Showing papers in "Social Psychiatry and Psychiatric Epidemiology in 2007"

Self-harm in England: a tale of three cities. Multicentre study of self-harm.

Abstract: Background Self-harm is a major healthcare problem in the United Kingdom, but monitoring of hospital presentations has largely been done separately in single centres Multicentre monitoring of self-harm has been established as a result of the National Suicide Prevention Strategy for England

The prevalence of postpartum depression: the relative significance of three social status indices.

Abstract: Background Little is known about the prevalence of clinically significant postpartum depression in women of varying social status. The purpose of the present study was to examine the prevalence of postpartum depression as a function of three indices of social status: income, education and occupational prestige.

Virtual reality in mental health : a review of the literature.

Abstract: Several virtual reality (VR) applications for the understanding, assessment and treatment of mental health problems have been developed in the last 10 years. The purpose of this review is to outline the current state of virtual reality research in the treatment of mental health problems. PubMed and PsycINFO were searched for all articles containing the words “virtual reality”. In addition a manual search of the references contained in the papers resulting from this search was conducted and relevant periodicals were searched. Studies reporting the results of treatment utilizing VR in the mental health field and involving at least one patient were identified. More than 50 studies using VR were identified, the majority of which were case studies. Seventeen employed a between groups design: 4 involved patients with fear of flying; 3 involved patients with fear of heights; 3 involved patients with social phobia/public speaking anxiety; 2 involved people with spider phobia; 2 involved patients with agoraphobia; 2 involved patients with body image disturbance and 1 involved obese patients. There are both advantages in terms of delivery and disadvantages in terms of side effects to using VR. Although virtual reality based therapy appears to be superior to no treatment the effectiveness of VR therapy over traditional therapeutic approaches is not supported by the research currently available. There is a lack of good quality research on the effectiveness of VR therapy. Before clinicians will be able to make effective use of this emerging technology greater emphasis must be placed on controlled trials with clinically identified populations.

Mental health problems among single and partnered mothers. The role of financial hardship and social support.

Abstract: Research has shown elevated levels of common mental disorders among single mothers compared with partnered mothers. The objectives of this analysis were to examine the prevalence of mental health problems among single and partnered mothers and the extent to which this relationship is mediated by socio-demographic, financial and social support variables. Using cross-sectional data from a large, nationally representative longitudinal Australian household survey—the Household Income and Labour Dynamics in Australia (HILDA) Survey—the prevalence of moderate to severe mental disability (as measured by the SF-36) was assessed among 354 single mothers and 1,689 partnered mothers. A series of univariate and simultaneous logistic regression analyses assessed the association between parenting status, the other explanatory variables and mental disability. Mediational analyses were conducted using the ‘explained fraction’ approach. The prevalence of moderate to severe mental disability was significantly more pronounced among single mothers (28.7%) compared with partnered mothers (15.7%). Including all explanatory factors—socio-demographic, household income, financial hardship and social support—accounted for 94% of the association between single mother status and poor mental health. Financial hardship and social support were the strongest predictors, accounting for most of the predictive power of the other variables. Single mothers are more likely to experience poor mental health than partnered mothers, and the primary factors associated with this are the presence of financial hardship in particular, as well as perceived lack of social support. Future research should examine the extent to which changes in financial hardship among different family types relate to changes in mental health over time, as well as continue to examine variables that may moderate the relationship between social disadvantage and poor mental health.

What's in a name? Is accurate recognition and labelling of mental disorders by young people associated with better help-seeking and treatment preferences?

Abstract: The possible benefits or harms of using psychiatric labels in the community have been a focus of debate for many decades. The aim of this study was to examine associations between the accuracy of labelling of depression or psychosis by young people aged 12–25 and their help-seeking, treatment and self-help preferences, whilst controlling for a range of potential confounding factors. A randomly selected population sample of 1,207 young people aged 12–25 years from several regions of Victoria, Australia, was interviewed via a telephone survey. The structured interviews used vignettes of a young person with either depression or psychosis followed by a series of questions related to recognition of disorder and recommended forms of help and treatment. Multiple logistic regression analyses were used to measure the association between a range of help-seeking, treatment and self-help preferences and the predictor variables of accuracy of recognition, socio-demographic background and exposure to mental health problems. Correct labelling of the disorder was the predictor variable most frequently associated with choice of appropriate help and treatment for both the depression and psychosis vignettes. In regard to self-help preferences, correct labelling of the depression vignette was only associated with being less likely to recommend smoking marijuana to relax. Correct labelling of the psychosis vignette, or labelling it as depression, was associated with being less likely to recommend dealing with the problem alone. These findings support the view that improving the use of psychiatric labels by young people is beneficial, because it facilitates appropriate help-seeking and treatment choice. The label may be the cue to activating a schema about appropriate action to take.

