Managing complex problems: treatment for common mental disorders in the UK

SummaryAims– This paper aims to describe current trends in the UK primary care management of common mental disorders and explore the appropriateness of differing management approaches in light of the course and common complications of these disorders.Methods– It highlights key findings concerning the course and comorbidity of depression to indicate that depression and associated mental illnesses may often form part of more complex patterns of ill health and that these conditions have a clear potential for chronicity. A narrative review of studies providing detail of depression prevalence in selected comorbid conditions is presented for this purpose.Conclusion– The presentation and course of common mental disorders indicate organizational changes in health service delivery, and - for a sizeable patient group – the use of chronic disease management strategies.Declaration of Interest: None.

Download Full-text

Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014

BJPsych Open ◽

10.1192/bjpo.bp.115.002246 ◽

2016 ◽

Vol 2 (1) ◽

pp. 18-24 ◽

Cited By ~ 25

Author(s):

Sebastião Viola ◽

Joanna Moncrieff

Keyword(s):

Anxiety Disorder ◽

Mental Disorders ◽

Mental Disorder ◽

Common Mental Disorders ◽

Disability Benefits ◽

Common Cause ◽

Individual Support ◽

Government Data ◽

The Uk

BackgroundThere is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims.AimsTo examine trends in sickness and disability benefits awarded for mental disorders in the UK.MethodThe researchers analysed UK Government data from 1995 to 2014.ResultsMental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder.ConclusionsCommon mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.

Download Full-text

Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/prolas-2019-0026 ◽

2019 ◽

Vol 73 (2) ◽

pp. 164-170

Author(s):

Vineta Viktorija Vinogradova ◽

Jeļena Vrubļevska ◽

Elmārs Rancāns

Keyword(s):

Primary Care ◽

Mental Disorders ◽

Common Mental Disorders ◽

Current Knowledge ◽

Family Physicians ◽

Research Programme ◽

Primary Care Settings ◽

National Research Programme ◽

Management Approaches ◽

Training Programmes

Abstract Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.

Download Full-text

Socio-economic position and common mental disorders

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.014449 ◽

2006 ◽

Vol 189 (2) ◽

pp. 109-117 ◽

Cited By ~ 86

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.

Download Full-text

Socioeconomic inequalities in common mental disorders and psychotherapy treatment in the UK between 1991 and 2009

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.098863 ◽

2013 ◽

Vol 202 (2) ◽

pp. 115-120 ◽

Cited By ~ 21

Author(s):

Markus Jokela ◽

G. David Batty ◽

Jussi Vahtera ◽

Marko Elovainio ◽

Mika Kivimäki

Keyword(s):

Socioeconomic Status ◽

Mental Disorders ◽

Household Income ◽

Social Inequalities ◽

Common Mental Disorders ◽

Occupational Status ◽

Income Quintile ◽

Public Health Issue ◽

The Uk

BackgroundInequality in health and treatment of disease across socioeconomic status groups is a major public health issue.AimsTo examine differences in socioeconomic status in common mental disorders and use of psychotherapy provided by the public and private sector in the UK between 1991 and 2009.MethodDuring these years, 28 054 men and women responded to annual surveys by the nationally representative, population-based British Household Panel Survey (on average 7 measurements per participant; 207 545 person-observations). In each year, common mental disorders were assessed with the self-reported 12-item General Health Questionnaire and socioeconomic status was assessed on the basis of household income, occupational status and education.ResultsHigher socioeconomic status was associated with lower odds of common mental disorder (highest v. lowest household income quintile odds ratio (OR) 0.88, 95% CI 0.82–0.94) and of being treated by publicly provided psychotherapy (OR = 0.43, 95% CI 0.34–0.55), but higher odds of being a client of private psychotherapy (OR = 3.33, 95% CI 2.36–4.71). The status difference in publicly provided psychotherapy treatment was more pronounced at the end of follow-up (OR = 0.36, 95% CI 0.23–0.56, in 2005–2009) than at the beginning of the follow-up period (OR =0.96, 95% CI 0.66–1.39, in 1991–1994; time interaction P<0.001). The findings for occupational status and education were similar to those for household income.ConclusionsThe use of publicly provided psychotherapy has improved between 1991 and 2009 among those with low socioeconomic status, although social inequalities in common mental disorders remain.

