12-month Prevalence Rates Research Articles

Preventing Depression

Depressive disorders erode quality of life, productivity in the workplace, and fulfillment of social and familial roles. In today's knowledge- and service-driven economies, the population's mental capital (ie, cognitive, emotional, and social skills resources required for role functioning) becomes both more valuable and more vulnerable to the effects of depression. Depressive disorders, severe mental illnesses that should not be confused with normal mood variations, are part of a vicious circle of poverty, discrimination, and poor mental health in middle- and low-income countries.1 These realities also have major economic ramifications: treatment costs of depression are soaring but are only a fragment of the costs of reduced productivity due to depression.2 More than half of those with depression develop a recurrent or chronic disorder after a first depressive episode and are likely to spend more than 20% of their life-time in a depressed condition. With a 12-month prevalence rate of more than 5% in most high-, middle-, and low-income countries and its occurrence at almost any age,3 depression generates substantial loss of quality of life and personal morbidity and despair. But it also leads to considerable additional damage through biological sequelae and maladaptive illness behaviors, thus increasing risk of cardiovascular disease, dementing illnesses, and early death while amplifying disability, complications, and health services use in those with coexisting chronic illnesses. Depression ranks third among disorders responsible for global disease burden, with all the concomitant economic costs to society, and will rank first in high-income countries by 2030.4

Ethnic differences in mental illness and mental health service use among Black fathers.

We have presented nationally representative data on the prevalence and correlates of mental illness and mental health service use among African American and Caribbean Black (US-born and foreign-born) fathers in the United States. We have reported national estimates of lifetime and 12-month prevalence rates of mental illness, correlates, and service use among African American (n = 1254) and Caribbean Black (n = 633) fathers using data from the National Survey of American Life, a national household survey of Black Americans. We used bivariate cross-tabulations and Cox proportional hazards regression approaches and adjusted for the National Survey of American Life's complex sample design. The prevalence of mental illness, sociodemographic correlates, and service use among Black fathers varied by ethnicity and nativity. US-born Caribbean Black fathers had alarmingly high rates of most disorders, including depression, anxiety, and substance disorders. Mental health service use was particularly low for African American and foreign-born Caribbean Black fathers. These results demonstrate the need for more research on the causes and consequences of mental illness and the help-seeking behavior of ethnically diverse Black fathers.

An Ergonomics Study on the Prevalence of Musculoskeletal Disorders Among Indian Bus Conductors

This study was undertaken among 100 randomly selected bus conductors from 2 routes. A questionnaire study based on the modified Nordic musculoskeletal questionnaire, assessment of physical and physiological parameters, analysis of working postures and a detailed work study were performed. The analysis revealed that conductors had a work schedule of 16–18 h each day; the duration of work could vary from 15 to 20 days at a stretch. Discomfort leading to musculoskeletal disorders mainly affecting the leg (93.3%), knee (83.3%), shoulder (80%) and back areas (56.7%) had the highest 12-month prevalence rates and increased day by day. The conductors also suffered from extreme physiological stress due to prolonged working hours in hazardous standing posture conditions, excessive work pressure and minimum rest between trips. Consequently, all those factors affected their health and work performance.

Estimation de la prévalence de l’épisode dépressif chez l’adolescent en France

BackgroundAlthough the diagnosis and treatment of depressive disorders are important public health issues in adolescents, epidemiological data in this population are scarce. ObjectiveThe aims of this study were to estimate the 12-month prevalence rates of depressive disorders among ninth grade pupils in French schools, and to identify the sociodemographic correlates. MethodsThe data were collected through a national cross-sectional study conducted among ninth grade pupils in France in 2003–2004. Depressive disorders were assessed using a self-administered questionnaire derived from the standardised Composite International Diagnosis Interview–Short Form (CIDI–SF). ResultsA total of 7110 teenagers (mean age 15.1years) were included. Of these, 9.6% (95% CI 8.6–10.6) reported symptoms corresponding to at least one major depressive episode (MDE) over the past 12months. Three correlates were independently associated with a higher prevalence of 12-month MDE: being a female (adjusted odds ratio 3.0; 95% CI 2.4–3.8), being greater or equal to 16years old (aOR=2.2; 95% CI 1.0–5.0) and living alone with one's mother (aOR=1.7; 95% CI 1.3–2.4) or with one's mother and her spouse (aORa=1.4; 95% CI 1.0–2.1). ConclusionThe high prevalence of depressive disorders in French adolescents is thoroughly discussed. The needs for developing mental health surveillance, comprehensive prevention and care programs for this population are crucial.

