High Rates Of Mental Disorders Research Articles

Mental health among currently enrolled medical students in Germany

ObjectivesThe study identifies the prevalence of common mental disorders according to the patient health questionnaire (PHQ) and the use of psychotropic substances in a sample of currently enrolled medical students. Study designA cross-sectional survey with a self-administrated questionnaire. MethodsAll newly enrolled medical students at the University of Dusseldorf, with study beginning either in 2012 or 2013, respectively, were invited to participate. The evaluation was based on 590 completed questionnaires. Mental health outcomes were measured by the PHQ, including major depression, other depressive symptoms (subthreshold depression), anxiety, panic disorders and psychosomatic complaints. Moreover, information about psychotropic substances use (including medication) was obtained. Multiple logistic regression analysis was used to estimate associations between sociodemographic and socio-economic factors and mental health outcomes. ResultsThe prevalence rates, measured by the PHQ, were 4.7% for major depression, 5.8% for other depressive symptoms, 4.4% for anxiety, 1.9% for panic disorders, and 15.7% for psychosomatic complaints. These prevalence rates were higher than those reported in the general population, but lower than in medical students in the course of medical training. In all, 10.7% of the students reported regular psychotropic substance use: 5.1% of students used medication ‘to calm down,’ 4.6% ‘to improve their sleep,’ 4.4% ‘to elevate mood,’ and 3.1% ‘to improve cognitive performance.’ In the fully adjusted model, expected financial difficulties were significantly associated with poor mental health (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.31–3.48), psychosomatic symptoms (OR:1.85; 95% CI: 1.11–3.09) and psychotropic substances use (OR: 2.68; 95% CI: 1.51–4.75). ConclusionThe high rates of mental disorders among currently enrolled medical students call for the promotion of mental health, with a special emphasis on vulnerable groups.

Bereavement after sibling death: a population-based longitudinal case-control study.

The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N=7243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N=21,729) who did not have a sibling die in the study period. Generalized estimating equations were used to compare the two sibling groups in the two years before and after the index child's death on physician-diagnosed mental disorders and treatment utilization, with adjustment for confounding factors including pre-existing mental illness. Analyses were stratified by age of the bereaved (<13 vs. 13+). Results revealed that, in the two years after the death of the child, bereaved siblings had significantly higher rates of mental disorders than control siblings, even after adjusting for pre-existing mental illness. When comparing the effect of a child's death on younger versus older siblings, the rise in depression rates from pre-death to post-death was significantly higher for siblings aged under 13 (p<0.0001), increasing more than 7-fold (adjusted relative rate, ARR=7.25, 95% CI: 3.65-14.43). Bereaved siblings aged 13+ had substantial morbidity in the two years after the death: 25% were diagnosed with a mental disorder (vs. 17% of controls), and they had higher rates of almost all mental disorder outcomes compared to controls, including twice the rate of suicide attempts (ARR=2.01, 95% CI: 1.29-3.12). Siblings in the bereaved cohort had higher rates of alcohol and drug use disorders already before the death of their sibling. In conclusion, the death of a child is associated with considerable mental disorder burden among surviving siblings. Pre-existing health problems and social disadvantage do not fully account for the increase in mental disorder rates.

The mental health of fire-fighters: An examination of the impact of repeated trauma exposure.

Emergency workers, such as fire-fighters, are routinely exposed to potentially traumatic events. While a number of studies have examined the occurrence of post-traumatic stress disorder, the role of multiple traumas on other mental health sequelae, such as depression and alcohol misuse, among emergency workers remains unclear. This study aimed to assess the prevalence of post-traumatic stress disorder, depression and alcohol misuse in a sample of current and retired fire-fighters and examine their relationship with cumulative trauma exposure. A cross-sectional survey was completed by current (n = 488) and retired (n = 265) fire-fighters from Fire and Rescue New South Wales, Australia. Demographic and occupational information was collected, including the number of fatal incidents fire-fighters reported attending across years of service. Validated, self-report measures were used to determine probable caseness for post-traumatic stress disorder, depression and heavy drinking. Among current fire-fighters, rates of post-traumatic stress disorder and depression were 8% and 5%, respectively, while 4% reported consumption of more than 42 alcoholic drinks per week. Retired fire-fighters reported significantly greater levels of symptomatology, with the prevalence estimates of post-traumatic stress disorder at 18% (p = 0.001), depression at 18% (p < 0.001) and heavy drinking at 7%. There was a significant positive linear relationship between the number of fatal incidents attended and rates of post-traumatic stress disorder, depression and heavy drinking. Fire-fighters suffer from high rates of mental disorders, with rates of post-traumatic stress disorder, depression and heavy drinking continuing to rise in a linear manner with each additional trauma exposure. The level of psychiatric morbidity among retired fire-fighters appears to be particularly high. Our findings have important implications for the ongoing debates surrounding the detection of mental disorders in high-risk occupations and for policy considerations around the welfare of current and retired emergency workers.

