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Ul Husnain MI, Hajizadeh M, Ahmad H, Khanam R. The Hidden Toll of Psychological Distress in Australian Adults and Its Impact on Health-Related Quality of Life Measured as Health State Utilities. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:583-598. [PMID: 38530626 PMCID: PMC11178635 DOI: 10.1007/s40258-024-00879-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Psychological distress (PD) is a major health problem that affects all aspects of health-related quality of life including physical, mental and social health, leading to a substantial human and economic burden. Studies have revealed a concerning rise in the prevalence of PD and various mental health conditions among Australians, particularly in female individuals. There is a scarcity of studies that estimate health state utilities (HSUs), which reflect the overall health-related quality of life in individuals with PD. No such studies have been conducted in Australia thus far. OBJECTIVE We aimed to evaluate the age-specific, sex-specific and PD category-specific HSUs (disutilities) in Australian adults with PD to inform healthcare decision making in the management of PD. METHODS Data on age, sex, SF-36/SF6D responses, Kessler psychological distress (K10) scale scores and other characteristics of N = 15,139 participants (n = 8149 female individuals) aged >15 years were derived from the latest wave (21) of the nationally representative Household, Income and Labor Dynamics in Australia survey. Participants were grouped into the severity categories of no (K10 score: 10-19), mild (K10: 20-24), moderate (K10: 25-29) and severe PD (K10: 30-50). Both crude and adjusted HSUs were calculated from participants' SF-36 profiles, considering potential confounders such as smoking, marital status, remoteness, education and income levels. The calculations were based on the SF-6D algorithm and aligned with Australian population norms. Additionally, the HSUs were stratified by age, sex and PD categories. Disutilities of PD, representing the mean difference between HSUs of people with PD and those without, were also calculated for each group. RESULTS The average age of individuals was 46.130 years (46% male), and 31% experienced PD in the last 4 weeks. Overall, individuals with PD had significantly lower mean HSUs than those likely to be no PD, 0.637 (95% confidence interval [CI] 0.636, 0.640) vs 0.776 (95% CI 0.775, 0.777) i.e. disutility: -0.139 [95% CI -0.139, -0.138]). Mean disutilities of -0.108 (95% CI -0.110, -0.104), -0.140 (95% CI -0.142, -0.138), and -0.188 (95% CI -0.190, -0.187) were observed for mild PD, moderate PD and severe PD, respectively. Disutilities of PD also differed by age and sex groups. For instance, female individuals had up to 0.049 points lower mean HSUs than male individuals across the three classifications of PD. There was a clear decline in health-related quality of life with increasing age, demonstrated by lower mean HSUs in older population age groups, that ranged from 0.818 (95% CI 0.817, 0.818) for the 15-24 years age group with no PD to 0.496 (95% CI 0.491, 0.500) for the 65+ years age group with severe PD). Across all ages and genders, respondents were more likely to report issues in certain dimensions, notably vitality, and these responses did not uniformly align with ageing. CONCLUSIONS The burden of PD in Australia is substantial, with a significant impact on female individuals and older individuals. Implementing age-specific and sex-specific healthcare interventions to address PD among Australian adults may greatly alleviate this burden. The PD state-specific HSUs calculated in our study can serve as valuable inputs for future health economic evaluations of PD in Australia and similar populations.
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Affiliation(s)
| | | | | | - Rasheda Khanam
- University of Southern Queensland, Toowomba, QLD, Australia
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Kvestad CA, Holte IR, Reitan SK, Chiappa CS, Helle GK, Skjervold AE, Rosenlund AMA, Watne Ø, Brattland H, Helle J, Follestad T, Hara KW, Holgersen KH. Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial. Trials 2024; 25:179. [PMID: 38468321 DOI: 10.1186/s13063-024-08028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/01/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Referrals to specialised mental health care (such as community mental health centres; CMHC) have increased over the last two decades. Patients often have multifaceted problems, which cannot only be solved by such care. Resources are limited, and triaging is challenging. A novel method which approaches patients early and individually upon referral to a CMHC-possibly with a brief intervention-is an Early assessment Team (EaT). In an EaT, two therapists meet the patient early in the process and seek to solve the present problem, often involving community services, primary health care, etc.; attention is paid to symptoms and functional strife, rather than diagnoses. This is in contrast to treatment as usual (TAU), where the patient (after being on a waiting list) meets one therapist, who focuses on history and situation to assign a diagnosis and eventually start a longitudinal treatment. The aim of this study is to describe and compare EaT and TAU regarding such outcomes as work and social adjustment, mental health, quality of life, use of health services, and patient satisfaction. The primary outcome is a change in perceived function from baseline to 12-month follow-up, measured by the Work and Social Adjustment Scale. METHOD Patients (18 years and above; n = 588) referred to outpatient health care at a CMHC are randomised to EaT or TAU. Measures (patient self-reports and clinician reports, patients' records, and register data) are collected at baseline, after the first and last meeting, and at 2, 4, 8, 12, and 24 months after inclusion. Some participants will be invited to participate in qualitative interviews. TRIAL DESIGN The study is a single-centre, non-blinded, RCT with two conditions involving a longitudinal and mixed design (quantitative and qualitative data). DISCUSSION This study will examine an intervention designed to determine early on which patients will benefit from parallel or other measures than assessment and treatment in CMHC and whether these will facilitate their recovery. Findings may potentially contribute to the development of the organisation of mental health services. TRIAL REGISTRATION ClinicalTrials.gov NCT05087446. Registered on 21 October 2021.
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Affiliation(s)
- Camilla Angelsen Kvestad
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Ingvild Rønneberg Holte
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Solveig Klæbo Reitan
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Charlotte S Chiappa
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Gunn Karin Helle
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne E Skjervold
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne Marit A Rosenlund
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øyvind Watne
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Heidi Brattland
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Helle
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Turid Follestad
- Clinical Research Unit Central Norway, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Norwegian Labour and Welfare Administration Trøndelag, Trondheim, Norway
| | - Katrine Høyer Holgersen
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Deady M, Collins DAJ, Lavender I, Mackinnon A, Glozier N, Bryant R, Christensen H, Harvey SB. Selective Prevention of Depression in Workers Using a Smartphone App: Randomized Controlled Trial. J Med Internet Res 2023; 25:e45963. [PMID: 37616040 PMCID: PMC10485707 DOI: 10.2196/45963] [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] [Received: 01/25/2023] [Revised: 06/27/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND There is increasing evidence that depression can be prevented; however, universal approaches have had limited success. Appropriate targeting of interventions to at-risk populations has been shown to have potential, but how to selectively determine at-risk individuals remains unclear. Workplace stress is a risk factor for depression and a target for intervention, but few interventions exist to prevent depression among workers at risk due to heightened stress. OBJECTIVE This trial aimed to evaluate the efficacy of a smartphone-based intervention in reducing the onset of depression and improving related outcomes in workers experiencing at least moderate levels of stress. METHODS A randomized controlled trial was conducted with participants who were currently employed and reported no clinically significant depression and at least moderate stress. The intervention group (n=1053) were assigned Anchored, a 30-day self-directed smartphone app-based cognitive behavioral- and mindfulness-based intervention. The attention-control group (n=1031) were assigned a psychoeducation website. Assessment was performed via web-based self-report questionnaires at baseline and at 1-, 3-, and 6-month postbaseline time points. The primary outcome was new depression caseness aggregated over the follow-up period. The secondary outcomes included depressive and anxiety symptoms, stress, well-being, resilience, work performance, work-related burnout, and quality of life. Analyses were conducted within an intention-to-treat framework using mixed modeling. RESULTS There was no significant between-group difference in new depression caseness (z score=0.69; P=.49); however, those in the Anchored arm had significantly greater depressive symptom reduction at 1 month (Cohen d=0.02; P=.049) and 6 months (Cohen d=0.08; P=.03). Anchored participants also showed significantly greater reduction in anxiety symptoms at 1 month (Cohen d=0.07; P=.04) and increased work performance at 1 month (Cohen d=0.07; P=.008) and 6 months (Cohen d=0.13; P=.01), compared with controls. Notably, for Anchored participants completing at least two-thirds of the intervention, there was a significantly lower rate of depression onset (1.1%, 95% CI 0.0%-3.7%) compared with controls (9.0%, 95% CI 6.8%-12.3%) at 1 month (z score=4.50; P<.001). Significant small to medium effect sizes for most secondary outcomes were seen in the highly engaged Anchored users compared with controls, with effects maintained at the 6-month follow-up for depressive symptoms, well-being, stress, and quality of life. CONCLUSIONS Anchored was associated with a small comparative reduction in depressive symptoms compared with controls, although selective prevention of case-level depression was not observed in the intention-to-treat analysis. When users adequately engaged with the app, significant findings pertaining to depression prevention, overall symptom reduction, and functional improvement were found, compared with controls. There is a need for a greater focus on engagement techniques in future research. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000178943; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378592.
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Affiliation(s)
- Mark Deady
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Daniel A J Collins
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Isobel Lavender
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Andrew Mackinnon
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Samuel B Harvey
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
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Strudwick J, Gayed A, Deady M, Haffar S, Mobbs S, Malik A, Akhtar A, Braund T, Bryant RA, Harvey SB. Workplace mental health screening: a systematic review and meta-analysis. Occup Environ Med 2023; 80:469-484. [PMID: 37321849 PMCID: PMC10423530 DOI: 10.1136/oemed-2022-108608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/30/2023] [Indexed: 06/17/2023]
Abstract
Workplaces are an important location for population mental health interventions. Screening to detect employees at risk of or experiencing mental ill health is increasingly common. This systematic review and meta-analysis examined the efficacy of workplace mental health screening programmes on employee mental health, work outcomes, user satisfaction, positive mental health, quality of life, help-seeking and adverse effects. PubMed, PsycINFO, EMBASE, CENTRAL, Global Index Medicus, Global Health and SciELO were searched (database inception-10 November 2022) and results screened by two independent reviewers. Controlled trials evaluating screening of workers' mental health as related to their employment were included. Random effects meta-analysis was performed to calculate pooled effect sizes for each outcome of interest. Grading of Recommendations Assessment, Development and Evaluation was conducted to evaluate the certainty of findings. Of the 12 328 records screened, 11 were included. These reported 8 independent trials collectively assessing 2940 employees. Results indicated screening followed by advice or referral was ineffective in improving employee mental health symptoms (n=3; d=-0.07 (95% CI -0.29 to 0.15)). Screening followed by facilitated access to treatment interventions demonstrated a small improvement in mental health (n=4; d=-0.22 (95% CI -0.42 to -0.02)). Limited effects were observed for other outcomes. Certainty ranged from low to very low. The evidence supporting workplace mental health screening programmes is limited and available data suggest mental health screening alone does not improve worker mental health. Substantial variation in the implementation of screening was observed. Further research disentangling the independent effect of screening alongside the efficacy of other interventions to prevent mental ill health at work is required.
