Do Older Australians Truly have Low Rates of Anxiety and Depression? A Critique of the 1997 National Survey of Mental Health and Wellbeing

2006 ◽  
Vol 40 (8) ◽  
pp. 623-631 ◽  
Author(s):  
Daniel W. O'Connor

This paper sets out to critically evaluate reports from the Australian-wide National Survey of Mental Health and Wellbeing of very low rates of ICD-10 anxiety and depressive disorders in community resident older Australians. Data from the National Survey, which relied on the Composite International Diagnostic Interview (CIDI) were re-computed and re-analysed to address concerns about population sampling, interview response patterns and alternate measures of mental health. Rates of anxiety and depressive disorders fell to low levels after 65 years and continued to fall thereafter. This is at odds with findings from gerontological surveys that used assessment tools better suited to frail older people. Scores on mental health scales, together with diagnostic algorithms that obviated CIDI skip patterns, showed much less change in mental wellbeing across generations. It is argued that sampling and case ascertainment bias combined to reduce rates of anxiety and depression in very old people, especially when adjustments are made for the high morbidity levels encountered in aged residential facilities. Functional mental disorders almost certainly rise in frequency in advanced old age, often in conjunction with dementia.

2008 ◽  
Vol 39 (9) ◽  
pp. 1527-1531 ◽  
Author(s):  
D. W. O'Connor ◽  
R. A. Parslow

BackgroundEpidemiological surveys based on complex diagnostic interviews, such as the Composite International Diagnostic Interview (CIDI), report very low rates of anxiety and depressive disorders in older age groups. Mental health checklists show much less change over the lifespan. This paper explores the possibility that complex interviews present a special challenge to older respondents and thereby exaggerate the decline in mental disorder with age.MethodAnalysis of data from an Australian national mental health survey with 10 641 community-resident adult respondents. Measures of interest included ICD-10 anxiety and depression diagnoses, scores on the Kessler Psychological Distress Scale (K-10), agreement between K-10 and CIDI anxiety and depressive questions, and changes in agreement with age.ResultsLevels of inconsistency between simple and complex questions about anxiety and depression rose with age.ConclusionsOlder people may have difficulty attending to and processing lengthy, complex questionnaires. When in doubt, their preferred response may be to deny having experienced symptoms, thus deflating rates of diagnosed mental disorder. We recommend that simple mental health scales be included in epidemiological studies involving older age groups.


2021 ◽  
pp. 002076402110478
Author(s):  
Agaah Ashrafi ◽  
Murtaza Kadhum ◽  
Andrew Molodynski ◽  
Dinesh Bhugra

Background: The psychological wellbeing and stresses on medical students are currently under a global spotlight. Under a wider initiative supported by the British Medical Association (BMA), international surveys have been conducted to understand and begin to tackle these issues. Method: This study aimed at describing the mental wellbeing and levels of burnout of Iranian medical students. A total of 179 medical students from 19 different cities participated voluntarily in the survey by answering an online questionnaire between April and August 2020. We detected a trend toward higher prevalence of psychiatric disorders (namely depressive disorders) and substance misuse when compared to previous national studies. Results: About 6% of students screened positive for alcohol problems with the CAGE questionnaire. About 77% of medical students screened positive for mental health problems with the GHQ12 questionnaire. Very high rates of burnout were also reported. These findings emphasize the urgent need to define methods to screen at risk medical students and implement local and national initiatives to curtain their potential detrimental effects.


Author(s):  
Jiao Song ◽  
Richard Fry ◽  
Amy Mizen ◽  
Ashley Akbari ◽  
Benedict Wheeler ◽  
...  