Mental Health Care of Detained Youth and Solitary Confinement and Restraint Within Juvenile Detention Facilities.

Justice-involved youth are a complex and heterogeneous population with extremely high rates of mental disorder, trauma, and numerous other psychosocial stressors. Although working with this population has several challenges it can be highly rewarding for clinicians and a powerful opportunity for prevention of subsequent problems. Psychosocial interventions remain some of the most robust and effective interventions targeting specific developmental deficits common in this population. Medication treatment is also often appropriate. Seclusion may be clinically appropriate in some cases and is seen as distinct from disciplinary interventions such as isolation or solitary confinement, which are generally not appropriate.

Mental disorder among nonreligious adolescents

This study is the first of its kind to investigate mental disorder among nonreligious adolescents. In this paper, we report three main findings based on data from the National Comorbidity Survey of Adolescents. First, nonreligious adolescents on average have higher rates of mental disorder than adolescents who identify as religious. Second, there is variability in rates of mental disorder among the three types of nonreligious adolescents, with atheists/agnostics experiencing the highest rates, followed by those with no religion, and those with no religious preference. Indeed, after controlling for a host of sociodemographic characteristics, adolescents with no preference have levels of mental disorder that do not differ from the religiously affiliated. Third, the mental health disadvantage of nonreligiosity is strongest among nonreligious adolescents with two highly religious parents. Their rates of mental illness are almost twice that of religious adolescents raised in religious households. Moreover, neither nonreligious nor religious adolescents are negatively affected by being raised in nonreligious households.

Classification of Mental Disorders Figures based on Soft Computing Methods

The purpose of this paper is to present the design and implementation of Soft Computing approaches (SOFM and MLP) for classifying mental disorders figures. World Health Organization (WHO) referred to the higher rates of mental disorders as a result of the pressures of life and its difficulties. This prompted the non-governmental organizations and civil institutions to increase research and reduce the risk of mental illness. However, despite all these efforts, the researchers still did not achieved the anticipated results. The classification of mental disorders is a significant concern for researchers as well as health care service providers. The comparison study is tested two different techniques under the same environment , conditions and using same data. The MLP achieved high accuracy of (99%), while SOFM achieved an accuracy of (97%) in the classification phase for predicting the desired output. In the meaning of data amount usage, both MLP & SOMF are used a small amount of data to perform the training phase. While other approaches like SVM are huge data sets to perform the training phase. Consequently, using a few data in the learning network phase leads to a rapid process and getting a results in short time. General Terms Computer science, artificial intelligence, neural network, applications, soft computing.

Diagnosing an alcohol use disorder-what criteria should be used?

Diagnosing an alcohol use disorder-what criteria should be used?

The lived experience of US parents of children with autism spectrum disorders: a systematic review and meta-synthesis.

Current US statistics indicate that 1 in 68 children is diagnosed with an autistic spectrum disorder (Centers for Disease Control (2014) Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 Sites, United States, 2010. Morbidity and Mortality Weekly Report (MMWR)). The lived experience of parents with children diagnosed with autism spectrum disorder is important to know since quantitative studies have indicated that higher rates of mental disorders exist in this population as compared to parents of typically developing children (Yirmiya and Shaked (2005) Psychiatric disorders in parents of children with autism: a meta-analysis. Journal of Child Psychology and Psychiatry 46: 69-83). This study was a meta-synthesis of the qualitative literature in this area embedded within a systematic review. A comprehensive search and review yielded 14 studies. A total of six major themes were identified: (a) emotional stress and strain; (b) adaptation; (c) impact on the family; (d) services; (e) stigmatization; and (f) appreciating the little things. Implications of these results are discussed.