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Affiliation(s)
- Jessica Strudwick
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Sam Haffar
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Sophia Mobbs
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Aiysha Malik
- Department of Mental Health and Substance Use, World Health Organization, Geneve, Switzerland
| | - Aemal Akhtar
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Taylor Braund
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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Bryant E, Koemel N, Martenstyn J, Marks P, Hickie I, Maguire S. Mortality and mental health funding-do the dollars add up? Eating disorder research funding in Australia from 2009 to 2021: a portfolio analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100786. [PMID: 37693868 PMCID: PMC10485676 DOI: 10.1016/j.lanwpc.2023.100786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/01/2023] [Accepted: 04/25/2023] [Indexed: 09/12/2023]
Abstract
Background Eating Disorders (EDs) are among the deadliest of the mental disorders and carry a sizeable public health burden, however their research and treatment is consistently underfunded, contributing to protracted illness and ongoing paucity of treatment innovation. Methods We compare absolute levels and growth rates of Australian mental health research funding by illness group for the years 2009-2021, with a specific focus on eating disorders analysed at the portfolio level. Findings Actual and adjusted data obtained from Australia's three national medical research funding bodies (NHMRC, ARC and MRFF) shows eating disorders receive a disproportionately low allocation of mental health research funding despite having amongst the highest mortality rates. Forty-one category one research grants totalling $AUD28.1 million were funded for eating disorders over the period. When adjusted for inflation, this equates to $2.05 per affected individual, compared with $19.56 for depression, $32.11 for autism, and $176.19 for schizophrenia. Half of all research funded for eating disorders was 'basic' research (e.g., illness underpinning), with little investment in the development of innovative treatment models, novel therapeutics or translation, well reflected by recovery rates of less than 50% in individuals with Anorexia Nervosa. Interpretation Significant discrepancy remains between research funding dollars and disease burden associated with the mental health disorders. The extent to which eating disorders are underfunded may in part be attributable to inaccuracies in epidemiological and burden of disease data. Funding This work was in-part funded by the Australian Government Department of Health and the National Eating Disorder Research & Translation Strategy. The funder was not directly involved in informing the development of the current study.
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Affiliation(s)
- E. Bryant
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - N. Koemel
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - J.A. Martenstyn
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
- School of Psychology, Faculty of Science, University of Sydney, Australia
| | - P. Marks
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - I. Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - S. Maguire
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
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Bartholomaeus JD, Collier LR, Lang C, Cations M, Kellie AR, Inacio MC, Caughey GE. Trends in mental health service utilisation by Australia's older population. Australas J Ageing 2023; 42:159-164. [PMID: 35912507 PMCID: PMC10947389 DOI: 10.1111/ajag.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the incidence, trends, and differences between age groups and sex in Medicare Benefits Schedule (MBS)-subsidised mental health service utilisation by older Australians over the past 10 years. METHODS A cross-sectional cohort study between 1 July 2009 and 30 June 2019 was conducted using publicly available MBS data for older individuals aged ≥65 years. Age- and sex-standardised yearly incidence rates of psychological therapy (MBS M06), GP mental health treatments (MBS A20), focussed psychological strategy (MBS M07), and psychiatric attendances (MBS A08) and incidence rate ratios (IRR) estimated using Poisson regression were calculated. RESULTS Overall, the rate of utilisation of primary care mental health services by the older population increased over the study period, with psychological therapy claims increasing the greatest from 14.4/1000 older persons in 2009/10 to 38.5/1000 in 2018/19 (IRR 1.11, 95% CI 1.09-1.13), followed by GP mental health treatments increasing from 43.7/1000 (95% CI 43.4-43.9) in 2009/10 to 81.0/1000 (95% CI 80.7-81.3) in 2018/19 (IRR 1.07/year, 95% CI 1.06-1.09). Females aged 65-74 years had the highest use of GP mental health treatments at 123.8/1000 compared to 63.6/1000 in males in 2018/2019. CONCLUSIONS While utilisation of mental health services by the older population in Australia has increased over the study period, it is important that policymakers and service providers continue to support access and use of these services, which may facilitate well-being and quality of life in the older population.
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Affiliation(s)
- Jonathan D. Bartholomaeus
- The Registry of Senior Australians (ROSA)South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- School of PsychologyUniversity of AdelaideSouth AustraliaAustralia
| | - Luke R. Collier
- The Registry of Senior Australians (ROSA)South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| | - Catherine Lang
- The Registry of Senior Australians (ROSA)South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| | - Monica Cations
- College of Education, Psychology and Social WorkFlinders UniversityBedford ParkSouth AustraliaAustralia
| | | | - Maria C. Inacio
- The Registry of Senior Australians (ROSA)South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- UniSA Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Gillian E. Caughey
- The Registry of Senior Australians (ROSA)South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- UniSA Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
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Weaver B, Kirk-Brown A, Goodwin D, Oxley J. Psychosocial safety behavior: A scoping review of behavior-based approaches to workplace psychosocial safety. JOURNAL OF SAFETY RESEARCH 2023; 84:33-40. [PMID: 36868661 DOI: 10.1016/j.jsr.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/13/2022] [Accepted: 10/17/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In an era of workplace safety where psychosocial risks are widely recognized as occupational hazards, emerging research has sought to clarify the impact of these risks and the requisite interventions for improving psychosocial safety climate and reducing psychological injury risk. METHOD The construct of psychosocial safety behavior (PSB) provides a novel framework for emerging research that seeks to apply a behavior-based safety approach to workplace psychosocial risks across several high-risk industries. This scoping review aims to provide a synthesis of existing literature on PSB, including its development as a construct and application in workplace safety interventions to date. RESULTS Although a limited number of studies of PSB were identified, the findings of this review provide evidence for growing cross-sector applications of behaviorally-focused approaches to improving workplace psychosocial safety. In addition, the identification of a broad spectrum of terminology surrounding the construct of PSB provides evidence of key theoretical and empirical gaps, with implications for future intervention-based research to address emerging areas of focus.
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Affiliation(s)
- Bodhi Weaver
- Monash Sustainable Development Institute, Australia.
| | | | | | - Jennie Oxley
- Monash University Accident and Research Centre (MUARC), Australia
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Crawford J, Spence J, Lovegrove T, Tam E, Collins D, Harvey SB, Deady M. Pilot Trial of Workable: A Therapist-Supported Digital Program for Injured Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2460. [PMID: 36767833 PMCID: PMC9916348 DOI: 10.3390/ijerph20032460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Workplace sickness absence is a major public health and economic problem, and common mental disorders (CMDs) such as anxiety and depression are associated with particularly high rates of long-term sickness absence. Effective return-to-work (RTW) interventions are required. This pilot study investigates the feasibility, acceptability, and potential effectiveness of a new therapist-assisted Web-based RTW intervention (Workable) for injured workers on sick leave for a psychological or physical injury. A single-group open pilot trial design was used, with assessments at pre-treatment and post-treatment. The intervention consisted of 6 weeks of online modules and 6 coaching calls from a psychologist. A total of 13 participants were recruited and 9 completed all questionnaires. Program adherence was high, with 92% of participants completing the 6-week intervention. Participants reported high levels of intervention satisfaction and ease of use. There were large and significant reductions between pre- and post-treatment on measures of depression, anxiety, stress, and workdays missed over the past four weeks, along with a significant increase in self-reported work ability. These results suggest that Workable is a feasible and acceptable intervention for injured workers, with the potential to improve mental health and RTW outcomes. A randomized controlled trial is required to determine the efficacy of the intervention.
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Affiliation(s)
- Joanna Crawford
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Jay Spence
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | | | - Edman Tam
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | - Daniel Collins
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Samuel B. Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
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Chen WH, Hsieh MH, Liao SC, Liu CC, Liu CM, Wu CS, Lin YT, Hwang TJ, Chien YL. A quarter of century after: The changing ecology of psychiatric emergency services. Asia Pac Psychiatry 2022; 14:e12487. [PMID: 34510765 DOI: 10.1111/appy.12487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Previous studies demonstrated a trend of increasing common mental disorders among the Emergency Department (ED) visitors in Western countries. Little is known about the current conditions of the emergency psychiatric services in Asian countries. This study aims to survey the current epidemiology and the changing ecology of emergency psychiatry services in Taiwan. METHODS A total of 804 psychiatry consultations were initiated at the ED during the 1-year period from July 1, 2014 to June 30, 2015 in a medical center in northern Taiwan. Clinical data of gender, age, chief complaints, tentative diagnoses, dispositions, and ED staying hours were compared to a previous report in the same hospital in 1988. RESULTS Psychiatry consultation was initiated in 0.72% of all ED visits (804/111,923). Among these visits, females were 1.73 times of the males. The most common chief complaints were psychosis/mania (33.5%) and suicide/self-harm (33.2%), followed by homicide/violence (12.8%) and anxiety/depression (10.3%). Top tentative diagnoses were schizophrenia spectrum and other psychotic disorders (31.3%), trauma- and stressor-related disorders (17.5%), bipolar disorders (15.9%), and depressive disorders (14.2%). Compared to 1988, there are three major changes: (1) over-representation of female patients, (2) an increase of "neurosis" patients, and (3) an increase of suicide/self-harm as chief problem. DISCUSSION This study portrays the current epidemiology and changing ecology of psychiatric emergency in Taiwan. The increase of neurotic and suicide/self-harm patients requires more services and clinical training in managing common mental disorders and suicide in the ED.
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Affiliation(s)
- Wen-Hao Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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10
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Schofield D, Zeppel MJB, Tanton R, Veerman JL, Kelly SJ, Passey ME, Shrestha RN. Individual and national financial impacts of informal caring for people with mental illness in Australia, projected to 2030. BJPsych Open 2022; 8:e136. [PMID: 35848155 PMCID: PMC9345331 DOI: 10.1192/bjo.2022.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental illness has a significant impact not only on patients, but also on their carers' capacity to work. AIMS To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. METHOD The output data of a microsimulation model Care&WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care&WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. RESULTS The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. CONCLUSIONS The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.