IntroductionGreen-blue spaces (GBS), such as parks, woodlands, and beaches, may be beneficial for population mental health and wellbeing. However, there are few longitudinal studies on the association between GBS and mental health and wellbeing, and few that incorporate network analysis as opposed to simple Euclidian proximity. Objectives and ApproachWe are examining the association between the availability of GBS with wellbeing and common mental health disorders. We will use geographic information systems (GIS) to create quarterly household level GBS availability data using digital map and satellite data (2008-2018) for over 1 million homes in Wales, United Kingdom. We will link GBS availability to individual level mental health (1.7 million people with General Practitioner (GP) data) and data from the National Survey for Wales (n = 24,000) on wellbeing (Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)) using the Secure Anonymised Information Linkage (SAIL) databank. ResultsWe created an historic dataset of GBS availability using road network and path data to create quarterly household level GBS exposures (2008-2018). We tested Residential Anonymised Linking Fields (RALFs) and accurately linked 97\% of individuals and their health data to their home and GBS exposure. The 1.65 million exposure-health data pairs, updated quarterly, will enable a longitudinal panel study to be built. Using GP recorded data on treatments, diagnoses, symptoms and prescriptions for mental health problems we identified 35,000 people had a common mental health disorder in 2016, and 24,000 people answered the National Survey for Wales questions about their wellbeing and use of GBS. We will explore how house moves, and visits to GBS change the association between GBS availability and outcomes. Conclusion/ImplicationsThis study fills the gap in the evidence base around environmental planning policy to shape living environments to benefit health. It will inform the planning and management of GBS in urban and rural environments and contribute to international work on impacts of the built environment on mental health and wellbeing.


2000 ◽  
Vol 34 (5) ◽  
pp. 792-800 ◽  
Author(s):  
Stephen Rosenman ◽  
Ailsa Korten ◽  
Jo Medway ◽  
Mandy Evans

Objective: This study examines the factorial structure of symptoms and signs in psychosis in data from the Study on Low Prevalence (psychotic) Disorders which is part of the National Survey of Mental Health and Wellbeing, Australia 1997–1998. Method: The present study examined a wide variety of symptoms taken from the Schedules for Clinical Assessment in Neuropsychiatry items and the substance use items in the Diagnostic Interview for Psychosis, an instrument specially constructed for the national study. The instrument was applied to 980 community and hospital subjects with a wide range of psychotic illness diagnoses. The data were factor analysed and scales of ‘domains of psychopathology’ derived. Results: The data were best fitted by five principal factors (‘domains’) which can be approximately labelled dysphoria, positive symptoms, substance use, mania and negative symptoms/incoherence. These factors together explained 55.4% of variance in symptoms. Solutions with more numerous factors did not improve the representation. Conclusion: The five domains successfully characterise a large part of the variance in psychopathology found in the present study of low prevalence (psychotic) disorders. The approach allows sufferer's symptom range and severity to be well expressed without multiple comorbid diagnoses or the limits imposed by categorical diagnosis. Knowledge of alternative dimensional representations of psychopathology may usefully complement our use of categories, enhance awareness of symptoms and ensure that important psychopathology is heeded in practice and research.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Magdalena Grzesiak ◽  
Jan Aleksander Beszłej ◽  
Ewa Waszczuk ◽  
Marcin Szechiński ◽  
Monika Szewczuk-Bogusławska ◽  
...  

Aim. To assess the association of six polymorphisms in serotonin-related genes with depressive or anxiety disorders in patients with irritable bowel syndrome (IBS).Methods. The lifetime prevalence of depressive and anxiety disorders was assessed in 95 IBS patients (85% women) using the Munich version of the Composite International Diagnostic Interview (CIDI). IBS was diagnosed according to the Rome III criteria.SCL6A4HTTLPR polymorphism (rs4795541) was determined using PCR-based method. Single-nucleotide polymorphisms inHTR1A(rs6295),HTR2A(rs6313 and rs6311),HTR2C(rs6318), andTPH1(rs1800532) were detected by minisequencing method.Results. IBS patients with depressive disorders were characterized by higher frequency of 5-HTTLPR L allele in comparison to IBS patients with anxiety disorders. The lower frequency of 1438 A allele inHTR2Awas found in IBS patients with depressive disorders in comparison to IBS patients without mental disorders. The lower G allele frequency inHTR2Crs6318 polymorphism among IBS patients with anxiety disorders was also observed.Conclusions. Our results provide further evidence for the involvement ofSLC6A4rs4795541 andHTR2Ars6311 polymorphisms in the pathophysiology of depressive disorders in IBS patients. The new findings indicate thatHTR2Crs6318 polymorphism may be associated with the susceptibility to anxiety disorders in IBS patients.


