Minding the treatment gap: results of the Singapore Mental Health Study

Abstract Purpose To establish the 12-month treatment gap and its associated factors among adults with mental disorders in the Singapore resident population using data from the second Singapore Mental Health Study and to examine the changes since the last mental health survey conducted in 2010. Methods 6126 respondents were administered selected modules of the Composite International Diagnostic Interview, to assess major depressive disorder (MDD), dysthymia, bipolar disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol use disorder (AUD) (which included alcohol abuse and dependence). Past year treatment gap was defined as the absolute difference between the prevalence of a particular mental disorder in the past 12 months preceding the interview and those who had received treatment for that disorder. Results The prevalence of overall 12-month treatment gap in this population was high (78.6%). A multiple logistic regression analysis revealed significantly higher odds of treatment gap among those diagnosed with OCD (compared to those with MDD) and in those with a comorbid chronic physical disorder; while those who had primary education and below and those who were unemployed were less likely to have a treatment gap as compared to those with post-secondary education and those employed, respectively. Conclusions The high treatment gap in the population is concerning and highlights the need to promote help-seeking and uptake of treatment. Given the unique demographic characteristics, i.e., those with higher education and employed were more likely not to seek treatment, targeted interventions in the educational and workplace settings should be implemented.

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Psychiatric Morbidity in Pain Conditions: Results from the Singapore Mental Health Study

Pain Research and Management ◽

10.1155/2013/798205 ◽

2013 ◽

Vol 18 (4) ◽

pp. 185-190 ◽

Cited By ~ 13

Author(s):

Mythily Subramaniam ◽

Janhavi Ajit Vaingankar ◽

Edimansyah Abdin ◽

Siow Ann Chong

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Major Depressive Disorder ◽

Psychiatric Disorders ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Health Study ◽

Major Depressive ◽

Medical Disorders ◽

Mental Health Study

BACKGROUND: Chronic pain is a common problem among the general population and has been found to be associated with psychiatric disorders in studies based on both clinical samples and epidemiological surveys.OBJECTIVES: To establish the prevalence, correlates and comorbidities of chronic pain disorders among the adult population of Singapore.METHODS: The data used in the present analysis were derived from the Singapore Mental Health Study, a cross-sectional epidemiological survey of a representative sample of the adult resident population of Singapore. Diagnoses of psychiatric disorders were established using the Composite International Diagnostic Interview version 3.0. A modified version of the Composite International Diagnostic Interview 3.0 checklist of chronic medical disorders was used, in which the chronic medical disorders were reclassified into eight types of physical disorders. Chronic pain disorders included arthritis or rheumatism, back problems including disk or spine problems, and migraine headaches.RESULTS: The lifetime prevalence estimates for arthritis, back pain and migraine in the Singapore general population were 6.0% (n=282), 7.0% (n=436) and 5.6% (n=446), respectively. After adjusting for sociodemographic factors, comorbid pain disorders and the presence of other chronic physical conditions, migraine remained significantly associated with major depressive disorder (adjusted OR=2.4), generalized anxiety disorder (adjusted OR=3.0) and alcohol use disorders (adjusted OR=2.1), while back pain was significantly associated with major depressive disorder (adjusted OR=2.0).CONCLUSIONS: The significant association between pain and psychiatric disorders emphasizes the need to screen individuals with chronic pain conditions for psychiatric disorders, particularly depression. There is a need to develop integrated pharmacological and psychological treatments for both conditions.

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Impact of unemployment on mental disorders, physical health and quality of life: Findings from the Singapore Mental Health Study

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.2020637 ◽

2021 ◽

Vol 50 (5) ◽

pp. 390-401

Author(s):

Mythily Subramaniam ◽

Jue Hua Lau ◽

Edimansyah Abdin ◽

Janhavi Ajit Vaingankar ◽

James Junda Tan ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Physical Health ◽

Household Survey ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Health Study ◽

