Comorbid mental disorders among adults in the mental health surveillance survey

Purpose

To examine the prevalence and correlates of mental disorder comorbidity in the adult U.S. household population.

Prevalence of tinnitus in community-dwelling Japanese adults

Background

Several studies have reported the prevalence of tinnitus among general populations; however, most of these studies were conducted in Europe or the United States. We estimated the prevalence of tinnitus among the general adult population in Japan.

Methods

The subjects were participants in the Takayama Study, a population-based cohort study. In 2002, a total of 14 423 adults (6450 men and 7973 women) aged 45 to 79 years responded to a self-administered questionnaire that inquired about history of tinnitus, which was defined as episodes lasting longer than 5 minutes, excluding those occurring immediately after noise exposure. Respondents were also asked about the loudness and severity of tinnitus.

Results

Overall, 11.9% of the subjects reported having tinnitus; the percentage was somewhat higher among men (13.2%) than women (10.8%). The prevalence of tinnitus increased with age in both sexes. Approximately 0.4% of the overall population reported that tinnitus had a severe effect on their ability to lead a normal life. Medical history of hypertension or ischemic heart diseases, use of steroid or antihypertensive medication, and employment as a factory worker or machine operator were associated with tinnitus status in both men and women.

Conclusions

Tinnitus is relatively common in Japan. Although the use of various definitions of tinnitus in different studies makes it difficult to compare prevalence among populations, the present prevalence estimate was similar to those in studies in Europe and the United States.Key words: tinnitus, prevalence, population-based, Japanese     

Prevalence of disabilities of the upper and lower extremities among community-dwelling middle-aged and elderly women]

OBJECTIVE: In order to obtain baseline data for designing programs aimed at promoting physical function among elderly people in Japan, we determined the prevalence of disabilities affecting upper and lower extremities and their impact on function in community-dwelling middle-aged and elderly Japanese women. METHODS: Subjects were 580 women aged 40 years and over, living in Oshima town, Nagasaki, Japan. Information on disabilities affecting all four extremities was collected by questionnaire. Subjects were asked about the extent of disability in each extremity (no disability, some, moderate, cannot or very difficult to use extremity) and the reason for the disability. The functional level was defined using a disability score, calculated by summing the disabilities for upper or lower extremities (no disability, 0; some, 1; moderate, 2; cannot or very difficult to use, 3). Women who scored 0 were classified as 'good', women who scored 1-2 'fair', and who scored 3-6 as 'poor'. RESULTS: Prevalence of disability affecting the upper extremities increased significantly with age (11.9% with some or greater, and 4.3% with moderate or worse). Disabilities of the lower extremities also increased significantly with age (27.2% with some or greater, and 12.9% with moderate or worse), affecting a larger proportion of individuals. With regard to the upper extremities, the women classified a 'fair' and 'poor' increased significantly with age (9.5% with 'fair', and 2.4% with 'poor'), and function decreased (p = 0.003). The same was the case for the lower extremities (19.0% with 'fair', and 8.3% with 'poor') (P < 0.001). The most frequently cited cause of disability was arthritis, both in the upper (20%) and lower (40%) extremities, followed by stroke (10%), fracture (10%) and trauma not associated with fracture (10%). CONCLUSIONS: In middle aged and elderly women, disabilities of the upper and lower extremities become more prevalent and are associated with further functional impairment with aging. Such disabilities are more common in the lower extremities, and arthritis seems to be the most frequent cause.     

Prevalence and risk factors of common mental disorders among medical students

OBJECTIVE: To estimate the prevalence and assess risk factors of common mental disorders among medical students. METHODS: A cross-sectional study was carried out comprising 551 university medical students in the state of S?o Paulo, Southeastern Brazil. A self-administered questionnaire to collect sociodemographic and course-related data as well as the Self-Reporting Questionnaire were used. Both Chi-square test and logistic regression were used in data analyses. RESULTS: A total of 82.6% of the students enrolled in the course participated in the study. Most of them were women (61%), 60% aged between 20 and 23 years, and 99% were from other cities. The prevalence of common mental disorders was 44.7% and they were independently associated with: difficulty in making friends (OR=2.0), poor self-evaluation of academic performance (OR=1.7), thoughts of dropping out of the medical course (OR=5.0) and perceived lack of emotional support (OR=4.6). Although prevalence of these disorders was associated with the course period in the first analysis, this association was not maintained in the multivariate analysis. CONCLUSIONS: The prevalence of common mental disorders was shown to be high among medical students, associated with variables concerning support networks. Emotionally tense experiences such as dealing with seriously ill patients and peer group formation in the last years of the medical course are potentially strong stressors, especially for those with poor social support. It is suggested that educational institutions should be aware of that and make interventions aiming at treating and caring for the students' distress.     