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Affiliation(s)
- Deborah Schofield
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Melanie J B Zeppel
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Robert Tanton
- National Centre for Social and Economic Modelling, University of Canberra, Australian Capital Territory, Australia
| | | | - Simon J Kelly
- National Centre for Social and Economic Modelling, University of Canberra, Australian Capital Territory, Australia
| | - Megan E Passey
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Rupendra N Shrestha
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
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11
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Fassnacht DB, Ali K, van Agteren J, Iasiello M, Mavrangelos T, Furber G, Kyrios M. A Group-Facilitated, Internet-Based Intervention to Promote Mental Health and Well-Being in a Vulnerable Population of University Students: Randomized Controlled Trial of the Be Well Plan Program. JMIR Ment Health 2022; 9:e37292. [PMID: 35471196 PMCID: PMC9084447 DOI: 10.2196/37292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/15/2022] [Accepted: 03/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A growing literature supports the use of internet-based interventions to improve mental health outcomes. However, most programs target specific symptoms or participant groups and are not tailored to facilitate improvements in mental health and well-being or do not allow for needs and preferences of individual participants. The Be Well Plan, a 5-week group-facilitated, internet-based mental health and well-being group intervention addresses these gaps, allowing participants to select a range of activities that they can tailor to their specific characteristics, needs, and preferences. OBJECTIVE This study aims to test whether the Be Well Plan program was effective in improving primary outcomes of mental well-being, resilience, anxiety, and depression compared to a waitlist control group during the COVID-19 pandemic; secondary outcomes included self-efficacy, a sense of control, and cognitive flexibility. The study further seeks to examine participants' engagement and satisfaction with the program. METHODS A randomized controlled trial (RCT) was conducted with 2 parallel arms, an intervention and a waitlist control group. The intervention involved 5 weekly 2-hour sessions, which were facilitated in group format using Zoom videoconferencing software. University students were recruited via social media posts, lectures, emails, flyers, and posters. RESULTS Using an intentional randomization 2:1 allocation strategy, we recruited 215 participants to the trial (n=126, 58.6%, intervention group; n=89, 41.4%, waitlist control group). Of the 126 participants assigned to the intervention group, 75 (59.5%) commenced the program and were included in modified intention-to-treat (mITT) analyses. mITT intervention participants attended, on average, 3.41 sessions (SD 1.56, median 4); 55 (73.3%) attended at least 4 sessions, and 25 (33.3%) attended all 5 sessions. Of the 49 intervention group participants who completed the postintervention assessment, 47 (95.9%) were either very satisfied (n=31, 66%) or satisfied (n=16, 34%). The mITT analysis for well-being (F1,162=9.65, P=.002, Cohen d=0.48) and resilience (F1,162=7.85, P=.006, Cohen d=0.44) showed significant time × group interaction effects, suggesting that both groups improved over time, but the Be Well Plan (intervention) group showed significantly greater improvement compared to the waitlist control group. A similar pattern of results was observed for depression and anxiety (Cohen d=0.32 and 0.37, respectively), as well as the secondary outcomes (self-efficacy, Cohen d=0.50; sense of control, Cohen d=0.42; cognitive flexibility, Cohen d=0.65). Larger effect sizes were observed in the completer analyses. Reliable change analysis showed that the majority of mITT participants (58/75, 77.3%) demonstrated a significant reliable improvement in at least 1 of the primary outcomes. CONCLUSIONS The Be Well Plan program was effective in improving mental health and well-being, including mental well-being, resilience, depression, and anxiety. Participant satisfaction scores and attendance indicated a high degree of engagement and satisfaction with the program. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12621000180819; https://tinyurl.com/2p8da5sk.
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Affiliation(s)
- Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.,Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia.,Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.,Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia.,Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Joep van Agteren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.,Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia.,Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia.,College of Nursing and Health Science, Flinders University, Adelaide, Australia
| | - Teri Mavrangelos
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Gareth Furber
- Health, Counselling & Disability Services, Flinders University, Adelaide, Australia
| | - Michael Kyrios
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.,Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
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12
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Zainal NH, Newman MG. Life Satisfaction Prevents Decline in Working Memory, Spatial Cognition, and Processing Speed: Latent Change Score Analyses Across 23 Years. Eur Psychiatry 2022; 65:1-55. [PMID: 35437134 PMCID: PMC9121850 DOI: 10.1192/j.eurpsy.2022.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/01/2022] Open
Abstract
Background Within-person growth in life satisfaction (LS) can protect against declines in cognitive functioning, and, conversely, over time. However, most studies have been cross-sectional, thereby precluding causal inferences. Thus, we used bivariate dual latent change score modeling to test within-person change-to-future change relations between LS and cognition. Method Community adults completed in-person tests of verbal working memory (WM), processing speed, spatial cognition, and an LS self-report. Five waves of assessment occurred across 23 years. Results Reduction in LS predicted future decreases in spatial cognition, processing speed, and verbal WM (|d | = 0.150–0.354). Additionally, depletion in processing speed and verbal WM predicted a future decrease in LS (d = 0.142–0.269). However, change in spatial cognition did not predict change in LS (|d | = 0.085). Discussion LS and verbal WM and processing speed predicted one another across long durations. Evidence-based therapies can be augmented to target LS and cognition.
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Affiliation(s)
- Nur Hani Zainal
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
- National University of Singapore, Singapore
| | - Michelle G. Newman
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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13
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Crisan C, Van Dijk PA, Oxley J, De Silva A. Worker and manager perceptions of the utility of work-related mental health literacy programmes delivered by community organisations: a qualitative study based on the theory of planned behaviour. BMJ Open 2022; 12:e056472. [PMID: 35351719 PMCID: PMC8961141 DOI: 10.1136/bmjopen-2021-056472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Reluctance to seek help is a leading contributor to escalating mental injury rates in Australian workplaces. We explored the benefit of using community organisations to deliver mental health literacy programmes to overcome workplace barriers to help-seeking behaviours. DESIGN This study used a qualitative application of the theory of planned behaviour to examine underlying beliefs that may influence worker's intentions to participate in mental health literacy programmes delivered by community organisations and manager support for them. SETTING This study took place within three large white-collar organisations in the Australian state of Victoria. PARTICIPANTS Eighteen workers and 11 managers (n=29) were interviewed to explore perspectives of the benefits of such an approach. RESULTS Community organisations have six attributes that make them suitable as an alternative mental health literacy programme provider including empathy, safety, relatability, trustworthiness, social support and inclusivity. Behavioural beliefs included accessibility, understanding and objectivity. The lack of suitability and legitimacy due to poor governance and leadership was disadvantages. Normative beliefs were that family and friends would most likely approve, while line managers and colleagues were viewed as most likely to disapprove. Control beliefs indicated that endorsements from relevant bodies were facilitators of participation. Distance/time constraints and the lack of skills, training and lived experiences of coordinators/facilitators were seen as barriers. CONCLUSIONS Identifying workers' beliefs and perceptions of community organisations has significant implication for the development of effective community-based strategies to improve worker mental health literacy and help seeking. Organisations with formal governance structures, allied with government, peak bodies and work-related mental health organisations would be most suitable. Approaches should focus on lived experience and be delivered by qualified facilitators. Promoting supervisor and colleague support could improve participation. Models to guide cross-sector collaborations to equip community organisations to deliver work-related mental health literacy programmes need to be explored.
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Affiliation(s)
- Corina Crisan
- Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Victoria, Australia
| | | | - Jennie Oxley
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Andrea De Silva
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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14
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Alotaibi MS, Fox M, Coman R, Ratan ZA, Hosseinzadeh H. Smartphone Addiction Prevalence and Its Association on Academic Performance, Physical Health, and Mental Well-Being among University Students in Umm Al-Qura University (UQU), Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063710. [PMID: 35329397 PMCID: PMC8954621 DOI: 10.3390/ijerph19063710] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 12/24/2022]
Abstract
Smartphone use can lead to smartphone addiction, which is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This study aims to fill this gap. This is a quantitative study conducted among undergraduate students in Umm Al-Qura University (UQU), Saudi Arabia from May 2019 and February 2021. Study data were collected using both online and hard copy administered surveys. A self-administered questionnaire, Grade point average, Smartphone Addiction Short Version, and Kessler Psychological Distress scales were used to assess the outcomes. A total of 545 undergraduate students, mostly females, aged ≤21 years old and lived with large family sizes. More than half owned a smartphone for 5–8 years and the majority used their smartphone on average 6–11 h per day for social networking (82.6%), entertainment (66.2%) and web surfing (59.6%). Most of the participants were smartphone-addicted (67.0%). Logistic regression analysis showed that age ≤ 21, not gainfully employed, small family size and high family income were the main significant socio-demographic predictors of smartphone addiction. Smartphone-addicted participants were more likely to: have lower academic performance (GPA); be physically inactive; have poor sleep; be overweight/obese; have pain in their shoulder (39.2%), eyes (62.2%) and neck (67.7%) and have a serious mental illness (30.7%). This finding has significant implications for decision makers and suggests that smartphone education focusing on the physical and mental health consequences of smartphone addiction among university students can be beneficial.
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Affiliation(s)
- Mohammad Saud Alotaibi
- Department of Social Work, College of Social Sciences, Umm Al-Qura University, Mecca 24382, Saudi Arabia;
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia; (M.F.); (R.C.); (Z.A.R.)
| | - Mim Fox
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia; (M.F.); (R.C.); (Z.A.R.)
| | - Robyn Coman
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia; (M.F.); (R.C.); (Z.A.R.)
| | - Zubair Ahmed Ratan
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia; (M.F.); (R.C.); (Z.A.R.)
- Department of Biomedical Engineering, Khulna University of Engineering and Technology, Khulna 9203, Bangladesh
| | - Hassan Hosseinzadeh
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia; (M.F.); (R.C.); (Z.A.R.)
- Correspondence:
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15
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Iranpour S, Sabour S, Koohi F, Saadati HM. The trend and pattern of depression prevalence in the U.S.: Data from National Health and Nutrition Examination Survey (NHANES) 2005 to 2016. J Affect Disord 2022; 298:508-515. [PMID: 34785265 DOI: 10.1016/j.jad.2021.11.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND To assess the trend and pattern of depression prevalence among adult population by demographic characteristics and severity of disease from 2005 to 2016. METHODS We used six cycles of National Health and Nutrition Examination Survey. The Patient Health Questionnaire (PHQ-9) was used to measure of depression with the total score ranges 0-27. Socio-demographic variables including age, gender, marital status, race, education, and poverty income ratio (PIR) were used. The weighted prevalence was calculated for each cycle. Logistic regression was used for assessing time-trends in the prevalence of depression. RESULTS A total of 31,191 participants aged>20 years were included. The intensity of prevalence trend was different among subgroups of demographic characteristics. Prevalence in females was 1.5-fold more than that in males and increased approximately 2-fold during the study period. The prevalence in "never married" and "other marital status" subgroups was almost 1.5-fold and 2-fold more than that in "married" subgroup, respectively. Prevalence in the never married subgroup increased 2-fold from the first cycle to the latest one. The prevalence of depression was more in the aged<60 years, race group other than white, low education and PIR≤1 subgroups. But, the intensity of the increasing trend was more in the subgroups of aged≥60 years, white race and PIR>1. LIMITATIONS the possibility of age-period-cohort (APC) effect that we were unable to assess and control them. CONCLUSIONS In sum, there was an overall increasing trend of depression which was different by demographic characteristics based on subtype of depression.
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Affiliation(s)
- Sohrab Iranpour
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Koohi
- Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Mozafar Saadati
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak, Daneshjoo Blvd, Tehran, Iran.
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16
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Enticott J, Dawadi S, Shawyer F, Inder B, Fossey E, Teede H, Rosenberg S, Ozols Am I, Meadows G. Mental Health in Australia: Psychological Distress Reported in Six Consecutive Cross-Sectional National Surveys From 2001 to 2018. Front Psychiatry 2022; 13:815904. [PMID: 35432016 PMCID: PMC9010616 DOI: 10.3389/fpsyt.2022.815904] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To examine Australian psychological distress trends from 2001 to 2017/18, including analysis by age, sex, location, and household income. METHODS Secondary analysis of the working age population (18-64 years) in six successive representative national health surveys. Measures were prevalence of psychological distress at very-high symptom level (defined by a Kessler Psychological Distress Scale (K10) score of 30 or more) and combined high/very-high level (K10 score of 22 or more). Very-high K10 scores are associated with mental health problems meeting diagnostic thresholds in past year. RESULTS From 2001 to 2017/18 Australian rates of K10 very-high distress rose significantly from 3.8 to 5.1% and combined high/very-high from 13.2 to 14.8%. In women aged 55-64, very-high distress rose significantly and substantially from 3.5 to 7.2% and high/very-high distress from 12.4 to 18.7%. In men aged 25-34, very-high distress increased from 2.1 to 4.0% and high/very-high from 10.6 to 11.5%. Income was strongly and inversely associated with distress (lowest vs. highest quintile adjusted OR 11.4). An apparent association of increased distress with regional location disappeared with adjustment for income. CONCLUSION Australia's population level of psychological distress increased significantly from 2001-2017/18, with levels highest in women and with rates inversely associated with income. This is likely to be indicative of increased community rates of mental disorders. Given that this has occurred whilst mental healthcare expenditure has increased, there is an urgent need to reconsider how best to respond to mental illness, including targeting the most vulnerable based on social determinants such as age, gender, and lower incomes.