Download Full-text

Help-seeking and receipt of treatment among UK service personnel

The British Journal of Psychiatry ◽

10.1192/bjp.bp.109.075762 ◽

2010 ◽

Vol 197 (2) ◽

pp. 149-155 ◽

Cited By ~ 59

Author(s):

Amy C. Iversen ◽

Lauren van Staden ◽

Jamie Hacker Hughes ◽

Tess Browne ◽

Neil Greenberg ◽

...

Keyword(s):

Primary Care ◽

Mental Disorders ◽

Help Seeking ◽

Service Use ◽

Common Mental Disorders ◽

Armed Forces ◽

Service Utilisation ◽

Professional Help ◽

Military Health ◽

The Uk

BackgroundFor armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy.AimsTo examine mental healthcare service use and receipt of treatment in a sample of the UK military.MethodParticipants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt.ResultsOnly 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive–behavioural therapy (CBT). These findings are comparable with those reported for the general population.ConclusionsIn the UK armed forces, the majority of those with mental disorders are not currently seeking medical help for their symptoms. Further work to understand barriers to care is important and timely given that this is a group at risk of occupational psychiatric injury.

Download Full-text

Poor physical activity as a risk factor for mental health disorders

European Journal of Public Health ◽

10.1093/eurpub/ckab164.021 ◽

2021 ◽

Vol 31 (Supplement_3) ◽

Author(s):

B Stubbs

Keyword(s):

Mental Health ◽

Physical Activity ◽

Mental Disorders ◽

Healthy Aging ◽

Common Mental Disorders ◽

Adult Population ◽

Life Quality ◽

Hippocampal Neurogenesis ◽

Mental Illnesses ◽

Adjunctive Treatment

Abstract Rates of common mental disorders appear to be increasing among both adolescent and adult population affecting life quality and expectancy. Availability of the treatments il limited to a large portion of the global population thus new approaches toward the prevention and treatment of mental illnesses need to emerge in order to reduce the global and growing burden of these conditions. A great body of evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as physical activity and diet. Given their modifiable nature, there has been an increasing interest in the implementation of physical activity in the prevention and adjunctive treatment among people with mental illnesses. Robust evidence indicates that physical activity may in fact, by influencing a range of biological and psychosocial processes, contribute to healthy aging, improve sleep and preserve cognition across the lifespan as well as affect associated with mental disorders serious physical health comorbidities including cardiovascular disease, metabolic risk factors such as adiposity and premature mortality. The plausible effects of physical activity toward mental health may be at least partially explained by its potential in modulating hippocampal neurogenesis and synaptic plasticity. Finally, higher levels of physical activity have been consistently associated with a reduced risk of both affective and cognitive disorders.

Download Full-text

Common Mental Disorders and Folk Mental Illnesses

Mental Health and Illness Worldwide - Mental Health and Illness in Rural World ◽

10.1007/978-981-10-0751-4_8-1 ◽

2019 ◽

pp. 1-15

Author(s):

Abhilash Balakrishnan ◽

Hargun Ahluwalia ◽

Geetha Desai

Keyword(s):

Mental Disorders ◽

Common Mental Disorders ◽

Mental Illnesses

Download Full-text

Common mental disorders, subthreshold symptoms and disability: longitudinal study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.079244 ◽

2010 ◽

Vol 197 (5) ◽

pp. 411-412 ◽

Cited By ~ 38

Author(s):

Dheeraj Rai ◽

Petros Skapinakis ◽

Nicola Wiles ◽

Glyn Lewis ◽

Ricardo Araya

Keyword(s):

Mental Disorders ◽

Functional Disability ◽

Psychiatric Symptoms ◽

Common Mental Disorders ◽

Psychiatric Morbidity ◽

Diagnostic Categories ◽

Icd 10 ◽

The Uk ◽

Aggregate Burden

SummaryIn a representative sample of the UK population we found that common mental disorders (as a group and in ICD–10 diagnostic categories) and subthreshold psychiatric symptoms at baseline were both independently associated with new-onset functional disability and significant days lost from work at 18-month follow-up. Subthreshold symptoms contributed to almost half the aggregate burden of functional disability and over 32 million days lost from work in the year preceding the study. Leaving these symptoms unaccounted for in surveys may lead to gross underestimation of disability related to psychiatric morbidity.

Download Full-text