Prevalence of mental disorders based on general population surveys

Abstract: In the last two decades, a multitude of investigations into the frequency of mental disorders in the population have emerged, making it difficult to keep track of recent findings and tasks. Building on a historical review, the present study provides a comprehensive overview of knowledge about the prevalence of mental disorders. The review is based on current national surveys with comparable methodology. Study selection, based on a consecutive literature search through August 2005, led to the inclusion of Australian, German, Dutch and US-American (NCS; NCS-R) surveys of mental disorders in the general population. A considerable proportion of the population is found to have a mental disorder. The most frequent disorders within the preceding 12 months are mood disorders (6.6–11.9%) and anxiety disorders (5.6–18.1%). Substance disorders (3.8–11.3%) and somatoform disorders (11.0%) are also very frequent. The prevalence rates presented in each survey are dependent on the specific disorders included and the classification system underlying them. Important risk factors are being female, being unmarried, being unemployed and having a low social status. Knowledge about mental disorders in the general population can contribute to bringing about considerable improvement in the treatment of mental disorders. In addition to available knowledge, however, there is a continued need to address existing challenges from both a methodological and content-related perspective, e.g. the lack of or inadequate inclusion of specific disorders, the lack of prevalence rates of mental disorders in childhood and adolescence, and the as yet only rare inclusion of personality disorders.

Stigma and discrimination towards people with schizophrenia and their family members. A qualitative study with focus groups

Abstract: There is a scarcity of data regarding the actual stigma and discrimination experienced by schizophrenic patients and their relatives. Those experiences can vary significantly depending on the specific social group involved. We have explored such phenomena in our culture with a qualitative technique. We developed a qualitative study with focus groups of clinically stable schizophrenic outpatients (N = 18) and relatives (N = 26). Three groups were performed in each sample. Six categories of stigma and discrimination experiences were extracted from the patients’ data: Mental illness vs. Lack of will, Prejudice related to dangerousness, Over-protection-infantilization, Daily social discrimination, Discrimination in health care, Descendants, Avoidance-social isolation. Data from relatives were divided into three sets: discrimination towards the patients witnessed by relatives, discrimination suffered by the relatives themselves and discrimination exerted by the relatives on the patients. Patients and relatives describe a great variety of stigma and discrimination experiences in all areas of life, including health care. Isolation and avoidance are common reactions to those experiences. Publicizing these stigma and discrimination experiences could help to reduce stigmatizing attitudes in society and result in healthier reactions from patients, favoring a better course of the illness.

Physical activity, dietary habits and Coronary Heart Disease risk factor knowledge amongst people with severe mental illness: a cross sectional comparative study in primary care.

Abstract: Background Evidence regarding Coronary Heart Disease (CHD) related lifestyle in people with severe mental illnesses (SMI) such as schizophrenia is sparse. We aimed to quantify adverse CHD knowledge, diet and exercise in a representative primary care sample, and to determine whether socio-economic deprivation explained any findings.

The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents.

Abstract: Background Previous studies examining the relationship between physical activity levels and broad-based measures of psychological wellbeing in adolescents have been limited by not controlling for potentially confounding variables. The present study examined the relationship between adolescents’ self-reported physical activity level, sedentary behaviour and psychological wellbeing; while controlling for a broad range of sociodemographic, health and developmental factors.

Health habits of patients with schizophrenia.

