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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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Lee S, Creed FH, Ma YL, Leung CM. Somatic symptom burden and health anxiety in the population and their correlates. J Psychosom Res 2015; 78:71-6. [PMID: 25466323 DOI: 10.1016/j.jpsychores.2014.11.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/10/2014] [Accepted: 11/12/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Somatic symptom burden and health anxiety demonstrate overlapping clinical characteristics but their relationship in the general population is unclear. This study examined the association between these dimensions after adjustment for confounders and their respective correlation with outcome measures. METHODS A randomly selected population-based sample of 3014 respondents aged 15-65 was interviewed by telephone using a structured questionnaire that included the 15-item Patient Health Questionnaire (PHQ-15), Whiteley-7, Kessler-6, Sheehan Disability Scale, socio-demographic variables and items regarding health care utilization. Respondents who scored 10 or above on PHQ-15 and 4 or above on Whiteley-5 were regarded as having high somatic symptom burden and high health anxiety respectively. RESULTS Somatic symptom burden and health anxiety are moderately correlated after adjustment for confounders (p<.001). Both have important effects on psychological distress, functional impairment and health care utilization independent of each other (ps<.001). A considerable number of respondents (5.7%) reported both high somatic symptom burden and high health anxiety and this group showed the greatest general psychological distress, functional impairment and health care utilization. CONCLUSION This study demonstrates the close association of somatic symptom burden and health anxiety but also their independent association with psychological distress, functional impairment and health care utilization. The findings support the concept of the DSM-5 category of somatic symptom disorder, but also demonstrate that individuals with high somatic symptom burden or high health anxiety alone may merit separate diagnoses. More sophisticated studies of the relationship between somatic symptom burden and health anxiety are needed.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, Hong Kong, China.
| | - Francis H Creed
- School of Community-based Medicine, The University of Manchester, United Kingdom
| | - Yee-Ling Ma
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Candi Mc Leung
- Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, Hong Kong, China
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Zhang DX, Lewis G, Araya R, Tang WK, Mak WWS, Cheung FMC, Mercer SW, Griffiths SM, Woo J, Lee DTF, Kung K, Lam AT, Yip BHK, Wong SYS. Prevention of anxiety and depression in Chinese: a randomized clinical trial testing the effectiveness of a stepped care program in primary care. J Affect Disord 2014; 169:212-20. [PMID: 25216464 DOI: 10.1016/j.jad.2014.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 07/30/2014] [Accepted: 08/08/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Despite empirical evidence demonstrating the effectiveness of collaborative stepped care program (SCP) in Western countries, such programs have not been evaluated in the east, which has a different services system structure and cultural nuances in seeking help for mental illness. Furthermore, only a few studies have used SCP for depression and anxiety prevention. We conducted a trial to test its effectiveness in preventing major depressive disorder and generalized anxiety disorder among primary care patients with subthreshold depression and/or anxiety in Hong Kong. METHODS Subthreshold depression and/or anxiety patients were randomized into the SCP group (n=121) or care as usual (CAU) group (n=119). The SCP included watchful waiting, telephone counseling, problem solving therapy, and family doctor treatment within one year. The primary outcome was the onset of major depressive disorder or generalized anxiety disorder in 15 months. The secondary outcomes were depressive and anxiety symptoms, quality of life and time absent from work due to any illness. RESULTS Survival analysis showed no differences between the SCP and CAU groups (the cumulative probability of onset at 15 month was 23.1% in the SCP group and 20.5% in the CAU group; Hazard Ratio=1.62; 95% Confidence Interval: 0.82-3.18; p=0.16). No significant differences were found in secondary outcomes. LIMITATIONS Sample size might not have been large enough. CONCLUSIONS SCP did not show beneficial effect on depression/anxiety prevention compared with CAU in Hong Kong primary care. As a large majority of patients improved overtime without any intervention, we are not able to exclude the possibility that the intervention might be effective. Future studies would need to have a larger sample size and conduct on patients with more severe symptoms or perform a second screening.
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Affiliation(s)
- De Xing Zhang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), Hong Kong, China
| | - Glyn Lewis
- Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, United Kingdom
| | - Ricardo Araya
- Department of Population Health, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Wai Kwong Tang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie Wing Sze Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Sian Meryl Griffiths
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), Hong Kong, China
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Diana Tze Fan Lee
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Kenny Kung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), Hong Kong, China
| | - Augustine Tsan Lam
- Department of Family Medicine, New Territories East Cluster, Hospital Authority, Hong Kong, China
| | - Benjamin Hon Kei Yip
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), Hong Kong, China
| | - Samuel Yeung Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), Hong Kong, China.
