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Bhugra D, Liebrenz M, Ventriglio A, Ng R, Javed A, Kar A, Chumakov E, Moura H, Tolentino E, Gupta S, Ruiz R, Okasha T, Chisolm MS, Castaldelli-Maia J, Torales J, Smith A. World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health. Asian J Psychiatr 2024; 98:104105. [PMID: 38861790 DOI: 10.1016/j.ajp.2024.104105] [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: 11/02/2023] [Revised: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College, London SE5 8AF, United Kingdom.
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | | | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | | | | | - Susham Gupta
- East London NHS Foundation Trust, London, United Kingdom
| | - Roxanna Ruiz
- University of Francisco Moaroquin, Guatemala City, Guatemala
| | | | | | | | | | - Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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Mohamed AA, Alomair SM, Alnijadi AA, Abd Aziz F, Almulhim AS, Hammad MA, Emeka PM. Barriers to Mental Illness Treatment in Saudi Arabia: A Population-Based Cross-Sectional Study. Cureus 2024; 16:e53797. [PMID: 38465168 PMCID: PMC10924077 DOI: 10.7759/cureus.53797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Mental illness is a disorder that can cause impairment and disability, affecting mood, thinking, and behavior; therefore, early intervention will reduce morbidity. This study aims to evaluate all the personal, family, societal, and medical barriers that prevent mental health patients from seeking consultation and treatment. METHODS In Saudi Arabia, a cross-sectional study was conducted on 463 individuals aged 18 and above. Data were collected by face-to-face interviews using a validated questionnaire, which consisted of two parts. The first part included sociodemographic data, while the second part contained subsections of society/family, personal, and medical barriers. RESULTS The results showed that 379 (81.9%) indicated that society and family barriers impacted them, whereas 325 (70.3%) believed that personal barriers hindered seeking help. However, 294 (63.5%) opted for medical barriers as a hindrance. Regarding the highest barriers, 120 of the total respondents (25.9%) saw psychiatric illness as a source of shame and stigma, 166 respondents (35.9%) said that the psychiatric patient is seen as crazy, 159 of them (34.3%) believed it is tough for anyone to talk about their feelings and emotions and 183 respondent (39.5%) feared that psychiatric illness would decrease the chance of marriage to the appropriate person. Our findings also indicated a low trust in hospital treatment, hence a loss of confidence in using medications. CONCLUSION The findings of this study indicate that societal stigma is the most common barrier preventing people from seeking mental health consultation. Many barriers differ significantly between males and females.
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Affiliation(s)
- Ahmed A Mohamed
- Clinical Pharmacy, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Sufyan M Alomair
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Fatimatuzzahra Abd Aziz
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Abdulaziz S Almulhim
- Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
| | | | - Promise M Emeka
- Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, SAU
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Cui J, Guo S, Kan WS, Zhang L, He X, Chen R, Chen N, Xun K. Protocol for a scoping review of the role of siblings in supporting middle-aged and older people with early-acquired severe mental illness. BMJ Open 2023; 13:e076645. [PMID: 37865407 PMCID: PMC10603443 DOI: 10.1136/bmjopen-2023-076645] [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: 06/13/2023] [Accepted: 10/06/2023] [Indexed: 10/23/2023] Open
Abstract
INTRODUCTION For older individuals who developed severe mental illness (SMI) during late adolescence or early adulthood (referred to as early-acquired SMI), the combination of ageing and SMI presents persistent health and psychosocial challenges. This group, with a higher likelihood of being unmarried or experiencing marriage dissolution, often lacks social and economic resources to address the difficulties they face in later life. In recent years, there has been a growing interest in understanding the role of siblings in supporting the ageing process of individuals with early-acquired SMI. However, to date, no reviews have investigated the role of siblings in assisting their middle-aged and older brothers or sisters with SMI as they age within community settings. Our scoping review aims to explore and synthesise the existing literature on sibling support for individuals with early-acquired SMI, with the goal of informing further advancements in research, practice and policy. METHODS AND ANALYSIS The methodological framework developed by Arksey and O'Malley will inform this scoping review. Four groups of search keywords, derived from four related concepts (sibling, SMI, support and ageing), will be employed. Additionally, a group of keywords related to unrelated life stages and diseases will be used to exclude irrelevant articles. A search will be carried out across major online databases, namely PubMed, Scopus, PsycINFO, Ovid MEDLINE, ProQuest and Google Scholar to identify the articles between 2000 and 2023. English-language studies meeting specific eligibility criteria will be identified following a review of titles and abstracts and will then undergo a full-text review. The data from the selected articles will be extracted using a customised data-charting framework and content analysis will be conducted. ETHICS AND DISSEMINATION There are no requirements for ethical approval. The findings of this review will be shared through professional connections, academic conferences and scholarly journals.
