Diagnostic prevalence and comorbidity

Author(s):  
Stuart D. M. Thomas

Prisons and jails remain a growth industry, with many countries increasing correctional services to cope with the ever-burgeoning inmate population. One longstanding issue is the perceived increase in prevalence of mental disorders that are found in correctional settings compared to the community. Definitions of mental illness and methods of assessment vary substantially. That said, emerging data reflect some consistency in the range of estimated prevalence. Personality disorder (predominantly antisocial personality disorder) is the most common mental disorder among prisoners, accounting for 65% of male and 42% of female prisoners. Estimated rates of psychosis in some settings are as high as 3.7% for males and 4.0% for females, while major depressive disorders are found in up to 10% of male and 12% of female prisoners. Estimated point prevalence rates for alcohol abuse and dependence varied between 18 and 30% for male prisoners and between 10 and 24% for female prisoners; these estimates were between 10 and 48% for males and 30 to 60% for female prisoners with respect to drug dependence and abuse. The rates of almost all disorders are several times higher than those found in the general community, and the rates of comorbidity are exceptionally high. This chapter outlines the best available correctional prevalence of common mental disorders and considers the key assumptions and methodological challenges around ascertaining rates of these different diagnoses.

2021 ◽  
pp. 000486742110256
Author(s):  
Min Yang ◽  
Helen Tyrer ◽  
Tony Johnson ◽  
Peter Tyrer

Background: Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years. Methods: Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline. Results: Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197). Conclusion: In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.


BJPsych Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. 58-60 ◽  
Author(s):  
Elizabeth Spry ◽  
Rebecca Giallo ◽  
Margarita Moreno-Betancur ◽  
Jacqui Macdonald ◽  
Denise Becker ◽  
...  

We examined prospective associations between men's common mental disorders in the decades prior to offspring conception and subsequent paternal antenatal mental health problems. Data came from a prospective intergenerational cohort study which assessed common mental disorder nine times from age 14 to 29 years, and in the third trimester of subsequent pregnancies to age 35 years (N = 295 pregnancies to 214 men). Men with histories of adolescent and young adult common mental disorders were over four times more likely to experience antenatal mental health problems. Future research identifying modifiable perinatal factors that counteract preconception risk would provide further targets for intervention.Declaration of interestNone.


2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd

BackgroundThe relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.AimsTo investigate associations between the small-area MINI score and common mental disorder at individual level.MethodMental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF-36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–74 years nested within the 2001 UK census geographies of 110 lower super output areas and 33 wards.ResultsThe MINI score was significantly associated with common mental disorder after adjusting for individual risk factors. This association was stronger at the smaller spatial scale of the lower super output area and for individuals who were permanently sick or disabled.ConclusionsThe MINI is potentially useful for small-area needs assessment and service planning for common mental disorder in community settings.


2020 ◽  
Vol 73 (suppl 1) ◽  
Author(s):  
Deise da Silva Monteiro ◽  
Ridalva Dias Martins ◽  
Nadirlene Pereira Gomes ◽  
Rosana Santos Mota ◽  
Marimeire Morais da Conceição ◽  
...  

ABSTRACT Objective: To identify the prevalence of common mental disorders and associated factors in school adolescents. Method: Cross-sectional study with 230 adolescents from a public school in Salvador, Bahia, Brazil. We used a questionnaire and an assessment scale for common mental disorders. The data were processed in STATA, version 12. Results: The prevalence of common mental disorders in schoolchildren was 52.2%. Multivariate analysis identified a positive association with statistical significance between the condition and the variables:female gender (PR = 3.06; 95% CI: 1.77-5.4), black race (PR = 2.08; 95% CI: 1.04-4.16),having a boyfriend (PR = 2.07; 95% CI: 1.06-4.03) and smoking cigarettes once in a lifetime (PR = 2.88; 95% CI : 1.31 - 6.31). The school increase (OR = 0.52; 95% CI: 0.29-0.91) was identified as a protective factor. Conclusion: Female gender, black race, having a relationship, and having smoked cigarettes are factors that increase the chances of adolescents having common mental disorders.


