High General Health Questionnaire Scores Research Articles

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Risk and protective factors for depressive symptoms and suicidality among children and adolescents in Lebanon: Results from a national survey

· 6·2% of children and adolescents in Lebanon experience clinically significant depressive symptoms and 11·5% experience suicidal ideations. · Parent child conflict, parental psychopathology and bullying emerge as strong correlates of depressive symptoms and suicidal ideations among children and adolescents. · Incorporating parental psychopathology and parent-child relationship during assessments of children and adolescents is important, as are interventions that target bullying. This may help decrease the risk of depressive symptoms and suicidality in this age group. Depressive disorders and suicidal ideations among children and adolescents present a global public health concern. Our aim is to investigate the prevalence and correlates of depressive symptoms and suicidality in a nationally representative sample of Lebanese children and adolescents. 1287 participants aged 8–17 years 11 months and their parents were recruited and completed the Mood and Feelings Questionnaire, Screen for Child Anxiety Related Emotional Disorders, Conflict Behavior Questionnaire(CBQ), Strengths and Difficulties Questionnaire, Peer Relations Questionnaire. Parents completed a sociodemographic questionnaire and the General Health Questionnaire (GHQ). 79 participants (6·2%) screened positive for depressive symptoms and 147 (11·5%) had suicidal ideations. Among children, depressive symptoms were associated with suboptimal school performance (OR=11·543;95%CI=3·341–39·887), higher GHQ scores (OR=1·076;95% CI=1·045–1·108), higher odds of being victims of bullying (OR=3·545,95% CI=1·313–9·088) and of being both a victim and a bully (OR=8·700;95%CI=3·202–23·638). Suicidal ideations were associated with lower odds of having a monthly income greater than 2000$(OR=0·095;95%CI=0·012–0·760), higher odds of being victims of bullying (OR=3·392;95%CI=1·435–8·017), and of being both a victim and a bully (OR=3·347;95%CI=1·605–6·980). Among adolescents, depressive symptoms were associated with older age (OR=1·429;95%CI=1·149–1·778), school performance with some difficulties (OR=2·950;95%CI=1·408–6·181), being both a victim and a bully (OR=7·114;95%CI=2·588–19·556), higher parent reported CBQ score (OR=1·199;95%CI=1·124–1·279);. Suicidal ideations were associated with lower odds of having a monthly income between 1000 and 2000$ (OR=0·435; 95%CI=2·223–0·847), higher odds of being both a bully and a victim (OR=5·851;95%CI=2·287–14·973), higher parent reported CBQ scores (OR=1·123;95%CI=1·061–1·188). Among participants who showed depressive symptoms or suicidality, only 3.2%-14.9% had ever sought mental health care . We couldn't comment on the progression of depressive symptoms over time or establish causality. We used a screening depression tool, not a diagnostic instrument or a suicide-specific diagnostic interview. Parent-child conflict, parental psychopathology and bullying emerge as correlates of depressive symptoms and suicidal ideations in children and adolescents in Lebanon and treatment gap in this population is alarming.

Mental Health Problems and Their Association With Internet Use in Medical Residents.

Objectives: Mental health problems (MHP) among medical residents are often found in clinical settings and sometimes lead to professional lapses. Evidence suggests that excessive Internet use is associated with MHP. We investigated the MHP of residents (depression, anxiety, and self-esteem) and their association with Internet use using a longitudinal design.Methods: Participants were 208 residents. The General Health Questionnaire (GHQ), Patient Health Questionnaire (PHQ), and the Rosenberg Self-Esteem Scale (RSES) were used to assess anxiety, depression, and self-esteem. The Generalized Problematic Internet Use Scale 2 (GPIUS2) was used to measure Internet use. Data were obtained twice, at baseline and 3 months later when the risk of MHP in residency is highest.Results: Residents with MHP (N = 36) had higher GHQ scores than those without MHP (N = 172) at follow-up. Residents with MHP had more depression and less self-esteem than those without MHP at baseline and follow-up. GPIUS2 total scores, and scores on the subscale preference for online social communication, were higher in residents with MHP. Preference for online social communication at follow-up was positively correlated with depression at baseline and follow-up, and negatively correlated with self-esteem at follow-up.Conclusions: Depression and self-esteem may predict Internet use when the risk of MHP is greatest for residents, indicating potential risks of excessive Internet use or Internet use as a compensatory coping behavior. Together with depression and self-esteem assessment, Internet use may be a useful index of resident mental health.

