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Journal ArticleDOI

2007 National Survey of Mental Health and Wellbeing: Methods and key findings.

TL;DR: Mental disorders are common in Australia, and many people have more than one class of mental disorder, yet many people with mental disorders do not seek help for their mental health problems.
Abstract: Objective: To provide a description of the methods and key findings of the 2007 Australian National Survey of Mental Health and Wellbeing. Method: A national face-to-face household survey of 8841 (60% response rate) community residents aged between 16 and 85 years was carried out using the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Diagnoses were made according to ICD-10. Key findings include the prevalence of mental disorder, sex and age distributions of mental disorders, severity of mental disorders, comorbidity among mental disorders, and the extent of disability and health service use associated with mental disorders. Results: The prevalence of any lifetime mental disorder was 45.5%. The prevalence of any 12 month mental disorder was 20.0%, with anxiety disorders (14.4%) the most common class of mental disorder followed by affective disorders (6.2%) and substance use disorders (5.1%). Mental disorders, particularly affective disorders, were disabling. One in four people (25.4%) with 12 month mental disorders had more than one class of mental disorder. One-third (34.9%) of people with a mental disorder used health services for mental health problems in the 12 months prior to the interview. Conclusions: Mental disorders are common in Australia. Many people have more than one class of mental disorder. Mental disorders are associated with substantial disability, yet many people with mental disorders do not seek help for their mental health problems.
Citations
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Journal ArticleDOI
TL;DR: The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked, yet cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms.
Abstract: In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record

1,173 citations

Journal ArticleDOI
TL;DR: The German health interview and examination survey for adults with the mental health module (DEGS1-MH) is the successor to the last survey of mental disorders in the general German population 15 years ago and reports the basic findings on the 12-month prevalence ofmental disorders, associated disabilities and self-reported healthcare utilization.
Abstract: Die „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) und ihr Zusatzmodul „Psychische Gesundheit“ (DEGS1-MH) erlauben erstmals seit dem 15 Jahre zuruckliegenden Bundesgesundheitssurvey (BGS98) aktuelle Abschatzungen zu Morbiditat, Einschrankungsprofilen und Inanspruchnahmeverhalten der deutschen Erwachsenen. Es werden die wichtigsten Ergebnisse zu Pravalenzen psychischer Storungen, zu damit assoziierten Beeintrachtigungen sowie zu Kontaktraten mit Gesundheitsdiensten berichtet. Der Studie liegt eine bevolkerungsreprasentative Erwachsenenstichprobe (18–79 Jahre, n = 5317) zugrunde, die uberwiegend personlich mit ausfuhrlichen klinischen Interviews (Composite International Diagnostic Interview; CIDI) untersucht wurde. Die 12-Monats-Pravalenz psychischer Storungen betragt insgesamt 27,7 %, wobei grose Unterschiede in verschiedenen Gruppen (z. B. Geschlecht, Alter, sozialer Status) zu verzeichnen sind. Psychische Storungen stellten sich als besonders beeintrachtigend heraus (erhohte Zahl an Einschrankungstagen). Weniger als die Halfte der Betroffenen berichtet, aktuell wegen psychischer Probleme in Behandlung zu stehen (10–40 % in Abhangigkeit von der Anzahl der Diagnosen). Psychische Storungen sind haufig. Die im Vergleich zu Personen ohne aktuelle psychische Diagnose deutlich erhohte Rate an Beeintrachtigungstagen signalisiert neben dem individuellen Leiden der Betroffenen eine grose gesellschaftliche Krankheitslast – auch verglichen mit vielen korperlichen Erkrankungen. Trotz des in Deutschland vergleichsweise gut ausgebauten Versorgungssystems fur psychische Storungen ist Optimierungsbedarf hinsichtlich der Behandlungsrate zu vermuten.

425 citations

Journal ArticleDOI
TL;DR: Mental disorders were found to be commonplace with a prevalence level comparable to that found in the 1998 predecessor study but several further adjustments will have to be made for a sound methodological comparison between the studies.
Abstract: Background and objectives The German health interview and examination survey for adults (DEGS1) with the mental health module (DEGS1-MH) is the successor to the last survey of mental disorders in the general German population 15 years ago (GHS-MHS). This paper reports the basic findings on the 12-month prevalence of mental disorders, associated disabilities and self-reported healthcare utilization. Methods A representative national cohort (age range 18-79 years, n = 5,317) was selected and individuals were personally examined (87.5 % face to face and 12.5 % via telephone) by a comprehensive clinical interview using the composite international diagnostic interview (CIDI) questionnaire. Results The overall 12-month prevalence of mental disorders was 27.7 % with substantial differences between subgroups (e.g. sex, age, socioeconomic status). Mental disorders were found to be particularly impairing (elevated number of disability days). Less than 50 % of those affected reported to be in contact with health services due to mental health problems within the last 12 months (range 10-40 % depending on the number of diagnoses). Conclusions Mental disorders were found to be commonplace with a prevalence level comparable to that found in the 1998 predecessor study but several further adjustments will have to be made for a sound methodological comparison between the studies. Apart from individual distress, elevated self-reported disability indicated a high societal disease burden of mental disorders (also in comparison with many somatic diseases). Despite a relatively comprehensive and well developed mental healthcare system in Germany there are still optimisation needs for treatment rates.

