The Australian National Survey of Psychotic Disorders: profile of psychosocial disability and its risk factors

2002 ◽  
Vol 32 (4) ◽  
pp. 639-647 ◽  
Author(s):  
O. GUREJE ◽  
H. HERRMAN ◽  
C. HARVEY ◽  
V. MORGAN ◽  
A. JABLENSKY
Keyword(s):  
Risk Factors ◽  
Social Adjustment ◽  
Urban Areas ◽  
Psychotic Disorders ◽  
Structured Interview ◽  
Service Planning ◽  
Response To Treatment ◽  
Epidemiological Surveys ◽  
Psychosocial Disability ◽  
The Impact

Background. Knowledge of the level of psychosocial impairment associated with psychosis is important in evaluating the impact of the illness on those affected. When such knowledge is derived from community-based epidemiological surveys, it can help in providing a public health perspective for service planning with information derived from representative samples of patients.Methods. A two-phase epidemiological survey of persons with psychosis in four predominantly urban areas of Australia. First phase screening for psychosis (N = 5710) was followed by a semi-structured interview of a stratified random sample (N = 980) to assess psychopathology (lifetime and current) and psychosocial disability.Results. Most of the interviewees were unemployed and had never married. There was widespread impairment in sexual and social relationships and in the performance of activities of daily living. Over half expressed dissatisfaction with life in general. Persons with affective psychoses were often as disabled as those with schizophrenia and diagnostic categorizations were not important in the conferment of risk for disability. Rather, poor pre-morbid work or social adjustment and poor course of illness were potent risk factors for diverse forms of disability in persons with psychosis.Conclusion. A large proportion of persons with experience of psychosis living in the community suffers from significant levels of psychosocial disability. Disablement seems to reflect, in part, a diathesis of poor pre-morbid functioning and less than optimal response to treatment of the disorder.

scholarly journals Identifying Heat Health Risks in the Urban Areas of Western Australia (WA) – An Enhanced Heat Vulnerability Assessment

2019 ◽  
Vol 1 ◽  
pp. 1-1
Author(s):  
Qian Sun ◽  
Grace Yun ◽  
Ting Ling
Keyword(s):  
Risk Factors ◽  
Urban Heat Island ◽  
Health Risks ◽  
Western Australia ◽  
Urban Areas ◽  
Heat Island ◽  
Climate Change Research ◽  
Urban Heat ◽  
Heat Vulnerability ◽  
The Impact

<p><strong>Abstract.</strong> The impact of heat on health can be more significant in urban areas with more population and where the microclimate is often unintentionally modified to create the Urban Heat Island (UHI) effect. Extreme heat and UHI pose a risk to the health of vulnerable individuals, such as the elderly, the very young, and those need care. Vulnerability has become a central concept in climate change research and policy. To assess it, many studies have used equal weighted cumulative indices to aggregate multiple factors into a composite HVI (Heat Vulnerability Index) and analyse the differences and intensity across local areas and regions. However, the aggregation and equal weighting rationality, and the disregard of spatial correlation can result in inaccurate explanation on local vulnerabilities.</p><p>This study develops an enhanced index of population heat vulnerability (HVI) in Perth metropolitan area, Western Australia (WA), using environmental, demographic, and health-related risk factors for heat exposure, sensitivity and adaptive capability. Satellite derived urban heat island data and community profiles were integrated by a spatial risk assessment methodology to highlight potential heat health risk areas and build the foundations for mitigation and adaptation plans. Principal component analysis (PCA) was used to identify the key risk factors for heat vulnerability. Geographically weighted regression (GWR) were used to model the spatial relationships between temperature and other contributing factors to produce weights for calculating HVI. The index was finally mapped to produce a spatial representation of risk. The maps of spatial heat health vulnerability provide information to target heat-related health risks by aiding policy advisors, healthcare professionals, and ancillary services to develop heatwave preparedness plans at a local scale.</p>