SCANXIETY AND PSYCHOLOGICAL DISTRESS IN CANCER PATIENTS AT ROUTINE FOLLOW UP VISITS

Background: Follow-up care for cancer patients after definitive treatment, includes: routine follow up visits and surveillance imaging to detect recurrence, new primaries, and maintaining quality of life. Scans may cause emotional - distress, including anxiety and fear of recurrence, a condition called “scanxiety’, which may lead to poor quality of life.Aim of work: To assess scanxiety and psychological distress associated with surveillance imaging at routine follow up visits among cancer patients, and different factors affecting its severity.Patients and methods:Consecutive sample of (179) cancer patients attending outpatient clinic at oncology department at Ain Shams University Hospital in Cairo, Egypt, for surveillance imaging from the period between October 2019 to February 2020. The General Health Questionnaire (GHQ), was used as a screening tool for psychological distress; patients with score ≥ 7, were subjected to Hamilton Anxiety Rating Scale (HAM-A), to assess the severity of anxiety symptoms during the periodsurrounding imaging scans. Sociodemographic and clinical data were obtained from the patients and from the medical records.Results: 179 Participants,with mean age of 52.64 (SD= 11.20), and 69.8% were females. Most of the patients had some degree of psychological distress during the time of follow up scans, as 60.9% of patients (n=109) found to have a score ≥ 7 at General Health Questionnaire. Using Hamilton Anxiety Scale,Mild degree of anxiety (HAM-A score ≤ 17) was found in 16.2% of patients, mild to moderate anxiety (score 18-24) in 14.0 %, moderate to severe anxiety (score 25-30) in 17.3%, and very severe anxiety (score 31-56) in 13.4%.Moderate to severe anxiety was the most common degree of anxiety in our patients (28.4 % of patients with anxiety). Significant relationship was found between high GHQ score: (≥ 7) and age of patients (mean age of: 50.7 and SD 11.16), Not having children,type of cancer, and years since diagnosis (median of 2 years). The highest prevalence of scan-associated distress in our study was found in patients with CNS tumor, skin cancer, sarcoma and head and neck cancer, and lowest prevalence in breast cancer.Conclusion: Surveillance imaging scans can provoke anxiety and fear of recurrence in cancer patients, so these studies should be justified, and supported by high quality evidence and guidelines recommendations. And psychological care should be a part of follow up care for cancer patients.

Associations between diet and mental health using the 12-item General Health Questionnaire: cross-sectional and prospective analyses from the Japan Multi-Institutional Collaborative Cohort Study

BackgroundMental health has become a major public health issue worldwide. Biological and epidemiological studies suggest diet has a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet and mental health. This study aimed to investigate associations between dietary intake of nutrients (macronutrients, vitamins, calcium, and fatty acids) and food groups (fish, meat and chicken, dairy products, and vegetables) and mental health among middle-aged Japanese in cross-sectional and prospective studies.MethodsIn total, 9298 men and women that participated in two areas of the Japan Multi-Institutional Collaborative Cohort Study were eligible for analysis at the baseline (cross-sectional) survey. Of these, 4701 participants were followed for about 5 years and included in the follow-up (prospective) analysis. The 12-item General Health Questionnaire (GHQ) was used to assess participants’ general mental health status over the past several weeks. The average intake of 46 foods over the past year was assessed by a validated food frequency questionnaire. We also evaluated lifestyle and medical factors using a self-administered questionnaire. A cross-sectional logistic regression analysis was performed to estimate odds ratios for a GHQ score ≥ 4 (poor mental health) according to dietary intake of foods/nutrients at baseline. The prospective study used baseline dietary and lifestyle factors and GHQ scores at follow-up.ResultsThe cross-sectional logistic regression analysis showed vegetables, protein, calcium, vitamin D, carotene and n-3 highly-polyunsaturated fatty acids were inversely associated with a GHQ score ≥ 4. On the other hand, mono-unsaturated fatty acids showed a positive association with higher GHQ score. The prospective logistic regression analysis found dairy products, calcium, vitamin B2, and saturated fatty acids were inversely correlated with a GHQ score ≥ 4. Calcium was associated with GHQ scores in both the cross-sectional and follow-up studies. In the follow-up study, the multivariable-adjusted odds ratio for a GHQ score ≥ 4 was 0.71 (95% confidence interval, 0.55–0.92) for the highest versus lowest quartiles of calorie-adjusted dietary calcium intake.ConclusionConsuming particular nutrients and foods, especially calcium and dairy products, may lead to better mental health in Japanese adults.

