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Navarra-Ventura G, Riera-Serra P, Roca M, Gili M, García-Toro M, Vilagut G, Alayo I, Ballester L, Blasco MJ, Castellví P, Colom J, Casajuana C, Gabilondo A, Lagares C, Almenara J, Miranda-Mendizabal A, Mortier P, Piqueras JA, Soto-Sanz V, Alonso J. Factors associated with high and low mental well-being in Spanish university students. J Affect Disord 2024; 356:424-435. [PMID: 38631424 DOI: 10.1016/j.jad.2024.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/27/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.
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Affiliation(s)
- Guillem Navarra-Ventura
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Miquel Roca
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain.
| | - Mauro García-Toro
- Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Biosistemak Institute for Health Systems Research, Basque Country, Spain
| | - Laura Ballester
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Joan Colom
- Agència de Salut Pública de Catalunya (ASPCat), Barcelona, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Carolina Lagares
- Departamento de Estadística e Investigación Operativa, Universidad de Cádiz, Cádiz, Spain
| | - José Almenara
- Departamento de Biomedicina, Biotecnología y Salud Pública, Universidad de Cádiz, Cádiz, Spain
| | - Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Victoria Soto-Sanz
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine and Life Science, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Miranda-Mendizabal A, Castellví P, Vilagut G, Alayo I, Almenara J, Ballester L, Echeburúa E, Gabilondo A, Gili M, Mortier P, Piqueras JA, Roca M, Auerbach RP, Bruffaerts R, Kessler RC, Alonso Caballero J. Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders. J Affect Disord 2024; 353:52-59. [PMID: 38417714 DOI: 10.1016/j.jad.2024.02.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Childhood/adolescence adversities and mental disorders are higher among LGB youths. AIMS To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. METHODS Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. RESULTS A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. LIMITATIONS Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. CONCLUSIONS Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.
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Affiliation(s)
- Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain; Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
| | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Carrer Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregar, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Laura Ballester
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso Caballero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
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3
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Molina JD, Amigo F, Vilagut G, Mortier P, Muñoz-Ruiperez C, Rodrigo Holgado I, Juanes González A, Combarro Ripoll CE, Alonso J, Rubio G. Impact of COVID-19 first wave on the mental health of healthcare workers in a Front-Line Spanish Tertiary Hospital: lessons learned. Sci Rep 2024; 14:8149. [PMID: 38589491 PMCID: PMC11001893 DOI: 10.1038/s41598-024-58884-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024] Open
Abstract
Healthcare workers (HCWs) were at high risk of experiencing psychological distress during COVID-19 pandemic. The objective of this study was to evaluate the impact on HCWs' mental health in a Spanish hospital. Cross-sectional study of HCW, active between May and June 2020. A web-based survey assessed probable current mental disorders (major depressive disorder [PHQ-8 ≥ 10], generalized anxiety disorder [GAD-7 ≥ 10], panic attacks, post-traumatic stress disorder [PTSD; PLC-5 ≥ 7], or substance use disorder [CAGE-AID ≥ 2]). The Sheehan Disability Scale (SDS) was used to assess severe impairment and items taken from the modified self-report version of the Columbia Suicide Severity Rating Scale (C-SSRS) assessed suicidal thoughts and behaviors. A total of 870 HCWs completed the survey. Most frequent probable mental disorders were major depressive disorder (33.6%), generalized anxiety disorder (25.5%), panic attacks (26.9%), PTSD (27.2%), and substance use disorder (5.0%). Being female, having aged 18-29 years, being an auxiliary nurse, direct exposure to COVID-19-infected patients, and pre-pandemic lifetime mental disorders were positively associated with mental issues. Hospital HCWs presented a high prevalence of symptoms of mental disorders, especially depression, PTSD, panic attacks, and anxiety. Younger individuals and those with lifetime mental disorders have been more vulnerable to experiencing them.
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Affiliation(s)
- Juan D Molina
- Centro de Investigación Biomédica en Red (CIBER) Salud Mental, Madrid, Spain.
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario, 12 de Octubre, Av. de Córdoba S.N, Madrid, Spain.
- Research Institute Hospital 12 de Octubre (I + 12), Madrid, Spain.
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain.
| | - Franco Amigo
- Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Muñoz-Ruiperez
- Occupational Medicine and Occupational Risk Prevention Service, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - Irene Rodrigo Holgado
- Clinic Psychologist, COVID-19 Assistance Project, 12 de Octubre University Hospital, Madrid, Spain
| | - Alba Juanes González
- Psychiatrist, COVID-19 Assistance Project, Consultation-Liaison Psychiatry Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - Carolina Elisa Combarro Ripoll
- Psychiatrist, COVID-19 Assistance Project, Consultation-Liaison Psychiatry Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Gabriel Rubio
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario, 12 de Octubre, Av. de Córdoba S.N, Madrid, Spain
- Research Institute Hospital 12 de Octubre (I + 12), Madrid, Spain
- Department of Psychiatry, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Addictive Disorders Network, Redes Temáticas de Investigación Cooperativa (RETICS) (Thematic Networks of Cooperative Research in Health), Carlos III Health Institute, Ministerio de Ciencia e Innovación (MICINN) and Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
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4
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Mortier P, Vilagut G, García-Mieres H, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo Del Barco Á, Campos M, Espuga M, González-Pinto A, Haro JM, López Fresneña N, Martínez de Salázar AD, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Gómez B, Pérez-Zapata A, Pijoan JI, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig T, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J. Health service and psychotropic medication use for mental health conditions among healthcare workers active during the Spain Covid-19 Pandemic - A prospective cohort study using web-based surveys. Psychiatry Res 2024; 334:115800. [PMID: 38387166 DOI: 10.1016/j.psychres.2024.115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.
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Affiliation(s)
- Philippe Mortier
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Gemma Vilagut
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Helena García-Mieres
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Bizkaia, Spain
| | - Montse Ferrer
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Franco Amigo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Meritxell Espuga
- Occupational Health Service. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA, Hospital Universitario Araba-Santiago, UPV/EHU, Vitoria-Gasteiz, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep M Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - Juan D Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M Ortí-Lucas
- Service of Preventive Medicine and Quality of Attention, University Clinical Hospital of Valencia, Valencia, Spain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Maria Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud de Castilla y Leon (SACYL). Ponferrada, León, Spain; Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - José Ignasio Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Clinical Epidemiology Unit-Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain/ Biocruces-Bizkaia Health Research Institute, Spain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Elena Polentinos-Castro
- Research Unit Primary Care Management, Madrid Health Service, Madrid, Spain; Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud RICAPPS-(RICORS). Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Portillo-Van Diest
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Ferran Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, MELIS, Universitat Pompeu Fabra, Barcelona, Spain; Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain; CiSAL-Centro de Investigación en Salud Laboral, Hospital del Mar Research Institute/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain; Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Víctor Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Jordi Alonso
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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5
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Arias de la Torre J, Ronaldson A, Vilagut G, Martínez-Alés G, Dregan A, Bakolis I, Valderas JM, Molina AJ, Martín V, Bellón JÁ, Alonso J. Implementation of community screening strategies for depression. Nat Med 2024; 30:930-932. [PMID: 38413728 DOI: 10.1038/s41591-024-02821-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Jorge Arias de la Torre
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain.
- Care in Long Term Conditions Research Division, King's College London, London, UK.
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Gemma Vilagut
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Gonzalo Martínez-Alés
- CAUSALab, Harvard University T.H. Chan School of Public Health, Boston, MA, USA
- Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Alex Dregan
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Ioannis Bakolis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Jose M Valderas
- Department of Medicine, National University of Singapore, Singapore, Singapore
- Department of Family Medicine, National University Health System, Singapore, Singapore
- Centre for Research in Health Systems Performance (CRiHSP) National University Health System, Singapore, Singapore
| | - Antonio J Molina
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Vicente Martín
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Juan Ángel Bellón
- Biomedical Research Institute of Málaga (IBIMA-Bionand platform), Malaga, Spain
- El Palo Health Centre, Andalusian Health Service (SAS), Malaga, Spain
- Department of Public Health and Psychiatry, University of Málaga (UMA), Malaga, Spain
| | - Jordi Alonso
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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Castro Ribeiro T, García Pagès E, Ballester L, Vilagut G, García Mieres H, Suárez Aragonès V, Amigo F, Bailón R, Mortier P, Pérez Sola V, Serrano-Blanco A, Alonso J, Aguiló J. Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study. JMIR Res Protoc 2024; 13:e51298. [PMID: 38551647 PMCID: PMC11015365 DOI: 10.2196/51298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. OBJECTIVE This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. METHODS This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. RESULTS Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. CONCLUSIONS This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. TRIAL REGISTRATION OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51298.
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Affiliation(s)
- Thais Castro Ribeiro
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
| | - Esther García Pagès
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
| | - Laura Ballester
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Gemma Vilagut
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Helena García Mieres
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Víctor Suárez Aragonès
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Franco Amigo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Raquel Bailón
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Philippe Mortier
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Víctor Pérez Sola
- CIBER en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Neurosciences Research Group, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Antoni Serrano-Blanco
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jordi Aguiló
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
- Departament of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Bellaterra, Spain
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7
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Mortier P, Amigo F, Bhargav M, Conde S, Ferrer M, Flygare O, Kizilaslan B, Latorre Moreno L, Leis A, Mayer MA, Pérez-Sola V, Portillo-Van Diest A, Ramírez-Anguita JM, Sanz F, Vilagut G, Alonso J, Mehlum L, Arensman E, Bjureberg J, Pastor M, Qin P. Developing a clinical decision support system software prototype that assists in the management of patients with self-harm in the emergency department: protocol of the PERMANENS project. BMC Psychiatry 2024; 24:220. [PMID: 38509500 PMCID: PMC10956300 DOI: 10.1186/s12888-024-05659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Self-harm presents a significant public health challenge. Emergency departments (EDs) are crucial healthcare settings in managing self-harm, but clinician uncertainty in risk assessment may contribute to ineffective care. Clinical Decision Support Systems (CDSSs) show promise in enhancing care processes, but their effective implementation in self-harm management remains unexplored. METHODS PERMANENS comprises a combination of methodologies and study designs aimed at developing a CDSS prototype that assists clinicians in the personalized assessment and management of ED patients presenting with self-harm. Ensemble prediction models will be constructed by applying machine learning techniques on electronic registry data from four sites, i.e., Catalonia (Spain), Ireland, Norway, and Sweden. These models will predict key adverse outcomes including self-harm repetition, suicide, premature death, and lack of post-discharge care. Available registry data include routinely collected electronic health record data, mortality data, and administrative data, and will be harmonized using the OMOP Common Data Model, ensuring consistency in terminologies, vocabularies and coding schemes. A clinical knowledge base of effective suicide prevention interventions will be developed rooted in a systematic review of clinical practice guidelines, including quality assessment of guidelines using the AGREE II tool. The CDSS software prototype will include a backend that integrates the prediction models and the clinical knowledge base to enable accurate patient risk stratification and subsequent intervention allocation. The CDSS frontend will enable personalized risk assessment and will provide tailored treatment plans, following a tiered evidence-based approach. Implementation research will ensure the CDSS' practical functionality and feasibility, and will include periodic meetings with user-advisory groups, mixed-methods research to identify currently unmet needs in self-harm risk assessment, and small-scale usability testing of the CDSS prototype software. DISCUSSION Through the development of the proposed CDSS software prototype, PERMANENS aims to standardize care, enhance clinician confidence, improve patient satisfaction, and increase treatment compliance. The routine integration of CDSS for self-harm risk assessment within healthcare systems holds significant potential in effectively reducing suicide mortality rates by facilitating personalized and timely delivery of effective interventions on a large scale for individuals at risk of suicide.
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Grants
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- AC22/00006; AC22/00045 Instituto de Salud Carlos III (ISCIII) and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia
- ESF+; CP21/00078 ISCIII-FSE Miguel Servet co-funded by the European Social Fund Plus
- PI22/00107 ISCIII and co-funded by the European Union
- PI22/00107 ISCIII and co-funded by the European Union
- PI22/00107 ISCIII and co-funded by the European Union
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- 202220-30-31 Fundación la Marató de TV3
- FI23/00004 PFIS ISCIII
- FI23/00004 PFIS ISCIII
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- SGR 00624 the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- CIBERESP; CB06/02/0046 CIBER of Epidemiology & Public Health
- ERAPERMED2022 the Health Research Board Ireland
- ERAPERMED2022 the Health Research Board Ireland
- no. 2022-00549 the Swedish Innovation Agency
- no. 2022-00549 the Swedish Innovation Agency
- project no. 342386 the Research Council of Norway
- project no. 342386 the Research Council of Norway
- project no. 342386 the Research Council of Norway
- the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement of the Generalitat de Catalunya AGAUR 2021
- CIBER of Epidemiology & Public Health
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Affiliation(s)
- Philippe Mortier
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain.
