Sexual abuse and psychiatric disorder in England: results from the 2007 Adult Psychiatric Morbidity Survey

2010 ◽  
Vol 41 (4) ◽  
pp. 709-719 ◽  
Author(s):  
S. Jonas ◽  
P. Bebbington ◽  
S. McManus ◽  
H. Meltzer ◽  
R. Jenkins ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Psychiatric Disorder ◽  
Sexual Intercourse ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Population Attributable Fraction ◽  
Quality Data ◽  
Post Traumatic Stress ◽  
Reverse Causality

BackgroundEvidence is accumulating that child sexual abuse (CSA) is associated with many psychiatric disorders in adulthood. This paper uses the detailed information available from the 2007 Adult Psychiatric Morbidity Survey of England (APMS 2007) to quantify links between CSA and a range of psychiatric conditions.MethodThe prevalence of psychiatric disorder was established in a random sample of the English household population (n=7403), which also provided sociodemographic and experiential information.ResultsWe analyzed six types of common mental disorder, alcohol abuse and drug abuse, and people who screened positively for post-traumatic stress disorder (PTSD) and eating disorders. All were strongly and highly significantly associated with CSA, particularly if non-consensual sexual intercourse was involved, for which odds ratios (ORs) ranged from 3.7 to 12.1. These disorders were also related to adult sexual abuse (ASA), although the likelihood of reverse causality is then increased. Revictimization in adulthood was common, and increased the association of CSA with disorder. For several disorders, the relative odds were higher in females but formal tests for moderation by gender were significant only for common mental disorders and only in relation to non-consensual sexual intercourse. The population attributable fraction (PAF) was higher in females in all cases.ConclusionsThe detailed and high-quality data in APMS 2007 provided important confirmation both of the strength of association of CSA with psychiatric disorder and of its relative non-specificity. Our results have major implications at the public health level and the individual level, in particular the need for better recognition and treatment of the sequelae of CSA.

scholarly journals Paid employment and common mental disorders in 50–64-year olds: analysis of three cross-sectional nationally representative survey samples in 1993, 2000 and 2007

2017 ◽  
Vol 28 (1) ◽  
pp. 88-99
Author(s):  
G. Perera ◽  
G. Di Gessa ◽  
L. M. Corna ◽  
K. Glaser ◽  
R. Stewart
Keyword(s):  
Mental Health ◽  
Employment Status ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Housing Tenure ◽  
Cross Sectional ◽  
Paid Employment ◽  
Nationally Representative ◽  
Over Time

Aims.Associations between employment status and mental health are well recognised, but evidence is sparse on the relationship between paid employment and mental health in the years running up to statutory retirement ages using robust mental health measures. In addition, there has been no investigation into the stability over time in this relationship: an important consideration if survey findings are used to inform future policy. The aim of this study is to investigate the association between employment status and common mental disorder (CMD) in 50–64-year old residents in England and its stability over time, taking advantage of three national mental health surveys carried out over a 14-year period.Methods.Data were analysed from the British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007. Paid employment status was the primary exposure of interest and CMD the primary outcome – both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule). Multivariable logistic regression models were used.Results.The prevalence of CMD was higher in people not in paid employment across all survey years; however, this association was only present for non-employment related to poor health as an outcome and was not apparent in those citing other reasons for non-employment. Odds ratios for the association between non-employment due to ill health and CMD were 3.05 in 1993, 3.56 in 2000, and 2.80 in 2007, after adjustment for age, gender, marital status, education, social class, housing tenure, financial difficulties, smoking status, recent physical health consultation and activities of daily living impairment.Conclusions.The prevalence of CMD was higher in people not in paid employment for health reasons, but was not associated with non-employment for other reasons. Associations had been relatively stable in strength from 1993 to 2007 in those three cross-sectional nationally representative samples.

Contribution of mental ill health during military service to postservice benefit claims in the UK

2021 ◽  
pp. oemed-2020-107050
Author(s):  
Howard Burdett ◽  
Nicola T Fear ◽  
Simon Wessely ◽  
Neil Greenberg ◽  
Roberto J Rona
Keyword(s):  
Mental Health ◽  
Military Service ◽  
Mental Health Problems ◽  
Common Mental Disorder ◽  
Population Attributable Fraction ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Civilian Life ◽  
Carry Over ◽  
The Uk

