Psychiatric morbidity in policemen and the effect of brief psychotherapeutic intervention — a pilot study

The level of psychiatric morbidity and perceived sources of stress among police officers were investigated using the General Health Questionnaire (GHQ) and a stress situation questionnaire, which were sent to 171 officers. Half of the responders were invited to attend group counselling sessions weekly for 12 weeks. Outcome measures studied were a second GHQ completed at the end of the treatment period and the amounts of sick leave taken in the 12-week period before, during and after the treatment period. The results were that 61 people returned the first GHQ of whom 59 were male and of whom 14 were classed as ‘cases’. Of the 31 assigned to the treatment group, 22 attended at least one session. Responses to the stress situation questionnaire and the content of counselling sessions tended to confirm the impression that internal aspects of the organization were viewed as prime sources of stress and dissatisfaction. There were no significant changes in GHQ score within or between groups, nor were there significant differences in the amount of sick leave taken. Nevertheless the sessions appeared to be valued and we conclude that this sort of intervention is at least feasible. We recommend that similar studies measure psychiatric morbidity during treatment and at follow-up, rather than immediately after finishing, when reactions to this termination are prominent.     

Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

  Aim: The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. Method: Psychological distress was assessed by means of the GHQ 12. The study covered 1092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. Results: Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. Conclusions: These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health. Accepted: 5 November 1999     

Associations between physical strength, cerebral function and mental health in independent-living elderly Japanese women

Objectives  To evaluate the physical strength, cerebral function, and mental health conditions in elderly persons, and to examine the correlation between these functions. Methods  The subjects were 151 independent-living elderly Japanese women, mean age 70 +/-5 years (+/-SD; range, 60 to 80 years), with normal abilities in daily life. The health check-up was conducted from April to May 1997. Physical strength was estimated by measuring seven activities. Cerebral functions were assessed by six sub-tests of the General Aptitude Test Battery (GATB). Their mental health status was measured by four sub-scales of the General Health Questionnaire (GHQ)-28. Results  The physical strenght and almost all of the cerebral functions decreased with age. Social dysfunction and severe depression on the GHQ sub-scales also worsened with age. Physical strength was strongly correlated with cerebral functions after adjusting for the confounding effect of aging. There were also interrelations between physical strength and mental health. Conclusions  This study provided important information on the correlation between physical and mental status in elderly women. Future longitudinal studies with the intervention of physical training are required to determine whether a causal relationship exists between these factors.     

Prevalence of psychiatric disorder in Europe: the potential and reality of meta-analysis

Abstract. Background: Within the European Mental Health Status Project, over 200 psychiatric surveys concerning members of the European Union (plus Norway) were examined for their potential for meta-analysis with regard to prevalence of psychiatric disorders and basic demographic and social variables. The diversity of samples, methods, analysis and presentation was such that only data derived from GHQ-12 and CIDI studies could be used, and those relating to sex differentials only. Methods: The statistical program Stata was used to compute odds ratios (with confidence intervals) for individual studies, and to produce fixed and random effects estimates of the pooled odds ratio for all studies together, and a measure of heterogeneity. Forrest Plots were also produced. Results: Analysis of GHQ-12 data with a cut-off point of 4, indicating a current or recent probable mental health problem, showed, as expected, that women had higher prevalence rates than men. However, there was a relatively high heterogeneity score, suggesting that these studies may not be measuring the same thing. Analysis of CIDI results showed homogeneity for major depressive disorder within the last 12 months, with the risk for men about half of that for women. Conclusions: In terms of advancing epidemiological knowledge, the results are trivial, at most confirming what is already well known. However, the study shows the potential for pooled analysis, with much greater power in epidemiological investigation if consistency could be achieved in research. Various ways in which this might be done are discussed. It also shows the value of personal knowledge and personal networks in fields which are not well handled by electronic literature databases.An erratum to this article can be found at     

Fifteen,female and stressed: changing patterns of psychological distress over time

