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Toropova A, Björk Brämberg E, Bergström G. Return to Work Trajectories of Swedish Employees on Sick-Leave Due to Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10216-9. [PMID: 38907784 DOI: 10.1007/s10926-024-10216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVES Recent research has emphasized that return to work (RTW) is a dynamic, gradual and often uneven process with a great degree of individual variation. This study aimed to identify RTW trajectories of Swedish employees on sick-leave due to common mental disorders (CMDs). The second aim was to explore which demographic, employment, health-related and work environment characteristics predicted RTW trajectory membership. METHODS Data comes from two 2-armed cluster-randomized controlled trials (RCT) with a 12-month follow-up. A participative problem-solving intervention aimed to reduce sick-leave was compared to care as usual (CAU) involving any kind of work-directed interventions. Participants on sick-leave due to CMDs at baseline (N = 197) formed the study sample. Latent growth mixture modeling and logistic regression were the main analytical approaches. RESULTS Five distinct RTW trajectories of Swedish employees were identified: Early RTW (N = 65), Delayed RTW (N = 50), Late RTW (N = 39), Struggling RTW (N = 21) and No RTW (N = 22). RTW trajectories differed consistently with regard to previous sick-leave duration and social support at work. More unique predictors of RTW trajectories included gender, rewards at work, work performance impairment due to health problems, home-to-work interference and stress-related exhaustion disorder. CONCLUSION The study may have important clinical implications for identifying patients belonging to a particular RTW trajectory. Knowledge on the modifiable work environment factors that differentiated between the RTW trajectories could be useful for designing effective workplace interventions, tailored to particular needs of employees with CMDs. However, in a first step, the results need to be replicated.
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Affiliation(s)
- Anna Toropova
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute, 171 77, Stockholm, Sweden.
| | - Elisabeth Björk Brämberg
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute, 171 77, Stockholm, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute, 171 77, Stockholm, Sweden
- Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Vanzetto S, Quarenghi A, Varinelli A, Dragoni C, Conti D, Boscacci M, Carrà G, Percudani M, Morganti C, Gambini O, Barbieri V, Brambilla P, Lazzaretti M, Rubelli P, Mencacci C, Fusi A, Viganò C, Dell'Osso B. Longitudinal outcomes of a work inclusion program in mental health departments in the city of Milan. Int J Soc Psychiatry 2024; 70:507-517. [PMID: 38312065 DOI: 10.1177/00207640231217177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND Work functioning impairment is a key diagnostic and prognostic criterion in patients with psychiatric disorders and work inclusion is a major goal of their therapeutic pathway. Since 2009, the Regional Innovative Program (PIR) TR106, promoted by ASST Fatebenefratelli-Sacco of Milan in collaboration with other Departments of Mental Health and Addictions (DSMDs) in the town of Milan (Italy), has been developing the employment inclusion of psychiatric patients. AIMS The objective of this study is to evaluate its outcomes over 8 years of observation. METHOD We reported the results of a retrospective epidemiologic analysis on 2,142 interventions on 1,066 patients recruited, investigating PIR TR106 outcomes per year focusing on different subgroups. We focused on 'positive', 'negative', and 'other' outcomes. RESULTS We preliminary calculated job maintenance interventions (5%, 107) and excluded these interventions from the overall. We observed 29 job firing (1.4%) and 15 job resignations (0.7%) as negative results (equal to 2.2% of the total) and 388 job hiring (16.6%), 647 traineeships (31.8%), and 413 work formation (20.3%) as positive outcomes (equal to 68.75%). In other outcomes (29.1%) we found 305 dismissals from PIR TR 106 (15%) and transitory outcomes (14.1%).Job hiring increased from 8.9% in 2012 to 23.8 % in 2019 (p < .001), while the dismissals diminished from 26.7% to 13.3% (p < .001). The effectiveness of traineeships in terms of job hiring increased in the ratio of annual job hiring versus job traineeship (+48.8%). The majority of hired patients (15.1%) were affected by a psychotic disorder. A significant hiring increase was observed in patients with psychotic disorders and personality disorders (p < .005). CONCLUSIONS PIR-TR106 represents a territorial employment inclusion program with progressively increasing effectiveness and specificity, as suggested by changes in outcomes during the 8-year observation. The adaptive capacity and sustainability of the intervention are worth further investigation.
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Affiliation(s)
- Simone Vanzetto
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Andrea Quarenghi
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Alberto Varinelli
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Chiara Dragoni
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Dario Conti
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Maria Boscacci
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Giuseppe Carrà
- Department of Mental Health and Addiction Services, ASST Nord Milano, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Mauro Percudani
- Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carla Morganti
- Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Orsola Gambini
- Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy
- CRC 'Aldo Ravelli' for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Lombardy, Italy
- Department of Health Sciences, University of Milan, Italy
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Paola Rubelli
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Claudio Mencacci
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Antonio Fusi
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences, Department of Mental Health and Addictions, ASST Fatebenefratelli Sacco, University of Milan, Italy
- CRC 'Aldo Ravelli' for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Lombardy, Italy
- Department of Psychiatry and Behavioural Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Italy
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Liu S, Zhang L, Deng D, Luo W. Associations between benign paroxysmal positional vertigo and seven mental disorders: a two-sample Mendelian randomization study. Front Neurol 2024; 15:1310026. [PMID: 38654741 PMCID: PMC11035833 DOI: 10.3389/fneur.2024.1310026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background The association between benign paroxysmal positional vertigo (BPPV) and various mental disorders is still controversial. This study used the Mendelian randomization (MR) method to clarify the correlation between BPPV and seven mental disorders (bipolar disorder, depression, anxiety disorder, schizophrenia, suicidality, neuroticism, and mood swings) to aid in the exploration of BPPV complications and prevention and early treatment of mental disorders. Methods The datasets for BPPV and seven mental disorders were obtained from genome-wide association studies (GWASs). Two-sample MR was used to analyze the correlation between exposure (BPPV) and various outcomes (bipolar disorder, depression, anxiety disorder, schizophrenia, suicidality, neuroticism, and mood swings). A reverse MR study was also performed. The inverse variance weighting (IVW) method, the MR-Egger method, the simple mode method, the weighted mode method, and the weighted median method were selected. Results The MR analysis and the reverse MR analysis results did not reveal significant associations between BPPV and bipolar disorder, depression, anxiety disorder, schizophrenia, suicidal tendencies, neuroticism, and mood swings. Interestingly, neuroticism (IVW: OR = 1.142, 95% CI: 1.059-1.231, P = 0.001; P-MR-PRESSO adjustment = 0.0002) and mood swings (IVW: OR = 3.119, 95% CI: 1.652-5.884, P = 0.0004) may have a significant association with BPPV. After MR-PRESSO adjustment, there was no horizontal pleiotropy or heterogeneity, and a significant association between neuroticism, mood swings, and BPPV has still been suggested. Conclusion We conducted MR analysis on genetic data from European populations and discovered a causal relationship between BPPV and the seven mental disorders. Our research findings suggest that BPPV may not have a significant causal relationship with bipolar disorder, depression, anxiety disorder, schizophrenia, or suicidal tendencies. However, neuroticism and mood swings may be risk factors for BPPV.
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Affiliation(s)
- Shihan Liu
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingli Zhang
- Department of Otorhinolaryngology, Central Hospital Affiliated to Chongqing University of Technology, Chongqing, China
| | - Dan Deng
- Department of Eye and ENT, Chongqing Maternal and Child Health Care Hospital, Chongqing, China
| | - Wenlong Luo
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Holmgren R, Grotta A, Farrants K, Magnusson Hanson LL. Bidirectional associations between workplace bullying and sickness absence due to common mental disorders - a propensity-score matched cohort study. BMC Public Health 2024; 24:744. [PMID: 38459468 PMCID: PMC10921817 DOI: 10.1186/s12889-024-18214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The link between workplace bullying and poor mental health is well-known. However, little is known about the prospective and potentially reciprocal association between workplace bullying and mental health-related sickness absence. This 2-year prospective study examined bidirectional associations between exposure to workplace bullying and sickness absence due to common mental disorders (SA-CMD) while controlling for confounding factors from both work and private life. METHODS The study was based on propensity score-matched samples (N = 3216 and N = 552) from the Swedish Longitudinal Occupational Survey of Health, using surveys from years 2012, 2014 and 2016. Self-reported exposure to workplace bullying was linked to registry-based information regarding medically certified SA-CMD (≥ 14 consecutive days). The associations were examined by means of Cox proportional hazards regression and via conditional logistic regression analysis. Hazard ratios and odds ratios with 95% confidence intervals were estimated. RESULTS Exposure to workplace bullying was associated with an increased risk of incident SA-CMD (HR: 1.3, 95% CI: 1.0-1.8), after accounting for the influence of job demands, decision authority, previous SA-CMD, as well as other sociodemographic covariates. However, we found no statistically significant association between SA-CMD and subsequent workplace bullying (OR 1.2, 95% CI 0.7-1.9). CONCLUSIONS The results support an association between self-reported workplace bullying and SA-CMD, independent of other sociodemographic factors and workplace stressors. Preventing workplace bullying could alleviate a share of the individual and societal burden caused by SA globally.
