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Tsimpida D, Tsakiridi A, Daras K, Corcoran R, Gabbay M. Unravelling the dynamics of mental health inequalities in England: A 12-year nationwide longitudinal spatial analysis of recorded depression prevalence. SSM Popul Health 2024; 26:101669. [PMID: 38708408 PMCID: PMC11066558 DOI: 10.1016/j.ssmph.2024.101669] [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] [Received: 04/20/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background Depression is one of the most significant public health issues, but evidence of geographic patterns and trends of depression is limited. We aimed to examine the spatio-temporal patterns and trends of depression prevalence among adults in a nationwide longitudinal spatial study in England and evaluate the influence of neighbourhood socioeconomic deprivation in explaining patterns. Methods Information on recorded depression prevalence was obtained from the indicator Quality and Outcomes Framework: Depression prevalence that measured the annual percentage of adults diagnosed with depression for Lower Super Output Areas (LSOA) from 2011 to 2022. We applied Cluster and Outlier Analysis using the Local Moran's I algorithm. Local effects of deprivation on depression in 2020 examined with Geographically Weighted Regression (GWR). Inequalities in recorded prevalence were presented using Prevalence Rate Ratios (PRR). Results The North West Region of England had the highest concentration of High-High clusters of depression, with 17.4% of the area having high values surrounded by high values in both space and time and the greatest percentage of areas with a high rate of increase (43.1%). Inequalities widened among areas with a high rate of increase in prevalence compared to those with a lower rate of increase, with the PRR increasing from 1.66 (99% CI 1.61-1.70) in 2011 to 1.81 (99% CI 1.76-1.85) by 2022. Deprivation explained 3%-39% of the variance in depression in 2020 across the country. Conclusions It is crucial to monitor depression's spatial patterns and trends and investigate mechanisms of mental health inequalities. Our findings can help identify priority areas and target prevention and intervention strategies in England. Evaluating mental health interventions in different geographic contexts can provide valuable insights to policymakers on the most effective and context-sensitive strategies, enabling them to allocate resources towards preventing the worsening of mental health inequalities.
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Affiliation(s)
- Dialechti Tsimpida
- Department of Public Health, Policy and Systems, University of Liverpool, UK
- Centre for Research on Ageing, University of Southampton, UK
- Department of Gerontology, University of Southampton, UK
| | | | - Konstantinos Daras
- Department of Public Health, Policy and Systems, University of Liverpool, UK
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
| | - Rhiannon Corcoran
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | - Mark Gabbay
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
- Department of Primary Care and Mental Health, University of Liverpool, UK
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Chung Y, Bagheri N, Salinas-Perez JA, Smurthwaite K, Walsh E, Furst M, Rosenberg S, Salvador-Carulla L. Role of visual analytics in supporting mental healthcare systems research and policy: A systematic scoping review. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2020. [DOI: 10.1016/j.ijinfomgt.2019.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Song Y, Liu Z, Chen H, Guo Q, Huang Y. Incidence and Risk Factors of Depressive Symptoms in Chinese College Students. Neuropsychiatr Dis Treat 2020; 16:2449-2457. [PMID: 33122908 PMCID: PMC7591009 DOI: 10.2147/ndt.s264775] [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: 06/09/2020] [Accepted: 09/12/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Previous surveys have shown an increase in the prevalence of depression among college students. However, knowledge on the incidence and risk factors of depressive symptoms in Chinese college students is limited. The aim of the present study was to determine the two-year cumulative incidence of depressive symptoms in Chinese college freshmen and identified related psychosocial risk factors. PATIENTS AND METHODS A prospective survey was used to examine the cumulative incidence and risk factors of depressive symptoms (as assessed by the Centre for Epidemiological Study-Depression Scale, CES-D) among undergraduate freshmen. Five times (baseline, 5, 12, 17, and 24 months later) of self-reported data were collected from the students. RESULTS Of the initial 758 non-depressed respondents at baseline, 235 developed depressive symptoms (CES-D ≥ 16) during the follow-up period. The two-year cumulative incidence was estimated to be 42% and not significantly different between males and females (χ2=3.138, df =1, p=0.077). Logistic regression model showed that female gender (OR=0.43, 95% CI (0.28-0.64)), high level of self-esteem (OR=0.67, 95% CI (0.52-0.86)), and moderate exercise (OR=0.71, 95% CI (0.55-0.92)) reduced the onset of depressive symptoms; while high levels of baseline anxiety (OR=1.48, 95% CI (1.12-1.94)), Eysenck Personality Questionnaire-Neuroticism (OR=1.40, 95% CI (1.09-1.79)), concern over mistakes (OR=1.35,95% CI (1.07-1.71)), daytime sleepiness (OR=1.28, 95% CI (1.02-1.60)), mild exercise (OR=1.25, 95% CI (1.01-1.55)) increased the new onset of depressive symptoms. CONCLUSION The high two-year cumulative incidence indicates that depressive symptoms are an important mental problem in Chinese college students. The present findings on the risk factors of depressive symptoms in Chinese college students may be useful for the design of student health screening and intervention programs.