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Affiliation(s)
- Jialiang Cui
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Siyuan Guo
- School of Humanities and Social Sciences, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong, China
| | - Wan Sang Kan
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, Hong Kong
| | - Lin Zhang
- Department of Social Work, Shandong University, Jinan, Shandong, China
- School of Law and Sociology, Qinghai Normal University, Xining, China
| | - Xin He
- Department of Social Work and Social Policy, Renmin University, Beijing, China
| | - Renxing Chen
- Department of Public Administration, Shandong University, Qingdao, Shandong, China
| | - Na Chen
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Kangwei Xun
- Discipline of Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Wang H, Guan Y, Hu R, Bragg F, Yu M, Zhong J. Willingness for community-based and institutional eldercare among older adults: a cross-sectional study in Zhejiang, China. BMJ Open 2022; 12:e055426. [PMID: 35440452 PMCID: PMC9020288 DOI: 10.1136/bmjopen-2021-055426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the proportion of willingness for community-based and institutional care and their correlating factors among older adults in Zhejiang Province, China. DESIGN Cross-sectional study. SETTING The Sixth National Health Service Survey, carried out in Zhejiang, China. PARTICIPANTS 7300 eligible older adults aged 60 years or older. MAIN OUTCOMES MEASURES Willingness for community-based and institutional eldercare. RESULTS The average age of the participants was 69.0±7.3 years. 50.9% of the participants were males, and 49.1% were females. 19.2% came from urban areas and 80.8% were from rural areas. The percentage of willingness for community-based and institutional eldercare was 2.7% and 3.8%, respectively. The corresponding figures for females were 2.9% and 3.5%, respectively, and for males were 2.5% and 4.1%, respectively. Factors positively associated with willingness for community-based eldercare included living in urban areas, high educational attainment, more frequent active exercise and living alone. Factors positively associated with willingness for institutional eldercare included age, living at urban areas, high education attainment, more frequent active exercise and receiving assistance with daily living. CONCLUSIONS Family eldercare was the priority for older adults compared with community-based and institutional eldercare in Zhejiang. The willingness for community-based and institutional eldercare among older adults was affected not only by the older adults themselves, but also by community and family members.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ruying Hu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fiona Bragg
- Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Nuffield Department of Population Health, Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Lin LH, Wang SB, Xu WQ, Hu Q, Zhang P, Ke YF, Huang JH, Ding KR, Li XL, Hou CL, Jia FJ. Subjective cognitive decline symptoms and its association with socio-demographic characteristics and common chronic diseases in the southern Chinese older adults. BMC Public Health 2022; 22:127. [PMID: 35042501 PMCID: PMC8767737 DOI: 10.1186/s12889-022-12522-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Subjective cognitive decline (SCD) may be the first symptomatic manifestation of Alzheimer’s disease, but information on its health correlates is still sparse in Chinese older adults. This study aimed to estimate SCD symptoms and its association with socio-demographic characteristics, common chronic diseases among southern Chinese older adults. Methods Participants aged 60 years and older from 7 communities and 2 nursing homes in Guangzhou were recruited and interviewed with standardized assessment tools. Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure poor sleep quality, depression symptoms and anxiety symptoms. The SCD symptoms were measured by SCD questionnaire 9 (SCD-Q9) which ranged from 0 to 9 points, with a higher score indicating increased severity of the SCD. Participants were divided into low score group (SCD-Q9 score ≤ 3) and higher score group (SCD-Q9 score > 3). Chi-square tests and multivariate logistic regression analysis were used for exploring the influences of different characteristics of socio-demographic and lifestyle factors on SCD symptoms. Univariate and multivariate logistic regression analysis were applied to explore the association between SCD symptoms with common chronic diseases. Results A total of 688 participants were included in our analysis with a mean age of 73.79 (SD = 8.28, range: 60–101), while 62.4% of the participants were females. The mean score of the SCD-Q9 was 3.81 ± 2.42 in the whole sample. A total of 286 participants (41.6%) were defined as the low score group (≤3 points), while 402 participants (58.4%) were the high score group (> 3 points). Multivariate logistic regression analysis revealed that female (OR = 1.99, 95%CI: 1.35–2.93), primary or lower education level (OR = 2.58, 95%CI: 1.38–4.83), nursing home (OR = 1.90, 95%CI: 1.18–3.05), napping habits (OR = 1.59, 95%CI: 1.06–2.40), urolithiasis (OR = 2.72, 95%CI: 1.15–6.40), gout (OR = 2.12, 95%CI: 1.14–3.93), poor sleep quality (OR = 1.93, 95%CI: 1.38–2.71), depression symptoms (OR = 3.01, 95%CI: 1.70–5.34) and anxiety symptoms (OR = 3.11, 95%CI: 1.29–7.46) were independent positive related to high SCD-Q9 score. On the other hand, tea-drinking habits (OR = 0.64, 95%CI: 0.45–0.92), current smoking (OR = 0.46, 95%CI: 0.24–0.90) were independent negative related to high SCD-Q9 score. Conclusions Worse SCD symptoms were closely related to common chronic diseases and socio-demographic characteristics. Disease managers should pay more attention to those factors to early intervention and management for SCD symptoms among southern Chinese older adults.
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Salime S, Clesse C, Jeffredo A, Batt M. Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review. Front Psychiatry 2022; 13:813338. [PMID: 35401263 PMCID: PMC8987193 DOI: 10.3389/fpsyt.2022.813338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders. METHODS Using PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected. RESULTS A total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented. CONCLUSIONS Recommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders.
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Affiliation(s)
- Samira Salime
- INTERPSY Laboratory, University of Lorraine, Nancy, France.,Hope 54 Association, Nancy, France
| | - Christophe Clesse
- INTERPSY Laboratory, University of Lorraine, Nancy, France.,Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine Dentistry, Queen Mary University of London, London, United Kingdom.,Psychiatric Hospital of Jury-les-Metz, Metz, France
| | | | - Martine Batt
- INTERPSY Laboratory, University of Lorraine, Nancy, France
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Petrova NN, Khvostikova DA. Prevalence, Structure, and Risk Factors for Mental Disorders in Older People. ADVANCES IN GERONTOLOGY 2021. [PMCID: PMC8654500 DOI: 10.1134/s2079057021040093] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.
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Affiliation(s)
- N. N. Petrova
- St. Petersburg State University, 199106 St. Petersburg, Russia
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8
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Pohl HH, Beschorner CE, Couto AN, Lenhard TH, Santos PRD. Quality of life: impacts of a health promotion program in the supplementary health sector. CIENCIA & SAUDE COLETIVA 2021; 26:3599-3607. [PMID: 34468655 DOI: 10.1590/1413-81232021269.2.20552019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/18/2019] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to compare quality of life indicators and clinical parameters among individuals participating in a cardiovascular health promotion program in the supplementary health sector. We conducted a cross-sectional study with 251 program participants living in the regions covered by the Vale do Taquari and Vale do Rio Pardo regional development councils in Rio Grande do Sul, Brazil. Quality of life was assessed using the WHOQOL-BREF questionnaire. Participants were predominantly women and elderly and had high cardiovascular risk (37.8%) and good self-reported quality of life. The clinical parameter means were body mass index obesity class I, normal blood pressure and lipid profile and adequate fasting blood sugar level. The results of the reassessment after one year showed a significant reduction in mean triglycerides (p = 0.031), diastolic blood pressure (p = 0.000) and systolic blood pressure (p = 0.013), and a significant increase in the mean score for the general domain of the WHOQOL-BREF (p = 0.004). It is necessary to consider and address social determinants of health and promote integrated actions across various sectors, including both the public and private spheres.