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Fiest KM, Patten SB, Wiebe S, Bulloch AG, Maxwell CJ, Jetté N. Validating screening tools for depression in epilepsy. Epilepsia 2014; 55:1642-50. [DOI: 10.1111/epi.12754] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 01/02/2023]
Affiliation(s)
- Kirsten M. Fiest
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Psychiatry; Mathison Centre for Mental Health Research & Education; University of Calgary; Calgary Alberta Canada
- Department of Clinical Neurosciences; Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Scott B. Patten
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Psychiatry; Mathison Centre for Mental Health Research & Education; University of Calgary; Calgary Alberta Canada
| | - Samuel Wiebe
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Clinical Neurosciences; Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Andrew G.M. Bulloch
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Psychiatry; Mathison Centre for Mental Health Research & Education; University of Calgary; Calgary Alberta Canada
| | - Colleen J. Maxwell
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- School of Public Health and Health Systems; University of Waterloo; Waterloo Ontario Canada
- School of Pharmacy; University of Waterloo; Waterloo Ontario Canada
| | - Nathalie Jetté
- Department of Community Health Sciences; Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Clinical Neurosciences; Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
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A community-based epidemiological study of health anxiety and generalized anxiety disorder. J Anxiety Disord 2014; 28:187-94. [PMID: 24295847 DOI: 10.1016/j.janxdis.2013.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 10/09/2013] [Accepted: 10/10/2013] [Indexed: 11/20/2022]
Abstract
This community-based study examined the frequency of worry about personal health in respondents with and without generalized anxiety disorder (GAD), and the impact of health anxiety on the disorder. A random community-based telephone survey of 5118 Chinese respondents aged 18-64 was conducted. A fully structured questionnaire covered the DSM-IV-TR criteria of GAD, major depressive episode (MDE), eight domains of worry, the seven-item Whiteley Index (WI-7), health service use, and socio-demographic information. Worry about personal health ranked fifth (75.6%) among eight domains of worries examined. GAD respondents with high level of health anxiety were significantly older, less educated, and had lower family income. High health anxiety significantly increased the occurrence of one-year MDE, previous persistent worry, previous persistent low mood, number of domains of worries, number of non-core DSM-IV-TR GAD symptoms, health service use, and mistrust of doctors. Health anxiety is common in GAD and may signify greater severity of the disorder.
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Mak ADP, Wu JCY, Chan Y, Chan FKL, Sung JJY, Lee S. Dyspepsia is strongly associated with major depression and generalised anxiety disorder - a community study. Aliment Pharmacol Ther 2012; 36:800-10. [PMID: 22957985 DOI: 10.1111/apt.12036] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 03/23/2012] [Accepted: 08/14/2012] [Indexed: 01/06/2023]
Abstract
BACKGROUND The relationship between dyspepsia and psychiatric comorbidity such as anxiety and depression is poorly defined. Previous studies have been limited by lack of standardised diagnostic criteria. AIM To examine the prevalence and comorbidity of dyspepsia as defined by Rome III (6-month duration) with DSM-IV-TR generalised anxiety disorder (GAD) and major depressive episodes (MDE) in the general population. METHODS A random population-based telephone survey was done using a questionnaire on symptoms of Rome III Dyspepsia, DSM-IV-TR GAD and MDE and their chronological relationship. RESULTS Of the 2011 respondents 8.0% currently had Rome III Dyspepsia, 3.8% reported GAD and 12.4% reported MDE respectively. Dyspeptic subjects had a twofold increased risk of GAD (OR = 2.03, 95% CI: 1.06-3.89, P < 0.001) and a threefold increased risk of MDE (OR = 3.56, 95% CI: 2.33-5.43, P < 0.001). MDE and GAD most often coincided with dyspepsia in onset. Dyspepsia (OR = 2.48, 95% CI: 1.65-3.72 P < 0.001), MDE (OR = 2.39, 95% CI: 1.64-3.46, P < 0.001) and female sex (OR = 1.65, 95% CI: 1.21-2.23, P < 0.001) independently predicted frequent medical consultations. GAD independently predicted high investigation expenditure (OR = 4.65, 95% CI: 1.15-18.70, P = 0.03). CONCLUSIONS With stringently adopted Rome III and DSM-IV-TR criteria, dyspepsia was strongly associated and often coincident in onset with generalised anxiety disorder and major depressive episodes in the community. Excessive healthcare utilisation should alert clinicians to risk of psychiatric comorbidity.
