Subjective Mental Health Research Articles

A constituição subjetiva e saúde mental: contribuições winnicottianas

RESUMO Perante o sofrimento emocional observado na clínica psicanalítica contemporânea, pretende-se discutir as implicações das relações inter-humanas iniciais para a constituição subjetiva. Sob o referencial psicanalítico winnicottiano, apresentam-se reflexões que contemplam as dimensões de saúde psíquica e adoecimento a partir de uma perspectiva psicopatológica relacional. O sofrimento psíquico aqui referido se origina de possíveis experiências traumáticas no bojo da relação mãe-bebê, que podem levar o indivíduo a uma vivência confusa, ou, ainda, à impossibilidade de gestar seu próprio nascimento psíquico. Conclui-se que o paradigma winnicottiano contribuiu de forma original para o campo da saúde mental possibilitando manejos clínicos diferenciados.

The long-run consequences of Chernobyl: Evidence on subjective well-being, mental health and welfare

This paper assesses the long-run toll taken by a large-scale technological disaster on welfare, well-being and mental health. We estimate the causal effect of the 1986 Chernobyl catastrophe after 20years by linking geographic variation in radioactive fallout to respondents of a nationally representative survey in Ukraine according to their place of residence in 1986. We exclude individuals who were exposed to high levels of radiation—about 4% of the population. Instead, we focus on the remaining majority of Ukrainians who received subclinical radiation doses; we find large and persistent psychological effects of this nuclear disaster. Affected individuals exhibit poorer subjective well-being, higher depression rates and lower subjective survival probabilities; they rely more on governmental transfers as source of subsistence. We estimate the aggregate annual welfare loss at 2–6% of Ukraine's GDP highlighting previously ignored externalities of large-scale catastrophes.

Mental health stigmatisation in deployed UK Armed Forces: a principal components analysis

IntroductionUK military research suggests that there is a significant link between current psychological symptoms, mental health stigmatisation and perceived barriers to care (stigma/BTC). Few studies have explored the construct of...

Subjective health of undocumented migrants in Germany - a mixed methods approach.

BackgroundHealth of migrants is known to be above-average in the beginning of the migration trajectory. At the same time reports from non-government organisations (NGOs) suggest that undocumented migrants in Germany tend to present late and in poor health at healthcare facilities. In this paper, we explore the health status of undocumented migrants with a mixed method approach including complementary qualitative and quantitative datasets.MethodsUndocumented migrants attending a NGO based in Hamburg, Germany, were asked to fill in the SF-12v2, a standardized questionnaire measuring health-related quality of life (HRQOL). The SF-12v2 was analyzed in comparison to the U.S. American norm sample and a representative German sample. Differences in mean scores for HRQOL were evaluated with a t-test and with a generalized linear model analyzing the impact of living without legal status on HRQOL. The quantitative research was complemented by a qualitative ethnographic study on undocumented migration and health in Berlin, Germany. The study included semi-structured interviews, informal conversations and participant observation with Latin American migrants over the course of three years. The study focused on subjective experiences of illness and health and the impact of illegality on migrants’ health and access to health care.ResultsHRQOL was significantly worse in the sample of undocumented migrants (n = 96) as compared to the U.S. American sample (p < 0.005). Living without legal status displayed a significant negative effect on subjective mental and physical health (p ≤ 0.003) in the generalized linear model when adjusted for age and gender compared to the representative German population sample. The ethnographic study, which included 35 migrants, identified socio-economic conditions, the subjective experiences of criminalization, and late presentation at healthcare-facilities as the three main factors impacting on health from migrant perspective.DiscussionThe present research suggests a high morbidity and mortality in this comparatively young population. The ethnographic research confirms negative impacts on health of social determinants in general and stressassociated with living without legal status in particular, both are further aggravated by exclusion from health care services. In addition to the provision of health care it appears to be important to structurally tackle the underlying social conditions which affect undocumented migrants’ health.ConclusionsLiving without legal status has a negative impact on health and well-being. Limited access to care may further exacerbate physical and mental illness. Possibilities to claim basic rights and protection as well as access to care without legal status appear to be important measures to improve health and well-being.