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Affiliation(s)
- Rebecka Holmgren
- Stress Research Institute, Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Sweden & Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linda L Magnusson Hanson
- Stress Research Institute, Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden
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de Oliveira C, Matias MA, Jacobs R. Microsimulation Models on Mental Health: A Critical Review of the Literature. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:226-246. [PMID: 37949353 DOI: 10.1016/j.jval.2023.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/20/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To retrieve and synthesize the literature on existing mental health-specific microsimulation models or generic microsimulation models used to examine mental health, and to critically appraise them. METHODS All studies on microsimulation and mental health published in English in MEDLINE, Embase, PsycINFO, and EconLit between January 1, 2010, and September 30, 2022, were considered. Snowballing, Google searches, and searches on specific journal websites were also undertaken. Data extraction was done on all studies retrieved and the reporting quality of each model was assessed using the Quality Assessment Reporting for Microsimulation Models checklist, a checklist developed by the research team. A narrative synthesis approach was used to synthesize the evidence. RESULTS Among 227 potential hits, 19 studies were found to be relevant. Some studies covered existing economic-demographic models, which included a component on mental health and were used to answer mental-health-related research questions. Other studies were focused solely on mental health and included models that were developed to examine the impact of specific policies or interventions on specific mental disorders or both. Most models examined were of medium quality. The main limitations included the use of model inputs based on self-reported and/or cross-sectional data, small and/or nonrepresentative samples and simplifying assumptions, and lack of model validation. CONCLUSIONS This review found few high-quality microsimulation models on mental health. Microsimulation models developed specifically to examine mental health are important to guide healthcare delivery and service planning. Future research should focus on developing high-quality mental health-specific microsimulation models with wide applicability and multiple functionalities.
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Affiliation(s)
- Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Maria Ana Matias
- Centre for Health Economics, University of York, York, England, UK
| | - Rowena Jacobs
- Centre for Health Economics, University of York, York, England, UK
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Sivertsen B, O'Connor RC, Nilsen SA, Heradstveit O, Askeland KG, Bøe T, Hysing M. Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies. Eur Child Adolesc Psychiatry 2024; 33:421-429. [PMID: 36843045 PMCID: PMC10869414 DOI: 10.1007/s00787-023-02167-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 02/13/2023] [Indexed: 02/28/2023]
Abstract
It is well established that mental health problems are highly recurrent and persistent from childhood to adolescence, but less is known to what extent mental health problems also persist from adolescence into young adulthood. The aim of the current study was therefore to examine the chronicity and risk of mental health problems and suicidality from adolescence to young adulthood. Data stem from two Norwegian population-based studies conducted 6 years apart; the youth@hordaland study from 2012 (age 16-19) and the SHoT2018 study (age 22-25). These two data sources were linked to produce a longitudinal sample of 1257 individuals. A wide range of self-reported mental health and suicidality instruments (used both continuously and categorically) were analyzed using log-link binomial regression analysis, adjusting for age, sex, parental education, and financial problems. We found that high levels of mental health problems in late adolescence were a significant risk factor for reporting poor mental health 6 years later. Internalizing and externalizing problems in adolescence were associated with a 2.8-fold and 1.9-fold increased risk, respectively, of reporting a mental disorder 6 years later. Similarly, self-harm in adolescence was associated with a 2.1-fold increased risk of suicidal thoughts 6 years later. The magnitudes of the adjusted risk ratios were generally similar across the various mental health and suicidality measures used at the two assessment points. Adjustment for confounders did not, or only slightly, attenuate the risk ratios, and all associations remained statistically significant in the adjusted analyses. This longitudinal study provides new evidence of the chronicity of mental health problems and suicidality from adolescence to adulthood in Norway. The results emphasize the importance of early identification and timely interventions to reduce the prevalence and impact of mental health problems and suicidality.
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Affiliation(s)
- Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
- Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway.
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Kristin Gärtner Askeland
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Rose U, Kersten N, Pattloch D, Conway PM, Burr H. Associations between depressive symptoms and 5-year subsequent work nonparticipation due to long-term sickness absence, unemployment and early retirement in a cohort of 2,413 employees in Germany. BMC Public Health 2023; 23:2159. [PMID: 37924018 PMCID: PMC10625302 DOI: 10.1186/s12889-023-17090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/28/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND We examined the association of depressive symptoms with subsequent events - and duration thereof - of work nonparticipation (long-term sickness absence, unemployment and early retirement). METHODS We employed a 5-year cohort from the Study on Mental Health at Work (S-MGA), based on a random sample of employees subject to social contributions aged 31-60 years in 2012 (N = 2413). Depressive symptoms were assessed at baseline through questionnaires, while work nonparticipation was recorded in follow-up interviews. Associations of depressive symptoms with subsequent events of work nonparticipation were examined in two-part models, with events analysed by logistic regressions and their duration by generalized linear models. RESULTS Medium to severe depressive symptoms were associated with events of work nonparticipation (males Odds Ratio [OR] = 3.22; 95% CI = 1.90-5.45; females OR = 1.92; 95% CI = 1.29-2.87), especially with events of long-term sickness absence in both genders and events of unemployment in males. Mild depressive symptoms were also associated with events of work nonparticipation (males OR = 1.59; 95% CI = 1.19-2.11; females OR = 1.42; 95% CI = 1.10-1.84). Among those experiencing one or more events, the duration of total work nonparticipation was twice as high among males [Exp(β) = 2.06; 95% CI = 1.53-2.78] and about one third higher [Exp(β) = 1.38; 95% CI = 1.05-1.83] among females with medium to severe depressive symptoms. CONCLUSIONS The present study focuses on both events and duration of work nonparticipation, which are both critical for examining societal consequences of depressive symptoms. It is key to regard also mild depressive symptoms as a possible risk factor and to include different types of work nonparticipation.
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Affiliation(s)
- Uwe Rose
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40/42, D-10317, Berlin, Germany.
| | - Norbert Kersten
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40/42, D-10317, Berlin, Germany
| | - Dagmar Pattloch
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40/42, D-10317, Berlin, Germany
| | - Paul Maurice Conway
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, København, 1353, Denmark
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40/42, D-10317, Berlin, Germany
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Chu V, Newman DG. Exercise Effect on Mental Health in Isolating or Quarantining Adults. Aerosp Med Hum Perform 2023; 94:686-695. [PMID: 37587629 DOI: 10.3357/amhp.6073.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
INTRODUCTION: In response to coronavirus disease 2019 (COVID-19), travelers are typically subject to quarantine, which is often associated with poorer mental health (MH). While the protective benefits of community-based exercise are widely recognized, the degree to which this extends to the confined setting is unknown. This systematic review aims to evaluate the effect of exercise on MH in isolating or quarantining adults.METHODS: A literature search of Ovid MEDLINE, APA PsycInfo, and the Cochrane Database of Systematic Reviews limited to January 2019-September 2021 inclusive yielded five eligible studies.RESULTS: Data comprised a total of 2755 college and university students, most of whom were confined. Depending on the scale used, 24.9-76.7% of respondents demonstrated impaired MH, which improved with physical activity (PA), especially when regular and moderate or vigorous. The frequency, duration, and participants of exercise increased as lockdown progressed. One study showed that while sleep, diet, and PA all have an impact on MH, PA was the factor most strongly correlated with MH.DISCUSSION: Physical fitness should be optimized before and maintained during quarantine while exercise space and equipment should be accessible. Importantly, the sustainability of persistent quarantine must be considered given the pervasiveness of COVID-19.Chu V, Newman DG. Exercise effect on mental health in isolating or quarantining adults. Aerosp Med Hum Perform. 2023; 94(9):686-695.
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Reutimann S, Hübscher N, Steiner J, Voderholzer U, Augsburger M. Assessing validity of the Klenico diagnostic software system in a large psychotherapeutic inpatient sample. Front Digit Health 2023; 5:1176130. [PMID: 37720163 PMCID: PMC10502166 DOI: 10.3389/fdgth.2023.1176130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Mental disorders are often underdiagnosed in routine diagnostic procedures due to the use of unstandardized assessments; this can result in people either not receiving necessary treatment or receiving ineffective treatment for their condition. Klenico is an online diagnostic software system that facilitates diagnosis of mental disorders in adults through the use of standardized procedures. The procedure encompasses two modules, self-report and clinical validation. The current study aimed to confirm the validity of the Klenico assessment in a large clinical sample. Methods Fully anonymized data from 495 adult inpatients were used. ICD-10 diagnoses were made during an initial interview by the clinical staff. Afterwards, patients filled out self-report questionnaires (BDI-II, BSI, EDE-Q, OCI-R, PHQ-D, and Y-BOCS) and completed the Klenico self-report module, which involves selecting and rating the severity of applicable symptoms. Finally, in the clinical validation module, mental health professionals validated the symptoms endorsed in the self-report module. Six Klenico domains were tested against patient self-reports and routine ICD-10 diagnoses by following the multitrait-multimethod approach. Internal consistency was assessed by calculating Cronbach's alpha. Results The Klenico depressive disorders, OCD, and somatoform disorders domains revealed high correlations with the congruent questionnaires (i.e., those pertaining to these specific disorders) and revealed low correlations with the noncongruent questionnaires (i.e., those pertaining to other disorders), therefore evidencing construct validity. For the eating disorders and psychotic disorders domains, divergent validity was demonstrated. For the anxiety disorders domain, although analysis mostly indicated construct validity, this should be further confirmed. Discussion Overall, the results largely confirmed the construct validity of the Klenico assessment, demonstrating its use as an easy-to-use, valid, standardized, and comprehensive instrument for diagnosing mental disorders.
