OAIster, Google, and relevant websites) for unpublished studies; and reference lists of retrieved records. No language, date, or country limiters were applied to the searches. Retrieved records from the database and gray literature searches were screened, with potentially relevant records then examined in full against the inclusion criteria. Eligible studies were critically appraised for methodological quality and those included in this review were subjected to data extraction of descriptive details and the study findings that were relevant to the review questions. Study findings were synthesized and were assigned confidence scores. RESULTS Forty-four studies of various qualitative designs and varied methodological quality (from low to high) were included in this review. The study samples represented a number of different chronic physical illnesses. There were 301 credible and unequivocal study findings, which were aggregated into 20 categories and 5 synthesized findings. Persons with chronic physical illnesses perceived barriers and facilitators relevant to the adequacy of disability policies in meeting their needs for returning to work after leave due to illness and for sustaining ongoing work engagement. They also perceived barriers and facilitators relevant to stakeholders' communication, help, and support respecting workers' efforts toward work engagement. CONCLUSION Although confidence in the synthesized findings is low due to limitations in the methods and research findings across primary studies, the evidence suggests that both the adequacy and implementation of work disability policies need to be improved to meet the needs of workers with chronic physical illnesses, for their labor market engagement. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42016033476.
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Affiliation(s)
- Sandra P Small
- Faculty of Nursing, Memorial University, St. John's, NL, Canada Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada School of Social Work, Memorial University, St. John's, NL, Canada Health Sciences Library, Memorial University, St. John's, NL, Canada
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Sambasivam R, Jeyagurunathan A, Abdin E, Shafie S, Chang S, Vaingankar JA, Chong SA, Subramaniam M. Occupational groups and its physical and mental health correlates: results from the Singapore Mental Health Study 2016. Int Arch Occup Environ Health 2021; 95:753-764. [PMID: 34302531 PMCID: PMC8938346 DOI: 10.1007/s00420-021-01741-8] [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: 05/10/2021] [Accepted: 06/23/2021] [Indexed: 11/21/2022]
Abstract
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.
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Affiliation(s)
- Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Tanaka C, Wakaizumi K, Kosugi S, Tanaka S, Matsudaira K, Morisaki H, Mimura M, Fujisawa D. Association of work performance and interoceptive awareness of 'body trusting' in an occupational setting: a cross-sectional study. BMJ Open 2021; 11:e044303. [PMID: 33980524 PMCID: PMC8117998 DOI: 10.1136/bmjopen-2020-044303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Work performance has been known to be influenced by both psychological stress (mind) and physical conditions (body). The aim of this study was to investigate the association between work performance and 'body trusting', which is a dimension of interoceptive awareness representing mind-body interactions. METHODS A cross-sectional study was conducted among a sample of workers in an industrial manufacturing company in Japan. Participants were assessed with a self-reported questionnaire including evaluations of work performance, body trusting, psychological distress, pain persistence, workplace and home stressors, and workaholism. Participants' sociodemographic, health and lifestyle characteristics were collected from their annual health check data. The association between work performance and body trusting was examined using multivariable regression analyses in the overall sample and in a subsample of people with pain. RESULTS A total of 349 workers participated in the study. A significant association between work performance and body trusting was observed, with higher body trusting representing higher work performance. The association was significant after controlling for psychological distress, workplace and home stress, workaholism and participants' characteristics (p<0.001). Compared with people without pain (n=126, 36.1%), people with pain (n=223, 63.9%) showed less body trusting, which was associated with decreased work performance after controlling for pain-related variables (p<0.001). CONCLUSIONS Workers with higher body trusting showed higher work performance, even after controlling for various influencing factors. Body trusting may be an important target to promote work performance and to prevent loss of performance induced by health problems.
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Affiliation(s)
- Chisato Tanaka
- Neuropsychiatry, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
- Interdisciplinary Pain Center, Keio University Hospital, Shinjuku-ku, Japan
| | - Kenta Wakaizumi
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Shizuko Kosugi
- Interdisciplinary Pain Center, Keio University Hospital, Shinjuku-ku, Japan
- Department of Anesthesiology, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Shintaro Tanaka
- Neuropsychiatry, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo-Hospital, Tokyo, Japan
| | - Hiroshi Morisaki
- Department of Anesthesiology, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Masaru Mimura
- Neuropsychiatry, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Daisuke Fujisawa
- Neuropsychiatry, Graduate School of Medicine, Keio University School of Medicine, Shinjuku-ku, Japan
- Interdisciplinary Pain Center, Keio University Hospital, Shinjuku-ku, Japan
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Toyoshima A, Moriyama M, Yamashita H, Rahman MM, Huq KE, Jahan Y, Kazawa K. Understanding the process for developing sleep disorders among Japanese workers: a qualitative study. Health Promot Perspect 2021; 11:87-96. [PMID: 33758760 PMCID: PMC7967132 DOI: 10.34172/hpp.2021.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/04/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Sleep disorders have an enormous impact on occupational health and are counterproductive from an economic perspective. However, the processes of causing sleep disorders from psychosocial aspects have not yet been known. The purpose of this study was to describe how sleep disorders develop among workers with respect to different psychosocial conditions. Methods: A conventional qualitative content analysis was conducted with a semi-structured interview among twenty-seven workers (14 males and 13 females) who were diagnosed with sleep disorders or had a self-reported history of sleep difficulties. Study participants were recruited from a specialized clinic and communities using snowball sampling. This paper adhered to the Standards for Reporting Qualitative Research (SRQR) checklist. Results: The results showed that there were four steps involved in the sleep disorders development process. Firstly, participants with sleep disorders developed ‘early warning signs’ with 11 categories of triggers; secondly, ‘aggravating factors’ on top of these early warning signs; thirdly, workers tried to ‘cope with’ their sleep disorders in the ways they thought would be effective. Finally, when coping failed to improve the quality of sleep, it led to the onset of sleep disorders. Conclusion: The development of sleep disorders and triggers of psychosocial factors were revealed. An occupational health nurse can bring these findings in practice for preventing worker’s sleep disorders.
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Affiliation(s)
- Ayako Toyoshima
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hidehisa Yamashita
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Katm Ehsanul Huq
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasmin Jahan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kana Kazawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Pan T, Mercer SW, Zhao Y, McPake B, Desloge A, Atun R, Hulse ESG, Lee JT. The association between mental-physical multimorbidity and disability, work productivity, and social participation in China: a panel data analysis. BMC Public Health 2021; 21:376. [PMID: 33602174 PMCID: PMC7890601 DOI: 10.1186/s12889-021-10414-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
Background The co-occurrence of mental and physical chronic conditions (mental-physical multimorbidity) is a growing and largely unaddressed challenge for health systems and wider economies in low-and middle-income countries. This study investigated the independent and combined (additive or synergistic) effects of mental and physical chronic conditions on disability, work productivity, and social participation in China. Methods Panel data study design utilised two waves of the China Health and Retirement Longitudinal Study (2011, 2015), including 5616 participants aged ≥45 years, 12 physical chronic conditions and depression. We used a panel data approach of random-effects regression models to assess the relationships between mental-physical multimorbidity and outcomes. Results After adjusting for socio-economic and demographic factors, an increased number of physical chronic conditions was independently associated with a higher likelihood of disability (Adjusted odds ratio (AOR) = 1.39; 95% CI: 1.33, 1.45), early retirement (AOR = 1.37 [1.26, 1.49]) and increased sick leave days (1.25 days [1.16, 1.35]). Depression was independently associated with disability (AOR = 3.78 [3.30, 4.34]), increased sick leave days (2.18 days [1.72, 2.77]) and a lower likelihood of social participation (AOR = 0.57 [0.47, 0.70]), but not with early retirement (AOR = 1.24 [0.97, 1.58]). There were small and statistically insignificant interactions between physical chronic conditions and mental health on disability, work productivity and social participation, suggesting an additive effect of mental-physical multimorbidity on productivity loss. Conclusion Mental-physical multimorbidity poses substantial negative health and economic effects on individuals, health systems, and societies. More research that addresses the challenges of mental-physical multimorbidity is needed to inform the development of interventions that can be applied to the workplace and the wider community in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10414-7.
