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Powell T, Taylor H. The relationship between self-reported poor mental health and complete tooth loss among the US adult population in 2019. FRONTIERS IN ORAL HEALTH 2024; 5:1363982. [PMID: 38606312 PMCID: PMC11007132 DOI: 10.3389/froh.2024.1363982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Very little is known about the association between poor mental health and poor oral health outcomes in the United Sates. This study investigated the prevalence of complete tooth loss among those with and without perceived poor mental health in a nationally representative sample of noninstitutionalized U.S. adults. Methods Using a cross-sectional study design, we analyzed the 2019 Medical Expenditures Panel Survey to determine the unweighted and weighted prevalence of complete tooth loss among adults. Chi-squared and multivariate logit regression with marginal effects were used to measure the association between complete tooth loss and perceived poor mental health, controlling for respondent characteristics. Results The prevalence of adults (ages 18 and older) experiencing complete tooth loss was 6% (95% CI: 5.6-6.4). Individuals who have perceived poor mental health were 1.90 percentage points (pps) more likely to report missing all their natural teeth (P = 0.006: 95% CI: 0.5-3.3). Other relevant predictors of complete tooth loss included current smoking status (5.9 pps; 95% CI: 4.5 to 7.2) and secondary education (-6.4 pps (95% CI: -7.0 to -4.8). Conclusions Overall, self-reported poor mental health was found to be associated with a greater likelihood of reporting complete tooth loss. Findings from this study underscore the need for greater integration of care delivery between behavioral health specialists and dental providers.
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Affiliation(s)
- Tasha Powell
- Comprehensive Care: Dental Hygiene, Indiana University School of Dentistry, Indianapolis, IN, United States
| | - Heather Taylor
- Health Policy and Management, Richard M. Fairbanks School of Public Health, Indianapolis University, Indianapolis, IN, United States
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Joshi D, Aschner A, Atkinson L, Halili-Sychangco D, Duku E, Puffer ES, Rieder A, Tonmyr L, Gonzalez A. Predictors of harsh parenting practices and inter-partner conflict during the COVID-19 pandemic in Ontario, Canada: a cross-sectional analysis from the Ontario Parent Survey. BMJ Open 2023; 13:e066840. [PMID: 37640470 PMCID: PMC10462979 DOI: 10.1136/bmjopen-2022-066840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Guided by the bioecological model, the purpose of this study was to examine the associations of (1) individual level factors (sociodemographic, health behaviour and mental health), (2) family (micro) level COVID-19 experiences (difficulty with household management, managing child mood and behaviour, and pandemic-related positive experiences) and (3) community (macro) level factors (residential instability, ethnic concentration, material deprivation and dependency, an indicator of age and labour force) with harsh parenting practices and inter-partner conflict during the early lockdown of the COVID-19 pandemic in Ontario, Canada. DESIGN A cross-sectional analysis of data from the Ontario Parent Survey. SETTING A convenience sample of 7451 caregivers living in Ontario, Canada, at the time of baseline data collection (May-June 2020). PARTICIPANTS Caregivers aged 18 years and older with children 17 years or younger. OUTCOME MEASURES Parenting practices over the past 2 months was assessed using a published modification of the Parenting Scale. The frequency of inter-partner conflict over the past month was assessed using the Marital Conflict scale. RESULTS Individual (sociodemographic factors, alcohol use, and higher depressive and anxiety symptoms) and family (difficulties with managing the household and child mood and behaviour) level factors were positively associated with inter-partner conflict and harsh parenting practices. Having fewer positive experiences (eg, performing activities with children), and economic adversity at the family level were positively associated with inter-partner conflict but inversely associated with harsh parenting. At the community level, residential instability was negatively associated with harsh parenting practices. CONCLUSIONS Individual and family level factors were associated with harsh parenting and inter-partner conflict. The associations of fewer positive experiences and economic hardship with harsh parenting practices may be more complex than initially thought. Efforts that raise awareness and address caregiver mental health concerns are needed as part of the pandemic response to promote positive inter-partner and parent-child interactions.
