1
|
Wootten JC, Rodrigues R, Gilliland J, Carter B, Shariff SZ, Zhong S, Archie S, Edwards J, Elton-Marshall T, Myran DT, Palaniyappan L, Perlman CM, Seabrook JA, Murray RM, Anderson KK. The effect of non-medical cannabis retailer proximity on use of mental health services for psychotic disorders in Ontario, Canada. Int J Soc Psychiatry 2024; 70:308-318. [PMID: 37886802 DOI: 10.1177/00207640231206053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis. METHODS We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14-60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use. RESULTS Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis. CONCLUSIONS Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.
Collapse
Affiliation(s)
- Jared C Wootten
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Jason Gilliland
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Pediatrics, Western University, London, ON, Canada
- Department of Geography and Environment, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
| | | | - Salimah Z Shariff
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- ICES Western, London, ON, Canada
- Department of Nursing, Western University, London, ON, Canada
| | - Shiran Zhong
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Tara Elton-Marshall
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, ON, Canada
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Daniel Thomas Myran
- Department of Family Medicine, University of Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, ON, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, PQ, Canada
| | | | - Jamie A Seabrook
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Pediatrics, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Robin M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
- ICES Western, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| |
Collapse
|
2
|
Aarestad SH, Harris A, Hjemdal O, Gjengedal RGH, Osnes K, Sandin K, Reme SE, Hannisdal M, Einarsen SV. Healing the wounds of workplace bullying: Evaluating mental health and workplace participation among victims seeking treatment for common mental disorders. Work 2022; 73:1379-1391. [PMID: 36093665 PMCID: PMC9837681 DOI: 10.3233/wor-210920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Victims of workplace bullying represent a group characterised by severe negative health complaints at risk of losing their foothold in working life. To date, very few studies have investigated the effect of psychological treatment of the health-related problems often facing victims of bullying. OBJECTIVE The aim was to investigate if victims of workplace bullying suffering from common mental disorders (CMD) benefit from clinical treatment for their mental health problems at an outpatient clinic treating patients using Metacognitive or Cognitive Behavioural Therapy with work-focus. Criteria were symptom reduction and change in workplace participation. Comparisons were made between the victims of workplace bullying with CMD, a wait-list control group consisting of patients who had also been exposed to bullying yet now awaiting treatment, and other patients not exposed to bullying. METHODS The sample comprised of 405 patients from an outpatient clinic in Norway. The study used a naturalistic observational design and data was collected pre-treatment and post-treatment. RESULTS The results showed the treatment to be effective in symptom reduction for victims of bullying to a similar degree as patients otherwise not exposed to bullying. Even more, victims receiving treatment had a larger improvement compared to the wait-list control group (p < 0.001). Yet, among patients on sick leave pre-treatment, fewer victims of bullying were fully working by the end of treatment compared to the patients not exposed to workplace bullying. CONCLUSION The findings provide ground for optimism for this treatment as an efficient way of dealing with the aftermath of workplace bullying.
Collapse
Affiliation(s)
- Sarah Helene Aarestad
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Address for correspondence: Sarah Helene Aarestad, Department of Psychosocial Science, University of Bergen, Bergen, Norway. E-mail:
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway,Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Kåre Osnes
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Kenneth Sandin
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Silje E. Reme
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Marit Hannisdal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | | |
Collapse
|
3
|
Examining the Relationship Between Mild Traumatic Brain Injuries and Development of Mental Illness Disorders in a Mid-Term Follow-up Period. Am J Phys Med Rehabil 2022; 101:1117-1121. [PMID: 35213394 DOI: 10.1097/phm.0000000000001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The sequalae of mild concussions continue to emerge with increased awareness in sports-related injuries. This study aimed to quantify the number of patients who are affected by a mental illness within 3 yrs of a concussion and identify whether demographic differences exist that may influence a mental illness diagnosis. DESIGN Using a nationwide database, data were queried for a diagnosis of concussion, capturing patients aged 18-45 yrs with no previous mental illness, and then identified if these patients were diagnosed with a mental illness within 3 yrs of their concussion. The mental illnesses specifically chosen for this study included depression, anxiety, panic disorder, posttraumatic stress disorder, bipolar, and schizophrenia. RESULTS Within 3 yrs after a concussion, 48% of patients were later diagnosed with a mental illness. All of the mental illnesses this study chose to evaluate were present in a higher proportion of patients after a concussion than the general population. CONCLUSIONS The mechanism between concussions and mental illness remains unclear. A large proportion of patients who experience a concussion are later diagnosed with a mental illness within 3 yrs. Patients with a history of a previous concussion may benefit from screening for the development of a mental illness.