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Affiliation(s)
- Stefan Reutimann
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
| | - Noah Hübscher
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Jasmin Steiner
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
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Robinson T, Condell J, Ramsey E, Leavey G. Self-Management of Subclinical Common Mental Health Disorders (Anxiety, Depression and Sleep Disorders) Using Wearable Devices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032636. [PMID: 36768002 PMCID: PMC9916237 DOI: 10.3390/ijerph20032636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 05/05/2023]
Abstract
RATIONALE Common mental health disorders (CMD) (anxiety, depression, and sleep disorders) are among the leading causes of disease burden globally. The economic burden associated with such disorders is estimated at $2.4 trillion as of 2010 and is expected to reach $16 trillion by 2030. The UK has observed a 21-fold increase in the economic burden associated with CMD over the past decade. The recent COVID-19 pandemic was a catalyst for adopting technologies for mental health support and services, thereby increasing the reception of personal health data and wearables. Wearables hold considerable promise to empower users concerning the management of subclinical common mental health disorders. However, there are significant challenges to adopting wearables as a tool for the self-management of the symptoms of common mental health disorders. AIMS This review aims to evaluate the potential utility of wearables for the self-management of sub-clinical anxiety and depressive mental health disorders. Furthermore, we seek to understand the potential of wearables to reduce the burden on the healthcare system. METHODOLOGY a systematic review of research papers was conducted, focusing on wearable devices for the self-management of CMD released between 2018-2022, focusing primarily on mental health management using technology. RESULTS We screened 445 papers and analysed the reports from 12 wearable devices concerning their device type, year, biometrics used, and machine learning algorithm deployed. Electrodermal activity (EDA/GSR/SC/Skin Temperature), physical activity, and heart rate (HR) are the most common biometrics with nine, six and six reference counts, respectively. Additionally, while smartwatches have greater penetration and integration within the marketplace, fitness trackers have the most significant public value benefit of £513.9 M, likely due to greater retention.
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Affiliation(s)
- Tony Robinson
- School of Computing, Engineering, and Intelligent Systems, Ulster University, Magee Campus, Derry/Londonderry BT48 7JL, UK
- Correspondence:
| | - Joan Condell
- School of Computing, Engineering, and Intelligent Systems, Ulster University, Magee Campus, Derry/Londonderry BT48 7JL, UK
| | - Elaine Ramsey
- Department of Global Business and Enterprise, Ulster University, Magee Campus, Derry/Londonderry BT48 7JL, UK
| | - Gerard Leavey
- The Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Coleraine Campus, Cromore Rd., Coleraine BT52 1SA, UK
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11
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Gu Y, Guo H, Zhou J, Wang X. Socio-demographic, clinical and offense-related characteristics of forensic psychiatric inpatients in Hunan, China: a cross-sectional survey. BMC Psychiatry 2023; 23:48. [PMID: 36653792 PMCID: PMC9847096 DOI: 10.1186/s12888-022-04508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is still a lack of comprehensive research on the profile of patients in forensic mental health hospitals in China. This study aims to investigate the socio-demographic, clinical, and offense-related characteristics of mentally ill offenders in the Hunan Provincial Forensic Psychiatric Hospital in China. METHODS This study was conducted from November 1, 2018, to January 30, 2019. The data of socio-demographic, clinical, and offense-related characteristics of the patients were collected. The Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS), and the Clinical Global Impression-Severity (CGI-S) scale were used to measure their psychiatric conditions. RESULTS A total of 461 participants were enrolled in this study. Among them, 86.3% were males and 56.8% were unmarried; the average age of them was 44.7 ± 10.1 years, and the mean years of education were 7.51 ± 3.3 years. Before their current offense, a total of 345 patients (74.8%) had sought medical help for their mental illnesses. While 303 (87.8%) of these patients were prescribed antipsychotics, 254 (73.6%) failed to take them regularly. Of all the inpatients, 90.5% were diagnosed with schizophrenia; 385 (83.5%) engaged in homicidal offenses, with 54.0% of the victims being their family members. In homicide cases, the relatives were more likely to be victims of female patients. The mean length of stay in the forensic hospital was 8.02 ± 4.74 years, and over 80.0% of the patients had been hospitalized for over 5 years. CONCLUSIONS To our knowledge, this is the first study investigating the profile of forensic patients receiving compulsory treatments in a forensic psychiatric hospital in China. These results add to the world literature on the characteristics of forensic patients and can help identify common treatment and risk-related needs of this population.
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Affiliation(s)
- Yu Gu
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - Huijuan Guo
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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12
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He Y, Jorgensen A, Sun Q, Corcoran A, Alfaro-Simmonds MJ. Negotiating Complexity: Challenges to Implementing Community-Led Nature-Based Solutions in England Pre- and Post-COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14906. [PMID: 36429624 PMCID: PMC9691162 DOI: 10.3390/ijerph192214906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS. We carried out a traditional literature review to establish the context and knowledge base for this study and interviewed 26 stakeholders. These came from environment, health and social care sectors at national and local levels, with local-level stakeholders from Bradford and Walsall: English cities significantly affected by the pandemic, with high levels of deprivation and health inequality. The interviews explored experiences of implementing NbS, both pre- and post-pandemic and the resulting renewed interest in the salutogenic effects of engaging with natural environments. We coded the interview transcriptions using NVivo to identify the challenges existing in the systems within which these stakeholders operate to create and manage NbS. By synthesizing what is known about the challenges from existing literature with findings from the interviews, we developed eight categories of challenges (perception and knowledge, political, financial, access to natural spaces, engagement, institutional and organisational, coordination, GSP referral and services) faced by multiple sectors in implementing community-led NbS in England. Furthermore, this study highlights the new challenges related to the pandemic. Identifying these challenges helps stakeholders in existing complex systems recognise what is needed to support and mainstream NbS in England.
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Affiliation(s)
- Yichao He
- Department of Landscape Architecture, University of Sheffield, The Arts Tower, Sheffield S10 2TN, UK
| | - Anna Jorgensen
- Department of Landscape Architecture, University of Sheffield, The Arts Tower, Sheffield S10 2TN, UK
| | - Qian Sun
- School of Design, Royal College of Art, Kensington Gore, London SW7 2EU, UK
| | - Amy Corcoran
- School of Design, Royal College of Art, Kensington Gore, London SW7 2EU, UK
| | - Maria Jesus Alfaro-Simmonds
- Just Futures Centre for Child, Youth, Family and Community Research, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
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Ceccarelli C, Prina E, Muneghina O, Jordans M, Barker E, Miller K, Singh R, Acarturk C, Sorsdhal K, Cuijpers P, Lund C, Barbui C, Purgato M. Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders. Epidemiol Psychiatr Sci 2022; 31:e75. [PMID: 36245402 PMCID: PMC9583628 DOI: 10.1017/s2045796022000580] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/09/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022] Open
Abstract
Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low- and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs).In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.
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Affiliation(s)
- C. Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - E. Prina
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - O. Muneghina
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | - M. Jordans
- War Child, Amsterdam, the Netherlands
- University of Amsterdam, Amsterdam, the Netherlands
| | - E. Barker
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - K. Miller
- Faculty of Education, University of British Columbia, Vancouver, Canada
| | - R. Singh
- Research Department, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
| | - C. Acarturk
- Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Turkey
| | - K. Sorsdhal
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - P. Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
- Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - C. Lund
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
- Health Service and Population Research Department, King's Global Health Institute, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - C. Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - M. Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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14
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Yang Y, Xia Y, Su C, Chen J, Long E, Zhang H, Gan Y, Yan F, Chen Y. Measuring the indirect cost associated with advanced non-small cell lung cancer: a nationwide cross-sectional study in China. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04258-w. [PMID: 36056953 DOI: 10.1007/s00432-022-04258-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/02/2022] [Indexed: 12/09/2022]
Abstract
PURPOSE This study was conducted to estimate the indirect cost of locally advanced and metastatic non-small cell lung cancer (NSCLC) without sensitizing EGFR and ALK alterations in China and explore the predictors from both patient and caregiver perspectives. METHODS Data were obtained from a nationwide cross-sectional study for the patients with advanced NSCLC (stage IIIB-IV) and their caregivers. Indirect medical cost was estimated as health productivity loss based on self-reported income and loss of work time. The generalized linear model was used to assess the independent associations between statistically significant variables and indirect economic burden. RESULTS 611 pairs of patients and patient caregivers from 13 medical centers in five provinces in China participated in this investigation. The indirect medical cost associated with advanced NSCLC since the patient diagnosed was $1413 per capita in China. General linear regression results showed that the indirect medical cost was significantly influenced by duration of disease since diagnosis, treatment options, caregivers' occupation and age (P < 0.05). CONCLUSION The indirect economic burden linked to advanced NSCLC in China is considerable on patients, and their caregivers. To minimize the severe challenges of indirect economic burden related to advanced NSCLC, expanding the coverage of the medical insurance and assistance system to reimburse part of the indirect costs related to cancer, as well as strengthening the accessibility for more effective therapies to improve the prognosis of advanced NSCLC, and further promote the patients and their caregivers to return to work or normal life may be the potentially feasible approaches.
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Affiliation(s)
- Yi Yang
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yu Xia
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chunxia Su
- Department of Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Jia Chen
- Department of Medical Oncology, The Affiliated Tumor Hospital of Nantong University & Nantong Tumor Hospital, Nantong, China
| | - Enwu Long
- Department of Pharmacy, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Sichuan, China
| | - Haibo Zhang
- Department of Organization and Personnel, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuying Gan
- Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Fei Yan
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yingyao Chen
- School of Public Health, Fudan University, Shanghai, China. .,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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15
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Schofield D, Zeppel MJB, Tanton R, Veerman JL, Kelly SJ, Passey ME, Shrestha RN. Individual and national financial impacts of informal caring for people with mental illness in Australia, projected to 2030. BJPsych Open 2022; 8:e136. [PMID: 35848155 PMCID: PMC9345331 DOI: 10.1192/bjo.2022.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental illness has a significant impact not only on patients, but also on their carers' capacity to work. AIMS To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. METHOD The output data of a microsimulation model Care&WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care&WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. RESULTS The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. CONCLUSIONS The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.