Mental health and individual experience of unemployed young adults in Japan.

This study focused on the subjective experiences and mental health of young, unemployed adults in Japan. We explored how individuals describe their experiences of becoming unemployed and how these experiences influence their mental health within the current Japanese sociocultural context, using a social constructionist approach. We collected data from October 2012 to January 2013. Participants were 25 young unemployed Japanese job seekers (15 females), who were recruited using a purposive sampling strategy including snowball sampling. We conducted semi-structured interviews focusing on participants’ previous work and job search experience, their lifestyle and health, the social support they considered necessary, their future job-seeking plans, and their demographic characteristics. Using thematic analysis, we identified four key themes from the interview data: stress relief, re-energization for future work, new job skills acquisition, and lifestyle change. The findings indicate that unemployment is sometimes experienced as more beneficial than employment. This might be because of the poor working environment in Japan, the financial support participants received, and the experience of short-term unemployment. The findings suggest that intervention is necessary to help young adults in Japan find high-quality jobs and that we must promote fair employment and decent working conditions for them.

Effect of Dynamic Meditation on Mental Health.

Although traditional meditation has been found to be effective in improving physical and mental health of subjects, there was a paucity of research of the effect of active or dynamic meditation on these variables. Therefore, the present study was aimed at studying the effect of dynamic meditation on mental health of the subjects. Total sample of the present study comprised 60 subjects, 30 each in experimental and control group. Subjects in experimental group were given 21-day training in dynamic meditation. Mental health of the experimental and control group subjects was measured in pre- and post-condition with the help of Mental Health Inventory developed by Jagadish and Srivastava (Mental Health inventory, Manovaigyanik Parikshan Sansthan, Varanasi, 1983). Obtained data were analyzed with the help of ANCOVA. In post-condition, experimental group scored better than control group on integration of personality, autonomy and environmental mastery. Effect sizes of dynamic meditation on these dimensions of mental health were large. However, experimental group and control group did not differ significantly on positive self-evaluation, perception of reality and group-oriented attitude dimensions of mental health in post-condition. Overall, dynamic meditation training was effective in improving mental health of the subjects.

Investigation and analysis of economic and family burden among patients with depression

Objective To investigate and analyze the economic burden and family burden among patients with depression. Methods 180 patients who diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorders-version IV (DSM-Ⅳ) had been enrolled randomly. The self-made economic costs questionnaire and the Family Burden Scale of Diseases (FBS) were utilized for investigation. 168 participants finished this study. Results The per capita total economic cost of patients was 21 650 Yuan, direct economic costs was 6 806 Yuan, indirect costs was 14 844 yuan. The total economic costs, direct economic costs and direct medical costs of hospitalized patients were significantly higher than outpatients. The total economic cost per capita, indirect economic costs, costs decreased by work delays and work ability impairment of urban patients were significantly higher than rural patients. Four factors of FBS such as subjective feeling, family life, home entertainment and mental health had higher positive answer rate, which was above 60%. The positive answer rate of family relationship and physical health was lower than 40%. Conclusions Patients with depression suffered high economic burden and family burden. Key words: Depression; Economic burden; Family burden

Impact of endometriosis on quality of life, anxiety, and depression: an Austrian perspective.