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain.
| | - Franco Amigo
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain
| | - Madhav Bhargav
- School of Public Health & National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Susana Conde
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Montse Ferrer
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Oskar Flygare
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Busenur Kizilaslan
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Laura Latorre Moreno
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Angela Leis
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Miguel Angel Mayer
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Víctor Pérez-Sola
- Neuropsychiatry and Drug Addiction Institute, Barcelona MAR Health Park Consortium PSMAR, Barcelona, Spain
- CIBER of Mental Health and Carlos III Health Institute (CIBERSAM, ISCIII), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Ana Portillo-Van Diest
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain
| | - Juan Manuel Ramírez-Anguita
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ferran Sanz
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- National Bioinformatics Institute - ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Gemma Vilagut
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain
| | - Jordi Alonso
- Hospital del Mar Research Institute, Barcelona Biomedical Research Park (PRBB), Carrer Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ella Arensman
- School of Public Health & National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Manuel Pastor
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Navarro-Mateu F, Salmerón D, Vilagut G, Husky M, Ballesta M, Chirlaque MD, Huerta JM, Martínez S, Navarro C, Alonso J, Nock M, Kessler RC. Childhood adversities and suicidal behavior in the general population. The cross-sectional PEGASUS-Murcia Project. Span J Psychiatry Ment Health 2024; 17:11-18. [PMID: 33099026 DOI: 10.1016/j.rpsm.2020.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of the present study is to estimate the lifetime prevalence of suicidal ideation, plans, and attempts in a regional representative sample and the association of these outcomes with sociodemographic factors, prior mental disorders, and childhood adversities. MATERIAL AND METHODS The PEGASUS-Murcia project is a cross-sectional survey of a representative sample of adults in Murcia that is part of the WHO World Mental Health Survey Initiative. The Composite International Diagnostic Interview (CIDI 3.0) was administered face-to-face to 2621 participants (67.4% response rate). The main outcomes were suicidal ideation, plans, and attempts. Lifetime prevalence, age of onset, and risk factors (sociodemographic variables, mental disorders, and childhood adversities) were examined using multiple discrete-time survival models. RESULTS Lifetime prevalence of suicidal ideation, plans and attempts were 8.0% (standard error, SE: 1.1), 2.1% (SE: 0.3), and 1.2% (SE: 1.1), respectively. Prevalence of any childhood adversities was 22.1% (SE: 1.3) in the total sample and, even higher, among those with suicide related outcomes (ranging between 36.8% and 53.7%). Female sex, younger age, prior (to onset of the outcome) lifetime prevalence of mood disorders, number of mental disorders, and exposure to childhood adversity were associated with significantly increased odds of suicidal ideation and plans. CONCLUSIONS Lifetime prevalence estimates of suicidality are similar to those in community epidemiological surveys. Childhood adversities and mental disorders, especially mood disorders, are important risk factors for suicidality. Early detection of these adversities and disorders should be targeted in suicide prevention programs.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Departamento de Psicología Básica y Metodología, Universidad de Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Diego Salmerón
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain.
| | - Gemma Vilagut
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain
| | - Mathilde Husky
- Laboratoire de Psychologie, Université de Bordeaux, Burdeos, France
| | - Mónica Ballesta
- Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - María Dolores Chirlaque
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - José María Huerta
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | | | - Carmen Navarro
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain; Departamento de Salud y Ciencias Experimentales, Universidad Pompeu Fabra, Barcelona, Spain
| | - Matthew Nock
- Department of Psychology, Harvard University, Cambridge, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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9
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Arias de la Torre J, Vilagut G, Ronaldson A, Bakolis I, Dregan A, Navarro-Mateu F, Pérez K, Szücs A, Bartoll-Roca X, Molina AJ, Elices M, Pérez-Solá V, Martín V, Serrano-Blanco A, Valderas JM, Alonso J. Reconsidering the Use of Population Health Surveys for Monitoring of Mental Health. JMIR Public Health Surveill 2023; 9:e48138. [PMID: 37995112 PMCID: PMC10704303 DOI: 10.2196/48138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/18/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023] Open
Abstract
Monitoring of the mental health status of the population and assessment of its determinants are 2 of the most relevant pillars of public mental health, and data from population health surveys could be instrumental to support them. Although these surveys could be an important and suitable resource for these purposes, due to different limitations and challenges, they are often relegated to the background behind other data sources, such as electronic health records. These limitations and challenges include those related to measurement properties and cross-cultural validity of the tools used for the assessment of mental disorders, their degree of representativeness, and possible difficulties in the linkage with other data sources. Successfully addressing these limitations could significantly increase the potential of health surveys in the monitoring of mental disorders and ultimately maximize the impact of the relevant policies to reduce their burden at the population level. The widespread use of data from population health surveys, ideally linked to electronic health records data, would enhance the quality of the information available for research, public mental health decision-making, and ultimately addressing the growing burden of mental disorders.
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Affiliation(s)
- Jorge Arias de la Torre
- Care in Long Term Conditions Research Division, King's College London, London, United Kingdom
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biomedical Sciences, Universidad de León, León, Spain
| | - Gemma Vilagut
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Ioannis Bakolis
- Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Alex Dregan
- Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Fernando Navarro-Mateu
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Katherine Pérez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Anna Szücs
- Department of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Antonio J Molina
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biomedical Sciences, Universidad de León, León, Spain
| | - Matilde Elices
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Víctor Pérez-Solá
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Vicente Martín
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biomedical Sciences, Universidad de León, León, Spain
| | - Antoni Serrano-Blanco
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | - Jordi Alonso
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medical and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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10
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Arias-de la Torre J, Vilagut G, Ronaldson A, Bakolis I, Dregan A, Martín V, Martinez-Alés G, Molina AJ, Serrano-Blanco A, Valderas JM, Viana MC, Alonso J. Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3). Lancet Public Health 2023; 8:e889-e898. [PMID: 37898521 DOI: 10.1016/s2468-2667(23)00220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018-20, and to evaluate point prevalence differences between countries and over time between 2013-15 and 2018-20. METHODS In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. FINDINGS The point prevalence of clinically relevant depressive symptoms in Europe in 2018-20 was 6·54% (95% CI 6·34-6·73), ranging across countries from 1·85% (1·53-2·17) in Greece to 10·72% (10·04-11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07-1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54-0·74) in Hungary to 1·88 (1·53-2·31) in Slovenia. INTERPRETATION This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. FUNDING Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.
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Affiliation(s)
- Jorge Arias-de la Torre
- Care in Long Term Conditions Research Division, King's College London, London, UK; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain.
| | - Gemma Vilagut
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Amy Ronaldson
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alex Dregan
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vicente Martín
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain
| | - Gonzalo Martinez-Alés
- CAUSALab, Harvard T H Chan School of Public Health, Boston, MA, USA; La Paz Research Institute, Madrid, Spain; Network Center for Biomedical Research in Mental Health, Madrid, Spain
| | - Antonio J Molina
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain
| | - Antoni Serrano-Blanco
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jose M Valderas
- Department of Medicine, National University of Singapore, Singapore; Department of Family Medicine, National University Health System, Singapore; Centre for Research in Health Systems Performance, National University Health System, Singapore
| | - Maria Carmen Viana
- Department of Social Medicine Post-Graduate Program in Public Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Jordi Alonso
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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11
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Fico G, Oliva V, De Prisco M, Fortea L, Fortea A, Giménez-Palomo A, Anmella G, Hidalgo-Mazzei D, Vazquez M, Gomez-Ramiro M, Carreras B, Murru A, Radua J, Mortier P, Vilagut G, Amigo F, Ferrer M, García-Mieres H, Vieta E, Alonso J. Anxiety and depression played a central role in the COVID-19 mental distress: A network analysis. J Affect Disord 2023; 338:384-392. [PMID: 37336249 PMCID: PMC10276655 DOI: 10.1016/j.jad.2023.06.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Psychological, socio-demographics, and clinical factors play an important role in patients with COVID-19, but their relationship is complex. The network approach might be used to disentangle complex interactions in different systems. Using data from a multicentre, cross-sectional, survey among patients with COVID-19 in Spain (July-November 2020), we investigated the network structure of mental disorders symptoms, social support, and psychological resilience, and changes in network structures according to the presence of a pre-existing mental disorder or hospitalization for COVID-19. METHODS Subjects completed a survey to evaluate sociodemographic characteristics, COVID-19 infection status, resilience, social support, and symptoms of depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder. 2084 patients with COVID-19 were included in the analysis. Network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between COVID-19 patients with and without a history of lifetime mental disorder, and between hospitalized and non-hospitalized patients. LIMITATIONS Generalization of our findings may be difficult since differences in network connectivity may exist in different populations or samples. RESULTS Anxiety and depression showed high centrality in patients with COVID-19 and anxiety showed the highest bridge influence in the network. Resilience and social support showed a low influence on mental disorder symptoms. Global network estimations show no statistically significant changes between patients with and without pre-existing mental disorders or between hospitalized and non-hospitalized patients. CONCLUSIONS Anxiety might be a key treatment target in patients with COVID-19 since its treatment might prevent other mental health adverse outcomes.
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Affiliation(s)
- Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Lydia Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain
| | - Adriana Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Giménez-Palomo
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Mireia Vazquez
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Gomez-Ramiro
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Alvaro Cunqueiro, SERGAS, Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain
| | - Bernat Carreras
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain
| | - Andrea Murru
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Helena García-Mieres
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), p. de la Vall d'Hebron, 171, 08035 Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain; Dept. Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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12
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Moreira I, Ferrer M, Vilagut G, Mortier P, Felez-Nobrega M, Domènech-Abella J, Haro JM, Alonso J. Correction: Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection. Int J Equity Health 2023; 22:192. [PMID: 37726713 PMCID: PMC10510113 DOI: 10.1186/s12939-023-01997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Affiliation(s)
- Isabel Moreira
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, Office 144, 08003, Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Universitat Pompeu Fabra - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, Office 144, 08003, Barcelona, Spain.
- CIBER de Epidemiología Y Salud Pública (CIBERESP), Barcelona, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, Office 144, 08003, Barcelona, Spain
- CIBER de Epidemiología Y Salud Pública (CIBERESP), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, Office 144, 08003, Barcelona, Spain
- CIBER de Epidemiología Y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Joan Domènech-Abella
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep-Maria Haro
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación del Hospital de La Princesa, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, Office 144, 08003, Barcelona, Spain
- CIBER de Epidemiología Y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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13
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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14
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Arias de la Torre J, Vilagut G, Ronaldson A, Valderas JM, Bakolis I, Dregan A, Molina AJ, Navarro-Mateu F, Pérez K, Bartoll-Roca X, Elices M, Pérez-Sola V, Serrano-Blanco A, Martín V, Alonso J. Reliability and cross-country equivalence of the 8-item version of the Patient Health Questionnaire (PHQ-8) for the assessment of depression: results from 27 countries in Europe. Lancet Reg Health Eur 2023; 31:100659. [PMID: 37332385 PMCID: PMC10272490 DOI: 10.1016/j.lanepe.2023.100659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
Background The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear whether its psychometric properties vary between European countries. Therefore, the aim of this study was to assess the internal structure, reliability and cross-country equivalence of the PHQ-8 in Europe. Methods All participants from the 27 countries included in the second wave of the European Health Interview Survey (EHIS-2) between 2014 and 2015 with complete information on the PHQ-8 were included (n = 258,888). The internal structure of the PHQ-8 was assessed using confirmatory factor analyses (CFA) for categorical items. Additionally, the reliability of the questionnaire was assessed based on the internal consistency, Item Response Theory information functions, and item-discrimination (using Graded Response Models), and the cross-country equivalence based on multi-group CFA. Findings The PHQ-8 shows high internal consistency for all countries. The countries in which the PHQ-8 was more reliable were Romania, Bulgaria and Cyprus and less reliable were Iceland, Norway and Austria. The PHQ-8 item with highest discrimination was item 2 (feeling down, depressed, or hopeless) in 24 of the 27 countries. Measurement invariance between countries in Europe was observed from multigroup CFA at the configural, metric and scalar levels. Interpretation The results from our study, likely the largest study to the date assessing the internal structure, reliability and cross-country comparability of a self-reported mental health assessment measure, shows that the PHQ-8 has an adequate reliability and cross-country equivalence across the 27 European countries included. These results highlight the suitability of the comparisons of the PHQ-8 scores in Europe. They could be helpful to improve the screening and severity assessment of depressive symptoms at the European level. Funding This work was partially funded by CIBER Epidemiology and Public Health (CIBERESP) as part of the Intramural call of 2021 (ESP21PI05).
