Showing papers by "Rob V. Bijl published in 2004"

Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Abstract: Objective: Data on the temporal relationships between duration of depression and recovery and functional disability are sparse. These relationships were examined in subjects from the general population (n = 250) with newly originated episodes of DSM-III-R major depression. Method: The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiological survey in the adult population (n = 7076), using the Composite International Diagnostic Interview (CIDI). Duration of depression and duration of recovery over 2 years were assessed with a life chart interview. Functional disabilities were assessed with the MOS-SF-36 and with absence days from work. Results: Functional disabilities and absence days in depressed individuals were not found to be associated with duration of depression. Functioning in daily activities improved with longer duration of recovery but social functioning not. Conclusion: Functioning deteriorates by actual depressive symptomatology and comorbid anxiety but not by longer duration of depression. After symptomatic recovery, functioning improves to premorbid level, irrespective of the length of the depression. Improvements in daily activities and work can be expected with longer duration of recovery.

Hallucinatory experiences and onset of psychotic disorder: evidence that the risk is mediated by delusion formation.

Abstract: Objective: To examine the hypothesis that the risk for onset of psychotic disorder in individuals with self-reported hallucinatory experiences (HE) would be higher in those who developed delusional ideation (DE) than in those who did not. Method: A population sample of 4673 individuals were interviewed with the Composite International Diagnostic Interview at baseline and 1 and 3 years later. At year 3, clinical re-interview took place to identify onset of psychotic disorder. Results: Given the presence of HEs at baseline, the increase in risk of having the psychosis outcome at year 3 was much higher in those with DE at year 1 than in those without DE (risk difference between individuals with and without DE: 18.72%, 95% CI: 2.22–35.23, χ2 = 4.94, df = 1, P = 0.026). Conclusion: The results are in line with current psychological theories stating that clinical outcome of psychosis-like experiences is related to the development of secondary beliefs and appraisals.

Neuroticism, a central link between somatic and psychiatric morbidity: path analysis of prospective data.

Abstract: Background. Neuroticism and somatic complaints are linked, and the aim of this study is to disentangle which mechanisms may be responsible for this association. Method. In a stratified sample of 7076 adults (18-65 years), neuroticism, 22 self-reported chronic somatic conditions and five broad CIDI-diagnosed psychiatric syndromes were assessed at baseline and, in 3625 (51%) subjects, 3 years later. Using path analysis we examined whether neuroticism has direct links with future somatic morbidity and, conversely, whether morbidity at baseline is linked with higher neuroticism later on. Results. Neuroticism at baseline is associated with psychiatric and somatic morbidity at follow-up after 3 years (31% and 24%, respectively, are direct associations, i.e. unmediated by each other or neuroticism at follow-up and independent of morbidity at baseline). Conversely, somatic and psychiatric morbidity at baseline are associated with increased neuroticism at follow-up (27% and 15%, respectively, are direct associations). Conclusions. Neuroticism raises risk for psychiatric and somatic morbidity but also results from them. It represents a central nexus in the process of morbidity accumulation.

Rapid onset of comorbidity of common mental disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).

Abstract: Objective: In a cohort of subjects with no history of psychopathology, we determined a 3-year incidence and the risk factors of comorbid and pure mood, anxiety and substance use disorders. Method: Data were obtained from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a longitudinal community study in which 4796 adults were interviewed in 1996, 1997 and 1999 with the Composite International Diagnostic Interview. Results: Of 2869 cases at risk, 10.8% developed an incident disorder within 3 years, of which 16.1% was comorbid. Neuroticism, childhood trauma and parental psychiatric history were more strongly associated with comorbid than with pure disorders. No differences emerged in events occurring in the first year after baseline, but events in the period thereafter showed markedly stronger associations with comorbidity and pure mood disorder than with pure anxiety and substance use disorder. Functional disability was also linked more strongly to comorbidity and pure mood disorder. Conclusion: Clear risk factors exist for the rapid onset of comorbidity. Interventions are needed to prevent rapid comorbidity in subjects who recently developed a primary disorder.