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Affiliation(s)
- Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Amir Aschner
- Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | - Eric Duku
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Eve S Puffer
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Amber Rieder
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lil Tonmyr
- Family Violence Surveillance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Karakis I, Boualam N, Moura LM, Howard DH. Quality of life and functional limitations in persons with epilepsy. Epilepsy Res 2023; 190:107084. [PMID: 36657252 DOI: 10.1016/j.eplepsyres.2023.107084] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Epilepsy can reduce quality of life (QOL), functionality, and social participation, but these effects have not been adequately quantified in large, population-based, controlled studies. We sought to evaluate the impact of epilepsy on patients' QOL and employment outcomes. METHODS In this cross-sectional study we used nationally representative, pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. MEPS is a population-based survey of U.S. community-dwelling persons. We included respondents with condition file records for epilepsy. We also analyzed respondents with records for seizure. The primary outcomes were short form-12 physical and mental health scores. Secondary outcomes included self-rated health status, employment status, educational attainment, school/household/work limitations, and missed workdays. We compared these outcomes between persons with epilepsy (PWE) and age- and gender-matched controls. RESULTS We identified 1078 people with epilepsy, 2344 seizure cases, and 3422 cases of either condition (persons with epilepsy and/or seizures). Epilepsy was associated with a decrease of - 4.0 (95% CI: -5.1 to -2.8) points in SF-12 physical health scores and - 3.1 (95% CI: -4.2 to -1.9) in SF-12 mental health scores. Epilepsy was also associated with decreases in the likelihood of reporting good/very good/excellent health status (-13.3 [95% CI: -16.1 to -10.4] percentage points). Epilepsy was also associated with adverse employment-related outcomes. Specifically, PWE were 17.9 (95% CI: 14.3-21.4) percentage points more likely to report that they had work or household limitations. The associations between outcomes and epilepsy were, in most cases, larger than those between outcomes and other common, chronic conditions. SIGNIFICANCE Epilepsy is associated with worse quality of life and employment-related outcomes. Interventions should aim to improve functioning and patients' ability to maintain employment.
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Affiliation(s)
- Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
| | - Nada Boualam
- Department of Health Policy, Emory University School of Medicine, Atlanta, Georgia
| | - Lidia Mvr Moura
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts. Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - David H Howard
- Department of Health Policy, Emory University School of Medicine, Atlanta, Georgia
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Galambos NL, Johnson MD, Krahn HJ. Self-rated mental health in the transition to adulthood predicts depressive symptoms in midlife. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36504487 PMCID: PMC9718454 DOI: 10.1007/s12144-022-04081-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/03/2022]
Abstract
Self-rated mental health (SRMH), a single item asking individuals to evaluate their mental or emotional health, is included in some surveys as an indicator of risk for mental disorders and to monitor population health, yet little longitudinal research examines how well it predicts future outcomes. Following a life course perspective, the current longitudinal study of 502 Canadian high school seniors tracked into midlife examined to what extent SRMH at ages 20, 25, and 32 years predicted depressive symptoms at ages 43 and 50. Hierarchical linear regressions showed that lower SRMH at age 25 and at 32 years was a significant predictor of higher levels of depressive symptoms at ages 43 and 50, even when controlling for sex, participant education, marital/cohabitation status, self-rated physical health, and baseline depressive symptoms. The results provide evidence that SRMH assessed during the transition to adulthood may be useful as a broad and powerful measure of risk for mental health problems decades into the future.
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Affiliation(s)
- Nancy L. Galambos
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB T6G 2E9 Canada
| | | | - Harvey J. Krahn
- Department of Sociology, University of Alberta, Edmonton, AB Canada
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Griep RH, Almeida MDCC, Barreto SM, Brunoni AR, Duncan BB, Giatti L, Mill JG, Molina MDCB, Moreno AB, Patrão AL, Schmidt MI, da Fonseca MDJM. Working from home, work-time control and mental health: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil). Front Psychol 2022; 13:993317. [PMID: 36262442 PMCID: PMC9574257 DOI: 10.3389/fpsyg.2022.993317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study investigated the association between work-time control (WTC), independently and in combination with hours worked (HW), and four mental health outcomes among 2,318 participants of the Longitudinal Study of Adult Health (ELSA-Brasil) who worked from home during the COVID-19 pandemic. WTC was assessed by the WTC Scale, and mental health outcomes included depression, anxiety, stress (measured by the Depression, Anxiety and Stress Scale, DASS-21), and self-rated mental health. Logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs). Among women, long HW were associated with stress (OR = 1.56; 95% CI = 1.11–2.20) and poor self-rated mental health (OR = 1.64; 95% CI = 1.13–2.38), whereas they were protective against anxiety among men (OR = 0.59; 95% CI = 0.37–0.93). In both sexes, weak WTC was associated with all mental health outcomes. Among women, the long HW/weak WTC combination was associated with all mental health outcomes, and short HW/weak WTC was associated with anxiety and stress. Among men, long HW/strong WTC was protective against depression and stress, while short HW/strong WTC and short HW/weak WTC was associated with all mental health outcomes. In both sexes, weak WTC, independently and in combination with HW, was associated with all mental health outcomes. WTC can improve working conditions, protect against mental distress, and fosterwork-life balance for those who work from home.