Mental health and well-being trends among children and young people in the UK, 1995-2014: analysis of repeated cross-sectional national health surveys.

There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales. Data were analysed from 140 830 participants (4-24 years, stratified into 4-12, 13-15, 16-24 years) in 36 national surveys in England, Scotland and Wales, 1995-2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick-Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score. Across all participants aged 4-24, long-standing mental health conditions increased in England (0.8-4.8% over 19 years), Scotland (2.3-6.0%, 11 years) and Wales (2.6-4.1%, 7 years) (all p < 0.001). Among young children (4-12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England [SDQE: odds ratio (OR) 0.97 (0.96-0.98), p < 0.001] and girls in Scotland [SDQE: OR 0.96 (0.93-0.99), p = 0.005]. The proportion with high SDQE scores (13-15 years) decreased in England [OR 0.98 (0.96-0.99), p = 0.006] but increased in Wales [OR 1.07 (1.03-1.10), p < 0.001]. The proportion with high GHQ scores decreased among English women (16-24 years) [OR 0.98 (0.98-0.99), p = 0.002]. Despite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being.

Assessment of psychiatric morbidity among health-care students in a teaching hospital, Telangana state: A cross-sectional questionnaire-based study

Introduction: Professional education can be a stressful experience for health-care students and may impact negatively on emotional well-being and academic performance which leads to psychiatric morbidity. The aim of this study is to assess the prevalence of psychiatric morbidity among the professional health-care students. Materials and Methods: A cross-sectional study was conducted among professional health-care students in a tertiary care teaching hospital of Telangana state. The information regarding demographic data, academic achievements, and positive and negative events in the recent past was collected using semi-structured pro forma, and the General Health Questionnaire (GHQ)-28 is used to assess the psychiatric morbidity. Descriptive analysis and Pearson's correlation analysis were done to analyze the data. Results: A total of 836 students participated in the study, and the overall mean GHQ total score in the study population was 26.8, which is above the cutoff (24) score. The prevalence of psychiatric morbidity among study population is about 58.7%. Academic achievement and negative events in the recent past had effect on psychological morbidity and showed high GHQ scores among study population which was found to be statistically significant. Conclusion: The poor academic performance and negative events had a strong impact on psychological morbidity of students. The higher level of psychological morbidity warrants need for intervention such as social and psychological support to improve the quality of life for the health-care students. Further, a creation of positive academic environment as a teamwork of faculty, administration, educational experts, and students helps to develop psychological healthy dental and medical professionals who can perform better in a coming future.

The associations between lifestyles and mental health using the General Health Questionnaire 12-items are different dependently on age and sex: a population-based cross-sectional study in Kanazawa, Japan.

The aim of this study was to examine potential differences of the associations between mental health and lifestyle factors across a wide range of age. In August/September 2011, data were collected from 4693 males (age 51.6±19.5) and 5678 females (age 52.4±19.4) living in Kanazawa, Japan. A cross-sectional community-based survey was conducted with self-administered questionnaire including the General Health Questionnaire (GHQ) 12-item version, sociodemographic, and lifestyle factors. Associations between the GHQ scores and other variables were examined using two-way analysis of variance (ANOVA) followed by multiple comparisons and logistic regression stratified by age and gender. Multiple comparisons indicated that people aged 20-39 or 40-64 had higher GHQ scores than older aged. The two-way ANOVA revealed significant interaction between body mass index and age group, and between exercise and age group. Overweight or underweight males aged 40-64 had poorer mental health than those at normal weight. In the elderly, being underweight was significantly associated with poor mental health. There were no significant effects of exercise on mental health for young adults. The logistic regression showed significant negative effects of short-time sleep in adults. The associations between mental health and lifestyles differ across age groups. Further study is needed to reveal effects of aging on lifestyle and mental health with a longitudinal design.

