scholarly journals Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder: findings from the REMAIN study

2020 ◽  
Author(s):  
Heidi Taipale ◽  
Thomas Niederkrotenthaler ◽  
Magnus Helgesson ◽  
Marit Sijbrandij ◽  
Lisa Berg ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Common Mental Disorder ◽  
Study Cohort ◽  
Clinical Factors ◽  
Refugee Youth ◽  
Factors Associated ◽  
Antidepressant Use ◽  
Specialized Health Care

Abstract Purpose The objective of this study was to compare the initiation and type of antidepressant use between refugees and matched Swedish-born youth after a diagnosis of a common mental disorder (CMD) and assess sociodemographic and clinical factors associated with the initiation. Methods The study cohort included youth aged 16–25 years, with an incident diagnosis of CMD based on specialized health care registers in Sweden 2006–2016, without prior antidepressant use during 1 year. One Swedish-born person was matched for each identified refugee youth (N = 3936 in both groups). Initiation of antidepressant use and factors associated with the initiation, were investigated with logistic regression yielding Odds ratios, OR, and 95% Confidence Intervals, CI. Results Refugees were less likely to initiate antidepressant use compared with Swedish-born (40.5% vs. 59.6%, adjusted OR 0.43, 95% CI 0.39–0.48). Selective serotonin reuptake inhibitors (SSRIs) were less frequently initiated for refugees than Swedish-born (71.2% vs. 81.3% of initiations, p < 0.0001). Sertraline was the most commonly initiated antidepressant both for refugees (34.3%) and Swedish-born individuals (40.3%). Among refugees, factors associated with increased odds of antidepressant initiation were previous use of anxiolytics or hypnotics, previous sickness absence of < 90 days, cancer and older age (OR range 1.07–2.72), and less than 5 years duration of residency in Sweden was associated with decreased odds (OR 0.76, 95% CI 0.63–0.92). Conclusion Young refugees with a CMD seem to initiate antidepressants in general and those most effective considerably less often than their Swedish-born counterparts.

scholarly journals Persistence of antidepressant use among refugee youth with common mental disorder

2021 ◽  
Author(s):  
Heidi Taipale ◽  
Thomas Niederkrotenthaler ◽  
Antti Tanskanen ◽  
Alexis E. Cullen ◽  
Magnus Helgesson ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Common Mental Disorder ◽  
Refugee Youth ◽  
Antidepressant Use

scholarly journals Demographic and clinical factors associated with different antidepressant treatments: a retrospective cohort study design in a UK psychiatric healthcare setting

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022170 ◽  
Author(s):  
Andrea C Fernandes ◽  
David Chandran ◽  
Mizanur Khondoker ◽  
Michael Dewey ◽  
Hitesh Shetty ◽  
...  
Keyword(s):  
Cohort Study ◽  
Study Design ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healthcare Setting ◽  
Clinical Factors ◽  
Factors Associated ◽  
Antidepressant Treatments ◽  
Cohort Study Design ◽  
Antidepressant Use

ObjectiveTo investigate the demographic and clinical factors associated with antidepressant use for depressive disorder in a psychiatric healthcare setting using a retrospective cohort study design.SettingData were extracted from a de-identified data resource sourced from the electronic health records of a London mental health service. Relative risk ratios (RRRs) were obtained from multinomial logistic regression analysis to ascertain the probability of receiving common antidepressant treatments relative to sertraline.ParticipantsPatients were included if they received mental healthcare and a diagnosis of depression with antidepressant treatment between March and August 2015 and exposures were measured over the preceding 12 months.ResultsOlder age was associated with increased use of all antidepressants compared with sertraline, except for negative associations with fluoxetine (RRR 0.98; 95% CI 0.96 to 0.98) and a combination of two selective serotonin reuptake inhibitors (SSRIs) (0.98; 95% CI 0.96 to 0.99), and no significant association with escitalopram. Male gender was associated with increased use of mirtazapine compared with sertraline (2.57; 95% CI 1.85 to 3.57). Previous antidepressant, antipsychotic and mood stabiliser use were associated with newer antidepressant use (ie, selective norepinephrine reuptake inhibitors, mirtazapine or a combination of both), while affective symptoms were associated with reduced use of citalopram (0.58; 95% CI 0.27 to 0.83) and fluoxetine (0.42; 95% CI 0.22 to 0.72) and somatic symptoms were associated with increased use of mirtazapine (1.60; 95% CI 1.00 to 2.75) relative to sertraline. In patients older than 25 years, past benzodiazepine use was associated with a combination of SSRIs (2.97; 95% CI 1.32 to 6.68), mirtazapine (1.94; 95% CI 1.20 to 3.16) and venlafaxine (1.87; 95% CI 1.04 to 3.34), while past suicide attempts were associated with increased use of fluoxetine (2.06; 95% CI 1.10 to 3.87) relative to sertraline.ConclusionThere were several factors associated with different antidepressant receipt in psychiatric healthcare. In patients aged >25, those on fluoxetine were more likely to have past suicide attempt, while past use of antidepressant and non-antidepressant use was also associated with use of new generation antidepressants, potentially reflecting perceived treatment resistance.

