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1.
Josine G. van Mill Nicole Vogelzangs Witte J.G. Hoogendijk Brenda W.J.H. Penninx 《Sleep medicine》2013,14(11):1170-1177
Objectives
We aimed to examine the associations between sleep disturbances and work functioning in an epidemiologic cohort study in subjects with or without depressive or anxiety disorders.Methods
There were 707 subjects included in our analyses with depressive or anxiety disorders and 728 subjects without current depressive or anxiety disorders. Insomnia was defined as a score ?9 using the Insomnia Rating Scale. Self-reported sleep duration was categorized in short, normal, and long (?6, 7–9, and ?10 h, respectively). Work absenteeism was defined as none, short (?2 weeks), or long (>2 weeks). Work performance was defined as not impaired, reduced, or impaired. Logistic regression analyses were performed to examine the associations of sleep disturbances with work functioning.Results
In subjects with psychopathology, insomnia and short sleep duration were significantly associated with impaired work performance (odds ratio [OR] for insomnia, 2.20; [95% confidence interval {CI}, 1.50–3.22]; OR for short sleep, 2.54 [95% CI, 1.66–3.88] compared to normal sleep duration). Insomnia (OR, 2.48 [95% CI, 1.67–3.69]) and short sleep duration (OR, 1.85 [95% CI, 1.23–2.78]) also were associated with long-term absenteeism. These findings remained the same after considering clinical characteristics including medication use and symptom severity.In subjects without psychopathology, no significant associations were found between insomnia and short sleep duration on work functioning after considering subthreshold depression symptoms.Conclusions
In subjects with psychopathology, sleep disturbances were negatively associated with work functioning, independent of disorder severity and use of psychotropic medication. Further research is needed to determine if treatment of sleep disturbances in subjects with psychopathology improves work functioning. 相似文献2.
Per Wändell Gunnar Ljunggren Lars Wahlström Axel C. Carlsson 《Journal of psychosomatic research》2014
Objective
Concomitant psychiatric disorders in people with diabetes affect morbidity and mortality. We aimed to study psychiatric morbidity in people with diabetes and the general population using administrative health care data in Stockholm County.Methods
The study population included all living persons who resided in Stockholm County, Sweden, on January 1, 2011 (N = 2,058,408). Subjects with a diagnosis of diabetes were identified with data from all consultations in primary health care, specialist outpatient care and inpatient care during the time span 2009–2013. As outcome, information was obtained on all consultations due to any psychiatric diagnosis as well as, specifically, schizophrenia, bipolar disorders, depression, and anxiety disorders, in 2011–2013. Analyses were performed by age group and gender. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with diabetes, using individuals without diabetes as referents, were calculated.Results
Age-adjusted OR for all psychiatric diagnoses among people with diabetes was 1.296 (95% CI 1.267–1.326) for women and 1.399 (95% CI 1.368–1.432) for men. The greatest excess risk was found for schizophrenia, with OR 3.439 (95% CI 3.057–3.868) in women and 2.787 (95% CI 2.514–3.089) in men, with ORs between 1.276 (95% CI 1.227–1.327) and 1.714 (95% CI 1.540–1.905) for the remaining diagnoses.Conclusion
The prevalence of psychiatric disorders is elevated in people with diabetes, which calls for preventive action to be taken to minimize suffering and costs to society. 相似文献3.
Megan L. Ranney Maureen Walton Lauren Whiteside Quyen Epstein-Ngo Rikki Patton Stephen Chermack Fred Blow Rebecca M. Cunningham 《General hospital psychiatry》2013
Objective
The study's objective was to identify correlates of depressive symptoms among at-risk youth in an urban emergency department (ED).Method
A systematic sample of adolescents (ages 14–18) in the ED were recruited as part of a larger study. Participants reporting past-year alcohol use and peer aggression self-administered a survey assessing: demographics, depressive symptoms and risk/protective factors. Logistic regression identified factors associated with depressive symptoms.Results
Among 624 adolescents (88% response rate) meeting eligibility criteria, 22.8% (n=142) screened positive for depressive symptoms. In logistic regression, depressive symptoms were positively associated with female gender [odds ratio (OR): 2.84, 95% confidence interval (CI): 1.78–4.51], poor academic performance (OR: 1.57, 95% CI: 1.01–2.44), binge drinking (OR: 1.88, 95% CI: 1.21–2.91), community violence exposure (OR: 2.25, 95% CI: 1.59–3.18) and dating violence (OR: 2.14, 95% CI: 1.36–3.38) and were negatively associated with same-sex mentorship (OR: 0.52, 95% CI: 0.29–0.91) and older age (OR: 0.55, 95% CI 0.34–0.89). Including gender interaction terms did not significantly change findings.Conclusions
Screening and intervention approaches for youth in the urban ED should address the co-occurrence of depressive symptoms with peer and dating violence, alcohol and nonmarijuana illicit drug use. 相似文献4.