383 citations

References
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Journal ArticleDOI
TL;DR: Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity, as shown in the recently completed US National Comorbidities Survey Replication.
Abstract: Background Little is known about the general population prevalence or severity of DSM-IV mental disorders. Objective To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Main Outcome Measures Twelve-month DSM-IV disorders. Results Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Conclusion Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

10,951 citations


"2007 National Survey of Mental Heal..." refers background in this paper

  • ...To be classified as severe, in addition to having a 12 month mental disorder, one of the following must have occurred in the previous 12 months: an episode of mania; a suicide attempt; at least two areas of severe role impairment on the disorder-specific Sheehan Disability Scales [19] or overall functional impairment at a level equivalent to a Global Assessment of Functioning score of 550 [20]....

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Journal ArticleDOI
TL;DR: An overview of the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (CIDI) is presented and a discussion of the methodological research on which the development of the instrument was based is discussed.
Abstract: This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection.

4,232 citations


"2007 National Survey of Mental Heal..." refers methods in this paper

  • ...Additional harmful use/abuse and dependence diagnostic algorithms were devised for the four separate drug categories, based on existing WMH-CIDI algorithms....

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  • ...The WMH-CIDI uses a lifetime time frame....

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  • ...Sequencing problems in earlier versions of the WMH-CIDI substance use section were also resolved [12 14]....

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  • ...The World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI) [11]...

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  • ...First, use of the WMH-CIDI as the base instrument for the survey capitalized on the extensive methodological testing and development invested in this instrument [11]....

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Journal ArticleDOI
TL;DR: The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI, and routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.
Abstract: Background Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI. Methods Three SMI screening scales were developed for possible use in the SAMHSA National Household Survey on Drug Abuse: the Composite International Diagnostic Interview Short-Form (CIDI-SF) scale, the K10/K6 nonspecific distress scales, and the World Health Organization Disability Assessment Schedule (WHO-DAS). An enriched convenience sample of 155 respondents was administered all screening scales followed by the 12-month Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning (GAF). We defined SMI as any 12-month DSM-IV disorder, other than a substance use disorder, with a GAF score of less than 60. Results All screening scales were significantly related to SMI. However, neither the CIDI-SF nor the WHO-DAS improved prediction significantly over the K10 or K6 scales. The area under the receiver operating characteristic curve of SMI was 0.854 for K10 and 0.865 for K6. The most efficient screening scale, K6, had a sensitivity (SE) of 0.36 (0.08) and a specificity of 0.96 (0.02) in predicting SMI. Conclusions The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI. Routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

4,170 citations


"2007 National Survey of Mental Heal..." refers methods in this paper

  • ...The interview consisted of demographic information and the Kessler 10 Psychological Distress Scale (K10) [10], included as an indicator of mental health status....

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Journal ArticleDOI
09 Aug 2002
TL;DR: The present article has the objective of updating rehabilitation health professionals on the International Classification of Functioning Disability and Health (ICF) developed by the World Health Organization.
Abstract: The present article has the objective of updating rehabilitation health professionals on the International Classification of Functioning Disability and Health (ICF) developed by the World Health Organization. The ICF’s history, application and perspectives in rehabilitation are discussed

3,246 citations

Journal ArticleDOI
TL;DR: The International Classification of Functioning, Disability and Health (CIDH) as mentioned in this paper was developed by the World Health Organization (WHO) to describe and measure health and disability in 191 countries after revamping the prior model and reaching a consensus regarding a new international model.
Abstract: The approach which had been being employed to date for dealing with and classifying those aspects related to health and disability have been revised and updated thanks to the World Health Organization (WHO) having drafted the International Classification of Functioning, Disability and Health, which has now been accepted 191 countries after revamping the prior model and reaching a consensus regarding a new international model for describing and measuring health and disability. As background information, it must be recalled that the Classification of Impairments, Disabilities and Handicaps (CIDH) previously in effect was first published by the WHO in 1980. The process of revising this classification has resulted in some changes of far-reaching importance. The change in the name has been aimed at reflecting the wish to replace the negative perspective of impairments, disabilities and handicaps for a more neutral view of structure and function, considering the positive perspectives of activities and of participation. Another new aspect has been that of including a section related to environmental factors in recognition of their importance, given that by interacting with the health condition they may give rise to a disability, or, at the opposite end of the scale, may restore functioning. The data available has enabled the WHO make estimates including that of some 500 million years of life being lost annually due to disabilities related to health problems, which totals over one half of the years lost annually due to premature deaths. The main objective of this new classification is that of providing the conceptual framework by means of unified, standardized language with a view to of the underlying challenges, setting out a valuable instrument of practical use in public health.

2,531 citations