Anxiolytic and hypnotic use in 376 psychiatric inpatients

1999 ◽  
Vol 14 (1) ◽  
pp. 25-33 ◽  
Author(s):  
P. Hardy ◽  
C. Payan ◽  
J.C. Bisserbe ◽  
J.P. Lepine ◽  
Keyword(s):  
Risk Factors ◽  
Psychiatric Inpatients ◽  
Structured Interview ◽  
Anxiety Scale ◽  
Anxiety Score ◽  
Drug Doses ◽  
High Age ◽  
Paris Region ◽  
The Impact ◽  
Dosage Frequency

SummaryThis objectives of this study were three-fold: retrospectively evaluate anxiolytic/hypnotic consumption by psychiatric inpatients, identify the risk factors of prolonged intakes, and prospectively measure the impact of hospitalisation on the use of those drugs. Three hundred and seventy-six patients hospitalised in 11 psychiatric departments in the Paris region were studied using a structured interview for the anxiolytic/hypnotic treatments, DSM-III-R criteria, GHQ-12, HAD, Spiegel's questionnaire, COVI's anxiety scale and the CGI. Eighty-five per cent of the patients had taken one anxiolytic/hypnotic or more in the 3 months preceding hospitalisation. Hospitalisation induced little change in anxiolytic/hypnotic use: dosage frequency increased from 77% to 84% between the week preceding hospitalisation and that preceding discharge; 26% of consumers were taking at least two anxiolytics or two hypnotics in the first period vs. 23% in the second. The absence of withdrawal during hospitalisation was related to the high age and a diagnosis of depression rather than schizophrenia, to the existence of continuous intake over the 3 months preceding hospitalisation and to higher drug doses during the 7 days preceding hospitalisation. Prescription of treatment at the end of hospitalisation in previously non-user subjects was related to a higher HAD anxiety score at discharge.

scholarly journals Identifying Genetic Risk Factors for Diabetic Macular Edema and the Response to Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Rajya L. Gurung ◽  
Liesel M. FitzGerald ◽  
Bennet J. McComish ◽  
Nitin Verma ◽  
Kathryn P. Burdon
Keyword(s):  
Risk Factors ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Genetic Risk ◽  
Vision Loss ◽  
Genetic Risk Factors ◽  
Response To Treatment ◽  
Diabetic Eye Disease ◽  
Genetic And Environmental Factors ◽  
The Impact

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM). DR is complex and the term encompasses several clinical subtypes of diabetic eye disease, including diabetic macular edema (DME), the most frequent cause of central vision loss in DR patients. Both genetic and environmental factors contribute to the pathophysiology of DR and its subtypes. While numerous studies have identified several susceptibility genes for DR, few have investigated the impact of genetics on DME susceptibility. This review will focus on the current literature surrounding genetic risk factors associated with DME. We will also highlight the small number of studies investigating the genetics of response to antivascular endothelial growth factor (anti-VEGF) injection, which is used to treat DME.

Modifiable Risk Factors for Hospitalization Among People with Psychosis: Evidence from the National Study of Low Prevalence (Psychotic) Disorders

2006 ◽  
Vol 40 (8) ◽  
pp. 683-690 ◽  
Author(s):  
Vera Morgan ◽  
Ailsa Korten ◽  
Assen Jablensky
Keyword(s):  
Risk Factors ◽  
Case Management ◽  
Service Utilization ◽  
Psychotic Disorders ◽  
Policy Implications ◽  
National Study ◽  
Symptom Profile ◽  
Risky Behaviours ◽  
Low Prevalence ◽  
The Impact

