Distribution Of Mental Disorders Research Articles

District-level differences in the distribution of mental and substance use disorders in Assam.

The lifetime prevalence of mental morbidity in Assam is estimated at 8% (NMHS 2015-16). Understanding the distribution patterns of different types of mental disorders among persons with mental morbidity in different districts would facilitate evidence-driven district mental health programming in Assam. Given the varied socio-geopolitical situation across districts in Assam, significant variations in the distribution of mental disorders are expected. To assess interdistrict differentials in common mental disorders (CMDs), severe mental disorders (SMDs), socioeconomic impact, healthcare utilization, and mental disability across three districts sampled in NMHS in Assam. This cross-sectional study used stratified random cluster sampling to identify and study eligible adult participants in Dibrugarh, Barpeta, and Cachar districts. Standardized scales and validated questionnaires were used to assess mental morbidity, disability, socioeconomic impact, and healthcare utilization. The distribution of different mental disorders among persons with mental disorders and their interdistrict differentials were tested using the Chi-square test of significance. Among persons with mental morbidity, the most common disorder was CMDs (79%). The proportional distribution of CMDs among persons with mental morbidity was significantly higher in the Dibrugarh district (79%), whereas the distribution of SMDs was higher in the Cachar district (55%). The distribution of alcohol use disorder was the highest in the Dibrugarh district (71.6%). Significant differences in disability and healthcare utilization were observed between the districts. NMHS 2015-16 Assam indicates significant differentials in the distribution of CMDs and SMDs, healthcare utilization, and associated disability between the three districts. The differentials necessitate further research to understand socio-ethnocultural, religious, geopolitical, and other factors influencing the distribution. These differences need to be accounted for during the implementation of mental health programs in the state.

Prevalence of mental disorders in the elderly population 5years after the Lushan earthquake in Ya'an, China.

This study aimed to explore the prevalence and distribution of mental disorders in the elderly population 5years after the Lushan earthquake in Ya'an, China. A multi-stage, group-matching random sampling method was adopted with 2579 elderly participants (≥ 60years old) who were interviewed from January to May 2019. Preliminary screening was conducted using the scale by trained psychiatric nurses, followed by a diagnostic interview during the second stage using Chinese Version of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder by trained psychiatrists. A total of 2561 participants were included in this study with complete data. The weighted lifetime prevalence of all mental disorders in the elderly was 16.2% (95% CI 15.3-17.1), and the weighted 12-month prevalence was 15.2% (95% CI 13.4-17.0). Depressive disorders, anxiety disorders, substance-related and addictive disorders were the most common mental disorders. The 12-month prevalence of all mental disorders were significantly higher in the elderly living alone, with chronic somatic disease, and being poor (P < 0.05). The 12-month prevalence of posttraumatic stress disorder (PTSD) was significantly higher in the elderly in extremely severely earthquake-affected areas (P < 0.001). The results of this study show that mental health status of the elderly in Ya'an area differ by socio-economic development, geographical location, and natural disasters. The social and economic development characteristics, the impact of major natural disasters (e.g., earthquakes), and population characteristics should be combined to formulate strategies and interventions to promote the mental health of the elderly.

The Incidence of Mental Disorders Increases over Time in Patients with Cancer Pain: Data from a Retrospective Cohort Study.

Background It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain. Materials and Methods We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain. Upon administration, each patient was psychiatrically assessed by a liaison-psychiatrist conducting a semistructured interview. In a second step, we compared the LCS patients with hitherto treated noncancer patients suffering from chronic pain and ACPPs with data published by Derogatis in 1983. Results In a comparison of LCSs with ACPPs, LCSs have more patients with brain organic disorders and more addictions. The largest cancer group within the LCSs is patients with urogenital (Uro) cancer (44.3%), while within the ACPPs, these are patients with cancer of the gastrointestinal (GI) tract (ACPP-GI, 57.2%). As far as the distribution of mental disorders is concerned, long-term cancer survivors show some similarities to noncancer patients. The data of ACPPs are similar to those of cancer patients, published by Derogatis. Discussion. The higher values of addiction and brain organic disorders, in particular, and the slight differences for psychic disorders in general of LCSs vs. ACPPs may result from the different cancer types and a longer survival time for urogenital tract cancer compared to GI cancer. In an additional examination, we compared patients with acute cancer of the GI tract (ACPP-GI, n = 50) with those of the urogenital tract (ACPP-Uro, n = 43). ACPP-Uro had the lowest percentage of patients with psychiatric disorders in general (ACPP-Uro 37.2%, ACPP-GI 50.0%, all LCSs 65.6%, and LCS-Uro 74.1%) and addiction, in particular (ACPP-Uro 2.3%, ACPP-GI 4.0%, and LCSs 13.1%). Conclusion Cancer patients can develop a process of chronification with an increase in the prevalence of mental disorders. For urogenital cancer, an increase in the probability to develop mental disorders is a function of time.

