Showing papers on "Mixed anxiety-depressive disorder published in 2004"

Mental health symptoms following war and repression in eastern Afghanistan

Abstract: ContextDecades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population.ObjectivesTo determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan.Design, Setting, and ParticipantsA cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate).Main Outcome MeasuresPosttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire.ResultsDuring the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval {CI}, 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%).ConclusionsIn this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced multiple traumatic events and having symptoms of anxiety, depression, and PTSD were high. These findings suggest that mental health symptoms in this region should be addressed at the population and primary health care level.

Influence of work environment on emotional health in a health care setting.

Abstract: Background Radical changes are taking place in health care services and might be expected to cause job dissatisfaction, absenteeism, somatic complaints and mental health problems. Research in this area is limited and focused primarily on nurses. Aim To understand the impact of the work environment on the emotional health of doctors and nurses in a general hospital setting. Methods Cross-sectional study using self-reported questionnaires including the General Health Questionnaire, the Posttraumatic Stress Disorder (PTSD) Checklist for Civilians, the Trauma Experiences and Work Environment Scale. Results The response rates for the study were 28% (60) for doctors and 54% (431) for nurses. Whilst the prevalences of psychiatric disorder, anxiety, depression and PTSD were higher for doctors compared with nurses, this was not statistically significant. Both groups reported witnessing someone badly injured or killed as their most distressing experience (doctors 46% versus nurses 41%). Using multiple logistic regression, significant predictors of emotional health was task orientation for doctors (OR = 1.96, 95% CI = 1.1-3.6), and PTSD (OR = 17.2, 95% CI = 6.0-49.6), work pressure (OR = 1.2, 95% CI = 1.01-1.4) and innovation (OR = 0.81, 95% CI = 0.70-0.94) for nurses. Conclusion The prevalence of psychiatric disorder among the doctors and nurses was similar to that in Britain. Elements of the work environment did impact on the emotional health of health care workers. Organizational development initiatives should include employee mental health issues in order to create a more positive work environment.

Gender differences in the relationships between alcohol, tobacco and mental health in patients attending an emergency department.

Abstract: Aims: There is evidence of a non-linear relationship between alcohol consumption and mental health status, and of an association between tobacco use and poor mental health. This paper examines the nature of the association between usual alcohol consumption, tobacco use and symptoms of anxiety and depression in Emergency Department patients in Queensland, Australia. Methods: A cross sectional survey of patients aged 16-84 presenting for treatment over a 14 day period to Gold Coast Hospital Emergency Department using socio-demographic items, the Alcohol Use Disorders Identification Test (AUDIT) to measure moderate, hazardous and harmful alcohol consumption, and the Hospital Anxiety and Depression Scale (HADS) to measure state anxiety and depression. Results: 812 patients were interviewed. Gender differences in results were evident. For men, there was a U-shaped relationship between alcohol consumption and anxiety/depression, and a linear association between smoking and anxiety. For women, alcohol consumption and anxiety/depression showed a more linear relationship, but there was no significant relationship between tobacco use and anxiety/depression. Conclusions: There may be important gender differences in the relationships between alcohol consumption, tobacco use and mental health status. This study supports previous evidence that mental health status of non-drinkers is worse than that of moderate drinkers, but only among males (First published on August 2, 2004, doi:10.1093/alcalc/agh080)