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Affiliation(s)
- Rosane Harter Griep
- Laboratory of Health and Environmental Education, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
- *Correspondence: Rosane Harter Griep, ; orcid.org/0000-0002-6250-2036
| | | | - Sandhi Maria Barreto
- School of Medicine and Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André R. Brunoni
- School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruce B. Duncan
- Postgraduate Programme in Epidemiology and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luana Giatti
- School of Medicine and Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Maria del Carmen B. Molina
- Postgraduate Programme in Health and Nutrition, Universidade Federal do Ouro Preto, Ouro Preto, Brazil
- Postgraduate Programme in Collective Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Arlinda B. Moreno
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana Luisa Patrão
- Center for Psychology, Faculty of Psychology and Education Science of the University of Porto, Porto, Portugal
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Maria Inês Schmidt
- Postgraduate Programme in Epidemiology and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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The Relationship between Alcohol Drinking Indicators and Self-Rated Mental Health (SRMH): Standardized European Alcohol Survey (SEAS). Healthcare (Basel) 2022; 10:healthcare10071260. [PMID: 35885787 PMCID: PMC9317716 DOI: 10.3390/healthcare10071260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/29/2022] [Accepted: 07/03/2022] [Indexed: 11/17/2022] Open
Abstract
Given that the self-perception of mental health is an important predictor of health outcomes and wellbeing, it is important to identify the indicators of mental health associated with alcohol consumption in order to reduce alcohol-related harms. This study used data from the cross-sectional RARHA SEAS survey (2015) in the Croatian general population, aged 18-64 years (n = 1500). Several aspects of drinking behaviors and alcohol-related harms were measured, as well as personal and sociodemographic factors. Logistic regression found a significant association between alcohol's harm to others (AHTO) and poor self-rated mental health (SRMH) (OR = 0.752; 95% CI 0.601-0.941) in the total sample, as well as in the group of participants who rarely drank alcohol (OR = 0.504; 95% CI 0.322-0.787) in the last 12 months. More frequent consumers reported poor SRMH if they had at least one harmful effect from drinking (OR 0.538; 95% CI 0.295-0.980). Younger age, higher education, professional activity, and living with someone else in a household contributed to better SRMH. AHTO has been identified as a strong predictor of poor SRMH in the general population. Targeted public health and preventive measures are needed with specific approaches for different types of alcohol consumers.
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Joshi D, Gonzalez A, Griffith L, Duncan L, MacMillan H, Kimber M, Vrkljan B, MacKillop J, Beauchamp M, Kates N, Raina P. The trajectories of depressive symptoms among working adults during the COVID-19 pandemic: a longitudinal analysis of the InHamilton COVID-19 study. BMC Public Health 2021; 21:1895. [PMID: 34666722 PMCID: PMC8526051 DOI: 10.1186/s12889-021-11900-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Longitudinal studies examining the impact of changes in COVID-19 pandemic-related stressors and experiences, and coping styles on the mental health trajectory of employed individuals during the lockdown are limited. The study examined the mental health trajectories of a sample of employed adults in Hamilton, Ontario during the initial lockdown and after the re-opening following the first wave in Canada. Further, this study also identified the pandemic-related stressors and coping strategies associated with changes in depressive symptoms in employed adults during the COVID-19 pandemic. Methods The InHamilton COVID-19 longitudinal study involved 579 employees aged 22–88 years from a large public university in an urban area of Hamilton, Ontario at baseline (April 2020). Participants were followed monthly with 6 waves of data collected between April and November 2020. A growth mixture modeling approach was used to identify distinct groups of adults who followed a similar pattern of depressive symptoms over time and to describe the longitudinal change in the outcome within and among the identified sub-groups. Results Our results showed two distinct trajectories of change with 66.2% of participants displaying low-consistent patterns of depressive symptoms, and 33.8% of participants displaying high-increasing depressive symptom patterns. COVID-19 pandemic-related experiences including health concerns, caregiving burden, and lack of access to resources were associated with worsening of the depressive symptom trajectories. Frequent use of dysfunctional coping strategies and less frequent use of emotion-focused coping strategies were associated with the high and increasing depressive symptom pattern. Conclusions The negative mental health impacts of the COVID-19 pandemic are specific to subgroups within the population and stressors may persist and worsen over time. Providing access to evidence-informed approaches that foster adaptive coping, alleviate the depressive symptoms, and promote the mental health of working adults is critical.
