Search

Aim. The aim of the study was to assess the prevalence of psychotropic medication use among adult population in Poland in past 12 months, and to analyse the relationship between psychotropic medication use and sociodemographic factors as well as mental health disorders experienced by respondents. Method. Composite International Diagnostic Instrument (WHO CIDI 3.0) was used in Polish survey of general population aged 18-64. Respondents were randomly selected from the population register. Ten thousand interviews were completed with a response rate of 50.4%. Results. In the general population, psychotropic medicines were used by almost 5% of the respondents in the past 12 months. These medicines were used more often by women, respondents from the oldest age group, with low level of education, retirees, unemployed, singles and residents of small and large cities. Among those experiencing mental health problems in the past 12 months, psychotropic medications were taken by up to 17% of the respondents. Pharmacological treatment was most often endorsed by over 40% of persons with symptoms of major depression and any mood disorders, while approximately 25% of respondents with major depression confirmed antidepressant use. Gender differences were small and mostly insignificant. Conclusions. The results indicate the need to improve access to mental health treatment and to better educate general practitioners (GPs) for appropriate diagnosing and treatment of mental health disorders. [ABSTRACT FROM AUTHOR]

Objective: To describe the current situation of mental health service utilization of community patients with five mental disorders in Inner Mongolia Autonomous Region and provide reference for health education and formulating relevant policies. Methods: The multistage stratified sampling method with unequal probability was used to select a total of 12 315 community residents aged 18 and over in Inner Mongolia Autonomous Region. Using Composite International Diagnostic Interview, mood disorders, anxiety disorders, substance use disorders, intermit tent explosive disorders, and eating disorders, and health service utilization were investigated. Descriptive statistics was completed by single factor analysis method. Results: The lifetime rates of consultation and treatment of any mental disorder were 18.7% and 10.2%, respectively. The highest proportion of patients received treatment by non-medical professionals was 31.4%, followed by psychiatrists in psychiatric hospital or psychologists in general hospitals. Among the patients, 1.1% of them received medication, and 2.5% received psychotherapy. Conclusion: The utilization rate of mental health services in community patients with five mental disorders is relatively low. It is necessary to conduct health education for medical help seeking properly. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of anxiety disorder and its distribution,and related factors in adults in Ningxia community. Methods: Using the method of China Mental Health Survey,anxiety disorder was investigated with the Composite International Diagnostic Interview, and related factors were analyzed.Twelve-month prevalence and life-time prevalence and their distributions were calculated according to DSM-Ⅳ criteria. Results: A total of 4 085 respondents were interviewed in the survey.The 12-month prevalence rate of any anxiety disorder was 4.2%,and the lifetime prevalence rate was 5.6%. The 12-month prevalence rates of social phobia, special phobia and generalized anxiety disorder were higher in women than in men (P ＜0.05). The prevalence of special phobia and any anxiety disorder in rural area was higher than that in urban area.Logistic regression model revealed that female (OR=1.86,95% CI:1.32-2.64) had higher prevalence risk of anxiety disorder,and individuals with somatic pain had higher risk of anxiety disorder than those without (P ＜0.05). Conclusion: Anxiety disorder is prevalent in Ningxia. It suggests that strengthening somatic pain community mental health service is necessary to develop targeted intervention programs among the high-risk population. [ABSTRACT FROM AUTHOR]

Objective: The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. Method: This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. Results: The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. Conclusions: The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations. [ABSTRACT FROM AUTHOR]

Objective: To introduce the sampling methods, weighting calculation, filed procedures, and quality controls of Urumqi Mental Health Survey（UMHS). Methods: A three-stage sampling design with unequal probability was used to conduct face-to-face interviews in residents aged 18 years and over in Urumqi. The Composite International Diagnostic Interview version-3. 0（CIDI-3. 0) was used by trained interviewers, and diagnostic algorism were run to diagnose mood disorder, anxiety disorder, substance use disorder, eating disorder, and impulse control disorder based on the American Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Methods of quality controls included data checks, telephone checks, audio checks, and field checks. Results: UMHS was carried out in 830 villages from 89 townships and streets of eight distrits and counties in Urumqi. Totally 1782 respondents completed the CIDI, and the response rate was 88. 9%. The initial weights were calculated by multiplying the sampling design weights by non-response weights. Then the calibration weights were generated by adjusting the initial weights according to the age and gender distributions of the total population in Urumqi. The results of quality checks showed that 98. 8% of the sample had no quality problems or only minor problems. The overall quality of the UMHS was satisfied. Conclusion: The UMHS is expected to obtain representative data of mental disorders and mental health services in Urumqi. This information will provide scientific evidences for the formulation of mental health policies in Urumqi. [ABSTRACT FROM AUTHOR]

Objective:To describe the prevalence and distribution of anxiety disorder in community residents in Urumqi. Methods:Using multiple stage stratified sampling, a cross-sectional study was carried out in 2178 residents aged 18 and over in Urumqi in 2013. The Composite International Diagnostic Interview 3. 0 was used for household interviews, and the anxiety disorder was diagnosed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The 12-month prevalence and lifetime prevalence of anxiety disorders in Urumqi were calculated, and distributions by gender, age, marital status, education levels, and income levels were compared by χ² test. Results:There were 1782 respondents in the survey. The weighted lifetime prevalence and 12-month prevalence of anxiety disorder were 6. 50% and 5. 23%. The top three categories were obsessive-compulsive disorder（4. 77%), special phobia（0. 46%） and social phobia（0. 01%). There were no significant differences of anxiety disorder prevalence rates by sex, age, marital status, education levels and income levels. Conclusion:The 12-month prevalence of anxiety disorder in community residents in Urumqi is high. [ABSTRACT FROM AUTHOR]