Geographical distribution and prevalence of mental disorders among healthcare workers in China: A cross-sectional country-wide survey: A cross-sectional study to assess mental disorders of healthcare workers in China.

Reliable and detailed nationwide data on the prevalence and distribution of mental disorders among healthcare workers in China during the coronavirus disease 2019 (COVID-19) outbreak are scarce. We did a cross-sectional online survey from March 2 to 2 April 2020 and a total of 19,379 healthcare workers from 25 provinces participated. Depression, anxiety and post-traumatic stress disorder (PTSD) were assessed by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and PTSD Checklist for DSM-5 (PCL-5), respectively. The age-standardized prevalence of depression, anxiety and PTSD was 15.5%, 12.7% and 5.2%, respectively. Frontline workers had higher prevalence estimates than non-frontline workers (depression: 18.2% vs. 13.9%; anxiety: 14.7% vs. 11.6%; PTSD: 6.1% vs. 4.6%). Subgroups who were nurses, were married or had dependent children reported higher prevalence of depression, anxiety and PTSD. Despite of the large variations, the prevalence of mental disorders was lowest in East China, followed by Middle China, and highest in West China. Healthcare workers faced enormous stress not only from the direct risk presented by the COVID-19 outbreak, but also from the profound changes in their professional practice. Prevalence of adverse psychological outcomes has a significant association with geographically distribution of health resources and regional economic level. Sufficient medical resource may be a protective factor to mental health condition of healthcare personnel when such a public health emergency happened.

A Central Clearing Clinic to Provide Mental Health Services for Refugees in Germany.

Objective: To determine migration related distress pattern in refugees and feasibility of a de novo established, central low-threshold outpatient clinic serving more than 80,000 newly arrived refugees in the metropole of Berlin.Methods: In an observational cohort study the relative prevalence of major psychiatric disorders by age, place of living within berlin, language and region of origin were assessed in a refugee cohort from 63 nationalities speaking 36 languages.Findings: Within 18 months, a total of 3,096 cases with a mean age of 29.7 years (11.7) have been referred from all 12 districts and 165 of 182 subdistricts of Berlin to the CCC. 33.7% of the patients were female. The three most frequent diagnoses were unipolar depression (40.4%), posttraumatic stress disorder (24.3%), and adjustment disorder (19.6%).Conclusion: The present data gives insight into the distribution of mental disorders in a large sample of refugees and provides evidence that a CCC is an effective service to quickly and broadly provide psychiatric consultations and thus to overcome classical barriers refugees usually experience in the host communities. In Berlin, Germany, and Europe treatment resources for this population should focus on stress and trauma related disorders.

WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders.

Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder. Syndromes typically had onsets in early to middle adolescence and persisted into the year of the survey. Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, nonheterosexual identification and behavior, low secondary school ranking, and extrinsic motivation for college enrollment. The weakness of these associations means that the syndromes considered are widely distributed with respect to these variables in the student population. Although the extent to which cost-effective treatment would reduce these risks is unclear, the high level of need for mental health services implied by these results represents a major challenge to institutions of higher education and governments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

19.1 World Health Organization World Mental Health Surveys International College Student Project (WMH-ICS): Prevalence and Distribution of Mental Disorders

19.1 World Health Organization World Mental Health Surveys International College Student Project (WMH-ICS): Prevalence and Distribution of Mental Disorders

Supplemental Material for WHO World Mental Health Surveys International College Student Project: Prevalence and Distribution of Mental Disorders

Supplemental Material for WHO World Mental Health Surveys International College Student Project: Prevalence and Distribution of Mental Disorders

Mental Disorders in Deaf and Hard of Hearing Adult Outpatients: A Comparison of Linguistic Subgroups

Deaf and hard of hearing (DHH) individuals who use signed language and those who use spoken language face different challenges and stressors. Accordingly, the profile of their mental problems may also differ. However, studies of mental disorders in this population have seldom differentiated between linguistic groups. Our study compares demographics, mental disorders, and levels of distress and functioning in 40 patients using Norwegian Sign Language (NSL) and 36 patients using spoken language. Assessment instruments were translated into NSL. More signers were deaf than hard of hearing, did not share a common language with their childhood caregivers, and had attended schools for DHH children. More Norwegian-speaking than signing patients reported medical comorbidity, whereas the distribution of mental disorders, symptoms of anxiety and depression, and daily functioning did not differ significantly. Somatic complaints and greater perceived social isolation indicate higher stress levels in DHH patients using spoken language than in those using sign language. Therefore, preventive interventions are necessary, as well as larger epidemiological and clinical studies concerning the mental health of all language groups within the DHH population.

