Neurological and mental health outcomes among conventional and organic farmers in Indiana, USA

Depression in Brazilian farmers: prevalence and associated factors

BACKGROUND

The unique characteristics of rural areas and agricultural work can contribute to the genesis of diseases, including mental disorders such as depression.

AIMS

To estimate the prevalence of and factors associated with depression symptoms in Brazilian farmers.

METHODS

A cross-sectional epidemiological study involving 784 farmers of the state of Espírito Santo/Brazil was carried out. Depression was identified using the Mini-International Neuropsychiatric Interview. Hierarchical logistic regression was used to assess the associated factors.

RESULTS

The prevalence of depression symptoms among farmers was 16.8% (n = 132). Of those experiencing symptoms, 6.1% (n = 48) we're currently experiencing a depressive episode, and 10.7% (n = 84) a recurrent depressive episodes. The associated factors were: female gender (OR 1.63; 95% CI 1.04-2.54), not owning the land (OR 1.79; 95% CI 1.11-2.89), professional dissatisfaction (OR 1.99; 95% CI 1.18-3.35), previous pesticide poisoning (OR 2.87; 95% CI 1.45-5.67), complex multimorbidity (OR 1.95; 95% CI 1.15-3.31) and occurrence of previous depressive episodes (OR 9.83; 95% CI 4.39-21.99).

CONCLUSIONS

A high prevalence of depression symptoms was identified among rural workers. Sociodemographic, occupational, clinical, and professional dissatisfaction factors were associated with a higher risk of depression symptoms in this population.

Could pesticide exposure be implicated in the high incidence rates of depression, anxiety and suicide in farmers? A systematic review

Pesticide exposure and poisoning may rise the risk of mental health problems and suicidal tendencies. To explore the potential connection between chronic occupational exposure to pesticides and depression, anxiety, and suicide-related outcomes in farmers, a systematic review was performed. Systematic review protocol is available in PROSPERO registration number CRD42022316285. A total of fifty-seven studies met inclusion criteria: twenty-nine on depression or other mental disorders, twelve on suicide (two of them on both depression and suicide), and fourteen on pesticide poisoning or self-poisoning and death. Among the fifty-seven selected studies, eighteen were conducted in Asia, seventeen in North America, fourteen in South America, seven in European Union, one in Africa, and one in Australia/Oceania. Selected studies demonstrated an increased prevalence of depressive disorders in farmworkers exposed to pesticides as well as an increased self-reported prevalence of depression in this population. Moreover, previous pesticide poisoning increased the risk estimates for depression or other mental disorders as compared with chronic pesticide exposure. Severe pesticide poisoning and multiple poisoning showed increased risks of depressive symptoms compared with milder cases. In addition, financial difficulties and poor health were positively correlated with depression. Among studies on suicide, nine of them found that suicide rates increased in areas devoted to agriculture with intensive pesticide consumption. Moreover, studies demonstrate a higher suicide risk among farmers. The present review suggests more attention to the farmer's mental health and more detailed studies on occupational exposure to the mixture of these compounds.

Psychological Morbidity in the Farming Community: A Literature Review

The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health (n = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers' progression through a different "pathway" to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers' "pathway" to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community.

The factors associated with the presence of psychotic symptoms in the HELIAD Greek community study of older adults

BACKGROUND

The prevalence and associated factors related to psychotic symptoms in older adults are understudied. The objectives were to assess the prevalence, incidence and factors associated with psychotic symptoms in a representative Greek sample of community living older adults.

METHODS

The sample includes n = 1,904 residents of the cities of Larissa and Maroussi in Greece participating in the Hellenic Longitudinal Investigation of Aging and Diet study with available data at baseline and n = 947 individuals at the 3-year follow-up. Past-month presence of delusions and hallucinations was assessed on the grounds of the 17 symptoms of the Columbia University Scale for Psychopathology in Alzheimer's Disease and 14 symptoms of the Neuropsychiatric Inventory Questionnaire. A comprehensive neuropsychological assessment for probable diagnosis of dementia and physical comorbidity was carried out by neurologists. Penalized logistic regression analyses were used to assess the socio-economic and clinical factors associated with psychotic symptoms.

