Anxiety is as common as depression; however, it has received less attention and is often undetected and undertreated. The authors administered a 7-item anxiety scale to 965 primary care patients, w...

Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection

Context Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. Objective To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. Design, Setting, and Participants Face-to-face household surveys of 60463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. Main Outcome Measures The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. Results The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5%.to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. Conclusions Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases,. especially those at risk for progressing to more serious disorders.

/pdf/prevalence-severity-and-unmet-need-for-treatment-of-mental-296czu49lz.pdf

Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys.

https://www.ecnp.eu/~/media/Files/ecnp/communication/reports/ECNP%20EBC%20Report.pdf

The size and burden of mental disorders and other disorders of the brain in Europe 2010

https://biblio.ugent.be/publication/8617256/file/8617262.pdf

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.

/pdf/suicide-and-suicidal-behavior-41x9ufvkfm.pdf

Suicide and Suicidal Behavior

Kindermishandeling: economische gevolgen op lange termijn1.

Background The effects of the implementation of a new Dutch hepatitis B virus (HBV) vaccination strategy (1991) for expatriates on HBV vaccination status and HBV infection prevalence were evaluated in a group of 864 expatriates returning from HBV-endemic areas. Methods During a routine medical examination at the participating medical centres Dutch expatriates were asked to complete a questionnaire and to donate a serum sample for HBV testing. Blood was tested for antibodies against the hepatitis B core (antiHBc) and surface antigens (anti-HBs). The serological data were related to information gathered on aspects of residence, sexual risk behaviour and occupational risks. Results A significantly higher percentage of expatriates (37%) were vaccinated compared to a previous study in 1987‐1989 (14%). However, the percentage of expatriates with HBV infection markers (5%) had not decreased significantly. Moreover, the risk for HBV infection, as determined with a questionnaire, was still affected by well-known risk factors such as homosexual contacts (odds ratio [OR] = 6.6, 95% CI : 1.7‐26), more than five casual local partners (OR = 3.6, 95% CI : 1.2‐11) and more than five occupational accidents in the last 3 years (OR = 20, 95% CI : 2‐187). Detailed analysis of the vaccination status indicated that especially young female expatriates with low risk behaviour (65%) were protected, while older male expatriates with high risk behaviour were less protected (20%). Conclusion We conclude that the new vaccination strategy has resulted in a higher percentage of expatriates protected. However, only a small proportion was reached of those at highest risk for HBV infection.

Broader vaccination of expatriates against HBV infection: do we reach those at highest risk?

To enable older people with severe and persistent mental illness to live in the community, the Dutch mental health sector has developed a program for supported living in residential homes for the elderly. It provides for the permanent stationing of mental health workers (MHWs) in elder care facilities to support both the resident patients and the elder care staff. The authors examined associations between the number of MHW staff and the degree to which (1) patients were integrated into the community and (2) elder care workers had developed effective working alliances with their patients. Participants included 110 patients participating in 18 supported living programs in the Netherlands. Community integration was assessed in face-to-face interviews with the patients about their perceived influence over daily life, involvement in social activities, and social network size. The quality of the worker-patient relationship was assessed using the Dutch Working Alliance Questionnaire for Community Care, completed...

Supported living in residential homes for the elderly: impact on patients and elder care workers.

Background In the Netherlands there is no up-to-date information about the attitude of the public to (discharged) psychiatric patients. Also, very little is known about which population groups hold stigmatising views. Aim To measure the public's attitudes to (discharged) psychiatric patients and to find out whether these attitudes differ according to the background characteristics (e.g. demographics, respondent's psychiatric history). Method In our study we used attitudes collected via the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological study of the adult general population (n = 6646; aged 18-64 years). The psychiatric history of the respondents was assessed by means of the Composite International Diagnostic Interview 3.0. Results More than 70% of the respondents stated that they had no objection to having a (discharged) psychiatric patient as a neighbour, friend or colleague. However, their ´willingness´ declined markedly, namely to less than 30%, when they were asked if they would be willing to have a (discharged) psychiatric patient as their son-in-law or baby-sitter. A comparison with other earlier Dutch studies indicates that since 1987 the willingness of members of the public to let (ex-)psychiatric patients participate in their private and/or family life has increased only very slightly. Conclusion Nowadays, just as in past decades, most Dutch citizens are not opposed to living alongside (discharged) psychiatric patients, but they have reservations about letting such persons participate in their private and family life.

R. de Graaf

Papers

Kindermishandeling: economische gevolgen op lange termijn1.

Broader vaccination of expatriates against HBV infection: do we reach those at highest risk?

Supported living in residential homes for the elderly: impact on patients and elder care workers.

[The attitude of the general public towards (discharged) psychiatric patients: results from NEMESIS-2].

Research report Depression-anxiety relationships with chronic physical conditions: Results from the World Mental Health surveys ☆