Prevalence,recognition and management of mental disorders in primary health care in Northern Jordan

This study examined the prevalence of psychiatric disorders and assessed factors that are assumed to be related to recognition of this morbidity among clinical patients. A total of 794 patients aged 18 years or older participated in the study. Using an Arabic-translated version of the General Health Questionnaire (GHQ-28), the prevalence of psychiatric morbidity was found to be 61%. The highest prevalence rates of psychiatric disorders were found in the 40 years and older age group, in female subjects, in uneducated and highly educated groups, in unemployed individuals, and in patients who were perceived to have ‘fair’ or ‘poor’ physical health. Multiple logistic regression analysis revealed that unemployment and perceived severity of physical illness were positively correlated with psychiatric disorders, but no significant correlation was found with sex, age or level of education. The physicians in the present study were able to detect morbidity in only 24% of the patients. Among patients with psychiatric disorders, recognition of this morbidity was significantly greater in women, in patients who had consulted with their family doctors, in patients previously known to their physicians, and in patients with mild physical illness than in their counterparts. The most common lines of psychiatric management used in this study were referral to psychiatrists (47%) and psychotropic medication (16%).     

Prevalence of mental disorders and mental health service use in Japan

A high disease burden of mental disorders has been noted worldwide, including Japan. It is important to monitor mental disorder prevalence trends and the use of mental health services over time using epidemiological data and to plan appropriate policies and measures that consider mental health in each country. This review outlines the prevalence trends of common mental disorders (CMD) and the use of mental health services in Japan from the 2000s to the 2010s and compares them with those in other countries. This review clarifies that the prevalence of CMD in Japan has been relatively stable in the past decade. The 12‐month prevalence of mental health service use has increased about 1.2 times to 1.6 times in the past 10–15 years. Thus, it is very likely that the rise in mental health service use contributes to increased patient numbers. Regarding cross‐national comparison, the prevalence rate of CMD in Japan is much lower compared to rates in the USA and Europe. The 12‐month prevalence of mental health service use was also lower in Japan compared to prevalence rates in other high‐income countries. Mental health epidemiology has clarified that the prevalence of CMD worldwide has remained unchanged, even though mental health service use has increased in high‐income countries. Thus, the gap in treatment quality and prevention should be addressed in the future.     

Prevalence and comorbidity of mental disorders among adolescents living in residential youth care

Most adolescents are placed in residential youth care (RYC) because of severe psychosocial strains and child maltreatment, which represent risk factors for developing mental disorders. To plan RYC units and ensure that residents receive evidence-based psychiatric interventions, it is necessary to obtain reliable and valid prevalence estimates of mental disorders in this population. However, there is a lacuna of research on diagnoses derived from standardized clinical interviews. The aim of this study was to assess the prevalence and comorbidity of mental disorders applying diagnostic interviews in an entire population of adolescents living in RYC in Norway. All young people in RYC were invited to participate in the study. Eighty-six RYC institutions with 601 eligible adolescents were included and 400 adolescents, 12–20 years old, participated in the study, yielding a response rate of 67 %. Anonymous Child Behaviour Checklist scores for 141 (70 %) of the declining residents were also available, allowing diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) for 541 youths to be estimated. Diagnoses were assessed by trained interviewers with the Child and Adolescent Psychiatric Assessment interview (CAPA). Seventy-six point two per cent (71.5–80.8 CI 95 %) of adolescents received at least one 3-month DSM-IV diagnosis. Prevalence rates for internalizing psychiatric disorders were higher than for behavioural disorders. Comorbidity was high between these two groups. Mental disorders were prevalent among children and youth in RYC. Our results create major concerns and challenge the existing organization of the RYC system.     