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Affiliation(s)
- Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Lauren Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Laura Duncan
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Harriet MacMillan
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Brenda Vrkljan
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nick Kates
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. .,Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada. .,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada. .,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
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8
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Unmet Need for Medical Care: The Role of Mental Health Status. Community Ment Health J 2021; 57:121-127. [PMID: 32303934 DOI: 10.1007/s10597-020-00613-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/28/2020] [Indexed: 12/29/2022]
Abstract
Mental health status is an important factor to consider when exploring correlates of unmet need for medical care and prescription drugs. This paper explores whether self-rated mental health status is associated with unmet need and delays in obtaining medical care and prescription drugs. Descriptive statistics and multivariable logistic regression with 27,305 non-institutionalized adults aged 18 and older from the 2012 Medical Expenditure Panel Survey explore factors associated with self-reported unmet need for medical care and prescriptions, as well as access delays. Patients with lower physical and mental health status had the highest odds of experiencing unmet need for medical care and prescriptions, as well as access delays. These findings highlight the importance of increasing access to a usual source of care among individuals with lower self-rated mental health status as a strategy for addressing unmet need.
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Moodie L, Ilie G, Rutledge R, Andreou P, Kirkland S. Assessment of Current Mental Health Status in a Population-Based Sample of Canadian Men With and Without a History of Prostate Cancer Diagnosis: An Analysis of the Canadian Longitudinal Study on Aging (CLSA). Front Psychiatry 2020; 11:586260. [PMID: 33391051 PMCID: PMC7772192 DOI: 10.3389/fpsyt.2020.586260] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/10/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Small-scale studies indicate an increase in mental health disorders among prostate cancer survivors compared to the general population, but large population-based data assessing this relationship are scarce. The present study examined the prevalence of lifetime history of prostate cancer in a cross-sectional sample of Canadian men and assessed the contribution of lifetime history of a prostate cancer diagnosis, multimorbidity, and current alcohol and smoking status to the association with current mental health outcomes in this population. Methods: The analytical sample included 25,183 men (aged 45 to 85 years old), who completed a survey as part of the Canadian Longitudinal Study on Aging (CLSA). The Center for Epidemiological Studies Depression Scale (CES-D10), Kessler's Psychological Distress Scale (K10), and self-reported mental health were mental health outcomes. Multiple logistic regression analyses, and controlling for the complexity of the design and covariates, evaluated the association between prostate cancer survivorship, multimorbidity, alcohol and smoking status, and current mental health outcomes. Results: The prevalence of lifetime history of prostate cancer diagnosis in this population-based sample of men was 4% (95% CI: 3.7, 4.4). Our results indicate statistically significantly higher odds of current psychological distress (aOR = 1.52, 95% CI: 1.09, 2.11) and screening positive for depression (aOR = 1.24; 95% CI: 1.02, 1.51) among survivors of prostate cancer, compared to men without a history of prostate cancer diagnosis in demographics controlled analyses. After addition of multimorbidity and substance use, the odds of screening positive for depression among survivors of prostate cancer are 1.32 (95% CI: 1.06, 1.64) higher compared to men who never had a history of prostate cancer diagnosis. Interpretation: Patient education and empowerment programs aimed at addressing concerns during the diagnosis and treatment and enhancing survivorship care plans by adding routine screening for mental distress to help survivors overcome poor mental health during the cancer survivorship journey, are warranted.
