1
|
Haslam SA, Fong P, Haslam C, Cruwys T. Connecting to Community: A Social Identity Approach to Neighborhood Mental Health. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2024; 28:251-275. [PMID: 38146705 PMCID: PMC11193917 DOI: 10.1177/10888683231216136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
ACADEMIC ABSTRACT Integrative theorizing is needed to advance our understanding of the relationship between where a person lives and their mental health. To this end, we introduce a social identity model that provides an integrated explanation of the ways in which social-psychological processes mediate and moderate the links between neighborhood and mental health. In developing this model, we first review existing models that are derived primarily from a resource-availability perspective informed by research in social epidemiology, health geography, and urban sociology. Building on these, the social identity model implicates neighborhood identification in four key pathways between residents' local environment and their mental health. We review a wealth of recent research that supports this model and which speaks to its capacity to integrate and extend insights from established models. We also explore the implications of the social identity approach for policy and intervention. PUBLIC ABSTRACT We need to understand the connection between where people live and their mental health better than we do. This article helps us do this by presenting an integrated model of the way that social and psychological factors affect the relationship between someone's neighborhood and their mental health. This model builds on insights from social epidemiology, health geography, and urban sociology. Its distinct and novel contribution is to point to the importance of four pathways through which neighborhood identification shapes residents' mental health. A large body of recent research supports this model and highlights its potential to integrate and expand upon existing theories. We also discuss how our model can inform policies and interventions that seek to improve mental health outcomes in communities.
Collapse
Affiliation(s)
| | - Polly Fong
- The University of Queensland, Brisbane, Australia
| | | | - Tegan Cruwys
- The Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
2
|
Helbich M, Zeng Y, Sarker A. Area-level Measures of the Social Environment: Operationalization, Pitfalls, and Ways Forward. Curr Top Behav Neurosci 2024. [PMID: 38453766 DOI: 10.1007/7854_2024_464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
People's mental health is intertwined with the social environment in which they reside. This chapter explores approaches for quantifying the area-level social environment, focusing specifically on socioeconomic deprivation and social fragmentation. We discuss census data and administrative units, egocentric and ecometric approaches, neighborhood audits, social media data, and street view-based assessments. We close the chapter by discussing possible paths forward from associations between social environments and health to establishing causality, including longitudinal research designs and time-series social environmental indices.
Collapse
Affiliation(s)
- Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands.
- Health and Quality of Life in a Green and Sustainable Environment Research Group, Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria.
- Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Yi Zeng
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Abeed Sarker
- Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
3
|
Packness A, Sparle Christensen K, Simonsen E. Prevalence of anxiety disorders and association to socioeconomic position. Results from the Lolland Falster Health Study. Nord J Psychiatry 2023:1-8. [PMID: 36662161 DOI: 10.1080/08039488.2022.2154836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study is to describe the prevalence of anxiety disorders in a general population and the association to socioeconomic position (SEP), which has not been described in a Danish context before. MATERIAL AND METHODS We present data on anxiety symptoms from respondents in the rural-provincial Lolland-Falster population Health Study (LOFUS). Analyses of the questionnaire responses to the Anxiety Symptom Scale were done by descriptive statistics and logistic regression analyses adjusted for sex and age. RESULTS 14,834 LOFUS respondents who completed the Anxiety Symptom Scale were included; According to the original algorithm 371 (2.5%) had an anxiety disorder. The adjusted odds ratios (aOR) for anxiety disorder were strongly associated to SEP. We found aOR for anxiety to be: 3.8 (confidence interval (CI 95%) 2.54 - 5.92) for respondents with no postsecondary education compared to those with 3+ years of postsecondary education; 11.9 (CI 8.89 - 16.01) for respondents temporarily out of a job compared to those working; 9.4 (CI 6.06 - 14.51) for those experiencing constant financial strain compared to those not experiencing financial strain. Relaxing the criteria for anxiety to item 10 > 1, the prevalence raised to 3.9%. The association was unchanged related to education; however, the aOR dropped to 9 and 8 respectively, for being temporally out of job, or in financial strain every month- when doing same comparisons. CONCLUSIONS The 14-day prevalence of anxiety disorder seems low but strongly associated to SEP especially for individuals temporarily out of a job or experiencing financial strain.