Prevalence, comorbidity, and correlates of DSM-IV axis I mental disorders among female university students

This cross-sectional study evaluated the prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), axis I mental disorders among Spanish female students and investigated their psychiatric comorbidity and correlates. 1054 female students with a mean age of 22.2 years were randomly selected, with stratification by academic seniority and the type of academic discipline. The cases of mental disorder were identified by clinically trained interviewers with the aid of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version. The lifetime prevalence of the targeted psychiatric disorders was 50.8%, and its point prevalence was 37.3%. The commonest disorders were nicotine dependence, depression, and generalized anxiety disorder. Nearly 37% of subjects with a psychiatric disorder had two or more diagnoses. Mental illness was associated with family income, financial independence, type of academic discipline, violence from men, social support, and self-esteem. Psychiatric disorders are common among female university students. Serious attention should be paid to preventive and therapeutic programs in this group.     

Prevalence,symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar

Aim  

The aim of this study was to assess the prevalence of anxiety and depressive disorders in a Qatari population who attend the primary health care settings and examine their symptom patterns and comorbidity.     

Neurodevelopmental disorders: prevalence and comorbidity in children referred to mental health services

Background: Accurate prevalence rates of the neurodevelopmental disorders (ND) and comorbid conditions in child and adolescent mental health services (CAMHS) are essential for treatment planning and organization of health care. However, valid and reliable prevalence estimates from Nordic CAMHS populations are scarce, and the published findings vary.

Aims: To report prevalence rates of ND (attention-deficit hyperactivity disorder: ADHD, tic disorder: TD or autism spectrum disorder: ASD) and comorbid disorders by a validated diagnostic instrument in children referred to CAMHS outpatient clinics.

Methods: Parents of 407 consecutively referred children aged 7–13 years were interviewed with the semistructured interview schedule for affective disorders and schizophrenia, present and lifetime version (Kiddie-SADS-PL) at time of admittance.

Results: One or more ND was diagnosed in 226 children (55.5%; 69.9% boys): ADHD (44.5%; 68.5% boys); TD (17.7%; 77.8% boys) and ASD (6.1%; 76% boys). Among children with ND 70 (31.0%) had only one ND with no comorbid disorder, 49 (21.7%) had more than one ND (homotypic comorbidity) and 131 (58%) had a non-ND psychiatric disorder (heterotypic comorbidity). Anxiety disorders were the most frequently occurring heterotypic comorbidity in all three ND. Comorbid depressive disorder was associated with older age, and comorbid anxiety disorder with female gender.

Conclusion: In children referred to CAMHS, ND constitute the most frequently occurring group of disorders, with high rates of both homotypic and heterotypic comorbidity. This needs to be taken into consideration in health service planning and treatment delivery.     

Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders

Objective: The study presents data on the 3‐month prevalences of postpartum anxiety disorders (PAD) and postpartum depressive disorders (PDD) and their comorbidity in a German community sample. Associations with sociodemographic variables and previous history of psychopathology were analysed. Method: Data were gathered in a longitudinal study over the first 3 months postpartum. In a two‐stage screening procedure, a population‐based representative sample of 1024 postpartum women was assessed for symptoms of anxiety and depression using DSM‐IV‐based screening instruments. Results: The estimated rates of DSM‐IV disorders were 11.1% for PAD and 6.1% for PDD. Comorbidity was found in 2.1%. The rate for PAD with postpartum onset was 2.2% and for PDD 4.6%. Young mothers and mothers with a low education level had a heightened risk of developing depression following delivery. Conclusion: Because of the clinical relevance of PAD, controlled studies and specialized programmes for prevention and treatment are urgently required.     

The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams

Background  

Personality status is seldom assessed in community mental health teams except at a rudimentary level. This study challenges the assumption that this policy is either prudent or wise.     

Prevalence of mental disorders among patients attending primary health care centers in the capital of Saudi Arabia

Objectives:To assess the prevalence of common mental disorders at primary health care (PHC) centers in Saudi Arabia using the Self-Reporting Questionnaire.Methods:This was a cross-sectional study carried out at a single PHC center in Riyadh city, Kingdom of Saudi Arabia. A self-medication questionnaire was utilized to collect the data. The prevalence of mental disorders has assessed by the Self-Reporting Questionnaire that consists of 20 items with binary answers (Yes/No).Results:This study reports that the prevalence of mental disorders among patients attended primary health care center was 28.5%. Moreover, prevalence did not significant differ by sociodemographic (p>0.05)Conclusion:The prevalence of mental disorders was slight high. The rates of untreated mental disorders necessitate the healthcare makers in Kingdom of Saudi Arabia to implement efficient strategies to halt the progression of untreated mental disorders.