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Affiliation(s)
- Deborah Schofield
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Melanie J B Zeppel
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Robert Tanton
- National Centre for Social and Economic Modelling, University of Canberra, Australian Capital Territory, Australia
| | | | - Simon J Kelly
- National Centre for Social and Economic Modelling, University of Canberra, Australian Capital Territory, Australia
| | - Megan E Passey
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Rupendra N Shrestha
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
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Chartier MJ, Bolton JM, Ekuma O, Mota N, Hensel JM, Nie Y, McDougall C. Suicidal Risk and Adverse Social Outcomes in Adulthood Associated with Child and Adolescent Mental Disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:512-523. [PMID: 34796744 PMCID: PMC9234896 DOI: 10.1177/07067437211055417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The life course of children and adolescents with mental disorders is an important area of investigation, yet it remains understudied. This study provides a first-ever comprehensive examination of the relationship between child and adolescent mental disorders and subsequent suicidal and adverse social outcomes in early adulthood using population-based data. METHODS De-identified administrative databases were used to create a birth cohort of 60,838 residents of Manitoba born between April 1980 to March 1985 who were followed until March 2015. Unadjusted and adjusted hazard ratios (aHRs) and odds ratios (aORs) were calculated to determine associations between physician-diagnosed mental disorders in childhood or adolescence and a range of adverse early adulthood (ages 18 to 35) outcomes. RESULTS Diagnoses of mood/anxiety disorders, attention-deficit hyperactivity disorder, substance use disorder, conduct disorder, psychotic disorder, personality disorders in childhood or adolescence were associated with having the same diagnoses in adulthood. These mental disorder diagnoses in childhood/adolescence were strongly associated with an increased risk of suicidal behaviors and adverse adult social outcomes in adulthood. Similarly, suicide attempts in adolescence conferred an increased risk in adulthood of suicide death (aHR: 3.6; 95% confidence interval [CI]: 1.9-6.9), suicide attempts (aHR: 6.2; CI: 5.0-7.6), social housing use (aHR: 1.7; CI 1.4-2.1), income assistance (aHR: 1.8; CI 1.6-2.1), criminal accusation (aHR: 2.2; CI 2.0-2.5), criminal victimization (aHR:2.5; CI 2.2-2.7), and not completing high school (aOR: 3.1; CI: 2.5-3.9). CONCLUSION Mental disorders diagnosed in childhood and adolescence are important risk factors not only for mental disorders in adulthood but also for a range of early adult adversity. These findings provide an evidence-based prognosis of children's long-term well-being and a rationale for ensuring timely access to mental health services. Better population-level mental health promotion and early intervention for children and adolescents with mental disorders are promising for improving future adult outcomes.
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Affiliation(s)
- Mariette J. Chartier
- Department of Community Health
Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Mariette J. Chartier PhD, Manitoba Centre
for Health Policy, University of Manitoba, 408-727 McDermot Avenue, Winnipeg,
Manitoba, R3E 3P5, Canada.
| | - James M. Bolton
- Department of Psychiatry and Community Health Sciences, Rady Faculty
of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Okechukwu Ekuma
- Department of Community Health Sciences, Rady Faculty of Health
Sciences, University of Manitoba, Winnipeg, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
| | - Jennifer M. Hensel
- Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Yao Nie
- Department of Community Health Sciences, Rady Faculty of Health
Sciences, University of Manitoba, Winnipeg, Canada
| | - Chelsey McDougall
- Department of Community Health Sciences, Rady Faculty of Health
Sciences, University of Manitoba, Winnipeg, Canada
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17
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Zainal NH, Newman MG. Curiosity helps: Growth in need for cognition bidirectionally predicts future reduction in anxiety and depression symptoms across 10 years. J Affect Disord 2022; 296:642-652. [PMID: 34627855 PMCID: PMC8759714 DOI: 10.1016/j.jad.2021.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Decreased motivational tendency to seek out, engage in, and enjoy investing in complex cognitive processes in a sustained manner (need for cognition; NFC) may be a predictor and consequence of heightened anxiety and depression symptoms (ADS). However, the majority of investigations on this topic have been cross-sectional, which hinders causal inferences. METHODS The current study thus determined the within-person relations between NFC and ADS by using random intercept cross-lagged panel model (RI-CLPM) and bivariate dual latent change score (BLCS) approaches to separate between- and within-person effects. RI-CLPM and BLCS also present with advantages of adjusting for regression to the mean, baseline scores, autoregressive and lagged effects, and minimizing measurement error. Community-dwelling adults (n = 6750) completed the Mental Health Inventory-5 and trait-level NFC scales approximately every one year across 10 years. RESULTS RI-CLPM showed that within persons, lower level of NFC predicted higher future level of ADS, and vice versa (d = -0.852 to -0.498). Likewise, BLCS demonstrated that within persons, smaller change in NFC forecasted larger subsequent increase in ADS, and conversely (d = -0.631 to -0.519). Findings remained after adjusting for socio-demographic covariates. CONCLUSION Consistent with theories, findings suggested that the within-person level-to-future level and change-to-future change relations among NFC and ADS were bi-directional and negative, with moderate-to-large effect sizes. Targeting NFC may treat or prevent the emergence of depression and anxiety disorders. Such efforts may include augmenting or personalizing evidence-based cognitive-behavioral therapeutic strategies for individuals with or at-risk for heightened ADS.
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Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School - Massachusetts General Hospital, The Pennsylvania State University, National University of Singapore.
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França MH, Pereira FG, Wang YP, Andrade LH, Alonso J, Viana MC. Individual and population level estimates of work loss and related economic costs due to mental and substance use disorders in Metropolitan São Paulo, Brazil. J Affect Disord 2022; 296:198-207. [PMID: 34610514 DOI: 10.1016/j.jad.2021.09.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/04/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND We estimate work loss and economic costs due to mental and substance use disorders in the economically active population of the São Paulo Metropolitan Area, Brazil. METHODS The São Paulo Megacity Mental Health Survey assessed a population-based sample of 3,007 economically active residents using the Composite International Diagnostic Interview 3.0 and the World Health Organization Disability Assessment Schedule 2 to investigate, respectively, 12-month psychiatric disorders, work performance, and economic costs. RESULTS Absenteeism over the past 12 months was reported by 12.6%, and presenteeism by 14.7% (qualitative loss) and 13.1% (quantitative loss). Having any mental disorder was associated with 17.6 days of absenteeism and 37.7 days of reduced-qualitative and/or quantitative functioning. Fourteen mental disorders were significantly associated with work loss, with odds ratios ranging from 2.3 for adult separation anxiety to 40.4 for oppositional defiant disorder. At a population-level, oppositional defiant disorder, panic disorder, attention deficit disorder, and dysthymia contributed to the largest costs. The total annual economic costs were USD $83.2 billion/year, representing 6.1% of Brazil's Gross Domestic Product in 2007. LIMITATIONS Diagnosis of mental disorders was based on self-reported symptoms. Work loss assessment was restricted to 30 days before the interview and may not fully represents the annual real experience and symptoms of the respondents which would lead to an overestimation of the burden. CONCLUSIONS Mental disorders impose a great negative impact on work performance and functioning, with a consequent high economic burden, pointing to the need of implementing cost-effective interventions to prevent work loss.
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Affiliation(s)
| | - Flavia Garcia Pereira
- Post graduate Program in Public Health, Federal University of Espirito Santo, Brazil
| | - Yuan-Pang Wang
- Instituto and Departamento de Psiquiatria (LIM-23), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo SP, Brazil
| | - Laura Helena Andrade
- Section of Psychiatric Epidemiology - LIM 23, Department and Institute of Psychiatry, University of São Paulo, Medical School, São Paulo, SP- Brazil
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Carmen Viana
- Department of Social Medicine, Federal University of Espirito Santo, Brazil. Av. Marechal Campos 1468; Vitória/ES - Brazil; Post graduate Program in Public Health, Federal University of Espirito Santo, Brazil
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Bang Madsen K, Vogdrup Petersen L, Plana-Ripoll O, Musliner KL, Philippe Debost JC, Hordam Gronemann F, Mortensen PB, Munk-Olsen T. Early labor force exits in patients with treatment-resistant depression: an assessment of work years lost in a Danish nationwide register-based cohort study. Ther Adv Psychopharmacol 2020; 10:2045125320973791. [PMID: 33282176 PMCID: PMC7682207 DOI: 10.1177/2045125320973791] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/20/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Depression is one of the leading causes of premature workforce exit in many Western countries, but little is known about the extent to which treatment-resistance reduces number of work-years. We compared the risk of premature workforce exit among patients with treatment-resistant depression (TRD) relative to non-TRD patients and estimated work years lost (WYL) before scheduled retirement age. METHODS The study population, identified in the Danish National Prescription Registry, included all individuals born and living in Denmark who redeemed their first antidepressant (AD) prescription for depression at age 18-60 years between 2005 and 2012. TRD was defined as failure to respond to at least two different treatment trials. Premature workforce exit was measured using disability pension records. We used Cox regression to estimate the hazard ratio (HR) for premature workforce exit in TRD relative to non-TRD patients, adjusting for calendar year, psychiatric and somatic comorbidity, and educational level. Differences in WYL in patients with TRD and all depression patients were estimated through a competing risks model. RESULTS Out of the total sample of patients with depression (N = 129,945), 7478 (5.75%) were classified as having TRD. During follow up, 17% of patients with TRD and 8% of non-TRD patients received disability pension, resulting in a greater than three-fold larger risk of premature workforce exit [adjusted HR (aHR) 3.23 95% confidence interval (CI) 3.05-3.43]. The TRD group lost on average six work-years (95% CI 5.64-6.47) more than the total sample due to early labor force exit. The association between TRD and age at premature workforce exit was inversely U-shaped; the hazard rate of premature workforce exit for patients with TRD compared with non-TRD patients was highest in the age groups 31-35, 36-40, and 41-45 years. CONCLUSION Patients with TRD constitute a small group within depression patients, but contribute disproportionally to societal costs due to premature workforce exit at a young age.