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Affiliation(s)
- Yuqing Song
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, People's Republic of China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, People's Republic of China
| | - Zhaorui Liu
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, People's Republic of China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, People's Republic of China
| | - Hongguang Chen
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, People's Republic of China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, People's Republic of China
| | - Qi Guo
- School of Basic Medical Sciences, Peking University, Beijing 100191, People's Republic of China
| | - Yueqin Huang
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, People's Republic of China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, People's Republic of China
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Bagheri N, Batterham PJ, Salvador-Carulla L, Chen Y, Page A, Calear AL, Congdon P. Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1189-1198. [PMID: 30989255 DOI: 10.1007/s00127-019-01712-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE We know little about how community structures influence the risk of common mental illnesses. This study presents a new way to establish links between depression and social fragmentation, thereby identifying pathways to better target mental health services and prevention programs to the right people in the right place. METHOD A principal components analysis (PCA) was conducted to develop the proposed Australian neighborhood social fragmentation index (ANSFI). General practice clinical data were used to identify cases of diagnosed depression. The association between ANSFI and depression was explored using multilevel logistic regression. Spatial hot spots (clusters) of depression prevalence and social fragmentation at the statistical area level 1 (SA1) were examined. RESULTS Two components of social fragmentation emerged, reflecting fragmentation related to family structure and mobility. Individuals treated for depression in primary care were more likely to live in neighborhoods with lower socioeconomic status and with higher social fragmentation related to family structure. A 1-SD increase in social fragmentation was associated with a 16% higher depression prevalence (95% CI 11%, 20%). However, the association attenuated with adjustment for neighborhood socio-economic status. Considerable spatial variation in social fragmentation and depression patterns across communities was observed. CONCLUSIONS Developing a social fragmentation index for the first time in Australia at a small area level generates a new line of knowledge on the impact of community structures on health risks. Findings may extend our understanding of the mechanisms that drive geographical variation in the incidence of common mental disorders and mental health care.
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Affiliation(s)
- Nasser Bagheri
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
- Visual and Decision Analytics (VIDEA) Lab, Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Yingxi Chen
- Research School of Population Health, The Australian National University, Canberra, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Peter Congdon
- School of Geography, Queen Mary University of London, London, UK
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Romero-López-Alberca C, Gutiérrez-Colosía MR, Salinas-Pérez JA, Almeda N, Furst M, Johnson S, Salvador-Carulla L. Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs). Eur Psychiatry 2019; 61:97-110. [PMID: 31426008 DOI: 10.1016/j.eurpsy.2019.07.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/27/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. METHOD We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997-2018). RESULTS Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. CONCLUSIONS The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning.
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Affiliation(s)
| | | | - José A Salinas-Pérez
- Department of Quantitative Methods, Universidad Loyola Andalucía, Seville, Asociación Científica Psicost, Spain
| | - Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | - Maryanne Furst
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra. Menzies Centre for Health Policy, University of Sydney, Australia
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Spatial structure of depression in South Africa: A longitudinal panel survey of a nationally representative sample of households. Sci Rep 2019; 9:979. [PMID: 30700798 PMCID: PMC6354020 DOI: 10.1038/s41598-018-37791-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/05/2018] [Indexed: 12/18/2022] Open
Abstract
Wider recognition of the mental health burden of disease has increased its importance as a global public health concern. However, the spatial heterogeneity of mental disorders at large geographical scales is still not well understood. Herein, we investigate the spatial distribution of incident depression in South Africa. We assess depressive symptomatology from a large longitudinal panel survey of a nationally representative sample of households, the South African National Income Dynamics Study. We identified spatial clusters of incident depression using spatial scan statistical analysis. Logistic regression was fitted to establish the relationship between clustering of depression and socio-economic, behavioral and disease risk factors, such as tuberculosis. There was substantial geographical clustering of depression in South Africa, with the excessive numbers of new cases concentrated in the eastern part of the country. These clusters overlapped with those of self-reported tuberculosis in the same region, as well as with poorer, less educated people living in traditional rural communities. Herein, we demonstrate, for the first time, spatial structuring of depression at a national scale, with clear geographical ‘hotspots’ of concentration of individuals reporting new depressive symptoms. Such geographical clustering could reflect differences in exposure to various risk factors, including socio-economic and epidemiological factors, driving or reinforcing the spatial structure of depression. Identification of the geographical location of clusters of depression should inform policy decisions.
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