Digital mental health interventions (DMHI) have the potential to address barriers to face-to-face mental healthcare. In particular, digital mental health assessments offer the opportunity to increase access, reduce strain on services, and improve identification. Despite the potential of DMHIs there remains a high drop-out rate. Therefore, investigating user feedback may elucidate how to best design and deliver an engaging digital mental health assessment. The current study aimed to understand 1304 user perspectives of (1) a newly developed digital mental health assessment to determine which features users consider to be positive or negative and (2) the Composite International Diagnostic Interview (CIDI) employed in a previous large-scale pilot study. A thematic analysis method was employed to identify themes in feedback to three question prompts related to: (1) the questions included in the digital assessment, (2) the homepage design and reminders, and (3) the assessment results report. The largest proportion of the positive and negative feedback received regarding the questions included in the assessment (n = 706), focused on the quality of the assessment (n = 183, 25.92% and n = 284, 40.23%, respectively). Feedback for the homepage and reminders (n = 671) was overwhelmingly positive, with the largest two themes identified being positive usability (i.e., ease of use; n = 500, 74.52%) and functionality (i.e., reminders; n = 278, 41.43%). The most frequently identified negative theme in results report feedback (n = 794) was related to the report content (n = 309, 38.92%), with users stating it was lacking in-depth information. Nevertheless, the most frequent positive theme regarding the results report feedback was related to wellbeing outcomes (n = 145, 18.26%), with users stating the results report, albeit brief, encouraged them to seek professional support. Interestingly, despite some negative feedback, most users reported that completing the digital mental health assessment has been worthwhile (n = 1,017, 77.99%). Based on these findings, we offer recommendations to address potential barriers to user engagement with a digital mental health assessment. In summary, we recommend undertaking extensive co-design activities during the development of digital assessment tools, flexibility in answering modalities within digital assessment, customizable additional features such as reminders, transparency of diagnostic decision making, and an actionable results report with personalized mental health resources. [ABSTRACT FROM AUTHOR]

Functional Somatic Symptoms (FSS) are physical symptoms that cannot be attributed to underlying pathology. Their severity is often measured with sum scores on questionnaires; however, this may not adequately reflect FSS severity in subgroups of patients. We aimed to identify the items of the somatization section of the Composite International Diagnostic Interview that best discriminate FSS severity levels, and to assess their functioning in sex and age subgroups. We applied the two-parameter logistic model to 19 items in a population-representative cohort of 962 participants. Subsequently, we examined differential item functioning (DIF). "Localized (muscle) weakness" was the most discriminative item of FSS severity. "Abdominal pain" consistently showed DIF by sex, with males reporting it at higher FSS severity. There was no consistent DIF by age, however, "Joint pain" showed poor discrimination of FSS severity in older adults. These findings could be helpful for the development of better assessment instruments for FSS, which can improve both future research and clinical care. [ABSTRACT FROM AUTHOR]

Objectives: Recently, adult ADHD diagnoses have increased, complicating treatment when comorbid with other disorders. Subthreshold ADHD(sADHD) also poses challenges, especially with comorbidities and suicidality. This study explores psychiatric comorbidities' role in ADHD and sADHD suicidality., Methods: We analyzed microdata from the National Mental Health Survey of Korea 2021 to examine the association of ADHD on comorbidities and suicide-related behaviors., Results: Of the 5511 participants, 194(3.52 %) were diagnosed with ADHD, and 775(14.1 %) had sADHD. In 12-month prevalence, suicidal ideation and plans were more prevalent in both ADHD and sADHD patients than in controls, with higher odds ratios(ADHD vs. control OR 12.87; suicidal ideation, 54.06; suicidal plan, sADHD vs control OR 8.26; suicidal ideation, 17.63; suicidal plans). Lifetime suicidal ideation and plans were notably associated with alcohol use disorder(OR 6.15 in ideation, 3.83; plan) and nicotine use disorder in participants with ADHD(OR 5.36 in ideation, 5.31; plan), whereas sADHD associations were found with alcohol use disorder(OR 1.80 in ideation) and depressive disorder(OR 1.90 in ideation) compared to the controls. Additionally, differences in suicidal behavior between sADHD and ADHD were identified for alcohol use disorder(OR 3.42 in ideation, 4.15; plan) and nicotine use disorder(OR 4.02 in ideation, 4.98 in plan)., Conclusion: These results indicated a heightened risk of psychiatric comorbidities and suicidal ideation or plans in the ADHD and sADHD groups. These results suggest the need for a more diverse focus on comprehensive mental health assessments and proactive support for patients with ADHD, regardless of symptom severity., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Digital mental health interventions (DMHI) have the potential to address barriers to face-to-face mental healthcare. In particular, digital mental health assessments offer the opportunity to increase access, reduce strain on services, and improve identification. Despite the potential of DMHIs there remains a high drop-out rate. Therefore, investigating user feedback may elucidate how to best design and deliver an engaging digital mental health assessment. The current study aimed to understand 1304 user perspectives of (1) a newly developed digital mental health assessment to determine which features users consider to be positive or negative and (2) the Composite International Diagnostic Interview (CIDI) employed in a previous large-scale pilot study. A thematic analysis method was employed to identify themes in feedback to three question prompts related to: (1) the questions included in the digital assessment, (2) the homepage design and reminders, and (3) the assessment results report. The largest proportion of the positive and negative feedback received regarding the questions included in the assessment (n = 706), focused on the quality of the assessment (n = 183, 25.92% and n = 284, 40.23%, respectively). Feedback for the homepage and reminders (n = 671) was overwhelmingly positive, with the largest two themes identified being positive usability (i.e., ease of use; n = 500, 74.52%) and functionality (i.e., reminders; n = 278, 41.43%). The most frequently identified negative theme in results report feedback (n = 794) was related to the report content (n = 309, 38.92%), with users stating it was lacking in-depth information. Nevertheless, the most frequent positive theme regarding the results report feedback was related to wellbeing outcomes (n = 145, 18.26%), with users stating the results report, albeit brief, encouraged them to seek professional support. Interestingly, despite some negative feedback, most users reported that completing the digital mental health assessment has been worthwhile (n = 1,017, 77.99%). Based on these findings, we offer recommendations to address potential barriers to user engagement with a digital mental health assessment. In summary, we recommend undertaking extensive co-design activities during the development of digital assessment tools, flexibility in answering modalities within digital assessment, customizable additional features such as reminders, transparency of diagnostic decision making, and an actionable results report with personalized mental health resources.