Objective: Relatively little has been published on dynamic, that is, modifiable, as opposed to static risk factors for hospitalization in the research literature on risk factors for hospitalization in serious mental illness. The aim of this study was to develop a model to determine modifiable predictors of hospitalization using data from the Australian National Study of Low Prevalence (Psychotic) Disorders. Method: The Study of Low Prevalence Disorders used a two-phase design to estimate the prevalence of psychoses and identify characteristics of people with psychotic illness. This paper compares people hospitalized at the time of census and those using outpatient services. Logistic regression was used to examine the relative impact of dynamic characteristics including service utilization, symptom profile and risky behaviours on a base model for risk of hospitalization. Results: In the base model, course of disorder and age but not type of psychosis were significantly associated with hospitalization. Among symptoms, delusions (but not hallucinations) and negative symptoms significantly increased the odds of hospitalization. Service utilization, especially case management, reduced the odds significantly and substantially. Results for risky behaviours (e.g. substance abuse, offending) were ambiguous. Conclusions: The results highlight the impact of dynamic factors, particularly case management, over and above static factors in reducing the risk of hospitalization in psychosis, and point to a potential for targeted interventions to avert some of the burden, both emotional and financial, associated with the hospitalization of people with psychotic disorders. These findings have important clinical and policy implications.

Testing Ødegaard's selective migration hypothesis: a longitudinal cohort study of risk factors for non-affective psychotic disorders among prospective emigrants

2014 ◽  
Vol 45 (4) ◽  
pp. 727-734 ◽  
Author(s):  
E. van der Ven ◽  
C. Dalman ◽  
S. Wicks ◽  
P. Allebeck ◽  
C. Magnusson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychotic Disorder ◽  
Social Adjustment ◽  
Psychotic Disorders ◽  
Cannabis Use ◽  
Selection Hypothesis ◽  
Selective Migration ◽  
Relative Risks ◽  
History Of ◽  
Low Iq

BackgroundThe selection hypothesis posits that the increased rates of psychosis observed among migrants are due to selective migration of people who are predisposed to develop the disorder. To test this hypothesis, we examined whether risk factors for psychosis are more prevalent among future emigrants.MethodA cohort of 49 321 Swedish military conscripts was assessed at age 18 years on cannabis use, IQ, psychiatric diagnosis, social adjustment, history of trauma and urbanicity of place of upbringing. Through data linkage we examined whether these exposures predicted emigration out of Sweden. We also calculated the emigrants' hypothetical relative risk compared with non-emigrants for developing a non-affective psychotic disorder.ResultsLow IQ [odds ratio (OR) 0.5, 95% confidence interval (95% CI) 0.3–0.9] and ‘poor social adjustment’ (OR 0.4, 95% CI 0.2–0.8) were significantly less prevalent among prospective emigrants, whereas a history of urban upbringing (OR 2.3, 95% CI 1.4–3.7) was significantly more common. Apart from a non-significant increase in cannabis use among emigrants (OR 1.6, 95% CI 0.8–3.1), there were no major group differences in any other risk factors. Compared to non-emigrants, hypothetical relative risks for developing non-affective psychotic disorder were 0.7 (95% CI 0.4–1.2) and 0.8 (95% CI 0.7–1.0), respectively, for emigrants narrowly and broadly defined.ConclusionsThis study adds to an increasing body of evidence opposing the selection hypothesis.

scholarly journals Early onset of cannabis use and violent behavior in psychosis

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Valerie Moulin ◽  
Luis Alameda ◽  
David Framorando ◽  
Philipp-S Baumann ◽  
Mehdi Gholam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Early Onset ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Violent Behavior ◽  
Age At Onset ◽  
Cannabis Use ◽  
Early Psychosis ◽  
The Impact

Abstract Background: Although evidence from psychosis patients demonstrates the adverse effects of cannabis use (CU) at a young age and that the rate of CU is high in subgroups of young violent patients with psychotic disorders, little is known about the possible effect of the age of onset of CU on later violent behaviors (VB). So, we aimed to explore the impact of age at onset of CU on the risk of displaying VB in a cohort of early psychosis patients. Method: Data were collected prospectively over a 36-month period in the context of an early psychosis cohort study. A total of 265 patients, aged 18–35 years, were included in the study. Logistic regression was performed to assess the link between age of onset of substance use and VB. Results: Among the 265 patients, 72 had displayed VB and 193 had not. While violent patients began using cannabis on average at age 15.29 (0.45), nonviolent patients had started on average at age 16.97 (0.35) (p = 0.004). Early-onset CU (up to age 15) was a risk factor for VB (odds ratio = 4.47, confidence interval [CI]: 1.13–20.06) when the model was adjusted for age group, other types of substance use, being a user or a nonuser and various violence risk factors and covariates. History of violence and early CU (until 15) were the two main risk factors for VB. Conclusions: Our results suggest that early-onset CU may play a role in the emergence of VB in early psychosis.