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Affiliation(s)
- Tianxin Pan
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia.
| | - Stewart W Mercer
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Yang Zhao
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, Melbourne, Victoria, Australia
| | - Barbara McPake
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - Allissa Desloge
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - Rifat Atun
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA
| | - Emily Susannah Grace Hulse
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - John Tayu Lee
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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23
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Morabito DM, Mathes BM, Schmidt NB. The Impact of Two Brief Web-Based Psychological Interventions on Functional Outcomes. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10144-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Juurlink TT, Lamers F, van Marle HJF, Anema JR, Beekman ATF. The role of borderline personality disorder symptoms on absenteeism & work performance in the Netherlands Study of Depression and Anxiety (NESDA). BMC Psychiatry 2020; 20:414. [PMID: 32831059 PMCID: PMC7444043 DOI: 10.1186/s12888-020-02815-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Symptoms of borderline personality disorder (BPD) were previously found to be associated with decreased work performance, even after controlling for depressive and anxiety disorders. Furthermore, co-occurrence of BPD and affective disorders is common. Therefore, we examined the effect of BPD symptoms on occupational functioning in workers with affective disorders. METHODS Healthy workers (n = 287), workers with current depression/anxiety only (n = 195), workers with BPD symptoms only (n = 54), and workers with both depression/anxiety and BPD symptoms (n = 103) were selected from the Netherlands Study of Depression and Anxiety (NESDA). Both a categorical and dimensional approach were used to cross-sectionally study the effect of BPD symptoms on work performance and absenteeism. RESULTS Compared to healthy controls, all symptomatic groups had impaired occupational functioning. Workers with current depression/anxiety had higher long-term absenteeism (OR = 3.59; 95%CI:1.83-7.02) and impaired work performance (OR = 7.81; 95%CI:4.44-13.73), workers with BPD symptoms only had higher impaired work performance (OR = 6.02 95%CI:2.76-13.09), and workers with both depression/anxiety and BPD symptoms had higher long-term absenteeism (OR = 3.66 95%CI:1.69-7.91) and impaired work performance (OR = 10.41 95%CI:5.38-20.15). No difference was found between the (symptomatic) groups. In the dimensional analysis, all associations between BPD symptoms and occupational measures disappeared when depressive symptoms were added. Depressive and BPD symptoms were highly correlated (r = .67). CONCLUSIONS Our findings confirm that both affective disorders and BPD symptoms are associated with occupational dysfunction. The effect of BPD symptoms however, seems mediated by depressive symptoms. This would suggest that focusing on affective symptoms in occupational health may be effective to improve occupational functioning in persons with BPD.
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Affiliation(s)
- Trees T. Juurlink
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Oldenaller 1, Amsterdam, The Netherlands
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Oldenaller 1, Amsterdam, The Netherlands
| | - Hein J. F. van Marle
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Oldenaller 1, Amsterdam, The Netherlands
| | - Johannes R. Anema
- Amsterdam UMC, Vrije Universiteit, Social Medicine, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, De Boelelaan 1117, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Oldenaller 1, Amsterdam, The Netherlands
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25
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Atanda O, Callaghan P, Carter T, Durcan G, O'Shea N, Brown SD, Reavey P, Vangeli E, White S, Wood KV. Evaluation of Mental Health First Aid from the Perspective Of Workplace End UseRs-EMPOWER: protocol of cluster randomised trial phase. Trials 2020; 21:715. [PMID: 32795364 PMCID: PMC7427889 DOI: 10.1186/s13063-020-04636-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mental Health First Aid (MHFA) is a mental health intervention that teaches people how to identify, understand and help someone who may be experiencing a mental health issue. Reviews of the implementation of MHFA found between 68 and 88% of trained Mental Health First Aiders had used their skills when in contact with someone experiencing mental health difficulties. Reviews evaluating the impact of MHFA suggest positive outcomes. However, to date, there has been no systematic, rigorous evaluation of the impact of MHFA on recipients of the intervention, the organisations providing it and the cost-effectiveness of MHFA overall. This trial will evaluate the effectiveness and cost-effectiveness of MHFA. Methods The study is a multi-centred, two-arm clustered randomised controlled trial. Organisations will be randomly allocated to the control or intervention (estimated sample size 800 recipients). The intervention is the standard MHFA intervention provided by Mental Health First Aid England (MHFAE). The control condition will be organisations having a brief consultation from MHFAE on promoting mental health and well-being in the workplace. The primary outcome is health seeking behaviour, measured using the Actual Help Seeking Questionnaire, at 6 months’ follow-up. Data collection will be undertaken at baseline (T0), post-intervention—up to 3 months (T1), at 6 months (T2), 12 months (T3) and 24 months (T4). The primary analysis will be conducted on those participants who receive MHFA, a per protocol analysis. Discussion The study is the first to evaluate the effect of MHFA in the workplace on employees with direct and indirect experience of the intervention, when compared with usual practice. Being also the first to assess, systematically, the social impact of MHFA and investigate its cost-effectiveness adds to the originality of the study. The study promises to yield important data, as yet unknown, regarding the effectiveness, cost-effectiveness, implementation issues, and the sustainability of MHFA in the workplace. Trial registration Clinicaltrials.govNCT04311203. Registered on 17 March 2020.
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Affiliation(s)
| | | | - Tim Carter
- University of Nottingham, Institute of Mental Health and School of Health Sciences, Nottingham, UK
| | | | | | - Steve D Brown
- Nottingham Business School, Nottingham Trent University, Nottingham, UK
| | | | | | - Sarah White
- Population Health Research Institute, St George's University of London, London, UK
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26
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Abbott DJ, Lack CW. Conventional versus Mindfulness-based Interventions for Anxiety and Worry: A Review and Recommendations. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2020. [DOI: 10.2174/2666082216666200220121648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Anxiety disorders are among the most prevalent and most functionally impairing psychiatric
problems experienced by the population. Both pharmacological and psychological evidencebased
treatments exist for a number of specific disorders, but may fail to fully relieve symptoms,
pointing to the need for additional treatment options. Often considered to be part of the “third wave”
of cognitive-behavioral therapies, treatments incorporating mindfulness have emerged in the past
two decades as increasingly popular with clinicians and frequently sought out by consumers. The
present article reviews the extant literature regarding the efficacy and effectiveness of mindfulnessbased
treatments for anxiety, worry, and related problems. Although they have not attained the solid
empirical status of CBT or certain pharmacological treatments, the extant research shows mindfulness-
based interventions appear to be a promising and useful treatment for people suffering from
anxiety and worry. Further work should be done, levels 3-5 of the NIH stage model to determine
whether or not they should be further implemented.
