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Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, Hwang I, Kessler RC, Liu H, Mortier P, Nock MK, Pinder-Amaker S, Sampson NA, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH, Benjet C, Caldas-de-Almeida JM, Demyttenaere K, Florescu S, de Girolamo G, Gureje O, Haro JM, Karam EG, Kiejna A, Kovess-Masfety V, Lee S, McGrath JJ, O'Neill S, Pennell BE, Scott K, Ten Have M, Torres Y, Zaslavsky AM, Zarkov Z, Bruffaerts R. Mental disorders among college students in the World Health Organization World Mental Health Surveys - CORRIGENDUM. Psychol Med 2017; 47:2737. [PMID: 28462760 DOI: 10.1017/s0033291717001039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Andrade LH, Aguiar AO, Pires WL, Miranda GA, Amaral MCS. Integrated ultrafiltration-nanofiltration membrane processes applied to the treatment of gold mining effluent: Influence of feed pH and temperature. SEP SCI TECHNOL 2017. [DOI: 10.1080/01496395.2016.1262419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/20/2022]
Affiliation(s)
- L. H. Andrade
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - A. O. Aguiar
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - W. L. Pires
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G. A. Miranda
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - M. C. S. Amaral
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Andrade LH, Aguiar AO, Pires WL, Miranda GA, Teixeira LPT, Almeida GCC, Amaral MCS. NANOFILTRATION AND REVERSE OSMOSIS APPLIED TO GOLD MINING EFFLUENT TREATMENT AND REUSE. Braz J Chem Eng 2017. [DOI: 10.1590/0104-6632.20170341s20150082] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, Hwang I, Kessler RC, Liu H, Mortier P, Nock MK, Pinder-Amaker S, Sampson NA, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH, Benjet C, Caldas-de-Almeida JM, Demyttenaere K, Florescu S, de Girolamo G, Gureje O, Haro JM, Karam EG, Kiejna A, Kovess-Masfety V, Lee S, McGrath JJ, O'Neill S, Pennell BE, Scott K, Ten Have M, Torres Y, Zaslavsky AM, Zarkov Z, Bruffaerts R. Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychol Med 2016; 46:2955-2970. [PMID: 27484622 DOI: 10.1017/s003329176001665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. METHOD The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). RESULTS One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. CONCLUSIONS Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.
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Affiliation(s)
- R P Auerbach
- Department of Psychiatry,Harvard Medical School,Boston, MA,USA
| | - J Alonso
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM),Barcelona,Spain
| | - W G Axinn
- Department of Sociology,Population Studies Center, Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, MI,USA
| | - P Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology,Vrije Universiteit Amsterdam,Amsterdam,The Netherlands
| | - D D Ebert
- Department of Psychology, Clinical Psychology and Psychotherapy,Friedrich-Alexander University Nuremberg-Erlangen,Erlangen,Germany
| | - J G Green
- School of Education, Boston University,Boston, MA,USA
| | - I Hwang
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - R C Kessler
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - H Liu
- Department of Epidemiology,Harvard T.H. Chan School of Public Health,Boston, MA,USA
| | - P Mortier
- Research Group Psychiatry,Department of Neurosciences,KU Leuven University,Leuven,Belgium
| | - M K Nock
- Department of Psychology,Harvard University,Cambridge, MA,USA
| | - S Pinder-Amaker
- Department of Psychiatry,Harvard Medical School,Boston, MA,USA
| | - N A Sampson
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - S Aguilar-Gaxiola
- University of California Davis Center for Reducing Health Disparities,School of Medicine,Sacramento, CA,USA
| | - A Al-Hamzawi
- College of Medicine, Al-Qadisiya University,Diwania Governorate,Iraq
| | - L H Andrade
- Section of Psychiatric Epidemiology - LIM 23,Institute of Psychiatry, University of São Paulo Medical School,São Paulo,Brazil
| | - C Benjet
- Department of Epidemiologic and Psychosocial Research,National Institute of Psychiatry Ramón de la Fuente Muñiz,Mexico City,Mexico
| | - J M Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health,Faculdade de Ciências Médicas,Universidade Nova de Lisboa,Lisbon,Portugal
| | - K Demyttenaere
- Department of Psychiatry,University Hospital Gasthuisberg, Katholieke Universiteit Leuven,Leuven,Belgium
| | - S Florescu
- National School of Public Health, Management and Professional Development,Bucharest,Romania
| | - G de Girolamo
- IRCCS St John of God Clinical Research Centre,Brescia,Italy
| | - O Gureje
- Department of Psychiatry,University College Hospital,Ibadan,Nigeria
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain
| | - E G Karam