Several studies on the quality of life in patients with endometriosis have been performed with conflicting results. This cross-section survey examines the influence of endometriosis on the psychological well-being and the quality of life and the incidence of anxiety and depression among these patients, recruited from a tertiary care center in Austria. Three standardized questionnaires of 62 patients with endometriosis were evaluated: status of health questionnaire (SF-36), hospital anxiety and depression scale (HADS-D), and endometriosis health profile (EHP-30). Quality of life status (EHP-30) was compared with published samples of the Oxford hospital and the Charite Berlin. Chi-square tests, independent sample t-tests, and one-way independent ANCOVA's were used to compare SF- 36 and HADS- D scores to 61 healthy controls. Pearson product-moment-correlation coefficients were used to investigate correlations between symptoms of depression and anxiety in the patient sample. Moderate to severe anxiety symptoms were found in 29 %; depressive symptoms were present in 14.5 % of the patients. Both symptoms occurred in 12.9 %. We found significant better values in all subscales of the EHP compared to the Oxford and Berlin samples. The control sample showed significant better subjective general health (p < 0.001), vitality (p < 0.001), mental health (p < 0.001), and better emotional role functioning (p < 0.001). Participants age significantly influenced mental health and emotional role functioning. The impact of endometriosis on life quality in our study was considerably less than in other studies but equivalent to other chronic medical conditions. It could be shown that endometriosis is influenced by biopsychosocial variables. However, the elevated presence of anxiety and depressive symptoms indicates the need of psychosomatic treatment of affective disorders to prevent manifestation.

Understanding the effect of retirement on health: Mechanisms and heterogeneity

This paper investigates the mechanisms behind the health effects of retirement. Using a Regression Discontinuity Design to exploit financial incentives in the German pension system for identification, I find that retirement improves subjective health status and mental health, while also reducing outpatient care utilization. I explore a wide range of health behaviors, time use, and effect heterogeneity as potential mechanisms. Relief from work-related stress and strain, increased sleep duration as well as more frequent physical exercise seem to be key mechanisms through which retirement affects health.

Association among number, order and type of siblings and adolescent mental health at age 12.

Although the sibling relationship is a unique one, the effects of the number and type of siblings on mental health among adolescents have not been reported. Japanese children (total, 9276; boys, 4654; girls, 4622), all 12 years old, and from the Japanese Toyama Birth Cohort Study, were followed up until 2002. Subject self-reported mental health was obtained from the Japanese version of the Dartmouth Primary Care Co-operative Project (COOP) charts. The associations between number and type of siblings and self-reported mental health were examined. There was a significant difference in mental health between different sibling pairs, with brother pairs and brother/sister pairs having a positive effect on adolescent mental health, compared with those in sister pairs. Girls with brothers had better self-reported mental health than those without. The adjusted OR of good mental health was 1.44 (95%CI:1.00-2.08) for those with an older brother and 1.67 (95%CI: 1.17-2.38) for those with a younger brother compared with those without. Boys with a younger sister had a higher OR of good self-reported health than those without (OR, 1.62; 95%CI: 1.08-2.43). Children with siblings had better mental health status than those without, which has practical implications for Asian countries and worldwide considering the declining fertility.

Is the desire for status a fundamental human motive? A review of the empirical literature.

The current review evaluates the status hypothesis, which states that that the desire for status is a fundamental motive. Status is defined as the respect, admiration, and voluntary deference individuals are afforded by others. It is distinct from related constructs such as power, financial success, and social belongingness. A review of diverse literatures lent support to the status hypothesis: People's subjective well-being, self-esteem, and mental and physical health appear to depend on the level of status they are accorded by others. People engage in a wide range of goal-directed activities to manage their status, aided by myriad cognitive, behavioral, and affective processes; for example, they vigilantly monitor the status dynamics in their social environment, strive to appear socially valuable, prefer and select social environments that offer them higher status, and react strongly when their status is threatened. The desire for status also does not appear to be a mere derivative of the need to belong, as some theorists have speculated. Finally, the importance of status was observed across individuals who differed in culture, gender, age, and personality, supporting the universality of the status motive. Therefore, taken as a whole, the relevant evidence suggests that the desire for status is indeed fundamental.

Implications of participatory methods to address mental health needs associated with climate change: 'photovoice' in Nepal.

'Photovoice', a community-based participatory research methodology, uses images as a tool to deconstruct problems by posing meaningful questions in a community to find actionable solutions. This community-enhancing technique was used to elicit experiences of climate change among women in rural Nepal. The current analysis employs mixed methods to explore the subjective mental health experience of participating in a 4- to 5-day photovoice process focused on climate change. A secondary objective of this work was to explore whether or not photovoice training, as a one-time 4- to 5-day intensive intervention, can mobilise people to be more aware of environmental changes related to climate change and to be more resilient to these changes, while providing positive mental health outcomes.

