Risk Factors For Common Mental Disorders Research Articles

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio.

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Common mental disorders among women in reproductive age group: An analysis of national mental health survey, India 2016.

Common mental disorders (CMDs) have a higher prevalence among women in their reproductive age (WRA) compared to the general population. Large Indian epidemiological studies focusing on the prevalence and socioeconomic correlates of CMDs among WRA are lacking. The associated disability and treatment gap particularly in the women population is unknown. To estimate the current prevalence, correlates, disability, socioeconomic impact, and treatment gap of CMDs among WRA from a nationally representative sample from India. The National Mental Health Survey of India 2016 is a multisite nationwide household survey conducted across India using a uniform methodology. Overall, 39,532 adults were surveyed with a response rate of 88%. The diagnosis was based on Mini International Neuropsychiatric Interview 6.0.0. CMDs among WRA (18-49 years) for this secondary analysis included depression and anxiety disorders. The prevalence of CMDs among WRA in India was 5.83%. Two important risk factors for CMDs included being divorced and living in the urban metro. Nearly 70% of women reported disabilities of varying severity. The overall treatment gap was around 82% (urban nonmetro > metro > rural population). On average, the cost of treatment of CMDs was ₹ 2,000 per month. CMDs are prevalent among WRA groups with significant disabilities and treatment gaps in India. The disability and treatment gap associated with CMDs among WRA can be handled by integrating mental health into general medical/obstetric care.

Determinants of Common Mental Disorders (CMD) among adolescent girls aged 15-19 years in Indonesia: Analysis of the 2018 National Basic Health Survey Data.

Common Mental Disorders (CMD) are distress conditions which manifest themselves with anxiety, somatic, and depressive symptoms. CMD are highly prevalent in Indonesia especially among adolescents. Adolescent girls have a higher risk to develop CMD than boys. This may be related to anaemia, potentially aggravated by early onset of menstruation. This study aimed to determine the association between haemoglobin concentration and other determinants of CMD among adolescent girls in Indonesia. Data of 1,052 adolescent girls aged 15-19 years old from the Indonesian Basic Health Survey 2018 were analysed. CMD was measured using the Self Reporting Questionnaire (SRQ-20). Principal Component Analysis of main determinants was applied and resulting principal components were investigated as risk factors for CMD. The prevalence of CMD among the study population was 16.5%. Anaemia and Age at Menarche (AAM) were not associated with CMD. Three principal components were significantly associated with higher CMD score: 1) higher parental education, better employment of the father, and living in an urban area (β: 0.16, 95%-CI: 0.02; 0.30); 2) higher consumption of salty foods, high-fat foods, and soft drinks (β: 0.23, 95%-CI: 0.05; 0.40); and 3) having asthma, smoking, and a higher haemoglobin concentration (β: 1.74, 95%-CI: 1.59; 1.89). The strongest clustered associates of CMD among adolescent girls in Indonesia were asthma, smoking status, and higher haemoglobin concentration, whereas anaemia and AAM were not associated. Causality of smoking and diet to CMD could not be disentangled in this cross-sectional study. Our findings imply that adolescent girls who have asthma and smoke, as well as those having parents with higher education and secured occupation, are more likely to have mental disorders.

Racehorse Trainer Mental Health: Prevalence and Risk Factors

Racehorse trainers play an important role within the horseracing industry. Despite this, scarce empirical information exists regarding the mental health of this population. Thus, the purpose of the present study was to explore the prevalence of symptoms related to common mental disorders (CMDs) and their associations with specific risk factors for CMD. Participants completed an anonymous online questionnaire. CMDs were assessed including distress, depression, generalized anxiety and adverse alcohol use. The risk factors examined included career dissatisfaction, social support and financial difficulties. 124 participants (28% response rate) completed the questionnaire. In total, 45% met the threshold indicative of at least one CMD. Specifically, prevalence of symptoms associated with depression (41%), adverse alcohol use (38%), psychological distress (26%), and generalized anxiety (18%) was observed. Career dissatisfaction (28%) and financial difficulties (64%) were identified. Career dissatisfaction, lower levels of social support and financial difficulties all increased the likelihood of trainers meeting the criteria for at least one of distress, depression or generalized anxiety. The study was the first to highlight prevalence rates of symptoms associated with CMDs among racehorse trainers in Ireland and identify certain risk factors which may increase the likelihood of racehorse trainers meeting the criteria for a CMD. Assessment of risk factors can aid early identification of CMDs among racehorse trainers. Such benefits may include early diagnosis or signposting to professional support. Further research is required in examining other occupational stressors experienced by trainers and the impact these may have on symptoms of CMDs.