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Affiliation(s)
- Deah Jo Abbott
- Department of Psychology, Georgia State University, Atlanta, GA 30302, United States
| | - Caleb Wayne Lack
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73034, United States
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27
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De Venter M, Elzinga BM, Van Den Eede F, Wouters K, Van Hal GF, Veltman DJ, Sabbe BGC, Penninx BWJH. The associations between childhood trauma and work functioning in adult workers with and without depressive and anxiety disorders. Eur Psychiatry 2020; 63:e76. [PMID: 32669136 PMCID: PMC7443788 DOI: 10.1192/j.eurpsy.2020.70] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To examine the association between childhood trauma and work functioning, and to elucidate to what extent this association can be accounted for by depression and/or anxiety. METHODS Data of 1,649 working participants were derived from the Netherlands Study of Depression and Anxiety (NESDA, n = 2,981). Childhood trauma (emotional neglect, psychological, physical, and sexual abuse before age 16) was assessed with a structured interview and work functioning, in terms of absenteeism and presenteeism, with the Health and Labor Questionnaire Short Form (SF-HLQ) and the World Health Organization Disability Assessment Schedule II (WHODAS-II), respectively. Depressive and/or anxiety disorders were assessed with the Composite Interview Diagnostic Instrument (CIDI). Mediation analyses were conducted. RESULTS At baseline, 44.8% reported to have experienced childhood trauma. Workers with the highest childhood trauma level showed significantly (p < 0.001) more absenteeism as well as more presenteeism. Mediation analyses revealed that indirect effects between the childhood trauma index and both work indices were significantly mediated by current depressive disorder (p = 0.023 and p < 0.001, respectively) and current comorbid depression-anxiety (p = 0.020 and p < 0.001, respectively), with the latter accounting for the largest effects (PM = 0.23 and PM = 0.29, respectively). No significant mediating role in this relationship was found for current anxiety disorder and remitted depressive and/or anxiety disorder. CONCLUSIONS Persons with childhood trauma have significantly reduced work functioning in terms of absenteeism and presenteeism. This seems to be largely accounted for by current depressive disorders and current comorbid depression-anxiety.
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Affiliation(s)
- Maud De Venter
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Bernet M Elzinga
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Filip Van Den Eede
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.,University Department of Psychiatry, Campus Antwerp University Hospital (UZA), Antwerp, Belgium
| | - Kristien Wouters
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital (UZA), University of Antwerp, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Guido F Van Hal
- Social Epidemiology and Health Policy, Department Epidemiology and Social Medicine, University of Antwerp (UA), Antwerp, Belgium
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Bernard G C Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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28
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Farah R, Malaeb D, Sacre H, Akel M, Hallit S, Salameh P. Factors associated with work impairment and productivity among Lebanese community pharmacists. Int J Clin Pharm 2020; 42:1097-1108. [PMID: 32638293 DOI: 10.1007/s11096-020-01087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
Background Community pharmacists provide an essential service by promoting, maintaining and improving the health of the community. However, factors affecting community pharmacists' work productivity remain poorly studied. Objective Our study aimed to assess, on a national level, work productivity components and its correlates among Lebanese community pharmacists. Methods: The study was carried out between March and July 2018, using a representative sample of community pharmacies from all districts of Lebanon. Main outcome measure: The work productivity components were assessed using the Work Productivity and Activity Impairment questionnaire. Results The study included 435 community pharmacists, the prevalence of sickness presenteeism and sickness absenteeism reached 91% and 45%, respectively. Presenteeism was positively associated with reporting higher depression score (β = 0.26) and insomnia (β = 0.20) whereas better mental (β = - 0.35) and physical health (β = - 0.38) were negatively associated with presenteeism. Absenteeism was positively associated with male gender (adjusted OR 2.05, 95% CI 1.14-3.70), reporting higher depression score (adjusted OR = 1.07, 95% CI 1.02-1.11) and negatively associated with better mental and physical health (adjusted OR = 0.93, 95% CI 0.90-0.96 and adjusted OR = 0.96, 95% CI 0.93-0.99; respectively). Activity impairment was positively associated with depression (β = 0.16) and insomnia (β = 0.12) and negatively associated with better mental (β = - 0.22) and physical health (β = - 0.015). Conclusion This is the first study assessing work productivity and activity impairment among Lebanese community pharmacists. Further research is needed to predict sickness absenteeism and presenteeism and this information will be useful to ensure quality of care is delivered.
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Affiliation(s)
- Rita Farah
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Hala Sacre
- INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- INSPECT-LB, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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29
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Bhavsar V, Hatch SL, Dean K, McManus S. Association of prior depressive symptoms and suicide attempts with subsequent victimization: analysis of population-based data from the Adult Psychiatric Morbidity Survey. Eur Psychiatry 2020; 63:e51. [PMID: 32431256 PMCID: PMC7355179 DOI: 10.1192/j.eurpsy.2020.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Symptoms of mental disorder, particularly schizophrenia, predispose to victimization. Much less is known about the relationship between depressive symptoms and later victimization in the general population, the influence of these symptoms on types of subsequent victimization, or the role of symptom severity. We investigated this in nationally representative data from the United Kingdom. Methods: Data were from the Adult Psychiatric Morbidity Survey 2007. Multivariable logistic regressions estimated association between (a) prior depressive symptoms, (b) prior depressive symptoms with suicide attempt, and types of more recent victimization. Gender-specific associations were estimated using multiplicative interactions. Results: Prior depressive symptoms were associated with greater odds of any recent intimate partner violence (IPV), emotional IPV, sexual victimization, workplace victimization, any victimization, and cumulative victimization (adjusted odds ratio [aOR] for increasing types of recent victimization: 1.47, 95% confidence interval [CI]: 1.14, 1.89). Prior depressive symptoms with suicide attempt were associated with any recent IPV, emotional IPV, any victimization, and cumulative victimization (aOR for increasing types of recent victimization: 2.33, 95% CI: 1.22, 4.44). Self reported recalled data on previous depressive symptoms may have limited accuracy. Small numbers of outcomes for some comparisons results in imprecision of these estimates. Conclusions: Aside from severe mental illness such as schizophrenia, previous depressive symptoms in the general population are associated with greater subsequent victimization. Men and women with prior depressive symptoms may be vulnerable to a range of types of victimization, and may benefit from interventions to reduce this vulnerability.
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Affiliation(s)
- Vishal Bhavsar
- Department of Health Services and Population Research, Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, United Kingdom
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Kimberlie Dean
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Justice Health & Forensic Mental Health Network, Matraville, New South Wales, Australia
| | - Sally McManus
- National Center for Social Research, NatCen, London, United Kingdom
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30
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Kizuki M, Fujiwara T. Quality of supervisor behaviour, workplace social capital and psychological well-being. Occup Med (Lond) 2020; 70:243-250. [DOI: 10.1093/occmed/kqaa070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Employees with a higher level of workplace social capital (i.e. relationships, trust and reciprocity at work) have a lower risk of mental health problems. Supervisor behaviour may be a predictor of workplace social capital.