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Affiliation(s)
- A D P Mak
- Department of Psychiatry, Shatin Hospital, Hong Kong, China
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Chen L, Li W, He J, Wu L, Yan Z, Tang W. Mental health, duration of unemployment, and coping strategy: a cross-sectional study of unemployed migrant workers in eastern China during the economic crisis. BMC Public Health 2012; 12:597. [PMID: 22856556 PMCID: PMC3490784 DOI: 10.1186/1471-2458-12-597] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/25/2012] [Indexed: 11/10/2022] Open
Abstract
Background 20 million migrant workers in China lost their jobs during the economic crisis of 2008. Both urban migration and unemployment have long been documented to be associated with vulnerability to mental problems. This study aims to examine the mental health of unemployed migrant workers in Eastern China and its relation to duration of unemployment and coping strategy during the recent economic crisis. Methods The data were collected through interview-based survey with a sample of 210 unemployed migrant workers in Zhejiang Province of China from 2008 to 2009. Symptom Checklist-90-Revised, Coping Strategies Questionnaire, and seven short demographic questions were used. Results The majority of the unemployed migrant workers were found to be young male manufacturing industry workers with short-term unemployment and a relatively low education level. Nearly 50% of unemployed migrant workers were classified as mentally unhealthy and the most frequently reported symptom was depression. Compared with the adult norm of 1986, 2003, and 2007 in China, unemployed migrants had more mental problems. Long-term unemployed migrant workers had more psychiatric symptoms than the short-term unemployed workers and employed migrant workers. Unemployed migrant workers with immature coping strategies expressed significantly more psychiatric symptoms than those with mixed and mature coping strategies. Duration of unemployment and two coping strategies, problem-solving and self-blaming, predicted the mental problems of unemployed migrant workers. Conclusions The results indicated that mental health status of unemployed migrant workers in Eastern China was poorer than the national adult norm. More psychiatric symptoms are evidenced among unemployed migrant workers who lost their jobs for a long term and who had immature coping strategies. These findings can be used for prevention and intervention of mental illness among unemployed migrant workers.
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Affiliation(s)
- Li Chen
- Department of Psychology, School of Environmental Science and Public Health, Wenzhou Medical College, Wenzhou, China
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Cecatti JG, Camargo RPS, Pacagnella RC, Giavarotti T, Souza JP, Parpinelli MA, Osis MJD. Computer-assisted telephone interviewing (CATI): using the telephone for obtaining information on reproductive health. CAD SAUDE PUBLICA 2012; 27:1801-8. [PMID: 21986607 DOI: 10.1590/s0102-311x2011000900013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 04/07/2011] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer- assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ(2) test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.
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Lee S, Ma YL, Tsang A. A community study of generalized anxiety disorder with vs. without health anxiety in Hong Kong. J Anxiety Disord 2011; 25:376-80. [PMID: 21109390 DOI: 10.1016/j.janxdis.2010.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 10/27/2010] [Accepted: 10/28/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although generalized anxiety disorder (GAD) is characterized by multiple worries, anxiety about one's health is absent in the DSM-IV description of the illness. METHOD A random community-based telephone survey (N = 2005) that covered DSM-IV symptoms of GAD, two core symptoms of major depression, Rome-III criteria of Irritable Bowel Syndrome (IBS), Sheehan Disability Scale (SDS), and help-seeking behavior was conducted. RESULTS The 1-year prevalence of 3-month GAD was 5.4%. Among affected individuals, 78.9% reported worry about personal health while 21.1% did not. The former subgroup was significantly older, had higher mean numbers of associated anxiety symptoms and worries, more likely to have worry about finances and sought professional help than the latter subgroup. The two subgroups had similar sex distribution, core depressive symptoms, IBS, distress and SDS impairment profiles. CONCLUSION Health anxiety is common in GAD. Some but not all illness severity indicators differed between GAD with and without health anxiety.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.
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Chen YK, Lu JY, Chan DML, Mok VCT, Yeung MA, Wong KS, Ungvari GS, Tang WK. Anxiety disorders in Chinese patients with Parkinson's disease. Int J Psychiatry Med 2010; 40:97-107. [PMID: 20565048 DOI: 10.2190/pm.40.1.h] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Anxiety disorders (AND1) commonly occur in patients with Parkinson's disease (PD) but their socio-demographic and clinical correlates have not yet been unequivocally determined. This study aimed to assess the frequency of ANDI and their correlates in Chinese PD patients. METHODS A cohort of 133 patients of PD were recruited from three neurology outpatient clinics. Participants' neurological, cognitive, and psychiatric status was assessed using standardized rating instruments. ANDI were diagnosed by qualified psychiatrists using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders--4th Edition (SCID-DSM IV). RESULTS Thirty-six patients (27.1%) were diagnosed with some types of ANDI; Generalized Anxiety Disorder, Agoraphobia, and Social Phobia were the commonest subtypes of ANDI in PD (n = 11, 8.3%, in each of the three subtypes). Nine patients had more than one subtype of ANDI. In multivariate logistic regression, younger age of onset of PD [odds ratio (OR) = 2.654, 95% confident intervals (CI) = 1.120-6.289, p = 0.027), Geriatric Depression Scale score (OR = 1.179, 95% CI = 1.056-1.316, p = 0.003) and muscle cramps (> or = 1/week) (OR = 2.605, 95% CI = 1.098-6.184, p = 0.030) were independent correlates of ANDI. CONCLUSIONS ANDI are common in Chinese PD patients. Younger age of onset of PD, severity of depressive symptoms, and muscle cramps may be independent correlates of ANDI suggesting that anxiety in PD has multifactorial origin.