The growth of suicide ideation, plan and attempt among young adults in the Mexico City metropolitan area.

Low and middle income countries share a heavy burden of suicide with about three in every four suicides occurring in these countries. Mexico has witnessed a growing trend in suicide deaths; if this trend is not simply a reflection of better reporting of suicide on death certificates, then this increase should logically be accompanied by an increasing trend in suicide ideation, plan and attempts, but we lack information on the trends for suicide ideation, plan and attempt for this period. We therefore aim to report changes for suicidal behaviour for the period 2001-2013 in the Mexico City Metropolitan Area. Using two cross-sectional surveys conducted in Mexico in 2001 and 2013, we report the lifetime and 12-month prevalence of suicide ideation, plan and attempt and changes in treatment for these problems among respondents aged 19-26 living in the Mexico City Metropolitan Area 12 years apart. To estimate the changes in prevalence for each outcome, we used generalised linear models to calculate prevalence ratios (PR; the prevalence rate in the exposed (year 2013) divided by the prevalence rate in the unexposed (year 2001-2002), adjusting for sociodemographic variables. While increases in the prevalence are noted everywhere, statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7-5.8) and a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0-4.9). No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases). While PRs for 12-month prevalence were all above the null, none reached statistically significant differences. During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way. The limitations of our data are the small number of participants in the 2001 survey, the low follow-up rate for the survey in 2013 and that while representative from one city it does not represent the whole country. These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services. This information, coupled with the long-term trend of increasing suicide death rates in the country, draw a worrisome and neglected scenario for our youth in this region. Urgent measures, following the recent WHO guidelines for suicide prevention, must not be postponed.

Mental Disorders in Elderly Patients with Fracture of the Femoral Neck or the Femur

The aim of the investigation was to study prevalence rate and the diagnostic distribution of mental disorders in the elderly patients, hospitalized due to the fracture of the femoral neck or the femur and to determine the prognosis of the disease course. We included in this study 101 patients aged 60 years and over with a femoral neck fracture (49 persons) or the proximal femur fracture (52 persons), who was hospitalized in trauma departments of the 2 Clinical Hospitals in Moscow. There were 73 women and 28 men (in the ratio 1:2,6), the mean age in the group was 76,4 + 8.2 years. The analysis of the examined cohort of patients showed that 82.2% of them at the time of the study had various mental disorders. The fracture of the femoral neck or the femur can be viewed as provocative or etiological factors of such mental disorders as confusion (19,8%), situational depression (8,9%), sleep disorders (5,9%), alcohol delirium (3%). These mental disorders have been found more than a third of the survey population (37.6 %). The depressive spectrum disorders occurred more frequently in younger persons, while the confusion was more frequently among older persons. The data of one-year-follow up study revealed that 27.8 % of examinated patients died. The research confirmed the expected high frequency of the adverse outcomes of fracture of the femur or the femoral neck in elderly and senile patients with confusion or dementia. The probability of reduction of mental disorders after these fractures greatly increases after early surgical treatment.

Verification of Healthcare Needs by the Use of National Health Fund Data - Mental and Behavioural Disorders

Background: The ways of gaining the information on healthcare should be verified as the discrepancies between different sources may lead to serious mistakes. Unfortunately, there are few reports on the methodology on healthcare needs assessment especially when mental and behavioural disorders are considered. Methods: The whole-nation statistical data from the Central Statistical Office (CSO) were compared to the whole-nation information on the reimbursed psychotropic medicines from the National Health Found. The most important mental health problems, and the spatial (regional) distribution of mental disorders in Poland were analysed. Results: In 2011 the total number of outpatients registered in psychiatric facilities was 1 404 148 (CSO), and NHF reimbursed psychotropic drugs for 7 870 481 people. The ”neurotic disorders” and “affective disorders” were the most frequent mental problems according to CSO but NHF recognized “alcohol dependence syndrome” and “other neurotic disorders” as the most frequent mental health problems in Poland. The mental health needs in general population according to NHF data were 5,61 times higher than the needs for psychiatric care in outpatient facilities according to CSO. In some regions those differences were higher: up to 8 – 13 times. Conclusion: The comparison of data from CSO and NHF revealed the important spatial differences in healthcare inequalities, scale of double-registration of patients and overconsumption of medicines together with underestimation of healthcare needs. Also other information e.g. on patients’ non-compliance in alcohol dependence syndrome can be obtained in this way.