Common mental disorders in mothers of children attending out-patient malnutrition clinics in rural North-western Nigeria: a cross-sectional study

BackgroundChildren with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs.This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria.MethodsWe conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression.ResultsMaternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD.ConclusionsOur findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs.

Determinants of Common Mental Disorders (CMD) Among Adolescent Girls Aged 15-19 Years in Indonesia: Analysis of the 2018 National Basic Health Survey Data

Introduction: Common Mental Disorders (CMD) are distress conditions which manifest themselves with anxiety, somatic, and depressive symptoms. CMD are highly prevalent in Indonesia especially among adolescents. Adolescent girls have a higher risk to develop CMD than boys. This may be related to anaemia and/or early onset of menstruation. This study aimed to determine the association between haemoglobin concentration and other determinants of CMD among adolescent girls in Indonesia. Methods: Data of 1,052 adolescent girls aged 15-19 years old from the Indonesian Basic Health Survey (Riskesdas) 2018 were analysed. CMD was measured using the Self Reporting Questionnaire (SRQ-20). Principal Component Analysis (PCA) of main determinants was applied and resulting principal components were investigated as risk factors for CMD. Results: The prevalence of CMD among adolescent girls aged 15-19 years in Indonesia was 16.5 percent. Of the 28·2 percent of adolescents with anaemia, 16·8 percent were suspected to have CMD. Three principal components were significantly associated with higher CMD score: 1) higher parental education, better employment of the father, and living in an urban area (β: 0·16, 95%-CI: 0·02; 0·30); 2) higher consumption of salty foods, high-fat foods, and soft drinks (β: 0·23, 95%-CI: 0·05; 0·40); and 3) having asthma, smoking, and a higher haemoglobin concentration (β: 1·74, 95%-CI: 1·59; 1·89). Conclusion: The strongest clustered determinants of CMD among adolescent girls in Indonesia were asthma, smoking status, and higher haemoglobin concentration, while age at menarche and anaemia were not related to CMD. Anaemia and earlier age at menarche were not associated with CMD. This study implies that adolescent girls with asthma and smoking cigarettes, as well as those having higher parental education and secured occupation, have an increased risk of developing mental disorders. Funding Statement: This study was performed as part of obtaining a PhD degree for which MA received a scholarship from Lembaga Pengelola Dana Pendidikan (LPDP), Republic of Indonesia. Declaration of Interests: All authors stated no conflict of interest. Ethics Approval Statement: All procedures were in accordance with the ethical standards issued by the Health Research Ethics Commission, Ministry of Health, Republic of Indonesia, and informed consent was obtained from all participants.

Life Beyond the Home: Nutritional, Occupational, Social and Environmental Predictors of Common Mental Disorders Among Indian Mothers with 6- to 23-Month-old Infants (P11-026-19)

ObjectivesThe mental wellbeing of mothers with young children has been shown to positively affect child development. Little, however, is known about which factors are related to optimal maternal mental health in high poverty rural contexts where women face a broad array of challenges at multiple levels daily. MethodsData were from 1644 mother-infant pairs in five Indian states as part of the Women Improving Nutrition through Group-based Strategies study. Common mental disorders (CMD) were assessed through the 20-item Self Reporting Questionnaire. We report on factors spanning nutritional (women’s weight, fertility, food security, child illness), occupational (self-reported type of work, time spent in labor, domestic and caretaking activities), social (group membership, decision-making, gender attitudes, household dependents) and environmental (shocks, water, sanitation) aspects of life. Logistic regression models with district controls were used to examine associations between these factors and CMD. ResultsOn average, women were 26 years old and their children were 15 months old. CMD was present in 262 (16%) of the mothers. Risk factors for CMD included having a failed pregnancy (AOR 1.40, 95% CI 1.01-1.93), and food insecurity (1.13, 1.07-1.20). Protective factors included being engaged in agricultural labor as a main occupation relative to being a housewife (0.20, 0.11-0.35) more time working (AOR associated with 1 more hour of work: 0.88, 0.81-0.97), higher decision-making (0.91, 0.86-0.96), group membership (non-significant trend; 0.76, 0.56-1.02), and having an improved toilet (0.51, 0.35-0.73). ConclusionsIn a sample of rural and mostly tribal Indian households, we found a moderate prevalence of poor mental wellbeing among mothers with young children. We also found that the determinants span a range of factors. Future research should aim to better understand the ways in which working outside the home, albeit in rigorous agricultural work, appears to protect the wellbeing of women in this context. It is plausible that agricultural work mitigates food insecurity, connects women with others and generates income, but these pathways need empirical and ethnographic examination. Funding SourcesBill & Melinda Gates Foundation; CGIAR Research Program on Agriculture for Nutrition and Health.