- Department of Psychiatry and Clinical Psychology,Faculty of Medicine,Balamand University,Beirut,Lebanon
| | - A Kiejna
- Department of Psychiatry,Wroclaw Medical University,Wroclaw,Poland
| | - V Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris,France
| | - S Lee
- Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong
| | - J J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health,Wacol,Queensland,Australia
| | - S O'Neill
- School of Psychology, University of Ulster,Londonderry,UK
| | - B-E Pennell
- Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, MI,USA
| | - K Scott
- Department of Psychological Medicine,University of Otago,Dunedin,Otago,New Zealand
| | - M Ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction,Utrecht,the Netherlands
| | - Y Torres
- Center for Excellence on Research in Mental Health, CES University,Medellín,Colombia
| | - A M Zaslavsky
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - Z Zarkov
- Department Mental Health,National Center of Public Health and Analyses,Sofia,Bulgaria
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg,Leuven,Belgium
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Andrade LH, Mendes FDS, Espindola JC, Amaral MCS. REUSE OF DAIRY WASTEWATER TREATED BY MEMBRANE BIOREACTOR AND NANOFILTRATION: TECHNICAL AND ECONOMIC FEASIBILITY. Braz J Chem Eng 2015. [DOI: 10.1590/0104-6632.20150323s00003133] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, Bromet E, Bruffaerts R, de Girolamo G, de Graaf R, Florescu S, Gureje O, Hinkov HR, Hu C, Huang Y, Hwang I, Jin R, Karam EG, Kovess-Masfety V, Levinson D, Matschinger H, O'Neill S, Posada-Villa J, Sagar R, Sampson NA, Sasu C, Stein DJ, Takeshima T, Viana MC, Xavier M, Kessler RC. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med 2014; 44:1303-1317. [PMID: 23931656 DOI: 10.1017/s003329171300194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. METHOD Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity. RESULTS Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). CONCLUSIONS Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.
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Affiliation(s)
- L H Andrade
- Section of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - J Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Z Mneimneh
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon
| | - J E Wells
- Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
| | - A Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - G Borges
- Instituto Nacional de Psiquatria Ramon de la Fuente and Universidad Autonoma Metropolitana, Mexico DF, Mexico
| | - E Bromet
- Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - G de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - H R Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - C Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, P. R. China
| | - Y Huang
- Institute of Mental Health, Peking University, Beijing, P. R. China
| | - I Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R Jin
- Harvard Pilgrim Health Care, Boston, MA, USA
| | - E G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon
| | - V Kovess-Masfety
- EA 4069 Université Paris Descartes and Department of Epidemiology, EHESP School for Public Health, Paris, France
| | - D Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Germany
| | - S O'Neill
- Psychology Research Institute, University of Ulster, Londonderry, UK
| | - J Posada-Villa
- Pontificia Universidad Javeriana, Instituto Colombiano del Sistema Nervioso, Bogota, Colombia
| | - R Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - C Sasu
- Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar (SNSPMPDSB), Bucharest, Romania
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Cape Town, South Africa
| | - T Takeshima
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - M C Viana
- Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - M Xavier
- Mental Health Department, Faculdade Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - R C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, Bromet E, Bruffaerts R, de Girolamo G, de Graaf R, Florescu S, Gureje O, Hinkov HR, Hu C, Huang Y, Hwang I, Jin R, Karam EG, Kovess-Masfety V, Levinson D, Matschinger H, O’Neill S, Posada-Villa J, Sagar R, Sampson NA, Sasu C, Stein D, Takeshima T, Viana MC, Xavier M, Kessler RC. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med 2014; 44:1303-1317. [PMID: 23931656 PMCID: PMC4100460 DOI: 10.1017/s0033291713001943] [Citation(s) in RCA: 609] [Impact Index Per Article: 60.9] [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: 12/18/2022]
Abstract
BACKGROUND To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. METHOD Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity. RESULTS Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). CONCLUSIONS Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.