Objective : To investigate the major depressive disorder (MDD) and its related factors in Inner Mongolia Autonomous Region. Methods : The multistage stratified sampling method with unequal probability was used to select permanent residents aged 18 years and above for face-to-face interview. The Composite International Diagnostic Interview 3.0 was used as a diagnostic tool. The diagnosis of MDD was based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) and the Tenth Revision of the International CIassification of Diseases (ICD-10) . Results : Totally 12 315 individuals were interviewed. Weighted 12-month prevalence of MDD was 3.1%. By fitting a two-level empty model analysis,the intra-class correlation coefficient was 0.10. Final model results showed that female (OR=1.46,95% CI : 1.03-2.08),unmarried (OR=2.76,95% CI : 1.35-5.67),separated and divorced (OR=2.98,95% CI : 1.40-6.36),unemployed (OR=2.50,95% CI : 1.52-4.11),low-income level (OR=1.88,95% CI : 1.21-2.91),daily drinking (OR=1.95,95% CI : 1.03-3.69) and chronic disease (OR=4.47,95% CI : 3. 03-6. 57) were the risk factors of MDD. Aged 65 and over (OR=0. 39,95% CI : 0. 20-0. 75),junior high school (OR=0. 47,95% CI : 0. 29-0. 75) and high school or secondary specialized school (OR=0. 43,95% CI : 0. 26-0. 72) were the protective factors of MDD. Conclusion : It indicates that female residents and those who are unemployed,with unstable marital status,low-income level,daily drinking and chronic disease are more likely to suffer from major depressive disorder. [ABSTRACT FROM AUTHOR]

Background: Medical and psychiatric comorbidities are commonly comorbid with diabetes. Race and ethnicity may, however, modify the link between medical and psychiatric comorbidities in individuals with diabetes. In this study we compared Non-Hispanic Whites, African Americans, and Caribbean Blacks with diabetes for the association between number of comorbid medical conditions and lifetime and 12-month major depressive disorder (MDD) in individuals with diabetes. Methods: Data came from the National Survey of American Life (NSAL), 2001–2003. We included 603 patients with diabetes (75 non-Hispanic Whites, 396 African Americans, and 131 Caribbean Blacks). Number of comorbid medical conditions was the independent variable, lifetime and 12-month MDD were dependent variables, and age, gender, education, marital status, employment, and body mass index were covariates. Race- and ethnic- specific logistic regressions were used to determine race and ethnic differences in the associations between number of chronic medical conditions and lifetime and 12-month MDD, while the effect of all covariates were controlled. Results: Number of chronic medical conditions was positively associated with lifetime MDD among non-Hispanic Whites (OR = 1.719, 95 % CI = 1.018 – 2.902) and African Americans (OR = 1.235, 95 % CI = 1.056– 1.445) but not Caribbean Blacks (P >.05). Number of chronic medical conditions was also associated with 12-month MDD among non-Hispanic Whites (OR = 1.757, 95 % CI = 1.119 – 2.759) and African Americans (OR = 1.381, 95 % CI = 1.175 - 1.623) but not Caribbean Blacks (P >.05). Conclusions: This study shows race- and ethnic- differences in the association between number of medical comorbidities and MDD among patients with diabetes. These findings invite researchers to study the mechanisms behind race- and ethnic- differences in vulnerability and resilience to the mental health effects of chronic medical conditions. [ABSTRACT FROM AUTHOR]