Collapse
Affiliation(s)
- Aake Packness
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
| | - Kaj Sparle Christensen
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Erik Simonsen
- Mental Health Services, Psychiatry East, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
4
|
Larnyo E, Dai B, Nutakor JA, Ampon-Wireko S, Larnyo A, Appiah R. Examining the impact of socioeconomic status, demographic characteristics, lifestyle and other risk factors on adults' cognitive functioning in developing countries: an analysis of five selected WHO SAGE Wave 1 Countries. Int J Equity Health 2022; 21:31. [PMID: 35216605 PMCID: PMC8876754 DOI: 10.1186/s12939-022-01622-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Though extensive studies have been conducted on assessing the predictors of cognitive functioning among older adults in small community-based samples, very few studies have focused on understanding the impact of socioeconomic status (SES), demographic characteristics and other risk factors such as lifestyle and chronic diseases on the cognitive functioning among adults of all ages in a nationally representative population-based sample across low- and middle-income countries. This study, therefore, seeks to evaluate the impact of SES, demographic characteristics and risk factors on the cognitive functioning of adults across all ages in five selected developing countries. METHODS Data from 12,430 observations obtained from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1; consisting of 2,486 observations each for China, Ghana, India, the Russian Federation, and South Africa, were used for the study. A meta-regression and a five-step hierarchical linear regression were used to analyze the data, with cognitive functioning as the dependent variable. Independent variables used in this study include SES; assessed by household income and education, demographic characteristics, other risk factors such as lifestyle, self-reported memory difficulty and chronic diseases. RESULTS This study found that SES and lifestyle significantly predicted cognitive functioning in all the five selected countries as obtained by the pooled results of the meta-regression analysis. The hierarchical linear regression results also revealed that demographic characteristics such as age, type of residency, and self-reported memory difficulty significantly impact cognitive functioning in China, Ghana, Russia, and South Africa. CONCLUSION The findings in this study provide new insights for policymakers, caregivers, parents, and individuals, especially those in developing countries, to implement policies and actions targeted at improving SES and eliminating risk factors associated with cognitive decline, as these measures could help improve the cognitive functioning among their populations.
Collapse
Affiliation(s)
- Ebenezer Larnyo
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Baozhen Dai
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China.
- Department of Labor and Social Security, School of Public Health, Southeast University, 87# Dingjiaqiao, Nanjing, 210009, Jiangsu province, China.
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Sabina Ampon-Wireko
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Abigail Larnyo
- School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Ruth Appiah
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| |
Collapse
|
5
|
Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Screening for generalized anxiety disorder (GAD) and associated factors in adolescents and young adults with type 1 diabetes: Cross-sectional results of a Germany-wide population-based study. Diabetes Res Clin Pract 2022; 184:109197. [PMID: 35065100 DOI: 10.1016/j.diabres.2022.109197] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 01/09/2023]
Abstract
AIMS The aims of this study were to screen 14- to 30-year-olds with early-onset type 1 diabetes for generalized anxiety disorder (GAD) and to compare the characteristics of the study participants who had a positive result for GAD with those who had a negative result. METHODS This study used data from a questionnaire survey conducted from 2018 to 2019. The GAD-7 questionnaire was used to screen for GAD (positive: GAD-7 score ≥ 10). All regression analyses were adjusted for age, sex, depression diagnosis and considered multiple testing. RESULTS The 713 participants had a mean GAD-7 score of 4.32 (SD 4.18). A total of 12% of the study population (10% of adolescents, 13% of adults) was screened positive for GAD. Positive screening results were associated with impairments in various domains, such as self-assessed physical performance (RR poor versus good 3.03 [95% CI 1.85-4.96]), difficulty falling asleep (RR ≥3 times/week versus not during the last 4 weeks 5.36 [2.86-10.07]), glycemic control (RR HbA1c per 1% 1.16 [1.03-1.31]), and diabetes treatment satisfaction (RR poor versus good 2.67 [1.43-5.00]). CONCLUSIONS Diabetologists should be aware that adolescents and young adults with GAD symptoms might experience extensive impairments in their daily lives.