Prevalence and determinants of symptoms of antenatal common mental disorders among women who had recently experienced an earthquake: a systematic review

BackgroundAntenatal common mental disorders (CMDs) including anxiety, depressive, adjustment, and somatoform disorders are prevalent worldwide. There is emerging evidence that experiencing a natural disaster might increase the risk of antenatal CMDs. This study aimed to synthesise the evidence about the prevalence and determinants of clinically-significant symptoms of antenatal CMDs among women who had recently experienced an earthquake.MethodsThis systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search included both electronic and manual components. Five major databases were searched. A data extraction table was used to summarise study characteristics and findings. Two authors examined the quality of studies independently using a quality assessment tool. A narrative synthesis of the findings reported.ResultsIn total seven articles met inclusion criteria. Quality scores ranged from six to seven out of ten. All the studies were cross-sectional surveys and were conducted in high and middle-income countries. Sample sizes varied among studies. The prevalence of clinically-significant symptoms of antenatal CMD ranged from 4.6% (95% CI, 3.2; 6.5) experiencing ‘psychological stress’ in Japan to 40.8% (95% CI, 35.5; 46.4) ‘depression’ in China. While all studies were conducted in an earthquake context, only four examined some aspect of earthquake experiences as a risk factor for antenatal CMDs. In multivariable analyses, higher marital conflict, poor social support, multiparity, stresses of pregnancy and the personality characteristic of a negative coping style were identified as risks and a positive coping style as protective against antenatal CMDs.ConclusionsThis systematic review found that women who have recently experienced an earthquake are at heightened risk of antenatal mental health problems. It indicates that in addition to the establishment of services for safe birth which is recognised in post-disaster management strategies, pregnancy mental health should be a priority. The review also revealed that there is no evidence available from the world’s low-income nations where natural disasters might have more profound impacts because local infrastructure is more fragile and where it is already established that women experience a higher burden of antenatal CMDs.Trial registrationPROSPERO-CRD42017056501.

Prevalence and factors associated to common mental disorders among municipal teachers in Uberlândia, Minas Gerais, Brazil.

Association analysis between common mental disorders (CMD) and working conditions is necessary to achieve a better understanding of the reasons for physical and mental illness among teachers. In the present cross-sectional study we sought to establish the prevalence of CMD among teachers in public municipal elementary schools in Uberlândia, Minas Gerais, Brazil, and its correlation with sociodemographic, environmental and occupational aspects. A random sample of 330 teachers from 36 schools responded the General Health Questionnaire-12 and a structured questionnaire designed to investigate risk and protective factors for CMD. The collected data were first subjected to bivariate, then to multiple logistic regression analysis. The results indicate that the following characteristics were associated with CMD: female sex, permanent employment relationship, working double shifts, previous experience with school violence and use of sleep disorder drugs. We conclude that the mental health of teachers does not receive the proper attention and care even though it has direct impact on the teaching-learning cycle. Decreasing the rates of absenteeism, presenteeism, turnover, early retirement and sick leave reduces the government's costs, while positive impacts extend to society at large.

The intertwined effect of lack of emotional warmth and child abuse and neglect on common mental disorders in adolescence.