Rochelle Frounfelker Stephen E. Gilman Sergio Aguilar-Gaxiola Jordi Alonso Evelyn J. Bromet Ronny Bruffaerts Giovanni de Girolamo Semyon Gluzman Oye Gureje Elie G. Karam Sing Lee Jean-Pierre Lépine Yutaka Ono Beth-Ellen Pennell Daniela G. Popovici Margreet ten Have Ronald C. Kessler On behalf of the WHO World Mental Health Survey Collaborators 《Social psychiatry and psychiatric epidemiology》2018,53(2):207-219
Purpose
Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders.Methods
Adults (n?=?3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence).Results
Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7).Conclusions
Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.5.
Kate Walsh Jennifer C. Elliott Dvora Shmulewitz Efrat Aharonovich Rael Strous Amos Frisch Abraham Weizman Baruch Spivak Bridget F. Grant Deborah Hasin 《Comprehensive psychiatry》2014
Background
Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence.Objectives
This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association.Method
1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence.Results
In the full sample, mean number of traumatic events was 2.7 (sd = 2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd = 3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR = 1.3; 95% CI = 1.2–1.4) and nicotine (OR = 1.2; 95% CI = 1.1–1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR = 3.1; 95% CI = 1.6–6.0) and nicotine (OR = 1.9; 95% CI = 1.2–2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR = 1.2; 95% CI = 1.1–1.3), nicotine (OR = 1.1; 95% CI = 1.1–1.2), and marijuana (OR = 1.1; 95% CI = 1.04–1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR = 3.4; 95% CI = 2.1–5.5), nicotine (OR = 2.2; 95% CI = 1.4–3.4), and marijuana (OR = 2.6; 95% CI = 1.2–5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%).Conclusion
Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms. 相似文献6.
Context
No studies have evaluated whether the presence of a depressive episode is associated with an increased risk of not returning to work following myocardial infarction (MI).Objectives
To examine the prospective associations between depressive episode and anxiety disorders with return to work (RTW) after MI at 3 and 12 months based on International Classification of Diseases, 10th Revision.Design
Prospective cohort study.Setting
Four hospitals in the North of The Netherlands.Participants
From a sample of patients hospitalized for MI (n= 487), we selected those who had a paid job at the time of the MI (N= 200).Main exposure measures
Presence of a depressive episode and presence of any anxiety disorder during the first 3 months post-MI.Main outcome measures
RTW at 12 months post-MI.Results
Of the patients with work prior to MI, 75% had returned to work at 12 months. The presence of a depressive episode during the first 3 months (prevalence: 19.4%) was a significant predictor of no RTW at 12 months post-MI, also after controlling for confounders [odds ratio (OR) 3.48; 95% confidence interval (CI): 1.45–8.37]. The presence of an anxiety disorder (prevalence: 11.9%) had a borderline significant association with no RTW as well. This association remained after controlling for confounders (OR 2.90; 95% CI: 1.00–6.38) but diminished when controlling for depression.Conclusions
The presence of a depressive episode was associated with an increased risk of no RTW in MI patients. The association between anxiety and risk of no RTW could in part be explained by the presence of depression. Further studies may address the possibility of countering the effect of depression by effective treatment. 相似文献7.
