Common mental disorders in young refugees in Sweden: the role of education and duration of residency

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Mittendorfer Rutz ◽  
M Helgesson ◽  
M Norredam ◽  
M Sijbrandij ◽  
C Jamil de Montgomery ◽  
...  

Abstract Background Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration. Methods This register-based, longitudinal cohort study included 743,671 individuals (whereof 33,501 refugees) between 19-25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers. Results Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.73 (95% CI 0.68-0.78) and 0.74 (95% CI 0.70-0.79) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had an 8-fold elevated risk for PTSD (aHR: 8.40, 95% CI 6.16-11.47) and accompanied refugees had a nearly 3-fold risk of PTSD (aHR: 2.78, 95% CI 2.29-3.37). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education. Conclusions Young refugees had a lower risk of treated depressive and anxiety disorders, but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time, whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs. Key messages Our study highlights the need to specifically focus on stress-related mental disorders in studies on refugees as risk estimates might differ. Moreover, providing scalable low-intensity interventions to address CMDs including posttraumatic stress are an important first step in order to prevent prolonged suffering and persistence of PTSD in refugee youth.

Author(s):  
Jessica Scharf ◽  
Peter Angerer ◽  
Gesine Müting ◽  
Adrian Loerbroks

Common mental disorders (CMDs) are risk factors for long-term sickness absence and unemployment. Therefore, return-to-work (RTW) processes have been introduced to facilitate the return of employees. As the success of RTW processes is considered to be determined by the cooperativeness of the involved stakeholders, we aimed to investigate the views of those stakeholders to disclose potentially diverging expectations. Qualitative interviews were conducted (08/2018-04/2019) among five stakeholder groups: returnees with a diagnosed CMD who were eligible for a RTW process; health care professionals nominated by the returnees; supervisors, colleagues and occupational physicians (the latter three groups were not nominated by the returnees). In total, 24 returnees, 13 health care professionals, 13 occupational physicians, 9 supervisors and 9 colleagues were interviewed (68 interviews in total). Potentially diverging expectations of the stakeholders related to whether diagnoses need to be disclosed by returnees. Agreement existed in terms of the need for a trustful relationship between employees and occupational physicians to initiate a RTW process early. As the understanding of all stakeholders’ viewpoints is one of the main factors promoting a successful RTW, we explored the expectations of those involved in the RTW process. One implication of our findings is to strengthen the role of occupational physicians, who could coordinate the return process.


2017 ◽  
Vol 100 ◽  
pp. 8-14 ◽  
Author(s):  
Marlous Tuithof ◽  
Margreet ten Have ◽  
Aartjan Beekman ◽  
Saskia van Dorsselaer ◽  
Marloes Kleinjan ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Edith Kamaru Kwobah ◽  
Ann Mwangi ◽  
Kirtika Patel ◽  
Thomas Mwogi ◽  
Robert Kiptoo ◽  
...  

Background: Healthcare workers responding to the Corona Virus Pandemic (COVID-19) are at risk of mental illness. Data is scanty on the burden of mental disorders among Kenyan healthcare workers responding to the pandemic that can inform mental health and psychosocial support. The purpose of this study was to establish the frequency and associated factors of worry, generalized anxiety disorder, depression, posttraumatic stress disorder and poor quality of sleep among Kenyan health care workers at the beginning of COVID-19 pandemic.Methods: We conducted an online survey among 1,259 health care workers in Kenya. A researcher developed social demographic questionnaire and several standardized tools were used for data collection. Standardized tools were programmed into Redcap, (Research Electronic Data Capture) and data analysis was performed using R Core Team. In all analysis a p-value < 0.05 was considered significant.Results: 66% of the participants reported experiencing worry related to COVID-19. 32.1% had depression, 36% had generalized anxiety, 24.2% had insomnia and 64.7% scored positively for probable Post Traumatic Stress Disorder (PTSD). Depression was higher among females compared to men (36.5 vs. 26.9%, p = 0.003), workers <35 years old compared to older ones (38.1 vs. 26.4%, p < 0.001), and those who were not married compared to those who were married (40.6 vs. 27.6%, p < 0.001). Generalized anxiety was commoner among workers aged <35 years (43.5 vs. 29.3%, p < 0.001), females (41.7 vs. 29.2%, p < 0.001), those who mere not married compared to the married (45.2 vs. 31.2%, p < 0.001) and those with <10 years working experience (41.6 to 20.5%, p < 0.001). Younger health care professional had a higher proportion of insomnia compared to the older ones (30.3 vs. 18.6%, p < 0.001). Insomnia was higher among those with <10 years' experience compared to those with more than 20 years' experience(27.3 vs. 17.6%, p = 0.043)Conclusion: Many Kenyan healthcare workers in the early phase of COVID-19 pandemic suffered from various common mental disorders with young, female professionals who are not married bearing the bigger burden. This data is useful in informing interventions to promote mental and psychosocial wellbeing among Kenyan healthcare workers responding to the pandemic.