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Affiliation(s)
- Jorge Arias de la Torre
- Care in Long Term Conditions Research Division, King’s College London, London, UK
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Gemma Vilagut
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Jose M. Valderas
- Department of Medicine, National University of Singapore, Singapore
- Department of Family Medicine, National University Health System, Singapore
- Centre for Research in Health Systems Performance (CRiHSP), National University Health System, Singapore
| | - Ioannis Bakolis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Alex Dregan
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Antonio J. Molina
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Fernando Navarro-Mateu
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Murcia, Spain
- IMIB-Arrixaca, Murcia, Spain
| | - Katherine Pérez
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut de Recerca de l’Hospital de laSanta Creu i Sant Pau, Barcelona, Spain
| | | | | | - Antoni Serrano-Blanco
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Vicente Martín
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Jordi Alonso
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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15
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Domènech-Abella J, Gabarrell-Pascuet A, García-Mieres H, Mortier P, Felez-Nobrega M, Cristóbal-Narváez P, Vilagut G, Olaya B, Alonso J, Haro JM. Loneliness during the last phase of the COVID-19 pandemic in Spain: A longitudinal study of group-based trajectories, risk factors, and consequences in mental health. Psychiatry Res 2023; 326:115327. [PMID: 37413806 DOI: 10.1016/j.psychres.2023.115327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION The present study aims to investigate the courses of loneliness following a national state of emergency including a curfew due to a rise in COVID-19 cases, associated risk factors, and the effect of loneliness on symptoms of depression and anxiety. METHODS Data of 2,000 adults in Spain which were interviewed by telephone at the first follow-up of the MINDCOVID project (February-March 2021) and of whom 953 were interviewed nine months later (November-December 2021) were analyzed. Group-based trajectories and mixed models were constructed. RESULTS Three courses of loneliness were detected: (1) invariant low loneliness (42.6%), (2) decreasing medium loneliness (51.5%), and (3) fairly invariant high loneliness (5.9%). Loneliness courses were associated with the severity and variability of symptoms of depression and anxiety. In contrast to the majority of pre-pandemic studies, younger adults more frequently reported loneliness compared to middle-aged and, particularly, older individuals. Other risk factors for loneliness were being female, being unmarried, and, notably, having pre-pandemic mental disorders. CONCLUSIONS Future studies should validate whether the newly observed loneliness patterns across age groups persist and assess the evolution of loneliness courses and their impact on mental health, with particular attention given to young adults and individuals with pre-existing mental disorders.
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Affiliation(s)
- Joan Domènech-Abella
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Aina Gabarrell-Pascuet
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Helena García-Mieres
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mireia Felez-Nobrega
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Paula Cristóbal-Narváez
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Olaya
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josep Maria Haro
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
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16
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Leung ONW, Chiu NKH, Wong SYS, Cuijpers P, Alonso J, Chan PKS, Lui G, Wong E, Bruffaerts R, Yip BHK, Mortier P, Vilagut G, Kwok D, Lam LCW, Kessler RC, Mak ADP. Dimensional structure of one-year post-COVID-19 neuropsychiatric and somatic sequelae and association with role impairment. Sci Rep 2023; 13:12205. [PMID: 37500708 PMCID: PMC10374659 DOI: 10.1038/s41598-023-39209-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/21/2023] [Indexed: 07/29/2023] Open
Abstract
This study examined the latent structure of the broad range of complex neuropsychiatric morbidities occurring 1 year after COVID-19 infection. As part of the CU-COVID19 study, 248 (response rate=39.3%) of 631 adults hospitalized for COVID-19 infection in Hong Kong completed an online survey between March-2021 and January-2022. Disorder prevalence was compared against a random non-infected household sample (n=1834). 248 surveys were received on average 321 days post-infection (Mean age: 48.9, 54% female, moderate/severe/critical infection: 58.2%). 32.4% were screened to have at least one mental disorder, 78.7% of whom had concurrent fatigue/subjective cognitive impairment (SCI). Only PTSD (19.1%) was significantly more common than control (14%, p=0.047). Latent profile analysis classified individuals into P1 (12·4%)-no current neuropsychiatric morbidities, P2 (23.1%)-SCI/fatigue, P3 (45.2%)-anxiety/PTSD, P4 (19.3%)-depression. SCI and fatigue pervaded in all profiles (P2-4) with neuropsychiatric morbidities one-year post-infection. PTSD, anxiety and depressive symptoms were most important in differentiating P2-4. Past mental health and P4 independently predicted functional impairment. Neuropsychiatric morbidity was associated with past mental health, reduced resilience, financial problems, but not COVID-19 severity. Their confluence with depressive and anxiety symptoms predicted impairment and are associated with psychological and environmental factors.
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Affiliation(s)
- Owen N W Leung
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Nicholas K H Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- International Institute for Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Jordi Alonso
- Health Services Research group, IMIM-Institut Hospital Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra, CIBERESP, Barcelona, Spain
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Grace Lui
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Eliza Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Benjamin H K Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Philippe Mortier
- Health Services Research group, IMIM-Institut Hospital Mar d'Investigacions Mèdiques, CIBER Epidemiología y Salud Pública CIBERESP, Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research group, IMIM-Institut Hospital Mar d'Investigacions Mèdiques, CIBER Epidemiología y Salud Pública CIBERESP, Barcelona, Spain
| | - Dora Kwok
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Arthur D P Mak
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
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17
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Moreira I, Ferrer M, Vilagut G, Mortier P, Felez-Nobrega M, Domènech-Abella J, Haro JM, Alonso J. Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection. Int J Equity Health 2023; 22:136. [PMID: 37488575 PMCID: PMC10367254 DOI: 10.1186/s12939-023-01933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/12/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Understanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants' level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021). METHODS This is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender. RESULTS A total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08-1.59) for women and 1.34 (95%CI 1.05-1.69) for men in pain/discomfort to 2.59 (95%CI 0.98-6.81) for women and 4.03 (95%CI 1.52-10.70) for men in self-care; aPR decreased after nine months for most dimensions. CONCLUSIONS Prevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.
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Affiliation(s)
- Isabel Moreira
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Universitat Pompeu Fabra - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain.
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Joan Domènech-Abella
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep-Maria Haro
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación del Hospital de la Princesa, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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18
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Portillo-Van Diest A, Ballester Coma L, Mortier P, Vilagut G, Amigo F, Puértolas Gracia B, García-Mieres H, Alayo I, Blasco MJ, Carrasco Espi P, Falcó R, Forteza-Rey I, Garcia-Pazo P, Gili M, Giménez-García C, Machancoses FH, Marzo Campos JC, Navarra-Ventura G, Piqueras JA, Rebagliato M, Roca M, Rodriguez Jiménez T, Roldan L, Ruiz-Palomino E, Soto-Sanz V, Alonso J. Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project. BMJ Open 2023; 13:e072641. [PMID: 37451741 PMCID: PMC10351263 DOI: 10.1136/bmjopen-2023-072641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION osf.io/p7csq.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Laura Ballester Coma
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Philippe Mortier
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Franco Amigo
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Beatriz Puértolas Gracia
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Helena García-Mieres
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- Kronikgune, Baracaldo, Euskadi, Spain
| | | | - Paula Carrasco Espi
- Department of Medicine, Universitat Jaume I, Castello de la Plana, Spain
- Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain
| | - Raquel Falcó
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Ines Forteza-Rey
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | - Patricia Garcia-Pazo
- Department of Nursing and Physiotherapy, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
- Development and Psychopathology, IdISBa, Palma de Mallorca, Illes Balears, Spain
| | - Margalida Gili
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Psychology, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | - Cristina Giménez-García
- Department of Basic and Clinical Psychology, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Castelló, Spain
| | - Francisco H Machancoses
- Predepartamental Unit of Medicine, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
| | | | | | - Jose A Piqueras
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Marisa Rebagliato
- CIBERESP, Madrid, Comunidad de Madrid, Spain
- Predepartamental Unit of Medicine, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- Environment and Health, CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Miquel Roca
- IdISBa, Palma de Mallorca, Illes Balears, Spain
- Department of Medicine, Universitat de les Illes Balears, Palma de Mallorca, Illes Balears, Spain
| | | | | | - Estefanía Ruiz-Palomino
- Department of Basic and Clinical Psychology, Science Health Faculty, Universitat Jaume I, Castello de la Plana, Castelló, Spain
| | - Victoria Soto-Sanz
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Jordi Alonso
- Health Services Research Group, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
- CIBERESP, Madrid, Comunidad de Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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19
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Bharat C, Glantz MD, Aguilar-Gaxiola S, Alonso J, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, Cardoso G, Chardoul S, de Jonge P, Gureje O, Haro JM, Harris MG, Karam EG, Kawakami N, Kiejna A, Kovess-Masfety V, Lee S, McGrath JJ, Moskalewicz J, Navarro-Mateu F, Rapsey C, Sampson NA, Scott KM, Tachimori H, Ten Have M, Vilagut G, Wojtyniak B, Xavier M, Kessler RC, Degenhardt L. Development and evaluation of a risk algorithm predicting alcohol dependence after early onset of regular alcohol use. Addiction 2023; 118:954-966. [PMID: 36609992 PMCID: PMC10073308 DOI: 10.1111/add.16122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 12/10/2022] [Indexed: 01/09/2023]
Abstract
AIMS Likelihood of alcohol dependence (AD) is increased among people who transition to greater levels of alcohol involvement at a younger age. Indicated interventions delivered early may be effective in reducing risk, but could be costly. One way to increase cost-effectiveness would be to develop a prediction model that targeted interventions to the subset of youth with early alcohol use who are at highest risk of subsequent AD. DESIGN A prediction model was developed for DSM-IV AD onset by age 25 years using an ensemble machine-learning algorithm known as 'Super Learner'. Shapley additive explanations (SHAP) assessed variable importance. SETTING AND PARTICIPANTS Respondents reporting early onset of regular alcohol use (i.e. by 17 years of age) who were aged 25 years or older at interview from 14 representative community surveys conducted in 13 countries as part of WHO's World Mental Health Surveys. MEASUREMENTS The primary outcome to be predicted was onset of life-time DSM-IV AD by age 25 as measured using the Composite International Diagnostic Interview, a fully structured diagnostic interview. FINDINGS AD prevalence by age 25 was 5.1% among the 10 687 individuals who reported drinking alcohol regularly by age 17. The prediction model achieved an external area under the curve [0.78; 95% confidence interval (CI) = 0.74-0.81] higher than any individual candidate risk model (0.73-0.77) and an area under the precision-recall curve of 0.22. Overall calibration was good [integrated calibration index (ICI) = 1.05%]; however, miscalibration was observed at the extreme ends of the distribution of predicted probabilities. Interventions provided to the 20% of people with highest risk would identify 49% of AD cases and require treating four people without AD to reach one with AD. Important predictors of increased risk included younger onset of alcohol use, males, higher cohort alcohol use and more mental disorders. CONCLUSIONS A risk algorithm can be created using data collected at the onset of regular alcohol use to target youth at highest risk of alcohol dependence by early adulthood. Important considerations remain for advancing the development and practical implementation of such models.
