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Arundell LLC, Saunders R, Buckman JEJ, Lewis G, Stott J, Singh S, Jena R, Naqvi SA, Leibowitz J, Pilling S. Differences in psychological treatment outcomes by ethnicity and gender: an analysis of individual patient data. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1519-1531. [PMID: 38321296 PMCID: PMC11343885 DOI: 10.1007/s00127-024-02610-8] [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: 09/11/2023] [Accepted: 01/01/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE There are discrepancies in mental health treatment outcomes between ethnic groups, which may differ between genders. NHS Talking Therapies for anxiety and depression provide evidence-based psychological therapies for common mental disorders. This study examines the intersection between ethnicity and gender as factors associated with psychological treatment outcomes. Aims were to explore by gender: (1) differences in psychological treatment outcomes for minoritized ethnic people compared to White-British people, (2) whether differences are observed when controlling for clinical and socio-demographic factors associated with outcomes, and (3) whether organization-level factors moderate differences in outcomes between ethnic groups. METHODS Patient data from eight NHS Talking Therapies for anxiety and depression services (n = 98,063) was used to explore associations between ethnicity and outcomes, using logistic regression. Stratified subsamples were used to separately explore factors associated with outcomes for males and females. RESULTS In adjusted analyses, Asian (OR = 0.82 [95% CI 0.78; 0.87], p < .001, 'Other' (OR = 0.79 [95%CI 0.72-0.87], p < .001) and White-other (0.93 [95%CI 0.89-0.97], p < .001) ethnic groups were less likely to reliably recover than White-British people. Asian (OR = 1.48 [95% CI 1.35-1.62], p < .001), Mixed (OR = 1.18 [95% CI 1.05-1.34], p = .008), 'Other' (OR = 1.60 [95% CI 1.38-1.84], p < .001) and White-other (OR = 1.18 [95% CI 1.09-1.28], p < .001) groups were more likely to experience a reliable deterioration in symptoms. Poorer outcomes for these groups were consistent across genders. There was some evidence of interactions between ethnic groups and organization-level factors impacting outcomes, but findings were limited. CONCLUSIONS Across genders, Asian, 'Other' and White-other groups experienced worse treatment outcomes across several measures in adjusted models. Reducing waiting times or offering more treatment sessions might lead to increased engagement and reduced drop-out for some patient groups.
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Affiliation(s)
- Laura-Louise C Arundell
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK.
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.
| | - Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, W1T 7NF, UK
| | - Joshua Stott
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Satwant Singh
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | - Renuka Jena
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | | | - Judy Leibowitz
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
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Stea TH, Bertelsen TB, Fegran L, Sejersted E, Kleppang AL, Fyhn T. Interventions targeting young people not in employment, education or training (NEET) for increased likelihood of return to school or employment-A systematic review. PLoS One 2024; 19:e0306285. [PMID: 38935788 PMCID: PMC11210863 DOI: 10.1371/journal.pone.0306285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024] Open
Abstract
The present systematic review aims to identify, synthesize, and evaluate evidence of effects from interventions targeting youth not in education, employment, or training (NEET). We searched relevant multidisciplinary databases to identify randomized controlled trials (RCTs) and quasi-randomized re-engagement trials. Primary outcomes were participation in education and employment, and training status. Secondary outcomes included changes in financial status, quality of life and well-being, social functioning, and physical, psychological, and behavioral outcomes. The Joanna Briggs Institute methodology and PRISMA guidelines were applied. Eligible studies were screened, included, and extracted for data. Nine trials were included (eight RCTs and one quasi-experimental study), in which samples ranged from 96 to 7346 participants. Results on primary outcomes showed that five studies found an effect of interventions on employment outcomes, while three studies indicated an effect on education or training. Results on secondary outcomes included effects on mental health, subjective health complaints, drug use, self-esteem, and self-efficacy. Studies with other main outcomes than re-engagement showed an effect of interventions on pass rates for the driving test, independent housing, and increased job-seeking activities. Limitations and future directions are discussed, including the lack of rigorous studies, theoretical underpinnings, and standardized measures for re-engagement outcomes. Systematic review registration: registered in PROSPERO, CRD42023463837.