Purpose: This cross-sectional study investigated distribution, sociodemographic correlates, and health outcomes in early versus late age of onset (AOO) of mood, anxiety, and alcohol use disorders in Singapore. Methods: The Composite International Diagnostic Interview established lifetime diagnoses of major depressive, bipolar, generalized anxiety, obsessive compulsive and alcohol use disorders in a representative sample of residents aged 18 years and over (n = 6126). The AOO of the individual and any mental disorders were classified into early and late onset using median values as cut-offs. Data included socio-demographic and health background, health utility score, and productivity losses. Multivariable logistic regression analysis was conducted to assess sociodemographic correlates of early versus late AOO of any mental disorder while linear regression analysis investigated the associations between AOO of individual disorders with health utility score and productivity loss. Results: Respondents' mean (SD) age was 45.6 (16.5) years, comprising 50.5% women and majority of Chinese ethnicity (75.8%). The median AOO for any of the five studied disorders was 21 years (IQR: 15–29). Lowest AOO was observed for obsessive compulsive disorder (Median: 14, IQR: 11–26). Those aged 35 years and over (versus 18–34) were less likely to have earlier AOO [35–49 years (OR: 0.287; 95% CI: 0.154–0.534); 50–64 years (OR:0.156; 95% CI: 0.068–0.361) and 65 and over (OR:0.112; 95% CI:0.027–0.461)], while Malay ethnicity (versus Chinese) (OR: 2.319; 95% CI: 1.384–3.885) and being never married (versus married) (OR: 2.731; 95% CI: 1.493–4.993) were more likely to have early AOO for any mental disorder. Sample with early (versus late) AOO had a lower health utility score (β = − 0.06,95% CI: − 0.08 to − 0.03) and higher number of days cut down on the type of work (β = 1.61,95% CI: 0.12–3.10) in those with any mental disorders. Conclusion: This study showed that half of the adults with mood, anxiety or alcohol use disorders in Singapore experienced their illness onset by 21 years of age. Early AOO is associated with sociodemographic background and poor health outcomes. Prevention, early detection, and interventions to improve health outcomes in mental disorders should consider the sociodemographic profile and age at first onset of symptoms in the population. [ABSTRACT FROM AUTHOR]

Objective: National surveys revealed a high prevalence of psychiatric disorders in Iran. Province-level estimates are needed to manage the resources and focus on preventive efforts more efficiently. The objective of this study was to provide province-level estimates of psychiatric disorders. Method: In this study, Iranian Mental Health Survey (IranMHS) data (n = 7886) was used to produce province-level prevalence estimates of any psychiatric disorders among 15-64 year old males and females. Psychiatric disorders were diagnosed based on structured diagnostic interview of the Persian version of Composite International Diagnostic Interview (CIDI, version, 2.1). The Hierarchical Bayesian (HB) random effect model was used to calculate the estimates. The mental health status of half of the participants was also measured using a 28-item general health questionnaire (GHQ). Results: A wide variation in the prevalence of psychiatric disorders was found among 31 provinces of Iran. The direct estimates ranged from 3.6% to 62.6%, while the HB estimates ranged from 12.6% to 36.5%. The provincial prevalence among men ranged from 11.9% to 34.5%, while it ranged from 18.4% to 38.8% among women. The Pearson correlation coefficient between HB estimates and GHQ scores was 0.73. Conclusion: The Bayesian small area estimation provides estimation with improved precision at local levels. Detecting high-priority communities with small-area approach could lead to a better distribution of limited facilities and more effective mental health interventions.

Aims: The second Singapore Mental Health Study (SMHS) – a nationwide, cross-sectional, epidemiological survey - was initiated in 2016 with the intent of tracking the state of mental health of the general population in Singapore. The study employed the same methodology as the first survey initiated in 2010. The SMHS 2016 aimed to (i) establish the 12-month and lifetime prevalence and correlates of major depressive disorder (MDD), dysthymia, bipolar disorder, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol use disorder (AUD) (which included alcohol abuse and dependence) and (ii) compare the prevalence of these disorders with reference to data from the SMHS 2010. Methods: Door-to-door household surveys were conducted with adult Singapore residents aged 18 years and above from 2016 to 2018 (n = 6126) which yielded a response rate of 69.0%. The subjects were randomly selected using a disproportionate stratified sampling method and assessed using World Health Organization Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). The diagnoses of lifetime and 12-month selected mental disorders including MDD, dysthymia, bipolar disorder, GAD, OCD, and AUD (alcohol abuse and alcohol dependence), were based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: The lifetime prevalence of at least one mood, anxiety or alcohol use disorder was 13.9% in the adult population. MDD had the highest lifetime prevalence (6.3%) followed by alcohol abuse (4.1%). The 12-month prevalence of any DSM-IV mental disorders was 6.5%. OCD had the highest 12-month prevalence (2.9%) followed by MDD (2.3%). Lifetime and 12-month prevalence of mental disorders assessed in SMHS 2016 (13.8% and 6.4%) was significantly higher than that in SMHS 2010 (12.0% and 4.4%). A significant increase was observed in the prevalence of lifetime GAD (0.9% to 1.6%) and alcohol abuse (3.1% to 4.1%). The 12-month prevalence of GAD (0.8% vs. 0.4%) and OCD (2.9% vs. 1.1%) was significantly higher in SMHS 2016 as compared to SMHS 2010. Conclusions: The high prevalence of OCD and the increase across the two surveys needs to be tackled at a population level both in terms of creating awareness of the disorder and the need for early treatment. Youth emerge as a vulnerable group who are more likely to be associated with mental disorders and thus targeted interventions in this group with a focus on youth friendly and accessible care centres may lead to earlier detection and treatment of mental disorders. [ABSTRACT FROM AUTHOR]