scholarly journals Trajectories of antidepressant use and characteristics associated with trajectory groups among young refugees and their Swedish-born peers with diagnosed common mental disorders—findings from the REMAIN study

2021 ◽  
Author(s):  
S. Rahman ◽  
S. Filatova ◽  
L. Chen ◽  
E. Björkenstam ◽  
H. Taipale ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Disability Pension ◽  
Common Mental Disorders ◽  
Multinomial Logistic Regression ◽  
Common Mental Disorder ◽  
Influential Factors ◽  
Transcultural Psychiatry ◽  
Refugee Youth ◽  
Study Population ◽  
Antidepressant Use

Abstract Purpose This study aimed to (1) identify the trajectories of prescribed antidepressants in refugee youth and matched Swedish-born peers diagnosed with common mental disorder (CMD) and (2) characterize the trajectories according to sociodemographic and medical factors. Methods The study population comprised 2,198 refugees and 12,199 Swedish-born individuals with both Swedish-born parents, aged 16–25 years in 2011, residing in Sweden and treated in specialised healthcare for CMD 2009–11. Group-based trajectory modelling was used to identify different trajectory groups of antidepressant use-based on annual defined daily dosages (DDDs). Multinomial logistic regression was applied to investigate the association of sociodemographic and medical characteristics with the identified trajectories. Nagelkerke pseudo-R2 values were estimated to evaluate the strength of these associations. Results Four trajectory groups of antidepressant use among young refugees were identified with following proportions and DDD levels in 2011: ‘low constant’ (88%, < 100), ‘low increasing’ (2%, ≈710), ‘medium decreasing’ (8%, ≈170) and ‘high increasing’ (2%, ≈860). Similar trajectories, however, with different proportions were identified in Swedish-born: 67%, 7%, 21% and 5%, respectively. The most influential factors discriminating the trajectory groups among refugees were ‘duration of stay in Sweden’ (R2 = 0.013), comorbid ‘other mental disorders’ (R2 = 0.009) and ‘disability pension’ (R2 = 0.007), while ‘disability pension’ (R2 = 0.017), comorbid ‘other mental disorders’ (R2 = 0.008) and ‘educational level’ (R2 = 0.008) were the most important determinants discriminating trajectory groups among Swedish-born youth. Conclusion The lower use of antidepressants in refugees with CMDs compared to their Swedish-born counterparts warrants health literacy programs for refugees and training in transcultural psychiatry for healthcare professionals.

Somatic and psychological models of common mental disorder in primary care in India

1998 ◽  
Vol 28 (1) ◽  
pp. 135-143 ◽  
Author(s):  
V. PATEL ◽  
J. PEREIRA ◽  
A. H. MANN
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Care Provider ◽  
Common Mental Disorder ◽  
Somatic Symptoms ◽  
Cross Sectional Survey ◽  
Psychiatric Interview ◽  
Practical Advantage ◽  
Psychological Models