Aims
To examine the associations between supervisor behaviour, workplace social capital and psychological well-being.
Methods
We conducted a secondary analysis of the sixth European Working Conditions Survey. The study sample included 28 900 employees in 35 European countries with an immediate line manager. Depression was assessed with the WHO-5 Well-Being Index. Supervisor behaviour quality and workplace social capital were each measured with a 6-item question. Association between quality of supervisor behaviour and workplace social capital was analysed using a hierarchical linear modelling. A mediation analysis was conducted by using hierarchical logistic models of depression with and without workplace social capital index.
Results
A higher supervisor behaviour quality index was associated with an increased workplace social capital index (β, 0.55; 95% confidence interval [CI], 0.51–0.59). A higher workplace social capital index was associated with lower odds of depression (odds ratio [OR], 0.89; 95% CI, 0.87–0.90). A higher supervisor behaviour quality index was associated with lower odds of depression (OR, 0.90; 95% CI, 0.89–0.92); 58% of the effect was mediated by workplace social capital.
Conclusions
Our findings support the hypothesis that better supervisor behaviour quality increases workplace social capital and contributes to psychological well-being of employees. This may be useful for planning organizational interventions to enhance mental health of workers.
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Affiliation(s)
- Masashi Kizuki
- Japan Support Center for Suicide Countermeasures, National Center of Neurology and Psychiatry, Ogawa-Higashi, Kodaira city, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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31
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Knipscheer J, Sleijpen M, Frank L, de Graaf R, Kleber R, ten Have M, Dückers M. Prevalence of Potentially Traumatic Events, Other Life Events and Subsequent Reactions Indicative for Posttraumatic Stress Disorder in the Netherlands: A General Population Study Based on the Trauma Screening Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051725. [PMID: 32155752 PMCID: PMC7084195 DOI: 10.3390/ijerph17051725] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/14/2022]
Abstract
The 12-month and lifetime prevalence of posttraumatic stress disorder (PTSD) in different country populations has been assessed while using clinical interviews. Because this methodology is relatively time-consuming and resource-intensive, disaster health researchers adopted instruments, like the Trauma Screening Questionnaire (TSQ). This study (1) used the TSQ to estimate the lifetime prevalence of potentially traumatic events and other life events (PTE/OLEs) and the one-week prevalence of subsequent reactions indicative for PTSD (based on DSM-IV PTSD criteria) in The Netherlands and (2) investigated risk and protective factors for the development of PTSD to overcome the lack of baseline comparison data on general populations and subgroups. The data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a representative study in the Dutch general population aged 18 to 64 years (N = 6646), using face-to-face interviews. Logistic regression modeling was used to assess PTSD correlates. The lifetime PTE/OLE prevalence was 71.1%. Among exposed subjects, one-week PTSD prevalence was estimated at 2.0%. The correlates of PTSD were female gender, Moroccan, or Turkish ethnicity, and exposure to sexual abuse and exposure time less than four years ago. The results are discussed in relation to earlier 12-month and lifetime general population prevalence of PTSD in the Netherlands and other countries, and TSQ-based disaster studies. General population replications can provide additional TSQ baseline data, and shed light on exposure and PTSD prevalence assessed with different instruments.
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Affiliation(s)
- Jeroen Knipscheer
- ARQ National Psychotrauma Centre, 1112 XE Diemen, The Netherlands; (M.S.); (L.F.); (R.K.); (M.D.)
- Department of Methodology and Statistics, Utrecht University, 3584 CS Utrecht, the Netherlands
- Correspondence: ; Tel.: +31-206-274-974
| | - Marieke Sleijpen
- ARQ National Psychotrauma Centre, 1112 XE Diemen, The Netherlands; (M.S.); (L.F.); (R.K.); (M.D.)
- Department of Methodology and Statistics, Utrecht University, 3584 CS Utrecht, the Netherlands
| | - Laurence Frank
- ARQ National Psychotrauma Centre, 1112 XE Diemen, The Netherlands; (M.S.); (L.F.); (R.K.); (M.D.)
- Department of Methodology and Statistics, Utrecht University, 3584 CS Utrecht, the Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, 3521 VS Utrecht, The Netherlands; (R.d.G.); (M.t.H.)
| | - Rolf Kleber
- ARQ National Psychotrauma Centre, 1112 XE Diemen, The Netherlands; (M.S.); (L.F.); (R.K.); (M.D.)
- Department of Methodology and Statistics, Utrecht University, 3584 CS Utrecht, the Netherlands
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, 3521 VS Utrecht, The Netherlands; (R.d.G.); (M.t.H.)
| | - Michel Dückers
- ARQ National Psychotrauma Centre, 1112 XE Diemen, The Netherlands; (M.S.); (L.F.); (R.K.); (M.D.)
- Nivel–Netherlands Institute for Health Services Research, 3513 CR Utrecht, The Netherlands
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32
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Mutambudzi M, Henkens K. Chronic health conditions and work-related stress in older adults participating in the Dutch workforce. Eur J Ageing 2020; 17:499-508. [PMID: 33376462 PMCID: PMC7752930 DOI: 10.1007/s10433-020-00554-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The proportion of workers with chronic health conditions (CHCs) will increase over the years as pension reform is increasing the age of retirement in many European countries. This will increase the percentage of older adults with CHCs performing highly demanding work. This study sought to examine the association between common CHCs [cardiovascular disease (CVD), diabetes, arthritis, respiratory and sleep disorders] and three domains of work stress in older Dutch workers. This study used data from the first wave of the NIDI Pension Panel Study for working adults aged 60–65 years (n = 6793). Logistic regression models examined the strength of association between CHCs and (1) general work stress, (2) emotional, and (3) physical demands. All five CHC were independently associated with one or more domains of stress. After including all CHCs in the model, CVD, sleep disorders, and arthritis were significantly associated with general stress. Respiratory disorders, sleep disorders, and arthritis were significantly associated with physical demands. Diabetes (1.25, 95% CI 1.01–1.53), sleep disorders (1.99, 95% CI 1.72–2.31), and arthritis (1.18, 95% CI 1.06–1.31) were significantly associated with emotional demands. Our findings demonstrate that work stress is associated with prevalent CHCs, and these conditions are differentially associated with several domains of work stress in adults approaching retirement. More research is needed to understand the causal relationship between CHCs and work stress. Such research may provide insights for effective workplace and public health interventions to ensure that older workers remain physically and mentally healthy, and productive through their working years.
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Affiliation(s)
- Miriam Mutambudzi
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G2 3AX UK
| | - Kene Henkens
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), The Hague, The Netherlands
- University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
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Improvements in Workplace Productivity in Working Patients With Major Depressive Disorder: Results From the AtWoRC Study. J Occup Environ Med 2020; 62:e94-e101. [PMID: 31895735 DOI: 10.1097/jom.0000000000001805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess changes in workplace productivity and functioning in an open-label study in working patients receiving vortioxetine (10 to 20 mg/d) for major depressive disorder (MDD). METHODS Associations between items in the Work Limitations Questionnaire (WLQ), the Sheehan Disability Scale (SDS), and the Work Productivity and Activity Impairment (WPAI) questionnaire were assessed at 12 and 52 weeks by Pearson correlation coefficients. RESULTS Significant improvements were observed across all domains of workplace productivity and functioning after 12 and 52 weeks' vortioxetine treatment. Strong correlations were seen between improvements in WLQ mental domains and WPAI presenteeism and SDS work/school items. Presenteeism showed stronger correlations with other workplace productivity measures than absenteeism. CONCLUSIONS Presenteeism and absenteeism impact productivity in working patients with MDD. Vortioxetine confers long-term benefits across all workplace functioning domains.