Objective: This paper aimed to describe the sample design, weighting, filed procedures and quality control in Inner Mongolia Mental Health Survey (IMMHS), also called Mental Health Survey among Community Population in Inner Mongolia. Methods: The survey mode of IMMHS was mainly computer-assisted personal interview (CAPI). Face-to-face interviews were finished in the homes of respondents who were selected from a provincial representative multi-stage disproportionate stratified sampling procedure. One-stage design of data collection was used in the IMMHS lo obtain information of menial disorders including mood disorders, anxiety disorders, substance use disorders, eating disorder and impulsive disorder, while two-stage design was applied for schizophrenia and other psychotic disorders, and dementia. Results: A total of 14 130 respondents were selected from 246 communities among 41 districts or counties. Totally 12 360 persons finished the first stage interviews with 87. 5% of the o-verall response rate. At the second stage, 5263 respondents were selected from the first stage interviews, and 4448 persons finished the interviews with 84. 5% of the overall response rate. Three procedures were used in the weighting of IMMHS samples, including sampling design weights, non-response adjustment weights, and post-stratification adjustment weights. Trimming of the weights was also considered to adjust extreme values. Totally 314 lay interviews and 51 psychiatrists attended training and were qualified to carry out interviews. Comprehensive and timely quality control of fieldwork. including data check, telephone check and audio check were carried out in the IMMHS. Final results of the quality control showed that most interviews passed quality check and the rest only had minor problems. Conclusion: Substantial and provincial representative information about mental disorders, service use and risk factors were collected in the IMMHS. Professionals in different areas could carry out analyses of the rich data, so as lo enrich our knowledge and understanding of mental health. [ABSTRACT FROM AUTHOR]

The Inner Mongolia Menial Health Survey (IMMHS), also called Menial Health Survey among Community Population in Inner Mongolia, is the first provincial representative survey on mental disorders and mental health services in community residents in Inner Mongolia Autonomous Region. The main aims of the IMMHS were to investigate the prevalence of mental disorders, to obtain data of service use of individuals with mental disorders, and to analyze the related psycho-social risk factors or correlates. The IMMHS was divided into two stages. Considering the consistency of the measures, comparability with other researches, target diseases and innovation, in Stage one, the diagnoses of mood disorders, anxiety disorders, substance use disorders, impulse-control disorder, and eating disorders were obtained by using the Composite International Diagnostic Interview-3. 0. In Stage two, schizophrenia and other psychotic disorders and dementia were diagnosed with the Structured Clinical Interview for DSM-IV Axis I disorders and the 10/66 dementia diagnosis package representatively. The information yielded from the IMMHS would be of great value for policy making of mental health and further studies. [ABSTRACT FROM AUTHOR]

L'augmentation du nombre de familles sans logement en Île-de-France interroge la nécessité de mieux les connaître pour adapter la prise en charge à leurs besoins. L'objectif de cet article est d'étudier les facteurs associés à la santé mentale de ces mères et ces enfants. Les données sont issues de l'enquête ENFAMS menée par des binômes enquêteurs-psychologues bilingues auprès de 801 familles pendant l'hiver 2012–2013. La dépression des mères était évaluée par le Composite International Diagnostic Interview (CIDI) et leur État de Stress Post Traumatique était évalué par le Mini International Neuropsychiatric Interview (MINI). La dépression et l'ESPT des mères ont été étudiés par des régressions de Poisson à variance robuste. Les difficultés émotionnelles et comportementales des enfants ont été évaluées par le Strengths and Difficulties Questionnaire (SDQ) et ont été étudiés par une régression linéaire. Les mères présentent une forte prévalence de dépression caractérisée (28,8 %) et d'ESPT (18,9 %), et leurs enfants présentent un niveau élevé de difficultés émotionnelles et comportementales (20,8 %). Les facteurs associés à la dépression des mères sont le fait de savoir parler français, le risque suicidaire, l'ESPT et le renoncement à des soins médicaux ; les facteurs associés à l'ESPT des mères sont le départ du pays d'origine pour une cause violente, la dépression et l'instabilité résidentielle. Les difficultés émotionnelles et comportementales des enfants sont associées à la région de naissance des parents, la mobilité résidentielle de la famille, la santé des enfants et le surpoids, les habitudes de sommeil des enfants, le risque suicidaire des mères, le fait que les enfants n'aiment pas leur hébergement et qu'ils soient victimes de moqueries à l'école. Le système de santé de droit commun et les professionnels en soins primaires doivent saisir l'opportunité de chaque contact avec ces familles pour dépister les troubles de la santé mentale et les aiguiller vers les structures existantes pour faciliter leur accès aux soins. The number of homeless families in the Greater Paris region has increased over time and given their vulnerability, it is necessary to better know their characteristics, especially in terms of mental health. Our objective was to study the prevalence of mental health difficulties among homeless women and their children and associated factors. This study was based on the ENFAMS survey, conducted during the winter of 2012–2013 among 801 homeless families in the Greater Paris region, by trained interviewers and psychologists. Mothers' depression was assessed by the Composite International Diagnostic Interview (CIDI) and their Post Traumatique Stress Disorders was assessed by the Mini International Neuropsychiatric Interview (MINI). Depression and PTSD of the mothers were studied in weighted Poisson regression models with robust error variance. The emotional and behavioural difficulties of children were assessed by the Strengths and Difficulties Questionnaire (SDQ) and studied by linear regression. Homeless women have a high prevalence of depression (28.8 %) and Post Traumatic Stress Disorder (PTSD) (18.9 %); their children have high levels of emotional and behavioral difficulties (20.8 %). Factors associated with maternal depression include fluency in French, suicidal risk, PTSD, and unmet medical needs. The risk of PTSD in mothers was associated with departure from the country of origin for a violent cause, depression and residential instability. Children's emotional and behavioral difficulties were associated with parents' birth region, residential mobility, children's health and overweight, children's sleep patterns, mother's suicidal risk, the fact that children do not like their housing or are victim of school bullying. The standard health care system and primary care professionals must take advantage of the opportunity offered by each contact with homeless families to detect mental health disorders, which have a high prevalence in both mothers and their children, and refer them to existing structures to facilitate their access to health care. [ABSTRACT FROM AUTHOR]