Background. Primary care attenders with a common mental disorder (CMD) frequently present with somatic symptoms. This study aimed to examine somatic and psychological models of CMD in primary care attenders in India.Methods. Cross-sectional survey of attenders at two primary care clinics. Psychiatric caseness was determined on three criteria: standardized psychiatric interview (biomedical criterion), patients' self-assessment of emotional disorder (emic criterion) and health care provider diagnosis. The GHQ-12 and the PPQ, which emphasize psychological and somatic symptoms respectively, were used as screening instruments.Results. Although somatic symptoms were the presenting complaints for 97% of subjects, 51% of subjects with a biomedically defined CMD had a psychological illness attribution. Patients with psychological attributions were more likely to be women, to have a longer duration of illness, to have higher CISR scores and were more likely to be recognized by the primary health care (PHC) physician. The GHQ-12 was superior to the PPQ in identifying cases of CMD against the biomedical criterion for both psychologizers and somatizers; both instruments performed equally well against the emic and care provider criteria.Conclusions. Psychological models may be acquired by patients as CMD becomes more chronic or severe, making them more likely to be detected by PHC physicians. Psychological symptoms are superior to somatic symptoms in detecting CMD. Shorter versions of the GHQ have comparable discriminating abilities to the 12-item version and offer the practical advantage of brevity, which may make them more acceptable to PHC physicians as a clinical screening tool.

Mental Health and Wellbeing in Japan

2020 ◽  
pp. 233-248
Author(s):  
Norito Kawakami ◽  
Akihito Shimazu
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Common Mental Disorder ◽  
School Mental Health ◽  
Current Status ◽  
Mental Hospitals ◽  
Care And Support

This chapter provides an overview of the history and current status of mental health and mental health care in Japan in the last 50 years. One in 37 people currently receives treatment for any mental disorder, while one in 20 people have experienced a common mental disorder in the past year. Prevalence of mental disorders may not have increased significantly during the last 10–15 years, despite the economic slowdown and social change in this period. Mental hospitals played a central role in treating people with mental disorders, isolated from the community, and the number of beds in mental hospitals per population remains greater in Japan than in other countries. Policy has shifted from inpatient treatment towards community-based care and support, however change is slow. Suicide rates have been influenced by economic factors. The male rate was high between 2000 and 2012. Rates in both sexes have recently declined, but remain above those in other countries. The Japanese have a characteristic perception of wellbeing in the family- and community-oriented collective culture, based on a sense of the meaning of life (ikigai). However, it remains unclear whether the collective culture is entirely beneficial to mental health. In the last decade, Japan has faced several behavioural problems among younger generations, at home and at school. Mental health care in Japan faces many challenges.

scholarly journals Integration of mental health care into primary care

2000 ◽  
Vol 176 (6) ◽  
pp. 581-588 ◽  
Author(s):  
D. Chisholm ◽  
S. James ◽  
K. Sekar ◽  
K. Kishore Kumar ◽  
R. Srinivasa Murthy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Low Income ◽  
Common Mental Disorder ◽  
Low Income Countries

BackgroundTargeting resources on cost-effective care strategies is important for the global mental health burden.AimsTo demonstrate cost–outcome methods in the evaluation of mental health care programmes in low-income countries.MethodFour rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to seek treatment, and assessed prospectively on symptoms, disability, quality of life and resource use.ResultsBetween 12% and 39% of the four screened populations had a diagnosable common mental disorder. In three of the four localities there were improvements over time in symptoms, disability and quality of life, while total economic costs were reduced.ConclusionEconomic analysis of mental health care in low-income countries is feasible and practicable. Our assessment of the cost-effectiveness of integrating mental health into primary care was confounded by the naturalistic study design and the low proportion of subjects using government primary health care services.

scholarly journals Quality of life and mental disorders in caregivers of children with special needs

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61471
Author(s):  
Talita Cristina Pegorin ◽  
Marcela Martins Furlan de Léo ◽  
Samuel Spiegelberg Zuge ◽  
Crhis Netto de Brum ◽  
Lisiane da Rosa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Mental Disorder ◽  
Common Mental Disorder ◽  
World Health ◽  
Special Health Care ◽  
Self Reporting Questionnaire ◽  
The Relationship ◽  
Special Health

Objective: to analyze the relationship between quality of life and presence of common mental disorder in caregivers of children who need special health care. Methods: cross-sectional study with 87 caregivers of children with special health care needs. A sociodemographic questionnaire, the World Health Organization Quality of Life-bref and the Self-Reporting Questionnaire were used. Descriptive statistical analyses were performed based on frequencies and inferential with Mann-Whitney, Kruskal-Wallis and Spearman’s Correlation Coefficient tests. Results: mean rank differences were found in the relationship between responsible caregiver and common mental disorder; caregiver has some grievance, undergoes psychopharmacological treatment and psychological monitoring and the physical and general domains of quality of life and common mental disorder. Moreover, there was an inverse correlation between the domains of quality of life and common mental disorder. Conclusion: the lower the socres in the quality of life domains, the higher the development of common mental disorder in caregivers.