scholarly journals A Cross-Sectional Survey of Vitamin A Deficiency and the Associated Risk Factors among the Children of District Gujrat, Punjab, Pakistan

2020 ◽  
Vol 2 (3) ◽  
pp. 46-59
Author(s):  
Adil Hussain ◽  
Safa Rafique ◽  
Sana Batool ◽  
Saman Hina ◽  
Malik Siddique Mahmood
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Vitamin A ◽  
Low Income ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
The Impact

Vitamin A deficiency (VAD) is a very common problem in developing countries and in extreme situations, it is responsible for vision impairment as well as death. To conduct a comprehensive cross-sectional evaluation of the deficiency of vitamin A and the associated risk factors responsible for its deficiency, a questionnaire based survey was conducted in District Gujrat, Punjab, Pakistan. In order to evaluate the data related to VAD and its relationship with different variables, a cross-sectional survey was conducted of 400 female students from three different schools in District Gujrat. The schools were situated in both rural and urban areas. A questionnaire eliciting personal information, family status and diet related information was used to collect the required data for the survey. The results did not pertain with the participants’ gender. The results were based on the summer season routine of diet and physical activity. All information was sorted and the results were analyzed using the Microsoft Excel 2010 update and SPSS version 20. It was found that 39% girls (156 out of 400) were deficient in vitamin A. The main source of VAD was found to be inadequate dietary consumption. It was also found that children with poor socioeconomic standing, low fluid consumption, and from urban areas have more VAD than others. Moreover, the age group of 8-11 years carried a higher percentage of VAD, while physical activity had no impact on VAD. A large number of girls were reported as the victims of VAD due to poverty and related socioeconomic constraints prevailing among the school going children in District Gujrat. A crucial approach towards reducing VAD is to learn about the preventive measures to control VAD. In low-income countries, the use of vitamin A supplements with daily diet is required to reduce the impact of VAD.

scholarly journals A Cross-Sectional Survey of Vitamin A Deficiency and the Associated Risk Factors among the Children of District Gujrat, Punjab, Pakistan

2020 ◽  
Vol 2 (3) ◽  
pp. 46-59
Author(s):  
Adil Hussain ◽  
Safa Rafique ◽  
Sana Batool ◽  
Saman Hina ◽  
Malik Siddique Mahmood
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Vitamin A ◽  
Low Income ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
The Impact

Vitamin A deficiency (VAD) is a very common problem in developing countries and in extreme situations, it is responsible for vision impairment as well as death. To conduct a comprehensive cross-sectional evaluation of the deficiency of vitamin A and the associated risk factors responsible for its deficiency, a questionnaire based survey was conducted in District Gujrat, Punjab, Pakistan. In order to evaluate the data related to VAD and its relationship with different variables, a cross-sectional survey was conducted of 400 female students from three different schools in District Gujrat. The schools were situated in both rural and urban areas. A questionnaire eliciting personal information, family status and diet related information was used to collect the required data for the survey. The results did not pertain with the participants’ gender. The results were based on the summer season routine of diet and physical activity. All information was sorted and the results were analyzed using the Microsoft Excel 2010 update and SPSS version 20. It was found that 39% girls (156 out of 400) were deficient in vitamin A. The main source of VAD was found to be inadequate dietary consumption. It was also found that children with poor socioeconomic standing, low fluid consumption, and from urban areas have more VAD than others. Moreover, the age group of 8-11 years carried a higher percentage of VAD, while physical activity had no impact on VAD. A large number of girls were reported as the victims of VAD due to poverty and related socioeconomic constraints prevailing among the school going children in District Gujrat. A crucial approach towards reducing VAD is to learn about the preventive measures to control VAD. In low-income countries, the use of vitamin A supplements with daily diet is required to reduce the impact of VAD.