Objective: National surveys revealed a high prevalence of psychiatric disorders in Iran. Province-level estimates are needed to manage the resources and focus on preventive efforts more efficiently. The objective of this study was to provide province-level estimates of psychiatric disorders. Method: In this study, Iranian Mental Health Survey (IranMHS) data (n = 7886) was used to produce province-level prevalence estimates of any psychiatric disorders among 15-64 year old males and females. Psychiatric disorders were diagnosed based on structured diagnostic interview of the Persian version of Composite International Diagnostic Interview (CIDI, version, 2.1). The Hierarchical Bayesian (HB) random effect model was used to calculate the estimates. The mental health status of half of the participants was also measured using a 28-item general health questionnaire (GHQ). Results: A wide variation in the prevalence of psychiatric disorders was found among 31 provinces of Iran. The direct estimates ranged from 3.6% to 62.6%, while the HB estimates ranged from 12.6% to 36.5%. The provincial prevalence among men ranged from 11.9% to 34.5%, while it ranged from 18.4% to 38.8% among women. The Pearson correlation coefficient between HB estimates and GHQ scores was 0.73. Conclusion: The Bayesian small area estimation provides estimation with improved precision at local levels. Detecting high-priority communities with small-area approach could lead to a better distribution of limited facilities and more effective mental health interventions. [ABSTRACT FROM AUTHOR]

BackgroundIn 1986, Reactor 4 of the Chernobyl nuclear power plant near Pripyat, Ukraine exploded, releasing highly-radioactive materials into the surrounding environment. Although the physical effects of the disaster have been well-documented, a limited amount of research has been conducted on association of the disaster with long-term, clinically-diagnosable mental health disorders. According to the diathesis–stress model, the stress of potential and unknown exposure to radioactive materials and the ensuing changes to ones life or environment due to the disaster might lead those with previous vulnerabilities to fall into a poor state of mental health. Previous studies of this disaster have found elevated symptoms of stress, substance abuse, anxiety, and depression in exposed populations, though often at a subclinical level.Materials and methodsWith data from The World Mental Health Composite International Diagnostic Interview, a cross-sectional large mental health survey conducted in Ukraine by the World Health Organization, the mental health of Ukrainians was modeled with multivariable logistic regression techniques to determine if any long-term mental health disorders were association with reporting having lived in the zone affected by the Chernobyl nuclear disaster. Common classes of psychiatric disorders were examined as well as self-report ratings of physical and mental health.ResultsReporting that one lived in the Chernobyl-affected disaster zone was associated with a higher rate of alcohol disorders among men and higher rates of intermittent explosive disorders among women in a prevalence model. Subjects who lived in the disaster zone also had lower ratings of personal physical and mental health when compared to controls.DiscussionStress resulting from disaster exposure, whether or not such exposure actually occurred or was merely feared, and ensuing changes in life circumstances is associated with increased rates of mental health disorders. Professionals assisting populations that are coping with the consequences of disaster should be aware of possible increases in psychiatric disorders as well as poorer perceptions regarding personal physical and mental health.

Objective: This study aimed to (i) examine the prevalence and types of gambling, (ii) establish prevalence of ‘pathological’ gambling, (iii) explore the correlates of gambling, and (iv) establish psychiatric and physical comorbidity in a sample of older adult gamblers (≥60 years) in contrast to younger gamblers in a representative population sample in Singapore. Method: This paper reports the results of a secondary analysis of data from a representative community survey of 6616 participants, of which 2252 had engaged in gambling activities at least once in their lifetime. Results: 48.9% of older adults reported lifetime gambling. Older gamblers were more likely to be males, married or widowed (vs. never married), with pre-primary, primary and secondary education (vs. university), economically inactive (vs. employed) and had personal annual income of SGD $19,999 and below (vs. SGD $50,000 and above). Older gamblers had significantly higher rates of betting on horses, playing numbers or betting on lotteries, and playing Mahjong. After adjusting for demographic variables in multiple logistic regression analyses, gamblers aged 60 years and older had significantly lower odds of having pathological gambling than those in the younger age group (OR = 0.4). Older gamblers had significantly higher odds of having diabetes (OR = 3.2), hypertension (OR = 4.9), and any comorbid chronic physical condition assessed in this study. Conclusions: For the majority of older adults, gambling remains a recreational activity that is entertaining and a way of socialization. However, one must remain cognizant of the possible risks for some to develop disordered gambling.