Physical And Mental Health ◽

Mental Health Study

ABSTRACT Introduction: This study examines: (1) the employment rate among those with a mental disorder in the 12 months preceding the survey (referred henceforth as 12-month mental disorder); (2) the sociodemographic correlates of unemployment; and (3) the association of unemployment with 12-month mental disorders and chronic physical conditions in the adult resident population in Singapore. Methods: Data are from the Singapore Mental Health Study 2016, a household survey of a nationally representative sample of 6,126 Singapore residents. The Composite International Diagnostic Interview (CIDI) was used to assess mental disorders and physical health conditions. Employment-related information was collected using a modified employment module of the CIDI. Results: Of the 6,125 participants who took part in the study, 4,055 (72%) were employed, 1,716 (22.7%) were economically inactive, and 354 (5.3%) were unemployed. The unemployment rate was twice as high among those with a 12-month mental disorder (11.5%) than those without (4.8%). The proportion of unemployed individuals increased sharply with the increasing severity of mental disorders. Being married and higher household income were significantly associated with a higher likelihood of being employed than unemployed. In contrast, the presence of one 12-month mental disorder was significantly associated with a lower likelihood of being employed. Conclusion: Our findings provide information on the significant association of mental disorders with unemployment. Clinicians should remain vigilant and consider the loss of employment a potential risk factor for adverse physical and mental health changes. Management of unemployed patients with a combination of pharmacotherapy and work-directed interventions can facilitate their re-entry into the workforce and improve health outcomes. Keywords: Employment, epidemiology, mental health, survey

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Latent structure of psychosis in the general population: results from the Singapore Mental Health Study

Psychological Medicine ◽

10.1017/s0033291713000688 ◽

2013 ◽

Vol 44 (1) ◽

pp. 51-60 ◽

Cited By ~ 8

Author(s):

M. Subramaniam ◽

E. Abdin ◽

J. A. Vaingankar ◽

S. Verma ◽

S. A. Chong

Keyword(s):

Mental Health ◽

Latent Trait ◽

Composite International Diagnostic Interview ◽

Latent Structure ◽

Health Study ◽

Psychotic Symptoms ◽

Psychotic Experience ◽

Clinical Correlates ◽

Latent Construct ◽

Mental Health Study

BackgroundFew studies have examined the latent construct of psychotic symptoms or distinguished between the latent construct and its manifest indicators. The current study aimed to investigate the latent structure of psychotic symptoms using factor mixture modeling (FMM) and to use the best-fitting model to examine its sociodemographic and clinical correlates.MethodThe Singapore Mental Health Study (SMHS) was based on an adult representative sample of the Singapore population. Psychotic symptoms were assessed by using the Psychosis Screen section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0). FMM analyses were applied to determine the latent construct of psychotic symptoms. Sociodemographic and clinical correlates of the latent structure of psychosis symptoms were examined using multiple linear and logistic regression analyses.ResultsThe overall weighted lifetime prevalence of any psychotic experience was 3.8% in the SMHS after excluding subthreshold experiences. The FMM analysis clearly supported the dimensional model of the latent structure of psychotic symptoms. On deriving the total score for ‘psychosis symptoms’ in accordance with the one latent trait model, and correlating it with sociodemographic factors, we found that female gender, vocational education, current and past smokers were positively associated with the ‘psychosis’ total score.ConclusionsThere is a need for an increased understanding of, and research into, this intermediate state of ‘psychosis symptoms’ that do not meet diagnostic criteria for psychosis. It is also important to learn more about the group of individuals in the community who may have preserved functioning to elucidate the protective factors that prevent transition to psychosis.

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Review of Social order and mental health: The Florida Mental Health Study.

American Journal of Orthopsychiatry ◽

10.1037/h0098885 ◽

1980 ◽

Vol 50 (2) ◽

pp. 376-378

Author(s):

Thomas F. McGee

Keyword(s):

Mental Health ◽

Social Order ◽

Health Study ◽

Mental Health Study

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The Relationship between Suicidality and Socio-Demographic Variables, Physical Disorders, and Psychiatric Disorders: Results from the Singapore Mental Health Study 2016

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084365 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4365

Author(s):

Kundadak Ganesh Kudva ◽

Edimansyah Abdin ◽

Janhavi Ajit Vaingankar ◽

Boon Yiang Chua ◽

Saleha Shafie ◽

...

