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3. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis

Author

Masefield, Sarah C., Prady, Stephanie L., Sheldon, Trevor A., Small, Neil, Jarvis, Stuart, and Pickett, Kate E.

Subjects
Child development deviations -- Care and treatment -- Psychological aspects, Child care -- Health aspects -- Psychological aspects, Caregivers -- Health aspects -- Psychological aspects, Developmental disabilities -- Care and treatment -- Psychological aspects, Health care industry
Abstract

Objectives Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status. Methods Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity. Results The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings. Conclusions for Practice Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving., Author(s): Sarah C. Masefield [sup.1] , Stephanie L. Prady [sup.1] , Trevor A. Sheldon [sup.1] , Neil Small [sup.2] , Stuart Jarvis [sup.1] , Kate E. Pickett [sup.1] Author Affiliations: [...]

Published
2020
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7. Parenting and Infant Temperament amongst Pakistani Women Living in the UK According to Country of Birth: Results from the Born in Bradford Cohort Study

Author

Prady, Stephanie L., Kiernan, Kathleen, Fairley, Lesley, and Wright, John

Abstract

Some parenting behaviours and child characteristics can result in future behavioural problems. Relatively little is known about parenting behaviours in Pakistani-origin women, and how the timing of migration to the United Kingdom might affect such behaviours. We analysed differences in parenting behaviours and six-month infant temperament by mothers' country of birth in a contemporary community cohort, Born in Bradford. We analysed data on 587 women of Pakistani origin and their infants by maternal country of birth. We used logistic regression to assess differences by country of birth on the most problematic quintile of psychometrically equivalised self-reported parental self-efficacy, warmth and hostility, and children's temperament using two domains of the Infant Characteristics Questionnaire (fussy/difficult and unadaptable). We adjusted for psychological distress, socio-demographic variables, questionnaire language, and child temperament in the parenting models. We also compared the self-rating of parental confidence. There was some evidence that mothers born in Pakistan were more likely to report a higher hostile style of parenting, which was associated with being in the United Kingdom for a shorter period/not using English. Mothers born in Pakistan were more likely to have greater confidence in their abilities as parents. Infants of women born in the United Kingdom were more likely to be classified as unadaptable. We saw little evidence of difference in parental warmth and self-efficacy. Our analyses indicate some potential differences in parenting behaviours in women of Pakistani origin living in the United Kingdom by country of birth, which may be related to acculturation. Further work is needed to understand how parenting practices are learned and applied in recent migrants.

Published
2013
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13. Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England: longitudinal matched-cohort study using the Clinical Practice Research Datalink

Author

Wang, Han-I, Han, Lu, Jacobs, Rowena, Doran, Tim, Holt, Richard IG, Prady, Stephanie L, Gilbody, Simon, Shiers, David, Alderson, Sarah, Hewitt, Catherine, Taylor, Jo, Kitchen, Charlotte EW, Bellass, Sue, Siddiqi, Najma, Wang, Han-I, Han, Lu, Jacobs, Rowena, Doran, Tim, Holt, Richard IG, Prady, Stephanie L, Gilbody, Simon, Shiers, David, Alderson, Sarah, Hewitt, Catherine, Taylor, Jo, Kitchen, Charlotte EW, Bellass, Sue, and Siddiqi, Najma

Abstract

Background Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions. Aims To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions. Method This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively. Results There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year. Conclusions Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation.

Published
2022

17. Association of environmental and socioeconomic indicators with serious mental illness diagnoses identified from general practitioner practice data in England: A spatial Bayesian modelling study

Author

Hanna, Liz, Cruz, Joana, Li, Guangquan, Aragon, Maria Jose, Coventry, Peter A., Jacobs, Rowena, Prady, Stephanie L., and White, Piran C. L.

Subjects
B900, Adult, Young Adult, England, Socioeconomic Factors, General Practitioners, Mental Disorders, Humans, Bayes Theorem, General Medicine, C800, Retrospective Studies
Abstract