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Affiliation(s)
- Joanne Enticott
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Shrinkhala Dawadi
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Brett Inder
- Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, Monash University Peninsula Campus, Melbourne, VIC, Australia.,School of Primary and Allied Health Care, Monash University, Victoria, VIC, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Sebastian Rosenberg
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Ingrid Ozols Am
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Mental Health at Work, Melbourne, VIC, Australia
| | - Graham Meadows
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia.,School of Primary and Allied Health Care, Monash University, Victoria, VIC, Australia.,Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Monash Health, Dandenong, VIC, Australia
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17
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Workplace Mental Health Awareness Training: A Cluster Randomized Controlled Trial. J Occup Environ Med 2021; 63:311-316. [PMID: 33350660 DOI: 10.1097/jom.0000000000002121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the efficacy of a workplace mental health awareness training program on help-seeking and mental health outcomes. METHODS A cluster randomized controlled trial was conducted comparing those who received standard training (N = 210) or standard training with a mental health awareness module (N = 208). Both groups were followed up for 3 years with the primary outcome being likelihood to seek help. RESULTS Rates of likely help-seeking were slightly higher in the intervention group 6 months after the training, but this was not maintained over time. There was no significant difference between study conditions for mental health outcomes or actual help-seeking among those with probable mental disorder at any time point. CONCLUSIONS Workplace mental health awareness training has a limited short-term impact on likelihood of help-seeking and does not appear to improve mental health outcomes.
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18
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Shakespeare M, Fisher M, Mackean T, Wilson R. Theories of Indigenous and non-Indigenous wellbeing in Australian health policies. Health Promot Int 2021; 36:669-679. [PMID: 32968777 DOI: 10.1093/heapro/daaa097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Governments in Australia and internationally show growing interest in wellbeing as a policy goal; however, such interests raise questions about the theories or definitions of wellbeing they will apply. Choices about how wellbeing is defined for policy purposes are likely to delimit the strategies applied. Wholly individualized conceptualizations of wellbeing may lead to policy focused narrowly on 'improving' individuals rather than on creating favourable social conditions. Also, Indigenous theories of wellbeing may have much to offer policy for public wellbeing, but little research has examined whether this potential is considered in contemporary health policy. We report on research examining Indigenous and non-Indigenous theories of wellbeing in a representative sample of current Australian health policy documents. We examine what theories or definitions of wellbeing are present, whether policies recognize social determinants of health; if 'lifestyle drift' is present; how Indigenous and non-Indigenous theories of wellbeing are positioned; and whether policies propose strategies consistent with their definitions of wellbeing. We discuss implications of current approaches for effective policy to promote Indigenous and non-Indigenous wellbeing.
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Affiliation(s)
- Madison Shakespeare
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Matthew Fisher
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Tamara Mackean
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia 5001, Australia.,The George Institute for Global Health, Sydney, NSW 2000, Australia
| | - Roland Wilson
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia 5001, Australia
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19
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Czeisler MÉ, Wiley JF, Facer-Childs ER, Robbins R, Weaver MD, Barger LK, Czeisler CA, Howard ME, Rajaratnam SMW. Mental health, substance use, and suicidal ideation during a prolonged COVID-19-related lockdown in a region with low SARS-CoV-2 prevalence. J Psychiatr Res 2021; 140:533-544. [PMID: 34174556 PMCID: PMC8177437 DOI: 10.1016/j.jpsychires.2021.05.080] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health consequences due to direct (i.e., SARS-CoV-2 infection, potentially due to neuronal or astrocytic infection, microvascular, or inflammatory mechanisms) and indirect (i.e., social and economic impacts of COVID-19 prevention measures) effects. Investigation of mental health in a region with one of the longest lockdowns and lowest COVID-19 prevalence globally (Victoria, Australia) allowed for evaluation of mental health in the absence of substantial direct pandemic mental health consequences. Surveys were administered during 15-24 September 2020 to Victorian residents aged ≥18 years for The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Responses were compared cross-sectionally with April-2020 data, and longitudinally among respondents who completed both surveys. Multivariable Poisson regressions were used to estimate prevalence ratios for adverse mental health symptoms, substance use, and suicidal ideation adjusted for demographics, sleep, and behaviours (e.g., screen-time, outdoor-time). In September-2020, among 1157 Victorians, one-third reported anxiety or depressive disorder symptoms, one-fifth reported suicidal ideation, and one-tenth reported having seriously considered suicide in the prior 30 days. Young adults, unpaid caregivers, people with disabilities, and people with diagnosed psychiatric or sleep conditions showed increased prevalence of adverse mental health symptoms. Prevalence estimates of symptoms of burnout, anxiety, and depressive disorder were unchanged between April-2020 and September-2020. Persistently common experiences of adverse mental health symptoms despite low SARS-CoV-2 prevalence during prolonged lockdown highlight the urgent need for mental health support services.
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Affiliation(s)
- Mark É Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States.
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Elise R Facer-Childs
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Matthew D Weaver
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Laura K Barger
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Charles A Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Mark E Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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20
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Jun D, Johnston V, McPhail SM, O'Leary S. A Longitudinal Evaluation of Risk Factors and Interactions for the Development of Nonspecific Neck Pain in Office Workers in Two Cultures. HUMAN FACTORS 2021; 63:663-683. [PMID: 32119582 DOI: 10.1177/0018720820904231] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify risk factors for the development of interfering neck pain in office workers including an examination of the interaction effects between potential risk factors. BACKGROUND The 1-year incidence of neck pain in office workers is reported as the highest of all occupations. Identifying risk factors for the development of neck pain in office workers is therefore a priority to direct prevention strategies. METHODS Participants included 214 office workers without neck pain from two cultures. A battery of measures evaluating potential individual and workplace risk factors were administered at baseline, and the incidence of interfering neck pain assessed monthly for 12 months. Survival analysis was used to identify relationships between risk factors and the development of interfering neck pain. RESULTS One-year incidence was 1.93 (95% CI [1.41, 2.64]) per 100 person months. Factors increasing the risk of developing interfering neck pain were older age, female gender, increased sitting hours, higher job strain, and stress. A neutral thorax sitting posture, greater cervical range of motion and muscle endurance, and higher physical activity were associated with a decreased risk of neck pain. The effects of some risk factors on the development of neck pain were moderated by the workers' coping resources. CONCLUSION Multiple risk factors and interactions may explain the development of neck pain in office workers. Therefore, plans for preventing the development of interfering neck pain in office workers should consider multiple individual and work-related factors with some factors being potentially more modifiable than others.
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Affiliation(s)
- Deokhoon Jun
- 1974 The University of Queensland, Brisbane, Australia
| | | | - Steven M McPhail
- 1969 Queensland University of Technology, Brisbane, Australia
- Metro South Health, Brisbane, Australia
| | - Shaun O'Leary
- 1974 The University of Queensland, Brisbane, Australia
- Royal Brisbane and Women's Hospital, Australia
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21
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Occhipinti JA, Skinner A, Carter S, Heath J, Lawson K, McGill K, McClure R, Hickie IB. Federal and state cooperation necessary but not sufficient for effective regional mental health systems: insights from systems modelling and simulation. Sci Rep 2021; 11:11209. [PMID: 34045644 PMCID: PMC8160145 DOI: 10.1038/s41598-021-90762-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/17/2021] [Indexed: 11/09/2022] Open
Abstract
For more than a decade, suicide rates in Australia have shown no improvement despite significant investment in reforms to support regionally driven initiatives. Further recommended reforms by the Productivity Commission call for Federal and State and Territory Government funding for mental health to be pooled and new Regional Commissioning Authorities established to take responsibility for efficient and effective allocation of ‘taxpayer money.’ This study explores the sufficiency of this recommendation in preventing ongoing policy resistance. A system dynamics model of pathways between psychological distress, the mental health care system, suicidal behaviour and their drivers was developed, tested, and validated for a large, geographically diverse region of New South Wales; the Hunter New England and Central Coast Primary Health Network (PHN). Multi-objective optimisation was used to explore potential discordance in the best-performing programs and initiatives (simulated from 2021 to 2031) across mental health outcomes between the two state-governed Local Health Districts (LHDs) and the federally governed PHN. Impacts on suicide deaths, mental health-related emergency department presentations, and service disengagement were explored. A combination of family psychoeducation, post-attempt aftercare, and safety planning, and social connectedness programs minimises the number of suicides across the PHN and in the Hunter New England LHD (13.5% reduction; 95% interval, 12.3–14.9%), and performs well in the Central Coast LHD (14.8% reduction, 13.5–16.3%), suggesting that aligned strategic decision making between the PHN and LHDs would deliver substantial impacts on suicide. Results also highlighted a marked trade-off between minimising suicide deaths versus minimising service disengagement. This is explained in part by the additional demand placed on services of intensive suicide prevention programs leading to increases in service disengagement as wait times for specialist community based mental health services and dissatisfaction with quality of care increases. Competing priorities between the PHN and LHDs (each seeking to optimise the different outcomes they are responsible for) can undermine the optimal impact of investments for suicide prevention. Systems modelling provides essential regional decision analysis infrastructure to facilitate coordinated federal and state investments for optimal impacts.