Objective
This study aimed to identify primary care practice characteristics associated with the quality of depression care in patients with comorbid chronic medical and/or psychiatric conditions.Method
Using data from cross-sectional organizational and patient surveys conducted within 61 primary care clinics in Quebec, Canada, the relationships between primary care practice characteristics, comorbidity profile, and the recognition and minimally adequate treatment of depression were assessed using multilevel logistic regression analysis with 824 adults with past-year depression and comorbid chronic conditions.Results
Likelihood of depression recognition was higher in clinics where accessibility of mental health professionals was not viewed to be a major barrier to depression care [odds ratio (OR)=1.61; 95% confidence interval (CI) 1.13–2.30]. Four practice characteristics were associated with minimal treatment adequacy: greater use of treatment algorithms for depression (OR=1.77; 95% CI=1.18–2.65), high value given to teamwork (OR=2.48; 95% CI=1.40–4.38), having at least one general practitioner at the clinic devote significant time in practice to mental health (OR=1.54; 95% CI=1.07–2.21) and low perceived barriers to depression care due to inadequate payment models (OR=2.12; 95% CI=1.30–3.46).Conclusions
Several primary care practice characteristics significantly influence the quality of care provided to patients with depression and comorbid chronic conditions and should be targeted in quality improvement efforts. 相似文献8.
Terri L. Barrera Juliette M. Mott Natalie E. Hundt Joseph Mignogna Hong-Jen Yu Melinda A. Stanley Jeffrey A. Cully 《General hospital psychiatry》2014
Objective
This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization.Method
This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization.Results
Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29).Conclusion
Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings. 相似文献9.
Song Yi Han Maeng Je Cho Seunghee Won Jin Pyo Hong Jae Nam Bae Seong-Jin Cho Jong-Ik Park Jun-Young Lee Hong Jin Jeon Sung Man Chang 《Psychiatry investigation》2015,12(3):316-323
Objective
The lifetime prevalence of alcohol dependence in South Korea remains higher than other countries. The aim of our study is to identify factors associated with remission from alcohol dependence.Methods
Data from the Korean Epidemiological Catchment Area-Replication (KECA-R) study were used in our study. The Korean version of the Composite International Diagnostic Interview 2.1 (K-CIDI 2.1) was administered. Remission was defined as having no symptom of alcohol dependence for 12 months or longer at the time of the interview. Demographic and clinical variables putatively associated with remission from alcohol dependence were examined by t-test, chi-square-test and logistic regression analysis.Results
The lifetime prevalence rate of alcohol dependence was 7.0%. Among them, 3.2% of the subjects were diagnosed with active alcohol dependence in the previous 12 months, and 3.8% were found to be in remission. Subjects in 35- to 44-year-old group, not living with partner group, and lower level of educational attainment group were more likely to be in the active alcohol dependence state. Of the comorbid mental disorders, dysthymia, anxiety disorder, nicotine use, and nicotine dependence were more common among the actively alcohol-dependent subjects.Conclusion
There is considerable level of recovery from alcohol dependence. Attention to factors associated with remission from alcohol dependence may be important in designing more effective treatment and prevention programs in this high-risk population. 相似文献10.
David J. Breland Carolyn A. McCarty Chuan Zhou Elizabeth McCauley Carol Rockhill Wayne Katon Laura P. Richardson 《General hospital psychiatry》2014
Objective
Evaluate determinants of mental health service use among depressed adolescents.Method
We assessed mental health services use over the 12 months following screening among 113 adolescents (34 males, 79 females) from an integrated healthcare system who screened positive for depression (Patient Health Questionnaire-9 score ≥ 11). Youth characteristics (demographics, depression severity, and co-morbidity) and parent characteristics (parent history of depression, parent-report of youth externalizing and internalizing problems) were compared among youth who had received mental health services and those who had not. Multivariate regression was used to evaluate the strongest factors associated with mental health service use.Results
Overall, 52% of adolescents who screened positive for depression received mental health service in the year following screening. Higher parent-reported youth internalizing problems (OR 5.37, CI 1.77–16.35), parental history of depression/anxiety (OR 4.12, CI 1.36–12.48) were significant factors associated with mental health service use. Suicidality and functional impairment were not associated with increased mental health services use.Conclusion
Parental factors including recognition of the adolescent's internalizing symptoms and parental experience with depression/anxiety are strongly associated with mental health service use for depressed adolescents. This highlights the importance of educating parents about depression and developing systems to actively screen and engage youth in treatment for depression. 相似文献11.