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Affiliation(s)
- Tonje Holte Stea
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | | | - Liv Fegran
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | | | | | - Tonje Fyhn
- NORCE Norwegian Research Centre, Bergen, Norway
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Boyer L, Fernandes S, Brousse Y, Yon DK, Tran B, Auquier P, Fond G. Enhancing patient experience assessment with psychological care in severe mental disorders: A study of the PREMIUM program. Asian J Psychiatr 2023; 90:103804. [PMID: 37913651 DOI: 10.1016/j.ajp.2023.103804] [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: 08/21/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
Incorporating the experiences of patients with severe mental disorders (SMD) into clinical practice offers valuable insights for optimizing psychological care's effectiveness with more patient-centered and personalized interventions. The study aimed to develop a patient-reported experience measure regarding psychological care (PREMIUM-PSY) using adaptive testing and investigate its association with quality of life. In a multicenter study involving 443 patients with SMD, PREMIUM-PSY demonstrated both validity and efficiency (6-item average). Positive patient experiences were associated with enhanced mental and physical quality of life (β = 3.15[2.17;4.12], p < 0.001 and β = 1.18[0.04;2.32], p = 0.042), suggesting PREMIUM-PSY's potential for optimizing psychological care outcomes.
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Affiliation(s)
- Laurent Boyer
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France.
| | - Sara Fernandes
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France
| | - Yann Brousse
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Bach Tran
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France; Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam
| | - Pascal Auquier
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France
| | - Guillaume Fond
- AP-HM, Aix-Marseille University, School of medicine - La Timone Medical Campus, UR3279: Health Service Research and Quality of Life Center (CEReSS), Marseille, France
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O'Driscoll C, Buckman JEJ, Saunders R, Ellard S, Naqvi SA, Singh S, Wheatley J, Pilling S. Symptom-specific effects of counselling for depression compared to cognitive-behavioural therapy. BMJ MENTAL HEALTH 2023; 26:e300621. [PMID: 36792174 PMCID: PMC10035778 DOI: 10.1136/bmjment-2022-300621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) and counselling for depression (CfD) are recommended first-line treatments for depression. While they approach change differently, there is little understanding of the impact those approaches have on change during treatment. OBJECTIVES This study aimed to identify whether CBT and CfD target different symptoms and explore the implications of modelling choices when quantifying change during treatment. METHODS Symptom-specific effects of treatment were identified using moderated network modelling. This was a retrospective cohort study of 12 756 individuals who received CBT or CfD for depression in primary/community care psychological therapy services in England. Change was modelled several ways within the whole sample and a propensity score matched sample (n=3446). FINDINGS CBT for depression directly affected excessive worry, trouble relaxing and apprehensive expectation and had a stronger influence on changes between suicidal ideation and concentration. CfD had a stronger direct influence on thoughts of being a failure and on the associated change between being an easily annoyed and apprehensive of expectation. There were inconsistencies when modelling change using the first and second appointments as the baseline. Residual score models produced more conservative findings than models using difference scores. CONCLUSIONS CfD and CBT for depression have differential effects on symptoms demonstrating specific mechanisms of change. CLINICAL IMPLICATIONS CBT was uniquely associated with changes in symptoms associated with anxiety and may be better suited to those with anxiety symptoms comorbid to their depression. When assessing change, the baseline should be the first therapy session, not the pretreatment assessment. Residual change scores should be preferred over difference score methods.
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Affiliation(s)
- Ciarán O'Driscoll
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- iCope-Camden & Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Syed Ali Naqvi
- North East London NHS Foundation Trust, Rainham, Havering, UK
| | - Satwant Singh
- North East London NHS Foundation Trust, Rainham, Havering, UK
| | - Jon Wheatley
- Talk Changes: City and Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