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Wang G, Tan KHX, Ren H, Hammer-Helmich L. Impact of Cognitive Symptoms on Health-Related Quality of Life and Work Productivity in Chinese Patients with Major Depressive Disorder: Results from the PROACT Study. Neuropsychiatr Dis Treat 2020; 16:749-759. [PMID: 32214816 PMCID: PMC7081063 DOI: 10.2147/ndt.s230403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/15/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This post hoc analysis was undertaken to further explore the association of cognitive symptoms with health-related quality of life (HRQoL) and work productivity at the time of treatment initiation in Chinese patients with major depressive disorder (MDD) in the Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study. PATIENTS AND METHODS This was an epidemiological, non-interventional, prospective cohort study in adult outpatients with moderate-to-severe MDD initiating antidepressant monotherapy (first or second line). Crude and adjusted analyses of covariance were performed to assess the association of perceived cognitive symptoms (20-item Perceived Deficits Questionnaire-Depression [PDQ-D] total score) or observed cognitive performance (Digit Symbol Substitution Test [DSST] score) with HRQoL (EuroQoL 5-Dimensions Questionnaire index) and work productivity (Work Productivity and Activity Impairment [WPAI] or Sheehan Disability Scale [SDS] absenteeism and presenteeism scores). Adjusted analyses included depression severity, age, sex, residential area (urban/rural), and educational level. RESULTS Of 1008 patients enrolled in the PROACT study, 986 were included in this analysis. Severity of perceived cognitive symptoms (ie, higher PDQ-D total score) was significantly associated with worse HRQoL (P<0.001) and higher levels of absenteeism (P=0.020 for the WPAI and P=0.002 for the SDS) and presenteeism (P<0.001 for both scales). The association of perceived cognitive symptoms with HRQoL and presenteeism was independent of depression severity. The association between observed cognitive performance (DSST score) and HRQoL was less robust. No association was seen between observed cognitive performance and levels of absenteeism or presenteeism assessed by either scale. CONCLUSION Results of this real-world study illustrate the impact of cognitive symptoms on HRQoL and work productivity in Chinese patients with MDD, and highlight the importance of assessing and targeting cognitive symptoms in order to improve functional outcomes when treating patients with MDD.
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Affiliation(s)
- Gang Wang
- Psychiatry Department, Beijing an Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, People's Republic of China
| | - Kristin Hui Xian Tan
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Ltd, Singapore
| | - Hongye Ren
- Medical Affairs Value Evidence, H. Lundbeck A/S, Valby, Denmark
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Fusco N, Ricciardelli R, Jamshidi L, Carleton RN, Barnim N, Hilton Z, Groll D. When Our Work Hits Home: Trauma and Mental Disorders in Correctional Officers and Other Correctional Workers. Front Psychiatry 2020; 11:493391. [PMID: 33658946 PMCID: PMC7917131 DOI: 10.3389/fpsyt.2020.493391] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background: International estimates suggest that up to one in three public safety personnel experience one or more mental disorders, including post-traumatic stress disorder (PTSD). Canadian data have been sparse until very recently, and correctional officers and forensic psychiatric staff have rarely been included. Working as a correctional officer is associated with negative health outcomes and increased work-related stress, with several variables affecting reported levels of stress. Healthcare staff also report higher rates of PTSD, especially those who are exposed to aggression in their workplace. In the present study, we compare current symptoms of diverse staff working in correctional occupations. Method: Data were collected from a Canadian national online survey of public safety personnel, including employees of correctional services at the federal level. Correctional officers and wellness services staff were compared for prevalence of mental disorders and suicidal ideation. Results: Correctional officers self-reported statistically significantly more exposure to potentially psychologically traumatic events than wellness services employees. Correctional officers also self-reported higher rates of symptoms of mental disorders, including PTSD, social anxiety, panic disorder, and depression. There were no statistically significant differences in reports of suicidal thoughts, plans, or attempts. Contribution to Society: Correctional and forensic staff contribute to society by working with justice-involved individuals in correctional institutions. Trauma-related disorders and other mental health problems threaten the well-being of correctional and forensic staff. Mental health likely impacts the ability of correctional and forensic staff to develop a therapeutic or working alliance with persons in custody. Staff well-being must be recognized and addressed to ensure that prisoners and staff receive optimal treatment in prison. Conclusion: Our results add to the limited knowledge about the well-being of staff, particularly wellness staff in prisons, who provide daily treatment and care for prisoners with serious mental disorders. Our work is a step toward identifying avenues for promoting staff well-being.
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Affiliation(s)
- Nina Fusco
- Integrated Forensic Program, Ontario Provincial Police, Ottawa, ON, Canada
| | - Rosemary Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Laleh Jamshidi
- Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - Nigel Barnim
- Department of Psychiatry, Queen's University at Kingston, Kingston, ON, Canada
| | - Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Dianne Groll
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Guimarães LAM, Laudelino Neto A, Massuda Júnior J. Intervenção integrada em saúde mental do trabalhador em uma corporação policial de Campo Grande (MS). REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369000018618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução: transtornos mentais relacionados ao trabalho têm gerado crescente impacto econômico e social. A Organização Mundial da Saúde recomenda intervenções integradas no local de trabalho para lidar com os fatores que repercutem na saúde mental, visando a proposição de medidas preventivas mais efetivas. Objetivos: descrever e analisar uma intervenção integrada em saúde mental do trabalhador. Métodos: estudo descritivo-analítico de experiência profissional de atendimento psicológico em programa integrado de saúde mental do trabalhador em uma corporação de policiais rodoviários federais, em Campo Grande (MS). Resultados: o trabalho desenvolvido pode ter contribuído para reduzir o número de afastamentos por transtorno mental e os dias de afastamento do trabalho. Conclusão: a atuação integrada do serviço de atendimento ao trabalhador propiciou um momento de escuta, aprendizado e pertencimento que possivelmente repercutiu na redução do absenteísmo por doença.