Adolescence is a vulnerable period for mental health problems. Although child abuse and neglect (CAN) are known risk factors for some of them, it is not clear if the negative consequences on mental health also occur in families where CAN and a warm parent-child relationship coexist. The aim of this study is to explore this gap and investigate the effects of different types of CAN according to levels of warmth in the parent-child relationship on common mental disorders (CMD) in adolescence. This is a cross-sectional study encompassing 487 adolescents attending the ninth grade at 2 public and 4 private schools in Rio de Janeiro, Brazil. CAN was measured by the Child Trauma Questionnaire (CTQ), CMD by the General Health Questionnaire (GHQ-12) and the level of warmth in the parent-child relationship were recalled using short Egna Minnen Betraffände Uppfostran (s-EMBU-23). The adjusted separate effects of different types of CAN and a low level of warmth in the parent-child relationship, and both in tandem, were estimated using multivariate linear regression models. Results indicated that emotional abuse and neglect, physical abuse and neglect, and a low level of warmth in the parent-child relationship are important risk factors for CMD in adolescence. Nevertheless, in families where CAN coexist with a warm and affectionate parent-child relationship, the negative effects of CAN on mental health are attenuated. Evidence indicates that actions to prevent or interrupt CAN and improving parental practices could be effective strategies to reduce CMD in adolescence.

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care - a long-term, population-based study.

ObjectiveIrritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs).Methods and study designA longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982–1987) and Inter99 (1999–2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS.ResultsOver a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained.ConclusionIn a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.

Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa

BackgroundEthiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa.MethodA cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression.ResultsThe prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long term mental illnesses.ConclusionsCMD symptoms were found to be prevalent among Ethiopian migrant returnees. As pre-migration factors are associated with CMD symptoms, pre-departure training could be useful to mitigate the risk factors. Creating and routinely arranging mental health interventions and rehabilitation services are advisable for returnees who are screened for, or diagnosed with, mental health problems.

Exploring Work-Related Causal Attributions of Common Mental Disorders.

Purpose Common mental disorders (CMDs) are major causes of sickness absence and disability. Prevention requires knowledge of how individuals perceive causal mechanisms, and in this study we sought to examine work-related factors as causal attribution of CMDs. Methods A trial sample of n = 1,193, recruited because they struggled with work participation due to CMDs, answered an open-ended questionnaire item about what they believed were the most important causes of their CMDs. The population included participants at risk of sickness absence, and participants with reduced work participation due to sickness absence, disability or unemployment. We used thematic content analysis and categorized responses from 487 participants who reported work-related factors as causal attributions of their CMDs. Gender differences in work-related causal attributions were also examined. Results The participants attributed their CMDs to the following work-related factors; work stress, leadership, reduced work participation, job dissatisfaction, work conflict, social work environment, job insecurity and change, workplace bullying, and physical strain. Women tended to attribute CMDs to social factors at work. Conclusion Findings from this study suggest several work-related risk factors for CMDs. Both factors at the workplace, and reduced work participation, were perceived by study participants as contributing causes of CMDs. Thus, there is a need to promote work participation whilst at the same time targeting aversive workplace factors. Further, our findings indicate that work-related factors may affect women and men differently. This illustrates that the association between work participation and CMDs is complex, and needs to be explored further.

P4.141 Predictors of Incident and Persistent Common Mental Disorder (CMD) in People Living with HIV (PLHIV)- A Longitudinal Follow Up Study in Goa, India

Common mental disorders (CMD) are common in people with HIV. Depression adds to the burden of disease experienced, contributes to difficulties with medication adherence as well as self care skills;...

Changing trends in the prevalence of common mental disorders in Taiwan: a 20-year repeated cross-sectional survey

Macrosocial changes might affect mental health. We investigated whether the prevalence of common mental disorders (CMDs) changed over a 20-year period of industrialisation in Taiwan. We used the 12-item Chinese Health Questionnaire to assess mental status of Taiwanese adults in 1990, 1995, 2000, 2005, and 2010. Respondents with scores of 3 or higher were classified as having probable CMDs. We assessed trends of probable CMDs with the Cochran-Armitage test and their risk factors (sex, age, marital status, educational level, employment status, and physical health) with multivariable logistic regression. The trends were compared with national rates of unemployment, divorce, and suicide. Of 10,548 respondents, 9079 (86·1%) completed questionnaires. The prevalence of probable CMDs doubled from 11·5% in 1990 to 23·8% in 2010 (time trend p<0·001). Increases paralleled rises in national rates of unemployment, divorce, and suicide at all five timepoints. Significant risk factors for probable CMDs were female sex (adjusted odds ratio 1·6, 95% CI 1·4-1·8), 6 or fewer years of education (1·3, 1·1-1·5), unemployment (1·4, 1·1-1·7), and poor physical health that limited daily activities (6·5, 5·4-8·0). When we controlled for these factors in multivariable models, the time trends remained significant (p<0·0001). National rates of unemployment, divorce, and suicide increased in parallel with prevalence of probable CMDs in Taiwan. Therefore, clinical and social preventive measures both seem important during times of change to the economy and labour market. Taiwan National Science Council.