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Stott J, Saunders R, Desai R, Bell G, Fearn C, Buckman JEJ, Brown B, Nurock S, Michael S, Ware P, Marchant NL, Aguirre E, Rio M, Cooper C, Pilling S, Richards M, John A. Associations between psychological intervention for anxiety disorders and risk of dementia: a prospective cohort study using national health-care records data in England. THE LANCET. HEALTHY LONGEVITY 2023; 4:e12-e22. [PMID: 36509102 PMCID: PMC10570142 DOI: 10.1016/s2666-7568(22)00242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Meta-analyses support an association between anxiety in older adulthood and dementia. The aim of this study was to use routinely collected health data to test whether treatment of anxiety disorders through psychological intervention is associated with a lower incidence of dementia. METHODS In this prospective cohort study, data from nationally provided psychological therapy services in England termed Improving Access to Psychological Therapies from 2012 to 2019 were linked to medical records, including dementia diagnoses as defined by the tenth edition of the International Classification of Diseases, up to 8 follow-up years later. Inclusion criteria were as follows: (1) patients who were aged 65 years and older; (2) patients with a probable anxiety disorder; and (3) those with no previous or current diagnosis of dementia. Cox proportional hazards models were constructed to test whether reliable improvement in anxiety following psychological intervention was associated with future dementia incidence. The primary outcome was all-cause dementia and cases were identified using ICD-10 dementia codes from Hospital Episode Statistics, Mental Health Services Dataset, and mortality data. For main analyses, hazards ratios (HRs) are presented. FINDINGS Data from 128 077 people aged 65 years and older attending a nationally provided psychological intervention service in England were linked to medical records. 88 019 (69·0%) of 127 064 participants with available gender data were women and 39 585 (31·0%) were men. 111 225 (95·9%) of 115 989 with available ethnicity data were of White ethnicity. The mean age of the sample was 71·55 years (SD 5·69). Fully adjusted models included data from 111 958 people after 16 119 were excluded due to missing data on key variables or covariates. 4510 (4·0%) of 111 958 participants had a dementia diagnosis. The remaining 107 448 (96·0%) were censored either at date of death or when the final follow-up period available for analyses was reached. People who showed reliable improvement in anxiety had lower rates of later dementia diagnosis (3·9%) than those who did not show reliable improvement (5·1%). Reliable improvement in anxiety following psychological intervention was associated with reduced incidence of all-cause dementia (HR 0·83 [95% CI 0·78-0·88]), Alzheimer's disease (HR 0·85 [0·77-0·94]), and vascular dementia (HR 0·80 [0·71-0·90]). Effects did not differ depending on anxiety disorder diagnosis. INTERPRETATION Results showed that reliable improvement in anxiety from psychological therapy was associated with reduced incidence of future dementia. There are multiple plausible explanations for this finding and further research is needed to distinguish between these possibilities. Missing data in the sample limit reliability of findings. FUNDING Alzheimer's Society, Medical Research Council, Wellcome Trust, and UCLH National Institute for Health and Care Research Biomedical Research Centre.
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Affiliation(s)
| | - Rob Saunders
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | | | | | | | - Joshua E J Buckman
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK; iCope-Camden and Islington Psychological Therapies Services, St Pancras Hospital, London, UK
| | | | | | | | | | | | | | - Miguel Rio
- Department of Electronic and Electrical Engineering, UCL, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Queen Mary University of London, London, UK
| | - Stephen Pilling
- Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK; Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
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Smyth N, Buckman JEJ, Naqvi SA, Aguirre E, Cardoso A, Pilling S, Saunders R. Understanding differences in mental health service use by men: an intersectional analysis of routine data. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2065-2077. [PMID: 35318495 PMCID: PMC9477949 DOI: 10.1007/s00127-022-02256-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Rates of help-seeking for common mental health problems are lower for men, but less is known about patterns of engagement once they are in contact with services. Previous research has been limited in its ability to understand the intersection between service user characteristics and engagement. This study compared analytic approaches to investigate intersectional associations between sociodemographic and socioeconomic indicators and use of psychological treatment services by men. METHOD Data from 9,904 male service users attending two psychological treatment services in London were analysed. The association between ethnicity, sexual orientation, religious affiliation and employment status of service users and service use outcomes was explored using multinomial logistic regression and latent class analysis (LCA). RESULTS Being from a minoritised ethnic background, of Muslim faith, being unemployed, and living in the most deprived neighbourhoods were associated with greater risk of not commencing or completing treatment. Seven classes were identified in LCA, with men predominately differentiated by self-reported ethnicity and religion. Compared with the 'White British, non-religious' class, the 'Asian Muslim' class and the 'minoritised ethnic, non-religious' class were at higher risk of disengagement, whilst the 'Asian, other religion' class were at higher risk of being referred elsewhere rather than completing initiated treatment. CONCLUSIONS There were significant inequalities in engagement by men associated with ethnicity, religion and socioeconomic status. Compared with the regression models, further nuance was apparent in LCA regarding the intersection of gender, religion and ethnicity. Identifying groups at greater risk of discontinuation of treatment could inform more personalised pathways through care.
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Affiliation(s)
- Natasha Smyth
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 7HB, UK.