Collapse
|
4
|
Tveit OG, Ruud T, Hanssen-Bauer K, Haavet OR, Hussain A. An explorative study of factors associated with treatment in specialized mental health care centers among GP patients in Norway. BMC Health Serv Res 2021; 21:960. [PMID: 34517868 PMCID: PMC8436443 DOI: 10.1186/s12913-021-06982-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Effectiveness and efficiency are part of the quality of care for mental health problems, and treatment should thus be performed at the right level of care. Norwegian guidelines specify which patients should be given priority for treatment in specialized mental health care (SMHC) centers, but there is a lack of agreement on which patients should actually receive SMHC. In this study we wanted to examine what factors (patient and GP characteristics) were related to GP patients who received treatment in SMHC centers. METHODS In this retrospective cohort study, we looked at 12 months of data from electronic health records from six GP and SMHC centers of hospitals in the catchment area. We included all patients who had been treated at any of the GP centers during the 12-month period (N=18032). We fit a generalized linear mixed model to explore which factors were related to patients receiving treatment in SMHC centers. Further exploration was performed to study the effects of gender and contact frequency. RESULTS We found that 4.6% of all GP patients and 18.4% of the GP patients with a mental health problems were treated in SMHC centers. There were more women than men among the GP-patients (56% vs 44%) and in SMHC centers (55% vs 45%), women with mental health problems were more severely ill than men. However, after adjusting for other factors men were more likely to be treated in SMHC centers (OR: 1.44). Patients with frequent GP contact were more likely to be treated in SMHC centers. The GP characteristics age, gender and specialization did not relate to patients receiving treatment in SMHC centers. CONCLUSIONS Men were more likely to be treated in SMHC centers than women, which may imply that they have different thresholds for entering SMHC centers. GP characteristics were not related to receiving treatment in SMHC centers. More specific knowledge is needed to determine whether men and women currently receive treatment at the lowest possible level of care.
Collapse
Affiliation(s)
- Ole Gunnar Tveit
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ole Rikard Haavet
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ajmal Hussain
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| |
Collapse
|
5
|
Xie X, Wang N, Chu J. Social experiences with mental health service use among US adolescents. J Ment Health 2021; 31:203-211. [PMID: 34008455 DOI: 10.1080/09638237.2021.1922652] [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: 10/21/2022]
Abstract
BACKGROUND Little is known about the associations of social experiences with mental health service use. AIM This study aimed to classify social experiences variables in the past year and examine the associations of selected variables in social experiences with mental health service use among US adolescents. METHODS A total of 13,038 adolescents (aged 12 to 17), of which 2208 received mental health services, were from the 2018 National Survey on Drug Use and Health. Multivariate logistic regression (MLR) analysis was conducted. RESULTS The overall prevalence of mental health service use was 16.1%. 44 variables on social experiences were grouped into 10 disjoint clusters and one variable from each cluster was selected for MLR analysis. Being female, African American, Hispanics, insured and having depression in the past year were associated with increased odds of mental health service use. Negative feelings about going to school, having a serious fight at school/work, active involvement in substance use help programs, knowledge of drug prevention, negative perceptions about the role of religious beliefs on life decisions were positively associated with mental health service use. CONCLUSION Mental health service use is associated with feelings about school and peers, perceptions about drug use, and involvement in activities.