BackgroundThe evidence is sparse regarding the associations between serious mental illnesses (SMIs) prevalence and environmental factors in adulthood as well as the geographic distribution and variability of these associations. In this study, we evaluated the association between availability and proximity of green and blue space with SMI prevalence in England as a whole and in its major conurbations (Greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle).Methods and findingsWe carried out a retrospective analysis of routinely collected adult population (≥18 years) data at General Practitioner Practice (GPP) level. We used data from the Quality and Outcomes Framework (QOF) on the prevalence of a diagnosis of SMI (schizophrenia, bipolar affective disorder and other psychoses, and other patients on lithium therapy) at the level of GPP over the financial year April 2014 to March 2018. The number of GPPs included ranged between 7,492 (April 2017 to March 2018) to 7,997 (April 2014 to March 2015) and the number of patients ranged from 56,413,719 (April 2014 to March 2015) to 58,270,354 (April 2017 to March 2018). Data at GPP level were converted to the geographic hierarchy unit Lower Layer Super Output Area (LSOA) level for analysis. LSOAs are a geographic unit for reporting small area statistics and have an average population of around 1,500 people. We employed a Bayesian spatial regression model to explore the association of SMI prevalence in England and its major conurbations (greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle) with environmental characteristics (green and blue space, flood risk areas, and air and noise pollution) and socioeconomic characteristics (age, ethnicity, and index of multiple deprivation (IMD)). We incorporated spatial random effects in our modelling to account for variation at multiple scales.Across England, the environmental characteristics associated with higher SMI prevalence at LSOA level were distance to public green space with a lake (prevalence ratio [95% credible interval]): 1.002 [1.001 to 1.003]), annual mean concentration of PM2.5(1.014 [1.01 to 1.019]), and closeness to roads with noise levels above 75 dB (0.993 [0.992 to 0.995]). Higher SMI prevalence was also associated with a higher percentage of people above 24 years old (1.002 [1.002 to 1.003]), a higher percentage of ethnic minorities (1.002 [1.001 to 1.002]), and more deprived areas.Mean SMI prevalence at LSOA level in major conurbations mirrored the national associations with a few exceptions. In Birmingham, higher average SMI prevalence at LSOA level was positively associated with proximity to an urban green space with a lake (0.992 [0.99 to 0.998]). In Liverpool and Manchester, lower SMI prevalence was positively associated with road traffic noise ≥75 dB (1.012 [1.003 to 1.022]). In Birmingham, Liverpool, and Manchester, there was a positive association of SMI prevalence with distance to flood zone 3 (land within flood zone 3 has ≥1% chance of flooding annually from rivers or ≥0.5% chance of flooding annually from the sea, when flood defences are ignored): Birmingham: 1.012 [1.000 to 1.023]; Liverpool and Manchester: 1.016 [1.006 to 1.026]. In contrast, in Leeds, there was a negative association between SMI prevalence and distance to flood zone 3 (0.959 [0.944 to 0.975]). A limitation of this study was because we used a cross-sectional approach, we are unable to make causal inferences about our findings or investigate the temporal relationship between outcome and risk factors. Another limitation was that individuals who are exclusively treated under specialist mental health care and not seen in primary care at all were not included in this analysis.ConclusionsOur study provides further evidence on the significance of socioeconomic associations in patterns of SMI but emphasises the additional importance of considering environmental characteristics alongside socioeconomic variables in understanding these patterns. In this study, we did not observe a significant association between green space and SMI prevalence, but we did identify an apparent association between green spaces with a lake and SMI prevalence. Deprivation, higher concentrations of air pollution, and higher proportion of ethnic minorities were associated with higher SMI prevalence, supporting a social-ecological approach to public health prevention. It also provides evidence of the significance of spatial analysis in revealing the importance of place and context in influencing area-based patterns of SMI.

Published
2021

20. Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England: longitudinal matched-cohort study using the Clinical Practice Research Datalink

Author

Wang, Han-I., primary, Han, Lu, additional, Jacobs, Rowena, additional, Doran, Tim, additional, Holt, Richard I. G., additional, Prady, Stephanie L., additional, Gilbody, Simon, additional, Shiers, David, additional, Alderson, Sarah, additional, Hewitt, Catherine, additional, Taylor, Jo, additional, Kitchen, Charlotte E. W., additional, Bellass, Sue, additional, and Siddiqi, Najma, additional

Published
2021
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21. Associations Between Maternal Depression, Antidepressant Use During Pregnancy, and Adverse Pregnancy Outcomes

Author

Vlenterie, Richelle, primary, van Gelder, Marleen M. H. J., additional, Anderson, H. Ross, additional, Andersson, Liselott, additional, Broekman, Birit F. P., additional, Dubnov-Raz, Gal, additional, El Marroun, Hanan, additional, Ferreira, Ema, additional, Fransson, Emma, additional, van der Heijden, Frank M. M. A., additional, Holzman, Claudia B., additional, Kim, J. Jo, additional, Khashan, Ali S., additional, Kirkwood, Betty R., additional, Kuijpers, Harold J. H., additional, Lahti-Pulkkinen, Marius, additional, Mason, Dan, additional, Misra, Dawn, additional, Niemi, Maria, additional, Nordeng, Hedvig M. E., additional, Peacock, Janet L., additional, Pickett, Kate E., additional, Prady, Stephanie L., additional, Premji, Shahirose S., additional, Räikkönen, Katri, additional, Rubertsson, Christine, additional, Sahingoz, Mine, additional, Shaikh, Kiran, additional, Silver, Richard K., additional, Slaughter-Acey, Jaime, additional, Soremekun, Seyi, additional, Stein, Dan J., additional, Sundström-Poromaa, Inger, additional, Sutter-Dallay, Anne-Laure, additional, Tiemeier, Henning, additional, Uguz, Faruk, additional, Varela, Pinelopi, additional, Vrijkotte, Tanja G.M., additional, Winterfeld, Ursula, additional, Zar, Heather J., additional, Zervas, Iannis M., additional, Prins, Judith B., additional, Pop-Purceleanu, Monica, additional, and Roeleveld, Nel, additional