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Affiliation(s)
- Jo-An Occhipinti
- Systems Modelling, Simulation, and Data Science, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallet Street, Camperdown, NSW, Australia. .,Computer Simulation & Advanced Research Technologies (CSART), Sydney, Australia. .,Menzies Centre for Health Policy, University of Sydney, Sydney, Australia. .,Translational Health Research Institute, Western Sydney University, Penrith, Australia.
| | - Adam Skinner
- Systems Modelling, Simulation, and Data Science, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallet Street, Camperdown, NSW, Australia
| | - Samantha Carter
- Hunter New England & Central Coast Primary Health Network, Newcastle, Australia
| | - Jacinta Heath
- Everymind, Hunter New England Local Health District, Newcastle, Australia
| | - Kenny Lawson
- Systems Modelling, Simulation, and Data Science, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallet Street, Camperdown, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Katherine McGill
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, Australia.,MH-READ, Hunter New England Local Health District, Newcastle, Australia
| | - Rod McClure
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Ian B Hickie
- Systems Modelling, Simulation, and Data Science, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallet Street, Camperdown, NSW, Australia
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22
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Merson F, Newby J, Shires A, Millard M, Mahoney A. The temporal stability of the Kessler Psychological Distress Scale. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1893603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Francis Merson
- Graduate School of Health, University of Technology, Ultimo, Australia
| | - Jill Newby
- School of Psychology, University of New South Wales, Sydney, Australia
- Prince of Wales Hospital, Black Dog Institute, Randwick, Australia
| | - Alice Shires
- Graduate School of Health, University of Technology, Ultimo, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital and School of Psychiatry, University of New South Wales, Darlinghurst, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital and School of Psychiatry, University of New South Wales, Darlinghurst, Australia
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23
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Hashmi R, Alam K, Gow J, March S. Prevalence of Mental Disorders by Socioeconomic Status in Australia: A Cross-Sectional Epidemiological Study. Am J Health Promot 2020; 35:533-542. [PMID: 33111532 DOI: 10.1177/0890117120968656] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To present the prevalence of 3 broad categories of mental disorder (anxiety-related, affective and other disorders) by socioeconomic status and examine the associated socioeconomic risk factors of mental disorders in Australia. DESIGN A population-based, cross-sectional national health survey on mental health and its risk factors across Australia. SETTING National Health Survey (NHS), 2017-2018 conducted by the Australian Bureau of Statistics (ABS). PARTICIPANTS Under aged: 4,945 persons, Adult: 16,370 persons and total: 21,315 persons. MEASURES Patient-reported mental disorder outcomes. ANALYSIS Weighted prevalence rates by socioeconomic status (equivalised household income, education qualifications, Socio-Economic Index for Areas (SEIFA) scores, labor force status and industry sector where the adult respondent had their main job) were estimated using cross-tabulation. Logistic regression utilizing subsamples of underage and adult age groups were analyzed to test the association between socioeconomic status and mental disorders. RESULTS Anxiety-related disorders were the most common type of disorders with a weighted prevalence rate of 20.04% (95% CI: 18.49-21.69) for the poorest, 13.85% (95% CI: 12.48-15.35) for the richest and 16.34% (95% CI: 15.7-17) overall. The weighted prevalence rate for mood/affective disorders were 20.19% (95% CI: 18.63-21.84) for the poorest, 9.96% (95% CI: 8.79-11.27) for the richest, and 13.57% (95% CI: 12.99-14.17) overall. Other mental disorders prevalence were for the poorest: 9.07% (95% CI: 7.91-10.39), the richest: 3.83% (95% CI: 3.14-4.66), and overall: 5.93% (95% CI: 5.53-6.36). These patterns are also reflected if all mental disorders were aggregated with the poorest: 30.97% (95% CI: 29.15-32.86), the richest: 19.59% (95% CI: 18.02-21.26), and overall: 23.93% (95% CI: 23.19-24.69). The underage logistic regression model showed significant lower odds for the middle (AOR: 0.75, 95% CI: 0.53 -1.04, p < 0.1), rich (AOR: 0.71, 95% CI: 0.5-0.99, p < 0.05) and richest (AOR: 0.6, 95% CI: 0.41-0.89, p < 0.01) income groups. Similarly, in the adult logistic model, there were significant lower odds for middle (AOR: 0.84, 95% CI: 0.72-0.98, p < 0.05), rich (AOR: 0.73, 95% CI: 0.62-0.86, p < 0.01) and richest (AOR: 0.76, 95% CI: 0.63-0.91, p < 0.01) income groups. CONCLUSION The prevalence of mental disorders in Australia varied significantly across socioeconomic groups. Knowledge of different mental health needs in different socioeconomic groups can assist in framing evidence-based health promotion and improve the targeting of health resource allocation strategies.
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Affiliation(s)
- Rubayyat Hashmi
- School of Commerce, Faculty of Business, Education, Law & Arts, 7932University of Southern Queensland, Toowoomba, Australia.,Centre for Health Research, 7932University of Southern Queensland, QLD, Australia
| | - Khorshed Alam
- School of Commerce, Faculty of Business, Education, Law & Arts, 7932University of Southern Queensland, Toowoomba, Australia.,Centre for Health Research, 7932University of Southern Queensland, QLD, Australia
| | - Jeff Gow
- School of Commerce, Faculty of Business, Education, Law & Arts, 7932University of Southern Queensland, Toowoomba, Australia.,Centre for Health Research, 7932University of Southern Queensland, QLD, Australia.,School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
| | - Sonja March
- Centre for Health Research, 7932University of Southern Queensland, QLD, Australia.,School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, 7932University of Southern Queensland, Springfield, Australia
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24
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A Cluster Randomized Controlled Trial to Evaluate HeadCoach: An Online Mental Health Training Program for Workplace Managers. J Occup Environ Med 2020; 61:545-551. [PMID: 31045851 DOI: 10.1097/jom.0000000000001597] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mental ill-health is now the leading cause of sickness absence and occupational incapacity in high-income countries. This study evaluated HeadCoach online manager training, designed to improve confidence, and managerial behaviors that create mentally healthy workplaces. METHODS A cluster randomized controlled trial was conducted comparing managers who received HeadCoach (N = 87) to waitlist control (N = 123). Managers' confidence and behavior were investigated at baseline, postintervention, and follow-up. Psychological distress of direct reports was evaluated. RESULTS Confidence significantly increased postintervention only; however, per-protocol analyses indicated a significant improvement for program completers compared with control at both time points. Responsive and preventive behaviors significantly improved. Psychological distress of direct reports remained unchanged. CONCLUSIONS HeadCoach online mental health training is an effective and scalable way to improve managers' confidence and workplace practices around mental health. The impact on direct reports remains unknown.
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25
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Stratton E, Player MJ, Dahlheimer A, Choi I, Glozier N. Prevalence and association of discrimination and bullying and the impact on mental health in an occupational setting. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2020. [DOI: 10.1108/ijwhm-02-2020-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeDiscrimination and bullying contribute to mental ill-health in the workplace. At face value, they would seem linked but are often dealt with by different legislations. Workplace studies generally focus on bullying and population studies on discrimination. The authors aimed to evaluate the prevalence and relationship of discrimination and bullying in a male-dominated workforce, associated factors and relative impact on mental ill-health.Design/methodology/approachAn online cohort survey was conducted amongst employees of an Australian mining company, measuring discrimination, bullying, demographics and workplace and health factors over two months. Cross-sectional and prospective analyses assessed the prevalence of each, their association and their effects on depression and anxiety.FindingsA total of 580 employees (82% male) participated. There was no association between workplace bullying (n = 56, 9.7%) and discrimination (n = 160, 27.6%). Discrimination, but not bullying, was associated with higher depression, anxiety and suicidal ideation and lower well-being and resilience. After controlling for demographic, workplace and health and well-being factors, depression had the main effect on discrimination ß = 0.39, p = 0.003. Discrimination predicted an increase in depression scores at follow-up F (1, 129) = 4.88, p = 0.029.Originality/valueIn this male-dominated industry, discrimination was more prevalent than bullying. Discrimination, but not bullying, was associated with poorer mental health both cross sectionally and prospectively. Supporting the need to assess and manage discrimination and bullying in the workplace independently and the need for interventions to reduce a broader range of adverse interpersonal behaviours.
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26
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Steffen A, Thom J, Jacobi F, Holstiege J, Bätzing J. Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data. J Affect Disord 2020; 271:239-247. [PMID: 32479322 DOI: 10.1016/j.jad.2020.03.082] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/21/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies based on health insurance funds unanimously indicate a rise in administrative prevalence of depression, while population surveys with standardized diagnostic procedures do not. We describe recent trends in the prevalence of depressive disorders as diagnosed in routine care from 2009-2017 in Germany. METHODS We used nationwide ambulatory claims data from all residents with statutory health insurance, covering 87% of the total population. Cases were defined as persons with at least one documented diagnosis of depression (ICD-10-GM codes: F32, F33 or F34.1). The administrative prevalence was computed for each year according to age, sex, degree of urbanization and severity of depression diagnosis. RESULTS The prevalence increased from 12.5% in 2009 to 15.7% in 2017 (+26%). Overall, women were twice as likely as men to receive a diagnosis, although the prevalence increased more strongly in men compared to women (+40% vs. +20%). Age- and sex-stratified analyses revealed the highest prevalence increase in adolescents and young men at the ages of 15-19 years (+95%) and 20-25 years (+72%). Rural areas with a low population density showed the highest rise in administrative prevalence (+34%), while big urban municipalities showed the lowest (+25%). LIMITATIONS Administrative claims data rely on diagnoses coded for billing purposes and thus depend on coding practice as well as patients' help seeking behavior. CONCLUSIONS Depressive disorders are of increasing importance in ambulatory health care in Germany. Parts of the increase may be attributed to changing cultural constructions of mental health along with the expansion of mental health care supply.
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Affiliation(s)
- Annika Steffen
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi).
| | - Julia Thom
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Jakob Holstiege
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi)
| | - Jörg Bätzing
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi)
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27
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Kafula MN, Ugburo E, Kibuule D. Consumption of psychotropic medicines at a referral hospital in Namibia: findings and implications. Afr Health Sci 2020; 20:1000-1010. [PMID: 33163069 PMCID: PMC7609123 DOI: 10.4314/ahs.v20i2.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
SETTING In Namibia, the burden of mental illnesses is estimated at 25.6% and is expected to double by 2025. Few studies in sub-Saharan Africa estimate the consumption rates of psychotropic medicines as a proxy of irrational use. AIM The consumption rate of psychotropic medicines at a referral hospital was determined. METHODS A hospital-based retrospective medicine utilization analysis of Facility Electronic Stock Card (FESC) psychotropic medication was conducted at Intermediate Hospital Katutura over a 7 year period, 2011-2017. Data on consumption and expenditure on psychotropic medicines were abstracted from FESC and analysed using descriptive statistics in SPSS v22. The main outcomes were consumption rates, daily Defined Dose, (DDD) and/or expenditure. RESULTS Of the 580 351,4 DDD of psychotropic medicines consumed, 84% were anti-psychotics, 9.2% anti-depressants and 6.8% anxiolytics. Anti-psychotics (48.8%) and anxiolytics (47.9%) had the highest consumption by cost relative to anti-depressants (3.3%). The most consumed antidepressants were imipramine (62%) by DDD and fluoxetine (55.8%) by cost. The most consumed anti-psychotics were chlorpromazine (74.6%) by DDD and haloperidol (68.4%) by cost respectively. Diazepam (79.4%) and hydroxyzine (94.2%) were most consumed sedative-hypnotics by DDD and cost respectively. CONCLUSION The consumption of new psychotropics contributes to higher costs. There is need for cost-effectiveness analysis of new versus conventional psychotropics to optimize treatment, outcomes and costs.
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Affiliation(s)
- Maria N Kafula
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek Namibia
| | - Emmanuel Ugburo
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek Namibia
| | - Dan Kibuule
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek Namibia
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28
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Abstract
The scientific study of compassion is burgeoning, however the putative neurophysiological markers of programs which actively train distress tolerance, such as Compassionate Mind Training (CMT), are less well known. Herein we offer an integrative, multi-method approach which investigated CMT at neural, physiological, self-report, and behavioural levels. Specifically, this study first assessed participants' neural responses when confronted with disappointments (e.g., rejection, failure) using two fundamental self-regulatory styles, self-criticism and self-reassurance. Second, participant's heart-rate variability (HRV) - a marker of parasympathetic nervous system response - was assessed during compassion training, pre- and post- a two-week self-directed engagement period. We identified neural networks associated with threat are reduced when practicing compassion, and heightened when being self-critical. In addition, cultivating compassion was associated with increased parasympathetic response as measured by an increase in HRV, versus the resting-state. Critically, cultivating compassion was able to shift a subset of clinically-at risk participants to one of increased parasympathetic response. Further, those who began the trial with lower resting HRV also engaged more in the intervention, possibly as they derived more benefits, both self-report and physiologically, from engagement in compassion.