Collapse
Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany; Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| |
Collapse
|
6
|
Ziaei S, Hammarström A. What social determinants outside paid work are related to development of mental health during life? An integrative review of results from the Northern Swedish Cohort. BMC Public Health 2021; 21:2190. [PMID: 34847924 PMCID: PMC8638423 DOI: 10.1186/s12889-021-12143-3] [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: 06/08/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite global increase in burden of mental health conditions, longitudinal studies on factors related to development of mental health are scarce. Particularly integrated understanding of how factors at each level of ecological system interact to influence mental health of individuals during their life is missing. Both work and outside work (life beyond work) spheres are two important areas in human life which can have independent effects on mental health of individuals. In this integrative review, we aimed to synthesis findings about social determinants outside paid work that are related to development of mental health during life in a 27-year prospective Swedish Cohort study by using Bronfenbrenner's Ecological Systems Theory. METHODS The material for this paper consists of all mental health related papers within Northern Swedish Cohort. Papers related to outside paid work exposures of life circumstances were selected. An integrative review was conducted on 27 papers and deductive qualitative content analysis in relation to Bronfenbrenner ecological framework was performed to identify the main themes. RESULTS The results of this review showed that class structures and gender order at macro-level permeated into all other levels and finally became embodied in the individuals as symptoms of mental health during life. At the "exo-level" neighbourhood disadvantage was related to mental ill-health of individuals. The importance of parental interaction with other settings, like school, for mental health of individuals was highlighted at "meso-level". At "micro-level" poor social relationships; social and material adversities and inequality in gender relations during adult life were related to mental ill-health. CONCLUSION We found mental health of individuals to be related to both unique and common factors manifesting at different socio-ecological levels. Social structures at the macro-level namely class structures and gender order permeate all other levels and eventually become embodied in the individuals as symptoms of mental health during life. Interventions addressing gender and class related inequalities might be of importance for improving mental health of individuals during their life.
Collapse
Affiliation(s)
- Shirin Ziaei
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Stockholm, Sweden.
| | - Anne Hammarström
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Stockholm, Sweden.,Department of Epidemiology and Global Health, Umea University, 901 87, Umea, Sweden
| |
Collapse
|
7
|
Salerno PSV, Bastos CR, Peres A, Ardais AP, Gazal M, Jansen K, Souza LDDM, da Silva RA, Kaster MP, Lara DR, Ghisleni G. Leptin polymorphism rs3828942: risk for anxiety disorders? Eur Arch Psychiatry Clin Neurosci 2021; 271:1141-1148. [PMID: 31420734 DOI: 10.1007/s00406-019-01051-8] [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: 03/06/2019] [Accepted: 08/07/2019] [Indexed: 11/30/2022]
Abstract
Leptin is an anorexigenic hormone well recognized by its role in mediating energy homeostasis. Recently, leptin has been associated with psychiatric disorders and interestingly, leptin treatment has shown antidepressant and anxiolytic effects. We examined the association of leptin levels and leptin (LEP) gene rs3828942 polymorphism with anxiety disorders considering sex differences. A cross-sectional population-based study, including 1067 young adults, of whom 291 presented anxiety disorders diagnosed by the Mini International Neuropsychiatric Interview (MINI 5.0). The rs3828942 polymorphism was genotyped by real-time PCR and ELISA measured leptin levels. Leptin levels were not associated with anxiety disorders after adjusting for sex and body mass index (BMI) [ß = - 0.009 (- 0.090-0.072); p = 0.832]. The distribution of rs3828942 genotypes was not associated with anxiety disorders. However, in a sex-stratified sample, the A-allele of rs3828942 polymorphism was associated with risk for GAD in women even when adjusting for confounding variables [OR = 1.87 (1.17-2.98); p = 0.008]. In a subsample of 202 individuals with GAD and control matched by sex and BMI, results suggest an interaction between genotypes and GAD diagnosis based on leptin levels only in the male group [F (1, 54) = 6.464; p = 0.0139]. Leptin is suggested to be related with the neurobiology of anxiety disorders in a sex-dependent manner since women carrying the A-allele of LEP rs3828942 present a higher risk for GAD, while leptin levels seem to be lower in men with GAD carrying A-allele. Studies on the relationship between leptin polymorphisms and levels are scarce and, therefore, further research is necessary.