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Affiliation(s)
- L. H. Andrade
- Section of Psychiatric Epidemiology-LIM 23, Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - J. Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Z. Mneimneh
- Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Survey Methodology Program, Institute for Social Research, University of Michigan, USA
| | - J. E. Wells
- Department of Public Health and General Practice, University of Otago, Christchurch. Christchurch, New Zealand
| | - A. Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - G. Borges
- Instituto Nacional de Psiquatria Ramon de la Fuente & Universidad Autonoma Metropolitana, Mexico DF, Mexico
| | - E. Bromet
- State University of New York at Stony Brook Department of Psychiatry, Stony Brook, NY
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum –Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - G. de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R. de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S. Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - H. R. Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, People’s Republic of China
| | - Y. Huang
- Institute of Mental Health, Peking University, Beijing, P. R. China
| | - I. Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - R. Jin
- Harvard Pilgrim Health Care, Boston, MA
| | - E. G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon
| | - V. Kovess-Masfety
- EA 4069 Université Paris Descartes & EHESP School for Public Health, Department of Epidemiology, Paris, France
| | - D. Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - H. Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Germany
| | - S. O’Neill
- Psychology Research Institute, University of Ulster, Londonderry, UK
| | - J. Posada-Villa
- Pontificia Universidad Javeriana, Instituto Colombiano del Sistema Nervioso, Bogota, Colombia
| | - R. Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - C. Sasu
- Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar (SNSPMPDSB), Bucharest, Romania
| | - D. Stein
- University of Cape Town, Department of Psychiatry and Mental Health, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - T. Takeshima
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - M. Xavier
- Mental Health Department, Faculdade Ciências Médicas - Universidade Nova de Lisboa Lisbon, Portugal
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Shahly V, Chatterji S, Gruber MJ, Al-Hamzawi A, Alonso J, Andrade LH, Angermeyer MC, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Hinkov HR, Hu C, Karam EG, Lépine JP, Levinson D, Medina-Mora ME, Posada-Villa J, Sampson NA, Trivedi J, Viana MC, Kessler RC. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med 2013; 43:865-879. [PMID: 22877824 PMCID: PMC4045502 DOI: 10.1017/s0033291712001468] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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: 01/21/2023]
Abstract
BACKGROUND Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. RESULTS Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle-income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. CONCLUSIONS Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries.
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Affiliation(s)
- V. Shahly
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | - M. J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - A. Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L. H. Andrade
- Section of Psychiatric Epidemiology, Sãu Paulo, Brazil
| | | | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - B. Bunting
- University of Ulster, Londonderry, Northern Ireland, United Kingdom
| | - J. M. Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisbon, Portugal
| | - G. de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- University Medical Center Groningen, Groningen, Netherlands
| | - S. Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - H. R. Hinkov
- National Center for Public Health Protection, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, People’s Republic of China
| | - E. G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon
| | - J.-P. Lépine
- Hôpital Lariboisiére Fernand Widal, Paris, France
| | - D. Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - M. E. Medina-Mora
- Instituto Nacional de Psiquiatria Ramon de La Fuente Muñiz, Mexico City, Mexico
| | | | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.K. Trivedi
- Department of Psychiatry, C.S.M. Medical University, Lucknow, India
| | - M. C. Viana
- Department of Social Medicine, Center for Health Sciences, Vitória, Spain
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Breslau J, Miller E, Jin R, Sampson NA, Alonso J, Andrade LH, Bromet EJ, de Girolamo G, Demyttenaere K, Fayyad J, Fukao A, Gălăon M, Gureje O, He Y, Hinkov HR, Hu C, Kovess-Masfety V, Matschinger H, Medina-Mora ME, Ormel J, Posada-Villa J, Sagar R, Scott KM, Kessler RC. A multinational study of mental disorders, marriage, and divorce. Acta Psychiatr Scand 2011; 124:474-86. [PMID: 21534936 PMCID: PMC4011132 DOI: 10.1111/j.1600-0447.2011.01712.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [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: 11/29/2022]
Abstract
OBJECTIVE Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. METHOD Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46,128) and age at first divorce in a subset of 12 countries (n = 30,729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. RESULTS Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. CONCLUSION This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders.