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29
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Kosic A, Lindholm P, Järvholm K, Hedman-Lagerlöf E, Axelsson E. Three decades of increase in health anxiety: Systematic review and meta-analysis of birth cohort changes in university student samples from 1985 to 2017. J Anxiety Disord 2020; 71:102208. [PMID: 32172210 DOI: 10.1016/j.janxdis.2020.102208] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 01/20/2023]
Abstract
Health anxiety can be defined as a multifaceted trait that is primarily characterised by a fear of, or preoccupation with, serious illness. Whereas low levels of health anxiety can be helpful, clinically significant levels are associated with personal suffering and substantial societal costs. As general anxiety is probably on the rise, and the Internet has increased access to health-related information, it is commonly speculated that health anxiety has increased over the past decades. We tested this hypothesis based on a systematic review and meta-analysis of birth cohort mean health anxiety in Western university student samples from 1985 to 2017. Sixty-eight studies with 22 413 student participants were included. The primary analysis indicated that the mean score on the Illness Attitudes Scales had increased by 4.61 points (95 % CI: 1.02, 8.20) from 1985 to 2017. The percentage of general population Internet users in the study year of data collection was not predictive of student mean health anxiety. In conclusion, this study corroborates the hypothesis of an increase in health anxiety, at least in the student population, over the past decades. However, this increase could not be linked to the introduction of the Internet.
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Affiliation(s)
- Amanda Kosic
- Department of Psychology, Lund University, Lund, Sweden
| | - Peo Lindholm
- Department of Psychology, Lund University, Lund, Sweden
| | | | - Erik Hedman-Lagerlöf
- Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erland Axelsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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30
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Bowden N, Gibb S, Thabrew H, Kokaua J, Audas R, Merry S, Taylor B, Hetrick SE. Case identification of mental health and related problems in children and young people using the New Zealand Integrated Data Infrastructure. BMC Med Inform Decis Mak 2020; 20:42. [PMID: 32106861 PMCID: PMC7045433 DOI: 10.1186/s12911-020-1057-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background In a novel endeavour we aimed to develop a clinically relevant case identification method for use in research about the mental health of children and young people in New Zealand using the Integrated Data Infrastructure (IDI). The IDI is a linked individual-level database containing New Zealand government and survey microdata. Methods We drew on diagnostic and pharmaceutical information contained within five secondary care service use and medication dispensing datasets to identify probable cases of mental health and related problems. A systematic classification and refinement of codes, including restrictions by age, was undertaken to assign cases into 13 different mental health problem categories. This process was carried out by a panel of eight specialists covering a diverse range of mental health disciplines (a clinical psychologist, four child and adolescent psychiatrists and three academic researchers in child and adolescent mental health). The case identification method was applied to the New Zealand youth estimated resident population for the 2014/15 fiscal year. Results Over 82,000 unique individuals aged 0–24 with at least one specified mental health or related problem were identified using the case identification method for the 2014/15 fiscal year. The most prevalent mental health problem subgroups were emotional problems (31,266 individuals), substance problems (16,314), and disruptive behaviours (13,758). Overall, the pharmaceutical collection was the largest source of case identification data (59,862). Conclusion This study demonstrates the value of utilising IDI data for mental health research. Although the method is yet to be fully validated, it moves beyond incidence rates based on single data sources, and provides directions for future use, including further linkage of data to the IDI.
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Affiliation(s)
- Nicholas Bowden
- A Better Start National Science Challenge, Auckland, New Zealand. .,Department of Women's and Children's Health, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand.
| | - Sheree Gibb
- A Better Start National Science Challenge, Auckland, New Zealand.,Department of Public Health, University of Otago Wellington, 23 Mein St, Newtown, Wellington, 6021, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, Auckland, New Zealand.,Department of Psychological Medicine, University of Auckland, 22-30 Park Ave Grafton, Auckland, 1023, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, Auckland, New Zealand.,Centre for Pacific Health, Va'a O Tautai, Health Sciences Division, University of Otago, 71 Frederick St, Dunedin, 9016, New Zealand
| | - Richard Audas
- A Better Start National Science Challenge, Auckland, New Zealand.,Department of Women's and Children's Health, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand
| | - Sally Merry
- A Better Start National Science Challenge, Auckland, New Zealand.,Department of Psychological Medicine, University of Auckland, 22-30 Park Ave Grafton, Auckland, 1023, New Zealand
| | - Barry Taylor
- A Better Start National Science Challenge, Auckland, New Zealand.,Dean of the Otago Medical School, University of Otago, 290 Great King St, Dunedin, 9016, New Zealand
| | - Sarah E Hetrick
- A Better Start National Science Challenge, Auckland, New Zealand.,Department of Psychological Medicine, University of Auckland, 22-30 Park Ave Grafton, Auckland, 1023, New Zealand
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31
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Butterworth P, Watson N, Wooden M. Trends in the Prevalence of Psychological Distress Over Time: Comparing Results From Longitudinal and Repeated Cross-Sectional Surveys. Front Psychiatry 2020; 11:595696. [PMID: 33324261 PMCID: PMC7725766 DOI: 10.3389/fpsyt.2020.595696] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background: While there is discussion of increasing rates of mental disorders, epidemiological research finds little evidence of change over time. This research generally compares cross-sectional surveys conducted at different times. Declining response rates to representative surveys may mask increases in mental disorders and psychological distress. Methods: Analysis of data from two large nationally representative surveys: repeated cross-sectional data from the Australian National Health Survey (NHS) series (2001-2017), and longitudinal data (2007-2017) from the Household, Income and Labor Dynamics in Australia (HILDA) Survey. Data from each source was used to generate weighted national estimates of the prevalence of very high psychological distress using the Kessler Psychological Distress scale (K10). Results: Estimates of the prevalence of very high psychological distress from the NHS were stable between 2001 and 2014, with a modest increase in 2017. In contrast, the HILDA Survey data demonstrated an increasing trend over time, with the prevalence of very high distress rising from 4.8% in 2007 to 7.4% in 2017. This increase was present for both men and women, and was evident for younger and middle aged adults but not those aged 65 years or older. Sensitivity analyses showed that this increase was notable in the upper end of the K10 distribution. Conclusions: Using household panel data breaks the nexus between declining survey participation rates and time, and suggests the prevalence of very high psychological distress is increasing. The study identifies potential challenges in estimating trends in population mental health using repeated cross-sectional survey data.
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Affiliation(s)
- Peter Butterworth
- Melbourne Institute: Applied Economic and Social Research, The University of Melbourne, Parkville, VIC, Australia.,Research School of Population Health, The Australia National University, Canberra, ACT, Australia
| | - Nicole Watson
- Melbourne Institute: Applied Economic and Social Research, The University of Melbourne, Parkville, VIC, Australia
| | - Mark Wooden
- Melbourne Institute: Applied Economic and Social Research, The University of Melbourne, Parkville, VIC, Australia
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32
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Chan A, Lomma C, Chih H, Arto C, McDonald F, Patterson P, Willsher P, Reid C. Psychosocial consequences in offspring of women with breast cancer. Psychooncology 2019; 29:517-524. [PMID: 31733016 DOI: 10.1002/pon.5294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/11/2019] [Accepted: 11/14/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Breast cancer (BC) accounts for 24% of female cancers, with approximately one quarter of women likely to have offspring aged less than 25 years. Recent publications demonstrate negative psychosocial well-being in these offspring. We prospectively assessed for psychological distress and unmet needs in offspring of BC patients. METHODS Eligible offspring aged 14 to 24 years were consented and completed the Kessler-10 Questionnaire and Offspring Cancer Needs Instrument. Demographic and BC details were obtained. RESULTS Over a 7-month period, 120 offspring from 74 BC patients were included. Fifty-nine mothers had nonmetastatic BC (nMBC), and 27 had metastatic BC (MBC) with median time from diagnosis of 27.6 and 36.1 months, respectively. The prevalence of high/very high distress was 31%, with significantly higher scores reported by female offspring (P = .017). Unmet needs were reported by more than 50% of offspring with the majority of needs relating to information about their mother's cancer. Greater unmet needs were seen in female offspring and offspring with none or one sibling for several domains (practical assistance, time-out, dealing with feelings, and support from friends; P < .05). Greater unmet needs were seen in regard to feelings for MBC patients' offspring compared with nMBC but were similar for other unmet needs. CONCLUSIONS Our study confirms high levels of psychological distress in offspring of BC patients, with female offspring reporting significantly higher emotional distress and unmet needs. More than 50% of respondents reported unmet needs in areas that can potentially be supported, including greater information provision, improving practical issues, and enabling sufficient recreational time.
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Affiliation(s)
- Arlene Chan
- Breast Cancer Research Centre-WA, Medical Oncology, Nedlands, Western Australia, Australia.,School of Medicine, Curtin University, Bentley, Perth, Western Australia, Australia
| | - Christopher Lomma
- Breast Cancer Research Centre-WA, Medical Oncology, Nedlands, Western Australia, Australia
| | - HuiJun Chih
- School of Public Health, Curtin University, Bentley, Perth, Western Australia, Australia
| | - Carmelo Arto
- Breast Cancer Research Centre-WA, Medical Oncology, Nedlands, Western Australia, Australia
| | - Fiona McDonald
- CanTeen Australia, Sydney, New South Wales, Australia.,Cancer Nursing Research Unit, University of Sydney, Sydney, New South Wales, Australia
| | - Pandora Patterson
- CanTeen Australia, Sydney, New South Wales, Australia.,Cancer Nursing Research Unit, University of Sydney, Sydney, New South Wales, Australia
| | - Peter Willsher
- Breast Cancer Research Centre-WA, Medical Oncology, Nedlands, Western Australia, Australia
| | - Christopher Reid
- School of Public Health, Curtin University, Bentley, Perth, Western Australia, Australia
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Richter D, Wall A, Bruen A, Whittington R. Is the global prevalence rate of adult mental illness increasing? Systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:393-407. [PMID: 31393996 DOI: 10.1111/acps.13083] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The question whether mental illness prevalence rates are increasing is a controversially debated topic. Epidemiological articles and review publications that look into this research issue are often compromised by methodological problems. The present study aimed at using a meta-analysis technique that is usually applied for the analysis of intervention studies to achieve more transparency and statistical precision. METHODS We searched PubMed, PsycINFO, CINAHL, Google Scholar and reference lists for repeated cross-sectional population studies on prevalence rates of adult mental illness based on ICD- or DSM-based diagnoses, symptom scales and distress scales that used the same methodological approach at least twice in the same geographical region. The study is registered with PROSPERO (CRD42018090959). RESULTS We included 44 samples from 42 publications, representing 1 035 697 primary observations for the first time point and 783 897 primary observations for the second and last time point. Studies were conducted between 1978 and 2015. Controlling for a hierarchical data structure, we found an overall global prevalence increase in odds ratio of 1.179 (95%-CI: 1.065-1.305). A multivariate meta-regression suggested relevant associations with methodological characteristics of included studies. CONCLUSIONS We conclude that the prevalence increase in adult mental illness is small, and we assume that this increase is mainly related to demographic changes.