Abstract: The aim of the study was to analyze the physical activity, dietary, drinking, and smoking habits of schizophrenia patients (SP). Data from 194 schizophrenia outpatients collected using sections of the German National Health Interview and Examination Survey were compared with data from the German general population (GP). In addition to univariate data analyses, a multivariate regression analysis was performed. Schizophrenia patients have a supper snack more frequently, consume instant meals and calorie-reduced food more frequently, and eat healthy groceries more rarely. Though they drink less alcohol, a greater proportion currently smokes, smoking on average 4 cigarettes more per day. On workdays they spend less time with strenuous activities, and in leisure time a greater proportion is involved in no sports. Regression analysis revealed that schizophrenia by itself or in interaction with demographic variables influences physical activity as well as alcohol, nicotine, and healthy grocery consumption. Health habits were particularly disadvantageously affected by schizophrenia in connection with unemployment. Schizophrenia patients are an appropriate target group for public health interventions. They need information about a healthy diet and motivation to prepare their own meals, to quit smoking, and to exercise.

Properties of the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan

Abstract: Background Recent epidemiological studies in Afghanistan using mental health questionnaires yielded high prevalence rates for anxiety and depression.

The mental health status of Chinese rural–urban migrant workers

Abstract: There are currently around 120 million rural–urban migrants in China. Elsewhere migration has been associated with increased vulnerability to mental health problems. This study was conducted to explore the mental health status and help seeking behaviours of migrant workers in Hangzhou city, Zhejiang Province, and to compare them with permanent urban and rural dwellers. A self-completion questionnaire including items relating to sociodemographics, health and lifestyles and mental health, was completed by 4453 migrant workers and 1957 urban workers in Hangzhou city, and by 1909 rural residents in Western Zhejiang Province. The mean age of the migrants was 27 years, (male 29 years, female 25 years). They worked long hours (28% >12 h per day, 81% 6 or 7 days per week) and their living conditions were very basic. On the SF-36 mental health scale migrants had lower scores (52.4) than rural residents (60.4, P < 0.0001) but scored higher than urban residents (47.2, P = 0.003). The difference between urbanites and migrants disappeared after adjustment for confounders (P = 0.06). Independent predictors of better mental health status among migrants were being unmarried, migrating with a partner, higher salary, good self-reported health and good relationships with co-workers. There were small significant differences in suicide ideation and attempts between the three groups with suicide ideation commonest in migrants and suicide attempts most common in the rural population. Fewer than 1% across all three groups had received any professional help for depression or anxiety. Rural–urban migrant workers in this part of China are not especially vulnerable to poor mental health. This may result from a sense of well being associated with upward economic mobility and improved opportunities, and the relatively high social capital in migrant communities.

General health mediates the relationship between loneliness, life satisfaction and depression - A study with Malaysian medical students

Abstract: Objective To examine the associations between life satisfaction, loneliness, general health and depression among 172 medical students in Malaysia.

The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour

Abstract: The subjective impact of a psychotic breakdown can be profound, potentially resulting in loss of social roles, hopes and aspirations and leading to stigmatisation, trauma and elevated suicide risk. This study aimed to assess the subjective effect and consequences of suffering a first episode of psychosis. It was hypothesised that suicide behaviour would be associated with the negative consequences of psychosis and co-morbid symptomatic-PTSD. Patients were assessed by means of a semi-structured interview on their reactions and experience of their psychotic episode and its treatment and by means of standardised methods for psychotic (PANSS) and trauma-related (CAPS) symptoms. A total of 35 patients suffering their first episode of psychosis were interviewed. As a result of the onset of their illness, 77% indicated they had suffered loss or disruption to their life, 60% had thwarted future aspirations, 38% had suffered violence or harassment, 53% had suffered stigma and 50% social exclusion. Totally, 80% felt they had been traumatised by their treatment and 38% were cases for symptomatic-PTSD. Symptomatic-PTSD was significantly associated with involuntary hospitalisation but not psychotic symptoms. Positive psychotic symptoms were associated with harassment, stigma and social exclusion. Suicidal ideation was reported by 40% and 31% reported attempting suicide. Suicidal behaviour was greater in those suffering symptomatic-PTSD but this was not significant, suicidal behaviour was significantly associated with the experience of trauma, but not the severity of that trauma, prior to the onset of their psychosis. The negative consequences of a psychotic episode are significant. The potential iatrogenic effect of psychiatric care needs to be considered. Interventions need to be developed to reduce traumatisation and suicide risk.