2021 ◽  
Author(s):  
Laura Jefferson ◽  
Su Golder ◽  
Veronica Dale ◽  
Holly Essex ◽  
Elizabeth McHugh ◽  
...  

Background Over recent years chronic stress and burnout have been reported by doctors working in general practice in the UK NHS and internationally. The COVID-19 pandemic has changed general practitioners working lives; adding potential pressures from avoiding infection and addressing pent-up demand for care, but also changing processes such as rapidly taking up remote consultations. To date, there has been a focus on exploring the impact of the pandemic on the wellbeing of hospital clinicians. No registered systematic reviews currently focus on exploring the impact of the pandemic on the mental health and wellbeing of general practitioners. Aims and objectives To synthesise the current international evidence base exploring the impact of COVID-19 on the mental health and wellbeing of general practitioners, and which factors are associated with their reported mental health and wellbeing during the pandemic. Methods In this paper we report a systematic review protocol, following PRISMA guidance. In our search strategy we will identify primary research studies or systematic reviews exploring the mental health and wellbeing of general practitioners during the COVID-19 pandemic in four databases (MEDLINE, Embase, PsychInfo and Medrxiv) and Google Scholar. We will hand-search reference lists and grey literature. Two reviewers will undertake all stages including study selection, data extraction and quality assessment, with arbitration by a third reviewer where necessary. We will use standardised quality assessment tools to ensure transparency and reduce bias in quality assessment. Depending on the quality of included studies, we may undertake a sensitivity analysis by excluding studies from narrative synthesis that are rated as low quality using the checklists. We will describe the findings across studies using narrative thematic data synthesis, and if sufficiently homogenous data are identified, we will pool quantitative findings through meta-analysis.


2020 ◽  
Author(s):  
Jelena Milicev ◽  
Stephany Biello ◽  
Maria Gardani

AbstractIntroduction: Recent research has revealed high rates of mental health issues in postgraduate researchers (PGRs). Mental ill-health is a barrier to life satisfaction and academic success. More knowledge is necessary to understand the extent and origins of mental health problems of PGRs in the UK. Aims: To assess the prevalence of anxiety, depression, sleep problems, subjective mental wellbeing, and suicide behaviours of PGRs in the UK, as well as to explore the factors that underpin these outcomes.Methods: An online survey (N=479) was used to measure the mental health outcomes, and assess the influence of demographic, trait and academic variables, and social support. Results: In this sample the prevalence of mental ill-health was high, while wellbeing was lower than in the general population. Female, non-binary and non-heterosexual PGRs had poorer mental health than their male and/or heterosexual counterparts. Researchers in the field of Arts had higher levels of wellbeing, while those in the 5th year of study or above were at a higher risk of suicidal behaviours. Resilience, adaptive perfectionism, social support and positive evaluations of progress and preparation, departmental climate, and supervisory relationship were associated with positive outcomes, while maladaptive perfectionism and workaholism were linked to the negative ones. Resilience and workaholism were the only variables that played a role in all mental health outcomes.Conclusions: The current paper contributes new knowledge about the PGR wellbeing, the prevalence of mental health symptoms, and some of the factors that shape them. Our findings imply that institutional efforts to improve PGR mental health and wellbeing should include a variety of strategies to promote equality, diversity, resilience, integration and work-life balance of PGRs.


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