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Affiliation(s)
- D Richter
- Bern University Hospital for Mental Health, Centre for Psychiatric Rehabilitation, Bern, Switzerland.,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - A Wall
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - A Bruen
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - R Whittington
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Brøset Centre for Research & Education in Forensic Psychiatry, St. Olav's Hospital and Institute of Mental Health, Norwegian University of Science & Technology (NTNU), Trondheim, Norway
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Ganci M, Suleyman E, Butt H, Ball M. The role of the brain-gut-microbiota axis in psychology: The importance of considering gut microbiota in the development, perpetuation, and treatment of psychological disorders. Brain Behav 2019; 9:e01408. [PMID: 31568686 PMCID: PMC6851798 DOI: 10.1002/brb3.1408] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The prevalence of psychological disorders remains stable despite steady increases in pharmacological treatments suggesting the need for auxiliary treatment options. Consideration of the brain-gut-microbiota axis (BGMA) has made inroads into reconceptualizing psychological illness from a more holistic perspective. While our understanding of the precise role of gut microbiota (GM) in psychological illness is in its infancy, it represents an attractive target for novel interventions. METHOD An extensive review of relevant literature was undertaken. RESULTS Gut microbiota are proposed to directly and indirectly influence mood, cognition, and behavior which are key components of mental health. This paper outlines how GM may be implicated in psychological disorders from etiology through to treatment and prevention using the Four P model of case formulation. CONCLUSION Moving forward, integration of GM into the conceptualization and treatment of psychological illness will require the discipline of psychology to undergo a significant paradigm shift. While the importance of the GM in psychological well-being must be respected, it is not proposed to be a panacea, but instead, an additional arm to a multidisciplinary approach to treatment and prevention.
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Affiliation(s)
- Michael Ganci
- Psychology Department, Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Emra Suleyman
- Psychology Department, Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Henry Butt
- Bioscreen Yarraville (Aust) Pty Ltd, Melbourne, Vic., Australia.,Melbourne University, Melbourne, Vic., Australia
| | - Michelle Ball
- Psychology Department, Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
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Glenister K, Bourke L, Terry D, Simmons D. Chronic ill health in a regional Victoria setting: A 13-year comparison. Aust J Rural Health 2019; 27:527-534. [PMID: 31650640 DOI: 10.1111/ajr.12565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 07/17/2019] [Accepted: 07/30/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. DESIGN Repeat cross-sectional studies conducted over a decade apart. SETTING The projects were conducted in the Goulburn Valley in regional Victoria. PARTICIPANTS The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. MAIN OUTCOME MEASURES Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. RESULTS The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). CONCLUSION The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation.
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Affiliation(s)
- Kristen Glenister
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | - Lisa Bourke
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | - Daniel Terry
- School of Nursing and Healthcare Professions, Federation University, Ballarat, Victoria, Australia
| | - David Simmons
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia.,Macarthur Clinical School, Western Sydney University, Penrith South DC, New South Wales, Australia
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The relationship between depression symptoms, absenteeism and presenteeism. J Affect Disord 2019; 256:536-540. [PMID: 31280078 DOI: 10.1016/j.jad.2019.06.041] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/07/2019] [Accepted: 06/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mental health problems are common within the working population. Depression is both highly prevalent and debilitating and is linked to increases in absenteeism and presenteeism. The use of summed depression scale scores may conceal differential impacts of depressive symptoms on absenteeism and presenteeism. We aimed to explore both the relationship between absenteeism and presenteeism and both depression severity, along with the independent contributions of different symptoms. METHODS Participants (N = 4953) were employees recruited as part of a larger study to evaluate a mental health smartphone app and were recruited via industry partner organisations and social media. Participants completed in-app assessment which included demographic information, the Patient Health Questionnaire-9 depression tool, and items of the World Health Organization Health and Work Performance Questionnaire. The relationship between depressive symptoms, absenteeism and presenteeism was estimated using both total summed scores and individual symptoms of depression. RESULTS Univariate linear regression confirmed a negative linear relationship between depression severity and presenteeism, which remained significant after controlling for age, gender, industry, and work position. Similarly, there was a statistically significant relationship between depression severity and the amount of mental health related sickness absence taken over the preceding 28 days. Johnson's relative weights analysis showed contributory differences amongst depression symptoms in relation to presenteeism and absenteeism. DISCUSSION Significant relationships between depression severity and both absenteeism and presenteeism were present indicating increases in absence and decreases in performance with increasing severity. There existed differences amongst the contribution of specific symptoms of depression to both outcomes of interest. The symptoms that contribute most to absence were more behavioural in nature, whilst those contributing most to presenteeism were more cognitive. These findings have practical implications for clinicians and employers in making treatment and return-to-work decisions.
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Gayed A, Tan L, LaMontagne AD, Milner A, Deady M, Milligan-Saville JS, Madan I, Calvo RA, Christensen H, Mykletun A, Glozier N, Harvey SB. A comparison of face-to-face and online training in improving managers' confidence to support the mental health of workers. Internet Interv 2019; 18:100258. [PMID: 31890611 PMCID: PMC6926278 DOI: 10.1016/j.invent.2019.100258] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/13/2019] [Accepted: 07/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In recognition of the important role managers play in the well-being of the staff they supervise, many workplaces are implementing specialised training for leaders to help them better understand and support the mental health needs of their staff. This training can be delivered through face-to-face or online training sessions. Evaluation of such programs have found positive results for each format when compared to a control group, but to date, face-to-face and online manager mental health training have not been compared with one another. AIMS This study brings together results from two trials evaluating the same program content, each employing a different mode of content delivery. Both types of training aimed to change managers' confidence to better support the mental health needs of the staff they supervise. METHODS Utilising data derived from two previously conducted trials, mean change in manager confidence from baseline at both post-intervention and follow-up were examined for each method of content delivery. An identical way of measuring confidence was used in each study. RESULTS Managers' confidence improved from baseline with both methods of training. A greater change was observed with face-to-face training than for online, although both methods had sustained improvement over time. Analyses indicate that at follow-up, improvements in confidence were significant for both face-to-face (t 18 = 5.99; P < .001) and online training (t 39 = 3.85; P < .001). Analyses focused on managers who fully completed either type of training indicated very similar impacts for face-to-face and online training. CONCLUSIONS Both face-to-face and online delivery of manager mental health training can significantly improve managers' confidence in supporting the mental health needs of their staff. This change is sustained over various follow-up periods. However, lower retention rates common in online training reduce the relative effect of this method of delivery.
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Affiliation(s)
- Aimée Gayed
- School of Psychiatry, University of New South Wales, Sydney, Australia,Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia,Corresponding author at: School of Psychiatry, University of New South Wales, Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia.
| | - Leona Tan
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Anthony D. LaMontagne
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia,School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Allison Milner
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | - Ira Madan
- Occupational Health Department, The Education Centre, Guy's and St Thomas' NHS Trust, London, UK,Department of Population Health Sciences, King's College London, London, UK
| | - Rafael A. Calvo
- Dyson School of Design Engineering, Imperial College London, London, UK,School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Arnstein Mykletun
- School of Psychiatry, University of New South Wales, Sydney, Australia,Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway,Department of Community Medicine, University of Tromsø, Tromsø, Norway,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway,Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway
| | - Nicholas Glozier
- Brain and Mind Centre & Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Samuel B. Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Yap M, Tuson M, Whyatt D, Vickery A. Anxiety and alcohol in the working-age population are driving a rise in mental health-related emergency department presentations: 15 year trends in emergency department presentations in Western Australia. Emerg Med Australas 2019; 32:80-87. [PMID: 31264385 DOI: 10.1111/1742-6723.13342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate age, gender and disease-specific trends in ED for mental health presentations over 15 years. METHODS The study population consisted of residents of metropolitan Perth, Western Australia, presenting to Perth ED between 1 July 2002 and 30 June 2017. Population rates of mental health-related ED presentations per year were calculated. RESULTS Rates of mental health ED presentations are significantly increasing in the working-age population for those with stress and anxiety-related diagnoses, particularly in younger females, and also for alcohol-related presentations for those aged 10-49 years, particularly in males. CONCLUSION The present study demonstrates that increased rates of mental health-related ED presentations are driven by increased rates of presentation for stress and anxiety-related and alcohol-related presentations in both genders across the working-age population.
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Affiliation(s)
- Matthew Yap
- Division of General Practice, School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew Tuson
- Division of General Practice, School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - David Whyatt
- Division of General Practice, School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Alistair Vickery
- Division of General Practice, School of Medicine, Faculty of Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Thistlethwaite JE, Dunston R, Yassine T. The times are changing: workforce planning, new health-care models and the need for interprofessional education in Australia. J Interprof Care 2019; 33:361-368. [PMID: 31106641 DOI: 10.1080/13561820.2019.1612333] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Following a history of the Australian health system and funding models, we outline workforce issues, in particular, the lack of health professionals in regional locations. The role of the Australian government health departments in workforce planning is discussed. We describe research funded by the Commonwealth government focussing on the development of interprofessional education (IPE) for collaborative practice. New models of interprofessional care have been introduced to help tackle the population needs: in the Australian Capital Territory (ACT); HealthOne in New South Wales; health-care homes nationally; and partnerships between pharmacists and general practitioners in Victoria. Changes in care delivery necessitate innovations in health education, however how IPE is embedded in Australian health professional education still varies. There is a growing sense of an IPE community complemented by an interest in IPE from peak policy and workforce bodies. There are changes underway in health professional registration and accreditation that are likely to regulate shared and common learning to enable the continuous development of a flexible, responsive and sustainable health workforce. We conclude that there are significant opportunities for further development of IPE and collaborative practice as key strategies for adding to the ability of health systems to address individual needs in conjunction with aiming for optimal and universal health coverage.
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Affiliation(s)
| | - Roger Dunston
- FASS, University of Technology Sydney , Sydney , NSW , Australia
| | - Tagrid Yassine
- HETI (Health Education and Training Institute) , Gladesville , NSW , Australia
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Milner A, Scovelle AJ, King TL, Madsen I. Exposure to work stress and use of psychotropic medications: a systematic review and meta-analysis. J Epidemiol Community Health 2019; 73:569-576. [PMID: 30914444 DOI: 10.1136/jech-2018-211752] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs. RESULTS There were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work-family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71). CONCLUSIONS The findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.