Twelve-month prevalence and correlates of subthreshold and threshold anxiety in community-dwelling older adults with cardiovascular diseases

Studies that examined the prevalence of anxiety in older adults with cardiovascular diseases (CVD) were mainly conducted in clinical settings limiting the generalizability of the results to community-based samples. Moreover, among older adults with CVD, little is known about the prevalence of subthreshold anxiety and about which characteristics differentiate those with subthreshold anxiety from those having an anxiety disorder. This study aimed at determining the 12-month prevalence rates of subthreshold and threshold anxiety in community-dwelling older adults with CVD as well as to examine whether older people with CVD reporting an anxiety disorder differ from their counterparts with subthreshold anxiety. From a representative sample of community-dwelling older adults aged 65years and older (N=2811), 613 cases of CVD were identified based on government medical records. Subthreshold and threshold anxiety were assessed using in-home interviews based on the DSM-IV criteria. The 12-month prevalence rates of anxiety disorders and subthreshold anxiety were, respectively, 5.1 and 14.8%. Compared to older adults with CVD reporting no anxiety, individuals reporting subthreshold or threshold anxiety are more likely to be women, to have high blood pressure, and to suffer from a depression. No information was gathered regarding alcohol and tobacco use. The present study provides evidence for the fact that subthreshold anxiety has a high prevalence among community-dwelling older people with CVD and that clinicians working with this population should screen for anxiety, even at a subthreshold level, since it may be associated with high blood pressure and depression.

Alcohol Use Disorders, Nicotine Dependence, and Co‐Occurring Mood and Anxiety Disorders in the United States and South Korea—A Cross‐National Comparison

The strong comorbidity between substance use disorders (SUDs) and mood and anxiety disorders has been well documented. In view of lack of research findings addressing the co-occurrence of SUDs and mood and anxiety disorders, this study examined the pattern of comorbidity of alcohol use disorders (AUDs) and nicotine dependence (ND) between 2 culturally diverse countries, the United States and South Korea. Using the nationally representative samples of the U.S. and Korean general populations, we directly compared rates and comorbidity patterns of AUDs, ND, and mood and anxiety disorders between the 2 countries. We further examined the rates and the comorbidity pattern among individuals with AUDs who sought treatment in the last 12 months. Twelve-month prevalence rates were derived to estimate country differentials, and odds ratios (ORs) and 95% confidence intervals were estimated to measure the strength of comorbid associations while adjusting for all sociodemographic characteristics in multivariate logistic models specific to each country. The 12-month prevalence rates of AUDs, ND, and any mood disorder and any anxiety disorder were 9.7, 14.4, 9.5, and 11.9% among Americans, whereas the corresponding rates were 7.1, 6.6, 2.0, and 5.2% among Koreans. These rates were significantly greater (except for any AUD) among Americans than among their Korean counterparts. With respect to comorbidity, both countries showed comparable patterns that the prevalence rates of mood and anxiety disorders were consistently the highest among persons with alcohol dependence (AD). Also, a disparate pattern was observed in Korea that the prevalence rates of mood and anxiety disorders were generally lower among individuals with ND than among those with alcohol abuse and AD. Furthermore, despite significantly greater prevalence of AD in Korea (5.1%) than in the United States (4.4%), alcohol-dependent Americans were 4 times (OR = 3.93) more likely to seek treatment compared to their Korean counterparts. Our results indicated that the prevalence of AD in Korea was substantially greater than that in both Western and other Asian countries, suggesting a maladaptive pattern of alcohol use in Korea, which is different from the general use pattern of other East Asian countries. The low rate of treatment utilization among Koreans might be attributable to perceived social stigma toward SUDs or mental health problems despite the fact that the Korean government offers national health insurance.