Associations between parents' subjective time pressure and mental health problems among children in the Nordic countries: a population based study.

BackgroundThe home, the family and the parents represent a context of everyday life that is important for child health and development, with parent-child relationships highlighted as crucial for children’s mental health. Time pressure is an emerging feature of modern societies and previous studies indicates that parents with children living at home experience time pressure to a greater extent than people with no children living at home. Previous studies of children’s mental health in relation to parents’ time pressure are lacking. Hence, the purpose of this study was to examine the association between parents’ subjective time pressure and mental health problems among children in the Nordic countries as well as potential disparities between boys and girls in different age groups.Methods4592 children, aged 4-16 from Denmark, Finland, Norway and Sweden, participating in the 2011 version of the NordChild study, were included. The Strength and Difficulties Questionnaire was used to measure children’s mental health and associations to parents’ time pressure were assessed by multiple logistic regression analysis.ResultsAmong children of parents experiencing time pressure, 18.6% had mental health problems compared to 10.1% among children of parents experiencing time pressure not or sometimes. The odds of mental health problems were higher among both boys (OR 1.80 95% CI 1.32-2.46) and girls (OR 1.95 95% CI 1.42-2.66) if their parents experienced time pressure when adjusted for financial stress. The highest prevalence of mental health problems in the case of parental time pressure was found among girls 13-16 years old (23.6%) and the lowest prevalence was found among boys 13-16 years old (10.7%).ConclusionsIn this study an association between parents’ subjective time pressure and increased mental health problems among children was found. Given that time pressure is a growing feature of modern societies, the results might contribute to an explanation as to mental health problems are common among children in the Nordic countries in spite of otherwise favourable conditions. Additional research on the linkage between parents’ experienced time pressure and children’s and adolescents’ mental health problems is needed to confirm the novel findings of this study.

Does Co-Existing Lumbar Spinal Canal Stenosis Impair Functional Outcomes and Activity Levels after Primary Total Hip Arthroplasty?

Degenerative lumbar spinal stenosis (LSS) is a cause for substantial morbidity in the elderly population: many often undergo total hip arthroplasty for associated hip arthritis. With a matched cohort we investigated the effect of co-existing LSS on aseptic survivorship, functional outcomes, activity levels, overall subjective physical and mental health status, and satisfaction rates in patients undergoing primary THA. The aseptic-implant survivorship was similar in LSS and non-stenosis cohort. Although both cohorts significantly improved, the LSS cohort achieved lower improvements in HHS, UCLA, SF-36 physical, and satisfaction rates than the matched non-stenotic cohort. Surgeons should consider cautioning patients with LSS that although they can expect relief of their arthritic symptoms following THA, they may continue to expect limitations in function, physical-status, activity-levels, and satisfaction rates.

Subjective Social Status, Mental and Psychosocial Health, and Birth Weight Differences in Mexican-American and Mexican Immigrant Women.

Recent Mexican immigrant women on average have an unexpectedly low incidence of low birth weight (LBW). Birth weights decline and LBW incidence increases in post-immigrant generations. This pilot project tested the hypothesis that subjective social status (SSS) of pregnant women predicts variation in birth weight between Mexican immigrant and Mexican-American women. 300 low-income pregnant Mexican immigrant and Mexican-American women in South Texas were surveyed for SSS, depression, pregnancy-related anxiety, perceived social stress and self-esteem and subsequent birth weight. No significant difference in SSS levels between pregnant Mexican immigrant and Mexican-American women were found. However, SSS better predicted variation in birth weight across both groups than mental and psychosocial health variables. Results suggest distinct relationships among SSS, mental and psychosocial health that could impact birth weight. They underscore the relevance of a multilevel, biopsychosocial analytical framework to studying LBW.