Religion and mortality among the community-dwelling elderly.

OBJECTIVES: This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state. METHODS: The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect. RESULTS: Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support. CONCLUSIONS: Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.     

Prevalence of adverse life events, depression and suicidal thoughts and behaviour among a community sample of young people aged 15–24 years

OBJECTIVE: To provide prevalence data on several key mental health indicators for young people aged 15 to 24 years. METHODS: A cross-sectional household survey, using telephone recruitment followed by a postal pencil-and-paper questionnaire. The overall response rate was 67.3%. RESULTS: Difficulties with interpersonal relationships are common causes of distress for young people, in particular problems with parents, problems with friends and relationship break-ups. Depressive symptomatology is common among young people with approximately one in eight males and one in four females reporting current depressive symptomatology. One in three young people reported that they had had suicidal thoughts at some time in the past, 1.2% of young people reported that they had made a plan on how to kill themselves in the four-week period prior to completing the survey and 6.9% of young people reported that they had tried to kill themselves at some time during their life time (4.2% of males and 9.0% of females). CONCLUSIONS AND IMPLICATIONS: The prevalence figures for the various mental health indicators presented in this paper represent good baseline information upon which to examine the progress over time of interventions designed to improve the mental health of young people.     

麻风病受累者心理障碍及其影响因素分析

目的了解麻风病受累者的心理障碍情况及其相关影响因素。方法采用一般情况调查表、症状自评量表（SCL-90）对浙江省余杭、上虞、海宁3个地区的部分社区和麻风病院整群抽取的392例治愈存活麻风受累者进行问卷调查。结果392例麻风病受累者心理障碍的流行率为24.49%;与全国常模比较,麻风病受累者躯体化[（1.56±0.51）分]、抑郁[（1.63±0.54）分]、恐怖[（1.33±0.51）分]因子得分均高于常模[（1.37±0.48）、（1.50±0.59）、（1.23±0.41）分],人际敏感[（1.47±0.62）分]、焦虑[（1.30±0.39）分]、敌对[（1.33±0.40）分]、偏执[（1.23±0.39）分]、精神病性[（1.24±0.34）分]因子得分均低于常模[（1.65±0.51）、（1.39±0.43）、（1.48±0.56）、（1.43±0.57）、（1.29±0.42）分],差异均有统计学意义（P<0.05）;多因素logistic回归分析表明,年龄、健康状况、经济状况、社会歧视、残疾情况、亲友关心为麻风病受累者心理障碍的影响因素。结论麻风病受累者存在心理障碍,在麻风防治活动中进行相应的心理康复十分必要。     

中国成年及老年人预防性口腔卫生行为状况

目的 了解中国35~44岁成年人和65~74岁老年人看牙、洗牙、刷牙、使用含氟牙膏4种预防性口腔行为水平及达到《中国居民口腔健康指南》推荐标准情况。方法 采用多阶段分层随机整群抽样方法,对全国23 271名35~44岁成年人和8 902名65~74岁老年人就上述4种口腔卫生行为进行问卷调查,采用描述性统计分析方法对调查结果进行分析。结果 中国35~44岁居民达到《指南》推荐的“每年进行1次口腔检查”、“每年洗牙1次”、“早晚刷牙”、“使用含氟牙膏刷牙” 4种口腔卫生行为的人数比例分别为8.4%、2.3%、36.3%和42.3%,65~74岁居民达到标准的人数比例分别为12.1%、1.5%、22.1%和32.5%;城市居民4种口腔行为达到推荐标准的人数比例均高于农村居民(P<0.05);每年口腔检查、早晚刷牙、使用含氟牙膏行为达标比例均为东部地区>中部地区>西部地区(P<0.05);女性口腔检查和早晚刷牙情况好于男性(P<0.05);不同地区、性别居民洗牙情况差异无统计学意义(P>0.05)。结论 当前中国成年人和老年人的4种口腔卫生行为达到《指南》推荐标准的人群比例均较低,并以农村地区、西部地区、男性最为突出,应采取及时有效的干预措施。     

Prevalence of metabolic syndrome among Filipino adults aged 20 years and over

This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables analyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > or =25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.     