Background: Psychiatric disorders including anxiety, depression, somatization, obsessive compulsive, and bipolar disorders are recognized as causing the biggest burden of disease worldwide. Aim: In this study, we aimed to assess the prevalence and burden of common mental disorders at Primary Health Care Centers (PHCC) using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) in the Qatari population, aged 18-65 who attended Primary Health Care (PHC) settings. Design: A prospective cross-sectional study conducted during November 2011 to October 2012. Setting: Primary Health Care Centers of the Supreme Council of Health, Qatar. Subjects: A total of 2,000 Qatari subjects aged 18-65 years were approached; 1475 (73.3%) agreed to participate. Methods: Prevalence and severity of International Classification of Disease-10 disorders were assessed with the WHO-CIDI (Version 3.0). Results: Of the 1475 participants, 830 (56.3%) were females and 645 (43.7%) was males. One-third were aged 35-49 years 558 (37.8%). The three most common disorders were major depression disorders (18.31%), any anxiety disorders (17.3%), any mood disorders (16.95%), followed by separation anxiety disorders (15.25%), personality disorder (14.1%). In the present study, prevalence in women was significantly higher than men for the most common psychiatric disorders, specifically generalized anxiety disorder, panic disorder, social phobia, specific phobias, obsessive compulsive disorders, posttraumatic disorder, somatization, major depressive disorder, bipolar disorder, dysthymia, and oppositional defiant disorder. Of the total 20% had only one psychiatric diagnosis and 12% had two disorders, 9.7% respondents with three diagnoses, and finally 4.3% of respondents had four or more diagnoses. Conclusion: One-fifth of all adults who attended the PHCC (20%) had at least one psychiatric diagnosis. The CIDI is a useful instrument for psychiatric diagnosis in community settings such as PHC clinics, clinical research and intervention studies. There is an urgent need to not only assess prevalence, but also risk factors, burden, treatment gaps and outcomes to obtain evidence for policy making.

Background: The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings. Methods: We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen′s K. Results: Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient. Conclusions: Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa.

Abstract Objective This study examines the association of depressive and anxiety disorders and their clinical characteristics (disorder type, severity, chronicity and clinical subtypes) with diet quality. Method Data from 1634 adults (controls = 336, current disorder = 414, remitted = 886) were sourced from the 9-year follow-up of the Netherlands Study of Depression and Anxiety. Depressive and anxiety disorders were established with Composite International Diagnostic Interviews. Severity was measured with the Inventory of Depressive Symptomatology (IDS), Fear Questionnaire and the Beck Anxiety Inventory. Chronicity was measured with life-chart interviews expressed as percentage time with a disorder(s). Diet quality was evaluated using the Mediterranean Diet Score (MDS) and the Alternative Healthy Eating Index (AHEI). Results Diet quality was significantly worse among subjects with a current disorder than among healthy controls. Subdividing subjects showed that those with concurrent depressive and anxiety disorders had the lowest diet quality score (MDS: β = −0.41 per SD, 95% Confidence interval (95%CI) = -0.60, −0.21; AHEI β = −0.22 per SD 95% CI = −0.42,-0.03). More chronic depression or anxiety disorders and increased severity in all participants showed a dose-response association with poorer diet quality. There was no distinct pattern between IDS items related to depression subtypes and diet quality. Conclusion Diet quality is poorer in persons with depressive and anxiety disorders; in particular in those with comorbidity. The more severe and chronic the symptoms, the poorer the diet quality. Prospective studies are needed to confirm the direction of the relationship of depressive and anxiety disorders with diet quality and to examine whether improving diet quality could improve mental health. [ABSTRACT FROM AUTHOR]

In a previous study (Van Ditzhuijzen et al., 2017) we investigated the incidence and recurrence of mental disorders 2.5 to 3 years post-abortion. The aim of the current study was to extend these findings with longer term follow up data, up until 5–6 years post-abortion. We compared data of women who had had an abortion of the Dutch Abortion and Mental Health Study (DAMHS) to women who did not have an abortion from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) ( N total  = 2227). We used 1-to-1 matching on background confounding variables and measured post-abortion incidence and recurrence of common DSM-IV mental disorders (mood, anxiety, and substance use disorders) using the Composite International Diagnostic Interview (CIDI) version 3.0. After matching on confounding variables, abortion did not increase the likelihood that women had incident or recurrent mental disorders in the 5–6 years post-abortion (any incident mental disorder: OR = 3.66, p  = .16; any recurrent mental disorder: OR = 0.22, p  = .47). We found no evidence that experiencing an abortion increases the risk on new or recurrent mental disorders on the longer term. [ABSTRACT FROM AUTHOR]