Schleudertrauma und Werther-Effekt – das Potenzial von Google Insights for Search für die medizinische Forschung und öffentliche Gesundheit

Illness behaviour involves cultural, situational and personal predispositions. World Wide Web search statistics provided by internet applications like Google Insights for Search have the potential to facilitate our research on the distribution of mental disorders, our understanding of both sociocultural imprintings and trends in psychophenomenology and could make a remarkable contribution to medical research and public health.

P03-593 - The viennese psychiatric intensive care unit - diagnostic distribution

BackgroundPsychiatric intensive care is supposed to offer treatment and to hold patients with psychiatric illness, if they pose a threat to themselves or to others.MethodsA chart review was performed including 100 consecutive inpatients (52% females, age: 45.7 ± 17.8 years) treated at the Viennese psychiatric intensive care unit (PICU) in the years 2008 and 2009. Clinical key features and the distribution of mental disorders (according to ICD-10) in these patients are reported here.ResultsThe mean duration of stay was 18.9 ± 14.8 days. 52% of patients were admitted involuntarily. 18% suffered from organic mental disorder (12% from delirium), 20% were diagnosed with mental disorders due to psychoactive substance use (9% alcohol dependency, 6% benzodiazepine dependency, 5% multiple drug use), 16% had a diagnosis of schizophrenia, 10% of schizoaffective disorder and 5% of transient psychotic disorder. 20% suffered from recurrent depressive disorder, 15% from bipolar affective disorder and 3% from a single depressive episode. 8% fulfilled diagnostic criteria of a neurotic, stress-related or somatoform disorder. 12% had eating disorders, 9% had personality disorders and 1% was diagnosed with mental retardation. Only 15% of patients had a first episode of psychiatric illness. 4% were admitted after an accident and 21% after a suicide attempt (45% poisoning, 25% jumping from height, 20% cutting/piercing with sharp object, 5% vehicular impact, 5% self-immolation).ConclusionsAll major psychiatric diagnoses can be found at the Viennese PICU, either if patients are in a life-threatening condition, or if additional somatic illnesses require intensive care management.

Mental Disorders and Suicide Among Young Rural Chinese: A Case-Control Psychological Autopsy Study

The authors examined the prevalence and distribution of mental disorders in rural Chinese 15-34 years of age who committed suicide. They hypothesized that mental illness is a risk factor for suicide in this population and that the prevalence of mental illness is lower in females than in males. In this case-control psychological autopsy study, face-to-face interviews were conducted to collect information from proxy informants for 392 suicide victims and 416 living comparison subjects. Five categories of DSM-IV mental disorders (mood disorders, schizophrenia and other psychotic disorders, substance use disorders, anxiety disorders, and other axis I disorders) at the time of death or interview were assessed using the Chinese version of the Structured Clinical Interview for DSM-IV. Sociodemographic variables, social support, and life events were also assessed. The prevalence of current mental illness was 48.0% for suicide victims and 3.8% for comparison subjects. Among suicide victims, mental illness was more prevalent in males than in females (55.1% compared with 39.3%). A strong association between mental illness and suicide was observed after adjustment for sociodemographic characteristics. Other risk factors included having a lower education level, not being currently married, having a lower level of social support, and having a history of recent and long-term life events. Additive interactions were observed between mental illness and lower level of social support. Although mental illness is a strong risk factor for suicide, it is less prevalent among rural Chinese young people who committed suicide, particularly females, in comparison with other populations in China and in the West.

Completed Suicide and Psychiatric Diagnoses in Young People: A Critical Examination of the Evidence.