2020 ◽  
Author(s):  
Kefyalew Dagne Gizachew ◽  
Gashaw Andargie Biks ◽  
Abate Dargie Wubetu

Abstract Introduction: The high prevalence of antenatal mental disorders in Sub-Saharan African countries is poorly understood. Pregnancy and childbirth are gaining recognition as significant risk factors for the development and exacerbation of mental health problems. In low- and lower-middle income countries about one in six pregnant women are experiencing antenatal common mental disorders (CMD). Objective: To assess prevalence and associated factors of common mental disorders (CMD) among pregnant women in Debre Berhan town, North Showa Zone, Amhara region, Ethiopia, 2016. Methods: Community based cross-sectional study was employed among 569 participants. Data was collected using face-to-face interviews with Amharic version of Self Reporting Questionnaire (SRQ-20) from seven selected kebeles. Kebeles were selected by simple random sampling and individuals were selected using cluster sampling. Crude and adjusted OR was analyzed using bivariate and multivariable logistic regression analysis and the level of significance for association was determined with 95% CI and at P- value < 0.05. Result: A total 557 study participants were completed the interview and the prevalence of antenatal common mental disorder was found to be 45.2%. Loss of loved one (AOR = 1.97; 95% CI: 1.19–3.27), history of chronic medical illness (AOR = 6.57; 95% CI: 2.17–19.94), unwanted pregnancy (AOR = 2.13; 95% CI: 1.15–3.95), nulliparity (AOR = 8.71; 95% CI: 1.58–47.94), one or less ANC consultations (AOR = 0.22; 95% CI: 0.08–0.64), two-three ANC consultations (AOR = 0.30; 95% CI: 0.11–0.83) and current obstetric complications (AOR = 4.45; 95% CI: 2.21–8.99) were important factors significantly associated with antenatal common mental disorder. Conclusion: The prevalence of antenatal common mental disorder (CMD) was high in this study that shows antenatal CMD is significant public health issue that requires a great emphasis. So, early screening and intervention for antenatal CMD should be integrated in primary health care and antenatal care service settings.


2019 ◽  
Vol 55 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
M. Wang ◽  
L. Mather ◽  
P. Svedberg ◽  
E. Mittendorfer-Rutz

Abstract Purpose The aim of this study was to investigate if sickness absence and disability pension (SA/DP) in general and due to specific common mental disorders (CMDs) are associated with subsequent suicide attempt among women and men by taking familial factors (genetics and shared environment) into consideration. Methods This register-based cohort study includes 4871 twin pairs 18–65 years of age discordant for SA/DP due to CMDs 2005–2010. Twins were followed up for suicide attempt from inpatient and specialised outpatient care until December 2012. Conditional Cox proportional hazards regression models, adjusting for familial factors, were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results SA/DP due to CMDs was associated with a higher risk of suicide attempt (HR 3.14, CI 2.51–3.93). The risk of suicide attempt was five times higher among men and three times higher among women, compared to the SA/DP unaffected co-twins. In the diagnosis-specific analysis, SA/DP due to anxiety disorders resulted in the highest HR (4.09, CI 2.37–7.06) for suicide attempt, followed by depressive disorders (HR 3.70, CI 2.66–5.14) and stress-related disorders (HR 1.96, CI 1.35–2.84). The stratified analysis on zygosity indicates that there seems to be a genetic influence on the associations between SA/DP due to CMDs and suicide attempt, particularly among women and among those with SA/DP due to depressive disorders. Conclusions SA/DP due to CMDs was a risk factor for suicide attempt among women and men. Genetic factors might explain part of the associations for women and for those with SA/DP due to depressive disorders.