Association between physical activity and mental disorders among adults in the United States

BACKGROUND: The objective of this study was to determine the association between regular physical activity and mental disorders among adults in the United States. METHODS: Multiple logistic regression analyses were used to compare the prevalence of mental disorders among those who did and did not report regular physical activity using data from the National Comorbidity Survey (n = 8098), a nationally representative sample of adults ages 15-54 in the United States. CONCLUSIONS: Slightly over one-half of adults reported regular physical activity (60.3%). Regular physical activity was associated with a significantly decreased prevalence of current major depression and anxiety disorders, but was not significantly associated with other affective, substance use, or psychotic disorders. The association between regular physical activity and lower prevalence of current major depression (OR = 0.75 (0.6,0.94)), panic attacks (OR = 0.73 (0.56, 0.96)), social phobia (OR = 0.65 (0.53, 0.8)), specific phobia (OR = 0.78 (0.63, 0.97)), and agoraphobia (OR = 0.64 (0.43, 0.94)) persisted after adjusting for differences in sociodemographic characteristics, self-reported physical disorders, and comorbid mental disorders. Self-reported frequency of physical activity also showed a dose-response relation with current mental disorders. DISCUSSION: These data document a negative association between regular physical activity and depressive and anxiety disorders among adults in the U.S. population. Future research that investigates the mechanism of this association using longitudinal data to examine the link between physical activity and incident and recurrent mental disorders across the lifespan is needed.     

Eating disorders among female adolescents in Switzerland: Prevalence and associations with mental and behavioral disorders

Objectives: To measure the prevalence of eating disorders in a national representative sample of adolescent girls and association of eating disorders with other behavioral/mental problems in Switzerland. Methods: As part of a national health survey, a subsample of 1,084 15 to 20-year-old female students attending school aged filled in a self-administered anonymous questionnaire focusing on eating behavior and body image. Factor analysis made on these specific questions reveals two major dimensions: weight and image concern (WIC) and problematic eating conduct (PEC). The correlates of these two dimensions were measured using bivariate analyses. Results: Among girls, 62% say they want to lose weight, 36% feel too fat, 37% report fasting episodes, 18.9% fear not to be able to stop eating, 9.1% engage in binge eating at least once a week (1.9% daily), 1.6% self-induced vomit at least once a week (0.2% daily). Girls who exhibit high WIC (N = 198) or high PEC (N = 75) scores report significantly more mood problems (p < .05), suicidal conducts (p < .05), or violent and aggressive behaviors (p < .05). No association is found with substance use. Associations with acting-out behavior are stronger among high PEC subjects, whereas those with mood disorders are stronger among high WIC subjects. Conclusion: A large proportion of adolescent girls show concerns regarding their weight and body image whereas a less important proportion exhibit dysfunctional eating behavior. The results confirm the associations between eating disorder and mood, suicide, and conduct problems but infirm the association with substance use. Girls who exhibit problematic conducts appear to require more attention from health resources. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 207–216, 1998.     

大学生2年随访期间自杀意念与自杀尝试流行现状及影响因素分析

了解大学生2年在校期间自杀意念与自杀尝试流行现状及影响因素,为制定更有针对性的自杀预防体系提供参考.方法 采用整群抽样方法,抽取广州某医科院校学生2 291名,采用自编自杀态度调查、个体自杀风险调查、个体健康状态调查与青少年生存理由量表(Reasons of Living Inventory for Adolescents,RFL-A)、五因素正念度量表(Five Facet Mindfulness Questionnaire,FFMQ)以及自杀行为问卷—修订版(Suicidal Behaviors Questionnaire-Revised,SBQ-R)进行追踪研究,2次施测时间分别是2014年9月和2016年9月.结果 大学生在校2年间自杀意念流行率为6.33%,自杀尝试流行率为2.01%;Logistic回归分析显示,在校2年间患有精神疾病(OR=10.31,95%CI=3.26~ 32.61)、对自杀持接受态度(OR=1.66,95%CI=1.21~2.27)、入校时自杀风险高(OR=1.41,95%CI=1.29~1.54)的大学生更容易产生自杀意念,而在校2年间患有重大躯体疾病(OR=0.23,95%CI=1.38~ 13.95)、在校2年间患有精神疾病(OR=8.68,95% CI=2.10~35.94)、对自杀持接受态度(OR=1.19,95%CI=1.17~3.13)、入校时自杀风险高(OR=1.34,95%CI=1.17~1.53)的大学生更容易产生自杀尝试.结论 既往自杀风险高、对自杀持接受态度以及精神、身体状态较差的大学生是自杀意念与自杀尝试的高危人群.应采取针对性的自杀预防措施.     