RESULTS

Past-month prevalence of psychotic symptoms was 1.9% and 1.0% when excluding cases of dementia. The prevalence of any delusion and hallucination was 0.8% and 0.3% when excluding dementia. The incidence of psychotic symptoms without dementia was 1.3%. Recent widows and farmers/breeders/craftsmen, versus public servants/teachers/executives, had both six times the odds of experiencing psychotic symptoms without dementia. Hearing impairment and the number of health conditions also increased the odds while increased age was protective.

CONCLUSION

Psychotic symptoms unrelated to dementia constitute a considerable mental health problem in old age. Paranoid delusions were the most prevalent. Socio-economic and health status factors are significant predictors of psychotic symptoms.

Risk Factors for Brain Health in Agricultural Work: A Systematic Review

Certain exposures related to agricultural work have been associated with neurological disorders. To date, few studies have included brain health measurements to link specific risk factors with possible neural mechanisms. Moreover, a synthesis of agricultural risk factors associated with poorer brain health outcomes is missing. In this systematic review, we identified 106 articles using keywords related to agriculture, occupational exposure, and the brain. We identified seven major risk factors: non-specific factors that are associated with agricultural work itself, toluene, pesticides, heavy metal or dust exposure, work with farm animals, and nicotine exposure from plants. Of these, pesticides are the most highly studied. The majority of qualifying studies were epidemiological studies. Nigral striatal regions were the most well studied brain area impacted. Of the three human neuroimaging studies we found, two focused on functional networks and the third focused on gray matter. We identified two major directions for future studies that will help inform preventative strategies for brain health in vulnerable agricultural workers: (1) the effects of moderators such as type of work, sex, migrant status, race, and age; and (2) more comprehensive brain imaging studies, both observational and experimental, involving several imaging techniques.

Risk for Depressive Symptoms and Suicide Among U.S. Primary Farmers and Family Members: A Systematic Literature Review

Background: About 84% of the agriculture, fishing, and forestry occupational sector is comprised of farmers. This sector is at high risk for suicide in the United States. Recent disasters and trade upheavals may make farmers and their families more vulnerable to depression and suicide. This review focused on the risk for depression and suicide among United States’ primary farm operators and their families. Methods: A systematic search of the literature published between January 2000 and June 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted. Results: A total of 30 articles met full inclusion criteria. Seventeen reports emanated from the midwest. Twenty studies used a cross-sectional design, primarily assessing a convenience sample or random stratified sample from a limited geographic area. We discovered only one intervention evaluation study. Depressive symptoms were assessed as part of the studies, but it was not the major focus. A variety of instruments measured depressive symptoms, with the Centers for Disease Control Epidemiologic Studies—Depression (CES-D) Scale used more frequently than other scales. Thirteen studies focused on the relationship between pesticide/chemical exposure and depression or suicide risk. Increased stress, poor physical health, compromised financial position, and previous injury were among the leading indicators of depression. Conclusion/Application to Practice: The limited number of studies that was discovered identified the need for more robust science where the risk for depression and suicide is the primary focus of the study and for intervention studies grounded in science. Occupational health providers should be vigilant about farm exposure and be aware of factors that may influence depressive symptoms of workers who operate farm establishments.

Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review

Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.

Exploring the Drivers of Irrigator Mental Health in the Murray–Darling Basin, Australia

There has been little work conducted on how landholders’ farm management approaches and financial capital (specifically (i) farm method such as organic farming and (ii) financial profitability) may impact mental health. In particular, there is emerging evidence that an increase in natural farm capital and environmental conditions may improve farmers’ wellbeing. We used a 2015–2016 survey, which randomly sampled 1000 irrigators from the southern Murray–Darling Basin, to model the drivers of irrigators’ psychological distress. Results highlight that worsening financial capital (namely, lower farmland value, higher farm debt, lower percentage of off-farm income, lower productivity change over the past five years, and lower net farm income) was the most statistically significant factor associated with increased irrigator distress. In addition, there was some evidence that being a certified organic irrigator was also associated with lower psychological distress; however, it was only weakly significant in our overall model, with the most significance within the horticultural industry model. Contrary to expectations, drought and water scarcity were not the main drivers of psychological distress in the time-period studied, with their influence seemingly through reducing financial capital as a whole.