Australia's Mental Health: An Overview of the General Population Survey

2000 ◽  
Vol 34 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Scott Henderson ◽  
Gavin Andrews ◽  
Wayne Hall

Objectives: The objectives of this study were to estimate the 1-month and 1-year prevalence of mental disorders in the Australian adult population; to determine the amount of disablement associated with this; and to determine the use of health and other services by persons with common mental disorders. Method: For the Adult Survey, a household sample of 10 600 persons aged 18 years and over were interviewed across Australia by experienced field staff of the Australian Bureau of Statistics. This was 78%% of the target sample. The interview consisted of the composite international diagnostic interview in its automated presentation (CIDI-A) and other components to determine disablement, use of services and satisfaction with services received. The diagnostic classifications used in the analyses were both ICD-10 and DSM-IV. Only the results from ICD-10 are reported here. Results: A total of 17.7%% of the sample had one or more common mental disorders, anxiety, depression, alcohol or substance abuse and neurasthenia. This morbidity was associated with considerable disablement in daily life: 3 days of impaired social role performance in the previous 4 weeks, compared with 1 day for the general population. Of all cases, 64.6%% had had no contact with health services in the previous year; 29.4%% had seen GPs and 7.5%% had seen psychiatrists. Conclusion: Australia now has its own national estimates of psychiatric morbidity. The morbidity is associated with considerable disablement, but most of it is untreated. General practitioners encounter by far the largest proportion of those reaching services.

2004 ◽  
Vol 34 (6) ◽  
pp. 1013-1024 ◽  
Author(s):  
V. JORDANOVA ◽  
C. WICKRAMESINGHE ◽  
C. GERADA ◽  
M. PRINCE

Background. The most widely used survey measures in psychiatry, the Composite International Diagnostic Interview (CIDI) and the Clinical Interview Schedule – Revised (CIS-R) have generated estimates of psychiatric morbidity that show considerable variation. Doubts have been raised regarding the validity of these structured lay interviewer assessments. There have been no direct comparisons of the performances of these instruments against a common, established criterion.Method. A total of 105 unselected primary care attendees were each interviewed with CIDI, CIS-R and SCAN in a single sitting with random order of administration. SCAN was administered by a SCAN trained psychiatrist, and CIDI and CIS-R by a public health doctor. Concordance was estimated for all ICD-10 neurotic disorders. We assessed the overall discriminability of the CIS-R morbidity scale using a receiver operating characteristic (ROC) analysis.Results. The concordance for CIDI for ICD-10 diagnoses was moderate to excellent (kappa=0·58–0·97). Concordance for CIS-R ranged between poor and moderate (kappa=0·10–0·65). The area under the ROC curve for the CIS-R morbidity scale with respect to any ICD-10 disorder [0·87 (95% CI 0·79–0·95)] indicated good overall discriminability, but poor sensitivity (44%) and high specificity (97%) at the usual CIS-R cut-point of 11/12.Conclusion. Among primary care attendees the CIDI is a highly valid assessment of common mental disorders, and the CIS-R is moderately valid. Previous studies may have underestimated validity. Against the criteria of all ICD-10 diagnoses (including less severe depressive and anxiety disorders) a much lower CIS-R cut-point is required than that which is usually advocated.


2009 ◽  
Vol 24 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Ronny Bruffaerts ◽  
Anke Bonnewyn ◽  
Koen Demyttenaere

AbstractPurposeThe purpose of this study is to examine the association between non-psychotic serious mental disorders and earnings in the general population of Belgium on both the individual- and society-level.Subjects and methodsData stem from a cross-sectional population study of the non-institutionalized adult (between 18 and 64) population from Belgium (N = 863). The third version of the Composite International Diagnostic Interview (CIDI-3.0) was administered to assess 12-month non-psychotic serious mental disorders and annual earnings. Multivariate approaches were used to estimate the observed and estimated annual earnings for persons with serious mental disorders, controlling for sociodemographic variables and alcohol disorders.ResultsOn the individual-level, 12-month serious mental disorders significantly predicted the probability of having any earnings (OR = 0.32; 95%CI = 0.14–0.74). Respondents with serious mental disorders had 12-month earnings of 5969€ less than expected in the absence of serious mental disorders. Taking into account the prevalence of serious mental disorders (i.e. 4.9%), the society-level effects of serious mental disorders in 2002 can be estimated at about 1797 million € per year for the Belgian general population.DiscussionNon-psychotic serious mental disorders had considerable impact on annual earnings.ConclusionThis is the first study in Belgium that addresses the association between mental illness and earnings. Serious mental disorders are associated with individual- and societal-level impairments and loss of human capital.