Risk of trauma exposure among persons with mental illness in jails and prisons

Traumatic victimization, particularly sexual abuse, is a serious problem in correctional facilities and those suffering from mental illnesses are especially vulnerable. This review examines our current knowledge regarding trauma victimization among persons with mental illness serving time in jails/prisons, considers methodological challenges, and provides recommendations for future research. Traumatic victimization, particularly sexual abuse, has consistently been identified as a high-frequency problem within jails and prisons. Lifetime, 6-month, and 12-month prevalence rates of physical and sexual violence among incarcerated people are quite high relative to nonincarcerated populations, and women report much higher rates of most traumatic events than men. Moreover, data show that inmates with mental illnesses are up to eight times more likely to be victims of sexual abuse than nonmentally ill inmates. Additional research is needed to improve our understanding of this issue and inform change efforts. Future research should include: epidemiological studies to improve our knowledge of risk factors and correlates of victimization; prospective studies to determine causality between trauma victimization and mental illness or other adverse outcome; and intervention studies to examine strategies for reducing violence and traumatic victimization inside correctional facilities, effective treatments for posttraumatic psychopathology, and improved re-entry outcomes.

Concurrent binge drinking and depression among Canadian youth: prevalence, patterns, and suicidality

This study compared differences in risk for suicidality among youth living in the community who met criteria for comorbid depression and binge drinking, depression without binge drinking, and binge drinking without depression relative to a reference group with neither condition. Logistic regression analysis was used to analyze data from the Canadian Community Health Survey, Cycle 3.1 (CCHS 3.1, 2005): a cross-sectional survey of respondents from the Canadian population. To restrict the sample to youth, respondents were excluded who were younger than 15 or older than 24 years. Over 17,000 respondents were assessed to determine whether they met criteria for depression, binge drinking, the comorbid condition, or neither condition (reference group). Binge drinking was defined as five drinks or more on an occasion. The 12-month prevalence rates for comorbid binge drinking and depression were 2.7% for male respondents and 2.1% for female respondents. When adjusted for demographic factors and when compared with the reference group, the risk of suicidality was increased for the depressed group (odds ratio [OR] 5.23, 95% confidence interval [CI]: 3.34–8.2) and the comorbid group (OR 6.28, 95% CI: 3.68–10.70), but not for the binge-drinking group. With the exception of increasing age, sociodemographic factors were not correlates of comorbidity. In conclusion, binge drinking was not associated with an increased risk of suicidality among Canadian youth living in the community, although depression and comorbidity were associated with suicidality.

185 Delayed Encephalopathy from Carbon-Monoxide Poisoning: Can It Be Precipitated by Electro Convulsive Therapy (ECT)?

The aim of this study was to estimate the prevalence of the DSM-IV major mental disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI).The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas using a multistage, cluster sampling design. The target population included all eligible community dwelling residents aged 18–64 years. Face-to-face interviews were conducted using the K-CIDI based on the DSM-IV.A total of 6510 participants completed the interview (response rate = 81.7%). The lifetime and 12-month prevalence rates for DSM-IV major mental disorders were 29.0% and 16.9%, respectively. Those of specific disorders were as follows: (1) alcohol use disorder, 16.2% and 5.6%; (2) nicotine use disorder, 9.0% and 6.0%; (3) specific phobia, 3.8% and 3.4%; (4) major depressive disorder, 5.6% and 2.5%; and (5) generalized anxiety disorder, 1.6% and 0.8%. Additionally, data related to nicotine and alcohol use disorder revealed a very high male to female ratio. Further, mood and anxiety disorders were more prevalent in females than in males.The prevalence of major mental disorders was high. In comparison with the studies performed in other countries, notable differences were observed with respect to the distribution of mental disorders in Korea.

Economic burden of depression in South Korea

A recent national survey in South Korea indicated that the 12-month prevalence rate of major depressive disorder was 2.5%. Depressive disorders may lead to disability, premature death, and severe suffering of patients and their families. This study estimates the economic burden of depression in Korea from a societal perspective. Annual direct healthcare costs associated with depression were calculated based on the National Health Insurance database. Annual direct non-healthcare costs were estimated for transport. Annual indirect costs were estimated for the following components of productivity loss due to illness such as morbidity (absenteeism and presenteeism) and premature mortality. Indirect costs were estimated using the large national psychiatric epidemiological surveys in Korea. The human capital approach was used to estimate indirect costs. The total cost of depression was estimated to be $4,049 million, of which $152.6million represents a direct healthcare cost. Total direct non-healthcare costs were estimated to be $15.9 million. Indirect costs were estimated at $3,880.5 million. The morbidity cost was $2,958.9 million and the mortality cost was $921.6 million. The morbidity cost was identified as the largest component of overall cost. Depression is a considerable burden on both society and the individual, especially in terms of incapacity to work. The Korean society should increase the public health effort to prevent and detect depression in order to ensure that appropriate treatment is provided. Such actions will lead to a significant reduction in the total burden resulting from depression.