Collapse
Affiliation(s)
- Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jun Chu
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
| |
Collapse
|
6
|
Kristoffersen AE, Quandt SA, Stub T. Use of complementary and alternative medicine in Norway: a cross-sectional survey with a modified Norwegian version of the international questionnaire to measure use of complementary and alternative medicine (I-CAM-QN). BMC Complement Med Ther 2021; 21:93. [PMID: 33726724 PMCID: PMC7962303 DOI: 10.1186/s12906-021-03258-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Background In recent decades complementary and alternative medicine (CAM) has been widely used worldwide as well as in Norway, where CAM is offered mainly outside the national health care service, mostly complementary to conventional treatment and fully paid for by the patients. With few exceptions, previous research has reported on frequency and associations of total CAM use in Norway rather than on single therapies and products. Therefore, in this present study we will map the use of CAM more precisely, including types of services, products, and self-help practices and further include reasons for use and helpfulness of the specific therapies used based on a modified Norwegian version of the I-CAM-Q (I-CAM-QN). Method Computer assisted telephone interviews using I-CAM-QN were conducted with 2001 randomly selected Norwegians aged 16 and above using multistage sampling in January 2019 with age and sex quotas for each area. Weights based on sex, age, education, and region corrected for selection biases, so that results are broadly representative of the Norwegian population. Descriptive statistics were carried out using Pearson’s Chi-square tests and t-tests to identify group differences. Result CAM use was reported by 62.2% of the participants during the prior12 months. Most participants had used natural remedies (47.4%), followed by self-help practices (29.1%) and therapies received from CAM providers (14.7%). Few of the participants had received CAM therapies from physicians (1.2%). Women were generally more likely to use CAM than men, younger people more likely than older, and participants with lower university education and income more likely than participants without university education, with higher university education and higher income. Mean number of visits per year to the different CAM providers ranged from 3.57 times to herbalists to 6.77 times to healers. Most of the participants found their use of CAM helpful. Conclusion This study confirms that CAM is used by a considerable segment of the Norwegian population. We suspect that the number of participants reporting CAM use is greater when specific therapies are listed in the questionnaire as a reminder (as in the I-CAM-QN) compared to more general questions about CAM use. The CAM modalities used are mainly received from CAM providers operating outside public health care or administered by the participants themselves. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03258-6.
Collapse
Affiliation(s)
- Agnete Egilsdatter Kristoffersen
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| | - Sara A Quandt
- Department of Epidemiology and Prevention Division of Public Health Sciences Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, Winston-Salem, North Carolina, 27157-1063, USA
| | - Trine Stub
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| |
Collapse
|
7
|
Rosato M, Tseliou F, O'Reilly D. Unmet need for chronic mental ill health: A population-based record linkage study. Int J Popul Data Sci 2019; 4:1122. [PMID: 34095538 PMCID: PMC8142951 DOI: 10.23889/ijpds.v4i1.1122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Many people with chronic mental ill health do not receive the treatment they require, though the true extent of the associated socio-demographic and socio-economic factors is unknown. Objectives This unique record linkage study quantifies the characteristics of those reporting chronic poor mental health and the likelihood of being in receipt of pharmacological treatment for those who report chronic mental ill health. Methods The Northern Ireland Longitudinal Study (NILS), a random 28% of the 2011 Census returns (aged 25-74), was linked to a population-wide electronic database of prescribed medications. All cohort attributes, including presence of chronic poor mental health were derived from the Census. Logistic regression was used to test the likelihood of people with poor mental health being prescribed psychotropic medication. These findings were compared against similarly derived characteristics of those with respiratory illness on treatment. Results Overall, 23,803 (8.3%) of the enumerated 286,717 reported poor mental health and, while 81.5% received pharmacological treatment, those of non-white background (OR=0.38: 95%CI=0.26-0.54), never married (OR=0.67: 95%CI=061-0.73), unemployed (OR=0.65: 95%CI=0.53-0.81) or living in a rural area (OR=0.88: 95%CI=0.79-0.98) were less likely than their respective peers to receive medication for poor mental health. Non-treatment of respiratory illness was less socially patterned. Conclusions Some but not all of the observed variation in receipt of psychotropic medicines may represent unmet need. Further studies are required to clarify the patterning of and possible reasons for underuse, including understanding of and attitudes towards healthcare services of groups who are identified as being less likely to receive treatment (for example ethnic minorities and unemployed). Highlights
Collapse