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Affiliation(s)
- Hildegard Hedwig Pohl
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul. Av. Independência 2.293, Bairro Universitário. 96815-900. Santa Cruz do Sul RS Brasil.
| | - Carmem Elisa Beschorner
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul. Av. Independência 2.293, Bairro Universitário. 96815-900. Santa Cruz do Sul RS Brasil.
| | - Analie Nunes Couto
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul. Av. Independência 2.293, Bairro Universitário. 96815-900. Santa Cruz do Sul RS Brasil.
| | - Tiago Henrique Lenhard
- Programa de Pós-Graduação em Economia, Universidade do Vale do Rio dos Sinos. São Leopoldo RS Brasil
| | - Polliana Radtke Dos Santos
- Programa de Residência Multiprofissional em Saúde - Urgência, Emergência e Intensivismo, Hospital Santa Cruz. Santa Cruz do Sul RS Brasil
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Howard EP, Martin L, Heckman GA, Morris JN. Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities? Front Psychiatry 2021; 12:704764. [PMID: 34867509 PMCID: PMC8632811 DOI: 10.3389/fpsyt.2021.704764] [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: 05/03/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Person-centered care approaches continue to evolve in long-term care (LTC). At the same time, these settings have faced increased challenges due to a more diverse and complex population, including persons with intellectual and developmental disabilities (IDD) and serious mental illness (SMI). This study examined the mental, social, and physical wellbeing of residents with different diagnoses, within a person-centered care model. It was hypothesized that individual wellbeing would be comparable among all residents, regardless of primary diagnosis. The study cohort was drawn from all admissions to long-term care facilities in the USA from 2011 to 2013. Data are based on admission, 3 and 6 month follow-up Minimum Data Set (MDS) 3.0 assessments. The groups examined included: schizophrenia, other psychotic disorders, IDD, dementia, and all others (i.e., none of the above diagnoses). The wellbeing outcomes were depression (mental), pain (physical), and behaviors (social). All residents experienced improvements in pain and depression, though the group without the examined diagnoses experienced the greatest gains. Behaviors were most prevalent among those with psychotic disorders; though marked improvements were noted over time. Improvement also was noted among persons with dementia. Behavior worsened over time for the three other groups. In particular, those with IDD experienced the highest level of worsening at 3-month follow-up, and continued to worsen. The results suggest person-centered care in US nursing homes provides the necessary foundation to promote mental and physical wellbeing in persons with complex needs, but less so for social wellbeing.
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Affiliation(s)
- Elizabeth P Howard
- Connell School of Nursing, Boston College, Newton, MA, United States.,Hebrew SeniorLife, The Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, United States
| | - Lynn Martin
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada.,Centre for Education and Research on Aging and Health, Thunder Bay, ON, Canada
| | - George A Heckman
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
| | - John N Morris
- Hebrew SeniorLife, The Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, United States
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Abstract
Objectives: Research evidence has demonstrated disparities and barriers associated with mental illness, which creates challenges for individuals with mental illness to maintain physical, mental, and social health as they age. The aim of this study was to examine the meaning of aging from the perspective of individuals with mental illness and explore their motivations and challenges to adopting healthy aging lifestyles and practices.Method: Using a qualitative narrative inquiry approach, interviews were conducted with 61 aging patients with mental illness aged 40 and older in community and institutional settings in Hong Kong.Results: Participants discussed the meaning of healthy aging in terms of meaningful occupation and use of time, and independence and autonomy. Motivating factors included a desire to avoid 'burdening' other people, to 'give back' to society, and gain back 'lost time'. These were connected to strategies for healthy aging, including social relationships and activities, spirituality, and healthy lifestyles. Challenges to adopting healthy aging practices included physical health difficulties and medication side effects, lack of purpose and boredom associated with daily routines and use of time, and conflicts and loss affecting family and peer relationships.Conclusion: Social and health services should be tailored to support aging individuals with mental illness and their families, addressing motivations and barriers to adopting healthy lifestyles. Promoting healthy aging practices to enable individuals with mental illness to achieve healthy aging is important for preparing for the aging of this population.
