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Zhang Z, Das S. Unveiling the patterns: exploring social and clinical characteristics of frequent mental health visits to the emergency department-a comprehensive systematic review. DISCOVER MENTAL HEALTH 2024; 4:17. [PMID: 38802580 PMCID: PMC11130112 DOI: 10.1007/s44192-024-00070-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Frequent presenters (FPs) are a group of individuals who visit the hospital emergency department (ED) frequently for urgent care. Many among the group present with the main diagnosis of mental health conditions. This group of individual tend to use ED resources disproportionally and significantly affects overall healthcare outcomes. No previous reviews have examined the profiles of FPs with mental health conditions. AIMS This study aims to identify the key socio-demographic and clinical characteristics of patients who frequently present to ED with a mental health primary diagnosis by performing a comprehensive systematic review of the existing literature. METHOD PRISMA guideline was used. PubMed, PsycINFO, Scopus and Web of Science (WOS) were searched in May 2023. A manual search on the reference list of included articles was conducted at the same time. Covidence was used to perform extraction and screening, which were completed independently by two authors. Inclusion and exclusion criteria were defined. RESULTS The abstracts of 3341 non-duplicate articles were screened, with 40 full texts assessed for eligibility. 20 studies were included from 2004 to 2022 conducted in 6 countries with a total patient number of 25,688 (52% male, 48% female, mean age 40.7 years old). 27% were unemployed, 20% married, 41% homeless, and 17% had tertiary or above education. 44% had a history of substance abuse or alcohol dependence. The top 3 diagnoses are found to be anxiety disorders (44%), depressive disorders (39%) schizophrenia spectrum and other psychotic disorders (33%). CONCLUSION On average, FPs are middle-aged and equally prevalent in both genders. Current data lacks representation for gender-diverse groups. They are significantly associated with high rates of unemployment, homelessness, lower than average education level, and being single. Anxiety disorder, depressive disorder, and schizophrenia spectrum disorders are the most common clinical diagnoses associated with the group.
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Affiliation(s)
| | - Soumitra Das
- The University of Melbourne, Melbourne, Australia
- Western Health, Footscray, Australia
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Hämmig O. Overindebtedness, unemployment, and poor mental health - and the role of sense of control: a population-based Swiss study. Front Public Health 2024; 12:1324402. [PMID: 38711763 PMCID: PMC11073489 DOI: 10.3389/fpubh.2024.1324402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
Background Both overindebtedness and unemployment are critical life events that can result in or lead to poor mental health. What is less known is that the two partly interrelated events frequently go along with a feeling of loss or lack of control in life, which could be the main reason why they are associated with poor mental health. This has not been examined in previous research, particularly not in this combination. Methods This study used and merged two cross-sectional data sets. Data collected in 2019 on 219 overindebted clients of the four official debt advisory centers in the Canton of Zurich were linked with a comparable subsample of 1,997 respondents from the Swiss Health Survey of 2017. The entire study population covered 2,216 adult individuals living in the Canton of Zurich. Results The prevalence of no or low sense of control, medium to high psychological distress, and moderate to major depression was much higher among the 44 solely unemployed (36/30/12%), the 189 solely overindebted (73/83/53%), and particularly among the 30 unemployed and overindebted (93/97/60%) than among all 1,953 other survey participants (21/13/7%). Unemployment, overindebtedness, and a (resulting) lack or loss of control were all found to be strong risk factors for the two mental health outcomes under study. Associations, or rather negative health effects, were partly but not fully mediated by the sense of control. Overindebtedness much more strongly predicted psychological distress (ß = -0.37) and depression (ß = 0.17) than unemployment (ß = -0.05/0.01). The sense of control turned out to be an independent explanatory factor for poor mental health and even the strongest of all (ß = 0.49/-0.59). Conclusion Improving a person's control beliefs could be a promising measure for preventing mental health disorders in general and in people who are unemployed and/or overindebted in particular.
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Affiliation(s)
- Oliver Hämmig
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zürich, Switzerland
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Jung FU, Pabst A, Rodriguez FS, Luppa M, Engel C, Kirsten T, Witte V, Reyes N, Loeffler M, Villringer A, Riedel-Heller SG. Perceived stress of mental demands at work, objective stress and resilience - an analysis of the LIFE-Adult-study. J Occup Med Toxicol 2023; 18:20. [PMID: 37679809 PMCID: PMC10485996 DOI: 10.1186/s12995-023-00388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level. OBJECTIVE The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience. METHOD A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work. RESULTS According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload. CONCLUSION Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.