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Affiliation(s)
- Louise Moodie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax Regional Municipality, NS, Canada
- Department of Urology, Dalhousie University, Halifax Regional Municipality, NS, Canada
- Department of Radiation Oncology, Dalhousie University, Halifax Regional Municipality, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Robert Rutledge
- Department of Radiation Oncology, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Pantelis Andreou
- Department of Community Health and Epidemiology, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, Halifax Regional Municipality, NS, Canada
- Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
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Vadiei N, Bhattacharjee S. Concurrent Opioid and Benzodiazepine Utilization Patterns and Predictors Among Community-Dwelling Adults in the United States. Psychiatr Serv 2020; 71:1011-1019. [PMID: 32517642 DOI: 10.1176/appi.ps.201900446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Using benzodiazepines and opioids together substantially increases the risk of fatal overdose. Yet, concurrent benzodiazepine and opioid prescribing rates continue to increase amid the opioid overdose epidemic. Therefore, this study sought to identify patterns and predictors associated with self-reported concurrent benzodiazepine and opioid use among community-dwelling adults. METHODS This retrospective, cross-sectional study used Medical Expenditure Panel Survey data from 2011, 2013, and 2015. The study population included adults (age ≥18) who did not die during the calendar year. The dependent variable was concurrent benzodiazepine and opioid use, which was identified with Multum Lexicon therapeutic class codes. Multivariable logistic regression analysis was conducted to examine the association of various individual-level factors with concurrent benzodiazepine and opioid use. RESULTS The final study sample consisted of 44,808 individuals (unweighted), of which 680 (1.6%) (weighted frequency=7,806,636) reported concurrent benzodiazepine and opioid use. Several individual-level factors were significantly associated with reporting use of this combination. For example, individuals with anxiety were more likely to report using both benzodiazepines and opioids (odds ratio [OR]=9.61, 95% confidence interval [CI]=7.37-12.5), and those with extreme pain levels were more likely to report concurrent use (OR=5.11, 95% CI=2.98-8.78). Other predictors of reporting concurrent benzodiazepine and opioid use were depression, arthritis, region, race-ethnicity, insurance, activities disability, general and mental health status, and smoking status. CONCLUSIONS Several individual-level factors were associated with reporting concurrent benzodiazepine and opioid use. Therefore, enhanced educational interventions targeting both clinicians and community-dwelling adults are warranted to minimize use of this high-risk medication combination.
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Affiliation(s)
- Nina Vadiei
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson
| | - Sandipan Bhattacharjee
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson
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Grafova IB, Monheit AC, Kumar R. HOW DO CHANGES IN INCOME, EMPLOYMENT AND HEALTH INSURANCE AFFECT FAMILY MENTAL HEALTH SPENDING? REVIEW OF ECONOMICS OF THE HOUSEHOLD 2020; 18:239-263. [PMID: 32051683 PMCID: PMC7014816 DOI: 10.1007/s11150-018-9436-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Using eight two-year panels from the Medical Expenditure Panel Survey data for the period 2004 to 2012, we examine the effect of economic shocks on mental health spending by families with children. Estimating two-part expenditure models within the correlated random effects framework, we find that employment shocks have a greater impact on mental health spending than do income or health insurance shocks. Our estimates reveal that employment gains are associated with a lower likelihood of family mental health services utilization. By contrast employment losses are positively related to an increase in total family mental health. We do not detect a link between economic shocks and mental health spending on behalf of fathers.
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Affiliation(s)
- Irina B Grafova
- Department of Health Systems and Policy, Rutgers University School of Public Health
| | - Alan C Monheit
- Department of Health Systems and Policy, Rutgers University School of Public Health and National Bureau of Economic Research
| | - Rizie Kumar
- Department of Health Systems and Policy, Rutgers University School of Public Health
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Bratman GN, Anderson CB, Berman MG, Cochran B, de Vries S, Flanders J, Folke C, Frumkin H, Gross JJ, Hartig T, Kahn PH, Kuo M, Lawler JJ, Levin PS, Lindahl T, Meyer-Lindenberg A, Mitchell R, Ouyang Z, Roe J, Scarlett L, Smith JR, van den Bosch M, Wheeler BW, White MP, Zheng H, Daily GC. Nature and mental health: An ecosystem service perspective. SCIENCE ADVANCES 2019. [PMID: 31355340 DOI: 10.1126/sciadv.aax0903/suppl_file/aax0903_sm.pdf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.