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Affiliation(s)
- Kathrine Bang Madsen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Fuglesangs Allé 26, Building R, Aarhus V, 8210, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Katherine L. Musliner
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Jean-Christophe Philippe Debost
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Psychosis, Aarhus University Hospital Skejby, Denmark
| | | | - Preben Bo Mortensen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- CIRRAU - Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
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Christensen MK, Lim CCW, Saha S, Plana-Ripoll O, Cannon D, Presley F, Weye N, Momen NC, Whiteford HA, Iburg KM, McGrath JJ. The cost of mental disorders: a systematic review. Epidemiol Psychiatr Sci 2020; 29:e161. [PMID: 32807256 PMCID: PMC7443800 DOI: 10.1017/s204579602000075x] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 01/05/2023] Open
Abstract
AIMS To identify and synthesise the literature on the cost of mental disorders. METHODS Systematic literature searches were conducted in the databases PubMed, EMBASE, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to January 1980-May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses; (2) diagnosis of at least one mental disorder; (3) study population based on the general population; (4) outcome in monetary units. The systematic review was preregistered on PROSPERO (ID: CRD42019127783). RESULTS In total, 13 579 potential titles and abstracts were screened and 439 full-text articles were evaluated by two independent reviewers. Of these, 112 articles were included from the systematic searches and 31 additional articles from snowball searching, resulting in 143 included articles. Data were available from 48 countries and categorised according to nine mental disorder groups. The quality of the studies varied widely and there was a lack of studies from low- and middle-income countries and for certain types of mental disorders (e.g. intellectual disabilities and eating disorders). Our study showed that certain groups of mental disorders are more costly than others and that these rankings are relatively stable between countries. An interactive data visualisation site can be found here: https://nbepi.com/econ. CONCLUSIONS This is the first study to provide a comprehensive overview of the cost of mental disorders worldwide.
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Affiliation(s)
- M. K. Christensen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - C. C. W. Lim
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - S. Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - O. Plana-Ripoll
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - D. Cannon
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - F. Presley
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - N. Weye
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - N. C. Momen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - H. A. Whiteford
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
- School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - K. M. Iburg
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - J. J. McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
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Mousavi SAM, Hooshyari Z, Ahmadi A. The Most Stressful Events during the COVID-19 Epidemic. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:220-227. [PMID: 33193770 PMCID: PMC7603585 DOI: 10.18502/ijps.v15i3.3814] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 12/14/2022]
Abstract
Objective: Stressful events increase in traumatic conditions. Coronavirus is a new and serious challenge and significant public health problem, which can cause different stressors. This study has identified stressful events experienced by Iranian adults during the COVID-19 epidemic. Method: Data on stressful events during the COVID-19 epidemic were collected online from 418 adults (mean age 37.16 years; 57.4% female and 42.6% male) using quota sampling method. Epidemic Stressful Events Checklist was applied for data collection. Data were analyzed by applying descriptive graphs and tables, the independent sample t-test, the Fisher's F test, and post hoc Bonferroni test. Results: The most frequent stressful event was rise in essential goods prices (84.7%); however, its perceived stress was not at the highest level. The highest severity of perceived stress was related to the death of a family member (4.83) due to COVID-19 infection, which was an event with the least occurrence, and the lowest severity of perceived stress was related to medical team performance (2.50). The results showed the severity of perceived stress is higher in women than men (t = 3.42; P value < 0.01) and also in the laboring occupations compared to other occupations (F = 3.18; P value < 0.05). Conclusion: Traumatic events can lead to more serious concerns, eg., worrying about those we love, concerns about the future of our life, and about what politicians and macro planners will do to protect our lives. Moreover, traumatic events can cause concerns about food, basic needs, and lack of resources to survive.
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Affiliation(s)
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Measurement and Assessment Department, School of Psychology and Education, Allameh Tabataba’i University, Tehran, Iran
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Forchuk C, Martin ML, Sherman D, Corring D, Srivastava R, O'Regan T, Gyamfi S, Harerimana B. Healthcare professionals' perceptions of the implementation of the transitional discharge model for community integration of psychiatric clients. Int J Ment Health Nurs 2020; 29:498-507. [PMID: 31863520 DOI: 10.1111/inm.12687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 12/17/2022]
Abstract
Research has demonstrated the benefits of mental healthcare interventions that ensure a safe transition of clients throughout the discharge and community integration process. This paper reports on qualitative data from focus groups with health professionals collected as part of a larger a mixed method study designed to examine the effectiveness and sustainability of implementing the transitional discharge model. Data collection involved two sets of focus groups, which were held at six months and one-year post-implementation. There were 216 health professional participants from nine (9) hospitals across the Province of Ontario, Canada. Data analysis used a four-step ethnographic framework by Leininger (1985) to identify descriptors and recurrent and major themes. The study identified four major themes, including healthcare professionals' roles and positive experiences in implementing the transitional discharge model; perceived benefits of the model; challenges to implementing the model; and suggestions for sustaining the model's implementation. Healthcare professionals felt that the implementation of the transitional discharge model has the potential for increasing their awareness of the process of clients' integration, serving as a framework for discharge planning, and reducing hospital readmissions. The study findings may provide healthcare providers with information on pragmatic ways to plan clients' discharge, to bridge the gap between hospital and community care, and to positively impact client health outcomes.
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Affiliation(s)
- Cheryl Forchuk
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Mary-Lou Martin
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Deborah Corring
- Division of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rani Srivastava
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tony O'Regan
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Sebastian Gyamfi
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Boniface Harerimana
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
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23
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Doran CM, Kinchin I. Economic and epidemiological impact of youth suicide in countries with the highest human development index. PLoS One 2020; 15:e0232940. [PMID: 32428034 PMCID: PMC7236997 DOI: 10.1371/journal.pone.0232940] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/25/2020] [Indexed: 11/22/2022] Open
Abstract
This research estimates the economic and epidemiological impact of youth suicide in countries with the highest human development index. The study relied on secondary analysis of suicide mortality data for youth aged between 15-24 years in countries with the highest human development index-Norway, Australia, Switzerland, Germany, Denmark, Singapore, Netherlands, Ireland, Canada and the United States. The impact of youth suicide is measured using years of life lost, years of productive life lost and present economic value of lost productivity. Costs are expressed in 2014 International dollars. Future earning potential is estimated using adjusted gross domestic product per capita, employment potential and historical trends in productivity and real interest rates. In 2014, an estimated 6,912 young people living in the most developed countries in the world lost their lives to suicide. These preventable deaths resulted in a loss of 406,730 years of life at a cost of $5.53 billion in lost economic income with the average cost of suicide estimated at $802,939. The United States stands out as a country with the most significant youth suicide problem accounting for 77% of total costs. Reducing youth suicide requires a multifaceted approach and significant investment by governments.
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Affiliation(s)
- Christopher M. Doran
- Cluster for Resilience and Wellbeing, Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Central Queensland University Australia, Brisbane, Australia
| | - Irina Kinchin
- Centre for Health Economics Research and Evaluation and the Centre for Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation, University of Technology Sydney, Ultimo, Australia
- Global Brain Health Institute, Dublin, Ireland
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24
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Doran CM, Kinchin I. A review of the economic impact of mental illness. AUST HEALTH REV 2019; 43:43-48. [PMID: 29129189 DOI: 10.1071/ah16115] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/01/2017] [Indexed: 12/17/2022]
Abstract
Objective To examine the impact and cost associated with mental illness. Methods A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only limited information is available on the impact of attention deficit hyperactivity disorder, anxiety, cognitive function, conduct disorder, eating disorder and psychological distress. There was also a dearth of evidence on the intangible elements of pain and suffering of people and their families with depressive disorders. More research is required to better understand the full extent of the impact of mental illness and strategies that may be implemented to minimise this harm. What are the implications for practitioners? Knowing the current and future impact of mental illness highlights the imperative to develop an effective policy response.
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Affiliation(s)
- Christopher M Doran
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Central Queensland University, Level 4, 160 Ann Street Brisbane Qld 4000, Australia. Email
| | - Irina Kinchin
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Central Queensland University, Level 4, 160 Ann Street Brisbane Qld 4000, Australia. Email
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25
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Changes in socioeconomic position among individuals with mental disorders during the economic recession in Portugal: a follow-up of the National Mental Health Survey. Epidemiol Psychiatr Sci 2019; 28:638-643. [PMID: 30078385 PMCID: PMC6998866 DOI: 10.1017/s2045796018000392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS Portugal was one of the European countries most affected by the period of economic recession initiated in 2008. Social inequalities are likely to widen during such periods and disproportionately affect people with mental disorders. The present study aims to compare self-reported changes in indicators of socioeconomic position during the economic recession in Portugal among people with and without mental disorders in the beginning of this period. Three dimensions were assessed, namely employment situation, experiences of financial hardship and subjective social status. METHODS Data from the World Mental Health Survey Initiative Portugal (2008/2009) and from the National Mental Health Survey Follow-up (2015/2016) were used (n = 911). Multinomial and logistic recession models were performed to examine the association between the presence of any 12-month mood or anxiety mental disorder in 2008/2009 and indicators of socioeconomic position in 2015/2016. All analyses were adjusted for gender, age, presence of any physical disorder and education at the baseline. RESULTS Participants that had any mental disorder in the beginning of the economic recession reported 2.20 (95% CI 1.31-3.71; P < 0.01) higher odds of financial hardship related to daily life in 2015/2016, when compared with those without any mental disorder, after adjusting for age, gender, education and presence of any physical disorder. The results may also suggest a pattern of increased socioeconomic disadvantage among people with prior mental disorder, despite not reaching statistical significance. CONCLUSIONS The results of this study suggest that the economic recession may have contributed to wider social inequalities between people with and without mental disorders. Policies to support these individuals, such as access to treatment and alleviation of financial hardship, should be a priority in times of economic downturn.