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Affiliation(s)
- Allison Milner
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Anna J Scovelle
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania L King
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ida Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Lee CW, Frost AD. Where Australia's Better Access scheme has had an impact on mental health: A commentary on Jorm (2018). Aust N Z J Psychiatry 2019; 53:259-261. [PMID: 30727743 DOI: 10.1177/0004867419828495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Christopher W Lee
- 1 Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Aaron Dj Frost
- 2 Benchmark Psychology, Upper Mount Gravatt, QLD, Australia.,3 School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia
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Deady M, Johnston D, Milne D, Glozier N, Peters D, Calvo R, Harvey S. Preliminary Effectiveness of a Smartphone App to Reduce Depressive Symptoms in the Workplace: Feasibility and Acceptability Study. JMIR Mhealth Uhealth 2018; 6:e11661. [PMID: 30514694 PMCID: PMC6299234 DOI: 10.2196/11661] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/14/2018] [Accepted: 09/14/2018] [Indexed: 12/18/2022] Open
Abstract
Background The workplace represents a unique setting for mental health interventions. Due to range of job-related factors, employees in male-dominated industries are at an elevated risk. However, these at-risk groups are often overlooked. HeadGear is a smartphone app–based intervention designed to reduce depressive symptoms and increase well-being in these populations. Objective This paper presents the development and pilot testing of the app’s usability, acceptability, feasibility, and preliminary effectiveness. Methods The development process took place from January 2016 to August 2017. Participants for prototype testing (n=21; stage 1) were recruited from industry partner organizations to assess acceptability and utility. A 5-week effectiveness and feasibility pilot study (n=84; stage 2) was then undertaken, utilizing social media recruitment. Demographic data, acceptability and utility questionnaires, depression (Patient Health Questionnaire-9), and other mental health measures were collected. Results The majority of respondents felt HeadGear was easy to use (92%), easily understood (92%), were satisfied with the app (67%), and would recommend it to a friend (75%; stage 1). Stage 2 found that compared with baseline, depression and anxiety symptoms were significantly lower at follow-up (t30=2.53; P=.02 and t30=2.18; P=.04, respectively), days of sick leave in past month (t28=2.38; P=.02), and higher self-reported job performance (t28=−2.09; P=.046; stage 2). Over 90% of respondents claimed it helped improve their mental fitness, and user feedback was again positive. Attrition was high across the stages. Conclusions Overall, HeadGear was well received, and preliminary findings indicate it may provide an innovative new platform for improving mental health outcomes. Unfortunately, attrition was a significant issue, and findings should be interpreted with caution. The next stage of evaluation will be a randomized controlled trial. If found to be efficacious, the app has the potential to reduce disease burden and improve health in this at-risk group.
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Affiliation(s)
- Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David Johnston
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Milne
- School of Systems, Management and Leadership, Faculty of Engineering and IT, University of Technology, Sydney, Australia
| | - Nick Glozier
- Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Dorian Peters
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Rafael Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
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The Genetic Relationship Between Psychological Distress, Somatic Distress, Affective Disorders, and Substance Use in Young Australian Adults: A Multivariate Twin Study. Twin Res Hum Genet 2018; 21:347-360. [DOI: 10.1017/thg.2018.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychological distress (PSYCH), somatic distress (SOMA), affective disorders (AD), and substance use (SU) frequently co-occur. The genetic relationship between PSYCH and SOMA, however, remains understudied. We examined the genetic and environmental influences on these two disorders and their comorbid AD and SU using structural equation modeling. Self-reported PSYCH and SOMA were measured in 1,548 twins using the two subscales of a 12-item questionnaire, the Somatic and Psychological Health Report. Its reliability and psychometric properties were examined. Six ADs, involvement of licit and illicit substance, and two SU disorders were obtained from 1,663–2,132 twins using the World Mental Health Composite International Diagnostic Interview and/or from an online adaption of the same. SU phenotypes (heritability: 49–79%) were found to be more heritable than the affective disorder phenotypes (heritability: 32–42%), SOMA (heritability: 25%), and PSYCH (heritability: 23%). We fit separate non-parametric item response theory models for PSYCH, SOMA, AD, and SU. The IRT scores were used as the refined phenotypes for fitting multivariate genetic models. The best-fitting model showed the similar amount of genetic overlap between PSYCH–AD (genetic correlationrG= 0.49) and SOMA–AD (rG=0.53), as well as between PSYCH–SU (rG= 0.23) and SOMA–SU (rG= 0.25). Unique environmental factors explained 53% to 76% of the variance in each of these four phenotypes, whereas additive genetic factors explained 17% to 46% of the variance. The covariance between the four phenotypes was largely explained by unique environmental factors. Common genetic factor had a significant influence on all the four phenotypes, but they explained a moderate portion of the covariance.
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Gayed A, LaMontagne AD, Milner A, Deady M, Calvo RA, Christensen H, Mykletun A, Glozier N, Harvey SB. A New Online Mental Health Training Program for Workplace Managers: Pre-Post Pilot Study Assessing Feasibility, Usability, and Possible Effectiveness. JMIR Ment Health 2018; 5:e10517. [PMID: 29970359 PMCID: PMC6053610 DOI: 10.2196/10517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental health has become the leading cause of sickness absence in high-income countries. Managers can play an important role in establishing mentally healthy workplaces and coordinating their organization's response to a mentally ill worker. OBJECTIVE This pilot study aims to evaluate the feasibility, usability, and likely effectiveness of a newly developed online training program for managers called HeadCoach. HeadCoach aims to build managers' confidence in supporting the mental health needs of staff and promote managerial behavior most likely to result in a more mentally healthy workplace. METHODS In total, 66 managers from two organizations were invited to participate in this pre-post pilot study of HeadCoach, which was made available to managers to complete at their own pace over a 4-week period. Data were collected at baseline and post intervention via an online research platform. The difference in mean scores for each outcome between these two time points was calculated using paired samples t tests. RESULTS Of all the invited managers, 59.1% (39/66) participated in the trial, with complete pre-post data available for 56.4% (22/39) of the participants. The majority of respondents reported positive engagement with the program. During the study period, managers' knowledge regarding their role in managing mental health issues (P=.01) and their confidence in communicating with employees regarding mental illness (P<.001) significantly increased. In addition, a significant increase was observed from the baseline in managers' self-reported actions to use strategies to prevent and decrease stress among their team members (P=.02). CONCLUSIONS Although caution is needed due to the absence of a control group, preliminary results of this study suggest that HeadCoach could be a feasible, acceptable, and efficient method of training managers in best workplace practices to help support the mental health needs of their staff.
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Affiliation(s)
- Aimée Gayed
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia
| | - Anthony D LaMontagne
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Allison Milner
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Rafael A Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Arnstein Mykletun
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine,, University of Tromsø, Tromsø, Norway.,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway.,Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway
| | - Nick Glozier
- Brain and Mind Centre and Central Clinical School, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Deady M, Johnston DA, Glozier N, Milne D, Choi I, Mackinnon A, Mykletun A, Calvo RA, Gayed A, Bryant R, Christensen H, Harvey SB. A smartphone application for treating depressive symptoms: study protocol for a randomised controlled trial. BMC Psychiatry 2018; 18:166. [PMID: 29859060 PMCID: PMC5984798 DOI: 10.1186/s12888-018-1752-5] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/17/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Depression is a commonly occurring disorder linked to diminished role functioning and quality of life. The development of treatments that overcome barriers to accessing treatment remains an important area of clinical research as most people delay or do not receive treatment at an appropriate time. The workplace is an ideal setting to roll-out an intervention, particularly given the substantial psychological benefits associated with remaining in the workforce. Mobile health (mhealth) interventions utilising smartphone applications (apps) offer novel solutions to disseminating evidence based programs, however few apps have undergone rigorous testing. The present study aims to evaluate the effectiveness of a smartphone app designed to treat depressive symptoms in workers. METHODS The present study is a multicentre randomised controlled trial (RCT), comparing the effectiveness of the intervention to that of an attention control. The primary outcome measured will be reduced depressive symptoms at 3 months. Secondary outcomes such as wellbeing and work performance will also be measured. Employees from a range of industries will be recruited via a mixture of targeted social media advertising and Industry partners. Participants will be included if they present with likely current depression at baseline. Following baseline assessment (administered within the app), participants will be randomised to receive one of two versions of the Headgear application: 1) Intervention (a 30-day mental health intervention focusing on behavioural activation and mindfulness), or 2) attention control app (mood monitoring for 30 days). Participants will be blinded to their allocation. Analyses will be conducted within an intention to treat framework using mixed modelling. DISCUSSION The results of this trial will provide valuable information about the effectiveness of mhealth interventions in the treatment of depressive symptoms in a workplace context. TRIAL REGISTRATION The current trial is registered with the Australian and New Zealand Clinical Trials Registry ( ACTRN12617000547347 , Registration date: 19/04/2017).
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Affiliation(s)
- M. Deady
- Black Dog Institute; Faculty of Medicine, UNSW, Sydney, Australia
| | - D. A. Johnston
- Black Dog Institute; Faculty of Medicine, UNSW, Sydney, Australia
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - N. Glozier
- Central Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - D. Milne
- School of Electrical and Information Engineering, University of Sydney, Sydney, NSW 2006 Australia
- School of Systems Management and Leadership, Faculty of Engineering and IT, University of Technology Sydney, Sydney, Australia
| | - I. Choi
- Central Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - A. Mackinnon
- Black Dog Institute; Faculty of Medicine, UNSW, Sydney, Australia
| | - A. Mykletun
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway
| | - R. A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, NSW 2006 Australia
| | - A. Gayed
- School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - R. Bryant
- School of Psychology, UNSW Sydney, Sydney, Australia
| | - H. Christensen
- Black Dog Institute; Faculty of Medicine, UNSW, Sydney, Australia
| | - S. B. Harvey
- Black Dog Institute; Faculty of Medicine, UNSW, Sydney, Australia
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Petrie K, Gayed A, Bryan BT, Deady M, Madan I, Savic A, Wooldridge Z, Counson I, Calvo RA, Glozier N, Harvey SB. The importance of manager support for the mental health and well-being of ambulance personnel. PLoS One 2018; 13:e0197802. [PMID: 29791510 PMCID: PMC5965892 DOI: 10.1371/journal.pone.0197802] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/28/2018] [Indexed: 11/18/2022] Open
Abstract
Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622). Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate) and managers' observed behaviours (manager behaviour) on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6%) were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, p<0.01) and well-being (13%, p<0.01). Manager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, p<0.01) and well-being (10% of variance, p<0.05). The perceived importance management places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.
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Affiliation(s)
| | - Aimée Gayed
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Bridget T. Bryan
- Black Dog Institute, Sydney, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Mark Deady
- Black Dog Institute, Sydney, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Ira Madan
- Guys and St Thomas NHS Foundation Trust, Occupational Health Department, The Education Centre, St Thomas’ Hospital, London, United Kingdom
- King’s College London, London, United Kingdom
| | - Anita Savic
- Ambulance Victoria, Doncaster, Victoria, Australia
| | | | - Isabelle Counson
- Black Dog Institute, Sydney, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, NSW, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Samuel B. Harvey
- Black Dog Institute, Sydney, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Stratton E, Lampit A, Choi I, Calvo RA, Harvey SB, Glozier N. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLoS One 2017; 12:e0189904. [PMID: 29267334 PMCID: PMC5739441 DOI: 10.1371/journal.pone.0189904] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 02/03/2023] Open
Abstract
Background Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees. Methods Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”. Results 23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups. Interpretation There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.
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Affiliation(s)
- Elizabeth Stratton
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | - Amit Lampit
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Isabella Choi
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel B. Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
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Whiteford HA. The disparity between changes in the prevalence of mental illness and disability support rates in Australia. Med J Aust 2017; 206:486-487. [DOI: 10.5694/mja17.00274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Harvey A Whiteford
- University of Queensland, Brisbane, QLD
- Queensland Centre for Mental Health Research, Brisbane, QLD
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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