A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery.

Abstract: Introduction Employment discrimination is considered as a major impediment to community integration for people with serious mental illness, yet little is known about how the problem manifests differently across western and non-western societies. We developed a lay model based on Chinese beliefs and values in terms of Confucianism, Taoism, Buddhism, and folk religions which may be used to explain cross-cultural variation in mental illness stigma, particularly in the arena of employment discrimination. In this study, we tested this lay approach by comparing employers’ concerns about hiring people with psychotic disorder for entry-level jobs in US and China.

Risk behaviours, victimisation and mental distress among adolescents in different family structures

Abstract: Previous studies have shown an elevated risk with regard to social and behavioural domains in adolescents of single parents. However, the diversity of single parent families concerning gender of the resident parent has seldom been taken into account when investigating the relation between family structure and children’s negative outcomes. Thus, the aim of this study was to investigate risk behaviours, victimisation and mental distress among adolescents in different family structures using more detailed sub-groups of single parents (i.e., single mother, single father and shared physical custody). The sample consisted of 15,428 ninth graders from all municipal and private schools in the county of Stockholm (response rate 83.4%). Risk behaviours included use of alcohol, illicit drugs and smoking. Victimisation was measured by experiences of exposure to bullying and physical violence. Mental distress was assessed with the anxious/depressed and aggressive behaviour syndrome scales in the Youth Self Report (YSR). Bivariate and multivariate logistic regression analyses were used to investigate the associations between family structure and outcome variables. Adolescents in single-mother/father families were at higher risk of risk behaviours, victimisation and mental distress than their counterparts in two-parent families. However, after control for possible confounders the associations between victimisation, aggressive behaviour problems and single motherhood were no longer significant, whereas these relations remained for children living with single fathers. Adolescents in shared physical custody run no increased risk of any of the studied outcomes (except drunkenness) after adjustment for covariates. Post hoc analyses revealed that adolescents in single-father families were at higher risk for use of alcohol, illicit drugs, drunkenness, and aggressive behaviour as compared to their peers in single-mother families, whereas no differences were found between adolescents in single-mother families and those in shared physical custody. Children of single parents should not be treated as a homogenous group when planning prevention and intervention programmes. Researchers and professionals should be aware of and consider the specific problems of single parent children and that their problems may vary depending on their living arrangements.

To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors

Abstract: BACKGROUND: Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can ...

A 15-year national follow-up: legislation is not enough to reduce the use of seclusion and restraint.

Abstract: Seclusion and restraint are frequent but controversial coercive measures used in psychiatric treatment. Legislative efforts have started to emerge to control the use of these measures in many countries. In the present study, the nationwide trends in the use of seclusion and restraint were investigated in Finland over a 15-year span which was characterised by legislative changes aiming to clarify and restrict the use of these measures. The data were collected during a predetermined week in 1990, 1991, 1994, 1998 and 2004, using a structured postal survey of Finnish psychiatric hospitals. The numbers of inpatients during the study weeks were obtained from the National Hospital Discharge Register. The total number of the secluded and restrained patients declined as did the number of all inpatients during the study weeks, but the risk of being secluded or restrained remained the same over time when compared to the first study year. The duration of the restraint incidents did not change, but the duration of seclusion increased. A regional variation was found in the use of coercive measures. Legislative changes solely cannot reduce the use of seclusion and restraint or change the prevailing treatment cultures connected with these measures. The use of seclusion and restraint should be vigilantly monitored and ethical questions should be under continuous scrutiny.

Trauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees - A comparison with the Australian-born population

Abstract: Uncertainty persists about the impact of trauma on the long-term mental health of resettled refugees. The present study aimed to assess the contributions of trauma and PTSD to overall mental disorder and related need for services amongst Vietnamese refugees resettled for over a decade in Australia. The data were compared with a survey of the host population. The study involved a probabilistic sample of Vietnamese refugees (n = 1,161) resettled in Australia for 11 years. The Australian-born sample (n = 7,961) was drawn from a national survey using the same diagnostic measure, the Composite International Diagnostic Interview (CIDI). The PTSD prevalence for both groups was 3.5% and the diagnosis was present in 50% of Vietnamese and 19% of Australians with any mental disorder(s). Trauma made the largest contribution to mental disorder in the Vietnamese (odds ratio >8), whereas amongst Australians, younger age (odds ratio >3) and trauma (odds ratio >4) each played a role. PTSD was equally disabling in both populations but Vietnamese with the disorder reported more physical, and Australians more mental disability. Approximately one in three Australians and one in 10 Vietnamese with PTSD sought help from mental health professionals. Trauma and PTSD continue to affect the mental health of Vietnamese refugees even after a decade of resettlement in Australia. The tendency of Vietnamese with PTSD to report symptoms of physical disability may create obstacles to their obtaining appropriate mental health care.

A longitudinal study of acculturative stress and homesickness: high-school adolescents immigrating from Russia and Ukraine to Israel without parents

Abstract: Background Acculturative stress and homesickness are psychological reactions to cross-cultural transition. They may cause a decline in social functioning, increased psychological distress, and, in severe cases, psychiatric disorders among immigrants.

Sickness absence and disability pension in a cohort of employees initially on long-term sick leave due to psychiatric disorders in Sweden.

Abstract: Over the last decade sickness absence and disability pension (DP) due to psychiatric disorders have increased considerably in Western countries. The scientific knowledge base about prognoses for such absences is very limited, but employers and clinicians often predict them to be very long. The aim of this study was to investigate sickness absence and disability pension in a cohort of employees who initially were on long-term sick leave due to psychiatric disorders, with regard to gender, age, socioeconomic status, and previous sickness absence. The cohort included 4,891 employees in Sweden, who, in 1999 were aged 20–61 and had a new sick-leave spell >90 days with a psychiatric disorder. Retrospective and prospective registry data on sickness absence and DP for 1996–2002 were obtained. Logistic regressions were performed to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for having a low, intermediate, or high level of sickness absence (<17, 17–90, and 91–365 days, respectively) or DP in 2002. The mean number of sick-leave days per person per year 3 years prior to inclusion was low; 17 days, but had increased to 211 days by 2000. In 2002, 26% had been granted DP, significantly higher rate among men, while a higher rate of the women had long-term sickness absence. Of all 4,891 subjects, 35% had <17 sick-leave days in 2002. The OR of having low, intermediate, or long-term sickness absence decreased with age. The reverse was found for obtaining DP, for which also low socioeconomic status was an independent predictor of an increased risk (OR = 3.40, CI 2.28–5.08). Employees with long-term sick leave due to psychiatric disorders did not have a high level of sickness absence in the 3 years prior to inclusion in the study. Also, 3 years after inclusion, only 35% had very low levels of sickness absence, whereas 26% had been granted DP. Employees who were aged 55–61 showed the lowest risk of sick leave but the highest risk of DP. Low SES was a significant predictor of DP in 2002.

Belief models in first episode schizophrenia in South India

Abstract: Existing evidence indicates that dissonance between patients’ and professionals’ explanatory models affects engagement of patients with psychiatric services in Western and non-Western countries. To assess qualitatively the explanatory models (EMs) of psychosis and their association with clinical variables in a representative sample of first episode patients with schizophrenia in South India. One hundred and thirty one patients with schizophrenia presenting consecutively were assessed. Measures included the patient’s explanatory models, and clinician ratings of insight, symptoms of psychosis, and functioning on standard scales. The majority of patients (70%) considered spiritual and mystical factors as the cause of their predicament; 22% held multiple models of illness. Patients who held a biomedical concept of disease had significantly higher scores on the insight scale compared to those who held non-medical beliefs. Multivariate analyses identified three factors associated with holding of spiritual/mystical models (female sex, low education and visits to traditional healers); and a single factor (high level of insight) for the endorsement of biological model. Patients with schizophrenia in this region of India hold a variety of non-medical belief models, which influence patterns of health seeking. Those holding non-medical explanatory models are likey to be rated as having less insight.