ObjectivesWhile most UK military personnel transition successfully into civilian life, some experience unemployment and disability, which may be partly attributable to in-service factors. This study aims to determine the degree to which in-service mental health problems impact on postservice benefit claims.MethodsUsing data from a cohort of 5598 recent leavers from regular service in the UK Armed Forces linked with data from the Department for Work and Pensions, we assessed associations between in-service mental health and postservice benefit claims, and the population attributable fraction (PAF) of benefit claims related to in-service mental health. An analysis with postservice mental ill health as mediator was performed to determine the degree to which the observed effects were a consequence of persistent illness, as opposed to remitted.ResultsMental illness occurring in-service predicted both unemployment and disability claims, partly mediated by postservice health (23%–52% total effects mediated), but alcohol misuse did not. Common mental disorder (CMD) (PAF 0.07, 95% CI: 0.02 to 0.11) and probable post-traumatic stress disorder (PTSD) (PAF 0.05, 95% CI 0.01 to 0.09) contributed to unemployment claims. Probable PTSD was the largest contributor to disability claims (PAF 0.25, 95% CI 0.13 to 0.36), with a smaller contribution from CMD (PAF 0.16, 95% CI 0.03 to 0.27).ConclusionsIn-service mental ill health gives rise to benefit claims. These effects are only partly mediated by postservice mental health, implying that in-service (or pre-service) mental issues have carry-over effects into civilian life even if remitted. Better prevention and treatment of in-service PTSD symptoms may well reduce postservice disability claims.

scholarly journals Socio-economic position and common mental disorders

2006 ◽  
Vol 189 (2) ◽  
pp. 109-117 ◽  
Author(s):  
Petros Skapinakis ◽  
Scott Weich ◽  
Glyn Lewis ◽  
Nicola Singleton ◽  
Ricardo Araya
Keyword(s):  
Mental Disorders ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Population Sample ◽  
Diagnostic Categories ◽  
Longitudinal Association ◽  
Economic Position ◽  
The Uk

BackgroundIndividuals in lower socio-economic groups have an increased prevalence of common mental disorders.AimsTo investigate the longitudinal association between socio-economic position and common mental disorders in a general population sample in the UK.MethodParticipants (n=2406) were assessed at two time points 18 months apart with the Revised Clinical Interview Schedule. The sample was stratified into two cohorts according to mental health status at baseline.ResultsNone of the socio-economic indicators studied was significantly associated with an episode of common mental disorder at follow-up after adjusting for baseline psychiatric morbidity. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both cohorts.ConclusionsThese findings support the view that apart from objective measures of socio-economic position, more subjective measures might be equally important from an aetiological or clinical perspective.

Common mental disorder symptom counts in populations: are there distinct case groups above epidemiological cut-offs?

2002 ◽  
Vol 32 (7) ◽  
pp. 1195-1201 ◽  
Author(s):  
D. MELZER ◽  
B. D. M. TOM ◽  
T. S. BRUGHA ◽  
T. FRYERS ◽  
H. MELTZER
Keyword(s):  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Exponential Model ◽  
Depression Score ◽  
Population Characteristics ◽  
Depression Symptom ◽  
Neurotic Symptom ◽  
Single Exponential

Background. At the lower end of IQ distributions in general populations, there is a clear excess of cases, representing the distinct pathology of severe learning disability. This study aimed to establish whether such a subpopulation exists in distributions of common mental disorder and depression symptom scores, above epidemiological ‘case’ cut-offs.Method. Data from 9556 non-psychotic respondents to the 1993 OPCS (Office of Population Censuses and Surveys) National Household Psychiatric Morbidity Survey were analysed. The distribution of total neurotic symptom and depression scores from the revised Clinical Interview Schedule were examined. Automated least squares methods were used to fit the best single statistical distribution to the data.Results. A single exponential curve provided the best fit for the whole population, but floor effects produced deviations at symptom counts of 0–3. After truncation, exponential distributions fitted excellently. Proportions of the population above conventional cut-offs of [ges ]12 symptoms differed by <12% from expected for a range of low and high prevalence groups. The single exponential model also fitted the depression score.Conclusions. Symptom counts for the common mental disorders fall within single population distributions, with little apparent numerical excess in the case range. High and low prevalences of these disorders appear to be population characteristics, with shifts in exponential means predicting proportions above case cut-offs.

scholarly journals Gender differences in intimate partner violence and psychiatric disorders in England: results from the 2007 adult psychiatric morbidity survey

2013 ◽  
Vol 23 (2) ◽  
pp. 189-199 ◽  
Author(s):  
S. Jonas ◽  
H. Khalifeh ◽  
P. E. Bebbington ◽  
S. McManus ◽  
T. Brugha ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Intimate Partner Violence ◽  
Psychiatric Disorders ◽  
Partner Violence ◽  
Common Mental Disorders ◽  
Psychiatric Morbidity ◽  
Intimate Partner ◽  
Post Traumatic Stress ◽  
Alcohol Disorders ◽  
Men And Women

Aims.To assess the extent to which being a victim of intimate partner violence (IPV) is associated with psychiatric disorders in men and women.Methods.A stratified multistage random sample was used in the third English psychiatric morbidity survey. Psychiatric disorders were measured by the Clinical Interview Schedule (Revised) and screening questionnaires. IPV was measured using British Crime Survey questions.Results.18.7% (95% CI 17.1–20.4; n = 595 of 3197) of men had experienced some form of IPV compared with 27.8% of women (95% CI 26.2–29.4; n = 1227 of 4206; p < 0.001). IPV was associated with all disorders measured (except eating disorders in men). Physical IPV was significantly linked to psychosis and with substance and alcohol disorders in men and women, but significant associations with common mental disorders (CMDs), post-traumatic stress disorder (PTSD) and eating disorders were restricted to women. Emotional IPV was associated with CMDs in men and women.Conclusions.The high prevalence of experiences of partner violence, and strength of the association with every disorder assessed, suggests enquiry about partner violence is important in identifying a potential risk and maintenance factor for psychiatric disorders, and to ascertain safety, particularly in women as they are at greatest risk of being victims of violence.