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Affiliation(s)
- Daniel W L Lai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - K C Chan
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - X J Xie
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - G D Daoust
- Department of International Relations, The University of Sussex, Sussex, UK
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Grassi L, Caruso R, Da Ronch C, Härter M, Schulz H, Volkert J, Dehoust M, Sehner S, Suling A, Wegscheider K, Ausín B, Canuto A, Muñoz M, Crawford MJ, Hershkovitz Y, Quirk A, Rotenstein O, Santos-Olmo AB, Shalev A, Strehle J, Weber K, Wittchen HU, Andreas S, Belvederi Murri M, Zerbinati L, Nanni MG. Quality of life, level of functioning, and its relationship with mental and physical disorders in the elderly: results from the MentDis_ICF65+ study. Health Qual Life Outcomes 2020; 18:61. [PMID: 32143635 PMCID: PMC7060594 DOI: 10.1186/s12955-020-01310-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Background An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. Method As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65–84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. Results Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). Conclusions The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Chiara Da Ronch
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Martin Härter
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Jana Volkert
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115, Heidelberg, Germany
| | - Maria Dehoust
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Susanne Sehner
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Anna Suling
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Karl Wegscheider
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Berta Ausín
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Alessandra Canuto
- Nant Foundation, East Vaud Psychiatric Institute, Route de Nant, 1804, Corsier-sur-Vevey, Switzerland
| | - Manuel Muñoz
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Mike J Crawford
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Yael Hershkovitz
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Alan Quirk
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Ora Rotenstein
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Ana Belén Santos-Olmo
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Arieh Shalev
- Department of Psychiatry, Langone Medical Center, New York, NY, USA
| | - Jens Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Kerstin Weber
- Curabilis, Medical Direction, University Hospitals of Geneva, Chemin de Champ-Dollon 20, 1241, Puplinge, Switzerland
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Sylke Andreas
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Institute for Psychology, Alpen-Adria Universität Klagenfurt, A-9020, Klagenfurt, Austria
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
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Association between frailty and incident risk of disability in community-dwelling elder people: evidence from a meta-analysis. Public Health 2019; 175:90-100. [PMID: 31454631 DOI: 10.1016/j.puhe.2019.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/11/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Frailty is considered to be one of the risk factors of disability. However, the results of original reported studies are not consistent with respect to the frailty and incidence of disability, and previously published meta-analyses have also shown inconsistent results. This meta-analysis was conducted to investigate the relationship between the different stages of frailty and the incidence of disability by examining updated overall trends in community-dwelling elders. STUDY DESIGN Cohort studies in English or Chinese based on associations between frailty and incident disability risks that were published from 2000 until the current date were researched using PubMed, Embase, Web of Science, and CENTRAL databases. METHODS The Q test and I2 statistic were used to examine between-study heterogeneity. Random-effect models were adopted to synthesize the results based on the study heterogeneity. Subgroup analyses were also conducted to explore the possible sources of between-study heterogeneity based on the characteristics of participants. RESULTS Eighteen cohort studies with 88,906 participants were included in our meta-analyses. Compared with the non-frailty category, the combined relative risks (RRs) (95% confidence interval [CI]) of the disability were 1.66 (1.49-1.85) and 2.53 (2.01-3.14) for the category of prefrailty and frailty, respectively. Results suggested that the incident risk of disability at follow-up times <5 (RR = 3.19, 95% CI = 2.25-4.53) was significantly higher than for follow-up times ≥5 in the frailty category (RR = 2.00, 95% CI = 1.55-2.56). The risk in a sample size of ≥1000 (RR = 2.78, 95% CI = 2.04-3.14) was significantly higher than that when the sample size was <1000 (RR = 1.91, 95% CI = 1.53-2.37) in the frailty group. Compared with a value adjusted for comorbidity, the unadjusted comorbidity was significantly higher in the prefrailty category (1.90 vs. 1.52). Compared with a value adjusted for education, the unadjusted education was significantly higher in the prefrailty category (1.81 vs. 1.46). No publication bias was observed. CONCLUSION The overall meta-analysis confirms that frailty has significantly increased the incident risk of disability. Frail, elderly people are at the highest risk of future disability and may be adequate candidates for taking part in prevention and intervention programs.
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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