Violent Crime Perpetrated by Young People

Results: 92 (80.7%) of the offenders were German citizens, 12 (10.5%) were from immigrant families, and 22 (19.3%) were foreigners. In 96 cases (84.2%), a psychiatric diagnosis was made at the time of assessment; this was not the case for only 18 individuals (15.8%). 20 (17.5%) were admitted to a psychiatric hospital or drug withdrawal clinic. 44 (38.6%) developed into chronic criminal offenders who continued to commit crimes after the index offense. As a subgroup of the chronic criminal offenders, 13 individuals (11.4% of the overall sample) were identified as multiple intensive offenders; these individuals displayed the most extreme features in every respect. A total of 70 individuals (61.4%) no longer came to the attention of the criminal justice system during the entire duration of follow-up after the index offense. The legal prognosis test was able to predict the offenders’ further course with statistical significance, but not accurately enough to be safe. Discussion: The high rate of mental disorders (84.2%) is noteworthy and in accordance with other, comparable studies. This finding implies that more importance should be attached to psychiatric and psychological diagnosis and treatment. We did not find any limitation of cognitive function in our group of subjects, even though this has been reported in multiple studies in the literature. The intelligence of our subjects was normally distributed. ►Cite this as:

Prevalence Rates of Mental Disorders in Chilean Prisons

ObjectiveHigh rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners.MethodA nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population.ResultsPrevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05) and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001). Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05), simple (3.3% vs. 11.5%, Z=-3.13, p<0.001) and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05) were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05) and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001) were less prevalent in the male prison population than in the general population.ConclusionsService provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders.

Prevalence of depression, anxiety, and obsessive–compulsive disorders among secondary school students in Menoufia Governorate, Egypt

Objectives The aim of this study was to estimate the prevalence of depression, anxiety, and obsessive–compulsive disorders among secondary school students and to assess the comorbidities of these disorders. Background Any type of mental illness can have a negative impact on cognitive development and learning and involves a very high cost to both the individual and society. Anxiety and depression can be considered reliable indicators for the assessment of mental illness in a community. Participants and methods From a total of 83 635 secondary school students in Menoufia Governorate during the academic year 2010–2011, using a multistage random sampling technique, a sample of 1373 students was selected and surveyed from March 2011 to April 2012 by means of the Beck Depression Inventory, 2nd ed., the Costello–Comrey Anxiety Scale, and the Obsessive–Compulsive Disorder Scale, all of which were answered by the participants. Those with scores higher than the cutoff values were interviewed by a psychiatrist for the final clinical diagnosis on the basis of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria. Results The prevalence of depressive symptoms was 21.5% for mild, 7.1% for moderate, and 0% for severe depression in this study group. The total prevalence of depressive symptoms was 28.6%, and the prevalence of depressive disorders was 11.3%. The prevalence of anxiety symptoms was 41.2% and that for anxiety disorders was 21%. The prevalence of obsessive–compulsive symptoms was 15.8% and that of obsessive–compulsive disorder was 2.7%. Comorbidities of mental disorders were common. Conclusion According to these findings, the high rate of mental disorders among adolescents in our community calls for more attention from the family and educational and health institutes. Comorbidities associated with mental disorders are common. In addition, assessment using screening is recommended.

Self-harm in postpartum depression and referrals to a perinatal mental health team: an audit study.

There is a paucity of research on self-harm during pregnancy and the postpartum period despite suicide being a leading cause of death and high rates of mental disorder during this time. This audit describes a cohort of women referred to a new perinatal mental health team (PMHT) based in a large maternity hospital in the UK over a 12-month period. The audit was conducted in two stages. Stage one describes the clinical and socio-demographic characteristics of 225 pregnant women referred to the team after screening positive for a significant mental health history. Stage two determines the veracity of data on a subgroup of 73 pregnant women referred for previous postpartum depression (PPD), 58 % of whom disclosed an episode of self-harm with the ‘intent to kill themselves’ to the maternity staff when they first booked in for antenatal care. Previous PPD accounted for the largest majority of referrals (32 %) to the PMHT followed by depression (27 %) and self-harm (10 %). The majority of women (85 %) referred to the PMHT were engaged. Eight percent were so unwell at the point of referral they required an admission to the hospital. Attempted suicide in the subgroup of 73 women with previous PPD ranged from 24–49 %. The findings from this audit suggest that self-harm in PPD warrants further investigation.