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Affiliation(s)
- Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- The Natural Capital Project, Stanford, CA 94305, USA
| | - Christopher B Anderson
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Marc G Berman
- Department of Psychology, University of Chicago, Chicago, IL 60637, USA
- Grossman Institute for Neuroscience, Quantitative Biology, and Human Behavior, University of Chicago, Chicago, IL 60637, USA
| | | | - Sjerp de Vries
- Wageningen Environmental Research, Wageningen University and Research, Wageningen, Netherlands
| | - Jon Flanders
- School of Biological Sciences, University of Bristol, Bristol, UK
- Bat Conservation International, Austin, TX 78746, USA
| | - Carl Folke
- Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
- Beijer Institute, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Howard Frumkin
- Wellcome Trust, London, UK
- School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Peter H Kahn
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Ming Kuo
- Landscape and Human Health Laboratory, Department of Natural Resources and Environmental Sciences, University of Illinois, Urbana, IL 61801, USA
| | - Joshua J Lawler
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
| | - Phillip S Levin
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
- The Nature Conservancy, Seattle, WA 98121, USA
| | - Therese Lindahl
- Beijer Institute, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Zhiyun Ouyang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Jenny Roe
- Center for Design and Health, University of Virginia, Charlottesville, VA 22904, USA
| | | | - Jeffrey R Smith
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Matilda van den Bosch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benedict W Wheeler
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Mathew P White
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Hua Zheng
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Gretchen C Daily
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- The Natural Capital Project, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- Stanford Woods Institute, Stanford University, Stanford, CA 94305, USA
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13
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Bratman GN, Anderson CB, Berman MG, Cochran B, de Vries S, Flanders J, Folke C, Frumkin H, Gross JJ, Hartig T, Kahn PH, Kuo M, Lawler JJ, Levin PS, Lindahl T, Meyer-Lindenberg A, Mitchell R, Ouyang Z, Roe J, Scarlett L, Smith JR, van den Bosch M, Wheeler BW, White MP, Zheng H, Daily GC. Nature and mental health: An ecosystem service perspective. SCIENCE ADVANCES 2019; 5:eaax0903. [PMID: 31355340 PMCID: PMC6656547 DOI: 10.1126/sciadv.aax0903] [Citation(s) in RCA: 449] [Impact Index Per Article: 89.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/20/2019] [Indexed: 05/17/2023]
Abstract
A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.
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Affiliation(s)
- Gregory N. Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- The Natural Capital Project, Stanford, CA 94305, USA
| | - Christopher B. Anderson
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Marc G. Berman
- Department of Psychology, University of Chicago, Chicago, IL 60637, USA
- Grossman Institute for Neuroscience, Quantitative Biology, and Human Behavior, University of Chicago, Chicago, IL 60637, USA
| | | | - Sjerp de Vries
- Wageningen Environmental Research, Wageningen University and Research, Wageningen, Netherlands
| | - Jon Flanders
- School of Biological Sciences, University of Bristol, Bristol, UK
- Bat Conservation International, Austin, TX 78746, USA
| | - Carl Folke
- Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Sciences, Stockholm, Sweden
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
- Beijer Institute, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Howard Frumkin
- Wellcome Trust, London, UK
- School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - James J. Gross
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Peter H. Kahn
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Ming Kuo
- Landscape and Human Health Laboratory, Department of Natural Resources and Environmental Sciences, University of Illinois, Urbana, IL 61801, USA
| | - Joshua J. Lawler
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
| | - Phillip S. Levin
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
- Center for Creative Conservation, University of Washington, Seattle, WA 98195, USA
- The Nature Conservancy, Seattle, WA 98121, USA
| | - Therese Lindahl
- Beijer Institute, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Zhiyun Ouyang
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Jenny Roe
- Center for Design and Health, University of Virginia, Charlottesville, VA 22904, USA
| | | | - Jeffrey R. Smith
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Matilda van den Bosch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benedict W. Wheeler
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Mathew P. White
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Hua Zheng
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Gretchen C. Daily
- Center for Conservation Biology, Stanford University, Stanford, CA 94305, USA
- The Natural Capital Project, Stanford, CA 94305, USA
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- Stanford Woods Institute, Stanford University, Stanford, CA 94305, USA