2000 ◽  
Vol 177 (6) ◽  
pp. 557-562 ◽  
Author(s):  
David B. Mumford ◽  
Fareed A. Minhas ◽  
Imtiaz Akhtar ◽  
Saeed Akhter ◽  
Malik H. Mubbashar

BackgroundRecent studies in rural areas of Pakistan have yielded high prevalence rates of common mental disorders, especially among women.AimsTo investigate emotional distress and common mental disorders in a poor urban district using the same survey method.MethodFirst-stage screening of a slum district of Rawalpindi used the Bradford Somatic Inventory. Psychiatric interviews were conducted with stratified samples using the ICD–10 research diagnostic criteria.ResultsOn a conservative estimate, 25% of women and 10% of men suffered from anxiety and depressive disorders. Levels of emotional distress increased with age in both men and women. Women living in joint households reported more distress than those living in unitary families. Higher levels of education were associated with lower risk of common mental disorders, especially in younger women. Emotional distress was negatively correlated with socio-economic variables among women.ConclusionsThis study found levels of emotional distress and psychiatric morbidity in a poor district of Rawalpindi to be less than half those in a nearby rural village in the Punjab, although rates in women were still double those in men. Possible explanations are that more healthy people migrate to the cities or that urban living is more conducive to good mental health in Pakistan.


2020 ◽  
Vol 33 (4) ◽  
pp. e100214
Author(s):  
Hui Shen ◽  
Meijuan Chen ◽  
Donghong Cui

In recent years, research on meditation as an important alternative therapy has developed rapidly and been widely applied in clinical medicine. Mechanism studies of meditation have also developed progressively, showing that meditation has great impact on brain structure and function, and epigenetic and telomere regulation. In line with this, the application of meditation has gradually been expanded to mental illness, most often applied for major depressive disorders and substance-related and addictive disorders. The focus of this paper is to illustrate the biological mechanisms of meditation and its application in mental disorders.


2006 ◽  
Vol 189 (2) ◽  
pp. 109-117 ◽  
Author(s):  
Petros Skapinakis ◽  
Scott Weich ◽  
Glyn Lewis ◽  
Nicola Singleton ◽  
Ricardo Araya

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.


Author(s):  
S. Rahman ◽  
S. Filatova ◽  
L. Chen ◽  
E. Björkenstam ◽  
H. Taipale ◽  
...  

Abstract Purpose This study aimed to (1) identify the trajectories of prescribed antidepressants in refugee youth and matched Swedish-born peers diagnosed with common mental disorder (CMD) and (2) characterize the trajectories according to sociodemographic and medical factors. Methods The study population comprised 2,198 refugees and 12,199 Swedish-born individuals with both Swedish-born parents, aged 16–25 years in 2011, residing in Sweden and treated in specialised healthcare for CMD 2009–11. Group-based trajectory modelling was used to identify different trajectory groups of antidepressant use-based on annual defined daily dosages (DDDs). Multinomial logistic regression was applied to investigate the association of sociodemographic and medical characteristics with the identified trajectories. Nagelkerke pseudo-R2 values were estimated to evaluate the strength of these associations. Results Four trajectory groups of antidepressant use among young refugees were identified with following proportions and DDD levels in 2011: ‘low constant’ (88%, < 100), ‘low increasing’ (2%, ≈710), ‘medium decreasing’ (8%, ≈170) and ‘high increasing’ (2%, ≈860). Similar trajectories, however, with different proportions were identified in Swedish-born: 67%, 7%, 21% and 5%, respectively. The most influential factors discriminating the trajectory groups among refugees were ‘duration of stay in Sweden’ (R2 = 0.013), comorbid ‘other mental disorders’ (R2 = 0.009) and ‘disability pension’ (R2 = 0.007), while ‘disability pension’ (R2 = 0.017), comorbid ‘other mental disorders’ (R2 = 0.008) and ‘educational level’ (R2 = 0.008) were the most important determinants discriminating trajectory groups among Swedish-born youth. Conclusion The lower use of antidepressants in refugees with CMDs compared to their Swedish-born counterparts warrants health literacy programs for refugees and training in transcultural psychiatry for healthcare professionals.


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