Collapse
Affiliation(s)
- Pamela Silva Vitória Salerno
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Clarissa Ribeiro Bastos
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Ariadni Peres
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Ana Paula Ardais
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Marta Gazal
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Karen Jansen
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Luciano Dias de Mattos Souza
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Ricardo Azevedo da Silva
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil
| | - Manuella Pinto Kaster
- Department of Biochemistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Diogo Rizzato Lara
- Department of Cellular and Molecular Biology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gabriele Ghisleni
- Institute of Health Sciences, Department of Health and Behavior, Catholic University of Pelotas - UCPel, Rua Gonçalves Chaves 373, Sala 324, Pelotas, RS, 96010-280, Brazil.
| |
Collapse
|
8
|
Vinaccia Alpi S, Ortega Bechara A. Variables asociadas a la ansiedad-depresión en estudiantes universitarios. UNIVERSITAS PSYCHOLOGICA 2021. [DOI: 10.11144/javeriana.upsy19.vaad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
La salud, como un estado subjetivo de bienestar, responde a las características del contexto sociodemográfico. Estudios previos sugieren que los indicadores de salud mental entre estudiantes universitarios son comparativamente menores que los del resto de la población, probablemente debido a la interacción de factores contextuales. Este estudio busca evaluar la relación entre variables sociodemográficas, ansiedad y depresión en estudiantes de una universidad en la costa Atlántica colombiana. En un diseño transversal, los participantes (n = 6.224) completaron la escala PROMIS y un cuestionario de información sociodemográfica. Mediante análisis descriptivos se examinaron la incidencia y comorbilidad de la ansiedad-depresión. El efecto de las variables sociodemográficas en la ansiedad-depresión se analizó con un modelo regresión logística. Resultados. 55.7 % de los participantes presentaron síntomas de ansiedad, 32.2 % presentaron síntomas de depresión, y 28.9 % presentaron comorbilidad. El sexo, estado civil, grupo étnico y estrato socioeconómico fueron predictores significativos de la ansiedad-depresión. Los hallazgos indican que la ansiedad y la depresión son frecuentes entre estudiantes universitarios. La importancia de desarrollar intervenciones para promover la salud en el desempeño profesional de los estudiantes es discutida.
Collapse
|
9
|
Zhou R, Liu HM, Li FR, Yang HL, Zheng JZ, Zou MC, Zou LW, Wu XX, Wu XB. Depression as a Mediator of the Association Between Wealth Status and Risk of Cognitive Impairment and Dementia: A Longitudinal Population-Based Cohort Study. J Alzheimers Dis 2021; 80:1591-1601. [PMID: 33720888 DOI: 10.3233/jad-201239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Wealth and income are potential modifiable risk factors for dementia, but whether wealth status, which is composed of a combination of debt and poverty, and assessed by wealth and income, is associated with cognitive impairment among elderly adults remains unknown. OBJECTIVE To examine the associations of different combinations of debt and poverty with the incidence of dementia and cognitive impairment without dementia (CIND) and to evaluate the mediating role of depression in these relationships. METHODS We included 15,565 participants aged 51 years or older from the Health and Retirement Study (1992-2012) who were free of CIND and dementia at baseline. Dementia and CIND were assessed using either the modified Telephone Interview for Cognitive Status (mTICS) or a proxy assessment. Cox models with time-dependent covariates and mediation analysis were used. RESULTS During a median of 14.4 years of follow-up, 4,484 participants experienced CIND and 1,774 were diagnosed with dementia. Both debt and poverty were independently associated with increased dementia and CIND risks, and the risks were augmented when both debt and poverty were present together (the hazard ratios [95% confidence intervals] were 1.35 [1.08-1.70] and 1.96 [1.48-2.60] for CIND and dementia, respectively). The associations between different wealth statuses and cognition were partially (mediation ratio range: 11.8-29.7%) mediated by depression. CONCLUSION Debt and poverty were associated with an increased risk of dementia and CIND, and these associations were partially mediated by depression. Alleviating poverty and debt may be effective for improving mental health and therefore curbing the risk of cognitive impairment and dementia.