Objective: The naturalistic course of major depressive disorder (MDD) and risk indicators for recurrence and chronicity are best studied using a population sample without clear selection bias. However, such studies are scarce. This limits clinical decision‐making concerning monitoring and maintenance treatment. Method: Data were used from the Netherlands Mental Health Survey and Incidence Study‐2, a psychiatric epidemiological cohort study among a representative adult population. Two groups at baseline were selected to study recurrence and chronicity of MDD at follow‐up. Diagnoses were assessed with the Composite International Diagnostic Interview 3.0. Results: Among remitted MDD cases (n = 746), the cumulative recurrence rate was 4.3% at 5 years, 13.4% at 10 years and 27.1% at 20 years. Time to recurrence was predicted by vulnerability characteristics (childhood abuse, negative life events, parental psychopathology), physical health, functioning, clinical characteristics of depression (previous episodes, severity, medication use), psychiatric comorbidity and mental health use. Among current MDD cases (n = 242), 12% developed a chronic depressive episode over 6 years. Chronic course was predicted by similar risk indicators as recurrence, except for vulnerability characteristics and physical health. Conclusion: These risk indicators may help to identify patients requiring monitoring and who could benefit from preventive interventions or maintenance treatment. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption is pivotal for the subsequent development of alcohol use disorders (AUD). The Alcohol Use Disorders Identification Test (AUDIT) is a recommended AUD screening tool for prevention and primary care settings. The objectives of this study were to test how many participants with heavy drinking are unidentified by the AUDIT, if proportions of unidentified participants vary over time, and whether this unidentified risk group (URG) was clinically relevant in terms of drinking behavior reports and AUD risk factors, as well as future adverse outcomes, such as craving, dependence symptoms, or depression.Methods: Our prospective cohort study followed 164 German males aged 18-19years without an alcohol dependence diagnosis over 24months. Only men were included due to higher AUD prevalence and gender-specific differences in metabolism, drinking patterns, and progression to AUD. All participants were screened via telephone interview and answered questionnaires both in person and via internet. Heavy drinking was classified using the AUDIT consumption score (AUDIT-C≥4.50). Standardized AUD diagnoses and symptoms, as well as alcohol use-related outcome criteria were assessed via standardized Composite International Diagnostic Interview (CIDI), and self-report questionnaires.Results: One in four participants (22-28% across all four follow-ups) reported heavy drinking but was unidentified by AUDIT total score (i.e. score<8), thus qualifying for URG status. The URG status did not fluctuate considerably across follow-ups (repeated-measures ANOVA, p=0.293). URG participants identified at the six-month follow-up did not generally differ from participants without URG status in terms of AUD family history or temperament (multivariate ANOVA, p=0.114), except for anxiety sensitivity (pBonferroni<0.001). After two years, URG participants reported a similar level of adverse outcomes compared to low-risk participants (multivariate ANOVA, p=0.438), but less alcohol-related problems and less loss of control due to craving compared to high-risk participants (pBonferroni≤0.007).Conclusions: Despite the considerable number of heavy-drinking individuals unidentified by AUDIT total scores, an additional classification according to AUDIT-C values did not prove useful. Combining AUDIT and AUDIT-C scores might not be sufficient for identifying AUD risk groups among young adult German males. There is an urgent need for a replication of our findings among female participants. [ABSTRACT FROM AUTHOR]

Background: In 1986, Reactor 4 of the Chernobyl nuclear power plant near Pripyat, Ukraine exploded, releasing highly-radioactive materials into the surrounding environment. Although the physical effects of the disaster have been well-documented, a limited amount of research has been conducted on association of the disaster with long-term, clinically-diagnosable mental health disorders. According to the diathesis-stress model, the stress of potential and unknown exposure to radioactive materials and the ensuing changes to ones life or environment due to the disaster might lead those with previous vulnerabilities to fall into a poor state of mental health. Previous studies of this disaster have found elevated symptoms of stress, substance abuse, anxiety, and depression in exposed populations, though often at a subclinical level. Materials and methods: With data from The World Mental Health Composite International Diagnostic Interview, a cross-sectional large mental health survey conducted in Ukraine by the World Health Organization, the mental health of Ukrainians was modeled with multivariable logistic regression techniques to determine if any long-term mental health disorders were association with reporting having lived in the zone affected by the Chernobyl nuclear disaster. Common classes of psychiatric disorders were examined as well as self-report ratings of physical and mental health. Results: Reporting that one lived in the Chernobyl-affected disaster zone was associated with a higher rate of alcohol disorders among men and higher rates of intermittent explosive disorders among women in a prevalence model. Subjects who lived in the disaster zone also had lower ratings of personal physical and mental health when compared to controls. Discussion: Stress resulting from disaster exposure, whether or not such exposure actually occurred or was merely feared, and ensuing changes in life circumstances is associated with increased rates of mental health disorders. Professionals assisting populations that are coping with the consequences of disaster should be aware of possible increases in psychiatric disorders as well as poorer perceptions regarding personal physical and mental health. [ABSTRACT FROM AUTHOR]

Background: Suicidal behaviors are strong predictors of suicide death and are much more common than completed suicides. This study aimed to describe the prevalence and transitions of suicidal behaviors in an Inner Mongolian City of China and to explore the association of comorbidity of mood and anxiety disorders with suicidal behaviors.Method: This study was a cross-sectional study. The Composite International Diagnostic Interview-3.0 (CIDI-3.0) was administered face-to-face to make diagnoses of mental disorders, measure suicidal behaviors and collect social demographic information.Results: A total of 4528 respondents were interviewed. The lifetime prevalence of suicidal ideation, suicide plan and suicide attempt were 1.52%, 0.70% and 0.54%, respectively. Among those respondents with suicidal ideation, 21.1% of them had planned suicide attempt, and 6.6% had unplanned suicide attempt. When comorbidity was not considered in the model, mood and anxiety disorders were the most important drivers of suicidal behaviors. However, when including the comorbidity, those respondents with mood and anxiety disorders, rather than those with a specific disorder only, had a significant positive association with suicidal behaviors. In the model, being unemployed, rural, female, no income and childhood adversities were also related to suicidal behaviors.Limitations: There might be systematic recall bias as the data were based on retrospective self-reports. Suicide is a sensitive question, so the respondents were probably ashamed to talk about suicidal behaviors.Conclusions: The comorbidity of mood and anxiety disorders was the most important risk factor of suicidal behaviors. Special attention should be paid to those patients with this comorbidity. [ABSTRACT FROM AUTHOR]

Background: Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders.Methods: The data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30-55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 - 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work.Results: During an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 - 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 - 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 - 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 - 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders.Conclusions: These results highlight the need to distinguish between former drinking and lifelong abstinence, as only former drinking was associated with sickness absence. Alcohol use disorder and high-volume drinking were strongly predictive of sickness absence due to mental disorders. Identifying people with excessive alcohol use e.g. in occupational health care, and mapping and supporting their mental health may help in preventing sickness absences. [ABSTRACT FROM AUTHOR]