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Affiliation(s)
- Chrianna Bharat
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales Australia, Sydney, NSW, Australia
| | - Meyer D Glantz
- Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, MA, USA
| | | | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Life and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | | | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Stephanie Chardoul
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Peter de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | - Meredith G Harris
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Elie G Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Andrzej Kiejna
- Institute of Psychology, University of Lower Silesia, Wroclaw, Poland
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
- Queensland Brain Institute, The University of Queensland, National Centre for Register-based Research, Aarhus University, Aarhus V, Denmark
| | | | - Fernando Navarro-Mateu
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Basic Psychology and Methodology, University of Murcia, Murcia Biomedical Research Institute (IMIB-Arrixaca), Unidad de Docencia, Investigación y Formación en Salud Mental, Servicio Murciano de Salud, Murcia, Spain
| | - Charlene Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Hisateru Tachimori
- Department of Clinical Data Science, Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Endowed Course for Health System Innovation, Keio University School of Medicine, Tokyo, Japan
| | - Margreet Ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bogdan Wojtyniak
- Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Research Institute, Warsaw, Poland
| | - Miguel Xavier
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales Australia, Sydney, NSW, Australia
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20
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Kiekens G, Hasking P, Bruffaerts R, Alonso J, Auerbach RP, Bantjes J, Benjet C, Boyes M, Chiu WT, Claes L, Cuijpers P, Ebert DD, Mak A, Mortier P, O’Neill S, Sampson NA, Stein DJ, Vilagut G, Nock MK, Kessler RC. Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative. Psychol Med 2023; 53:875-886. [PMID: 34140062 PMCID: PMC8683565 DOI: 10.1017/s0033291721002245] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
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Affiliation(s)
- Glenn Kiekens
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | | | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences Stellenbosch University, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mark Boyes
- School of Population Health, Curtin University, Perth, Australia
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Siobhan O’Neill
- School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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21
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Mar J, Larrañaga I, Ibarrondo O, González-Pinto A, Las Hayas C, Fullaondo A, Izco-Basurko I, Alonso J, Zorrilla I, Vilagut G, Mateo-Abad M, de Manuel E. Incidence of mental disorders in the general population aged 1-30 years disaggregated by gender and socioeconomic status. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02425-z. [PMID: 36692520 PMCID: PMC9872752 DOI: 10.1007/s00127-023-02425-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE The objective of this study was to estimate the incidence and age of onset of mental disorders diagnosed by gender and socioeconomic status (SES) in children, adolescents, and young adults up to 30 years of age in the whole population of the Basque Country (Spain). METHODS All mental health diagnoses documented in Basque Health Service records from 1 January 2003 to 31 December 2018, were classified into eight clusters: anxiety, attention deficit hyperactivity disorder (ADHD), conduct disorders, depression, psychosis/personality disorders, substance use, eating disorders, and self-harm. We calculated incidence and cumulative incidence for each cluster, disaggregated by gender, and socioeconomic status (SES). Poisson regression analyses were performed. RESULTS Overall, 9,486,853 person-years of observation were available for the 609,281 individuals included. ADHD and conduct disorders were diagnosed in the first decade, anxiety and depression disorders in the second and third decades, and psychosis/personality and substance use in the third. The cumulative incidence at 18 years of age for any type of disorder was 15.5%. The group with low SES had a statistically significantly higher incidence of all eight clusters. The incidence of ADHD, conduct disorders, depression, psychosis/personality disorders, and substance use was higher in males and that of anxiety, eating disorders and self-harm was higher in females. CONCLUSIONS The incidence of mental disorders is high among children, adolescents, and young adults in the Basque Country underlining the need for preventive interventions. Marked differences by gender and SES highlight mental health inequalities, especially for depression and psychosis in low SES males.
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Affiliation(s)
- Javier Mar
- Osakidetza Basque Health Service, Research Unit, Debagoiena Integrated Health Organisation, Hospital 'Alto Deba', Unidad de Gestión Sanitaria, Avenida Navarra 16, 20500, Arrasate-Mondragón, Spain.
- Biodonostia Health Research Institute, Donostia-San Sebastián, Spain.
- REDISSEC (Health Services Research on Chronic Patients Network), Bilbao, Spain.
- Kronikgune Institute for Health Services Research, Barakaldo, Spain.
| | - Igor Larrañaga
- Osakidetza Basque Health Service, Research Unit, Debagoiena Integrated Health Organisation, Hospital 'Alto Deba', Unidad de Gestión Sanitaria, Avenida Navarra 16, 20500, Arrasate-Mondragón, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Oliver Ibarrondo
- Osakidetza Basque Health Service, Research Unit, Debagoiena Integrated Health Organisation, Hospital 'Alto Deba', Unidad de Gestión Sanitaria, Avenida Navarra 16, 20500, Arrasate-Mondragón, Spain
| | - Ana González-Pinto
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- UPV/EHU-University of the Basque Country, Vitoria-Gasteiz, Spain
- CIBERSAM, CIBER en Salud Mental, Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
| | | | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | | | - Jordi Alonso
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBERESP, CIBER en Epidemiología y Salud Pública, Madrid, Spain
- UPF-Pompeu Fabra University, Barcelona, Spain
| | - Iñaki Zorrilla
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- UPV/EHU-University of the Basque Country, Vitoria-Gasteiz, Spain
- CIBERSAM, CIBER en Salud Mental, Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBERESP, CIBER en Epidemiología y Salud Pública, Madrid, Spain
- UPF-Pompeu Fabra University, Barcelona, Spain
| | - Maider Mateo-Abad
- REDISSEC (Health Services Research on Chronic Patients Network), Bilbao, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
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22
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Pérez V, Elices M, Vilagut G, Vieta E, Blanch J, Laborda-Serrano E, Prat B, Colom F, Palao D, Alonso J. Corrigendum to 'Suicide-related thoughts and behavior and suicide death trends during the COVID-19 in the general population of Catalonia, Spain' [European Neuropsychopharmacology 56 (2021) 4-12]. Eur Neuropsychopharmacol 2023; 66:66. [PMID: 36462446 PMCID: PMC9709522 DOI: 10.1016/j.euroneuro.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- V Pérez
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - M Elices
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - G Vilagut
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Blanch
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain; Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | | | - B Prat
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | - F Colom
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - D Palao
- Department of Mental Health, Parc Taulí-University Hospital; Unitat Mixta de Neurociència Traslacional I3PT, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona; CIBERSAM, Spain
| | - J Alonso
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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23
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Esteve-Matalí L, Llorens-Serrano C, Alonso J, Vilagut G, Moncada S, Navarro-Giné A. Mental health inequalities in times of crisis: evolution between 2005 and 2021 among the Spanish salaried population. J Epidemiol Community Health 2022; 77:jech-2022-219523. [PMID: 36344271 DOI: 10.1136/jech-2022-219523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/22/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studying the working population's mental health in times of crisis (such as the 2008 recession or the COVID-19 pandemic) is very relevant. This study aims to assess the prevalence of poor mental health among the Spanish salaried population, according to the labour market inequality axes (2005-2021). METHODS Repeated cross-sectional study by comparing different surveys from 2005, 2010, 2016 and 2021 on workers residing in Spain who had been working in a salaried job during the week preceding the survey. n=7197 (2005), n=4985 (2010), n=1807 (2016) and n=18 870 (2021). OUTCOME VARIABLE poor mental health (Mental Health Inventory of the 36-item Short Form Health Survey scale). Explanatory variables: gender, age, occupational class and type of contract. Prevalence of poor mental health was estimated for each year by means of logistic regression models with robust clustered SEs, stratifying by the explanatory variables. Additionally, prevalence ratios (PR) were estimated by means of robust Poisson regression models to assess differences between the explanatory variables' categories. All analyses were weighted to address unrepresentativeness. RESULTS Poor mental health significantly increased in 2021 (55.92%), compared with the previous years of study (15%-17.72%). Additionally, pattern changes were identified on inequality axes in 2021, with better mental health status among older workers (oldest group PR: 0.76; 95% CI 0.71 to 0.8) and permanent workers (PR: 0.9; 95% CI 0.85 to 0.94). CONCLUSION This study shows a steep worsening of mental health among the salaried population in 2021 compared with previous periods. In 2021, health inequalities have apparently narrowed, although not by improving the disadvantaged groups' mental health but by worsening the typically advantaged groups' mental health.
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Affiliation(s)
- Laura Esteve-Matalí
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Biostatistics Unit, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Clara Llorens-Serrano
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Instituto Sindical de Trabajo, Ambiente y Salud-Fundación Primero de Mayo (ISTAS-F1M), Barcelona, Spain
- Department of Sociology, Faculty of Sociology and Political Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM - Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM - Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Salvador Moncada
- Instituto Sindical de Trabajo, Ambiente y Salud-Fundación Primero de Mayo (ISTAS-F1M), Barcelona, Spain
| | - Albert Navarro-Giné
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Biostatistics Unit, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Institute for Labour Studies (IET), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
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24
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Marti-Pastor M, German D, Perez G, Bartoll X, Diez E, Pont A, Garín O, Alonso J, Hernandez G, Mayoral K, Zamora V, Vilagut G, Ferrer M. Health Inequalities by Sexual Orientation: Results from the 2016-2017 Barcelona Health Survey. LGBT Health 2022; 9:496-511. [PMID: 35802488 PMCID: PMC9639238 DOI: 10.1089/lgbt.2021.0171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The aim of this study was to assess health inequalities by sexual attraction in the 2016-2017 Barcelona population, stratifying by sex. Methods: Data came from the 2016-2017 Barcelona Health Survey, where 3362 adults answered among other instruments the EuroQol-5 dimensions-5 levels (EQ-5D-5L), which measures five dimensions and summarizes health-related quality of life into a single utility index score. To assess health differences by sexual attraction, we constructed Tobit models for the EQ-5D index score and Poisson regression models for the EQ-5D dimensions. Nested models were constructed to examine the mediating role of discrimination and health-related variables. Results: After adjusting for sociodemographic variables, women feeling attraction to more than one sex showed a lower EQ-5D index score (worse health) than those with only other sex attraction (-0.042, p = 0.012), and higher prevalence of problems with mobility, usual activities, and anxiety/depression with the following adjusted prevalence ratios (aPR) and confidence intervals (CIs): 1.79 (95% CI 1.05-3.05), 1.84 (95% CI 1.05-3.21), and 1.76 (95% CI 1.27-2.43). Women feeling attraction only to their same sex also presented higher prevalence of anxiety/depression (aPR = 1.46, CI 95% 1.10-1.92). In contrast, differences were not observed for men. Conclusion: Women, but not men, feeling attraction to more than one sex and only same-sex attraction in Barcelona in 2016-2017 presented worse health than those feeling only other sex attraction, with discrimination playing a mediating role in explaining such inequalities. These results among women indicate the need to develop public health strategies in Barcelona addressed to lesbian and bisexual women, considering the intersection of gender and sexual orientation.
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Affiliation(s)
- Marc Marti-Pastor
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventative Medicine, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
| | - Danielle German
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gloria Perez
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Agency of Barcelona, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
- Health Inequalities Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Xavier Bartoll
- Public Health Agency of Barcelona, Barcelona, Spain
- Health Inequalities Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Elia Diez
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Agency of Barcelona, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
- Health Inequalities Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Angels Pont
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Olatz Garín
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Gimena Hernandez
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CAP Vila Olimpica, Parc Sanitari Pere Virgili, Barcelona, Spain
| | - Karina Mayoral
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventative Medicine, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
| | - Victor Zamora
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventative Medicine, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventative Medicine, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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Mortier P, Alonso J, Auerbach RP, Bantjes J, Benjet C, Bruffaerts R, Cuijpers P, Ebert DD, Green JG, Hasking P, Karyotaki E, Kiekens G, Mak A, Nock MK, O'Neill S, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Wilks C, Zaslavsky AM, Mair P, Kessler RC. Childhood adversities and suicidal thoughts and behaviors among first-year college students: results from the WMH-ICS initiative. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1591-1601. [PMID: 34424350 PMCID: PMC8878415 DOI: 10.1007/s00127-021-02151-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students. METHODS Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, plans and attempts along with seven CAs: parental psychopathology, three types of abuse (emotional, physical, sexual), neglect, bully victimization, and dating violence. Logistic regression estimated individual- and population-level associations using CA operationalizations for type, number, severity, and frequency. RESULTS Associations of CAs with lifetime ideation and the transition from ideation to plan were best explained by the exact number of CA types (OR range 1.32-52.30 for exactly two to seven CAs). Associations of CAs with a transition to attempts were best explained by the frequency of specific CA types (scaled 0-4). Attempts among ideators with a plan were significantly associated with all seven CAs (OR range 1.16-1.59) and associations remained significant in adjusted analyses with the frequency of sexual abuse (OR = 1.42), dating violence (OR = 1.29), physical abuse (OR = 1.17) and bully victimization (OR = 1.17). Attempts among ideators without plan were significantly associated with frequency of emotional abuse (OR = 1.29) and bully victimization (OR = 1.36), in both unadjusted and adjusted analyses. Population attributable risk simulations found 63% of ideation and 30-47% of STB transitions associated with CAs. CONCLUSION Early-life adversities represent a potentially important driver in explaining lifetime STB among incoming college students. Comprehensive intervention strategies that prevent or reduce the negative effects of CAs may reduce subsequent onset of STB.
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Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Jason Bantjes
- Department of Global Health, Faculty of Medicine and Health Sciences, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, USA
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Glenn Kiekens
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Derry-Londonderry, Northern Ireland
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Chelsey Wilks
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Alan M Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Ballester L, Alayo I, Vilagut G, Mortier P, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Miranda-Mendizabal A, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Alonso J. Predictive models for first-onset and persistence of depression and anxiety among university students. J Affect Disord 2022; 308:432-441. [PMID: 35398107 DOI: 10.1016/j.jad.2021.10.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions. METHODS Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up. RESULTS A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline. LIMITATIONS Self-report data were used; external validation of the multivariable prediction models is needed. CONCLUSION MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; Girona University (UdG), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pere Castellví
- International University of Catalonia (UIC), Barcelona, Spain
| | | | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Medicine and Life Scienes, Universitat Pompeu Fabra, Barcelona, Spain.