The Impact of DSM-IV Symptom and Clinical Significance Criteria on the Prevalence Estimates of Subthreshold and Threshold Anxiety in the Older Adult Population

Subthreshold anxiety refers to a condition where individuals do not meet the full symptom criteria (i.e., the number of symptoms required for a formal diagnosis is not reached) and/or do not report significant impairment or distress in functioning (i.e., the clinical significance criterion is not met). The purpose of this study was to examine how the symptom and the clinical significance criteria may affect the prevalence estimates of anxiety problems in the older adult population and whether applying these criteria results in an identifiable older group showing more severe anxiety. Data came from a large representative sample of community-dwelling older adults age 65 years and older (N = 2,784). Results showed that the 12-month prevalence rate of any anxiety problem varied from 5.6% when DSM-IV criteria for anxiety disorders were used to 26.2% when all subthreshold manifestations of anxiety were considered. Findings also indicated that when compared with respondents without anxiety, older adults presenting different manifestations of subthreshold or threshold anxiety appear to be more similar than different in their health and health behavior characteristics. Subthreshold anxiety has a high prevalence and may cause significant impairment. Both symptom and clinical significance criteria do not perfectly discriminate between older adults with or without a severe anxiety problem presenting comorbid disorders and needing psychiatric help.

Prevalence of suicidal behaviours in two Australian general population surveys: methodological considerations when comparing across studies

To investigate whether methodological differences between two Australian general population surveys have the capacity to affect the apparent prevalence rates of suicidal ideation and suicide attempts. 609 Wave 1 of the Personality and Total Health (PATH) Through Life Project participants, and 83 participants derived from the 1997 National Survey of Mental Health and Wellbeing (NSMHWB) met the criteria for inclusion (suicidal ideation/suicide attempt). Analysis involved Chi-square and binary logistic regression. Twelve-month prevalence rates for suicidal ideation and suicide attempt were 8.2%, (95% CI=7.6-8.8) and 0.8% (95% CI=0.6-1.0) for PATH (N=7,485), and contrast with 2.9% (95% CI=2.6-3.2) and 0.3% (95% CI=0.2-0.5) for NSMHWB (N=10,641) samples, respectively. While notable discrepancies are apparent between the prevalence statistics, both sets of statistics are within the bounds of other Australian and international studies. Parallel rate disparities for suicidal ideation are found across age-by-gender groups. Aside from differences in the basic prevalence rates, surveys have analogous age-by-gender profiles for suicidal ideation. While it is possible that samples are representative of the populations from which they are derived, 12-month prevalence rate discrepancies between PATH and NSMHWB surveys are likely to originate from demographic and survey methodology differences. Where investigations employ different methodologies, especially in relation to modes of survey administration and the assessment items utilised, a cautious approach should be taken when comparing findings.

The epidemiology of specific phobia and subthreshold fear subtypes in a community-based sample of older adults

Specific phobias have received little attention among older adults. This study is aimed at determining the 12-month prevalence rates of fear subtypes in older adults with a full or subthreshold DSM diagnosis of specific phobia as well as to examine differences among these conditions according to health and health behavior characteristics potentially associated with the severity of anxious symptoms. Data came from a representative sample of community-dwelling older adults aged 65 years and older (N = 2784). Diagnoses were established by in-home semi-structured interviews. DSM-IV criteria for specific phobia were slightly modified in line with recommendations for DSM-V. The 12-month prevalence rates of specific phobias and subthreshold fears were, respectively, 2.0 and 8.7%. More than half of the respondents with a specific phobia did not recognize the "excessiveness" of their fears. Situational and natural environment fears were the most frequent subtypes. Compared to respondents with no symptoms of anxiety, older adults with a full- or subthreshold-specific phobia reported more chronic physical health problems, more comorbid depressive disorders and a higher use of benzodiazepines. However, older adults with specific phobia reported more comorbid anxiety disorders than respondents with subthreshold fears. The present study provides evidence for the fact that subthreshold fears have a high prevalence among older adults. Since several older people with specific phobia do not recognize the "excessiveness" of their fears, it is recommended that DSM-V criteria allow clinicians to rely on their own judgment to assess whether the perceived danger is out of proportion.