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Affiliation(s)
- Franziska U Jung
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | | | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Christoph Engel
- LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Toralf Kirsten
- LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Veronica Witte
- Clinic of Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Nigar Reyes
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Markus Loeffler
- LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
- Clinic of Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
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Meiler B, Franke AG, Scherbaum N, Rabl J. Psychiatric Morbidity, Utilization and Quality of Mental Health Care in Long-Term Unemployed People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5066. [PMID: 36981975 PMCID: PMC10049213 DOI: 10.3390/ijerph20065066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Research has shown complex interactions between unemployment and mental health. However, the prevalence of specific mental disorders, utilization of mental health care services and influences on help-seeking behavior have been investigated surprisingly little in the past. In this study, we investigated a sample of long-term unemployed people in a cooperation program of the local unemployment agency and a psychiatric university hospital in a larger city in Germany. Mental disorders, treatment history, accordance of treatment to national treatment guidelines and factors influencing previous treatment were assessed. Participants (n = 879; male 56%, female 44%, mean age 43.9 years) showed a high psychiatric morbidity, mostly with diagnoses from the ICD-10 categories F1 (22%), F3 (61%) and F4 (68%). Currently, 18% were in psychiatric treatment, 6% were in psychotherapeutic treatment, and 28% received psychopharmacological treatment. Mostly young men underutilized the psychiatric-psychotherapeutic system, with middle-aged men and women being most frequently in psychopharmacological treatment. Of those treated, only about 10% of the subjects currently received a treatment according to national guidelines. The utilization of psychotherapeutic treatment was strikingly poor. This study identified high psychiatric morbidity and severe treatment gaps in unemployed people. These results can help to target subjects with specific needs for interventions and to modify counseling programs.
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Affiliation(s)
- Birgit Meiler
- Department of Psychiatry and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany
| | - Andreas G. Franke
- University of Applied Labour Studies, Seckenheimer Landstraße 16, 68163 Mannheim, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany
| | - Josef Rabl
- Johannesbad Kliniken Fredeburg GmbH, Zu den drei Buchen 1, 57392 Schmallenberg, Germany
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Fan YJ, Feng YJ, Meng Y, Su ZZ, Wang PX. The relationship between anthropometric indicators and health-related quality of life in a community-based adult population: A cross-sectional study in Southern China. Front Public Health 2022; 10:955615. [PMID: 36249240 PMCID: PMC9554305 DOI: 10.3389/fpubh.2022.955615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background This study was designed to analyze the relationship of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), relative fat mass (RFM), lipid accumulation product (LAP) and health-related quality of life (HRQoL) in the community-dwelling population of southern China and to explore the independent contribution of socio-demographic characteristics, number of chronic diseases and anthropometric indicators to HRQoL in that population. Methods This community-based cross-sectional survey studied 2,663 adults aged 18 years and older. HRQoL was assessed by the 3-level EuroQol 5-dimensional scale (EQ-5D-3L), and HRQoL were calculated using the Chinese EQ-5D-3L value set. The outcome variable was the EQ-5D-3L score (HRQoL). Cluster regression was used to analyse the independent contribution of each obesity indicator to HRQoL. Results A total of 2,663 people participated in this study, and their mean EQ-5D-3L score was 0.938 ± 0.072. In this study, according to the results of the one-way ANOVA, HRQoL was significantly different between the groups of WHtR, WHR, RFM and LAP, respectively. The independent contributions of socio-demographic factors, number of chronic diseases and anthropometric measures to HRQoL in the whole population accounted for 76.2, 7.9, and 15.9% of the total effect, respectively. Conclusion RFM and LAP were found to have a previously unreported negative impact on HRQoL in a community-dwelling population. In future studies, RFM and LAP could be used as new indicators of obesity to predict quality of life in humans.
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Affiliation(s)
- Yu-Jun Fan
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Yi-Jin Feng
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Ya Meng
- School of Medical, Huanghe Science and Technology University, Zhengzhou, China
| | - Zhen-Zhen Su
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Pei-Xi Wang
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China,*Correspondence: Pei-Xi Wang
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