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Affiliation(s)
- J. Breslau
- Department of Internal Medicine, University of California, Davis, CA
| | - E. Miller
- Department of Pediatrics, University of California, Davis, CA
| | - R. Jin
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - J. Alonso
- Health Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM-Hospital del Mar); CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain
| | - L. H. Andrade
- Department & Institute of Psychiatry, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - G. de Girolamo
- IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Bologna, Italy
| | - K. Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium
| | - J. Fayyad
- Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center and Faculty of Medicine, Balamand University, Beirut, Lebanon
| | - A. Fukao
- Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | - M. Gălăon
- Scoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar Bucharest, (SNSPMPDSB), Romania
| | - O. Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Y. He
- Shanghai Mental Health Center, Shanghai, China
| | - H. R. Hinkov
- Department of Global Mental Health, National Center for Public Health Protection, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health, Shenzhen, Guangdong, China
| | | | - H. Matschinger
- Clinic of Psychiatry, University of Leipzig, Leipzig, Germany
| | | | - J. Ormel
- Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center, Groningen, the Netherlands
| | - J. Posada-Villa
- Instituto Colombiano del Sistema Nervioso, Bogota D.C. Colombia
| | - R. Sagar
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - K. M. Scott
- Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, Dunedin, New Zealand
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Wang YP, Teng CT, Vieira Filho AHG, Gorenstein C, Andrade LH. Dimensionality of the premenstrual syndrome: confirmatory factor analysis of premenstrual dysphoric symptoms among college students. Braz J Med Biol Res 2007; 40:639-47. [PMID: 17464425 DOI: 10.1590/s0100-879x2007000500006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2006] [Accepted: 02/16/2007] [Indexed: 11/21/2022] Open
Abstract
Premenstrual syndrome and premenstrual dysphoric disorder (PMDD) seem to form a severity continuum with no clear-cut boundary. However, since the American Psychiatric Association proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome. The objective of the present study was to establish the core latent structure of PMDD symptoms in a non-clinical sample. Data concerning PMDD symptoms were obtained from 632 regularly menstruating college students (mean age 24.4 years, SD 5.9, range 17 to 49). For the first random half (N = 316), we performed principal component analysis (PCA) and for the remaining half (N = 316), we tested three theory-derived competing models of PMDD by confirmatory factor analysis. PCA allowed us to extract two correlated factors, i.e., dysphoric-somatic and behavioral-impairment factors. The two-dimensional latent model derived from PCA showed the best overall fit among three models tested by confirmatory factor analysis (chi(2)53 = 64.39, P = 0.13; goodness-of-fit indices = 0.96; adjusted goodness-of-fit indices = 0.95; root mean square residual = 0.05; root mean square error of approximation = 0.03; 90%CI = 0.00 to 0.05; Akaike's information criterion = -41.61). The items "out of control" and "physical symptoms" loaded conspicuously on the first factor and "interpersonal impairment" loaded higher on the second factor. The construct validity for PMDD was accounted for by two highly correlated dimensions. These results support the argument for focusing on the core psychopathological dimension of PMDD in future studies.