A comparison of scoring models for computerised mental health screening for federal prison inmates

There are high rates of mental disorder in correctional environments, so effective mental health screening is needed. Implementation of the computerised mental health screen of the Correctional Service of Canada has led to improved identification of offenders with mental health needs but with high rates of false positives. The goal of this study is to evaluate the use of an iterative classification tree (ICT) approach to mental health screening compared with a simple binary approach using cut-off scores on screening tools. A total of 504 consecutive admissions to federal prison completed the screen and were also interviewed by a mental health professional. Relationships between screening results and more extended assessment and clinical team discussion were tested. The ICT was more parsimonious in identifying probable 'cases' than standard binary screening. ICT was also highly accurate at detecting mental health needs (AUC=0.87, 95% CI 0.84-0.90). The model identified 118 (23.4%) offenders as likely to need further assessment or treatment, 87% of whom were confirmed cases at clinical interview. Of the 244 (48.4%) offenders who were screened out, only 9% were clinically assessed as requiring further assessment or treatment. Standard binary screening was characterised by more false positives and a comparable false negative rate. The use of ICTs to interpret screening data on the mental health of prisoners needs further evaluation in independent samples in Canada and elsewhere. This first evaluation of the application of such an approach offers the prospect of more effective and efficient use of the scarce resource of mental health services in prisons. Although not required, the use of computers can increase the ease of implementing an ICT model.

Tuberculosis Among Homeless Population from Medellín, Colombia: Associated Mental Disorders and Socio-Demographic Characteristics

Homeless people are highly susceptible to tuberculosis. It has been suggested that this population have high rates of mental disorders associated with tuberculosis. We assessed tuberculosis incidence, its transmission patterns and association with socio-demographic factors and mental disorders in Colombian homeless people. Prospective study which socio-demographic characteristics and mental disorders were assessed through interviews. Sputa from patients with respiratory symptoms were processed and clinical isolates analyzed by IS6110-RFLP. Multivariate analysis performed by logistic regression model. From 426 homeless studied, tuberculosis incidence found was 7.9%. 44% of isolates were clustering. It was found high risk of having tuberculosis associated with income from drugs trade (OR: 3.40 [95% CI: 1.28-9.05]), dysthymia (OR: 2.54 [95% CI: 1.10-5.86]) and receiving food from other homeless (OR: 2.47 [95% CI: 1.16-5.25]). Tuberculosis incidence and degree of transmission are high in homeless studied. Implementing programs to better control tuberculosis among homeless population must consider socio-demographic factors and mental disorders associated with the disease.

Mental disorders in primary care in Israel: prevalence and risk factors

Psychiatric morbidity is common among patients in primary care services and leads to disability and increased use of medical services. Comparison of primary care and community prevalence data is of interest in relation to the health services planning for mental disorders. The aim of the present study was to measure prevalence of mental disorders in six primary care clinics in Israel and to assess risk factors for these disorders. Prevalence of mental disorders was measured in a sample of 2,948 primary care consecutive attendees, using two-stage stratified sampling with the General Health Questionnaire 12 (GHQ-12) and the Composite International Diagnostic Interview (CIDI). A high rate (46.3%) of current mental disorders was found, with rates of current depressive episode, generalized anxiety disorder, somatization disorder, and neurasthenia being relatively high in comparison with rates in other countries. Low education was a risk factor for all categories of disorders, unemployment a risk factor for depressive disorders, and parenthood was protective for most categories of disorders. High rates of mental disorders were found in this Israeli primary care sample as compared to other countries, while in the community the rates were midrange as compared to other countries, pointing to a relatively higher use of primary care services by patients with mental disorders in Israel than in other countries.

Internalizing and externalizing problems, depression, and self-esteem in non-detained male juvenile offenders

BackgroundHigh rates of mental disorders have been found in detained juvenile offenders, whereas the role of psychopathology in non-detained offenders is less clear. Therefore, the present study compared psychopathology in male non-detained delinquent juveniles and two matched samples from the community and an adolescent psychiatric clinic.Methods125 male adolescents aged 11 to 19 years (m = 16.2 years, SD = 1.5 years) from an outpatient adolescent forensic clinic were compared to a community sample from the Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) and a referred sample from a psychiatric clinic matched for age and nationality. All subjects responded to questionnaires measuring internalizing and externalizing problems, depressive symptoms and self-esteem.ResultsThe sample of non-detained juvenile offenders showed similar rates of self-reported internalizing and externalizing problems when compared to the community sample, whereas the clinic sample displayed an increased rate of various disturbances. Similar results were found also for self-esteem. In agreement with these findings, non-detained juvenile offenders less frequently had a psychiatric diagnosis after full clinical assessment when compared to the clinical sample. However, a diagnosis of conduct disorders and a lower IQ range was found more frequently in non-detained juvenile offenders. Offenders with serious delinquent acts and involving weapons showed higher depression scores than the rest of the offenders.ConclusionIn non-detained assessment situations before court examination, juvenile offenders present rather normal behaviour. Their lack of awareness of potential behavioural problems should be considered during assessment and treatment of this group of offenders.