Joana C.M. Narvaez Karen Jansen Ricardo T. Pinheiro Flávio Kapczinski Ricardo A. Silva Flávio Pechansky Pedro V. Magalhães 《Comprehensive psychiatry》2014
Objective
To assess the association between lifetime crack cocaine use and psychiatric (post-traumatic stress disorder, current depression, current dysthymia, generalized anxiety disorder, panic disorder with agoraphobia, social phobia, as well as SRQ scores and suicide risk) and substance-use disorders (tobacco, alcohol, cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens and opioids) in youth in the general population of the city of Pelotas, RS.Method
This was a cross-sectional population-based study, involving 1560 participants between 18 and 24 years old. Lifetime substance use and abuse were investigated using the ASSIST inventory. Psychiatric comorbidities were assessed using the Mini-International Neuropsychiatric Interview and symptoms of common mental disorders were evaluated with the Self-Reported Questionnaire (SRQ).Results
The prevalence of lifetime crack cocaine use in the sample was 2.5%. Its use was associated with total SRW scores and the presence of post-traumatic stress disorder, antisocial personality disorder and suicide risk in the final regression model. Tobacco, alcohol, cannabis, cocaine, amphetamine and cocaine dependence were also associated with lifetime use of crack cocaine.Discussion
Youth with a history of crack cocaine use had a higher prevalence of psychiatric conditions such as post-traumatic stress disorder, as well as an increased risk of tobacco, alcohol, cannabis, cocaine, amphetamine and inhalant use and dependence. 相似文献12.
Stine Schou Mikkelsen Trine Flensborg-Madsen Marie Eliasen Erik Lykke Mortensen 《Comprehensive psychiatry》2014
Objective
Few studies on the associations between pre-morbid IQ and mental disorders are based on comprehensive assessment of intelligence in both women and men and include a wide range of confounding variables. Thus, the objective of the present study was to examine the association between pre-morbid IQ and hospitalisation with any mental disorder, including possible gender differences in the association.Methods
The study population was born in 1959–61 and premorbid IQ was assessed with the WAIS between 1982 and 1994. Information on mental disorders was obtained from Danish hospital registers with a mean follow-up interval of 21.1 years. A total of 1106 participants were analysed.Results
Those with a mental disorder had a significantly lower mean pre-morbid IQ score than those without. For women, the adjusted IQ difference was 8.5 points, and for men it was 5.1 points. A decrease of one standard deviation in pre-morbid IQ was associated with 83% greater risk of developing a mental disorder among women (HR = 1.83, 95% CI: 1.41–2.36), and 36% among men (HR = 1.36, 95% CI: 1.07–1.73). The interaction between gender and IQ was not statistically significant. Associations did not differ noteworthy between verbal and non-verbal IQ.Conclusions
Pre-morbid IQ was found to be significantly associated with the development of mental disorder. 相似文献13.
Joseph Murray Natália Peixoto Lima Ana Carolina Oliveira Ruivo Andrea Ramírez Varela Caroline Cardozo Bortolotto Elma Izze da Silva Magalhães Franciéle Marabotti Costa Leite Mariana Otero Xavier Jean-Baptiste Pingault Seena Fazel Gregore Iven Mielke Luciana Anselmi Fernando César Wehrmeister Helen Gonçalves Ana Maria Baptista Menezes 《Social psychiatry and psychiatric epidemiology》2018,53(5):487-496
Purpose
Urban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence.Methods
At age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15.Results
There was a dose–response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64–2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60–8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06–3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety.Conclusions
Robberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.14.
Marta Milan Valentina VedovettoFranca Bilora Raffaele PesaventoPaolo Prandoni 《Thrombosis research》2014
Introduction
Whether there is an association between venous thromboembolism (VTE) and atherosclerosis is still controversial.Aims
In a case–control study conducted on subjects older than 50, we assessed the prevalence of symptomatic or subclinical atherosclerosis in a group of unselected patients with unprovoked VTE, and compared it with that of patients with secondary VTE and of matched control individuals free from VTE disorders.Methods
Cases and controls were enquired about the presence of previous symptomatic manifestations of atherosclerosis. Those with a negative history underwent the ultrasound assessment of carotid arteries following a standardized procedure. An intima-media thickness higher than 0.9 mm or the detection of at least one carotid plaque was regarded as a subclinical manifestation of atherosclerosis. After adjusting for age, gender and risk factors for atherosclerosis, we calculated the odds ratio (OR) for symptomatic or subclinical atherosclerosis in patients with unprovoked VTE as compared to those with secondary VTE and controls.Results
We recruited 100 patients with unprovoked VTE, 100 with secondary VTE and 100 control individuals. In patients with unprovoked VTE, the adjusted OR for symptomatic or subclinical atherosclerosis was 5.1 (95% CI, 2.0 to 13.1) in comparison to patients with secondary VTE, and 14.5 (95% CI, 5.8 to 36.3) in comparison to controls. The prevalence of atherosclerosis was higher in patients with secondary VTE than in controls (OR, 3.1; 95% CI, 1.6 to 6.1).Conclusion
The results of this study confirm the presence of a strong association between venous thrombosis and atherosclerosis. 相似文献15.