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Hailemichael Y, Hailemariam D, Tirfessa K, Docrat S, Alem A, Medhin G, Lund C, Chisholm D, Fekadu A, Hanlon C. Catastrophic out-of-pocket payments for households of people with severe mental disorder: a comparative study in rural Ethiopia. Int J Ment Health Syst 2019; 13:39. [PMID: 31164919 PMCID: PMC6544918 DOI: 10.1186/s13033-019-0294-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 05/23/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There are limited data on healthcare spending by households containing a person with severe mental disorder (SMD) in low- and middle-income countries (LMIC). This study aimed to estimate the incidence and intensity of catastrophic out-of-pocket (OOP) payments and coping strategies implemented by households with and without a person with SMD in a rural district of Ethiopia. METHODS A comparative cross-sectional community household survey was carried out from January to November 2015 as part of the Emerald programme (emerging mental health systems in low- and middle-income countries). A sample of 290 households including a person with SMD and 289 comparison households without a person with SMD participated in the study. An adapted and abbreviated version of the World Health Organization SAGE (Study on global Ageing and adult health) survey instrument was used. Households were considered to have incurred catastrophic health expenditure if their annual OOP health expenditures exceeded 40% of their annual non-food expenditure. Multiple logistic regression was used to explore factors associated with catastrophic expenditure and types of coping strategies employed. RESULTS The incidence of catastrophic OOP payments in the preceding 12 months was 32.2% for households of a person with SMD and 18.2% for comparison households (p = 0.006). In households containing a person with SMD, there was a significant increase in the odds of hardship financial coping strategies (p < 0.001): reducing medical visits, cutting down food consumption, and withdrawing children from school. Households of a person with SMD were also less satisfied with their financial status and perceived their household income to be insufficient to meet their livelihood needs (p < 0.001). CONCLUSIONS Catastrophic OOP health expenditures in households of a person with SMD are high and associated with hardship financial coping strategies which may lead to poorer health outcomes, entrenchment of poverty and intergenerational disadvantage. Policy interventions aimed at financial risk pooling mechanisms are crucial to reduce the intensity and impact of OOP payments among vulnerable households living with SMD and support the goal of universal health coverage.
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Affiliation(s)
- Yohannes Hailemichael
- Department of Reproductive Health and Health Services Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Damen Hailemariam
- Department of Reproductive Health and Health Services Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebede Tirfessa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sumaiyah Docrat
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu-Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan Chisholm
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
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15
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Chiu M, Lebenbaum M, Cheng J, de Oliveira C, Kurdyak P. The direct healthcare costs associated with psychological distress and major depression: A population-based cohort study in Ontario, Canada. PLoS One 2017; 12:e0184268. [PMID: 28873469 PMCID: PMC5584795 DOI: 10.1371/journal.pone.0184268] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 08/21/2017] [Indexed: 11/17/2022] Open
Abstract
The objective of our study was to estimate direct healthcare costs incurred by a population-based sample of people with psychological distress or depression. We used the 2002 Canadian Community Health Survey on Mental Health and Well Being and categorized individuals as having psychological distress using the Kessler-6, major depressive disorder (MDD) using DSM-IV criteria and a comparison group of participants without MDD or psychological distress. Costs in 2013 USD were estimated by linking individuals to health administrative databases and following them until March 31, 2013. Our sample consisted of 9,965 individuals, of whom 651 and 409 had psychological distress and MDD, respectively. Although the age-and-sex adjusted per-capita costs were similarly high among the psychologically distressed ($3,364, 95% CI: $2,791, $3,937) and those with MDD ($3,210, 95% CI: $2,413, $4,008) compared to the comparison group ($2,629, 95% CI: $2,312, $2,945), the population-wide excess costs for psychological distress ($441 million) were more than twice that for MDD ($210 million) as there was a greater number of people with psychological distress than depression. We found substantial healthcare costs associated with psychological distress and depression, suggesting that psychological distress and MDD have a high cost burden and there may be public health intervention opportunities to relieve distress. Further research examining how individuals with these conditions use the healthcare system may provide insight into the allocation of limited healthcare resources while maintaining high quality care.
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Affiliation(s)
- Maria Chiu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Michael Lebenbaum
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Joyce Cheng
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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16
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Kanesarajah J, Waller M, Whitty JA, Mishra GD. The relationship between SF-6D utility scores and lifestyle factors across three life stages: evidence from the Australian Longitudinal Study on Women’s Health. Qual Life Res 2017; 26:1507-1519. [DOI: 10.1007/s11136-017-1498-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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