Prevalence and correlates of mental disorders among Native American women in primary care

OBJECTIVES: We examined the lifetime and the past-year prevalence and correlates of common mental disorders among American Indian and Alaska Native women who presented for primary care. METHODS: We screened 489 consecutively presenting female primary care patients aged 18 through 45 years with the General Health Questionnaire, 12-item version. A subsample (n = 234) completed the Composite International Diagnostic Interview. We examined associations between psychiatric disorders and sociodemographic variables, boarding school attendance, and psychopathology in the family of origin. RESULTS: The study participants had high rates of alcohol use disorders, anxiety disorders, and anxiety/depression comorbidity compared with other samples of non-American Indian/Alaska Native women in primary care settings. CONCLUSIONS: There is a need for culturally appropriate mental health treatments and preventive services.     

Prevalence of mental disorders and torture among Tibetan refugees: A systematic review

Background  

Many Tibetan refugees flee Tibet in order to escape physical and mental hardships, and to access the freedoms to practice their culture and religion. We aimed to determine the prevalence of mental illnesses within the refugee population and determine the prevalence of previous torture reported within this population.     

Prevalence of mental disorders and torture among Tibetan refugees: A systematic review

Background  

Rural Indian tribes are anthropologically distinct with unique cultures, traditions and practices. Over the years, displacement and rapid acculturation of this population has led to dramatic changes in their socio-cultural and value systems. Due to a poor health infrastructure, high levels of poverty and ignorance, these communities are highly vulnerable to various health problems, especially, communicable diseases including HIV/AIDS. Our study sought to assess knowledge, attitudes and practices regarding sexuality, and the risk factors associated with the spread of HIV/AIDS and STDs among these communities.     

辽宁省成人精神障碍流行病学调查

目的 了解辽宁省城乡居民各类精神障碍现患率及分布特点,为制定辽宁省精神卫生规划提供客观依据。方法 2014年10月-2015年6月,采用多阶段分层整群随机抽样方法,在辽宁省7个地级市随机抽取24000人为研究对象,应用增补后的一般健康问卷（GHQ-12）进行筛查,分为精神障碍高、中、低危险3组,由精神科医生用美国精神障碍诊断与统计手册（DSM-IV）轴I障碍临床定式检查（SCID-I/P）依次对100%、40%和10%的3组调查对象进行诊断检查。结果 有效调查19733人（82.22%）,其中精神障碍的总现患率（最近一个月）为14.05%,女性12.93%,男性15.47%;城市人群13.04%,农村人群14.83%;30~50岁及>60岁年龄段是多种精神障碍的高发年龄;心境障碍（4.57%）、焦虑障碍（3.63%）、物质使用障碍（2.29%）是3个最常见的疾病诊断组,酒精使用障碍（2.29%）、抑郁障碍（2.28%）是患病率最高的2种精神障碍。结论 辽宁省精神障碍的现患率较高,精神问题已经成为关注的公共精神问题。     

Conceptions of mental disorders and their treatment among elderly patients at a public mental health facility

In order to understand the thoughts and actions of elderly patients with mental disorders, we interviewed 13 elders (> 60 years of age) treated at a public hospital in Belo Horizonte, Minas Gerais State, Brazil. Data analysis was based on the signs, meanings, and actions model. The majority of the elderly patients denied the presence of any mental disorder, but identified signs of mental distress, grouped into three main categories: "nerves", "head problems", and "craziness". All patients identified the symptom that justified their treatment and highlighted the following causes of mental disorders: family, living, physical, eating, and sleep problems, moral weakness, and aging-related frailty. Although they contended that someone else had taken the initiative to seek treatment for them, they accepted their treatment and rated it positively, despite some complaints related to their conceptions of the causes and consequences of their conditions. They mentioned medication as the main therapeutic measure, despite its adverse effects and low efficacy and the way it was prescribed by physicians.