BACKGROUND: Despite a widespread view that the mental health of young people has deteriorated, the evidence base is limited by the lack of comparable datasets over time, and their capacity to test specific hypotheses about the causes of such change, in this case those particularly affecting young females. METHOD: Two cohorts of 15-year-olds in the West of Scotland, surveyed in 1987 and 1999, were compared, using the 12-item version of the General Health Questionnaire to measure psychological distress (GHQ caseness, cut-off 2/3), together with items and indices of personal and performance worries. RESULTS: Between 1987 and 1999, GHQ caseness increased significantly for females (from 19% to 33%), but not males (13% to 15%), a change particularly experienced by females from non-manual and skilled manual backgrounds. With one notable exception (unemployment), most worries also increased for both sexes, a gender gap emerging in respect of worries about school performance, females worrying more. While the effect of personal worries (e.g., looks and weight) on GHQ caseness persisted over time in both sexes, that of performance worries only emerged for females in 1999. Using survey date as an indicator, a relationship between proximity to exams and GHQ caseness was also only found among females in 1999. CONCLUSION: The increase in levels of psychological distress among young females over this period may be explained by an increase in educational expectations, which together with more traditional concerns about personal identity, appear to have elevated levels of stress, with adverse consequences for mental health.     

The impact on carers of behavioural difficulties in dementia: A pilot study on management

Sixteen day centre attenders with dementia and their carers were interviewed. The cognitive and behavioural impairments of subjects with dementia were assessed using the Mini-Mental State and the Stockton Geriatric Behaviour Rating Scale. Carers were assessed using the GHQ(28) as a screen for psychiatric morbidity. Where psychological intervention programmes were successful in reducing behaviour identified by carers as particularly distressing, carer GHQ fell. Future studies are needed.     

Do people become healthier after being promoted?

This paper examines the hypothesis that greater job status makes a person healthier. It begins by successfully replicating the well-known cross-section association between health and job seniority. Then, however, it turns to longitudinal patterns. Worryingly for the hypothesis, the data-on a large sample of randomly selected British workers through time-suggest that people who start with good health go on later to be promoted. The paper can find relatively little evidence that health improves after promotion. In fact, promoted individuals suffer a significant deterioration in their psychological well-being (on a standard General Health Questionnaire (GHQ) mental ill-health measure).     

A critical review of dimension-specific measures of health-related quality of life in cross-cultural research

This article reviews six dimension-specific health-related quality of life (HRQL) measures which have been used cross-culturally. The instruments reviewed are: the Beck Depression Inventory (BDI); the McGill Pain Questionnaire (MPQ); the Center for Epidemiologic Studies—Depression (CES-D); the Zung Self-Rating Depression Scale (SDS); the General Health Questionnaire (GHQ); and the Psychological General Well-Being Index (PGWB). These instruments primarily represent the psychological or emotional dimension of HRQL, and are scales that were developed and validated in the USA, Canada or the UK. The review of specific studies for each of the six instruments was not meant to be exhaustive, but rather to give an indication of the ways in which the instruments have been assessed or used in various countries. The focus throughout this article is on the psychometric properties (reliability, validity and responsiveness) of these scales in different cultures, as well as the processes used to translate the instruments from English into another language. Implications of the results of this review for cross-cultural use of dimension-specific HRQL instruments are drawn.     

Mental illness in Greek and Turkish adolescents

Summary Samples of 867 Greek adolescents in Munich, 2,702 Greek adolescents in Greece and 2,780 Turkish adolescents in Turkey were assessed concerning mental health in a two-stage procedure. In the first stage the General Health Questionnaire (GHQ) was used for screening. Significant age differences in the GHQ 28-item scale and most of its subscales were observed mainly for the samples in the homeland. Male adolescents had lower scores than female adolescents in the GHQ 28-item scale and its sub-scales while social class appeared to be of little influence. Significantly higher GHQ-28 scores were obtained for Greeks and Turks in their homelands as compared to Greeks in Munich. The GHQ-28 correlations with the Anorexia Nervosa Inventory for Self-Rating were fairly high. A principal component analysis with Varimax rotation showed fairly consistent results for this age group when compared with the results of Goldberg and Hillier (1979). With the exception of the GHQ factor social dysfunction Greek adolescents in their homeland had significantly higher scores in the total GHQ-28 and its sub-scales than Greeks in Germany. Thus, our data do not confirm the acculturation-stress hypothesis. The data would be consistent with the hypothesis of selective migration which states that Greek adolescents in Germany constitute a positive selection with respect to risk for mental illness.