2012 ◽  
Vol 42 (10) ◽  
pp. 2047-2055 ◽  
Author(s):  
N. Spiers ◽  
T. S. Brugha ◽  
P. Bebbington ◽  
S. McManus ◽  
R. Jenkins ◽  
...  

BackgroundThe National Psychiatric Morbidity Survey (NPMS) programme was partly designed to monitor trends in mental disorders, including depression, with comparable data spanning 1993 to 2007. Findings already published from this programme suggest that concerns about increasing prevalence of common mental disorders (CMDs) may be unfounded. This article focuses on depression and tests the hypothesis that successive birth cohorts experience the same prevalence of depression as they age.MethodWe carried out a pseudo-cohort analysis of a sequence of three cross-sectional surveys of the English household population using identical diagnostic instruments. The main outcome was ICD-10 depressive episode or disorder. Secondary outcomes were the depression subscales of the Clinical Interview Schedule – Revised (CIS-R).ResultsThere were 8670, 6977 and 6815 participants in 1993, 2000 and 2007 respectively. In men, the prevalence of depression increased between cohorts born in 1943–1949 and 1950–1956 [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4–4.2], then remained relatively stable across subsequent cohorts. In women, there was limited evidence of change in prevalence of depression. Women born in 1957–1963, surveyed aged 44–50 years in 2007, had exceptionally high prevalence. It is not clear whether this represents a trend or a quirk of sampling.ConclusionsThere is no evidence of an increase in the prevalence of depression in male cohorts born since 1950. In women, there is limited evidence of increased prevalence. Demand for mental health services may stabilize or even fall for men.


2010 ◽  
Vol 197 (5) ◽  
pp. 411-412 ◽  
Author(s):  
Dheeraj Rai ◽  
Petros Skapinakis ◽  
Nicola Wiles ◽  
Glyn Lewis ◽  
Ricardo Araya

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.


2008 ◽  
Vol 42 (10) ◽  
pp. 898-904 ◽  
Author(s):  
Matthew Sunderland ◽  
Tim Slade ◽  
Tracy M. Anderson ◽  
Lorna Peters

Objectives: It has been previously argued that the methodology used by the Composite International Diagnostic Interview version 2.1 to assess the substance-induced and general medical condition exclusion criteria are inadequate. As a result prevalence estimates generated from epidemiological studies using this interview may be underestimated. The purpose of the current study was to examine the substance-induced and general medical condition exclusion criteria in the Australian National Survey for Mental Health and Well-being and determine the impact that they have on prevalence estimates of the common mental disorders. Method: Data from the 1997 Australian National Survey of Mental Health and Well-being were analysed. Frequencies were generated as an indication of how many respondents believed that their psychiatric symptoms were always due to a substance or general medical condition. New DSM-IV prevalence estimates were calculated ignoring the application of the substance-induced and general medical condition exclusion criteria and compared to standard DSM-IV prevalence estimates. Results: The effect of the substance-induced and general medical condition exclusion criteria on final prevalence rates were minimal, with approximately a 0.1% increase when the exclusions were ignored. This equates to a relative difference ranging from no difference for generalized anxiety disorder to an increase of 12% of the base prevalence estimate for agoraphobia. Conclusions: In surveys that use the Composite International Diagnostic Interview version 2.1 the substance-induced and general medical condition exclusion criteria have a minor impact on determining final case definition in the majority of mental disorders.