Collapse
Affiliation(s)
- Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Hua-Min Liu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Jia-Zhen Zheng
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Meng-Chen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lian-Wu Zou
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Xiao-Xiang Wu
- Department of General Surgery, People's Liberation Army General Hospital of Southern Theatre Command, Guangzhou, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| |
Collapse
|
10
|
Oshio T, Kimura H, Nishizaki T, Omori T. How does area-level deprivation depress an individual's self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan. BMC Public Health 2021; 21:523. [PMID: 33731075 PMCID: PMC7968212 DOI: 10.1186/s12889-021-10578-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied. METHODS We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019 and 2020, as well as municipality-level data obtained from a Japanese government database (N = 12,461 living in 366 municipalities). We developed multilevel regression models to explain an individual's SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS. RESULTS Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p < 0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 and 33.1% of the impact of municipality-level deprivation on SRH and LS, depending on model specifications. CONCLUSION Results showed that area-level deprivation modestly decreased an individual's general health conditions and subjective well-being, underscoring the need for public health policies to improve area-level socioeconomic conditions.
Collapse
Affiliation(s)
- Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8603, Japan.
| | - Hiromi Kimura
- Survey Research Center, 3-13-5 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan
| | - Toshimi Nishizaki
- Japan Cabinet Office, 1-6-1 Nagatacho, Chiyoda-ku, Tokyo, 100-8914, Japan
| | - Takashi Omori
- Osaka University, 1-7 Machikaneyama Toyonaka, Osaka, 560-0043, Japan
| |
Collapse
|
11
|
Slee A, Nazareth I, Freemantle N, Horsfall L. Trends in generalised anxiety disorders and symptoms in primary care: UK population-based cohort study. Br J Psychiatry 2021; 218:158-164. [PMID: 32895062 PMCID: PMC8529638 DOI: 10.1192/bjp.2020.159] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Generalised anxiety disorder and symptoms are associated with poor physical, emotional and social functioning and frequent primary and acute care visits. We investigated recent temporal trends in anxiety and related mental illness in UK general practice. AIMS The aims of this analysis are to examine temporal changes in recording of generalised anxiety in primary care and initial pharmacologic treatments. METHOD Annual incidence rates of generalised anxiety diagnoses and symptoms were calculated from 795 UK general practices contributing to The Health Improvement Network (THIN) database between 1998 and 2018. Poisson mixed regression was used to account for age, gender and general practitioner practice. Subsequent pharmacologic treatment was examined. RESULTS Generalised anxiety recording rates increased in both genders aged 18-24 between 2014 and 2018. For women, the increase was from 17.06 to 23.33/1000 person years at risk (PYAR); for men, 8.59 to 11.65/1000 PYAR. Increases persisted for a composite of anxiety and depression (49.74 to 57.81/1000 PYAR for women; 25.41 to 31.45/1000 PYAR for men). Smaller increases in anxiety were seen in both genders age 25-34 and 35-44. Anxiety rates among older patients remained stable, although a composite of anxiety and depression decreased for older women. About half of drug-naïve patients were prescribed anxiety drugs within 1 year following diagnosis. The most common choice was a selective serotonin reuptake inhibitor. Benzodiazepine prescription rate has fallen steadily. CONCLUSIONS We observed a substantial increase in general practitioner consulting for generalised anxiety and depression recently, concentrated within younger people and in particular women.