Gertraud Hanel Peter Henningsen Wolfgang Herzog Nina Sauer Rainer Schaefert Joachim Szecsenyi Bernd Lwe 《Journal of psychosomatic research》2009,67(3):189-197
Objective
Depression, anxiety, and somatization are the most frequently observed mental disorders in primary health care. Our main objective was to draw on the often neglected general practitioners' (GPs) perspective to investigate what characterizes these three common mental diagnoses with regard to creating more suitable categories in the DSM-V and ICD-11.Methods
We collected independent data from 1751 primary care patients (participation rate=77%) and their 32 treating GPs in Germany. Patients filled out validated patient self-report measures for depression (PHQ-9), somatic symptom severity (PHQ-15), and illness anxiety (Whiteley-7), and questions regarding coping and attribution of illness. GPs' clinical diagnoses and associated features were assessed.Results
Patients diagnosed by their GPs with depression, anxiety, and/or somatoform disorders were significantly older, less educated, and more often female than the reference group not diagnosed with a mental disorder. They had visited the GP more often, had a longer duration of symptoms, and were more often under social or financial stress. Among the mental disorders diagnosed by the GPs, depression (OR=4.4; 95% CI=2.6 to 7.5) and comorbidity of somatoform, depressive, and anxiety disorders (OR=9.5; 95% CI=4.6 to 19.4) were associated with the largest degrees of impairment compared to the reference group. Patients diagnosed as having a somatoform/functional disorder only had mildly elevated impairment on all dimensions (OR=2.0; 95% CI=1.4 to 2.7). Similar results were found for the physicians' attribution of psychosocial factors for cause and maintenance of the disease, difficult patient-doctor relationship, and self-assessed mental disorder.Conclusion
In order to make the DSM-V and ICD-11 more suitable for primary care, we propose providing appropriate diagnostic categories for (1) the many mild forms of mental syndromes typically seen in primary care; and (2) the severe forms of comorbidity between somatoform, depressive, and/or anxiety disorder, e.g., with a dimensional approach. 相似文献16.
Objective
To estimate 12-month prevalence rate of mood, anxiety, and alcohol-use disorders among community samples of diabetic persons. We assess whether associations of specific mental disorders with diabetes are consistent across diverse countries after controlling for age and gender.Research design and methods
Eighteen surveys of household-residing adults were conducted in two phases across 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (Part 1, N=85,088). Mental disorders, identified by the World Mental Health-Composite International Diagnostic Interview, included anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social phobia), mood disorders (dysthymia and major depressive disorder), and alcohol abuse/dependence. Diabetes was ascertained by self-report (Part 2, N=42,697). Association was assessed by age-gender adjusted odds ratios.Results
Risk of mood and anxiety disorders was slightly higher among persons with diabetes relative to those without: odds ratio of 1.38 for depression (95% CI=1.15-1.66) and 1.20 for anxiety disorders, (95 % CI=1.01-1.42), after adjusting for age and gender. Odds ratio estimates across countries did not differ more than chance expectation. Alcohol-use disorders were uncommon among persons with diabetes in most countries, and not associated with diabetes in pooled survey data.Conclusions
Population sample surveys revealed mood and anxiety disorders occurred with somewhat greater frequency among persons with diabetes than those without diabetes. Prevalence of major depression among persons with diabetes was lower in the general population than suggested by prior studies of clinical samples. Strength of association did not differ significantly across disorders or countries. 相似文献17.