OP01 Did Health Inequality Increase in English Children and Young People between 1999 and 2009? Evidence from two Cross-Sectional Surveys and Inpatient Activity Data

BackgroundFrom 1999, the English government pursued a systematic strategy to reduce health inequalities. For interventions affecting children and young people, intermediate indicators may be more useful for evaluating short/medium term...

Accident proneness revisited: The role of psychological stress and cognitive failure

Understanding why accidents occur in the work place has a long and convoluted history. This paper adds to this corpus of research by investigating the relationship between an individual's level of cognitive failure, psychological stress, and work place accident occurrence. Retrospective analysis of accident-case individuals vs. control-match individuals on the General Health Questionnaire (GHQ) and Cognitive Failures Questionnaire (CFQ) was undertaken from amalgamated data of two Royal Navy databases. Individuals in the accident-case sub-sample had higher GHQ and CFQ scores when compared to matched-controls. Mediated regression analysis revealed high GHQ score predicted accidents but was transmitted through high CFQ scores. Individuals who are stressed are more likely to have an accident in the workplace because of a propensity for cognitive failures. A specific recommendation to reduce accident risk in the work-place is discussed.

Personality, choice of coping and T stage predict level of distress in head and neck cancer patients during follow-up

The aim of the present study was to investigate to what extent TNM stage, treatment level, personality, choice of coping, mood and health-related quality of life (HRQoL) scores predicted distress as measured by general health questionnaire (GHQ) in successfully treated head and neck squamous cell carcinoma (HNSCC) patients. All patients younger than 80 years who had been diagnosed with HNSCC in western Norway in the period from 1992 to 1997, and who had survived until 1999, were sampled. Ninety-six patients (90% response rate) were included 48 ± 2 months after diagnosis. We determined personality by the Eysenck personality inventory, coping by the COPE questionnaire; HRQoL by EORTC QLQ questionnaire; and mood by Beck depression inventory (BDI). Fifty-five of 58 eligible patients were interviewed a second time 47 ± 1 months after the first interview where neuroticism and GHQ-30 questionnaires were answered. Both HRQoL [explained variance (EV), 9-40%] and BDI (EV 26-30%) scores predicted the GHQ scores. Numerical T stage was inversely associated with GHQ scores (EV ~10%). High neuroticism generally predicted high GHQ scores (EV 16-28%). Avoidance focused, problem focused, drinking to cope predicted GHQ scores (EV 8-14%) and high alcohol consumption (EV ~8%) predicted GHQ scores. The present association pattern could still be shown when adjusted for gender, age and educational level when studied by multiple regression analyses. In conclusion, lowered HRQoL, low mood, a high T stage, high alcohol consumption, high neuroticism, coping by avoidance and coping by problem solving directly predicted worse distress as measured by high GHQ scores, whereas neuroticism was also associated with GHQ through choice of coping.

Malaysian Moslem Mothers’ Experience of Depression and Service Use

Standard psychiatric criteria for depression developed in the United States and United Kingdom are increasingly used worldwide to establish the prevalence of clinical disorders and to help develop services. However, these approaches are rarely sensitive to local and cultural expressions of symptoms or beliefs about treatment. Mismatch between diagnostic criteria and local understanding may result in underreporting of depression and underutilization of services. Little such research has been conducted in Malaysia, despite the acknowledged high rate of depression and low access to services. This study examines depression in Moslem Malay women living in Johor Bahru, Southern Peninsular Malaysia, to explore depression symptoms using the Structured Clinical Interview for DSM-IV. The 61 women interviewed were selected on the basis of high General Health Questionnaire scores from a large questionnaire survey of 1,002 mothers. The illustrative analysis looks at descriptions of depressed mood, self-depreciation and suicidal ideation, as well as attitudes toward service use. The women gave full and open descriptions of their emotional symptoms, easily recognizable by standard symptom categories, although somatic symptoms were commonly included, and the spiritual context to understanding depression was also prevalent. However, few women had knowledge about treatment or sought medical services, although some sought help from local spiritual healers. Attending to such views of depression can help develop services in Malaysia.