Affiliation(s)
- M Rosato
- Bamford Centre for Mental health and Wellbeing, Ulster University, BT48 7JL, Londonderry, Northern Ireland
| | - F Tseliou
- Centre for Public Health, Queen's University Belfast, BT12 6BA, Belfast, Northern Ireland
| | - D O'Reilly
- Centre for Public Health, Queen's University Belfast, BT12 6BA, Belfast, Northern Ireland
| |
Collapse
|
8
|
Kristoffersen AE, Broderstad AR, Musial F, Stub T. Prevalence, and health- and sociodemographic associations for visits to traditional and complementary medical providers in the seventh survey of the Tromsø study. Altern Ther Health Med 2019; 19:305. [PMID: 31711478 PMCID: PMC6849167 DOI: 10.1186/s12906-019-2707-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/03/2019] [Indexed: 02/06/2023]
Abstract
Background Patient-centered culturally sensitive health care (PC-CSHC) has emerged as a primary approach to health care. This care focuses on the cultural diversity of the patients rather than the views of the health care professionals. PC-CSHC enables the patient to feel comfortable, respected, and trusted in the health care delivery process. As users of traditional and complementary medicine (T&CM) rarely inform their conventional health care providers of such use, the providers need to identify the users of T&CM themselves to avoid negative interaction with conventional medicine and to be able to provide them with PC-CSHC. Since the patterns of traditional medicine (TM) use are different to those of complementary medicine (CM), the aim of this study was to investigate the prevalence, and the health- and sociodemographic associations for visits to TM- and CM providers in an urban population. Method The data were collected through two self-administrated questionnaires from the seventh survey of the Tromsø Study, a population-based cohort study conducted in 2015–2016. All inhabitants of Tromsø aged 40 or above were invited (n = 32,591) and n = 21,083 accepted the invitation (response rate 65%). Pearson chi-square tests and one-way ANOVA tests were used to describe differences between the groups whereas binary logistic regressions were used for adjusted values. Results The results revealed that 2.5% of the participants had seen a TM provider, 8.5% had seen a CM provider whereas 1% had visited both a TM and a CM provider during a 12-month period. TM users tended to be older, claim that religion was more important to them, have poorer economy and health, and have lower education compared to CM users. We found that more than 90% of the participants visiting T&CM providers also used conventional medicine. Conclusion A considerable number of the participants in this study employed parallel health care modalities including visits to conventional, traditional, and complementary medicine providers. To offer patient-centered culturally sensitive health care that is tailored to the patients’ treatment philosophy and spiritual needs, conventional health care providers need knowledge about, and respect for their patients’ use of parallel health care systems.
Collapse
|
9
|
Hansen AH, Claudi T, Årsand E. Use of Electronic Health and Its Impact on Doctor-Visiting Decisions Among People With Diabetes: Cross-Sectional Study. J Med Internet Res 2019; 21:e13678. [PMID: 31025957 PMCID: PMC6658259 DOI: 10.2196/13678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 01/28/2023] Open
Abstract
Background Despite the increasing prevalence of diabetes and increasing use of electronic health (eHealth) among people with diabetes, little is known about the association between the use of eHealth and the use of provider-based health services. Objective The objective of this study was to investigate whether the use of eHealth might change patients’ decisions regarding doctor-seeking behavior and whether information acquired from the internet was discussed with a doctor. Methods We used email survey data collected in 2018 from members of the Norwegian Diabetes Association (aged 18 to 89 years) diagnosed with diabetes. Using logistic regressions, we studied patients’ internet-triggered changes in decisions regarding doctor visits; whether they discussed information from the internet with a doctor; and whether these topics were associated with gender, age, education, self-rated health, and self-reported anxiety/depression. Results Among the 895 informants, 75.4% (645/856) had never made an internet-triggered change of decision in any direction regarding visiting a doctor, whereas 16.4% (41/859) had decided to visit and 17.3% (148/856) had decided not to visit. The probability of changing decisions decreased with higher age and increased with the severity of self-reported anxiety/depression. Around half of the study participants (448/858, 52.2%) had never discussed information from the internet with a doctor. The probability of discussing internet information with a doctor was higher for those in bad/very bad self-rated health (odds ratio 2.12, CI 1.15-3.90) and for those with moderate self-reported anxiety/depression (odds ratio 2.30, CI 1.30-4.10). Conclusions Our findings suggest that using eHealth has a significant impact on doctor-visiting decisions among people with diabetes, especially among people aged 18 to 39 years and among those reporting anxiety/depression. It is of great importance that the information posted is of high quality and that the large differences between internet-users regarding age as well as mental and somatic health status are taken into account. More research is needed to confirm and further explore the findings of this study.