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Arias De La Torre J, Vilagut G, Ronaldson A, Serrano-Blanco A, Valderas J, Martín V, Dregan A, Bakolis I, Alonso J. Prevalence of depression in Europe using two different PHQ-8 scoring methods. Eur Psychiatry 2022. [PMCID: PMC9567515 DOI: 10.1192/j.eurpsy.2022.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The prevalence of depression based on the Patient Health Questionnaire-8 (PHQ-8) may vary depending on the scoring method. Objectives 1) To describe the prevalence of depression in Europe using two PHQ-8 scoring methods. 2) To identify the countries with the highest prevalence according to each method. Methods Data from 27 countries included in the European Health Survey (EHIS-2) for the year 2014/2015 were used (n=258,888). All participants who completed the PHQ-8 were included. The prevalence of depression and its 95% Confidence Interval (95%CI) were calculated overall for the whole of Europe and for each country using a PHQ-8≥10 cut-off point and the PHQ-8 algorithm scoring method. Weights derived from the complex sample design were considered for their calculation. Results The overall prevalence of depression for all Europe was lower using the PHQ-8>=10 cut-off point (6.38%, 95%CI 6.24-6.52) than the PHQ-8 algorithm (7.01%, 95%CI, 6.86-7.16). Using the PHQ-8≥10 cut-off point, the highest prevalence was observed in Iceland (10.33%, 95%CI, 9.33-11.32), Luxembourg (9.74%, 95%CI, 8.76-10.72) and Germany (9.24%, 95%CI, 8.82-9.66). Using the PHQ-8 algorithm the highest rates were observed in Hungary (10.99%, 95%CI,10.14-11.84), Portugal (10.63%, 95%CI, 9.96-11.29) and Iceland (9.80%, 95%CI, 8.77-10.83). Conclusions There is variability in the prevalence of depression rates in Europe according to the PHQ-8 scoring method. These findings suggest the necessity of identify the method of choice for each country comparing with a gold standard measure (clinical diagnosis). Countries with consistent higher prevalence of depression based on PHQ-8 regardless of scoring method deserve further study. Disclosure This work has been funded by CIBERESP (ESP21PI05)
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Mortier P, Vilagut G, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo del Barco A, Campos M, Espuga M, González-Pinto A, Haro J, López Fresneña N, Martínez de Salázar A, Molina J, Ortí-Lucas R, Parellada M, Pelayo-Terán J, Pérez-Gómez B, Pérez-Zapata A, Pijoan J, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig M, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler R, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Alayo I, Alonso M, Álvarez M, Amann B, Amigo FF, Anmella G, Aragón A, Aragonés N, Aragonès E, Arizón AI, Asunsolo A, Ayora A, Ballester L, Barbas P, Basora J, Bereciartua E, Ignasi Bolibar IB, Bonfill X, Cotillas A, Cuartero A, de Paz C, Cura ID, Jesus del Yerro M, Diaz D, Domingo JL, Emparanza JI, Espallargues M, Espuga M, Estevan P, Fernandez MI, Fernandez T, Ferrer M, Ferreres Y, Fico G, Forjaz MJ, Barranco RG, Garcia TorrecillasC. Garcia-Ribera JM, Garrido A, Gil E, Gomez M, Gomez J, Pinto AG, Haro JM, Hernando M, Insigna MG, Iriberri M, Jimenez N, Jimenez X, Larrauri A, Leon F, Lopez-Fresneña N, Lopez C, Lopez-Atanes Juan Antonio Lopez-Rodriguez M, Lopez-Cortacans G, Marcos A, Martin J, Martin V, Martinez-Cortés M, Martinez-Martinez R, Martinez de Salazar AD, Martinez I, Marzola M, Mata N, Molina JM, de Dios Molina J, Molinero E, Mortier P, Muñoz C, Murru A, Olmedo J, Ortí RM, Padrós R, Pallejà M, Parra R, Pascual J, Pelayo JM, Pla R, Plana N, Aznar CP, Gomez BP, Zapata AP, Pijoan JI, Polentinos E, Puertolas B, Puig MT, Quílez A, Quintana MJ, Quiroga A, Rentero D, Rey C, Rius C, Rodriguez-Blazquez C, Rojas MJ, Romero Y, Rubio G, Rumayor M, Ruiz P, Saenz M, Sanchez J, Sanchez-Arcilla I, Sanz F, Serra C, Serra-Sutton V, Serrano M, Sola S, Solera S, Soto M, Tarrago A, Tolosa N, Vazquez M, Viciola M, Vieta E, Vilagut G, Yago S, Yañez J, Zapico Y, Zorita LM, Zorrilla I, Zurbano SL, Perez-Solá V. Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic. J Psychiatr Res 2022; 149:10-17. [PMID: 35217315 PMCID: PMC8852847 DOI: 10.1016/j.jpsychires.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.
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Affiliation(s)
- P. Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Corresponding author. IMIM, PRBB Building. Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
| | - G. Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - I. Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M. Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - F. Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - E. Aragonès
- Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - A. Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain,Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - A. Asúnsolo del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain,Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain,Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - M. Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - M. Espuga
- Occupational Health Service. Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - A. González-Pinto
- Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain,CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - J.M. Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Parc Sanitari Sant Joan de Déu, Barcelona, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - J.D. Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Villaverde Mental Health Center. Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain,Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain,Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - M. Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J.M. Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain,Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - B. Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A. Pérez-Zapata
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - J.I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain, Biocruces-Bizkaia Health Research Institute
| | - N. Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - E. Polentinos-Castro
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain,Research Unit. Primary Care Management. Madrid Health Service, Madrid, Spain,Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain,Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
| | - A. Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M.T. Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain,CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - C. Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - F. Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - C. Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Parc de Salut Mar PSMAR, Barcelona, Spain,CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - I. Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain,Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - E. Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - V. Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Parc de Salut Mar PSMAR, Barcelona, Spain
| | - J. Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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de Miquel C, Domènech-Abella J, Felez-Nobrega M, Cristóbal-Narváez P, Mortier P, Vilagut G, Alonso J, Olaya B, Haro JM. The Mental Health of Employees with Job Loss and Income Loss during the COVID-19 Pandemic: The Mediating Role of Perceived Financial Stress. Int J Environ Res Public Health 2022; 19:3158. [PMID: 35328846 PMCID: PMC8950467 DOI: 10.3390/ijerph19063158] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/13/2022]
Abstract
The COVID-19 outbreak, which was followed by home confinement, is expected to have had profound negative impact on the mental health of people. Associated factors, such as losing jobs and income, can be expected to lead to an increased risk of suffering from psychopathological problems. Therefore, this study was aimed at researching the associations of job and income loss with mental health, as well as the possible mediating role of perceived financial stress during the COVID-19 outbreak. The sample included 2381 Spanish workers who were interviewed right after the first COVID-19 lockdown. Measures were taken for generalized anxiety disorder, panic attacks, depression, post-traumatic stress disorder, substance abuse, suicidal thoughts and behaviors, working conditions, sociodemographic variables, and perceived financial stress. Logistic regression models were calculated with psychological variables as outcomes, and with job loss and income loss as predictors. Mediation analyses were performed by adding the financial threat as a mediator. Nineteen point six percent and 33.9% of participants reported having lost their jobs and incomes due to the pandemic, respectively. Only income loss was related to a higher risk of suffering from depression and panic attacks. When adding financial stress as a mediator, the indirect effects of job and income loss on the mental health measures were found to be significant, therefore indicating mediation. These findings pinpoint the vulnerability of this population, and highlight the need for interventional and preventive programs targeting mental health in economic crisis scenarios, such as the current one. They also highlight the importance of implementing social and income policies during the COVID-19 pandemic to prevent mental health problems.
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Affiliation(s)
- Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
| | - Joan Domènech-Abella
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Mireia Felez-Nobrega
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Paula Cristóbal-Narváez
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
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Pérez V, Elices M, Vilagut G, Vieta E, Blanch J, Laborda-Serrano E, Prat B, Colom F, Palao D, Alonso J. Suicide-related thoughts and behavior and suicide death trends during the COVID-19 in the general population of Catalonia, Spain. Eur Neuropsychopharmacol 2022; 56:4-12. [PMID: 34875491 PMCID: PMC8603035 DOI: 10.1016/j.euroneuro.2021.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/31/2022]
Abstract
The COVID-19 pandemic is expected to increase suicidal behavior. However, data available to date are inconsistent. This study examines suicidal thoughts and behaviors and suicide trends in 2020 relative to 2019 as an approximation to the impact of the pandemic on suicidal behavior and death in the general population of Catalonia, Spain. Data on suicide-related thoughts and behaviors (STBs) and suicidal mortality were obtained from the Catalonia Suicide Risk Code (CSRC) register and the regional police, respectively. We compared the monthly crude incidence of STBs and suicide mortality rates of 2020 with those of 2019. Joinpoint regression analysis was used to assess changes in trends over time during the studied period. In 2020, 4,263 consultations for STBs and 555 suicide deaths were registered in Catalonia (approx. 7.5 million inhabitants). Compared to 2019, in 2020 STBs rates decreased an average of 6.3% (incidence rate ratio, IRR=0.94, 95% CI 0,90-0,98) and overall suicide death rates increased 1.2% (IRR=1.01, 95% CI 0.90-1.13). Joinpoint regression results showed a substantial decrease in STBs rates with a monthly percent change (MPC) of -22.1 (95% CI: -41.1, 2.9) from January-April 2020, followed by a similar increase from April-July 2020 (MPC=24.7, 95% CI: -5.9, 65.2). The most restrictive measures implemented in response to the COVID-19 pandemic reduced consultations for STBs, suggesting that the "stay at home" message may have discouraged people from contacting mental health services. STBs and mortality should continue to be monitored in 2021 and beyond to understand better the mid-to-long term impact of COVID-19 on suicide trends.
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Affiliation(s)
- V Pérez
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - M Elices
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - G Vilagut
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Blanch
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain; Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | | | - B Prat
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | - F Colom
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - D Palao
- Department of Mental Health, Parc Taulí-University Hospital; Unitat Mixta de Neurociència Traslacional I3PT, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona; CIBERSAM, Spain
| | - J Alonso
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Monistrol-Mula A, Felez-Nobrega M, Domènech-Abella J, Mortier P, Cristóbal-Narváez P, Vilagut G, Olaya B, Ferrer M, Gabarrell-Pascuet A, Alonso J, Haro JM. The impact of COVID-related perceived stress and social support on generalized anxiety and major depressive disorders: moderating effects of pre-pandemic mental disorders. Ann Gen Psychiatry 2022; 21:7. [PMID: 35164779 PMCID: PMC8845272 DOI: 10.1186/s12991-022-00385-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/03/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND We assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health. METHODS A nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders. RESULTS Higher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders. CONCLUSIONS The impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.
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Affiliation(s)
- Anna Monistrol-Mula
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Mireia Felez-Nobrega
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. .,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.
| | - Joan Domènech-Abella
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.,Department of Sociology, Universitat de Barcelona, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Paula Cristóbal-Narváez
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Olaya
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | - Montse Ferrer
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aina Gabarrell-Pascuet
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Life and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Josep Maria Haro
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.,Departament de Medicine, Universitat de Barcelona, Barcelona, Spain
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Arias-de la Torre J, Vilagut G, Ronaldson A, Serrano-Blanco A, Alonso J. PHQ-8 scores and estimation of depression prevalence - Author's reply. Lancet Public Health 2021; 6:e794. [PMID: 34756167 DOI: 10.1016/s2468-2667(21)00226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jorge Arias-de la Torre
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London SE5 8AB, UK; CIBER Epidemiology and Public Health, Madrid, Spain; Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain.
| | - Gemma Vilagut
- CIBER Epidemiology and Public Health, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London SE5 8AB, UK
| | - Antoni Serrano-Blanco
- CIBER Epidemiology and Public Health, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jordi Alonso
- CIBER Epidemiology and Public Health, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Arias de la Torre J, Ronaldson A, Vilagut G, Peters M, Valderas JM, Serrano-Blanco A, Martín V, Dregan A, Alonso J. Prevalence of Major Depressive Episode in 27 European Countries. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Information about the prevalence of current Major Depressive Episode (MDE) across European countries is essential for its monitoring and for the development of evidence- based mental health policies. The aims were to: 1) estimate the prevalence of MDE by country in Europe; and 2) assess variations in prevalence between countries.
Methods
Data from participants of 27 countries that completed the questionnaire of the second wave of the European Health Interview Survey (EHIS-2) were analysed (n = 258,888). The prevalence of MDE was quantified using the Patient Health Questionnaire-8 (PHQ-8) with a cut-off score of ≥ 10. Prevalence and 95% Confidence Intervals (CI) were estimated for each country. Variation in prevalence (country vs the rest) was evaluated using bivariable and multivariable negative binomial regression models considering the specific country as the main explanatory variable. From these models, crude Prevalence Ratios (PR) and adjusted Prevalence Ratios (aPR) were obtained.