Suicide rates of young people are increasing in many geographic areas. There is a need to recognize more precisely the role of specific mental disorders and their comparative importance for understanding suicide and its prevention. The authors reviewed the published English-language research, where psychiatric diagnoses that met diagnostic criteria were reported, to reexamine the presence and distribution of mental disorders in cases of completed suicide among young people worldwide. The number and geographical distribution of cases were limited (N = 894 cases). The majority of cases (88.6%) had a diagnosis of at least 1 mental disorder. Mood disorders were most frequent (42.1%), followed by substance-related disorders (40.8%) and disruptive behavior disorders (20.8%). Those strategies focusing exclusively on the prevention and treatment of depression in young people need to be reconsidered. A comprehensive suicide prevention strategy among young people should target mental disorders as a whole, not depression alone, and consider contextual factors.

Mental illness in a general hospital's family medicine clinic in Taiwan.

There has been a paucity of evidence-based information regarding mental illness in general medical settings among the Chinese population. Aims of the present study are to investigate the patterns and distribution of mental disorders among family medicine clinic attenders, illness behavior of attenders with such disorders, and the recognition and management given by family physicians for them. A random sample (n = 200) of patients attending a family medicine clinic in a medical center in Taiwan, received a standardized psychiatric assessment using the semistructured Clinical Interview Schedule (CIS) after they had seen the family physician. A total of 12 family physicians, who were blind to the psychiatric status of their patients, were then asked to assess the physical and psychological condition of the subjects. Of all study subjects, 51% had at least one psychiatric diagnosis based on the CIS assessment, and the corresponding figure was 21.5% from family physicians. While the specificity of psychiatric case identification among family physician was high (91%), the sensitivity was very low (30%), especially for depressive disorders and alcohol-related disorders. Because the same magnitude of psychiatric morbidity and similarly low detection rates by general medical physicians were found in other developing countries, the improvement in psychiatric education for medical students and family physicians is highly implicated there.

Diagnostic classification: Results from a clinical experience of three years with DC: 0–3

AbstractInfancy and early childhood are characterized by a dynamic and ever changing process. Since the beginning of their clinical work at the Infancy Unit, the authors were concerned with individual assessment and the questions about the role played by parents as well as by babies in pathology and intervention. In this article, the authors begin with a description of the path that led them to the selection of DC 0–3 as a diagnostic classification system and how this has been instrumental in helping them to better define infant psychopathology and guide them in treatment orientations. Next, they present the results of the application of Axis I and II of DC: 0–3 in their clinical population in the years 1997, 1998, and 1999. The objectives of this study were to learn more about the distribution of mental disorders in a clinical population up to four years of age. The authors attempted to separate infants at risk for developing psychic disorders from those presenting current psychopathology as well as the possible influence of demographic features on this distribution, to define a target population and design adapted therapeutic measures. The identification of these objectives provides the rationale for the use of a diagnostic tool, like DC: 0–3, which is essential to plan clinical activity, to evaluate therapeutic efficacy, and to develop specific programs. ©2003 Michigan Association for Infant Mental Health.

La disfunción familiar como predisponente de la enfermedad mental. ¿Existe tal asociación?

The purpose is to describe the relationship between family disfunction and mental disorder. The secondary objective is to know the prevalence and distribution of mental disorders in primary care attended population. A cross-sectional study was conducted in a primary care setting. Random sample was selected over 280 subjects from consultant population. The variables (family function, family structure, social and economic conditions and mental disorders) were collected through interview. APGAR test and Mini International Neuropsychiatric Interview test were performed. 264 patients were finally included (64% women). Mean age was 45.6 years (SD 16.7). Mental disorders were detected in 87 patients (33%). The most prevalent disorders were generalized anxiety disorder, dysthymia and major depression, family disfunction was found in 32 patients (12.3%). Prevalence of mental disorders wasn't statistically different in the group with family disfunction. Mental disorders are a common problem between primary care attended population. There wasn't any association between family disfunction and mental disorders, because of the limitations in the APGAR test in detecting family disfunction.

Bomiljø og psykisk helse i en stor og mellomstor by: En intenju-undersøkelse

Previous research indicates that social segregation leads to dramatic differences in the quality of neighbourhoods within the big cities, in contrast to the more equal distribution of environmental qualities within rural areas and smaller cities. The present investigation, based on structured interviewing of 563 and 444 women from Oslo and Kristiansand respectively, confirms this finding, and shows that the distribution of mental disorders follows the same pattern. When comparing Oslo with Kristiansand, the differences in psychiatric morbidity is found to be much greater within the big city than within the smaller city, corresponding to the differences in quality of neighbourhood within the two cities. Lack of social support, combined with various environmental stressors, seems important in explaining the high rates of mental disorders in the poorest neighbourhoods. However, selective in-migration of people with social and psychological problems to the poorest neighbourhoods, may also play a role in expla...