Collapse
Affiliation(s)
- Anne Helen Hansen
- Centre for Quality Improvement and Development, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Tor Claudi
- Department of Medicine, Nordland Hospital, Bodø, Norway
| | - Eirik Årsand
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
10
|
Packness A, Halling A, Simonsen E, Waldorff FB, Hastrup LH. Are perceived barriers to accessing mental healthcare associated with socioeconomic position among individuals with symptoms of depression? Questionnaire-results from the Lolland-Falster Health Study, a rural Danish population study. BMJ Open 2019; 9:e023844. [PMID: 30878978 PMCID: PMC6429864 DOI: 10.1136/bmjopen-2018-023844] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To evaluate if perceived barriers to accessing mental healthcare (MHC) among individuals with symptoms of depression are associated with their socio-economic position (SEP). DESIGN Cross-sectional questionnaire-based population survey from the Lolland-Falster Health Study (LOFUS) 2016-17 of 5076 participants. PARTICIPANTS The study included 372 individuals, with positive scores for depression according to the Major Depression Inventory (MDI), participating in LOFUS . INTERVENTIONS A set of five questions on perceived barriers to accessing professional care for mental health problem was posed to individuals with symptoms of depression (MDI score >20). OUTCOMES The association between SEP (as measured by educational attainment, employment status and financial strain) and five different types of barriers to accessing MHC were analysed in separate multivariable logistic regression models adjusted for gender and age. RESULTS A total of 314 out of 372 (84%) completed the survey questions and reported experiencing barriers to MHC access. Worry about expenses related to seeking or continuing MHC was a considerable barrier for 30% of the individuals responding and, as such, the greatest problem among the five types of barriers. 22% perceived Stigma as a barrier to accessing MHC, but there was no association between perceived Stigma and SEP. Transportation was not only the barrier of least concern for individuals in general but also the issue with the greatest and most consistent socio-economic disparity (OR 2.99, 95% CI 1.19 to 7.52) for the lowest vs highest educational groups and, likewise, concerning Expenses (OR 2.77, 95% CI 1.34 to 5.76) for the same groups. CONCLUSION Issues associated with Expenses and Transport were more frequently perceived as barriers to accessing MHC for people in low SEP compared with people in high SEP. Stigma showed no association with SEP.Informed written consent was obtained. Region Zealand's Ethical Committee on Health Research (SJ-421) and the Danish Data Protection Agency (REG-24-2015) approved the study.
Collapse
Affiliation(s)
- Aake Packness
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry, Region Zealand, Slagelse, Denmark
| | - Anders Halling
- CRC, Lund University, Clinical sciences Malmo, Malmö, Sweden
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry, Region Zealand, Slagelse, Denmark
- Department of Clinical Midicine, University of Copenhagen, Copenhagen, Denmark
| | - Frans Boch Waldorff
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | |
Collapse
|
11
|
Lamb T, Pachana NA, Dissanayaka N. Update of Recent Literature on Remotely Delivered Psychotherapy Interventions for Anxiety and Depression. Telemed J E Health 2018; 25:671-677. [PMID: 30300082 DOI: 10.1089/tmj.2018.0079] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: Anxiety and depression are harmful to individuals suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated. This review examines the efficacy, practicality, and limitations of telephone, video, and online-administered psychotherapy for the treatment of anxiety and depression. Methods: A comprehensive literature search conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of psychotherapy for anxiety and depression. Results: Overall, interventions delivered through telephone, video, and online modalities demonstrated good efficacy in treating anxiety and depression in general, and when presenting comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective. However, there is less evidence for video-delivered psychotherapy for anxiety and depression compared with telephone-administered and online-administered modalities. Despite this, overall, the efficacy and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy. Conclusions: Further research evaluating the efficacy and practical benefits of video-delivered psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care.