Collapse
Affiliation(s)
- April Slee
- Department of Primary Care and Population Health, University College London, UK
| | - Irwin Nazareth
- Department of Primary Care and Population Health, University College London, UK
| | - Nick Freemantle
- Comprehensive Clinical Trials Unit, University College London, UK,Correspondence: Prof. Nick Freemantle.
| | - Laura Horsfall
- Department of Primary Care and Population Health, University College London, UK
| |
Collapse
|
12
|
Remes O, Lafortune L, Wainwright N, Surtees P, Khaw KT, Brayne C. Association between area deprivation and major depressive disorder in British men and women: a cohort study. BMJ Open 2019; 9:e027530. [PMID: 31767575 PMCID: PMC6886936 DOI: 10.1136/bmjopen-2018-027530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Studies have shown area-level deprivation can increase the risk for mental disorders over and above individual-level circumstances, such as education and social class. The objective of this study is to determine whether area deprivation is associated with major depressive disorder (MDD) in British women and men separately while adjusting for individual-level factors. DESIGN Large, population study. SETTING UK population-based cohort. PARTICIPANTS 30 445 people from the general population aged 40 years and older and living in England consented to participate at study baseline, and of these, over 20 000 participants completed a structured Health and Life Experiences Questionnaire used to capture MDD. Area deprivation was measured in 1991 using Census data, and current MDD was assessed in 1996-2000. 8236 men and 10 335 women had complete data on all covariates. PRIMARY OUTCOME MEASURE MDD identified according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). RESULTS In this study, 3.3% (339/10 335) of women and 2.1% (177/8236) of men had MDD. Men living in the most deprived areas were 51% more likely to have depression than those living in areas that were not deprived (OR=1.51, 95% CI 1.01 to 2.24; p=0.043), but the association between deprivation and MDD was not statistically significant in women (OR=1.24, 95% CI 0.93 to 1.65; p=0.143). CONCLUSION This study shows that the residential environment differentially affects men and women, and this needs to be taken into account by mental health policy-makers. Knowing that men living in deprived conditions are at high risk for having depression helps inform targeted prevention and intervention programmes.
Collapse
Affiliation(s)
- Olivia Remes
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Louise Lafortune
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Nick Wainwright
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paul Surtees
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
13
|
Morriss R, Xydopoulos G, Craven M, Price L, Fordham R. Clinical effectiveness and cost minimisation model of Alpha-Stim cranial electrotherapy stimulation in treatment seeking patients with moderate to severe generalised anxiety disorder. J Affect Disord 2019; 253:426-437. [PMID: 31103808 DOI: 10.1016/j.jad.2019.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/28/2019] [Accepted: 04/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cranial electrotherapy stimulation (CES) is a well-tolerated neuromodulation treatment with demonstrated trial efficacy in anxiety disorders. The aim of the current study was to demonstrate its clinical and cost effectiveness during and after CES in people with generalised anxiety disorder (GAD) who had not responded to low intensity psychological treatment in a routine health service. METHODS Consecutive sample of eligible patients with GAD waiting for individual cognitive behaviour therapy (CBT) selected from two publicly funded services in England. They received 60 min per day Alpha-Stim CES for 6-12 weeks. Primary outcome was remission on the GAD-7 scale at 12 and 24 weeks. Cost effectiveness was examined using a cost minimisation model of direct health costs. RESULTS Of 161 patients recruited, 72 (44.7%) and 77 (47.8%) achieved remission on the GAD-7 at 12 and 24 weeks respectively with 122 (75.8%) receiving at least 6 weeks CES. Mean (sd) GAD-7 score at baseline significantly improved from 15.77 (3.21) to 8.92 (5.42) and 8.99 (6.18) at 12 and 24 weeks respectively (p < 0.001). 80 (49.7%) participants required further individual CBT. CES provided a saving of £540.88 per patient (95% CI -£327.12, £648.69). LIMITATIONS Participants were not randomised and there was no control group. Only 48 (29.9%) participants completed every assessment. CONCLUSION In patients with generalised anxiety disorder not responding to low intensity psychological treatment, 6-12 weeks daily Alpha Stim CES may be effective after treatment and 3 months later, thereby reducing the need for individual CBT and saving health costs.