2006 ◽  
Vol 36 (11) ◽  
pp. 1593-1600 ◽  
Author(s):  
TIM SLADE ◽  
DAVID WATSON

Background. Patterns of co-occurrence among the common mental disorders may provide information about underlying dimensions of psychopathology. The aim of the current study was to determine which of four models best fits the pattern of co-occurrence between 10 common DSM-IV and 11 common ICD-10 mental disorders.Method. Data were from the Australian National Survey of Mental Health and Well-Being (NSMHWB), a large-scale community epidemiological survey of mental disorders. Participants consisted of a random population-based sample of 10641 community volunteers, representing a response rate of 78%. DSM-IV and ICD-10 mental disorder diagnoses were obtained using the Composite International Diagnostic Interview (CIDI), version 2.0. Confirmatory factor analysis (CFA) was used to assess the relative fit of competing models.Results. A hierarchical three-factor variation of a two-factor model demonstrated the best fit to the correlations among the mental disorders. This model included a distress factor with high loadings on major depression, dysthymia, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and neurasthenia (ICD-10 only); a fear factor with high loadings on social phobia, panic disorder, agoraphobia and obsessive–compulsive disorder (OCD); and an externalizing factor with high loadings on alcohol and drug dependence. The distress and fear factors were best conceptualized as subfactors of a higher order internalizing factor.Conclusions. A greater focus on underlying dimensions of distress, fear and externalization is warranted.


2001 ◽  
Vol 178 (3) ◽  
pp. 228-233 ◽  
Author(s):  
Ricardo Araya ◽  
Graciela Rojas ◽  
Rosemarie Fritsch ◽  
Julia Acuña ◽  
Glyn Lewis

BackgroundThere have been relatively few surveys in Latin America that have attempted to estimate the prevalence of psychiatric morbidity in private households.AimsTo determine the prevalence of common mental disorders and socio-demographic correlates among adults from Santiago, Chile.MethodCross-sectional survey of private households with a probabilistic sampling design was used. Common mental disorders were measured using the Clinical Interview Schedule–Revised (CIS–R).ResultsThree thousand eight hundred and seventy adults were interviewed. Twenty-five per cent were CIS–R cases and 13% met criteria for an ICD–10 diagnosis. Low education, female gender, unemployment, separation, low social status and lone parenthood were associated with a higher prevalence.ConclusionsPrevalence rates were higher than those found in urban areas of Great Britain, both for ICD–10 diagnoses and ‘non-specific neurotic disorders’. Similar socio-demographic factors were associated with an increased prevalence of common mental disorders in Chile as in the UK. There is a need to unify methodologies to be able to compare results internationally.


1999 ◽  
Vol 29 (5) ◽  
pp. 1029-1042 ◽  
Author(s):  
T. S. BRUGHA ◽  
P. E. BEBBINGTON ◽  
R. JENKINS ◽  
H. MELTZER ◽  
N. A. TAUB ◽  
...  

Background. Comparisons of structured diagnostic interviews with clinical assessments in general population samples show marked discrepancies. In order to validate the CIS-R, a fully structured diagnostic interview used for the National Survey of Psychiatric Morbidity in Great Britain, it was compared with SCAN, a standard, semi-structured, clinical assessment.Methods. A random sample of 1882 Leicestershire addresses from the Postcode Address File yielded 1157 eligible adults: of these 860 completed the CIS-R; 387 adults scores [ges ]8 on the CIS-R and 205 of these completed a SCAN reference examination. Neurotic symptoms, in the previous week and month only, were enquired about. Concordance was estimated for ICD-10 neurotic and depressive disorders, F32 to F42 and for depression symptom score.Results. Sociodemographic characteristics closely resembled National Survey and 1991 census profiles. Concordance was poor for any ICD-10 neurotic disorder (kappa = 0·25 (95% CI, 0·1–0·4)) and for depressive disorder (kappa = 0·23 (95% CI, 0–0·46)). Sensitivity to the SCAN reference classification was also poor. Specificity ranged from 0·8 to 0·9. Rank order correlation for total depression symptoms was 0·43 (Kendall's tau b; P<0·001; N=205).Discussion. High specificity indicates that the CIS-R and SCAN agree that prevalence rates for specific disorders are low compared with estimates in some community surveys. We have revealed substantial discrepancies in case finding. Therefore, published data on service utilization designed to estimate unmet need in populations requires re-interpretation. The value of large-scale CIS-R survey data can be enhanced considerably by the incorporation of concurrent semi-structured clinical assessments.


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