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Sugawara N, Yasui-Furukori N, Tsuji T, Hayashi S, Ajisawa Y, Ochiai T, Imagawa H, Shimoda K. The Relationship Between Baseline Clinical Symptom Characteristics and Working Ability in Japanese Patients Treated for Major Depressive Disorder and Painful Physical Symptoms. Neuropsychiatr Dis Treat 2020; 16:3063-3070. [PMID: 33335397 PMCID: PMC7737943 DOI: 10.2147/ndt.s274608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/20/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The objective of this post hoc analysis was to explore the relationship, including changes over time, between baseline clinical symptom characteristics and working ability, judged by investigators, after 12 weeks of antidepressant monotherapy in Japanese patients with major depressive disorder (MDD) and painful physical symptoms (PPS) in a real-world clinical setting. PATIENTS AND METHODS This prospective, observational study in patients treated with duloxetine or selective serotonin reuptake inhibitors was conducted from 2014 to 2016. Both treatment groups were pooled and divided into 2 groups, "working ability recovered" or "working ability not recovered," based on working ability at the end of the study. Patients were also divided into 4 subgroups by the presence or absence of previous depressive episodes and working ability. Main outcome measures included baseline demographics and clinical characteristics, and the 17-item Hamilton Rating Scale for Depression (HAM-D17). RESULTS Comparison between "working ability recovered" (n=122) and "working ability not recovered" (n=91) showed that the percentage of patients with complications and psychotherapy at baseline, and baseline HAM-D17 total, insomnia, somatic, and anxiety scores, were significantly different. The results of subgroup analyses were mostly the same as the results analyzed by working ability alone. Although statistical differences were observed for some outcome measures, the differences at baseline, except use of psychotherapy, may not be applicable clinically, and there were no specific trends observed that could predict working ability. CONCLUSION This post hoc analysis suggested that most baseline clinical characteristics, including the presence or absence of previous depressive episodes, were not predictive of working ability recovery. However, the use of psychotherapy in parallel with antidepressant monotherapy may be positively associated with working ability recovery. All outcome measures improved over time, reinforcing the importance of continuous treatment and observation to improve and accurately judge working ability in patients with MDD and PPS.
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Affiliation(s)
- Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toshinaga Tsuji
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | - Shinji Hayashi
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | | | | | - Hideyuki Imagawa
- Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Disability and common mental disorders: Results from the World Mental Health Survey Initiative Portugal. Eur Psychiatry 2020; 49:56-61. [DOI: 10.1016/j.eurpsy.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 02/05/2023] Open
Abstract
AbstractBackgroundCommon mental disorders are highly prevalent and disabling, leading to substantial individual and societal costs. This study aims to characterize the association between disability and common mental disorders in Portugal, using epidemiological data from the World Mental Health Survey Initiative.MethodsTwelve-month common mental disorders were assessed with the CIDI 3.0. Disability was evaluated with the modified WMHS WHODAS-II. Logistic regression models were used to assess the association between disability and each disorder or diagnostic category (mood or anxiety disorders).ResultsAmong people with a common mental disorder, 14.6% reported disability. The specific diagnoses significantly associated with disability were post-traumatic stress disorder (OR: 6.69; 95% CI: 3.20, 14.01), major depressive disorder (OR: 3.49; 95% CI: 2.13, 5.72), bipolar disorder (OR: 3.41; 95% CI: 1.04, 11.12) and generalized anxiety disorder (OR: 3.14; 95% CI: 1.43, 6.90). Both categories of anxiety and mood disorders were significantly associated with disability (OR: 1.88; 95% CI: 1.23, 2.86 and OR: 3.94; 95% CI: 2.45, 6.34 respectively).ConclusionsThe results of this study add to the current knowledge in this area by assessing the disability associated with common mental disorders using a multi-dimensional instrument, which may contribute to mental health policy efforts in the development of interventions to reduce the burden of disability associated with common mental disorders.
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Changes in socioeconomic position among individuals with mental disorders during the economic recession in Portugal: a follow-up of the National Mental Health Survey. Epidemiol Psychiatr Sci 2019; 28:638-643. [PMID: 30078385 PMCID: PMC6998866 DOI: 10.1017/s2045796018000392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS Portugal was one of the European countries most affected by the period of economic recession initiated in 2008. Social inequalities are likely to widen during such periods and disproportionately affect people with mental disorders. The present study aims to compare self-reported changes in indicators of socioeconomic position during the economic recession in Portugal among people with and without mental disorders in the beginning of this period. Three dimensions were assessed, namely employment situation, experiences of financial hardship and subjective social status. METHODS Data from the World Mental Health Survey Initiative Portugal (2008/2009) and from the National Mental Health Survey Follow-up (2015/2016) were used (n = 911). Multinomial and logistic recession models were performed to examine the association between the presence of any 12-month mood or anxiety mental disorder in 2008/2009 and indicators of socioeconomic position in 2015/2016. All analyses were adjusted for gender, age, presence of any physical disorder and education at the baseline. RESULTS Participants that had any mental disorder in the beginning of the economic recession reported 2.20 (95% CI 1.31-3.71; P < 0.01) higher odds of financial hardship related to daily life in 2015/2016, when compared with those without any mental disorder, after adjusting for age, gender, education and presence of any physical disorder. The results may also suggest a pattern of increased socioeconomic disadvantage among people with prior mental disorder, despite not reaching statistical significance. CONCLUSIONS The results of this study suggest that the economic recession may have contributed to wider social inequalities between people with and without mental disorders. Policies to support these individuals, such as access to treatment and alleviation of financial hardship, should be a priority in times of economic downturn.
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Wang D, Ma J, Tan L, Chen Y, Zhou X, Wang H, Guo J, Li X, Liu X. Characteristics of help-seeking behavior among bipolar disorder patients: A study in Hunan, China. Medicine (Baltimore) 2019; 98:e17687. [PMID: 31725611 PMCID: PMC6867767 DOI: 10.1097/md.0000000000017687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
To analyze the factors that affecting the help-seeking behavior of bipolar disorder (BD) patients by conducting interviews BD individuals in Hunan province of China.In 2015, 72,999 people from 123 counties of Hunan province of China were interviewed through multistage stratified random sampling. Twelve items of general health questionnaire (GHQ-12) and abnormal behavioral clue questionnaire were used as screening tools. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) (SCID) was used as a diagnostic tool.Among the 75 BD patients, 36% (27/75) sought help. Compared with help-seekers, non-help-seekers were more likely to be older, divorced, or widowed, mostly illiterate or elementary education, family monthly income at least 3000 ¥, more physically consulted in the past year, able to effective work or study, at a stable illness status. 70.4% help-seekers firstly sought help from a medical institution. The main reasons that patients did not seek help were economic problem, did not know where to seek help, unsatisfied with medical services, afraid of mental health stigma, and other problems, such as traffic inconvenience.Non-help-seekers were faced with more difficulties in their social functions and social interactions.
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Affiliation(s)
- Dongxin Wang
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
| | - Jing Ma
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
| | - Lihong Tan
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
| | - Yan Chen
- Department of Disease Control, Health and Family Planning Commission of Hunan Province
| | - Xuhui Zhou
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
| | - Huiying Wang
- Social Health Management, XiangYa School of Public Health & Central South University, Changsha, P.R. China
| | - Jing Guo
- Social Health Management, XiangYa School of Public Health & Central South University, Changsha, P.R. China
| | - Xiaosong Li
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
| | - Xuejun Liu
- Hunan Institute of Mental Health, Brain Hospital of Hunan Province
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Joling KJ, Ten Have M, de Graaf R, O'Dwyer ST. Risk factors for suicidal thoughts in informal caregivers: results from the population-based Netherlands mental health survey and incidence Study-2 (NEMESIS-2). BMC Psychiatry 2019; 19:320. [PMID: 31660914 PMCID: PMC6816143 DOI: 10.1186/s12888-019-2317-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research suggests that family caregivers contemplate suicide at a higher rate than the general population. Much of this research has been disease specific and in relatively small samples. This study aimed to compare suicidal thoughts between non-caregivers and informal caregivers of people with a variety of conditions, in a large representative sample, and to identify significant risk factors. METHODS The general population study NEMESIS-2 (N at baseline = 6646) included 1582 adult caregivers at the second wave (2010-2012) who also participated at the third wave (2013-2015). Suicidal thoughts were assessed over 4 years, with the Suicidality Module of the Composite International Diagnostic Interview 3.0. The presence of suicidal thoughts was estimated and risk factors for suicidal thoughts were assessed with logistic regression analyses adjusted for age and gender. RESULTS Thirty-six informal caregivers (2.9%) reported suicidal thoughts during the 4 year study period. The difference between caregivers and non-caregivers (3.0%) was not significant. Among caregivers, significant risk factors for suicidal thoughts included being unemployed, living without a partner, having lower levels of social support, having a chronic physical disorder, a mood disorder or an anxiety disorder, and having impaired social, physical and emotional functioning. These risk factors were also found in non-caregivers. No caregiving-related characteristics were associated with suicidal thoughts. CONCLUSION There was no elevated rate of suicidal thoughts in caregivers and risk factors for suicidal thoughts in caregivers were consistent with risk factors in non-caregivers. No association between caregiving characteristics and suicidal thoughts was found. Caregivers with limited resources and in poorer health might still benefit from prevention and intervention efforts.