A.J. Reid Finlayson Mary S. DietrichRon Neufeld B.S.W. Howard RobackPeter R. Martin M.D. 《General hospital psychiatry》2013
Objectives
We compare findings from 10 years of experience evaluating physicians referred for fitness-to-practice assessment to determine whether those referred for disruptive behavior are more or less likely to be declared fit for duty than those referred for mental health, substance abuse or sexual misconduct.Method
Deidentified data from 381 physicians evaluated by the Vanderbilt Comprehensive Assessment Program (2001–2012) were analyzed and compared to general physician population data and also to previous reports of physician psychiatric diagnosis found by MEDLINE search.Results
Compared to the physicians referred for disruptive behavior (37.5% of evaluations), each of the other groups was statistically significantly less likely to be assessed as fit for practice [substance use, %: odds ratio (OR)=0.22, 95% confidence interval (CI)=0.10–0.47, P< .001; mental health, %: OR=0.14, 95% CI=0.06–0.31, P< .001; sexual boundaries, %: OR=0.27, 95% CI=0.13–0.58, P= .001].Conclusions
The number of referrals to evaluate physicians presenting with behavior alleged to be disruptive to clinical care increased following the 2008 Joint Commission guidelines that extended responsibility for professional conduct outside the profession itself to the institutions wherein physicians work. Better strategies to identify and manage disruptive physician behavior may allow those physicians to return to practice safely in the workplace. 相似文献18.
Eduardo Chachamovich Laurence J Kirmayer John M Haggarty Margaret Cargo Rod McCormick Gustavo Turecki 《Revue canadienne de psychiatrie》2015,60(6):268-275
Objective:
The Inuit population in Canada’s North has suffered from high rates of death by suicide. We report on the first large-scale, controlled, epidemiologically representative study of deaths by suicide in an Indigenous population, which investigates risk factors for suicide among all Inuit across Nunavut who died by suicide during a 4-year period.Methods:
We identified all suicides by Inuit (n = 120) that occurred between January 1, 2003, and December 31, 2006, in Nunavut. For each subject, we selected a community-matched control subject. We used proxy-based procedures and conducted structured interviews with informants to obtain life histories, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits.Results:
Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse (OR 2.38; 95% CI 1.39 to 4.08), have family histories of major depressive disorder (P = 0.002) and suicide completion (P = 0.02), and have been affected by major depressive disorder (OR 13.00; 95% CI 6.20 to 27.25), alcohol dependence (OR 2.90; 95% CI 1.59 to 5.24), or cannabis dependence (OR 3.96; 95% CI 2.29 to 6.8) in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders (OR 10.18; 95% CI 3.34 to 30.80) and had higher scores of impulsive and aggressive traits (P < 0.001).Conclusions:
At the individual level, clinical risk factors for suicide among Inuit are similar to those observed in studies with the general population, and indicate a need for improved access to mental health services. The high rate of mental health problems among control subjects suggests the need for population-level mental health promotion. 相似文献19.
The goal was to analyze psychiatric disorders among individuals who satisfied at least one eating disorder criterion (EDC). The data derived from a cross-sectional survey study with a probability sample of residents of a northern German area with 4075 study participants, aged 18-64 years (participation rate 70.2%). Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) were used to assess the diagnostic criteria of eating disorders and nicotine dependence, alcohol dependence, depressive, anxiety, and somatoform disorders according to the Diagnostic and Statistical Manual (DSM-IV). Former or current smokers had an odds ratio (OR) of 1.7 (95% confidence intervals, CI, 1.1-2.4 and 1.1-2.6, respectively) for one EDC compared with never smokers. Subjects with a lifetime psychiatric disorder were more likely to have two or more EDC than individuals who never had the respective disorder (nicotine dependence: OR 2.5, CI 1.5-4.2; alcohol dependence or abuse: OR 2.4, CI 1.2-4.7; depressive disorders: OR 2.2, CI 1.4-3.4; anxiety disorders: OR 2.9, CI 1.9-4.5). To conclude, nicotine dependence, alcohol dependence or abuse, depressive disorders, and anxiety disorders are related to two or more EDC in this adult general population sample. 相似文献
20.
Bodenlos JS Lemon SC Schneider KL August MA Pagoto SL 《Journal of psychosomatic research》2011,71(5):319-324