There is growing concern about the mental disorders among people around the world.1 Due to its prevalence, depression and anxiety are considered major public health issues and is ranked as the fourth leading cause of the global diseases burden.2 However, the World Health Organization (WHO) has estimated that the impact of mental disorders will become the second leading cause of disability among individuals.3-5 Previous studies have shown that mental disorders are very common in almost every part of the world, with a significant difference in their frequency.1,6 Mental disorders refer to health conditions that are characterized by alterations in thinking, mood, or behavior. Diagnoses of mental disorders, also known as neuropsychiatric disorders, are made when people become mentally ill with the presence of somatic symptoms, such as irritation, headache, fatigue, forgetfulness, decreased concentration, anxiety, and mental retardation.7,8 It has been documented that in the USA, mental disorders are the third-most common cause of hospitalization of both young people and adults aged between 18 and 44 years. These include major depression, dysthymic disorders, and bipolar disorders.9 Approximately 1 in 5 adults in the USA, which can be expressed as 43.8 million or 18.5% of the individuals, suffer from mental disorders that cost about 193.2 billion dollars.10 Previously published studies have reported that 450 million people in the world suffer from some form of mental disorders.11 In the UK and the USA, about one-fourth and almost half of the populations, respectively, have a mental illness at some point during their life.12 In contrast to any other chronic illness, mental disorders are the highest reported illness.11 In Saudi Arabia, the prevalence rate of psychiatric disorders at primary health care (PHC) institutions is estimated to be 30-46%13 with the prevalence of depression of 20%.14 Chronic illness such as diabetes and hypertension increase the rate of the occurrence of mental disorders.15,16 Depression and anxiety are considered serious disorders that have a negative effect on the quality of life, medical comorbidity, and mortality.11,17-19 Despite the availability of some studies, most of these studies used specific screening tool for a particular disorder as the Beck Depression Inventory-Short Form (BDI-SF) for depression or the Rahim Anxiety-Depression Scale for anxiety/depression. The evaluation of common mental and psychiatric disorders at PHC centers using more generalized tools or techniques needs further research. In addition, the integration of mental health practices at PHC centers is one of the challenges faced by them, and investigating various psychiatric disorders using generalized assessment tools such as the Self-Reporting Questionnaire would help provide the real picture of mental disorder burden at PHC centers in Saudi Arabia. The objective of this study was to assess the prevalence of common mental disorders at PHC centers in Saudi Arabia using the Self-Reporting Questionnaire.     

Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: mental health disparities in a national context

OBJECTIVE: The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) provided estimates of the prevalence of DSM-III-R disorders and utilization of services for help with those disorders in American Indian populations. Completed between 1997 and 1999, the AI-SUPERPFP was designed to allow comparison of findings with the results of the baseline National Comorbidity Survey (NCS), conducted in 1990-1992, which reflected the general United States population. METHOD: A total of 3,084 tribal members (1,446 in a Southwest tribe and 1,638 in a Northern Plains tribe) age 15-54 years living on or near their home reservations were interviewed with an adaptation of the University of Michigan Composite International Diagnostic Interview. The lifetime and 12-month prevalences of nine DSM-III-R disorders were estimated, and patterns of help-seeking for symptoms of mental disorders were examined. RESULTS: The most common lifetime diagnoses in the American Indian populations were alcohol dependence, posttraumatic stress disorder (PTSD), and major depressive episode. Compared with NCS results, lifetime PTSD rates were higher in all American Indian samples, lifetime alcohol dependence rates were higher for all but Southwest women, and lifetime major depressive episode rates were lower for Northern Plains men and women. Fewer disparities for 12-month rates emerged. After differences in demographic variables were accounted for, both American Indian samples were at heightened risk for PTSD and alcohol dependence but at lower risk for major depressive episode, compared with the NCS sample. American Indian men were more likely than those in NCS to seek help for substance use problems from specialty providers; American Indian women were less likely to talk to nonspecialty providers about emotional problems. Help-seeking from traditional healers was common in both American Indian populations and was especially common in the Southwest. CONCLUSIONS: The results suggest that these American Indian populations had comparable, and in some cases greater, mental health service needs, compared with the general population of the United States.     