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Affiliation(s)
- Karlijn J Joling
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, de Boelelaan, 1117, Amsterdam, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands
| | - Siobhan T O'Dwyer
- University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
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Jung SW, Lee JH, Lee KJ. Associations Between Activities Outside Work and Presenteeism Among Korean Wage Workers: An Analysis Using a Nationwide Survey. J Prev Med Public Health 2019; 52:292-298. [PMID: 31588698 PMCID: PMC6780289 DOI: 10.3961/jpmph.19.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/12/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives Presenteeism is currently recognized as a significant global health issue that can potentially cause productivity losses. Hence, many studies have analyzed the relationships between workplace factors and presenteeism. However, few studies have considered non-occupational factors. This study examined the associations between presenteeism and activities outside work, including volunteering, self-development, leisure/sports, and gardening and house repair activities, in Korean wage workers. Methods This study analyzed the fourth Korean Working Conditions Survey, in which a total of 19 294 wage workers participated. To identify relationships between presenteeism and activities outside work, multivariate logistic regression analysis was used after adjusting for general and occupational characteristics. Results Self-development and leisure/sports activities significantly increased the odds ratio (OR) of presenteeism (OR, 1.166; 95% confidence interval [CI], 1.061 to 1.282 and OR, 1.276; 95% CI, 1.181 to 1.379, respectively). Conclusions Certain activities outside work, such as self-development or leisure/sports, were related to presenteeism among Korean wage workers. Although many previous studies have emphasized the positive effects of those activities on health, this study documented negative effects of these activities outside work on health.
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Affiliation(s)
- Sung Won Jung
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - June-Hee Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Kyung-Jae Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Korea
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Absenteeism and Presenteeism Associated With Common Health Conditions in Brazilian Workers. J Occup Environ Med 2019; 61:303-313. [DOI: 10.1097/jom.0000000000001538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Roche A, Kostadinov V, McEntee A, Allan J, Meumann N, McLaughlin L. Evaluation of a workshop to address drugs and alcohol in the workplace. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2019. [DOI: 10.1108/ijwhm-05-2018-0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeRisky alcohol and other drug (AOD) use is ubiquitous in some workplace cultures, and is associated with considerable risks to health, safety and productivity. A workplace drug and alcohol first aid program was developed to support supervisors and managers to recognize and respond appropriately to AOD problems, increase knowledge of AOD and reduce the stigma associated with AOD. The purpose of this paper is to undertake an evaluation to assess the program’s efficacy.Design/methodology/approachA self-report survey was administered to program participants before (T1), immediately after (T2) and three months following program completion (T3). Changes in alcohol/drug-related knowledge, role adequacy, motivation and personal views were examined using repeated measures ANOVA.FindingsA total of 109 participants took part in the program, with only 26 completing scores at all three time points. Mean scores increased significantly (p<0.05) between T1 and T2 for knowledge (12.7–16.0), role adequacy (11.8–17.4), motivation (9.7–10.4) and personal views (9.0–9.6). Significant improvements were maintained at T3 for knowledge (15.1) and role adequacy (17.3).Practical implicationsDrug and alcohol first aid programs offer a potentially valuable initiative to improve the knowledge, skills and understanding of managers and supervisors in tackling workplace AOD risks, associated stigma and improving help seeking.Originality/valueWorkplace programs for managers can facilitate organization-wide responses to the reduction of AOD-related problems, increase implementation of appropriate policy and interventions, minimize associated harms and stigma and reduce negative imposts on productivity and profit.
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Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions. Soc Psychiatry Psychiatr Epidemiol 2019; 54:145-156. [PMID: 30027449 DOI: 10.1007/s00127-018-1562-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Mental health problems are prevalent after combat; they are also common in its absence. Estimates of deployment-attributability vary. This paper quantifies the contribution of different subtypes of occupational trauma to post-deployment mental health problems. METHODS Participants were a cohort of 16,193 Canadian personnel undergoing post-deployment mental health screening after return from the mission in Afghanistan. The screening questionnaire assessed post-traumatic stress disorder, depression, panic disorder, generalized anxiety disorder, and exposure to 30 potentially traumatic deployment experiences. Logistic regression estimated adjusted population attributable fractions (PAFs) for deployment-related trauma, which was treated as count variables divided into several subtypes of experiences based on earlier factor analytic work. RESULTS The overall PAF for overall deployment-related trauma exposure was 57.5% (95% confidence interval 44.1, 67.7) for the aggregate outcome of any of the four assessed problems. Substantial PAFs were seen even at lower levels of exposure. Among subtypes of trauma, exposure to a dangerous environment (e.g., receiving small arms fire) and to the dead and injured (e.g., handling or uncovering human remains) had the largest PAFs. Active combat (e.g., calling in fire on the enemy) did not have a significant PAF. CONCLUSIONS Military deployments involving exposure to a dangerous environment or to the dead or injured will have substantial impacts on mental health in military personnel and others exposed to similar occupational trauma. Potential explanations for divergent findings in the literature on the extent to which deployment-related trauma contributes to the burden of mental disorders are discussed.
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An economic model of the cost-utility of pre-emptive genetic testing to support pharmacotherapy in patients with major depression in primary care. THE PHARMACOGENOMICS JOURNAL 2019; 19:480-489. [PMID: 30647446 DOI: 10.1038/s41397-019-0070-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 10/26/2018] [Accepted: 12/21/2018] [Indexed: 12/28/2022]
Abstract
The pharmacokinetics of many antidepressants (tricyclic antidepressants (TCA) or selective serotonin re-uptake inhibitors (SSRI)) are influenced by the highly polymorphic CYP2D6 enzyme. Therefore, pharmacogenetics could play an important role in the treatment of depressive patients. The potential cost-utility of screening patients is however still unknown. Therefore, a Markov model was developed to compare the strategy of screening for CYP2D6 and subsequently adjust antidepressant treatment according to a patient's metabolizer profile of poor, extensive, or ultra metabolizer, with the strategy of no screening ('one size fits all' principle). Each week a patient had a probability of side effects, which was followed by dosage titration or treatment switching. After 6 weeks treatment effect was evaluated followed by treatment adjustments if necessary, with a total time horizon of the model of 12 weeks. The analysis was performed from a societal perspective. The strategy of screening compared with no screening resulted in incremental costs of €91 (95 percentiles: €39; €152) more expensive but also more effect with 0.001 quality adjusted life years (QALYs) (95 percentiles: 0.001; 0.002) gain. The incremental cost-effectiveness ratio (ICER) was therefore €77,406 per QALY gained, but varied between €22,500 and €377,500 depending on the price of screening and productivity losses. According to our model, we cannot unequivocally conclude that screening for CYP2D6 in primary care patients using antidepressants is be cost-effective, as the results are surrounded by large uncertainty. Therefore, information from ongoing studies should be used to reduce these uncertainties.