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26
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Lidwall U, Bill S, Palmer E, Olsson Bohlin C. Mental disorder sick leave in Sweden: A population study. Work 2018; 59:259-272. [PMID: 29355123 DOI: 10.3233/wor-172672] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The inability to perform productive work due to mental disorders is a growing concern in advanced societies. OBJECTIVE To investigate medically certified mental disorder and all-cause sick leave in a working population using demographic, socioeconomic and occupational predictors. METHODS The study population was the entire Swedish work force aged 16-64 years in December 31st 2011. The outcome was sick leave exceeding 14 days in 2012 with adjustment for 13 confounders. RESULTS The risk of sick leave with a mental disorder is higher among women compared to men, among persons aged 30-39 and among parents in families with underage children. Employees in welfare service occupations within health care, education and social services have an elevated risk of mental disorder sick leave and constitute a large proportion of the workforce. CONCLUSION The results support the need for improving early detection and prevention of mental disorders in the workforce. Improvements in psychosocial work environments are essential, where the higher risk in female dominated welfare occupations particularly, have repercussions on the quality of the welfare services provided for vulnerable groups in society. Better work-life balance in families with younger children could also mitigate the effects of a high total workload in that particular phase of life.
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Affiliation(s)
- Ulrik Lidwall
- Department for Analysis and Forecast, Swedish Social Insurance Agency, Stockholm, Sweden.,Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Bill
- Department for Analysis and Forecast, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Edward Palmer
- Department for Analysis and Forecast, Swedish Social Insurance Agency, Stockholm, Sweden.,Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Economics and Uppsala Center for Labor Studies, Uppsala University, Uppsala, Sweden
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27
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Antunes A, Frasquilho D, Azeredo-Lopes S, Silva M, Cardoso G, Caldas-de-Almeida JM. The effect of socioeconomic position in the experience of disability among people with mental disorders: findings from the World Mental Health Survey Initiative Portugal. Int J Equity Health 2018; 17:113. [PMID: 30086758 PMCID: PMC6081835 DOI: 10.1186/s12939-018-0821-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders are a major cause of disability with impacts on daily functioning and quality of life, which has been associated with socioeconomic disadvantage. The present study aims to assess how socioeconomic position is related to the disability reported by people with mental disorders, using data from the World Mental Health Survey (WMHS) Initiative Portugal. METHODS Using data from the Portuguese Mental Health Survey, a nationally representative cross-sectional study (n = 3849), several logistic regression models with interaction terms were performed to evaluate the effect of different indicators of socioeconomic position on the disability reported by people with any mental disorder (any 12-month mood or anxiety disorder). Odds ratios were estimated at the specific values of the main effects and interaction terms between the presence of any mental disorder and education, employment status, self-perceived financial deprivation and subjective social status. RESULTS The prevalence rate of any mood or anxiety disorder was 21.0% (n = 788), among which 14.7% (n = 115) reported disability. The results show that among people with any 12-month mental disorder, those in the employment category of "retired or others" had two times higher odds of reporting disability (OR = 2.19; 95%CI: 1.06-4.48) when compared to participants categorized as "working". Likewise, individuals with financial deprivation had two times higher odds of reporting disability when compared to those non-financially deprived (OR = 2.36; 95%CI: 1.31-4.24). The odds ratios obtained for the specific years of education evaluated were not statistically significant but seem to suggest an educational gradient. CONCLUSIONS The findings of this study indicate that the disability reported by people with mental disorders varies according to socioeconomic position and draw attention to the need to develop policies to address these inequalities.
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Affiliation(s)
- Ana Antunes
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, nº5, 1150-082, Lisbon, Portugal. .,Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
| | - Diana Frasquilho
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, nº5, 1150-082, Lisbon, Portugal.,Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Sofia Azeredo-Lopes
- Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Manuela Silva
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, nº5, 1150-082, Lisbon, Portugal.,Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Graça Cardoso
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, nº5, 1150-082, Lisbon, Portugal.,Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Rua do Instituto Bacteriológico, nº5, 1150-082, Lisbon, Portugal.,Nova Medical School, Nova University of Lisbon, Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
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Callander EJ, Schofield DJ. Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness. BMC Psychol 2018; 6:16. [PMID: 29665851 PMCID: PMC5905185 DOI: 10.1186/s40359-018-0230-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. Methods We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. Results For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. Conclusions The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health.
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Affiliation(s)
- Emily J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Building 48, Douglas Campus, Townsville, QLD, 4811, Australia.
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29
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Laires PA, Canhão H, Rodrigues AM, Eusébio M, Gouveia M, Branco JC. The impact of osteoarthritis on early exit from work: results from a population-based study. BMC Public Health 2018; 18:472. [PMID: 29642918 PMCID: PMC5894139 DOI: 10.1186/s12889-018-5381-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/26/2018] [Indexed: 12/25/2022] Open
Abstract
Background Osteoarthritis (OA) is a leading cause of pain and disability, which may be a source of productivity losses. The objectives of this study were to describe the impact of OA, namely through pain and physical disability, on early exit from work and to calculate its economic burden. Methods We analysed data from the national, cross-sectional, population-based EpiReumaPt study (Sep2011–Dec2013) in which 10,661 individuals were randomly surveyed in order to capture all cases of rheumatic diseases. We used all participants aged 50–64, near the official retirement age, who were clinically validated by experienced rheumatologists (n = 1286), including OA cases. A national database was used to calculate productivity values by gender, age and region, using the human capital approach. The impact of OA on the likelihood of early exit from work and the population attributable fractions used to calculate due economic burden (indirect costs) were obtained at the individual level by logistic regression. All results were based on weighted data. Results Almost one third of the Portuguese population aged 50–64 had OA (29.7%; men: 16.2% and women: 43.5%) and more than half were out of paid work (51.8%). Only knee OA is associated with early exit from work (OR: 2.25; 95%CI: 1.42–3.59; p = 0.001), whereas other OA locations did not reach any statistical difference. Furthermore, we observed an association between self-reported longstanding musculoskeletal pain (OR: 1.55; 95%CI: 1.07–2.23; p = 0.02) and pain interference (OR: 1.35; 95%CI: 1.13–1.62; p = 0.001) with early exit from work. We also detected a clear relationship between levels of disability, measured by the Health Assessment Questionnaire (HAQ), and the probability of work withdrawal. The estimated annual cost of early exit from work attributable to OA was €656 million (€384 per capita; €1294 per OA patient and €2095 per OA patient out-of-work). Conclusions In this study, we observed an association between OA and early exit from work, largely dependent on pain and disability. This relationship translates into a meaningful economic burden amounting to approximately 0.4% of the national Gross Domestic Product (GDP). The high prevalence and the impact of this disabling chronic disease highlight the need to prioritize policies targeting early exit from work in OA.
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Affiliation(s)
- Pedro A Laires
- Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Center, Lisbon, Portugal. .,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Lisbon, Portugal. .,EpiReumaPt Study Group, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.
| | - Helena Canhão
- EpiReumaPt Study Group, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisbon, Portugal
| | - Ana M Rodrigues
- Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Center, Lisbon, Portugal.,EpiReumaPt Study Group, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
| | - Mónica Eusébio
- EpiReumaPt Study Group, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
| | - Miguel Gouveia
- Catolica Lisbon School of Business and Economics, Lisbon, Portugal
| | - Jaime C Branco
- EpiReumaPt Study Group, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisbon, Portugal.,Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental (CHLO- E.P.E.), Lisbon, Portugal
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Bates N, Callander E, Lindsay D, Watt K. Labour force participation and the cost of lost productivity due to cancer in Australia. BMC Public Health 2018; 18:375. [PMID: 29621995 PMCID: PMC5887244 DOI: 10.1186/s12889-018-5297-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background In Australia, 40% of people diagnosed with cancer will be of working age (25–64 years). A cancer diagnosis may lead to temporary or permanent changes in a person’s labour force participation, which has an economic impact on both the individual and the economy. However, little is known about this economic impact of cancer due to lost productivity in Australia. This paper aims to determine the labour force participation characteristics of people with cancer, to estimate the indirect cost due to lost productivity, and to identify any inequality in the distribution of labour force absence in Australia. Methods This study used national cross-sectional data from the 2015 Survey of Disability, Ageing and Carers, conducted by the Australian Bureau of Statistics (ABS). The ABS weighted each component of the survey to ensure the sample represented the population distribution of Australia. The analysis was limited to people aged 25–64 years. Participants were assigned to one of three health condition groups: ‘no health condition’, ‘cancer’, and ‘any other long-term health condition’. A series of logistic regression models were constructed to determine the association between health condition and labour force participation. Results A total of 34,393 participants surveyed were aged 25–64 years, representing approximately 12,387,800 Australians. Almost half (46%) of people with cancer were not in the labour force, resulting in a reduction of $1.7 billion to the Australian gross domestic product (GDP). Amongst those in the labour force, people with no health condition were 3.00 times more likely to be employed full-time compared to people with cancer (95% CI 1.96–4.57), after adjusting for age, sex, educational attainment and rurality. Amongst those with cancer, people without a tertiary qualification were 3.73 times more likely to be out of the labour force (95% CI 1.97–7.07). Conclusions This paper is the first in Australia to estimate the national labour force participation rates of people with cancer. People with cancer were less likely to be in the labour force, resulting in a reduction in Australia’s GDP. Cancer survivors, especially those without a tertiary qualification may benefit from support to return to work after a diagnosis.