地域包括支援センターにおける業務の現状および個人特性・労働環境と職業性ストレスとの関連

The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work environment and the occupational stress of the staff. Subjects of the study were 251 staff members of community general support centers. The current status of operations at the community general support centers and the personal traits, work environment, effort-remuneration imbalance model (ERI) and general health questionnaire (GHQ) were surveyed. The initial analysis involved a comparison by a chi-square test on: The effort-remuneration ratio (E/R ratio) of personal traits and work environment, risk of over-commitment (OC), and GHQ score. To explore the correlation between the E/R ratio of the three GHQ groups (low, middle and high score groups) and the OC value, one-way analysis of variance was performed. Out of the four basic functions of the community general support centers, 22.0% of the respondents noted that "establishment of a regional, comprehensive/multi-tiered service network" was functioning, and 50.4% of respondents noted that "comprehensive and continuous care management" was functioning. The average effort score was 15.5 +/- 5.3, approximately double the average value of preceding studies. Significant differences found in GHQ scores were related to working hours (p<0.001) and anxiety was related to task content (p<0.001). Moreover, a higher GHQ score was accompanied by a higher E/R ratio and as a result of the multiple comparison, a marked difference was observed between the GHQ low score group and the GHQ high score group (p<0.001), and a significant difference was also found between the GHQ low score group and GHQ medium score group (p=0.012). Items observed to have significant correlation with high E/R ratio were: "Weekly working hours of 50 h or more" (OR: 10.38, 95% CI: 2.52-42.70), "Unstable employment" (OR: 2.75, 95% CI: 1.22-6.21) and "Anxiety related to task content" (OR: 17.04, 95% CI: 3.57-81.24). Items observed to have significant correlation with OC value risk factors were: "Weekly working hours of 50 h or more" (OR: 8.04, 95% CI: 1.99-32.41) and "Anxiety related to task content" (OR: 4.60, 95% CI: 2.04-10.37). We conclude that the basic functions of the community general support centers are not presently very functional. The stress levels of the community general support center staff are high and their health levels are low. This indicates that staff are forced to work with anxiety related to task content under conditions of poor pay and long working hours.

Impact of caring for children with cerebral palsy on the general health of their caregivers in an African community

Caring for children with physical disabilities such as cerebral palsy can have an impact on the health of their caregivers. Records show a dearth of literature on the health impact of caring for children with cerebral palsy (CP) in Africa. This study compared the general health of caregivers of children with cerebral palsy (CGCP) with that of caregivers of age-matched children without cerebral palsy (CGNCP). The relationship between severities of motor disorder in children with CP and the general health of their caregivers was also investigated. Participants comprised 71 CGCP and 70 CGNCP in the Yoruba community of South-Western Nigeria. The General Health Questionnaire was administered to all participants and the severity of motor disorder was assessed in children with cerebral palsy using the Gross Motor Function Measure-66. Results showed significantly higher General Health Questionnaire scores in the caregivers of children with cerebral palsy than in the caregivers of age-matched children without cerebral palsy group (U=1237.5, P=0.00). No significant correlation was found between the Gross Motor Function Measure and General Health Questionnaire scores of the caregivers of children with cerebral palsy (rho=-0.104). Caring for children with cerebral palsy apparently had a negative impact on the health of their caregivers when compared with the health of caregivers of children without cerebral palsy. It seemed that severity of motor disorder in cerebral palsy had no direct bearing on the health status of caregivers.