Collapse
Affiliation(s)
- Timothy Lamb
- 1School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- 1School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nadeeka Dissanayaka
- 1School of Psychology, The University of Queensland, Brisbane, Australia.,2UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,3Department of Neurology, Royal Brisbane and Woman's Hospital, Brisbane, Australia
| |
Collapse
|
12
|
Packness A, Halling A, Hastrup LH, Simonsen E, Wehberg S, Waldorff FB. Socioeconomic position, symptoms of depression and subsequent mental healthcare treatment: a Danish register-based 6-month follow-up study on a population survey. BMJ Open 2018; 8:e020945. [PMID: 30287666 PMCID: PMC6194401 DOI: 10.1136/bmjopen-2017-020945] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Examine whether the severity of symptoms of depression was associated with the type of mental healthcare treatment (MHCT) received, independent of socioeconomic position (SEP). DESIGN Register-based 6-month follow-up study on participants from the Danish General Suburban Population Study (GESUS) 2010-2013, who scored the Major Depression Inventory (MDI). PARTICIPANTS Nineteen thousand and eleven respondents from GESUS. INTERVENTIONS The MHCT of the participants was tracked in national registers 4 months prior and 6 months after their MDI scores. MHCT was graduated in levels. SEP was defined by years of formal postsecondary education and income categorised into three levels. Data were analysed using logistic and Poisson regression analyses. OUTCOMES MHCT included number of contacts with: general practitioner (GP), GP mental health counselling, psychologist, psychiatrist, emergency contacts, admissions to psychiatric hospitals and prescriptions of antidepressants. RESULTS For 547 respondents with moderate to severe symptoms of depression there was no difference across SEP in use of services, contact (y/n), frequency of contact or level of treatment, except respondents with low SEP had more frequent contact with their GP. However, of the 547 respondents , 10% had no treatment contacts at all, and 47% had no treatment beyond GP consultation. Among respondents with no/few symptoms of depression, postsecondary education ≥3 years was associated with more contact with specialised services (adjusted OR (aOR) 1.92; 95% CI 1.18 to 3.13); however, this difference did not apply for income; additionally, high SEP was associated with fewer prescriptions of antidepressants (education aOR 0.69; CI 0.50 to 0.95; income aOR 0.56, CI 0.39 to 0.80) compared with low SEP. CONCLUSION Participants with symptoms of depression were treated according to the severity of their symptoms, independent of SEP; however, more than half with moderate to severe symptoms received no treatment beyond GP consultation. People in low SEP and no/few symptoms of depression were more often treated with antidepressants. The study was approved by The Danish Data Protection Agency Journal number 2015-41-3984. Accessible at: https://www.datatilsynet.dk/fortegnelsen/soeg-i-fortegnelsen/.
Collapse
Affiliation(s)
- Aake Packness
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
- Region Zealand, Psychiatry, Psychiatric Research Unit, Slagelse, Denmark
| | - Anders Halling
- Center for Primary Health Care Research, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Erik Simonsen
- Region Zealand, Psychiatry, Psychiatric Research Unit, Slagelse, Denmark
- Department of Clinical Medicine, Psychiatric Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Sonja Wehberg
- Department of Public Health and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Frans Boch Waldorff
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
13
|
Masillo A, Brandizzi M, Nelson B, Lo Cascio N, Saba R, Lindau JF, Telesforo L, Montanaro D, D'Alema M, Girardi P, McGorry P, Fiori Nastro P. Youth mental health services in Italy: An achievable dream? Early Interv Psychiatry 2018; 12:433-443. [PMID: 27061589 DOI: 10.1111/eip.12328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/15/2015] [Accepted: 02/08/2016] [Indexed: 11/30/2022]
Abstract
AIM "Liberiamo il futuro" (LIF) project was designed to assess psychological problems of adolescents and young adults and to identify individuals at high-risk for developing a psychosis through a collaboration between a University team, Child and Adolescent Mental Health Services and Adult Mental Health Services. This paper presents the baseline demographic and clinical characteristics of the cohort, particularly the nature and severity of psychopathology. METHOD All help-seeking young people aged 12-35 years residing in the health district involved in LIF were invited to participate in the study and completed a battery of self- report and interviewer-administered measures of psychopathology and functioning at baseline. RESULTS A total of 338 adolescents and young people (mean age 17.42) participated in the study. The majority of the sample (n = 107, 35%) had an anxiety disorder, followed by mood disorders (n = 62, 21%). Only 35 (12%) participants had no psychiatric diagnosis. After a screening phase, 166 (52%) individuals were assessed to detect the presence of an Ultra High Risk (UHR) state. Of these, 38.60% (n = 64) met UHR criteria. Overall, the majority of the sample resulted moderately functionally impaired at baseline. CONCLUSIONS LIF project showed that psychological problems, associated with impaired psychosocial functioning, are very common among help-seeking young people. The help-seeking behaviour of young people is in contrast with the barriers presented by the Italian community mental health system that is modelled around adults' requirements. A need of a strong, stigma-free, young oriented system of care for young people up to the mid-20s emerged.