Abuse and other correlates of common mental disorders in youth: a cross-sectional study in Goa, India.

PurposeThere is a paucity of known correlates of common mental disorders (CMDs) among the youth age group in India. This analysis aims to determine risk factors associated with a probable diagnosis of CMD in a youth sample in India.MethodsThis is a secondary analysis of data collected via a door-to-door (community) survey of 3,662 youth (aged 16–24 years) in selected urban and rural areas in Goa. The urban and rural areas were selected based on their engagement with a Goan-based mental health charity organisation, Sangath. Point prevalence of CMD was estimated using the general health questionnaire-12 (GHQ-12). Multivariate logistic regression analyses determined factors associated with CMD and associations were stratified by gender.ResultsIn total, 3,649 (1,796 urban; 1,853 rural) youth were assessed for probable diagnosis of CMD. There was an almost equal ratio of males (49 %) to females (51 %) in the sample. During the time of the survey, 91 % of the sample was residing with parents, with 83 % being between the ages of 22 and 24 years living with parents. A small proportion of the sample never attended school (1.1 %) with the rest either educated, employed or unemployed. The point prevalence of probable CMD in the sample was 7.87 %; 95 % CI 7.01–8.80 %. Those living in urban areas had a higher prevalence of CMD (9.12 %; 95 % CI 7.90–10.52 %) compared to those living in rural areas (6.60 %; 95 % CI 5.50–7.82 %). After adjusting for a range of potential confounders, independent risk factors for CMD were being older, i.e., between 22- and 24-years old, (OR 1.60; 95 % CI 1.10–2.24; p = 0.015), residing in urban areas (OR 1.51; 95 % CI 1.12–2.04; p = 0.007), physical abuse (beaten in the last 3 months) by parents, teachers or others (OR 3.10; 95 % CI 2.11–4.51; p < 0.001), sexual harassment (OR 2.01; 95 % CI 1.30–3.20; p = 0.003) and sexual abuse (OR 2.54; 95 % CI 1.94–3.33; p < 0.001). Being able to talk about personal problems (OR 0.52; 95 % CI 0.34–0.80; p = 0.003) was a protective factor. After stratifying by gender, sexual harassment, physical and sexual abuse were associated with a likely CMD diagnosis in females and males.ConclusionsSexual and recent physical abuses were independent risk factors for CMD in both genders. In addition, being older and being able to discuss problems were associated with CMD diagnosis in females but not in males.

Prevalence and risk factors for symptoms of common mental disorders in early and late pregnancy in Vietnamese women: A prospective population-based study

BackgroundLittle is known about the prevalence of and risk factors for common mental disorders (CMD) in pregnant women in low-income countries. The aim of this study was to establish the prevalence of and psychosocial risk factors for clinically significant symptoms of CMD in early and late pregnancy in women in rural Viet Nam. MethodsA population-based sample of women was surveyed in early and late pregnancy. CMD were assessed by the Edinburgh Postnatal Depression Scale-Viet Nam Validation and psychosocial risks by study-specific structured interviews. ResultsIn total 497/523 (97%) eligible women were recruited and 419 (84%) provided complete data. Prevalence of CMD only in early pregnancy was 22.4% (95% CI 18.4–26.4); only in late pregnancy was 10.7% (95% CI 7.8–13.7) and at both assessment waves was 17.4% (95% CI 13.8–21.1). Non-economic and economic coincidental life adversity, intimate partner violence, past pregnancy loss, and childhood abuse were positively associated with persistent antenatal CMD. Older age, having a preference for the baby’s sex, and nulli- or primiparity were risk factors for CMD in early pregnancy. ConclusionsPersistent antenatal CMD are prevalent in rural areas of Viet Nam. Psychosocial risk factors play a major role in this significant public health problem.