Results
The overall prevalence of current MDE in Europe was 6.38% (6.24%-6.52%). The country with the lowest prevalence was the Czech Republic (2.58%, 2.14%-3.02%) and the country with highest prevalence Iceland (10.33%, 9.33%-11.32%). In all the countries (except for Finland and Croatia) prevalence was higher in women than in men. The countries with the highest aPR were Germany (aPR: 1.80, 95% CI: 1.71-1.89) and Luxembourg (aPR: 1.50, 95% CI: 1.35-1.66), while Slovakia (aPR: 0.28, 95% CI: 0.24-0.33) and the Czech Republic (aPR: 0.32, 95% CI: 0.27-0.38) exhibited the lowest aPR.
Conclusions
Considerable variability in the prevalence of MDE by country in Europe was observed without a clear pattern. These results serve as baseline for monitoring the prevalence of MDE at a European level and suggest a need for developing preventive strategies against depression, particularly in those countries identified with the highest prevalence.
Key messages
The results of this study show that the overall prevalence of MDE is high (6.38%), with important variation across countries (ranging from 2.58% in the Czech Republic to 10.33% in Iceland). The results found could serve as a reference for the monitoring of MDE in Europe and for the development of screening and preventive strategies both at European level as well as at a country level.
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Affiliation(s)
- J Arias de la Torre
- Psychological Medicine, King's College London, London, UK
- CIBERESP, Madrid, Spain
- Universidad de León, León, Spain
| | - A Ronaldson
- Psychological Medicine, King's College London, London, UK
| | - G Vilagut
- CIBERESP, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - M Peters
- University of Oxford, Oxford, UK
| | | | - A Serrano-Blanco
- CIBERESP, Madrid, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi del Llobregat, Spain
| | - V Martín
- CIBERESP, Madrid, Spain
- Universidad de León, León, Spain
| | - A Dregan
- Psychological Medicine, King's College London, London, UK
| | - J Alonso
- CIBERESP, Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
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Arias-de la Torre J, Vilagut G, Ronaldson A, Serrano-Blanco A, Martín V, Peters M, Valderas JM, Dregan A, Alonso J. Prevalence and variability of current depressive disorder in 27 European countries: a population-based study. Lancet Public Health 2021; 6:e729-e738. [PMID: 33961802 PMCID: PMC8460452 DOI: 10.1016/s2468-2667(21)00047-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND We aimed to estimate the prevalence of current depressive disorder in 27 European countries, and to explore differences in prevalence between European countries and by gender. METHODS In this population-based study, we analysed data from respondents living in 27 European countries who were included in the second wave of the European Health Interview Survey, collected between 2013 and 2015. We assessed the prevalence of current depressive disorder using the eight-item Patient Health Questionnaire (PHQ-8), with depressive disorder defined as a PHQ-8 score of 10 or higher. Prevalence estimates and 95% CIs were calculated for all 27 countries overall and for each country individually. We assessed variation in prevalence (country vs the rest of Europe) using crude and adjusted prevalence ratios obtained from negative binomial regression models. We did all analyses for the total sample and stratified by gender. FINDINGS Our analysis sample comprised 258 888 individuals, of whom 117 310 (weighted proportion 47·8%) were men and 141 578 (52·2%) were women. The overall prevalence of current depressive disorder was 6·38% (95% CI 6·24-6·52) with important variation across countries, ranging from 2·58% (2·14-3·02) in the Czech Republic to 10·33% (9·33-11·32) in Iceland. Prevalence was higher in women (7·74% [7·53-7·95]) than in men (4·89% [4·71-5·08]), with clear gender differences for all countries except Finland and Croatia. Compared with the other European countries in our sample, those with the highest adjusted prevalence ratios were Germany (1·80 [1·71-1·89]) and Luxembourg (1·50 [1·35-1·66]), and those with the lowest adjusted prevalence ratios were Slovakia (0·28 [0·24-0·33]) and the Czech Republic (0·32 [0·27-0·38]). INTERPRETATION Depressive disorders, although common across Europe, vary substantially in prevalence between countries. These results could be a baseline for monitoring the prevalence of current depressive disorder both at a country level in Europe and for planning health-care resources and services. FUNDING UK Medical Research Council and CIBER Epidemiology and Public Health (CIBERESP).
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Affiliation(s)
- Jorge Arias-de la Torre
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; CIBER Epidemiology and Public Health, Madrid, Spain.
| | - Gemma Vilagut
- CIBER Epidemiology and Public Health, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Amy Ronaldson
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Antoni Serrano-Blanco
- CIBER Epidemiology and Public Health, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Vicente Martín
- CIBER Epidemiology and Public Health, Madrid, Spain; Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| | - Michele Peters
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jose M Valderas
- Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Alex Dregan
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jordi Alonso
- CIBER Epidemiology and Public Health, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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35
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Domènech-Abella J, Gabarrell-Pascuet A, Faris LH, Cristóbal-Narváez P, Félez-Nobrega M, Mortier P, Vilagut G, Olaya B, Alonso J, Haro JM. The association of detachment with affective disorder symptoms during the COVID-19 lockdown: The role of living situation and social support. J Affect Disord 2021; 292:464-470. [PMID: 34146897 PMCID: PMC8595065 DOI: 10.1016/j.jad.2021.05.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION There is growing concern about the effect of lockdown and social distancing on mental health. Subjective feelings related to social relationships such as detachment have shown a strong effect on mental health, whereas objective factors might have a moderating role in that association. OBJECTIVE To investigate whether social support and living situation have a moderating effect on the association between detachment and affective disorder symptoms during the COVID-19 lockdown. METHODS 3,305 Spanish adults were interviewed by phone at the end of the COVID-19 lockdown (May-June 2020). Detachment during confinement was assessed with a single-item frequency question. Anxiety symptoms were measured through GAD-7, depressive symptoms through PHQ-9, and social support through the Oslo Social Support Scale (OSSS). Associations with anxiety and depressive symptoms were tested through Tobit regression models. Interactions of detachment with living situation and social support were tested as independent variables. RESULTS People living alone showed significantly lower levels of anxiety whereas people living with another (but not as a couple) showed higher levels of depression. Detachment was strongly associated with both affective disorders. Social support had a statistically significant moderating effect on that association. Those with a low level of social support and a high level of detachment reported means of depression and anxiety above major depression (10.5 CI 95% 9.6, 11.4 at OSSS=10) and generalized anxiety disorders (10.1 CI 95% 9.2, 11.0 at OSSS=9) cut offs CONCLUSION: Interventions centered on improving social support could alleviate feelings of detachment and prevent affective disorders during lockdowns.
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Affiliation(s)
- Joan Domènech-Abella
- Department of Sociology, Universitat de Barcelona, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain.
| | - Aina Gabarrell-Pascuet
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain
| | - Lydia Hanaa Faris
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain
| | - Paula Cristóbal-Narváez
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain
| | - Mireia Félez-Nobrega
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josep Maria Haro
- Department of Sociology, Universitat de Barcelona, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
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Gabarrell-Pascuet A, Félez-Nóbrega M, Cristóbal-Narváez P, Mortier P, Vilagut G, Olaya B, Alonso J, Haro JM, Domènech-Abella J. The role of social support, detachment, and depressive and anxiety symptoms in suicidal thoughts and behaviours during the Covid-19 lockdown: Potential pathways. Curr Psychol 2021; 42:9237-9248. [PMID: 34429573 PMCID: PMC8375284 DOI: 10.1007/s12144-021-02205-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/25/2022]
Abstract
During the COVID-19 pandemic, anxiety and depressive symptoms, as well as problems related to social relationships, such as available social support and feelings of detachment from others, have worsened. These factors are strongly associated with suicidal thoughts and behaviours (STB). The effects of feelings of detachment on mental health and on STB have been scarcely studied, together with the relation that it may have with available social support. Therefore, the aim of the present study was to assess potential pathways connecting these conditions. A nationally representative sample of Spanish adults (N = 3305) was interviewed during the COVID-19 pandemic (June 2020). STB, social support, and depressive and anxiety symptoms were measured with the C-SSRS (modified version), OSSS-3, PHQ-8, and GAD-7 scales, respectively. Multivariable logistic regression models and mediation analyses were performed. Social support and some of its components (i.e., social network size and relations of reciprocity) were associated with lower odds of STB. Detachment significantly mediated (22% to 25%) these associations. Symptoms of emotional disorders significantly mediated the association between social support components (29% to 38%) – but not neighbourhood support – with STB, as well as the association between detachment and higher odds of STB (47% to 57%). In both cases, depressive symptoms were slightly stronger mediating factors when compared to anxiety symptoms. Our findings suggest that interventions aimed at lowering depressive and anxiety symptoms, and STB should provide social support and help tackle the feeling of detachment in a complementary way.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mireia Félez-Nóbrega
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Cristóbal-Narváez
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Olaya
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Josep Maria Haro
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
- Department of Medicine, Universitat de Barcelona (UB), Barcelona, Spain
| | - Joan Domènech-Abella
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Doctor Antoni Pujades, 42, ES-08830 Sant Boi de Llobregat, Barcelona Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Sociology, Universitat de Barcelona (UB), Barcelona, Spain
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Soldevila-Domenech N, Forero CG, Alayo I, Capella J, Colom J, Malmusi D, Mompart A, Mortier P, Puértolas B, Sánchez N, Schiaffino A, Vilagut G, Alonso J. Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors. Qual Life Res 2021; 30:2171-2185. [PMID: 33847868 PMCID: PMC8298347 DOI: 10.1007/s11136-021-02813-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors. METHODS Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated. RESULTS Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (β = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from β = 1.59, SE = 0.33 for moderate difficulties to β = 6.02 SE = 0.55 for no difficulties). Younger age (β = 5.21, SE = 0.26, eta2 = 3.4%) and being men (β = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible. CONCLUSIONS This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
| | - Carlos G Forero
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Itxaso Alayo
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Jordina Capella
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
- Direcció General d'Ordenació i Regulació Sanitàries, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Joan Colom
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
| | - Davide Malmusi
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
- Ajuntament de Barcelona, Barcelona, Spain
| | - Anna Mompart
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Beatriz Puértolas
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Néstor Sánchez
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Anna Schiaffino
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
- Institut Català D'Oncologia, Gran Via de l'Hospitalet 199-203, 08908, l'Hospitalet de Llobregat, Spain
| | - Gemma Vilagut
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Jordi Alonso
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
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Voorspoels W, Jansen L, Mortier P, Vilagut G, Vocht JD, Kessler RC, Alonso J, Bruffaerts R. Positive screens for mental disorders among healthcare professionals during the first covid19 wave in Belgium. J Psychiatr Res 2021; 140:329-336. [PMID: 34126428 PMCID: PMC8674999 DOI: 10.1016/j.jpsychires.2021.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022]
Abstract
We examined the manifestation of major depressive disorder, generalized anxiety disorder, substance use disorder, post-traumatic stress disorder, and panic attacks among health care professionals during the first COVID-19 wave (n = 6409) by means of mental disorder screening instruments. Logistic regressions were used to gauge individual risk factors; population attributable risk proportions (PARP) were inferred to identify the most important risk factors at the societal level. Data were weighted to represent general profiles of Belgian health care professionals. Lifetime, pre-pandemic emotional problems and work-related factors during the first wave of COVID-19 were strongly associated (mean adjusted odds ratios of 3.79 and 1.47, respectively) with positive screens for current mental disorders (occurrence of 29.3%). Most prominently, the data suggest that disruptions of work-life balance account for more than a quarter of the observed mental health problems due to the combination of widespread occurrence and strong association.
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Affiliation(s)
- Wouter Voorspoels
- Center for Public Health Psychiatry, KULeuven, Herestraat 49, B-3000, Leuven, Belgium; University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Leontien Jansen
- Center for Public Health Psychiatry, KULeuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Joke de Vocht
- Center for Public Health Psychiatry, KULeuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Ronald C Kessler
- Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Harvard University, Boston, MA, 02115-5899, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KULeuven, Belgium
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Alonso J, Vilagut G, Mortier P, Ferrer M, Alayo I, Aragón-Peña A, Aragonès E, Campos M, Cura-González ID, Emparanza JI, Espuga M, Forjaz MJ, González-Pinto A, Haro JM, López-Fresneña N, Salázar ADMD, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig MT, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solà V. Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:90-105. [PMID: 34127211 PMCID: PMC10068024 DOI: 10.1016/j.rpsmen.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/02/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. METHODS All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 - September 7, 2020). We report: probable current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder -PTSD- [PCL-5≥7]; and Substance Use Disorder -SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify probable "disabling" current mental disorders. RESULTS 9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Workers with pre-pandemic lifetime mental disorders had almost twice the prevalence than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring "all of the time" for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95). CONCLUSIONS One in seven Spanish healthcare workers screened positive for a disabling mental disorder during the first wave of the COVID-19 pandemic. Workers reporting pre-pandemic lifetime mental disorders, those frequently exposed to COVID-19 patients, infected or quarantined/isolated, female workers, and auxiliary nurses should be considered groups in need of mental health monitoring and support.