Post-traumatic stress disorder in women who were victims of childhood sexual abuse

1991 ◽  
Vol 8 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Kevin O'Neill ◽  
Kamal Gupta
Keyword(s):  
Sexual Abuse ◽  
Psychiatric Disorder ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Sexually Abused ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Post Traumatic ◽  
Ptsd Symptomatology

AbstractTwenty-six women who had been sexually abused in childhood were assessed by means of structured interviews as to the nature of the abusive experience and subsequent psychiatric disorder. Nineteen (73.1%) fulfilled the criteria of Post Traumatic Stress Disorder and a comparison was made between PTSD and non-PTSD groups with regard to quantitative abuse variables. The phenomenon of latency or delay in onset in PTSD symptomatology was investigated. The possible implications of those findings were discussed.

scholarly journals Occupations, work characteristics and common mental disorder

2012 ◽  
Vol 43 (5) ◽  
pp. 961-973 ◽  
Author(s):  
S. A. Stansfeld ◽  
C. Pike ◽  
S. McManus ◽  
J. Harris ◽  
P. Bebbington ◽  
...  
Keyword(s):  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Adult Population ◽  
Psychiatric Morbidity ◽  
Housing Tenure ◽  
Work Characteristics ◽  
Psychosocial Work ◽  
Personal Service ◽  
Explanatory Factors ◽  
Increased Risk

BackgroundThe present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics.MethodWe derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD.ResultsAfter adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16–2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD.ConclusionsAs has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.

scholarly journals A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD

2021 ◽  
Vol 6 (6) ◽  
pp. e005029
Author(s):  
Giulia Turrini ◽  
Federico Tedeschi ◽  
Pim Cuijpers ◽  
Cinzia Del Giovane ◽  
Ahlke Kip ◽  
...  
Keyword(s):  
Low Income ◽  
Asylum Seekers ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Risk Of Bias ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Refugees And Asylum Seekers

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.

scholarly journals Military and demographic predictors of mental ill-health and socioeconomic hardship among UK veterans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. Burdett ◽  
N. T. Fear ◽  
S. Wessely ◽  
R. J. Rona
Keyword(s):  
Socioeconomic Status ◽  
Common Mental Disorders ◽  
Economic Status ◽  
Childhood Adversity ◽  
Armed Forces ◽  
Sociodemographic Factors ◽  
Post Traumatic Stress ◽  
Length Of Service ◽  
Socioeconomic Outcomes ◽  
The Uk

Abstract Background Around 8% of the UK Armed Forces leave in any given year, and must navigate unfamiliar civilian systems to acquire employment, healthcare, and other necessities. This paper determines longer-term prevalences of mental ill health and socioeconomic outcomes in UK Service leavers, and how they are related to demographic factors, military history, and pre-enlistment adversity. Methods This study utilised data from a longitudinal sample of a cohort study UK Armed Forces personnel since 2003. A range of self-reported military and sociodemographic factors were analysed as predictors of probable Post-Traumatic Stress Disorder, common mental disorders, alcohol misuse, unemployment and financial hardship. Prevalences and odds ratios of associations between predictors and outcomes were estimated for regular veterans in this cohort. Results Veteran hardship was mostly associated with factors linked to socio-economic status: age, education, and childhood adversity. Few military-specific factors predicted mental health or socio-economic hardship, except method of leaving (where those leaving due to medical or unplanned discharge were more likely to encounter most forms of hardship as veterans), and rank which is itself related to socioeconomic status. Conclusion Transition and resettlement provisions become increasingly generous with longer service, yet this paper shows the need for those services becomes progressively less necessary as personnel acquire seniority and skills, and instead could be best targeted at unplanned leavers, taking socioeconomic status into consideration. Many will agree that longer service should be more rewarded, but the opposite is true if provision instead reflects need rather than length of service. This is a social, political and ethical dilemma.

scholarly journals The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity

2021 ◽  
Author(s):  
Paul E. Bebbington ◽  
Sally McManus ◽  
Jeremy W. Coid ◽  
Richard Garside ◽  
Terry Brugha
Keyword(s):  
Mental Health ◽  
Substance Dependence ◽  
Suicide Attempts ◽  
Common Mental Disorders ◽  
Psychiatric Morbidity ◽  
Childhood Adversity ◽  
Autistic Traits ◽  
Target Population ◽  
Psychiatric Disturbance ◽  
Cross Sectional

Abstract Purpose Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners’ mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). Methods APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England’s household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. Results One participant in seventy had been in prison (1.4%; 95% CI 1.1–1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02–3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. Conclusions Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.

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