Collapse
Affiliation(s)
- Richard Morriss
- Institute of Mental Health and NIHR MindTech MTEC, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK.
| | | | - Michael Craven
- NIHR MindTech MTEC, University of Nottingham, Nottingham, UK
| | - Larry Price
- Measurement and Statistical Analysis, Texas State University, TX, USA
| | - Richard Fordham
- University of East Anglia, Norwich Research Park, Norwich, UK
| |
Collapse
|
14
|
Kumar H, Arokiasamy P, Selvamani Y. Socioeconomic Disadvantage, Chronic Diseases and their Association with Cognitive Functioning of Adults in India: A Multilevel Analysis. JOURNAL OF POPULATION AGEING 2019. [DOI: 10.1007/s12062-019-09243-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
15
|
Uchida H, Tsujino D, Muguruma T, Hino N, Sasaki K, Miyoshi M, Koyama Y, Hirao K. Low sense of coherence is associated with anxiety among adults: Results based on data from all 47 prefectures of Japan. Compr Psychiatry 2018; 86:131-136. [PMID: 30125814 DOI: 10.1016/j.comppsych.2018.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/09/2018] [Accepted: 08/12/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Anxiety disorder is a major societal, economic, and healthcare burden, so it is essential to identify underlying risk factors. Sense of coherence (SOC), defined as an individual's perceived ability to control events and cope with challenges, is strongly associated with healthcare outcomes. METHODS This study investigated the association between SOC and anxiety among adults in all 47 prefectures of Japan using a cross-sectional online panel survey. SOC was assessed using the University of Tokyo Health Sociology version of the SOC Scale and anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale. RESULTS Among 2100 participants (1051 males and 1049 females), 475 (22.6%) were identified with anxiety (scoring 8 points or higher on the GAD-7 scale). Before adjustment for potential confounders, there was a significant negative association between SOC and presence of anxiety. Even after adjustment, the presence of anxiety was significantly higher among the lower SOC subgroup than the higher SOC subgroup. CONCLUSIONS These results indicate that approximately one-fifth of adults in Japan suffer from anxiety and that low SOC is a significant risk factor.
Collapse
Affiliation(s)
- Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Daisuke Tsujino
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Takuro Muguruma
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Naoki Hino
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Keiji Sasaki
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Masato Miyoshi
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Yuya Koyama
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Kazuki Hirao
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan.
| |
Collapse
|
16
|
Remes O, Wainwright NWJ, Surtees P, Lafortune L, Khaw KT, Brayne C. A strong sense of coherence associated with reduced risk of anxiety disorder among women in disadvantaged circumstances: British population study. BMJ Open 2018; 8:e018501. [PMID: 29685997 PMCID: PMC5914722 DOI: 10.1136/bmjopen-2017-018501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/13/2018] [Accepted: 02/23/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Many patients receiving medical treatment for anxiety relapse or do not improve. Research has therefore been turning to coping mechanisms as a way to decrease anxiety rates. Previously, we showed that living in a deprived area significantly increases the risk of anxiety in women, but not in men. The objective of this study is to assess whether sense of coherence (coping mechanism) buffers the influence of area deprivation on women's risk of generalised anxiety disorder using data from the European Prospective Investigation of Cancer-Norfolk. DESIGN Large, population study. SETTING UK population-based cohort. PARTICIPANTS 30 445 people over the age of 40 years were recruited through general practice registers in England. Of these, 20 919 completed a structured health and lifestyle questionnaire used to assess generalised anxiety disorder and sense of coherence. Area deprivation was measured using 1991 Census data, and sense of coherence and anxiety were examined in 1996-2000. 10 183 women had data on all variables. MAIN OUTCOME MEASURE Past-year generalised anxiety disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. RESULTS In this study, 2.6% (260/10 183) of women had generalised anxiety disorder. In those with a strong sense of coherence, area deprivation was not significantly associated with anxiety (OR 1.29, 95% CI 0.77 to 2.17). However, among women with a weak sense of coherence, those living in deprived areas were almost twice as likely to have generalised anxiety disorder compared with those living in more affluent areas (OR 1.99, 95% CI 1.37 to 2.91). CONCLUSION The number of women living in deprived conditions is large worldwide, and significant numbers are affected by generalised anxiety disorder. Sense of coherence moderates the association between area deprivation and anxiety in women; therefore, interventions targeting coping mechanisms may need to be considered for people with anxiety.
Collapse
Affiliation(s)
- Olivia Remes
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | - Paul Surtees
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Louise Lafortune
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| |
Collapse
|