Mental health 15 years after the killings in Rwanda: Imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors

Objectives of this study were to compare rates of mental health disorders in Rwandan genocide perpetrators with those of genocide survivors and to investigate potential predictors of symptoms of posttraumatic stress disorder (PTSD) and depression for both groups. We expected high rates of mental disorders in both study groups and hypothesized that symptom severity would be predicted by female gender, older age, lower level of education, higher level of trauma exposure, lower level of agreement to reconciliation, and the participation in killing. Structured clinical interviews were carried out with 269 imprisoned perpetrators (66% men) and 114 survivors (64% women). Significantly more survivors than perpetrators met symptom criteria for PTSD (46% vs. 14%) and suffered from anxiety symptoms (59% vs. 36%). A substantial proportion of both groups suffered from clinically significant depression (46% vs. 41%). PTSD severity in perpetrators was associated with trauma exposure, high levels of agreement to reconciliation, and no participation in killing; the severity of depression was associated with trauma exposure and no participation in killing. In the survivor sample, the severity of PTSD and depression were both correlated with female gender, trauma exposure, and low levels of agreement to reconciliation. Results suggest that both groups exhibit considerable psychiatric morbidity.

Mental Health and Turnover Following an Initial Term of Military Service

This study compared the rates of mental disorders between Marines who re-enlisted and Marines who separated after 1 term, distinguishing between Marines who were and were not recommended for re-enlistment. Participants included 28,693 male Marines enlisting for 4-year terms between 2002 and 2003, including 9,338 who re-enlisted after 1 term, 18,177 who voluntarily separated after 1 term, and 1,184 who were not recommended for re-enlistment and separated after 1 term. Analysis revealed disproportionately high rates of mental disorders among Marines not recommended for re-enlistment (Odds Ratio = 8.5, 95% Confidence Interval 7.5-9.8) compared with Marines who re-enlisted. Mental disorder prevalence was also elevated among service members who voluntarily separated after 1 term (Odds Ratio = 1.2, 95% Confidence Interval 1.1-1.3). Several specific categories of disorders, including personality disorders, substance use disorders, and post-traumatic stress disorder, predicted re-enlistment status. These results suggest that mental disorders influence personnel retention in diverse ways, including heightened turnover, which could have a substantial impact on military manpower costs.

Frequent attendance in family practice and common mental disorders in an open access health care system

Frequent attenders in family practice are known to have higher rates of mental disorder. However little is known about specific psychiatric disorders and whether this behavior extends to specialist services, in an open access fee-for-service health care system. Methods1060 patients from 46 family practices completed the Patient Health Questionnaire and the Client Service Receipt Inventory. During the consultation, family practitioners blind to the questionnaire responses rated the severity of mental health and physical disorders. The 10% of patients with the highest number of 6-month consultations in six age and sex stratified groups were defined as frequent attenders. ResultsAfter adjustments for sociodemographic variables, physical health and other psychiatric diagnoses, patients with a somatoform disorder were more likely to be frequent attenders, with an odds ratio of 2.3 (95% CI: 1.3–3.8, p=.002). ConclusionWhen adjusting for confounders, among the four psychiatric diagnoses investigated only somatoform disorders remain significantly associated with frequent attendance. Physical health and chronic disease were no longer associated with frequent attendance which does not support the hypothesis that in an open access fee-for-service system, patients will consult for a wider range of health problems. Greater investigation into unexplained somatic symptoms could help reduce the frequency of attendance in both primary and secondary care, as this behaviour appears to be a general health-seeking drive than extends beyond family practice.

Explaining African-Americans’ depressive symptoms: A stress-distress and coping perspective

Findings from five community surveys suggest that the depressive symptom scores of African-Americans are the same as, or lower than, those of Whites. This seems at odds with the minority status hypothesis that predicts higher rates of mental disorders for African-Americans. However, little is known about the role of African-American coping capacity during the life stress process which may shed light on the seeming contradiction. This cross-sectional survey examined the role of spirituality-coping, sense of control, and stress in predicting depressive symptoms among 3570 African-Americans. The findings showed that sense of control mediates the relationship between spirituality, life stressors, and depressive symptoms.