Caregiver burden and coping : A prospective study of relationship between burden and coping in caregivers of patients with schizophrenia and bipolar affective disorder

Abstract: Caregivers of patients of schizophrenia and bipolar affective disorder (BAD) experience considerable burden while caring their patients. They develop different coping strategies to deal with this burden. Longitudinal studies are required to assess the relationship between caregiver burden and coping. The present study was conducted to assess relationship between burden and coping in caregivers of clinically stable patients with schizophrenia and BAD. One hundred patients each of schizophrenia and BAD attending a psychiatric outpatient setting and their caregivers were followed up for a period of 6 months. Burden and coping strategies were assessed in the caregivers at baseline, and after 3 and 6 months using the Burden Assessment Schedule (BAS) and Ways of Coping Checklist - Hindi Adaptation (WCC - HA). Burden remained stable over 6 months and was comparable in the two groups of caregivers. Caregivers from both the groups were found to use problem focused coping strategies more often than seek social support and avoidance strategies. Scores on avoidance type of coping showed a positive correlation with the total burden scores and a number of burden factors. Caregivers of patients of schizophrenia and BAD face similar levels of burden and use similar types of coping methods to deal with it. Relationship between caregiver burden and coping is quite complex.

Prevalence and predictors of health service use among Iraqi asylum seekers in the Netherlands

Abstract: A long asylum procedure is associated with higher prevalence rates of psychiatric disorders, lower quality of life, higher disability and more physical health problems. Additional knowledge about health seeking behavior is necessary to guide governments and health professionals in their policies. To measure service use among one of the biggest asylum seekers population in the Netherlands and to assess its relationships with predisposing and need variables (including post-migration living problems). Two groups were randomly selected: Group 1 (n = 143), less than 6 months and Group 2 (n = 151), more than 2 years in the Netherlands. Respondents were interviewed with fully structured, culturally validated, translated questionnaires, which contained instruments to measure psychiatric disorders, quality of life, disability, physical health and post-migration living problems. Use of preventive and curative (physical and mental) health services was measured and the relationship with predisposing and need risk factors was estimated with univariate and multivariate logistic regression analyses. A long asylum procedure is not associated with higher service use, except for mental health service use and drug use. Use of mental health services is, however, low compared to the prevalence of psychiatric disorders. Low quality of perceived general health and functional disability are the most important predictors of services use. Psychopathology predicts use of a medical specialist (non-psychiatrist), but does not predict mental health service use. A high percentage of asylum seekers with a psychiatric disorder is not getting adequate treatment. There is a mismatch between the type of health problem and the type of health service use. The various health services should work together in education, detection, referral and care in order to provide help to this group of patients.

Doctors' attitude towards people with mental illness in Western Nigeria.

Abstract: Introduction It had been suggested that those more knowledgeable about mental illness are less likely to endorse negative or stigmatizing attitudes. This study aimed to evaluate the attitude of doctors in Nigeria towards the mentally ill.

Neighbourhood variation in the incidence of psychotic disorders in Southeast London

Abstract: Background Urbanicity is a risk factor for schizophrenia, but it is unclear whether this risk is homogenous across urban areas.

The mental health effects of multiple work and family demands. A prospective study of psychiatric sickness absence in the French GAZEL study

Abstract: BACKGROUND: Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men. METHODS: We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8,869 men, 2,671 women) over a period of 9 years (1995-2003). Work stress and family demands were measured by questionnaire. Medically certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline. RESULTS: Participants simultaneously exposed to high levels of work and family demands (>/=2 work stress factors and >/=4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0-1 work stress factors and with 1-3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02-5.52) in men and 6.36 (95% CI 3.38-11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86-3.87) in men, 5.04 (95% CI 2.84-8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression: age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96-11.24) in men, 8.57 (4.26-17.22) in women; fully adjusted RRs: 3.55 (95% CI 1.62-7.77) in men, 6.58 (95%CI 3.46-12.50) in women. CONCLUSIONS: Men and women simultaneously exposed to high levels of work stress and family demands are at high risk of experiencing mental health problems, particularly depression.

Prevalence and predictors of post-traumatic stress disorder (PTSD) in physically injured victims of non-domestic violence. A longitudinal study.