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Affiliation(s)
- Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain.
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de Atención Primaria, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel D Cura-González
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain; Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de Atención Primaria, Comunidad de Madrid, Madrid, Spain
| | - José I Emparanza
- Hospital Universitario Donostia, San Sebastián, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Maria João Forjaz
- National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
| | - Ana González-Pinto
- Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep M Haro
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | | | - Juan D Molina
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain; Faculty of Health Sciences, Francisco de Vitoria University, Madrid, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Madrid, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | | | - José I Pijoan
- Hospital Universitario Cruces/OSI EEC, Bilbao, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Nieves Plana
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Maria Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Cristina Rius
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain; CIBER Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Ferran Sanz
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - Consol Serra
- Parc de Salut Mar PSMAR, Barcelona, Spain; CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Víctor Pérez-Solà
- Parc de Salut Mar PSMAR, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
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Ballester L, Alayo I, Vilagut G, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, G. Forero C, Mortier P, Alonso J. Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students. Int J Environ Res Public Health 2021; 18:ijerph18105213. [PMID: 34068945 PMCID: PMC8156263 DOI: 10.3390/ijerph18105213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18-24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT's Cronbach's alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- Department of Psychology, Girona University (UdG), 17004 Girona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - José Almenara
- Department of Biomedicine, Biotechnology and Public Health, Faculty of Nursing and Physiotherapy, University of Cádiz (UCA), 11009 Cádiz, Spain;
| | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, 08208 Sabadell, Spain;
- CIBER Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Enrique Echeburúa
- Department of Clinical and Health Psychology, University of the Basque Country (UPV-EHU), 20018 San Sebastián, Spain;
- BioDonostia Health Research Institute, Osakidetza, 20014 San Sebastián, Spain;
| | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, 20014 San Sebastián, Spain;
| | - Margalida Gili
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.R.)
| | - Carolina Lagares
- Department of Statistic and Operational Research, Faculty of Medicine, University of Cádiz (UCA), 11009 Cádiz, Spain;
| | - José A. Piqueras
- Department of Health Psychology, Center for Applied Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University of Elche (UMH), 03202 Elche, Spain; (J.A.P.); (V.S.-S.)
| | - Miquel Roca
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands (UIB), 07122 Palma de Mallorca, Spain; (M.G.); (M.R.)
| | - Victoria Soto-Sanz
- Department of Health Psychology, Center for Applied Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University of Elche (UMH), 03202 Elche, Spain; (J.A.P.); (V.S.-S.)
| | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Pere Castellví
- School of Medicine, International University of Catalonia (UIC), 08195 Sant Cugat del Vallès, Spain; (P.C.); (C.G.F.)
| | - Carlos G. Forero
- School of Medicine, International University of Catalonia (UIC), 08195 Sant Cugat del Vallès, Spain; (P.C.); (C.G.F.)
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), 08003 Barcelona, Spain; (L.B.); (I.A.); (G.V.); (M.J.B.); (P.M.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), 08003 Barcelona, Spain
- Correspondence: ; Tel.: +34-933160760
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Mortier P, Vilagut G, Ferrer M, Serra C, Molina JD, López‐Fresneña N, Puig T, Pelayo‐Terán JM, Pijoan JI, Emparanza JI, Espuga M, Plana N, González‐Pinto A, Ortí‐Lucas RM, de Salázar AM, Rius C, Aragonès E, del Cura‐González I, Aragón‐Peña A, Campos M, Parellada M, Pérez‐Zapata A, Forjaz MJ, Sanz F, Haro JM, Vieta E, Pérez‐Solà V, Kessler RC, Bruffaerts R, Alonso J. Thirty-day suicidal thoughts and behaviors among hospital workers during the first wave of the Spain COVID-19 outbreak. Depress Anxiety 2021; 38:528-544. [PMID: 33393724 PMCID: PMC8246904 DOI: 10.1002/da.23129] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/20/2020] [Accepted: 12/05/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Healthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID-19 outbreak (March-July 2020). METHODS Data come from the baseline assessment of a cohort of Spanish hospital workers (n = 5450), recruited from 10 hospitals just after the height of the coronavirus disease 2019 (COVID-19) outbreak (May 5-July 23, 2020). Web-based self-report surveys assessed 30-day STB, individual characteristics, and potentially modifiable contextual factors related to hospital workers' work and financial situation. RESULTS Thirty-day STB prevalence was estimated at 8.4% (4.9% passive ideation only, 3.5% active ideation with or without a plan or attempt). A total of n = 6 professionals attempted suicide in the past 30 days. In adjusted models, 30-day STB remained significantly associated with pre-pandemic lifetime mood (odds ratio [OR] = 2.92) and anxiety disorder (OR = 1.90). Significant modifiable factors included a perceived lack of coordination, communication, personnel, or supervision at work (population-attributable risk proportion [PARP] = 50.5%), and financial stress (PARP = 44.1%). CONCLUSIONS AND RELEVANCE Thirty-day STB among hospital workers during the first wave of the Spain COVID-19 outbreak was high. Hospital preparedness for virus outbreaks should be increased, and strong governmental policy response is needed to increase financial security among hospital workers.
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Affiliation(s)
- Philippe Mortier
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - Gemma Vilagut
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - Montse Ferrer
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Universitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Parc de Salut Mar PSMARBarcelonaSpain,CiSAL‐Centro de Investigación en Salud LaboralIMIM/UPFBarcelonaSpain
| | - Juan D. Molina
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric ServiceHospital Universitario 12 de OctubreMadridSpain,Research Institute Hospital 12 de Octubre (i+12)MadridSpain,Faculty of Health SciencesFrancisco de Vitoria UniversityMadridSpain,CIBER Salud Mental (CIBERSAM)MadridSpain
| | | | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,Department of Epidemiology and Public HealthHospital de la Santa Creu i Sant PauBarcelonaSpain,Biomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain,CIBER Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | | | - José I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Hospital Universitario Cruces/OSI EECBilbaoSpain
| | - José I. Emparanza
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Hospital Universitario DonostiaSan SebastiánSpain
| | - Meritxell Espuga
- Occupational Health ServiceHospital Universitari Vall d'HebronBarcelonaSpain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Príncipe de Asturias University HospitalAlcalá de HenaresMadridSpain
| | - Ana González‐Pinto
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Universitario Araba‐SantiagoVitoria‐GasteizSpain
| | - Rafael M. Ortí‐Lucas
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Clínic UniversitariValenciaSpain
| | | | - Cristina Rius
- CIBER Salud Mental (CIBERSAM)MadridSpain,Agència de Salut Pública de BarcelonaBarcelonaSpain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi GolBarcelonaSpain,Atenció Primària Camp de TarragonaInstitut Català de la SalutTarragonaSpain
| | - Isabel del Cura‐González
- Research Unit, Primary Care ManagementMadrid Health ServiceMadridSpain,Department of Medical Specialities and Public HealthKing Juan Carlos UniversityMadridSpain,Fundación Investigación e Innovación Biosanitaria de APComunidad de MadridMadridSpain
| | - Andrés Aragón‐Peña
- Fundación Investigación e Innovación Biosanitaria de APComunidad de MadridMadridSpain,Epidemiology UnitRegional Ministry of Health, Community of MadridMadridSpain
| | - Mireia Campos
- Service of Prevention of Labor RisksMedical Emergencies System, Generalitat de CatalunyaBarcelonaSpain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital General Universitario Gregorio MarañónMadridSpain
| | | | - Maria João Forjaz
- National Center of EpidemiologyInstituto de Salud Carlos III (ISCIII)MadridSpain,Health Services Research Network on Chronic Diseases (REDISSEC)MadridSpain
| | - Ferran Sanz
- Research Progamme on Biomedical Informatics (GRIB)Hospital del Mar Medical Research Institute (IMIM)BarcelonaSpain,Department of Experimental and Health SciencesPompeu Fabra UniversityBarcelonaSpain,Instituto Nacional de Bioinformatica—ELIXIR‐ESMadridSpain
| | - Josep M. Haro
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,CIBER Salud Mental (CIBERSAM)MadridSpain,Parc Sanitari Sant Joan de DéuBarcelonaSpain
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Clínic, University of Barcelona, IDIBAPSBarcelonaSpain
| | - Víctor Pérez‐Solà
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,Parc de Salut Mar PSMARBarcelonaSpain,CIBER Salud Mental (CIBERSAM)MadridSpain
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronny Bruffaerts
- Center for Public Health PsychiatryUniversitair Psychiatrisch Centrum, KU LeuvenLeuvenBelgium
| | - Jordi Alonso
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Department of Experimental and Health SciencesPompeu Fabra UniversityBarcelonaSpain
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Arias de la Torre J, Ronaldson A, Valderas JM, Vilagut G, Serrano-Blanco A, Hatch SL, Alonso J, Hotopf M, Dregan A. Diagnostic promiscuity: the use of real-world data to study multimorbidity in mental health. Br J Psychiatry 2021; 218:237-239. [PMID: 33436108 DOI: 10.1192/bjp.2020.257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Mental health-related multimorbidity can be considered as multimorbidity in the presence of a mental disorder. Some knowledge gaps on the study of mental health-related multimorbidity were identified. These knowledge gaps could be potentially addressed with real-world data.
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Affiliation(s)
- Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK; and Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Spain
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK
| | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter Medical School, UK
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Medical Research Institute (IMIM), Spain; and Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Spain
| | - Antoni Serrano-Blanco
- Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Spain; and Sant Joan de Déu Research Institute, Parc Sanitari Sant Joan de Déu, Spain
| | - Stephani L Hatch
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK; and ESRC Centre for Society and Mental Health, King's College London, UK
| | - Jordi Alonso
- Hospital del Mar Medical Research Institute (IMIM), Spain; and Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Spain
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK; and South London and Maudsley NHS Foundation Trust, UK
| | - Alexandru Dregan
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK
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Bruffaerts R, Voorspoels W, Jansen L, Kessler RC, Mortier P, Vilagut G, De Vocht J, Alonso J. Suicidality among healthcare professionals during the first COVID19 wave. J Affect Disord 2021; 283:66-70. [PMID: 33524660 PMCID: PMC7832920 DOI: 10.1016/j.jad.2021.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prevalence estimates of suicidal thoughts and behaviours (STB) among clinically active healthcare professionals during the first wave of COVID19 pandemic are non-existing. The main aim of this study was to investigate the 30-day prevalence of STB and associated risk factors. METHODS As part of the Recovering Emotionally from COVID study (RECOVID), 30-day STB among healthcare professionals (N = 6,409) was assessed in an e-survey in healthcare settings in Belgium. The prevalence of STB and associated risk factors were estimated in multivariable models with individual-level and society-level measures of association. We used post-stratification weights to make the data representative for the entire clinical workforce in Belgium. RESULTS Prevalence was 3.6% death wish, 1.5% suicide ideation, 1.0% suicide plan, and 0.0% suicide attempt. Thirty-day STB was (a) increased among respondents with lifetime and current mental disorders (mostly depression) and those hospitalized for COVID19 infection, (b) decreased among respondents with social support, and (c) unrelated to work environment. LIMITATIONS This is an explorative cross-sectional study using multivariate models that generates specific hypotheses on the prevalence of and risk factors for STB during the COVID19 pandemic rather than testing specific pathways that lead to STB onset. CONCLUSIONS Across age, gender, professional discipline, and exposure to COVID, lifetime and current mental disorders were highly associated with STB. These factors could guide governments and healthcare organizations in taking up responsibilities in preventing emotional problems and developing resilience among healthcare professionals during, but probably beyond, the current COVID19 pandemic.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KULeuven, Herestraat 49, B-3000 Leuven, Belgium.
| | - Wouter Voorspoels
- Center for Public Health Psychiatry, KULeuven, Herestraat 49, B-3000 Leuven, Belgium,University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium
| | - Leontien Jansen
- Center for Public Health Psychiatry, KULeuven, Herestraat 49, B-3000 Leuven, Belgium
| | - Ronald C. Kessler
- Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Harvard University, Boston, MA 02115-5899, US
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Joke De Vocht
- University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain,CIBER en Epidemiología y Salud Pública, Madrid, Spain,Pompeu Fabra University, Barcelona, Spain
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44
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Mortier P, Vilagut G, Ferrer M, Alayo I, Bruffaerts R, Cristóbal-Narváez P, del Cura-González I, Domènech-Abella J, Felez-Nobrega M, Olaya B, Pijoan JI, Vieta E, Pérez-Solà V, Kessler RC, Haro JM, Alonso J. Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic. Epidemiol Psychiatr Sci 2021; 30:e19. [PMID: 34187614 PMCID: PMC7925988 DOI: 10.1017/s2045796021000093] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
AIMS To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March-July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains. METHODS Cross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1-30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights. RESULTS Estimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7-42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events-experiences related to the pandemic. CONCLUSIONS STB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events-experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload. STUDY REGISTRATION NUMBER NCT04556565.