Stress and burnout among colorectal surgeons and colorectal nurse specialists working in the National Health Service

It has been suggested that changes to the organization of the National Health Service (NHS) and clinical practices in dealing with cancer are associated with increased stress and burnout in healthcare professionals. The aim of this study, therefore, was to evaluate stress and burnout in colorectal surgeons (surgeons) and colorectal clinical nurse specialists (nurses) working in the NHS. A list of all consultant surgeons and nurses was obtained from The Association of Coloproctology of Great Britain and Ireland. Participants were sent a questionnaire booklet consisting of standardized measures [General Health Questionnaire (GHQ), Maslach Burnout Inventory (MBI), Coping Questionnaire] and various ad hoc questions to obtain information about demographics, cancer workload and job satisfaction. Independent predictors of clinically significant distress and burnout were identified using logistic regression. Four hundred and fifty-five surgeons and 326 nurses were sent booklets. The response rate was 55.6% in surgeons and 54.3% in nurses. The mean age of the nurses was lower than that of surgeons (42.8 vs 47.7, P < 0.001). Psychiatric morbidity was similar in the surgeons and nurses as assessed using the GHQ (30.2% and 30.3% respectively). On the MBI, compared with nurses, surgeons had significantly higher levels of depersonalization (17.4%vs 7.4%, P = 0.003) and lower personal accomplishment (26.6%vs 14.2%, P = 0.002). Seventy-seven per cent of surgeons and 63.4% of nurses stated their intention to retire before the statutory retirement age. Coping strategies, especially those in which respondents isolated themselves from friends and family, were associated with higher psychiatric morbidity and burnout. Dissatisfaction with work, intention to retire early, intention to retire as soon as affordable and poor training in communication and management skills were also significantly associated with high GHQ scores and burnout in both groups. We found high levels of psychiatric morbidity and burnout in this national cohort of surgeons and nurses working in the NHS. However, psychiatric morbidity and burnout were unrelated to cancer workload. Nurses have lower burnout levels than surgeons and this may be related to their different working practices, responsibilities and management structure.

The relationship between stress and acute anterior uveitis

To examine the relationship between stress and anterior uveitis using the General Health Questionnaire (GHQ) and the Social Readjustment Rating Questionnaire (SRRQ). Patients attending eye casualty with acute anterior uveitis (AAU) and suitable controls were asked to complete the GHQ and the SRRQ. A follow-up postal survey, using the same questionnaires, was repeated at least 3 months later amongst AAU patients only. Scores for the GHQ and SRRQ at initial presentation and at follow-up were compared for different groups. Over 12 months, 42 patients and 25 controls participated in the first stage of this study. Patients with AAU had higher GHQ scores than controls (mean 6.8 versus 3.2, p = 0.01). A total of 25 patients responded to the follow-up postal survey. At follow-up, 13 had experienced resolution and 12 had recurrence. In the group with resolution, there was a significant fall in GHQ scores (mean 6.1 versus 1.5, p = 0.0044). Patients with recurrence had higher GHQ scores than those with resolution (mean 6.8 versus 1.5, p = 0.02). Using the GHQ reveals a clear relationship between stress and the recurrence of AAU in susceptible individuals.

Controlled study of anxiety and depression in mothers of children with learning disability in Lagos, Nigeria

Parents of children with learning disability have been reported to suffer great stress and frustration due to increased burden of care. The manifestation of stigmatization by familial environment and the collective effect of the children with adverse impact on mothers predispose them to mental shock or a variety of neurotic symptoms and other psychiatric conditions including anxiety and depression. The objectives of the study were: to determine the general Health Questionnaire (GHQ) score of mothers of children with learning disability. To identify sociodemographic variables and to assess anxiety and depression in them. Using structured questionnaires between March and May 2002, 106 mothers of children with learning disability in a Mentally Handicapped Home for children in Lagos, Nigeria were assessed and compared with mothers of normal healthy children in Lagos. The mean age of the subjects was 40.0 +/- 6.6 years. More of the subjects (26.4%) compared with mothers of normal healthy children (9.9%) had a high GHQ score and high levels of anxiety (25.5%) and depression (10.4%). Marital difficulties were associated with learning disability. Mothers of children with learning disability are prone to emotional and psychological disorders. In order to improve the well-being of children with learning disability, there is need to look into the mental and physical health of mothers. Early and prompt treatment of associated anxiety and depression will no doubt help the children.