scholarly journals Depressive symptoms, antidepressant use, and future cognitive health in postmenopausal women: the Women's Health Initiative Memory Study

2012 ◽  
Vol 24 (8) ◽  
pp. 1252-1264 ◽  
Author(s):  
Joseph S. Goveas ◽  
Patricia E. Hogan ◽  
Jane M. Kotchen ◽  
Jordan W. Smoller ◽  
Natalie L. Denburg ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Postmenopausal Women ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Future Research ◽  
Study Cohort ◽  
Late Life Depression ◽  
Increased Risk ◽  
Antidepressant Use ◽  
Different Levels

ABSTRACTBackground: Antidepressants are commonly prescribed medications in the elderly, but their relationship with incident mild cognitive impairment (MCI) and probable dementia is unknown.Methods: The study cohort included 6,998 cognitively healthy, postmenopausal women, aged 65–79 years, who were enrolled in a hormone therapy clinical trial and had baseline depressive symptoms and antidepressant use history assessments at enrollment, and at least one postbaseline cognitive measurement. Participants were followed annually and the follow-up averaged 7.5 years for MCI and probable dementia outcomes. A central adjudication committee classified the presence of MCI and probable dementia based on extensive neuropsychiatric examination.Results: Three hundred and eighty-three (5%) women were on antidepressants at baseline. Antidepressant use was associated with a 70% increased risk of MCI, after controlling for potential covariates including the degree of depressive symptom severity. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were both associated with MCI (SSRIs: hazard ratios (HR), 1.78 [95% CI, 1.01–3.13]; TCAs: HR, 1.78 [95% CI, 0.99–3.21]). Depressed users (HR, 2.44 [95% CI, 1.24–4.80]), non-depressed users (HR, 1.79 [95% CI, 1.13–2.85]), and depressed non-users (HR, 1.62 [95% CI, 1.13–2.32]) had increased risk of incident MCI. Similarly, all three groups had increased risk of either MCI or dementia, relative to the control cohort.Conclusions: Antidepressant use and different levels of depression severity were associated with subsequent cognitive impairment in a large cohort of postmenopausal women. Future research should examine the role of antidepressants in the depression–dementia relationship and determine if antidepressants can prevent incident MCI and dementia in individuals with late-life depression subtypes with different levels of severity.

scholarly journals Transtorno mental comum em idosos com doenças crônicas não transmissíveis na atenção primária à saúde/ Common mental disorder in elderly people with chronic non-communicable diseases in primary health care

2020 ◽  
Vol 19 ◽  
Author(s):  
Izabel Viviane de Oliveira Fagundes ◽  
Luciane Paula Batista Araújo de Oliveira ◽  
Wanessa Cristina Tomaz dos Santos Barros ◽  
Adriana Gomes Magalhães ◽  
Marília Rute de Souto Medeiros ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorder ◽  
Elderly People ◽  
Common Mental Disorder ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Primary Health ◽  
Self Reporting Questionnaire

Objetivo: Identificar o risco de Transtorno Mental Comum em idosos com Doenças Crônicas Não Transmissíveis e identificar sua relação com características sociodemográficas. Métodos: Estudo transversal, exploratório-descritivo, de abordagem quantitativa, desenvolvido na Estratégia Saúde da Família do Município de São Vicente/RN, com amostra de 99 idosos. A coleta ocorreu em setembro e outubro de 2018 mediante entrevista estruturada com aplicação do Self-Reporting Questionnaire-20,no domicílio. Foi realizada análise estatística descritiva e inferencial. Resultados: Foi identificado que 28,28% dos idosos apresentaram alto risco para Transtorno Mental Comum e a maioria (71,72%) tinha risco baixo. Não houve associação significativa deste risco com as Doenças Crônicas Não Transmissíveis e com características sociodemográficas. Conclusão:Apesar de não ter sido identificada associação estatística, é preocupante a presença de sofrimento psíquico em idosos com doenças crônicas, tendo em vista o possível comprometimento de sua qualidade de vida. Tal fato reafirma a importância de desenvolvimento de estratégias para detecção e acompanhamento de idosos com Transtorno Mental Comum nesse contexto de atenção à saúde.

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