2000 ◽  
Vol 26 (1) ◽  
pp. 2-3 ◽  
Author(s):  
Jukka Hintikka ◽  
Ulla Hintikka ◽  
Johannes Lehtonen ◽  
Heimo Viinamäki ◽  
Kaj Koskela ◽  
...  

2019 ◽  
pp. 31-56 ◽  
Author(s):  
R. Raguram

This chapter focuses on common mental disorders (CMDs). These disorders include a wide range of conditions that are frequently noticed in the community. It is essentially a convenient, functional grouping of conditions. The chapter analyses the trends on the basis of researches in this area over the past decade. The classification of CMDs for primary health care, according to ICD-10, includes depression, phobic disorder, panic disorder, generalized anxiety, mixed anxiety and depression, adjustment disorder, dissociative disorder, and somatoform disorders. Irrespective of the nature of the disorder, these patients often present with somatic complaints: some patients may admit to having emotional symptoms. It was observed that there is a high degree of co-morbidity among them, leading to significant levels of disability and increased health-care costs.


Author(s):  
Victoria J. Palmer ◽  
Rob Whitley

There is an abundance of published literature documenting the important role of primary care in the recognition, treatment and management of mental disorders. Despite this, general practitioners, nurses, social workers, occupational therapists, physiotherapists, and other primary health care professionals remain under acknowledged, and the multidisciplinary team arrangements needed for effective management elusive. Individual and community stigma attached to seeking help has not been removed. This chapter provides an overview of these existing barriers and outlines strategies for implementation to improve recognition and treatment of mental disorders across the spectrum in primary care. These strategies are focused on the delivery of whole person, resulting in integrated and person-centred care.


Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S8-S8
Author(s):  
Jesus Perez ◽  
Clare Knight ◽  
Debra A Russo ◽  
Jan Stochl ◽  
Peter B Jones

Abstract Background Systematic reviews indicate that approximately one third of people with at-risk mental states for psychosis (ARMS) will transition to a psychotic disorder. Research in non-specialised services, such as primary care settings, has shown that far fewer make such a conversion. Nonetheless, psychotic experiences (PE) may also be linked to common mental disorders (CMD), particularly depression and anxiety, and still predict poor outcomes. Population studies modelling the co-occurrence of CMD and PE have found an underlying unitary psychopathological factor, with PE emerging towards its more severe end. We know little about the prevalence of and recovery from PE in primary mental health care, where most CMD are treated. One example of primary mental health care setting in England is the Improving Access to Psychological Therapies (IAPT) programme (https://www.england.nhs.uk/mental-health/adults/iapt/). The IAPT programme provides evidence-based psychological therapies for mild to moderate CMD across the UK National Health Service (NHS). IAPT services adhere to current diagnostic paradigms and, therefore, do not either measure or treat PE. We aimed to establish the prevalence of PE in a large sample of patients with CMD from the IAPT programme and compare recovery rates between patients with CMD and PE (CMD-P) and those without PE. Methods We used the Community Assessment of Psychic Experiences - Positive 15-item Scale (CAPE-P15) to determine the prevalence of PE in patients with CMD receiving treatment from IAPT services across England. We employed the CAPE-P15 threshold score of 1.47, which identifies individuals with ARMS, and also a lower threshold of 1.30, chosen as within one standard error of measurement, in order to explore threshold effects in the association between PE and recovery. Patient-reported measures of depression (PHQ-9) and anxiety (GAD-7) are routinely collected in IAPT services and determine ‘caseness’ before, during and after therapy. Using recovery rates (moving from ‘caseness’ to recovery) monitored nationally in the IAPT programme, we stratified patients according to the absence and presence of PE. Multi-group growth models estimated improvement trajectories for each group. Results 2,042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The overall prevalence of CMD-P was 29.68% at CAPE-P15 threshold score for ARMS, i.e. 1.47, and 48.09% at threshold score 1.30. The overall recovery rate at threshold of 1.47 was 27.87% and 36.3% at 1.30. Recovery rates for those without PE were 58.92% and 62.43% for thresholds 1.47 and 1.30, respectively. Although patients with or without PE shared similar improvement trajectories, the initial severity of patients with CMD-P impeded their likelihood of recovery during treatment. Discussion At least one in four patients receiving treatment from IAPT services in primary care experience CMD-P. This significant group of people experience a lower recovery rate, with adverse implications not only for them but also for efficiency of services. Although recovery trajectories for this group showed improvement over therapy sessions, remittance of symptoms was insufficient to meet national IAPT standards of recovery. This patient group is not well-served by current interventions in primary care. This work forms part of a nation-wide NIHR research programme (TYPPEX; https://www.nihr.ac.uk/news/innovative-mental-health-study-launchesin-eastern-region) aiming to develop innovative therapies for people with CMD-P in primary care. Preliminary results related to feasibility and effectiveness of new therapeutic approaches will also be presented.


2004 ◽  
Vol 63 (sup2) ◽  
pp. 377-383 ◽  
Author(s):  
Inge Lynge ◽  
Povl Munk-Jørgensen ◽  
Amalia Lynge Pedersen ◽  
Gert Mulvad ◽  
Peter Bjerregaard

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