| | - Joshua E J Buckman
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 7HB, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Syed A Naqvi
- North East London NHS Foundation Trust, London, UK
| | | | - Ana Cardoso
- North East London NHS Foundation Trust, London, UK
| | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 7HB, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 7HB, UK
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Stålner O, Nordin S, Madison G. Six-year prognosis of anxiety and depression caseness and their comorbidity in a prospective population-based adult sample. BMC Public Health 2022; 22:1554. [PMID: 35971092 PMCID: PMC9380370 DOI: 10.1186/s12889-022-13966-4] [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] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Anxiety and depression are amongst the most prevalent mental health problems. Their pattern of comorbidity may inform about their etiology and effective treatment, but such research is sparse. Here, we document long-term prognosis of affective caseness (high probability of being a clinical case) of anxiety and depression, their comorbidity, and a no-caseness condition at three time-points across six years, and identify the most common prognoses of these four conditions. METHODS Longitudinal population-based data were collected from 1,837 participants in 2010, 2013 and 2016. Based on the Hospital Anxiety and Depression Scale they formed the four groups of anxiety, depression and comorbidity caseness, and no caseness at baseline. RESULTS The three-year associations show that it was most common to recover when being an anxiety, depression or comorbidity caseness (36.8 - 59.4%), and when not being a caseness to remain so (89.2%). It was also rather common to remain in the same caseness condition after three years (18.7 - 39.1%). In comorbidity it was more likely to recover from depression (21.1%) than from anxiety (5.4%), and being no caseness it was more likely to develop anxiety (5.9%) than depression (1.7%). The most common six-year prognoses were recovering from the affective caseness conditions at 3-year follow-up (YFU), and remain recovered at 6-YFU, and as no caseness to remain so across the six years. The second most common prognoses in the affective conditions were to remain as caseness at both 3-YFU and 6-YFU, and in no caseness to remain so at 3-YFU, but develop anxiety at 6-YFU. CONCLUSIONS The results suggest that only 37 - 60% of individuals in the general population with high probability of being a clinical case with anxiety, depression, and their comorbidity will recover within a three-year period, and that it is rather common to remain with these affective conditions after 6 years. These poor prognoses, for comorbidity in particular, highlight the need for intensified alertness of their prevalence and enabling treatment in the general population.
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Affiliation(s)
- Olivia Stålner
- Department of Psychology, Umeå University, 90187, Umeå, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, 90187, Umeå, Sweden.
| | - Guy Madison
- Department of Psychology, Umeå University, 90187, Umeå, Sweden
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Walrave R, Beerten SG, Mamouris P, Coteur K, Van Nuland M, Van Pottelbergh G, Casas L, Vaes B. Trends in the epidemiology of depression and comorbidities from 2000 to 2019 in Belgium. BMC PRIMARY CARE 2022; 23:163. [PMID: 35764925 PMCID: PMC9241171 DOI: 10.1186/s12875-022-01769-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression is a common mental disorder in family practice with an impact on global health. The aim of this study is to provide insight in the trends of epidemiological measures as well as pharmacological treatments and comorbidities of depression. METHODS A study using data from INTEGO, a family practice registration network in Flanders, Belgium. Trends in age-standardized prevalence and incidence of depression from 2000 to 2019 as well as antidepressant prescriptions in prevalent depression cases were analyzed with join point regression. Comorbidity profiles were explored using the Cochran-Armitage test and the Jonckheere-Terpstra test. RESULTS We identified 538 299 patients older than 15 years during the study period. We found an increasing trend in the age-standardized prevalence of depression from 6.73 % in 2000 to 9.20 % in 2019. For the incidence of depression, a decreasing trend was observed from 2000 to 2015 with an incidence of 9.42/1000 in 2000 and 6.89/1000 in 2015, followed by an increasing trend from 2015 to 2019 (incidence of 13.64/1000 in 2019). The average number of chronic diseases per patient with depression increased significantly during the study period (from 1.2 to 1.8), and the proportion of patients relative to the whole study population that received at least one antidepressant prescription per year increased between 2000 and 2019 from 26.44% to 40.16%. CONCLUSIONS The prevalence of depression increases while the incidence sharply rises, but only in recent years. Patients with depression tend to have more comorbidities, making a multi-faceted approach to these patients more important.
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Affiliation(s)
- Roosje Walrave
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Simon Gabriël Beerten
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium.
| | - Pavlos Mamouris
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Kristien Coteur
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Marc Van Nuland
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Lidia Casas
- Social Epidemiology and Health Policy (SEHPO), Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium
| | - Bert Vaes
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
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Multicomponent Intervention Associated with Improved Emotional and Cognitive Outcomes of Marginalized Unemployed Youth of Latin America. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11040155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mass migration and people seeking political refuge are critical social issues facing Latin America. Ecuador has the largest population of recognized refugees in the region. Youths from a migration background have an increased risk of becoming NEET (Young people not in employment, education, or training). Such youths struggle more with mental health problems than non-NEET peers. Being a refugee, NEET further increases the risk of having mental health problems and may be linked to lower cognitive functioning, which could maintain exclusion and unemployment. This intervention study was performed with a group of young people of different nationalities who were refugees or belonged to other vulnerable groups attending a six-week employability-support intervention in Ecuador. In order to assess the impact of the intervention, a range of measures of executive cognitive function, mental health, and the potential for positive change were used. We found that post-intervention, the group reported significantly less psychological distress and better self-esteem, self-efficacy, and cognitive response inhibition than before the intervention. We conclude that multicomponent interventions may effectively improve the psychological functioning of vulnerable NEET groups in the Latin American context.
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