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Psychiatric Disorders ◽

Population Level ◽

Risk Groups ◽

Epidemiological Survey ◽

Health Study ◽

Physical Disorders ◽

Mental Health Study ◽

The Relationship

Suicidality encompasses suicidal ideation, plans, and attempts. This paper aims to establish associations between suicidality and sociodemographic variables, physical disorders, and psychiatric disorders. The Singapore Mental Health Study 2016 was a population-level epidemiological survey, which determined the prevalence of physical disorders, psychiatric disorders, and suicidality. Questionnaires were used to determine socio-demographic information. A total of 6216 respondents were interviewed. Lifetime prevalence of suicidal ideation, planning, and attempts were 7.8%, 1.6%, and 1.6%, respectively. All components of suicidality were more likely in those with major depressive disorder, bipolar disorder, generalized anxiety disorder, alcohol use disorder, and chronic pain. Suicidal ideation and attempts were more likely in those with diabetes. Age above 65, being male, and a monthly household income of ≥ SGD 10,000 were associated with a lower likelihood of suicidal ideation. These findings indicate that there are high-risk groups for whom suicidality is a concern, and for whom interventions may be needed.

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685 Sleep Latency, Pre and Peri-COVID-19 Experiences and PTSD Symptoms: Results from the NYU COVID-19 Mental Health Study

SLEEP ◽

10.1093/sleep/zsab072.683 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A267-A268

Author(s):

April Rogers ◽

Judite Blanc ◽

Azizi Seixas ◽

Joao Nunes ◽

Georges Casimir ◽

...

Keyword(s):

Mental Health ◽

New York ◽

New York City ◽

York City ◽

Sleep Disturbances ◽

Health Study ◽

Sleep Onset Latency ◽

Ptsd Symptoms ◽

Effective Response ◽

Mental Health Study

Abstract Introduction An effective response to the COVID-19 pandemic has been the decision to subject individuals residing in New York City to quarantine rules in order to reduce the spread of the virus. As might have been expected, restriction of usual daily activities would affect individuals’ sleep-wake patterns. It is also known that exposure to traumatic experiences can also engender sleep disturbances, most notably in their ability to initiate sleep. This study investigated the associations between sleep onset latency (SOL), pre and peri-COVID-19 exposure and symptoms of posttraumatic stress disorder (PTSD) among New Yorkers. Methods 541 individuals (female = 373(69%); mean age=40.9) were recruited during the summer and fall of 2020 in New York City to participate in the NYU-COVID-19 Mental Health Study. Participants provided sociodemographic data and were also asked to respond to the COVID-19 quarantine experiences, comprised of seven binary questions, the PTSD Checklist-PCL-5, and the Pittsburg Sleep Quality Index. Descriptive and linear regression analysis were performed to explore associations of scores on the COVID-19 quarantine experience with PTSD and sleep data. All analyses were performed using SPSS 25.0 Results Regression analyses revealed that SOL emerged as the strongest independent predictor of PTSD symptoms [B(t) = −.630(12.7); p < .001]; factors adjusted in the model included pre and peri-covid-19 factors such as age, sex, job type, and quarantine experience. Analyses assessing potential interaction effect revealed that quarantine experience did not affect the relationship between SOL and PTSD [B(t) = .086(.831); p = >.005]. The other sleep factors in the model did not yield significance. sleep duration had a weak correlation with quarantine, it was not found to be a predictor of PTSD. Conclusion We observed that SOL was the most important determinant of PTSD symptoms among individuals exposed to COVID-19. This is consistent with other findings suggesting that a sizable proportion of individuals exposed to pandemics are likely to experience sleep disturbances. It is plausible that quarantine might lead to increased daytime naps, which may impact SOL. Further research is needed to better understand the association of SOL and PTSD as a result of Covid-19. Support (if any) K07AG052685, R01MD007716, R01HL142066, T32HL129953, K01HL135452, R01HL152453

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