Abstract: Victims of violent assault experience diverse post-event emotional problems such as post-traumatic stress disorder (PTSD), and they may have multiple emotional problems. The aim of the present study was to evaluate the prevalence and predictors of PTSD in a longitudinal design. The levels of physical injury, perceived life threat, prior experience of violence, peritraumatic dissociation (PD), acute PTSD, perceived self-efficacy and perceived social support are considered possible predictors. This study had a single group (N = 70), longitudinal design with three repeated measures over a period of 12 months. Questionnaires used were: Impact of Event Scale-15 and 22 (IES-15 and 22), Post-Traumatic Symptom Scale-10 (PTSS-10), Peritraumatic Dissociation (PD) 7-item self-report measure, Social Provisions Scale (SPS) and Generalized Self-Efficacy scale (GSE). Results showed a high prevalence and severity of PTSD on all outcomes, for instance 31% scored as probable PTSD-cases and 14% as risk level cases by IES-15 at T3. Either injury severity or prior experience of being a victim of violence predicted PTSD in this study. Early PTSD predicted subsequent PTSD, and perceived life threat was a predictor of PD. Furthermore, lack of perceived social support was a predictor of PTSD symptoms at T3. In addition, low perceived self-efficacy was a predictor of PTSD and influenced perceived social support at T1. Our results showed that experience of non-domestic violence may cause serious chronic emotional problems, and therefore it is important to be aware of early symptoms indicating needs for special follow-ups.

Depressed mood and n-3 polyunsaturated fatty acid intake from fish: non-linear or confounded association?

Abstract: There is increasing evidence of an association between low dietary intake of essential n-3 long chain polyunsaturated fatty acids (n-3 EFAs) and depressed mood. This study aimed to evaluate this association in a large population-based sample of UK individuals. N-3 EFA intake (intake from fish alone, and from all sources (fish and supplements)), depressed mood (assessed using the short-form Depression, Anxiety and Stress Scales) and demographic variables (sex, age, Index of Multiple Deprivation (IMD) based on postal code, and date of questionnaire completion) were obtained simultaneously by self-report questionnaire (N = 2982). Using polynomial regression, a non-linear relationship between depressed mood and n-3 EFA intake from fish was found, with the incremental decrease in depressed mood diminishing as n-3 EFA intake increased. However, this relationship was attenuated by adjustment for age and IMD. No relationship between depression and n-3 EFA intake from all sources was found. These findings suggest that higher levels of n-3 EFA intake from fish are associated with lower levels of depressed mood, but the association disappears after adjustment for age and social deprivation, and after inclusion of n-3 EFA intake from supplements. This study does have a number of limitations, but the findings available suggest that the apparent associations between depressed mood and n-3 EFA intake from fish may simply reflect a wider association between depressed mood and lifestyle.

Social phobia in Swedish university students: prevalence, subgroups and avoidant behavior

Abstract: Public speaking is a common situation that university students have to endure. This situation is feared or avoided by most individuals with social phobia, which has been associated with low levels of educational attainment. However, epidemiological data on social phobia in university students are scarce. The present study examined the prevalence of social phobia and its subgroups in a university student population. Demographic characteristics and avoidant behavior in educational settings were also examined. The Social Phobia Screening Questionnaire (SPSQ)—a validated and DSM-IV compatible instrument, was distributed as a postal survey to 753 randomly selected university students in Sweden. Interpretable questionnaires were obtained from 523 students (69.5%). To investigate subgroups, students who met the SPSQ diagnostic criteria of social phobia were analyzed by hierarchical cluster analysis. The point prevalence of social phobia among the Swedish university students was 16.1%, comparable with 15.6% previously reported for the general population. Two clusters were distinguished consisting of students scoring either low (discrete subgroup) or high (generalized subgroup) on all cluster variables. The discrete subgroup was more common representing 83% of the cases. Social phobia was associated with use of dysfunctional avoidant strategies in educational situations and in anticipation of public speaking. The disorder was less common among students following a pedagogic university program. Social phobia was highly prevalent among Swedish university students, most cases pertaining to a mild or discrete form of the disorder. The commonness and severity of social phobia in students did not deviate significantly from the general population suggesting that socially anxious individuals do apply for higher education. However, since avoidance and low educational attainment are commonly reported features, future studies should investigate whether sufferers of social phobia underachieve or abolish their studies prematurely.