Racial and ethnic differences in diabetes mellitus among people with and without psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions

Objective This study examined racial/ethnic differences in the prevalence of diabetes mellitus in a nationally representative sample of adults with and without common psychiatric disorders. Method Data were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions ( N=34,653). Logistic regression models adjusting for sociodemographic variables and diabetes risk factors were used to examine racial/ethnic differences in 12-month prevalence rates of diabetes by psychiatric status. Results Among people without psychiatric disorders, African Americans, Hispanics and American Indians/Alaska Natives, but not Asians/Pacific Islanders, had significantly higher rates of diabetes than non-Hispanic whites even after adjusting for sociodemographic variables and diabetes risk factors. In the presence of psychiatric disorders, these health disparities persisted for African Americans and Hispanics, but not for American Indians/Alaska Natives. No significant interactions between race/ethnicity and psychiatric disorders in the odds of diabetes were found across any group. Conclusion Policies and services that support culturally appropriate prevention and treatment strategies are needed to reduce racial/ethnic disparities in diabetes among people with and without psychiatric disabilities.

Closing the treatment gap

Byline: M. Thirunavukarasu The importance of mental health in the global health scenario has been amply demonstrated. Worldwide, community-based epidemiological studies have estimated that lifetime prevalence rates of mental disorders in adults are 12.2-48.6%, and the 12-month prevalence rates are 8.4-29.1%. [sup][1] In India, the prevalence of mental illness has been estimated to be around 7.3%. [sup][2] Neuropsychiatric disorders account for about 10.8% of the global burden of disorders in the country. [sup][3] As per the Government of India's National Commission on Economics and Health Report of 2005, the prevalence of serious mental illness in the Indian population is at least 6.5%, which, by a rough estimate, would be 71 million people. [sup][4] Despite these unnerving statistics, the treatment gap, as measured by the absolute difference between the true prevalence of a disorder and the treated proportion of individuals affected by the disorder, has been found to be very high. A large multicountry survey supported by the WHO showed that 35-50% of the serious cases in developed countries and 76-85% in the less-developed countries had received no treatment in the previous 12 months. [sup][5] One of the major reasons attributed to such a wide treatment gap is the problem of inadequate resources, which is more apparent in developing countries like India. In India, inadequacy exists for infrastructure as well as for human resources. This has been made apparent by the statistics provided by the WHO Mental Health Atlas, [sup][6] as summarized in [Table 1]. For example, India has 0.20 psychiatrists per 10,000 population. This can be compared with the ideal of 1 per 10,000 population. [sup][7]{Table 1} The inadequacy has been reported not only in the form of quantity but also in the quality of mental health services. Human rights violations in mental health institutions have been widely criticized as well. The National Human Rights Commission Report [sup][8] (1999) highlights these issues. The report mentions that many institutions still retained a prison-like structure and ambience and prison-like practices such as roll-call and lining up for handover still existed. Exclusively closed wards existed in 59% of the hospitals examined. The building maintenance was unsatisfactory in many hospitals with leaking roofs, eroded floors, overflowing toilets and broken doors. The overall ratio of beds to patients was 1:1.4, indicating that many patients slept on the floor. Some hospitals had no toilets and patients urinated and defecated in the cell, and archaic practices like shaving heads (for both male and female patients) and wearing uniforms were still prevalent. [sup][9] Bridging the GAP These deficits in the quantity and quality of mental health services have not been ignored and steps have been taken to bridge the treatment gap, especially to decrease the deficits in human resources. This has been attempted through the National Mental Health Program (NMHP), which envisages integration of mental health care with general health services, especially at the primary care level. Although the District Mental Health Program (DMHP), the basic unit of the NMHP, was launched with huge fanfare, the program failed to gain the desired momentum, and progress has been very slow. Stagnation in sectors like Departments of Psychiatry in medical colleges and mental hospitals has not only robbed the DMHPs of vital managerial support but had also led to an attitude of indifference and apathy among mental health professionals. [sup][10] Even if properly implemented, this program would have the disadvantage that it may have a long latency time before having the desired effect. Other innovative strategies have also been proposed to improve the gap, like starting short-duration courses for post-graduate training in psychiatry through distance learning. These may improve the quantity of mental health resources at the cost of quality. …