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Affiliation(s)
- Nicole Bates
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Building 48, Douglas Campus, Townsville City, Queensland, 4811, Australia.
| | - Emily Callander
- Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Queensland, 4811, Australia
| | - Daniel Lindsay
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Building 48, Douglas Campus, Townsville City, Queensland, 4811, Australia.,Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Queensland, 4811, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Building 48, Douglas Campus, Townsville City, Queensland, 4811, Australia
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Corscadden L, Levesque JF, Lewis V, Strumpf E, Breton M, Russell G. Factors associated with multiple barriers to access to primary care: an international analysis. Int J Equity Health 2018; 17:28. [PMID: 29458379 PMCID: PMC5819269 DOI: 10.1186/s12939-018-0740-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 02/06/2018] [Indexed: 11/19/2022] Open
Abstract
Background Disparities in access to primary care (PC) have been demonstrated within and between health systems. However, few studies have assessed the factors associated with multiple barriers to access occurring along the care-seeking process in different healthcare systems. Methods In this secondary analysis of the 2016 Commonwealth Fund International Health Policy Survey of Adults, access was represented through participant responses to questions relating to access barriers either before or after reaching the PC practice in 11 countries (Australia, Canada, France, Germany, Norway, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and United States). The number of respondents in each country ranged from 1000 to 7000 and the response rates ranged from 11% to 47%. We used multivariable logistic regression models within each of eleven countries to identify disparities in response to the access barriers by age, sex, immigrant status, income and the presence of chronic conditions. Results Overall, one in five adults (21%) experienced multiple barriers before reaching PC practices. After reaching care, an average of 16% of adults had two or more barriers. There was a sixfold difference between nations in the experience of these barriers to access. Vulnerable groups experiencing multiple barriers were relatively consistent across countries. People with lower income were more likely to experience multiple barriers, particularly before reaching primary care practices. Respondents with mental health problems and those born outside the country displayed substantial vulnerability in terms of barriers after reaching care. Conclusion A greater understanding of the multiple barriers to access to PC across the stages of the care-seeking process may help to inform planning and performance monitoring of disparities in access. Variation across countries may reveal organisational and system drivers of access, and inform efforts to improve access to PC for vulnerable groups. The cumulative nature of these barriers remains to be assessed. Electronic supplementary material The online version of this article (10.1186/s12939-018-0740-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Corscadden
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, 4812, Australia. .,Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW, 2067, Australia.
| | - J F Levesque
- Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW, 2067, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
| | - V Lewis
- Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, 3068, Australia
| | - E Strumpf
- Department of Economics and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 855 Sherbrooke St. West, Montreal, QC, H3A 2T7, Canada
| | - M Breton
- Department of community health, University of Sherbrooke, 150 Place Charles LeMoyne, Longueil, Québec, J4K 0A8, Canada
| | - G Russell
- General Practice Research, School of Primary and Allied Health Care, Monash University, 270 Ferntree Gull Rd Notting Hill, Melbourne, VIC, 3168, Australia
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Callander EJ. Youth labour force absence and chronic health conditions in Australia. Occup Med (Lond) 2018; 68:135-142. [DOI: 10.1093/occmed/kqy011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
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Stagnaro JC, Cía AH, Aguilar Gaxiola S, Vázquez N, Sustas S, Benjet C, Kessler RC. Twelve-month prevalence rates of mental disorders and service use in the Argentinean Study of Mental Health Epidemiology. Soc Psychiatry Psychiatr Epidemiol 2018; 53:121-129. [PMID: 29302708 DOI: 10.1007/s00127-017-1475-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/17/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Community surveys of mental disorders and service use are important for public health policy and planning. There is a dearth of information for Latin America. This is the first representative community survey in the Argentinean population. The purpose is to estimate the 12-month prevalence and severity of mental disorders, socio-demographic correlates and service use in a general population survey of adults from urban areas of Argentina. METHODS The World Mental Health Composite International Diagnostic Interview was administered to 3927 individuals aged 18 years and older participating in a multistage clustered area probability household survey. The response rate was 77%. RESULTS The 12-month prevalence of any disorder was 14.8%, and a quarter of those disorders were classified as severe. Younger participants and those with lower education had greater odds of any disorder and most classes of disorder. 11.6% of the total population received treatment in the prior 12 months and only 30.2% of those with a severe disorder. Women and those never married were more likely to receive or seek treatment, whereas those with low and low-average education were less likely. CONCLUSION Most individuals with a mental disorder in the past year, even those with a severe disorder, have not received treatment. Because low education is a barrier to treatment, initiatives aimed at mental health education might help timely detection and treatment of these disorders in Argentina.
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Affiliation(s)
- Juan Carlos Stagnaro
- Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
| | - Alfredo H Cía
- Anxiety Clinic and Research Center, Buenos Aires, Argentina
| | - Sergio Aguilar Gaxiola
- Center for Reducing Health Disparities, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Néstor Vázquez
- Department of Public Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Sebastián Sustas
- Department of Public Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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Hamilton MP, Hetrick SE, Mihalopoulos C, Baker D, Browne V, Chanen AM, Pennell K, Purcell R, Stavely H, McGorry PD. Identifying attributes of care that may improve cost‐effectiveness in the youth mental health service system. Med J Aust 2017; 207:S27-S37. [DOI: 10.5694/mja17.00972] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/17/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Matthew P Hamilton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
| | - Sarah E Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
- Centre of Youth Mental Health, University of Melbourne, Melbourne, VIC
| | | | - David Baker
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
| | - Vivienne Browne
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
- Centre of Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Andrew M Chanen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
- Centre of Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Kerryn Pennell
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
| | - Rosemary Purcell
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
- Centre of Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Heather Stavely
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC
- Centre of Youth Mental Health, University of Melbourne, Melbourne, VIC
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Burckhardt R, Manicavasagar V, Batterham PJ, Hadzi-Pavlovic D, Shand F. Acceptance and commitment therapy universal prevention program for adolescents: a feasibility study. Child Adolesc Psychiatry Ment Health 2017; 11:27. [PMID: 28559924 PMCID: PMC5445489 DOI: 10.1186/s13034-017-0164-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a need to prevent anxiety and depression in young people and mindfulness contains important emotion regulation strategies. Acceptance and commitment therapy (ACT), a mindfulness-based therapy, has yet to be evaluated as a prevention program, but has demonstrated an ability to reduce symptoms of anxiety and depression in adult and adolescent populations. This study examines the feasibility of using an ACT-based prevention program in a sample of year 10 (aged 14-16 years) high school students from Sydney, Australia. METHODS Participants were allocated to either their usual classes or to the ACT-based intervention. Participants were followed for a period of 5 months post-intervention and completed the Flourishing Scale, Depression Anxiety Stress Scale, and a program evaluation questionnaire. Analyses were completed using intention-to-treat mixed models for repeated measures. RESULTS The results indicated that the intervention was acceptable to students and feasible to administer in a school setting. There were no statistically significant differences between the conditions, likely due to the small sample size (N = 48). However, between-group effect sizes demonstrated small to large differences for baseline to post-intervention mean scores and medium to large differences for baseline to follow-up mean scores, all favouring the ACT-based condition. CONCLUSION The results suggest that an ACT-based school program has potential as a universal prevention program and merits further investigation in a larger trial. Trial registration Australian New Zealand Clinical Trials Registry. Trial ID: ACTRN12616001383459. Registered 06/10/2016. Retrospectively registered.
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Affiliation(s)
- Rowan Burckhardt
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
| | - Vijaya Manicavasagar
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
| | - Philip J. Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Fiona Shand
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
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The Economic Cost of Suicide and Non-Fatal Suicide Behavior in the Australian Workforce and the Potential Impact of a Workplace Suicide Prevention Strategy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040347. [PMID: 28346379 PMCID: PMC5409548 DOI: 10.3390/ijerph14040347] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/16/2022]
Abstract
Suicide and non-fatal suicide behavior (NFSB) are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at $6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $1.50 ($1.11-$3.07), representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.