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Affiliation(s)
- Y-P Wang
- Departamento e Instituto de Psiquiatria (LIM-23), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Abstract
The objective of the present study was to investigate the psychometric properties and cross-cultural validity of the Beck Depression Inventory (BDI) among ethnic Chinese living in the city of São Paulo, Brazil. The study was conducted on 208 community individuals. Reliability and discriminant analysis were used to test the psychometric properties and validity of the BDI. Principal component analysis was performed to assess the BDI's factor structure for the total sample and by gender. The mean BDI score was lower (6.74, SD = 5.98) than observed in Western counterparts and showed no gender difference, good internal consistency (Cronbach's alpha 0.82), and high discrimination of depressive symptoms (75-100%). Factor analysis extracted two factors for the total sample and each gender: cognitive-affective dimension and somatic dimension. We conclude that depressive symptoms can be reliably assessed by the BDI in the Brazilian Chinese population, with a validity comparable to that for international studies. Indeed, cultural and measurement biases might have influenced the response of Chinese subjects.
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Affiliation(s)
- Y-P Wang
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Hashimoto DM, Schmid J, Martins FM, Fonseca AM, Andrade LH, Kirchengast S, Eggers S. The impact of the weight status on subjective symptomatology of the Polycystic Ovary Syndrome: a cross-cultural comparison between Brazilian and Austrian women. Anthropol Anz 2003; 61:297-310. [PMID: 14524003] [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] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Group differences in symptomatology and symptom perception of young women ageing between 18 and 32 years suffering from polycystic ovarian syndrome (PCOS) were tested according to cultural background and weight status. In detail 31 Austrian women, living in Carinthia, Austria, and 102 Brazilian women, living in São Paulo, Brazil, were enrolled in the present study. All participants suffered from diagnosed PCOS. The prevalence of hirsutism, infertility, menstrual disturbances and overweight/obesity and their individual impact on health related quality of life were analysed. Furthermore the impact of weight status (BMI) on symptom perception was tested. It turned out, that the Brazilian sample exhibited higher prevalence of PCOS symptoms and these symptoms had a more negative impact on quality of life. The only exception was body weight. Although significantly leaner, the Austrian women showed a higher Cronin score of body weight than their Brazilian counterparts. The results of the present study may indicate that in western industrialized societies the fear of overweight is much more prevalent than in a developing country such as Brazil and thus it has more influence on the quality of life than all the other symptoms.
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Affiliation(s)
- D M Hashimoto
- Laboratório de Antropologia Biológica, Depto. Biologia, Centro de Estudos do Genoma Humano, Universidade de São Paulo, São Paulo, Brazil
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Kessler RC, Andrade LH, Bijl RV, Offord DR, Demler OV, Stein DJ. The effects of co-morbidity on the onset and persistence of generalized anxiety disorder in the ICPE surveys. International Consortium in Psychiatric Epidemiology. Psychol Med 2002; 32:1213-1225. [PMID: 12420891 DOI: 10.1017/s0033291702006104] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although it is well known that generalized anxiety disorder (GAD) is highly co-morbid with other mental disorders, little is known about the extent to which earlier disorders predict the subsequent first onset and persistence of GAD. These associations are examined in the current report using data from four community surveys in the World Health Organization (WHO) International Consortium in Psychiatric Epidemiology (ICPE). METHOD The surveys come from Brazil, Canada, the Netherlands and the United States. The Composite International Diagnostic Interview (CIDI) was used to assess DSM-III-R anxiety, mood and substance use disorders in these surveys. Discrete-time survival analysis was used to examine the associations of retrospectively reported earlier disorders with first onset of GAD. Logistic regression analysis was used to examine the associations of the disorders with persistence of GAD. RESULTS Six disorders predict first onset of GAD in all four surveys: agoraphobia, panic disorder, simple phobia, dysthymia, major depression and mania. With the exception of simple phobia, only respondents with active disorders have elevated risk of GAD. In the case of simple phobia, in comparison, respondents with a history of remitted disorder also have consistently elevated risk of GAD. Simple phobia is also the only disorder that predicts the persistence of GAD. CONCLUSIONS The causal processes linking temporally primary disorders to onset of GAD are likely to be state-dependent. History of simple phobia might be a GAD risk marker. Further research is needed to explore the mechanisms involved in the relationship between simple phobia and subsequent GAD.