"Blues" ain′t good for the heart

Byline: Krishnamachari. Srinivasan Research in recent decades suggests that depression and coronary heart disease (CHD) have a bidirectional relationship. Depression, independent of other risk factors in an otherwise healthy person, doubles the risk of developing CHD. [sup][1] Depression is seen in about 20% of the patients hospitalized with acute coronary syndromes either at admission or in the immediate period following recovery from CHD. [sup][2] Depression in Patients with Coronary Heart Disease Cross-sectional studies have reported that between 19 and 66% of the patients with myocardial infarction (MI) have depressive and anxiety symptoms, [sup][3],[4] and a significant proportion of these patients (17-44%) are diagnosed with major depression. [sup][5],[6],[7] In addition, major depression is also common following coronary bypass surgery [sup][8] and in patients with unstable angina. [sup][9] Thus, these studies suggest that the prevalence rate of depression among patients with CHD is far greater than the 12-month prevalence rate of 6.6% reported in the community. [sup][10] Impact of Depression on Pre-Existing Coronary Heart Disease Over the last two decades, evidence has accumulated for the adverse impact of depression in patients with CHD. In one of the earliest studies in this area, Frasure Smith et al. [sup][11] in their study of depression and coronary heart disease in 222 patients post MI, those diagnosed with major depression on a modified version of the Diagnostic Interview Schedule had an adjusted hazard ratio of 3.44 (95% CI 2.25-4.63) for mortality over 6 months of follow-up compared with the controls. This was approximately equivalent to the risk engendered by clinical factors such as diminished left ventricular function and past history of MI. In a subsequent study, the same group of investigators followed-up this cohort over 18 months. [sup][12] Although baseline depression still predicted mortality at 18 months, its impact mainly occurred in the first 6 months. Similar findings of high mortality in subjects with unstable angina and comorbid depression have been reported. [sup][9] In addition, depression also has a negative impact on survival rates following coronary artery bypass graft (CABG). Two studies reported that the presence of depression at baseline prior to CABG was an independent predictor of cardiovascular mortality post-CABG. [sup][13],[14] There is also a dose-response relationship between depression and death due to adverse cardiac events, [sup][15] with increased baseline depression scores being associated with a higher risk of cardiac mortality. [sup][16] Depression and the Risk of Development of Coronary Heart Disease Several prospective studies have reported depression as a risk factor for the development of CHD, and this risk is independent of other cardiovascular risk factors. In a large prospective community-based study, patients with a history of dysphoria or depression had 4.5-times relative risk (RR) of having an acute MI compared with non-depressed subjects independent of other cardiovascular risk factors. [sup][17] It was also noted in this study that the risk of developing CHD was linked to the severity of depression, with an RR of 4.5 for developing CHD in subjects with major depression as opposed to 2.1 for subjects with dysphoria. A metaanalysis of studies in this area reported an RR of 1.64 for the development of CHD in subjects with depression. [sup][1] Pathophysiological Link between Depression and Coronary Heart Disease Depression and lifestyle behavior There exist several possible mechanisms that underlie the relationship between depression and CHD. Depression is associated with unhealthy lifestyle; depressed patients have a sedentary lifestyle, more likely to smoke and consume alcohol and are overweight/obese. [sup][18],[19],[20] Depression is also associated with non-compliance to medical treatment. …

Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery

At present only a small number of studies have investigated psychiatric comorbidity in disc surgery patients. Objectives of this study are (1) to examine the prevalence rate of comorbid affective, anxiety, and substance-related disorders in nucleotomy patients in comparison to the German general population and (2) to investigate associations between psychiatric comorbidity and socio-demographic and illness-related characteristics. The study refers to 349 consecutive disc surgery patients (response rate 87%) between the age of 18 and 55years. The final study sample consists of 239 lumbar and 66 cervical nucleotomy patients. Face-to-face interviews were conducted approximately 3.45days (SD 3.170) after disc surgery, during hospital stay. Psychiatric comorbidity was assessed by means of the Composite International Diagnostic Interview (CIDI-DIA-X). The corresponding data of the German general population were derived from the German National Health Interview and Examination Survey (GHS). 12-Month prevalence rates of any affective, anxiety or substance-related disorders range between 33.7% in cervical and 23.5% in lumbar disc surgery patients. Four-week prevalence rates of any affective, anxiety or substance disorder vary between 13.2% in cervical and 14.0% in lumbar nucleotomy patients. Disc surgery patients suffer more often from affective disorders and illicit substance abuse than the general population. Significant associations were found between psychiatric comorbidity and gender, as well as pain intensity. Disc surgery patients show a higher risk to suffer from mental disorders than the general population. The assessment of psychiatric distress and the assistance by mental health professionals should be considered during hospital and rehabilitation treatment.