Perfekcionizam - pozitivna ili negativna osobina? relacije sa subjektivnim blagostanjem, optimizmom i pesimizmom

Cilj ovog istraživanja bio je da se ispita odnos pozitivnog i negativnog perfekcionizma sa subjektivnim blagostanjem i proveri medijatorska uloga optimizma i pesimizma kao kognitivnih mehanizama u ovom odnosu. Prema dvoprocesnom modelu perfekcionizma postoje razlike u kognitivnom funkcionisanju pozitivnih i negativnih perfekcionista, što posledično dovodi do različitih, pozitivnih ili negativnih ishoda. U istraživanju je učestvovalo 287 studenata Univerziteta u Nišu, ujednačenih po polu. Utvrđeni rezultati generalno podržavaju postavke dvoprocesnog modela da perfekcionizam ima i pozitivna i negativa svojstva i ukazuju da su njegovi pozitivni i negativni aspekti različito povezani sa subjektivnim blagostanjem. Nalazi takođe upućuju da se odnos pozitivnog perfekcionizma i subjektivnog blagostanja ostvaruje delimično preko optimizma, dok je veza negativnog perfekcionizma i subjektivnog blagostanja potpuno posredovana optimizmom i pesimizmom kao medijatorima. Čini se da generalni način razmišljanja koji usvajaju može da zaštiti, ali isto tako i da hendikepira perfekcioniste u pogledu ishoda aktivnosti koje preduzimaju, i na taj način doprinese višem, tj. nižem nivou subjektivnog blagostanja. U narednim istraživanjima bi bilo značajno ispitati i druge mehanizme koji mogu imati medijacionu ulogu između perfekcionizma i subjektivnog blagostanja, ali i drugih indikatora mentalnog zdravlja.

The Influence of Lifestyle on Subjective Mental and Physical Health：Comparative Analysis Among Baby-boomers

The Influence of Lifestyle on Subjective Mental and Physical Health：Comparative Analysis Among Baby-boomers

A lifecycle perspective of stock market performance and wellbeing

We estimate the effect of stock market fluctuations on subjective wellbeing and mental health using Australian survey data over the period 2001–2012, which includes the global financial crisis. A particular innovation of the paper is the use of three satisfaction measures – overall, financial, employment – and the use of a stylised lifecycle investment model. These features, coupled with a robust identification strategy based on comparing survey respondents interviewed in the same quarter and location, allow us to better understand individual reactions to stock market changes. We find that stock market increases lead to a significant but modest improvements in life satisfaction and mental health. This effect is driven by young and middle-aged males, and is stronger for those with direct exposure to the stock market. For young cohorts, the stock market index acts as a leading indicator of employment prospects, whilst for older cohorts it acts directly on financial satisfaction.

Adverse life events and health: A population study in Hong Kong

ObjectiveAlthough the effects of adverse life events on mental health have been well documented in the literature, there has never been a population based study that investigated systematically the association between history of adverse life events and physical health (objective and subjective) in adults. MethodCross-sectional, face-to-face household population based survey of adults (18+) in Hong Kong (N=1147). Participants were asked if they had a diagnosis of six health conditions including hypertension, heart disease, arthritis, diabetes, eyesight degeneration, and hearing loss. They were also asked if they had experienced five adverse life events including death of a partner or spouse, abuse, natural disaster, life threatening illness or injury, and family disruption. Interviews also included the Short-Form 12 Health Survey (SFHS-12) and the short version of the Centre for Epidemiologic Studies Depression Scale (CES-D). ResultsOverall, results indicate that specific adverse life events may be associated with specific health conditions. However, all tested life events were associated with subjective physical and mental health. Death of partner or parent and life threatening illness or injury were found to have the strongest association with physical health problems. A dose–response relationship between adverse life events and physical health in general was evident but more so for heart disease and eyesight degeneration. ConclusionConsidering the high prevalence of traumatic events and how common the conditions associated with such events are in the general population, screening for adverse life events as part of comprehensive assessment will allow a deeper understanding of patients' needs.

Health risks in different living circumstances of mothers. Analyses based on a population study

The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.