Relationship between Health Status and Psychological Distress among the Inhabitants in a Methylmercury-Polluted Area in Japan

This study examined the relationship between health parameters and psychological distress among inhabitants of methylmercury-polluted areas in Japan. The subjects were 133 inhabitants over the age of 40 yr living in two methylmercury-polluted villages. Information on demographic factors, health status, and mental health was obtained using questionnaires, including the General Health Questionnaire (GHQ). The proportional odds model was used to estimate the adjusted odds ratios of factors associated with a higher GHQ score after adjustment for age, gender, and district. Very poor self-rated health status, a high number (5+) of subjective symptoms, having monthly outpatient visits and medical house calls, and receiving compensation for methylmercury poisoning were significantly associated with psychological distress. Poor physical condition may lead to the development of psychological distress.

Preference, need and utilization of mental health services, Singapore National Mental Health Survey.

To ascertain the extent of the community's preference, needs for and utilization of mental health services, and their socio-demographic determinants in the multi-ethnic Asian community in Singapore. The extent to which need, enabling and predisposing factors determine the likelihood to seek professional help was also examined. Data were analyzed from the Singapore National Mental Health Survey of 1996, based on a stratified random sample of 2947 Chinese, Malay and Indian subjects of the general population aged 13-64 years. An estimated 37% of the general population indicated they would seek professional help if they experienced a serious emotional or mental problem. Although 16.9% were determined by their high general health questionnaire (GHQ) score to need mental health services, only 2.6% in the population used the services of any professional caregiver. Among persons with high GHQ scores, only 5.9% sought any professional help. Among those with a high GHQ score and who were receptive to professional help, only 10.4% actually sought professional help. General practitioners were the most commonly preferred caregiver (49.3%), and were used by 41.1% of those who sought help. Those who sought professional help were more likely to have a high GHQ score and to be inclined to seek professional help. Malays used mental health services more than Chinese, but they did not show a significantly greater prevalence of high GHQ scores, or a greater preference to seek professional help. Receptivity to professional help, high GHQ score, and Malay ethnicity were independent significant predictors of use of mental health service. Need and attitudinal factors predict mental health service utilization, but they still do not explain why a large majority of the population chose not to use mental health services.

Does psychological distress predict the risk of ischemic stroke and transient ischemic attack? The Caerphilly Study.

Psychological distress is common after stroke, but little is known about its etiologic importance, although the general public often ascribes stroke to the experience of stress. Therefore, we examined whether psychological distress leads to an increased risk of ischemic stroke and transient ischemic attack (TIA). The association between the 30-item General Health Questionnaire (GHQ), a measure of psychological distress, and the incidence of nonfatal and fatal ischemic stroke and TIA was measured by Cox regression modeling in a prospective observational study of 2201 men aged 45 to 59 years in phase II of the Caerphilly cohort. Hazard ratios comparing those with high (> or = 5) and normal GHQ scores were calculated with adjustment for age and other covariates. Twenty-two percent of men suffered from psychological distress, indicated by a score of > or =5 on the GHQ. There were 130 incident strokes recorded, of which 17 were fatal and 113 nonfatal. The relative risk of incident ischemic stroke was 1.45 (95% CI, 0.98 to 2.14) for those who showed symptoms of psychological distress compared with those who did not. For fatal stroke the relative risk was 3.36 (95% CI, 1.29 to 8.71) and for nonfatal stroke 1.25 (95% CI, 0.82 to 1.92). The relative risk of TIA for the distressed group was 0.63 (95% CI, 0.26 to 1.53). The results were unchanged after adjustment for body mass index, systolic blood pressure, smoking, heavy drinking, social class, and marital status. However, additionally controlling for previously diagnosed ischemic heart disease, diabetes, respiratory disease, and retirement due to ill health attenuated the relative risks, but not markedly. For fatal strokes the relative risk decreased to 2.56 (95% CI, 0.97 to 6.75) when all confounding variables were included in the model. There was a graded association between degree of psychological distress and risk of fatal ischemic stroke. Psychological distress is a predictor of fatal ischemic stroke but not of nonfatal ischemic stroke or TIA. Further work examining the mechanisms of this association is required.