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Lee S, Ma YL, Tsang A, Kwok K. Generalized anxiety disorder with and without excessive worry in Hong Kong. Depress Anxiety 2010; 26:956-61. [PMID: 19496076 DOI: 10.1002/da.20578] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Two previous U.S. studies found that although generalized anxiety disorder (GAD) without self-perceived excessive worry was milder than GAD with excessive worry, its persistence, impairment, and risk for subsequent onset of other mental disorders were still substantial. This study examined the implications of relaxing the "excessiveness" criterion on the prevalence and socio-demographic profile of GAD in a Chinese population sample by considering both self and others' perception of excessive worry. METHOD 2,005 respondents aged 15-65 years participated in a structured telephone interview that covered socio-demographic profile, 12-month DSM-IV diagnosis of GAD, core depressive symptoms, longest duration of worry episode, number of domains of worry, impairment measured by the Sheehan Disability Scale, and treatment-seeking. Excessive worry was assessed from the perception of both respondents and others as reported by respondents. RESULT The 12-month prevalence of GAD increased from 3.4 to 4% when the excessiveness requirement was relaxed. Excessive GAD and nonexcessive GAD had similar socio-demographic, symptom, chronicity, impairment, depressive symptom, and treatment-seeking profiles. CONCLUSION GAD without excessive worry was less common than GAD with excessive worry but was likely to be a valid nosological entity. Future iterations of the DSM-IV should clarify whether excessive worry should be retained and, if so, how individuals who only reported excessive worries perceived by others should be optimally assessed.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.
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Lee S, Wu J, Ma YL, Tsang A, Guo WJ, Sung J. Irritable bowel syndrome is strongly associated with generalized anxiety disorder: a community study. Aliment Pharmacol Ther 2009; 30:643-51. [PMID: 19552631 DOI: 10.1111/j.1365-2036.2009.04074.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND No previous study has examined the comorbidity of Irritable Bowel Syndrome (IBS) and Generalized Anxiety Disorder (GAD) in a general population using standardized diagnostic methods. AIM To examine the prevalence, comorbidity and risk correlates of IBS and GAD in a general population. METHODS A random community-based telephone survey was conducted. The questionnaire covered symptoms of IBS, GAD, core depressive symptoms, help-seeking behaviour and functional impairment on the Sheehan Disability Scale. RESULTS A total of 2005 participants completed the interview. The current prevalence of IBS was 5.4% and the 12-month prevalence of GAD was 4%. GAD was five times more common among IBS respondents than non-IBS respondents (OR: 5.84, P < 0.001), whereas IBS was 4.7 times more common among GAD respondents than among non-GAD respondents (OR: 6.32, P < 0.001). Core depressive symptoms (OR: 6.25, P < 0.01) and education level (OR: 5.918, P = 0.021) were risk correlates of GAD among IBS respondents. Comorbid respondents were more impaired than respondents having either disorder alone, but were not more likely to seek professional help than IBS-only respondents. CONCLUSION Irritable Bowel Syndrome and GAD comorbidity was common and added to impairment in the community. The strong association between psychiatric morbidity and IBS observed in referral centres was not a consequence of increased help-seeking behaviour.
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Affiliation(s)
- S Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong.
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Prevalence and correlates of social fears in Hong Kong. J Anxiety Disord 2009; 23:327-32. [PMID: 19232894 DOI: 10.1016/j.janxdis.2009.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Revised: 12/24/2008] [Accepted: 01/12/2009] [Indexed: 11/23/2022]
Abstract
This study examined the 12-month prevalence of social fears and their correlates in Hong Kong. A random telephone survey of 3006 Chinese individuals aged 15-45 years was conducted using a questionnaire that covered sociodemographic information, 14 social fears, age of onset, duration of fear, DSM-IV diagnostic features of social anxiety disorder and other psychosocial features. The prevalence of any social fear was 28.7%. The most common fear was talking to a person of higher status. Respondents with social fears were more likely to be younger and female than those without. A two-step cluster analysis revealed three subgroups with 1-3 (34.0%), 4-7 (43.9%) and 8-13 (22.0%) fears, respectively. As the number of social fears increased across these subgroups, respondents exhibited younger age of onset, more physical symptoms, avoidance behavior, impairment, and suicidality. The prevalence and profile of social fears among Chinese people resembled those of their Western counterparts.
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