Collapse
Affiliation(s)
- Alice Masillo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy
| | - Martina Brandizzi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Nella Lo Cascio
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy.,Department of Neurosciences and Neuro-rehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Riccardo Saba
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy
| | - Juliana Fortes Lindau
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - Ludovica Telesforo
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - Dori Montanaro
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - Marco D'Alema
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - Paolo Girardi
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Paolo Fiori Nastro
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy
| |
Collapse
|
14
|
Tseliou F, Donnelly M, O'Reilly D. Screening for psychiatric morbidity in the population - a comparison of the GHQ-12 and self-reported medication use. Int J Popul Data Sci 2018; 3:414. [PMID: 32934999 PMCID: PMC7299495 DOI: 10.23889/ijpds.v3i1.414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Uptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity. However, it is not known how this compares with estimates derived from population screening tools. Objective To compare estimates of psychiatric morbidity derived by a validated screening instrument of psychiatric morbidity and a self-reported medication uptake measure. Methods This study used data from two recent population-wide health surveys in Northern Ireland, a country (UK) with free health services and no prescription charges. The psychiatric morbidity of 7,489 respondents was assessed using the GHQ-12 and self-reported use of medication for stress, anxiety and depression (sDAS medication). Results Overall, 19% of respondents were defined as ‘cases’ and 14.3% were taking sDAS medication. Generally, the two methods identified the same population distributions of characteristics that were associated with psychiatric morbidity though nearly as many non-cases as cases received sDAS medication (46.4% vs. 53.6%). A greater proportion of women and older people were identified as cases according to sDAS medication use, while no such variation was observed between socio-economic status and method of assessment. Conclusions This study indicates that these two methods of assessing population psychiatric morbidity provide similar estimates, despite potentially identifying different individuals as cases. It is important to note that different health care systems might be linked to variations in obstacles when accessing and using health care services. Highlights
Collapse
|
15
|
Geyti C, Maindal HT, Dalsgaard EM, Christensen KS, Sandbæk A. Mental health assessment in health checks of participants aged 30-49 years: A large-scale cohort study. Prev Med Rep 2018; 9:72-79. [PMID: 29348995 PMCID: PMC5767564 DOI: 10.1016/j.pmedr.2017.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
Mental distress is an independent risk factor for illness related impairment. Awareness of mental health (MH) allows prevention, but early detection is not routinely performed in primary care. This cohort study incorporated MH assessment in a health promoting programme. We described the level of poor MH among health check participants, explored the potential for early intervention, and the potential for reducing social inequality in MH. The study was based on 9767 randomly selected citizens aged 30-49 years invited to a health check in Denmark in 2012-14. A total of 4871 (50%) were included; 49% were men. Poor MH was defined as a mental component summary score of ≤ 35.76 in the SF-12 Health Survey. Data was obtained from national health registers and health check. Participants with poor MH (9%) were more socioeconomic disadvantaged and had poorer health than those with better MH. Two thirds of men (64%) and half of women (50%) with poor MH had not received MH care one year before the health check. Among those with (presumably) unrecognized MH problems, the proportion of participants with disadvantaged socioeconomic characteristics was high (43-55%). Four out of five of those with apparently unacknowledged poor MH had seen their GP only once or not at all during the one year before the health check. In conclusion, MH assessment in health check may help identify yet undiscovered MH problems.
Collapse
Affiliation(s)
- Christine Geyti
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
- Corresponding author at: Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.Research Unit for General Practice & Section for General Medical PracticeDepartment of Public HealthAarhus UniversityBartholins Allé 2Aarhus CDK-8000Denmark
| | - Helle Terkildsen Maindal
- Section for Health Promotion and Health Services Research, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
- Steno Diabetes Centre Copenhagen, Health Promotion Research, Niels Steensens Vej 2, 2820 Gentofte, Denmark
| | - Else-Marie Dalsgaard
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Kaj Sparle Christensen
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Annelli Sandbæk
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| |
Collapse
|
16
|
Packness A, Waldorff FB, Christensen RD, Hastrup LH, Simonsen E, Vestergaard M, Halling A. Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1405-1413. [PMID: 28849245 PMCID: PMC5663810 DOI: 10.1007/s00127-017-1437-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/16/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. METHOD A nationwide register-based cohort study of 50,374 person-years. RESULTS Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact. CONCLUSION Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.