Published
2021
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23. Identifying determinants of diabetes risk and outcomes for people with severe mental illness: a mixed-methods study

Author

Lister, Jennie, primary, Han, Lu, additional, Bellass, Sue, additional, Taylor, Jo, additional, Alderson, Sarah L, additional, Doran, Tim, additional, Gilbody, Simon, additional, Hewitt, Catherine, additional, Holt, Richard IG, additional, Jacobs, Rowena, additional, Kitchen, Charlotte EW, additional, Prady, Stephanie L, additional, Radford, John, additional, Ride, Jemimah R, additional, Shiers, David, additional, Wang, Han-I, additional, and Siddiqi, Najma, additional

Published
2021
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24. Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England : longitudinal matched-cohort study using the Clinical Practice Research Datalink

Author

Wang, Han-I, Han, Lu, Jacobs, Rowena, Doran, Tim, Holt, Richard IG, Prady, Stephanie L, Gilbody, Simon, Shiers, David, Alderson, Sarah, Hewitt, Catherine, Taylor, Jo, Kitchen, Charlotte EW, Bellass, Sue, Siddiqi, Najma, Wang, Han-I, Han, Lu, Jacobs, Rowena, Doran, Tim, Holt, Richard IG, Prady, Stephanie L, Gilbody, Simon, Shiers, David, Alderson, Sarah, Hewitt, Catherine, Taylor, Jo, Kitchen, Charlotte EW, Bellass, Sue, and Siddiqi, Najma

Abstract

Background Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions. Aims To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions. Method This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively. Results There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year. Conclusions Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation.

Published
2021

25. Associations Between Maternal Depression, Antidepressant Use During Pregnancy, and Adverse Pregnancy Outcomes

Author

Vlenterie, Richelle, van Gelder, Marleen M. H. J., Anderson, H. Ross, Andersson, Liselott, Broekman, Birit F. P., Dubnov-Raz, Gal, El Marroun, Hanan, Ferreira, Ema, Fransson, Emma, van der Heijden, Frank M. M. A., Holzman, Claudia B., Kim, J. Jo, Khashan, Ali S., Kirkwood, Betty R., Kuijpers, Harold J. H., Lahti-Pulkkinen, Marius, Mason, Dan, Misra, Dawn, Niemi, Maria, Nordeng, Hedvig M. E., Peacock, Janet L., Pickett, Kate E., Prady, Stephanie L., Premji, Shahirose S., Räikkönen, Katri, Rubertsson, Christine, Sahingoz, Mine, Shaikh, Kiran, Silver, Richard K., Slaughter-Acey, Jaime, Soremekun, Seyi, Stein, Dan J., Sundström Poromaa, Inger, Sutter-Dallay, Anne-Laure, Tiemeier, Henning, Uguz, Faruk, Varela, Pinelopi, Vrijkotte, Tanja G.M., Winterfeld, Ursula, Zar, Heather J., Zervas, Iannis M., Prins, Judith B., Pop-Purceleanu, Monica, Roeleveld, Nel, Vlenterie, Richelle, van Gelder, Marleen M. H. J., Anderson, H. Ross, Andersson, Liselott, Broekman, Birit F. P., Dubnov-Raz, Gal, El Marroun, Hanan, Ferreira, Ema, Fransson, Emma, van der Heijden, Frank M. M. A., Holzman, Claudia B., Kim, J. Jo, Khashan, Ali S., Kirkwood, Betty R., Kuijpers, Harold J. H., Lahti-Pulkkinen, Marius, Mason, Dan, Misra, Dawn, Niemi, Maria, Nordeng, Hedvig M. E., Peacock, Janet L., Pickett, Kate E., Prady, Stephanie L., Premji, Shahirose S., Räikkönen, Katri, Rubertsson, Christine, Sahingoz, Mine, Shaikh, Kiran, Silver, Richard K., Slaughter-Acey, Jaime, Soremekun, Seyi, Stein, Dan J., Sundström Poromaa, Inger, Sutter-Dallay, Anne-Laure, Tiemeier, Henning, Uguz, Faruk, Varela, Pinelopi, Vrijkotte, Tanja G.M., Winterfeld, Ursula, Zar, Heather J., Zervas, Iannis M., Prins, Judith B., Pop-Purceleanu, Monica, and Roeleveld, Nel

Published
2021
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28. Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England: longitudinal matched-cohort study using the Clinical Practice Research Datalink.