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Hayward SM, McVilly KR, Stokes MA. Challenges for females with high functioning autism in the workplace: a systematic review. Disabil Rehabil 2016; 40:249-258. [DOI: 10.1080/09638288.2016.1254284] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Susan M. Hayward
- School of Social & Political Sciences, The University of Melbourne, Australia
| | - Keith R. McVilly
- School of Social & Political Sciences, The University of Melbourne, Australia
| | - Mark A. Stokes
- School of Psychology, Faculty of Health, Deakin University, Australia
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Shaw WS, Main CJ, Pransky G, Nicholas MK, Anema JR, Linton SJ. Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:394-398. [PMID: 27562584 PMCID: PMC5104772 DOI: 10.1007/s10926-016-9658-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
- University of Massachusetts Medical School, Worcester, MA, USA.
| | - Chris J Main
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care Sciences and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia
| | - Johannes R Anema
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Steven J Linton
- CHAMP, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Lee J, Kim I, Roh S. Descriptive study of claims for occupational mental disorders or suicide. Ann Occup Environ Med 2016; 28:61. [PMID: 27777785 PMCID: PMC5072321 DOI: 10.1186/s40557-016-0147-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/12/2016] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to identify the characteristics of claimed mental disorders. Because the workers believed the cause of the mental disorders was work-related stress or a specific event, we could identify the major work-related stressor for claimed cases. Methods We included claimed cases of occupational mental disorder or suicide reported during 2010–2014 to the Korea Workers Compensation and Welfare Service (KCOMWEL), established by Industrial Accidents Insurance (IACI) Act. We conducted qualitative analysis using a form specifically developed for this study as well as a quantitative analysis. Results Of the 569 claimed cases, 142 cases were recognized as occupational mental disorder or suicide. The approval rate was 24.9 %. Suicide was the most commonly approved mental disorder (23.0 %), followed by major depressive disorder (14.9 %). Regarding profession, 109 workers were managers, and 95 workers were office clerks. The main work-related stressors of the approved cases were acute stressful events (76 cases), long working hours (12 cases), and changes in workload (6 cases). The primary stressful events were work-related legal problems, workplace violence, and employment status-related issues. Conclusion Claims due to mental disorders or suicide increased during the 5-year study period, and the approval rate was approximately 33 %, and the main stressor of the claimed cases was an acute stressful event such as physiologic trauma, employment-related issues, fear of legal or financial responsibility, abrupt change in organizational responsibility, or workplace violence.
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Affiliation(s)
- Jihoon Lee
- Department of Occupational and Environmental Medicine, Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul 04763 Korea
| | - Inah Kim
- Department of Occupational and Environmental Health, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763 Korea
| | - Sooyong Roh
- Department of Occupational and Environmental Medicine, Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul 04763 Korea
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Abdin E, Ong C, Chong SA, Vaingankar JA, Subramaniam M. Days Out of Role Due to Mental and Physical Conditions: Results from the Singapore Mental Health Study. PLoS One 2016; 11:e0148248. [PMID: 26840741 PMCID: PMC4739696 DOI: 10.1371/journal.pone.0148248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 01/16/2016] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of the current study was to evaluate the relative contributions of mental and physical conditions to days out of role among adults aged 18 years and above in Singapore. Methods The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of residents aged 18 years or older. Diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. Days out of role were assessed using a WHO Disability Assessment Schedule item. Multivariate regression analyses were used to estimate individual-level and societal-level effects of disorders. Results Overall, 8.7% of respondents reported at least one day out of role, with a mean of 5.8 days. The most disabling conditions at the individual level were cancer (118.9 additional days), cardiovascular diseases (93.5), and bipolar disorder (71.0). At the societal level, cardiovascular diseases contributed the highest population attributable risk proportion (45%), followed by cancer (39.3%), and hypertension (13.5%). Conclusions Mental and physical conditions are linked to significant losses in productivity for society as well as role disability for individuals, underscoring the need to enhance prevention and intervention efforts to increase overall productivity and improve individual functioning.
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Affiliation(s)
- Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
- * E-mail:
| | - Clarissa Ong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Rudolph KE, Eaton WW. Previous anxiety and depression as risk factors for early labour force exit. J Epidemiol Community Health 2015; 70:390-5. [PMID: 26511888 DOI: 10.1136/jech-2015-206202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 10/09/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Individuals with a history of mental illness have lower earnings than individuals without. A possible reason is that those with prior anxiety or depression may be more likely to exit the labour force prior to retirement age, but evidence has been mixed and limited. Our objective was to compare risk of early labour force exit between employed adults with a history of depression or anxiety versus those without, separately for men and women. METHODS We used data from the Baltimore Epidemiological Catchment Area Follow-up Cohort, which collected baseline data in 1981 and follow-up data 1993-1996 and 2004-2005. Cox proportional hazards models estimated the relative risk of labour force exit comparing those with versus without prior history of anxiety or depressive disorders. RESULTS Women with prior anxiety or depression are at 37% increased risk of dropping out of the labour force as compared to women without, controlling for age, socioeconomic status, race and marital status (HR: 1.37, 95% CI 1.04 to 1.79). Men with prior anxiety or depression are 18% more likely to subsequently drop out of the labour force as compared to men without, controlling for the above confounders as well as veteran status, but this association is not statistically significant (HR: 1.18, 95% CI 0.72 to 1.27). CONCLUSIONS Prior anxiety or depression increases risk of early labour force exit for women. These findings may help explain previously reported lower earnings among female individuals with a history of mental illness and highlight the importance of considering anxiety and depressive disorders in policies supporting labour force participation.
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Affiliation(s)
- Kara E Rudolph
- School of Public Health, University of California, Berkeley, California, USA Center for Health and Community, University of California, San Francisco, California, USA Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1547-56. [PMID: 25994278 DOI: 10.1007/s00127-015-1074-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/13/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards. METHODS Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale. RESULTS After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty. CONCLUSION To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.
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Veerman JL, Shrestha RN, Mihalopoulos C, Passey ME, Kelly SJ, Tanton R, Callander EJ, Schofield DJ. Depression prevention, labour force participation and income of older working aged Australians: A microsimulation economic analysis. Aust N Z J Psychiatry 2015; 49:430-6. [PMID: 25425743 DOI: 10.1177/0004867414561528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Depression has economic consequences not only for the health system, but also for individuals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression. METHOD We used an epidemiological simulation model to estimate reductions in prevalence of depression, and a microsimulation model, Health&WealthMOD2030, to estimate the impact on labour force participation, personal income, savings, taxation revenue and welfare expenditure. RESULTS Group therapy is estimated to prevent around 5,200 prevalent cases of depression (2.2%) and add about 520 people to the labour force. Private incomes are projected to increase by $19 million per year, tax revenues by $2.4 million, and transfer payments are reduced by $2.6 million. CONCLUSION Group-based psychological intervention to prevent depression could result in considerable economic benefits in addition to its clinical effects.
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Affiliation(s)
| | | | | | - Megan E Passey
- University Centre for Rural Health - North Coast, School of Public Health, University of Sydney, Lismore, Australia
| | - Simon J Kelly
- National Centre for Social and Economic Modelling, University of Canberra, Bruce, Australia
| | - Robert Tanton
- National Centre for Social and Economic Modelling, University of Canberra, Bruce, Australia
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Laires PA, Canhão H, Gouveia M. Indirect costs associated with early exit from work attributable to rheumatic diseases. Eur J Public Health 2015; 25:677-82. [DOI: 10.1093/eurpub/cku241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cook JA, Burke-Miller JK. Reasons for job separations in a cohort of workers with psychiatric disabilities. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2015; 52:371-384. [PMID: 26348698 DOI: 10.1682/jrrd.2014.10.0260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 02/25/2015] [Indexed: 06/05/2023]
Abstract
We explored the relative effects of adverse working conditions, job satisfaction, wages, worker characteristics, and local labor markets in explaining voluntary job separations (quits) among employed workers with psychiatric disabilities. Data come from the Employment Intervention Demonstration Program in which 2,086 jobs were ended by 892 workers during a 24 mo observation period. Stepped multivariable logistic regression analysis examined the effect of variables on the likelihood of quitting. Over half (59%) of all job separations were voluntary while 41% were involuntary, including firings (17%), temporary job endings (14%), and layoffs (10%). In multivariable analysis, workers were more likely to quit positions at which they were employed for 20 h/wk or less, those with which they were dissatisfied, low-wage jobs, non-temporary positions, and jobs in the structural (construction) occupations. Voluntary separation was less likely for older workers, members of racial and ethnic minority groups, and those residing in regions with lower unemployment rates. Patterns of job separations for workers with psychiatric disabilities mirrored some findings regarding job leaving in the general labor force but contradicted others. Job separation antecedents reflect the concentration of jobs for workers with psychiatric disabilities in the secondary labor market, characterized by low-salaried, temporary, and part-time employment.
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Economic evaluation of the use of a pharmacogenetic diagnostic test in schizophrenia. HEALTH POLICY AND TECHNOLOGY 2014. [DOI: 10.1016/j.hlpt.2014.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Schofield DJ, Callander EJ, Shrestha RN, Passey ME, Percival R, Kelly SJ. Multiple chronic health conditions and their link with labour force participation and economic status. PLoS One 2013; 8:e79108. [PMID: 24223887 PMCID: PMC3815132 DOI: 10.1371/journal.pone.0079108] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 09/26/2013] [Indexed: 11/18/2022] Open
Abstract
AIMS To assess the labour force participation and quantify the economic status of older Australian workers with multiple health conditions. BACKGROUND Many older people suffer from multiple health conditions. While multiple morbidities have been highlighted as an important research topic, there has been limited research in this area to date, particularly on the economic status of those with multiple morbidities. METHODS Cross sectional analysis of Health&WealthMOD, a microsimulation model of Australians aged 45 to 64 years. RESULTS People with one chronic health condition had 0.59 times the odds of being employed compared to those with no condition (OR 0.59, 95% CI: 0.49, 0.71), and those with four or more conditions had 0.14 times the odds of being employed compared to those with no condition (OR 0.14, 95% CI: 0.11, 0.18). People with one condition received a weekly income 32% lower than those with no health condition, paid 49 % less tax, and received 37% more in government transfer payments; those with four or more conditions received a weekly income 94% lower, paid 97% less in tax and received over 2,000% more in government transfer payments per week than those with no condition. CONCLUSION While having a chronic health condition is associated with lower labour force participation and poorer economic status, having multiple conditions compounds the affect - with these people being far less likely to be employed and having drastically lower incomes.
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Affiliation(s)
- Deborah J. Schofield
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emily J. Callander
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Rupendra N. Shrestha
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Megan E. Passey
- University Centre for Rural Health – North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Richard Percival
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Simon J. Kelly
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, Australian Capital Territory, Australia
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