Post-traumatic stress disorder, drug abuse and migraine: New findings from the National Comorbidity Survey Replication (NCS-R)

Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse. This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH). Our sample consisted of 5,692 participants. Lifetime and 12-month prevalence rates of PTSD were increased in those with EM and CDH. After adjustments, the lifetime odds ratio (OR) of PTSD was greater in those with EM (OR 3.07 confidence interval [CI]: 2.12, 4.46) compared to those without headache; was greater in men than women with EM (men: OR 6.86; CI: 3.11, 15.11; women: OR 2.77; CI: 1.83, 4.21); and was comparable or greater than the association between migraine with depression or anxiety. The lifetime OR of PTSD was also increased in CDH sufferers. The OR of illicit drug abuse was not increased in those with EM or CDH unless co-occurring with PTSD or depression. The lifetime and 12-month OR of PTSD is increased in those with migraine or CDH, and is greater in men than women with migraine. The lifetime and 12-month OR of illicit drug abuse is not increased in those with migraine or CDH unless co-occurring with PTSD or depression.

A survey of sharps including needlestick injuries in nurses in New South Wales, Australia

ObjectivesThis cross-sectional study sought to determine the prevalence rate of sharps including needlestick injuries (NSI) in a 12-month periodamong nurses and midwives, factors associated with NSI injuries and to compare data across workplace categories and geographic regions. MethodsThe study surveyed a randomly selected representative sample of nurses (n=7423) from the NSW Nurses’ Association membership representing members from five major workplace categories and four major geographic regions. ResultsAtotal of 1301 eligible contactable nurses participated (response rate 18.5%). The 12-month self-reported prevalence rate of injury was 6.5% (n=84). NSI rates of injury were higher in the clinical areas of emergency room, operating theatres, medical and surgical wards, mental health and aged care. Bygeographic region the rate of injury was highest in remote areas (16.4%). Logistic regression modelling was used to identify factors which increase the risk of a NSI injury; only working in a remote region was statistically significant. The odds of sustaining a NSI injury for nurses and midwives working in remote areas was 2.9 times the odds for nurses working in city/inner regional areas when controlling for other risk factors. ConclusionsThe NSI rates of injury reported in this study are similar to those reported in other recent state and national studies in Australia and the UK. Nosignificant differences were identified when clinical areas were compared. This study suggests that the risk is significantly higher in remote areas.

Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study

BackgroundAlthough often providing more reliable and informative findings relative to other study designs, longitudinal investigations of prevalence and predictors of suicidal behaviour remain uncommon. This paper compares 12-month prevalence rates for suicidal ideation and suicide attempt at baseline and follow-up; identifies new cases and remissions; and assesses the capacity of baseline data to predict serious suicidality at follow-up, focusing on age and gender differences.Methods6,666 participants aged 20-29, 40-49 and 60-69 years were drawn from the first (1999-2001) and second (2003-2006) waves of a general population survey. Analyses involved multivariate logistic regression.ResultsAt follow-up, prevalence of suicidal ideation and suicide attempt had decreased (8.2%-6.1%, and 0.8%-0.5%, respectively). However, over one quarter of those reporting serious suicidality at baseline still experienced it four years later. Females aged 20-29 never married or diagnosed with a physical illness at follow-up were at greater risk of serious suicidality (OR = 4.17, 95% CI = 3.11-5.23; OR = 3.18, 95% CI = 2.09-4.26, respectively). Males aged 40-49 not in the labour force had increased odds of serious suicidality (OR = 4.08, 95% CI = 1.6-6.48) compared to their equivalently-aged and employed counterparts. Depressed/anxious females aged 60-69 were nearly 30% more likely to be seriously suicidal.ConclusionsThere are age and gender differentials in the risk factors for suicidality. Life-circumstances contribute substantially to the onset of serious suicidality, in addition to symptoms of depression and anxiety. These findings are particularly pertinent to the development of effective population-based suicide prevention strategies.