scholarly journals Impact of an urban regional medical campus: Perceptions of community stakeholders

2020 ◽  
Author(s):  
Gerry Cooper ◽  
Maher El-Masri ◽  
Kyle DeMars ◽  
Nathan Tam ◽  
Nicole Sbrocca ◽  
...  
Keyword(s):  
Urban Areas ◽  
Positive Impact ◽  
Strong Support ◽  
Structured Interview ◽  
Business Community ◽  
Urban Region ◽  
Urban City ◽  
Community Stakeholders ◽  
Regional Medical ◽  
The Impact

Background: Regional medical campuses (RMC) have shown promise in addressing physician shortages. RMCs have been positively evaluated in rural/remote communities, however, it is unclear whether this model will be as beneficial in underserved urban areas. This study evaluated the impact of a RMC on a midsized urban city (Windsor, Ontario). We compare our results with a similar study conducted in a remote community in British Columbia (BC). Methods: A broad array of community stakeholders representing different sectors were consulted using a semi-structured interview format replicated from the BC Northern Medical Program (NMP) study. Thematic analysis based on the resulting rich data was conducted within a grounded theory context. Results: Twenty-three participants (52% male) representing healthcare, education, business, community and government/politico sectors were consulted. Their views regarding the Windsor Regional Medical Campus (WRMC) aligned around several themes: improved healthcare, enhanced community reputation, stimulated economic/community development, expanded training opportunities and an engaged community regarding the WRMC. These results were compared to the main findings of the NMP study with both similarities (e.g. increased community pride) and differences (e.g. resource concerns) discussed. Conclusion: Community stakeholders provided strong support for the WRMC through their perceptions of its positive impact on this urban region. These findings are consistent with similar RMC studies in rural/remote areas. Those interested in developing a RMC might benefit from considering these findings.

scholarly journals Comorbid physical illnesses in adult outpatients with psychotic disorders: risk factors, psychological functioning, and quality of life outcomes

2021 ◽  
Author(s):  
Wen Lin Teh ◽  
Laxman Cetty ◽  
Anitha Jeyagurunathan ◽  
Fiona Devi ◽  
Kumarasan Roystonn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Psychological Functioning ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Life Outcomes ◽  
Physical Conditions ◽  
Quality Of Life Outcomes ◽  
The Impact

Abstract Purpose In contrast to global research, where physical comorbidity in psychotic disorders is established, only a few studies have been conducted in Southeast Asia. With a concerning trend of chronic physical illnesses emerging in adults below the age of 65, an investigation into comorbid chronic physical illnesses in adults diagnosed with psychotic disorders is necessary. This study aims to explore the risk factors, psychological functioning, and quality of life outcomes associated with comorbidity in adults below the age of 65, diagnosed with psychotic disorders, in a multi-ethnic non-Western setting. Methods Electronic medical records of 364 patients with psychotic disorders who had provided written consent to participate were screened for co-occurring physical conditions. The majority of participants were female (53.7%), Chinese (69%), single (74.5%), and had tertiary and above education (43%). They were approximately 35 years old on average and the mean age of onset for psychosis was 26.7 years old. Results Comorbid physical illnesses were present in approximately a third of adults with psychotic disorders (28%). They typically reported cardiovascular-related diseases, respiratory, and skin conditions. Comorbidity was significantly related to lower physical quality of life. As compared to other types of psychotic disorders, schizophrenia was significantly related to a greater frequency of comorbid physical conditions. Multinomial regression analyses revealed that age, age of onset, Malay and Indian ethnicities were significant factors. Conclusion Physical comorbidity in adults below the age of 65 is common, signifying an emerging need to place greater attention into the screening and emphasis on the physical care needs of this age group. Finally, more research is needed to understand the impact of common co-occurring acute and chronic cardiovascular, skin, and respiratory diseases locally.

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