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Kuga A, Otsubo T, Tsuji T, Hayashi S, Imagawa H, Fujikoshi S, Escobar R. Analysis of HAM-D scores and working ability in an observational study of Japanese patients with major depressive disorder and painful physical symptoms treated with duloxetine or SSRI monotherapy. Neuropsychiatr Dis Treat 2019; 15:809-817. [PMID: 31040680 PMCID: PMC6455004 DOI: 10.2147/ndt.s195445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate the relationship between Hamilton Depression Rating Scale (HAM-D) score and psychiatrists' judgment of working ability in patients with major depressive disorder (MDD) and painful physical symptoms. METHODS This was a prospective, observational, 12-week study in patients who received duloxetine or a selective serotonin reuptake inhibitor. Patients were ≥20 years old, resided in Japan, and had at least moderate depression (Quick Inventory of Depressive Symptomatology ≥16) and at least moderate painful physical symptoms (Brief Pain Inventory-Short Form average pain ≥3). The main outcome in this post-hoc analysis was the HAM-D17 cutoff best corresponding with patients' working ability according to the investigator's judgment. Area under the receiver-operator curve was used to determine the time point with the strongest relationship between HAM-D17 and working ability. The optimal HAM-D17 cutoff was determined based on the maximum of sensitivity (true positive rate) minus ([1 minus specificity] [true negative rate]). For the evaluation of binary data, a mixed effects model with repeated measures analysis was used. RESULTS For the estimation of the HAM-D17 cutoff, the area under the receiver-operator curve was maximal at 12 weeks, when a HAM-D17 score of 6 resulted in the best correspondence with working ability in the combined study population. At 12 weeks, a HAM-D17 score of 6 also resulted in the maximum predictive ability in each of the two treatment groups separately. For predicted working ability at 12 weeks, 52.7% of duloxetine-treated patients achieved the HAM-D17 cutoff of ≤6, whereas 48.5% of SSRIs-treated patients achieved HAM-D17 ≤6 (P=0.477). CONCLUSION In this study of patients with major depressive disorder and painful physical symptoms, a HAM-D17 score ≤6 corresponded best with patients' working ability. This finding is consistent with previous studies showing that a HAM-D17 cutoff of ≤7 may overestimate functional recovery from MDD.
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Affiliation(s)
- Atsushi Kuga
- Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan,
| | - Tempei Otsubo
- Department of Psychiatry, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Toshinaga Tsuji
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | - Shinji Hayashi
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | - Hideyuki Imagawa
- Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan,
| | - Shinji Fujikoshi
- Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan,
| | - Rodrigo Escobar
- Bio-Medicines Global Team, Eli Lilly and Company, Madrid, Spain
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Bovopoulos N, LaMontagne AD, Martin A, Jorm A. Exploring the role of mental health first aid officers in workplaces. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2018. [DOI: 10.1108/ijwhm-06-2018-0082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
An emerging trend in Australian workplaces is to appoint staff trained in mental health first aid as mental health first aid officers (MHFAOs), similar to physical first aid officers (PFAOs) focused on physical health emergencies. The purpose of this paper is to better understand the nature of MHFAO roles in workplaces and develop recommendations for other workplaces.
Design/methodology/approach
A case study methodology was used, with semi-structured qualitative interviews conducted with multiple individuals within five diverse organisations.
Findings
The results indicated that organisations tended to differ in their approach to implementation, based on their level of experience. There was a strong agreement across organisations on the benefits and challenges they have experienced with the role.
Practical implications
Organisational representatives highlighted some important differences between PFAO and MHFAO roles. Respondents across all organisations agreed that MHFA training should ideally be offered to all staff if feasible, not only MHFAOs. The greatest challenge experienced by respondents was inadequate support to, and internal resourcing for, MHFAO roles. Respondents suggested that workplaces provide more support and training to MHFAOs.
Originality/value
This is the first study to explore and describe the experiences of workplaces with MHFAOs. Recommendations are made to assist interested organisations in these efforts.
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Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Aust N Z J Psychiatry 2018. [DOI: 10.1177/0004867418799453] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: To provide practical clinical guidance for the treatment of adults with panic disorder, social anxiety disorder and generalised anxiety disorder in Australia and New Zealand. Method: Relevant systematic reviews and meta-analyses of clinical trials were identified by searching PsycINFO, Medline, Embase and Cochrane databases. Additional relevant studies were identified from reference lists of identified articles, grey literature and literature known to the working group. Evidence-based and consensus-based recommendations were formulated by synthesising the evidence from efficacy studies, considering effectiveness in routine practice, accessibility and availability of treatment options in Australia and New Zealand, fidelity, acceptability to patients, safety and costs. The draft guidelines were reviewed by expert and clinical advisors, key stakeholders, professional bodies, and specialist groups with interest and expertise in anxiety disorders. Results: The guidelines recommend a pragmatic approach beginning with psychoeducation and advice on lifestyle factors, followed by initial treatment selected in collaboration with the patient from evidence-based options, taking into account symptom severity, patient preference, accessibility and cost. Recommended initial treatment options for all three anxiety disorders are cognitive–behavioural therapy (face-to-face or delivered by computer, tablet or smartphone application), pharmacotherapy (a selective serotonin reuptake inhibitor or serotonin and noradrenaline reuptake inhibitor together with advice about graded exposure to anxiety triggers), or the combination of cognitive–behavioural therapy and pharmacotherapy. Conclusion: The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder provide up-to-date guidance and advice on the management of these disorders for use by health professionals in Australia and New Zealand.
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Which mental disorders are associated with the greatest impairment in functioning? Soc Psychiatry Psychiatr Epidemiol 2018; 53:1265-1276. [PMID: 29959451 DOI: 10.1007/s00127-018-1554-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The objective of this study is to estimate the comparative associations of mental disorders with three measures of functional impairment: the Global Assessment of Functioning (GAF); the number of days in the past 12 months of total inability to work or carry out normal activities because of emotions, nerves, or mental health (i.e., days out of role); and a modified version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). METHODS Secondary data analysis of the linked Mental Health Surveillance Study and the National Survey on Drug Use and Health (n = 5653), nationally representative population surveys conducted in the United States. Generalized linear models assessed the independent effects of mental disorders on each measure of functional impairment, controlling for mental disorder comorbidity, physical health disorders, and sociodemographic factors. RESULTS The results varied across measures of functional impairment. However, mood disorders generally tended to be associated with the greatest functional impairment, anxiety disorders with intermediate impairment, and substance use disorders with the least impairment. All 15 disorders were significantly associated with the GAF score in multiple regression models, eight disorders were significantly associated with the WHODAS score, and three disorders were significantly associated with days out of role. CONCLUSIONS Our results highlight the value of complementary measures of functional impairment.
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