The relationship between personal debt and specific common mental disorders

Personal debt is now recognized as one of the many factors associated with common mental disorders (CMD). We aim to estimate the prevalence of 'specific' mental disorders based on ICD-10 research diagnostic criteria by type of debt and quantify the additional influence of addictive behaviours. A random probability sample comprising 7461 respondents were interviewed for the third national survey of psychiatric morbidity of adults in England carried out in 2007. The prevalence of CMD was estimated from the administration of the CIS-R. Respondents were asked about sources of debt and their borrowing choices. In 2007, 8.5% of adults were in arrears. Adults in debt were three times more likely than those not in debt to have CMD. The increased likelihood of CMD among those in arrears was found for all CMD and was irrespective of source of debt--housing, utilities and purchases on credit. The situation was exacerbated among those with addictive behaviours--alcohol or drug dependence or problem gambling. Those with multiple sources of debt and who had to obtain money from pawnbrokers and moneylenders had the highest rate of CMD, ≈ 50%. Debt is one of the major risk factors for CMD. This has practical implications for both health services and financial services, which both need to be alert to the association and adapt and train their respective services accordingly so that people in debt can access help for mental disorders and people with mental disorders can access help for debt.

FC30-02 - Common mental disorders in TB/HIV co-infected patients in Ethiopia

BackgroundThe relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia.MethodsWe conducted a cross sectional study in three hospitals in Ethiopia from February to April, 2009.The study population consisted of 155 TB/HIV co-infected and 465 non-co-infected HIV patients. CMD was assessed through face to face interviews by trained clinical nurses using the Kessler 10 scale. Several risk factors for CMD were assessed using a structured questionnaire.ResultsTB/HIV co-infected patients had significantly (p = 0.001) greater risk of CMD (63.7%) than the non-co-infected patients (46.7%). When adjusted for the effect of potential confounding variables, the odds of having CMD for TB/HIV co-infected individuals was 1.7 times the odds for non-co-infected patients [OR = 1.7, (95%CI: 1.0, 2.9)]. Individuals who had no source of income [OR = 1.7, (95%CI: 1.1, 2.8)], and day labourers [OR= 2.4, 95%CI: 1.2, 5.1)] were more likely to have CMD as compared to individuals who had a source of income and government employees respectively. Patients who perceived stigma [OR = 2.2, 95%CI: 1.5, 3.2)] and who rate their general health as “poor” [OR = 10.0, 95%CI: 2.8, 35.1)] had significantly greater risk of CMD than individual who did not perceive stigma or who perceived their general health to be “good”.ConclusionTB/HIV control programs should develop guidelines to screen and treat CMD among TB/HIV co-infected patients.

Examining Overweight and Obesity as Risk Factors for Common Mental Disorders Using Fat Mass and Obesity-Associated (FTO) Genotype-Instrumented Analysis: The Whitehall II Study, 1985-2004

The Mendelian randomization approach exploits genetic variants to improve causal inference when using observational data. The authors examined the relation between long-term obesity and common mental disorders (CMD) by utilizing the known relation between fat mass and obesity-associated (FTO) genotype and body mass index (BMI; weight (kg)/height (m)(2)). Data collection in 2,981 men and 1,164 women (mean age at baseline = 44 years) from the Whitehall II Study (London, United Kingdom) included 4 repeated examinations of BMI and CMD over a 19-year follow-up period (1985-2004), plus an assessment of FTO polymorphism rs1421085. In men, there was an association of FTO genotype with all measures of adiposity (mean BMI, number of times obese, and, in nonobese persons, number of times overweight). FTO was also associated with CMD in men. This was independent of adiposity, thus potentially violating the exclusion restriction assumption. According to both conventional and FTO-instrumented regression analysis, measurement of obesity was associated with an increased occurrence of CMD. In the FTO-instrumented analysis only, higher BMI and overweight were also associated with CMD. In women, there was no link between FTO and adiposity. Mendelian randomization analyses supported the status of long-term obesity as a risk factor for CMD in men-a finding that should be interpreted cautiously because the function of the FTO gene is unknown.