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Affiliation(s)
- R C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115-5899, USA
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Farina M, Barbosa NBV, Nogueira CW, Folmer V, Zeni G, Andrade LH, Braga AL, Rocha JBT. Reaction of diphenyl diselenide with hydrogen peroxide and inhibition of delta-aminolevulinate dehydratase from rat liver and cucumber leaves. Braz J Med Biol Res 2002; 35:623-31. [PMID: 12045826 DOI: 10.1590/s0100-879x2002000600001] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The interaction of the product of H2O2 and (PhSe)2 with delta-aminolevulinate dehydratase (delta-ALA-D) from mammals and plants was investigated. (PhSe)2 inhibited rat hepatic delta-ALA-D with an IC50 of 10 microM but not the enzyme from cucumber leaves. The reaction of (PhSe)2 with H2O2 for 1 h increased the inhibitory potency of the original compound and the IC50 for animal delta-ALA-D inhibition was decreased from 10 to 2 microM. Delta-ALA-D from cucumber leaves was also inhibited by the products of reaction of (PhSe)2 with H2O2 with an IC50 of 4 microM. The major product of reaction of (PhSe)2 with H2O2 was identified as seleninic acid and produced an intermediate with a (lambda)max at 265 nm after reaction with t-BuSH. These results suggest that the interaction of (PhSe)2 with mammal delta-ALA-D requires the presence of cysteinyl residues in close proximity. Two cysteine residues in spatial proximity have been recently described for the mammalian enzyme. Analysis of the primary structure of plant delta-ALA-D did not reveal an analogous site. In contrast to (PhSe)2, seleninic acid, as a result of the higher electrophilic nature of its selenium atom, may react with additional cysteinyl residue(s) in mammalian delta-ALA-D and also with cysteinyl residues from cucumber leaves located at a site distinct from that found at the B and A sites in mammals. Although the interaction of organochalcogens with H2O2 may have some antioxidant properties, the formation of seleninic acid as a product of this reaction may increase the toxicity of organic chalcogens such as (PhSe)2.
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Affiliation(s)
- M Farina
- Departamento de Química, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
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Abstract
The effect of two selenides and their selenoxides on delta-aminolevulinic acid dehydratase (delta-ALA-D) from liver of adult rats was investigated. In vivo, selenides can be oxidized to selenoxides by flavin-containing monooxygenases (FMO) and selenoxides can regenerate selenides by thiol oxidation. Phenyl methyl selenide (PhSeCH3) and 1-hexynyl methyl selenide (C4H9Ctriple bondCSeCH3) were converted to selenoxides by reaction with H2O2. PhSeCH3 and C4H9Ctriple bondCSeCH3 had no effect on delta-ALA-D up to 400 microM. Conversely, their selenoxides inhibited delta-ALA-D, and the IC(50) for enzyme inhibition was about 100 and 70 microM, respectively. Partially purified delta-ALA-D (P(55)) from swine liver was also inhibited by these selenoxides. The inhibitory action of selenoxides was antagonized by dithiotreitol (DTT). Moreover, delta-ALA-D from a plant source was inhibited by the selenoxides, suggesting a possible involvement of SH groups in a distinct site of the homologous region implicated in Zn2+ binding in mammalian delta-ALA-D. After exposure to PhSeCH3 (500 micromol/kg/day) for 45 or 30 days, the activity of delta-ALA-D from liver of mice decreased to about 50% of the control group. The in vivo inhibitory action of this compound was not antagonized by DTT. PhSeCH3 and C4H9Ctriple bondCSeCH3 had no effect on the rate of DTT oxidation, but their selenoxides oxidized DTT. The results of the present study suggest that hepatic delta-ALA-D of rodents is a potential molecular target for selenides as a consequence of their metabolism to selenoxides by FMO.
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Affiliation(s)
- M Farina
- Departamento de Química, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, 97105-900, RS, Santa Maria, Brazil
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