Collapse
Affiliation(s)
- Aake Packness
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark.
| | - Frans Boch Waldorff
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
| | - René dePont Christensen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
| | | | - Erik Simonsen
- Psychiatric Research Unit, Region of Zealand, Slagelse, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mogens Vestergaard
- Department of Public Health, Institute of General Medical Practice, Aarhus University, Aarhus, Denmark
| | - Anders Halling
- Centre for Primary Health Care Research, Lund University, Lund, Sweden
| |
Collapse
|
17
|
Axmon A, Sandberg M, Ahlström G. Gender differences in psychiatric diagnoses in older people with intellectual disability: a register study. BMC Psychiatry 2017; 17:192. [PMID: 28532510 PMCID: PMC5441013 DOI: 10.1186/s12888-017-1353-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gender differences regarding psychiatric ill-health are well known in the general population. However, not much research is done on people with intellectual disability, and especially not among older people with intellectual disability. METHODS People with intellectual disability aged 55+ years in 2012 in Sweden were identified through a register containing information on those receiving support and service for this type of disability. The cohort comprised 3609 women and 4327 men with mean age 65 and 64 years, respectively. Information on psychiatric diagnoses was collected from the National Patient Register for the period 2002-2012. Potential gender differences were evaluated both for diagnostic categories (e.g. affective disorders) and single diagnoses (e.g. depressive episodes). RESULTS The most common diagnoses among women were in the diagnostic category affective disorders, and among men in psychotic disorders. The majority of both women (72%) and men (71%) had diagnoses in only one diagnostic category. Women were more likely than men to have at least one diagnosis of dementia (odds ratio 1.40, 95% confidence interval 1.06-1.83) or affective disorders (1.33, 1.21-1.58) during the study period. They were, however, less likely to have at least one diagnosis of alcohol/substance use related disorder (0.59, 0.43-0.80). No gender differences were found for diagnoses of psychotic (1.04, 0.86-1.27) or anxiety disorders (1.15, 0.94-1.40). Regarding single diagnoses, women were more likely than men to have had at least one diagnosis of unspecified nonorganic psychosis (1.75, 1.23-2.50), depressive episode (1.47, 1.19-1.82), recurrent depressive disorder (1.53, 1.06-2.22), other anxiety disorder (1.34, 1.06-1.69), or dementia in Alzheimer disease (2.50, 1.40-4.49), but less likely to be diagnosed with psychiatric and behavioral disorders due to use of alcohol (0.41, 0.27-0.61). CONCLUSIONS As in the general population, there seem to be gender differences with respect to several types of psychiatric diagnoses among older people with intellectual disability. More research is needed to establish if this is due to gender differences in the occurrence of disease, inclination to seek care, health care utilization patterns, or ability to correctly identify disorders.
Collapse
Affiliation(s)
- Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, SE-221 00, Lund, Sweden. .,Department of Health Sciences, Lund University, SE-221 00, Lund, Sweden.
| | - Magnus Sandberg
- 0000 0001 0930 2361grid.4514.4Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden
| | - Gerd Ahlström
- 0000 0001 0930 2361grid.4514.4Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden
| |
Collapse
|
18
|
Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. Altern Ther Health Med 2016; 16:461. [PMID: 27835971 PMCID: PMC5106802 DOI: 10.1186/s12906-016-1446-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/03/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Depression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use of CAM providers, and the use of CAM providers and psychiatric outpatient services in combination, among people with self-reported anxiety and/or depression. METHODS We used questionnaire data from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (conducted in 2007-8). Eligible for analyses in our study were 1685 participants who reported suffering from anxiety and/or depression. By descriptive statistical methods, we estimated the use of CAM providers, psychiatric outpatient services, and the combination of these. By logistic regressions we studied the association between the use of these services and gender, age, income, education, and self-reported degree of anxiety/depression. RESULTS During the previous year, 17.8 % of people with anxiety/depression visited a CAM provider once or more, 11.8 % visited psychiatric outpatient services, and 2.5 % visited both. Men with anxiety/depression were less likely to visit CAM providers compared to women (odds ratio [OR] 0.40, confidence interval [CI] 0.30-0.55), whereas higher educated people were more likely to visit compared to the lowest educated (OR 1.47, CI 1.02-2.13). The use of CAM providers was not associated with the degree of anxiety/depression. For those who used both CAM providers and psychiatric specialist services during the previous year, severe anxiety/depression was strongly associated with use compared to moderate disease (OR 7.53, CI 2.75-20.65). CONCLUSIONS People with severe anxiety/depression seem to use CAM providers and psychiatric services additionally, whereas those with moderate disease seem to use these services more as alternative pathways. CAM provider treatment might be a substitute for conventional care, particularly in patients with moderate disease.
Collapse
|