Author

Wang, Han-I., Han, Lu, Jacobs, Rowena, Doran, Tim, Holt, Richard I. G., Prady, Stephanie L., Gilbody, Simon, Shiers, David, Alderson, Sarah, Hewitt, Catherine, Taylor, Jo, Kitchen, Charlotte E. W., Bellass, Sue, and Siddiqi, Najma

Subjects
MENTAL illness treatment, PSYCHIATRIC epidemiology, MEDICAL care costs, RETROSPECTIVE studies, TYPE 2 diabetes, NATIONAL health services, RESEARCH funding, MENTAL illness, LONGITUDINAL method
Abstract

Background: Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions.Aims: To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions.Method: This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively.Results: There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year.Conclusions: Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation. [ABSTRACT FROM AUTHOR]

Published
2022
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32. Exploring Severe Mental Illness and Diabetes: Protocol for a Longitudinal, Observational, and Qualitative Mixed Methods Study

Author

Bellass, Sue, primary, Taylor, Johanna, additional, Han, Lu, additional, Prady, Stephanie L, additional, Shiers, David, additional, Jacobs, Rowena, additional, Holt, Richard Ian Gregory, additional, Radford, John, additional, Gilbody, Simon, additional, Hewitt, Catherine, additional, Doran, Tim, additional, Alderson, Sarah L, additional, and Siddiqi, Najma, additional

Published
2019
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37. Exploring Severe Mental Illness and Diabetes: Protocol for a Longitudinal, Observational, and Qualitative Mixed Methods Study (Preprint)

Author

Bellass, Sue, primary, Taylor, Johanna, additional, Han, Lu, additional, Prady, Stephanie L, additional, Shiers, David, additional, Jacobs, Rowena, additional, Holt, Richard Ian Gregory, additional, Radford, John, additional, Gilbody, Simon, additional, Hewitt, Catherine, additional, Doran, Tim, additional, Alderson, Sarah L, additional, and Siddiqi, Najma, additional

Published
2019
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38. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

Author

Hutchinson, Jayne, Prady, Stephanie L., Smith, Michaela A., White, Piran C. L., and Graham, Hilary M.

Subjects
lifestyle, pro-environmental behavior, Developed Countries, Health Behavior, lcsh:R, physical activity, lcsh:Medicine, Review, Environment, Motor Activity, active travel, health-related behavior, Observational Studies as Topic, public transport use, Humans, consumption, Sedentary Behavior
Abstract

Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling) and physical activity (92 studies) or sedentary behaviors (19 studies). Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14), including organic food, locally-sourced food and plate waste) and other health behaviors ((n = 20) smoking, dietary intake, alcohol). These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

Published
2015

39. A systematic review of maternal antidepressant use in pregnancy and short and long-term offspring's outcomes

Author

Prady, Stephanie L, Hanlon, Inna, Fraser, Lorna K, Mikocka-Walus, Antonina, Prady, Stephanie L, Hanlon, Inna, Fraser, Lorna K, and Mikocka-Walus, Antonina

Abstract

The relative safety of antidepressants during pregnancy has received substantial attention, but most syntheses fail to account for mental illness effects. We aimed to evaluate the literature comparing low birth weight (LBW) and neurodevelopmental and neurobehavioural outcomes for children whose mothers took antidepressants in pregnancy compared to those whose mothers had common mental disorders, or symptoms, but who did not take antidepressants during pregnancy. A systematic review was conducted searching PubMed, MEDLINE, PsycINFO and Embase in January 2015. A modified version of the Newcastle Ottawa Scale was used to assess study quality. Eleven cohort studies were included: four reporting a LBW outcome (all with higher risk of bias) and seven reporting a neurodevelopmental outcome (five with higher risk of bias). We found only limited evidence of gestational age-adjusted LBW in exposed children in two studies which had a higher risk of bias and did not control for depressive symptom severity. Only five (7.5%) neurodevelopmental outcomes and one (12.5%) neurobehavioural outcome showed evidence of a statistically significant effect, three out of four were from studies with a higher risk of bias. There is little robust evidence indicating a detrimental effect of antidepressant use during pregnancy on LBW and neurodevelopmental and neurobehavioural outcomes. More rigorous study designs are needed.

Published
2018

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