Prevalence and treatment of personality disorders in Dutch forensic mental health services

Offenders with serious personality disorders challenge forensic systems throughout the world. In this article, the authors describe the legal system that shapes the forensic treatment of personality-disordered offenders in the Dutch psychiatric and correctional systems. The evolution of laws and regulations are addressed, as is the bifurcation of treatment between forensic hospitals and correctional settings. Prevalence data of personality disorders in the Dutch systems are presented, and comparisons between the Dutch and American systems are delineated. Current treatment modalities are described. Research initiatives and future directions for the system are presented.     

Prevalence of mental health disorders among low-income African American adolescents

Purpose

Data on the prevalence of mental health disorders for low-income, urban African American adolescents are scarce. This study presents data about the burden of mental disorders for this understudied population.

Methods

Mental disorders were assessed using the Diagnostic Interview Schedule for Children (C-DISC), Youth Self-Report (YSR), and Child Behavior Checklist (CBCL) among a sample of adolescents and their caregivers from very impoverished neighborhoods in a Southern city.

Results

Based on the C-DISC, 3.8, 5.1 and 7.7 % of adolescents met diagnostic criteria for major depression, post-traumatic stress disorder, and conduct disorder, respectively. There were significant differences among some of the mental health disorders based on adolescent and caregiver characteristics such as sex, school status, caregiver work status, and income level. We found a low prevalence of alcohol, marijuana, and substance abuse and dependence disorders.

Conclusions

Information about the prevalence of mental health disorders in specific communities and populations can assist in addressing unmet needs, planning for services and treatment, and reducing health disparities.     

Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP)

Objective  

Previous epidemiological studies have revealed a high prevalence of mental disorders among primary care (PC) patients. However, most studies have methodological limitations (e.g. absence of structured clinical interviews, two-phase designs) that affect the generalizability of their results. The main objective of the present study was to estimate the lifetime and 12-month prevalence of mental disorders in the PC of Catalonia (Spain), using structured clinical interviews and a one-phase design.     

Patterns of comorbidity among mental disorders: a person-centered approach

Objective

Comorbidity poses a major challenge to conventional methods of diagnostic classification. Although dimensional models of psychopathology have shed some light on this issue, the reason for interrelationships among dimensions is unclear. The current study employed an alternative approach to characterizing patterns of comorbidity among common mental disorders by modeling them instead as clusters by using latent class analysis (LCA).

Method

Latent class analyses of Diagnostic and Statistical Manual of Mental Disorders diagnoses from two nationally representative epidemiological samples—the National Comorbidity Survey and National Comorbidity Survey–Replication datasets—were undertaken.

Results

Within each dataset, LCA yielded 5 latent classes exhibiting distinctive profiles of diagnostic comorbidity: a fear class (all phobias and panic disorder), a distress class (depression, generalized anxiety disorder, dysthymia), an externalizing class (alcohol and drug dependence, conduct disorder), a multimorbid class (highly elevated rates of all disorders), and a few-disorders class (very low probability of all disorders). Whereas some disorders were relatively specific to certain classes, others (major depression, posttraumatic stress disorder, social phobia) appeared to be evident across all classes. Profiles for the five classes were highly similar across the two samples. When bipolar I disorder was added to the LCA models, in both samples, it occurred almost exclusively in the multimorbid class.

Conclusions

Comorbidity among mental disorders in the general population appears to occur in a finite number of distinct patterns. This finding has important implications for efforts to refine existing diagnostic classification schemes, as well as for research directed at elucidating the etiology of mental disorders.     

Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees

OBJECTIVES: This study determined the prevalence of 20 HIV-AIDS risk behaviors of four groups of juvenile detainees: those with major mental disorders alone, those with substance use disorders alone, those with comorbid mental and substance use disorders, and those without any major mental or substance use disorder. METHODS: Interviewers administered the AIDS Risk Behavior Assessment to 800 randomly selected juvenile detainees aged ten to 18 years who were initially arrested between 1997 and 1998. Diagnoses were determined with the Diagnostic Interview Schedule for Children, Version 2.3. RESULTS: The sample included 340 females and 460 males. As with the other groups of detainees, youths with major mental disorders had a high prevalence of most HIV-AIDS risk behaviors, much higher than the rates found among youths in the general population. Comorbid substance use disorders substantially increased risk; 96 percent of youths in this group had been sexually active, 62 percent had had multiple partners within the past three months, and 59 percent had had unprotected vaginal sex in the past month. Among youths with a substance use disorder, either alone or with a comorbid major mental disorder, more than 63 percent had engaged in five or more sexual risk behaviors. CONCLUSIONS: Delinquents with substance use disorders, either with or without comorbid major mental disorders, are at particular risk of HIV-AIDS. The juvenile justice and public health systems must provide HIV-AIDS interventions as well as mental health and substance abuse treatment. Greater coordination between community services and correctional facilities can reduce the prevalence of HIV-AIDS risk behaviors of juvenile delinquents and stem the spread of HIV infection among young people.     

Prevalence and incidence of mental disorders estimated by a health questionnaire and a psychiatric case register

Some of the limitations and potentialities of the use of a psychiatric case register are briefly indicated. The special opportunities which record-linkage offers in Iceland make it possible to carry out new epidemiological studies which may help us in identifying high risk groups on a broad scale. As indicated in earlier studies, the incidence rate of mental disorders as measured by first psychiatric consultations has not changed with time. The expectancy of consulting a psychiatrist on account of functional psychoses, neuroses or alcoholism is only about 40 % of the expectancy of developing these diseases. Of the population aged 20–49 years, 13.5% have consulted a psychiatrist or been in contact with the institutions reporting to the psychiatric case register. For the estimation of prevalence of mental disorders with a health questionnaire it is necessary to add several questions related to symptoms of alcohol abuse. When this is done, the self-reported prevalence of mental disorders in the population of this most productive age group is approximately 20 %, one half of this being related to alcohol abuse among men. As there are relatively more patients among those not responding to the questionnaire the total prevalence is probably not less than 22 %. Studies based on the psychiatric case register would thus only account for 40–60 % of the total morbidity, depending on whether only contact with psychiatrists or with all the reporting institutions were included.     

Prevalence of DSM-IV disorders, comorbidity and impairment in 3-year-old Spanish preschoolers

Purpose

The goal is to examine the prevalence, comorbidity and impairment of DSM-IV disorders in 3-year-old children from the Spanish general population.

Method

A sample of 1,341 3-year-old preschoolers were randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and functional impairment measures.

Results

Prevalence of any diagnosis was 29.9 %, the most prevalent disorders being primary insomnia (11.7 %) and oppositional defiant disorder (ODD) (6.9 %). There were no sex differences in the prevalence. One-third of the families had sought professional help for the child’s symptoms, and 9.4 % received treatment (4.4 % psychological and 2.1 % pharmacological). After controlling for other comorbidities, ADHD was significantly associated with ODD, CD, insomnia and social phobia; ODD was associated with CD, separation anxiety, specific phobia and major depression. Diagnostic categories were associated with impairment, family burden, seeking professional help and receiving treatment. A diagnosis was more frequent in children of low socioeconomic status, born outside Spain, from one-parent families, with younger parents and with parents of lower educational level.

Conclusions

Psychopathology, comorbidity and associated factors are very frequent from age three, suggesting a need for efforts of detection, prevention and treatment in the different societies.