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Affiliation(s)
- P. Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - G. Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M. Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - I. Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - R. Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - P. Cristóbal-Narváez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - I. del Cura-González
- Research Unit Primary Care Management, Madrid Health Service. (REDISSEC). Universidad Rey Juan Carlos, Madrid, Spain
| | - J. Domènech-Abella
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - M. Felez-Nobrega
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - B. Olaya
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - J. I. Pijoan
- Clinical Epidemiology Unit, Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - E. Vieta
- Hospital Clínic, University of Barcelona, IDIBAPS, (CIBERSAM), Barcelona, Spain
| | - V. Pérez-Solà
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Parc de Salut Mar PSMAR, Barcelona, Spain
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Madrid, Spain
- Universitat de Barcelona (UB), Barcelona, Spain
| | - J. Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Arias de la Torre J, Vilagut G, Ronaldson A, Dregan A, Ricci-Cabello I, Hatch SL, Serrano-Blanco A, Valderas JM, Hotopf M, Alonso J. Prevalence and age patterns of depression in the United Kingdom. A population-based study. J Affect Disord 2021; 279:164-172. [PMID: 33059219 DOI: 10.1016/j.jad.2020.09.129] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
METHODS A representative sample of the UK population (n=17,152) from the European Health Interview Survey of 2014 was included in the analyses. The Patient Health Questionnaire (PHQ-8) was used to assess the prevalence of depressive symptoms and of probable depressive disorder. Prevalence estimates (95%CI) were calculated. The association between prevalence and age was assessed using multivariable multinomial logistic and logistic regression models. All analyses were carried out for the total sample and stratified by sex. RESULTS The prevalence of depressive symptoms ranged from 11.3% (10.6-11.9) for mild, to 3.3% (3.0-3.7) for severe symptoms. The prevalence of probable depressive disorder was 7.5% (95%CI: 7.0-8.0). A significantly higher prevalence of probable depressive disorder was found in those aged 45 to 59 years old compared with those aged 16 to 29. For the prevalence of severe depressive symptoms those age differences were even higher: 2.55 times higher (5.38 for men and 1.75 for women). LIMITATIONS The cross-sectional design precludes stablishing the direction of the relationship between age and the prevalence. CONCLUSIONS The prevalence and age patterns of depression in the UK were described. A peak in the prevalence was identified during middle adulthood. These results could serve as a reference for the monitoring of depression in the UK and the development of preventive strategies, particularly in the high-risk population groups identified.
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Affiliation(s)
- Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neurosciences (IoPPN), King's College London, London, UK; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Gemma Vilagut
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Amy Ronaldson
- Institute of Psychiatry, Psychology and Neurosciences (IoPPN), King's College London, London, UK
| | - Alex Dregan
- Institute of Psychiatry, Psychology and Neurosciences (IoPPN), King's College London, London, UK
| | - Ignacio Ricci-Cabello
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma, Illes Balears, Spain Health - Research Institute of the Balearic Islands (IdISBa), Palma, Illes Balears, Spain
| | - Stephani L Hatch
- Institute of Psychiatry, Psychology and Neurosciences (IoPPN), King's College London, London, UK; ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Antoni Serrano-Blanco
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter, Exeter, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neurosciences (IoPPN), King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jordi Alonso
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Dept. of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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46
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Arias-de la Torre J, Vilagut G, Serrano-Blanco A, Martín V, Molina AJ, Valderas JM, Alonso J. Accuracy of Self-Reported Items for the Screening of Depression in the General Population. Int J Environ Res Public Health 2020; 17:ijerph17217955. [PMID: 33138196 PMCID: PMC7662518 DOI: 10.3390/ijerph17217955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/02/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Though self-reported items (SRD, self-reported depression) are commonly used in health surveys and cohort studies, their metric properties as a depression indicator remain unclear. The aims were to evaluate the measurement properties of SRD using the Patient Health Questionnaire-8 (PHQ-8) as reference and to identify factors related to the agreement between both indicators. METHODS Data from the European Health Interview Survey in Spain in 2014/2015 (n = 22,065) were analyzed. Two indicators of depression were considered: SRD based on two items yes/no (positive: both yes), and the PHQ-8 (positive ≥ 10). Socioeconomic factors and use of health services were considered as independent variables. The prevalence of depression, sensitivity, specificity, global agreement, and positive and negative predictive values (PPV and NPV) of SRDs were evaluated using the PHQ-8 as a reference. Logistic regression models were fitted to determine factors associated with the agreement between indicators. RESULTS The prevalence of depression was lower when assessed with PHQ-8 (5.9%) than with SRD (7.7%). SRD sensitivity and PPV were moderate-low (52.9% and 40.4%, respectively) whereas global agreement, specificity, and NPV were high (92.7%, 95.1%, and 97.0%, respectively). Positive agreement was associated with marital status, country of birth, employment status, and social class. Negative agreement was related to all independent variables except country of birth. CONCLUSIONS SRD items tend to overestimate the current prevalence of depression. While its use in health surveys and cohorts may be appropriate as a quick assessment of possible depression, due to their low sensitivity, its use in clinical contexts is questionable.
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Affiliation(s)
- Jorge Arias-de la Torre
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (G.V.); (A.S.-B.); (V.M.); (J.A.)
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
- Correspondence:
| | - Gemma Vilagut
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (G.V.); (A.S.-B.); (V.M.); (J.A.)
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Antoni Serrano-Blanco
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (G.V.); (A.S.-B.); (V.M.); (J.A.)
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, 08950 Barcelona, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (G.V.); (A.S.-B.); (V.M.); (J.A.)
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
| | | | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter EX4 2LU, UK;
| | - Jordi Alonso
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (G.V.); (A.S.-B.); (V.M.); (J.A.)
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), 08002 Barcelona, Spain
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47
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Ballester L, Alayo I, Vilagut G, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Mortier P, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Jordi A. Mental disorders in Spanish university students: Prevalence, age-of-onset, severe role impairment and mental health treatment. J Affect Disord 2020; 273:604-613. [PMID: 32560960 DOI: 10.1016/j.jad.2020.04.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The university period carries risk for onset of common mental disorders. Epidemiological knowledge on mental disorders among Spanish university students is limited. AIMS To estimate lifetime and 12-month prevalence, persistence and age-of-onset of mental disorders among Spanish first-year university students, as well as associated role impairment and mental health treatment use. METHODS First-year university students (N=2,118; 55.4% female; mean age=18.8 years) from five Spanish universities completed a web-based survey, screening possible DSM-IV mental disorders (major depressive episode(MDE), mania/hypomania, generalized anxiety disorder(GAD), panic disorder(PD), alcohol abuse/dependence(AUD), drug abuse/dependence(DUD), and adult attention-deficit/hyperactivity disorder(ADHD)). Role impairment and treatment associated with mental disorders were assessed. RESULTS Lifetime and 12-month prevalence of any possible mental disorder was 41.3%(SE=1.08) and 35.7%(SE=1.05), respectively. Persistence (i.e., ratio of 12-month to lifetime prevalence) was 86.4%(SE=1.58). Median age-of-onset was 14 for adult ADHD, 15 for mood disorders and AUD, and 16 for anxiety disorders and DUD. One third (29.2%) of 12-month disorders were associated with role impairment. Twelve-month PD (OR=4.0;95%CI=1.9-8.5) had the highest odds for role impairment. Only 12.6% of students with 12-month disorder received any mental health treatment. Twelve-month treatment was the highest among those students with 12-month GAD (OR=7.4;95%CI=3.7-14.8). LIMITATIONS The assessment of mental disorders was based on self-reports. Cross-sectional nature of the data prevents causal associations. CONCLUSION One third of Spanish university students report a common mental disorder in the past year, and one third of those report severe role impairment. Only one out of eight students with 12-month mental disorders receives mental health treatment.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; Girona University (UdG), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria ParcTaulí, Sabadell, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- InstitutUniversitarid'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- InstitutUniversitarid'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pere Castellví
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KULeuven (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, Massachusetts, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Alonso Jordi
- Health Services Research Group, IMIM (Institut Hospital del Mar d´Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain.
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48
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Karyotaki E, Cuijpers P, Albor Y, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Ebert DD, Hasking P, Kiekens G, Lee S, McLafferty M, Mak A, Mortier P, Sampson NA, Stein DJ, Vilagut G, Kessler RC. Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative. Front Psychol 2020; 11:1759. [PMID: 32849042 PMCID: PMC7406671 DOI: 10.3389/fpsyg.2020.01759] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022] Open
Abstract
The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders (F = 20.6–70.6, p < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9–80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.
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Affiliation(s)
- Eirini Karyotaki
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Yesica Albor
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven, Leuven, Belgium
| | - David D Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Glenn Kiekens
- Center for Public Health Psychiatry, Katholieke Universiteit, Leuven, Belgium
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Margaret McLafferty
- School of Biomedical Sciences, Ulster University, Londonderry, United Kingdom
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Dan J Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
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49
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Mortier P, Vilagut G, Puértolas Gracia B, De Inés Trujillo A, Alayo Bueno I, Ballester Coma L, Blasco Cubedo MJ, Cardoner N, Colls C, Elices M, Garcia-Altes A, Gené Badia M, Gómez Sánchez J, Martín Sánchez M, Morros R, Prat Pubill B, Qin P, Mehlum L, Kessler RC, Palao D, Pérez Sola V, Alonso J. Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case-control study of suicide attempts in Catalonia, Spain. BMJ Open 2020; 10:e037365. [PMID: 32660952 PMCID: PMC7359191 DOI: 10.1136/bmjopen-2020-037365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/02/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools. METHODS AND ANALYSIS The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools. ETHICS AND DISSEMINATION This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines. TRIAL REGISTRATION NUMBER NCT04235127.
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Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Puértolas Gracia
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana De Inés Trujillo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Social Psychology, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Itxaso Alayo Bueno
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Laura Ballester Coma
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Psychology, University of Girona (UdG), Girona, Spain
| | - María Jesús Blasco Cubedo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Narcís Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Cristina Colls
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
| | - Matilde Elices
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Garcia-Altes
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Manel Gené Badia
- Legal Medicine Unit, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Javier Gómez Sánchez
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mario Martín Sánchez
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, Pompeu Fabra University, Barcelona, Spain
| | - Rosa Morros
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut Català de la Salut (ICS), Metropolitana Nord, Barcelona, Spain
| | - Bibiana Prat Pubill
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Barcelona, Spain
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Diego Palao
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Víctor Pérez Sola
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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50
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Husky MM, Bharat C, Vilagut G, Salmerón D, Martínez S, Navarro C, Alonso J, Kessler RC, Navarro-Mateu F. Birth-sex cohort alcohol use transitions in the general population: the cross-sectional PEGASUS-Murcia project. Adicciones 2020; 32:94-104. [PMID: 30627726 DOI: 10.20882/adicciones.1067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To examine the potential impact of prevalence of alcohol use in a birth-sex cohort on subsequent initiation and progression of alcohol use in the PEGASUS-Murcia project, a cross-sectional survey of a representative sample of non-institutionalized adults in Murcia (Spain). Data on lifetime history of alcohol use, DSM-IV use disorders, and remission were collected from 1,459 adults using face-to-face interviewers based on the Composite International Diagnostic Interview (CIDI 3.0). Life-table estimates based on survival functions for alcohol use age-of-onset and remission were used as time-varying predictors of subsequent individual-level alcohol use in discrete-time survival models. Nearly nine out of ten adults had a lifetime alcohol use history at time of interview. Of these lifetime users, 84.3% became regular users (>12 drinks a year) and 5.5-1.6% went on to meet criteria for DSM-IV alcohol abuse or dependence, respectively. By the age of 18, 70.9% of respondents had used alcohol, and one half (50.2%) had used regularly. Regular use sharply increased during early adulthood to reach 90.8% by age 22. Birth-sex cohort alcohol use was significantly and positively associated with increased odds of all subsequent transitions examined except for the transition from use to abuse. The findings highlight sensitive periods with rapid transitions to higher levels of alcohol use and emphasize the importance of cohort experiences in the full spectrum of stages of alcohol use. These results may contribute to predicting population-levels trends in alcohol-related problems in Spain.
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