Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey

ObjectiveThe primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder.DesignData came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed.Primary outcome measureThe primary outcomes were MHP, past-year mental disorders, identified using the WHO’s Composite International Diagnostic Interview, and past-year suicide ideation.ResultsResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The ‘ever felt responsible for the death of a Canadian or ally personnel’ experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU.ConclusionsPast-year MHP differences were identified between components. Our findings suggest that although deployment-related experiences were highly associated with MHP, these only partially accounted for MHP differences between components. Additional research is needed to further investigate MHSU differences between components.

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Mental Health Impact of the First Wave of COVID-19 Pandemic on Spanish Healthcare Workers: a Large Cross-sectional Survey

10.1101/2020.10.27.20220731 ◽

2020 ◽

Author(s):

Jordi Alonso ◽

Gemma Vilagut ◽

Philippe Mortier ◽

Montse Ferrer ◽

Itxaso Alayo ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Healthcare Workers ◽

Female Gender ◽

Individual Characteristics ◽

Panic Attacks ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Wide Range

ABSTRACTIntroductionHealthcare workers are vulnerable to adverse mental health impacts of COVID-19. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain.MethodsAll workers in 18 healthcare institutions (6 AACC) in Spain were invited to a series of online surveys assessing a wide range of individual characteristics, COVID-19 infection status and exposure, and mental health status. Here we report: current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder –PTSD- [PCL-5≥7]; and Substance Use Disorder –SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify “disabling” current mental disorders.Results9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Healthcare workers with prior lifetime mental disorders had almost twice the prevalence of current disorders than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring “all of the time” for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95).ConclusionsCurrent mental disorders were very frequent among Spanish healthcare workers during the first wave of COVID-19. As the pandemic enters its second wave, careful monitoring and support is needed for healthcare workers, especially those with previous mental disorders and those caring COVID-19 very often.

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Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796020000888 ◽

2020 ◽

Vol 29 ◽

Cited By ~ 1

Author(s):

P. Winkler ◽

T. Formanek ◽

K. Mlada ◽

A. Kagstrom ◽

Z. Mohrova ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Anxiety Disorders ◽

Mental Disorder ◽

Suicide Risk ◽

Mental Health Problems ◽

Scale Up ◽

Mental Health Crisis ◽

Cross Sectional ◽

Health Crisis

Abstract Aims The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. Methods We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. Results The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). Conclusions This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.

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Impact of arthritis on the perceived need and use of mental healthcare among Canadians with mental disorders: nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041371 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041371

Author(s):

Alyssa Howren ◽

J Antonio Aviña-Zubieta ◽

Deborah Da Costa ◽

Joseph H Puyat ◽

Hui Xie ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Clinical Care ◽

Mental Healthcare ◽

Cluster Sampling ◽

Cross Sectional ◽

Perceived Need ◽

Mental Health Support ◽

Health Support

ObjectiveTo evaluate the association between having arthritis and the perceived need for mental healthcare and use of mental health support among individuals with mental disorders.DesignA cross-sectional analysis using data from Canadian Community Health Survey—Mental Health (2012).SettingThe survey was administered across Canada’s 10 provinces using multistage cluster sampling.ParticipantsThe study sample consisted of individuals reporting depression, anxiety or bipolar disorder.Study variables and analysisThe explanatory variable was self-reported doctor-diagnosed arthritis, and outcomes were perceived need for mental healthcare and use of mental health support. We computed overall and gender-stratified multivariable binomial logistic regression models adjusted for age, gender, race/ethnicity, income and geographical region.ResultsAmong 1774 individuals with a mental disorder in the study sample, 436 (20.4%) reported having arthritis. Arthritis was associated with increased odds of having a perceived need for mental healthcare (adjusted OR (aOR) 1.71, 95% CI 1.06 to 2.77). In the gender-stratified models, this association was increased among men (aOR 2.69, 95% CI 1.32 to 5.49) but not women (aOR 1.48, 95% CI 0.78 to 2.82). Evaluation of the association between arthritis and use of mental health support resulted in an aOR of 1.50 (95% CI 0.89 to 2.51). Individuals with arthritis tended to use medications and professional services as opposed to non-professional support.ConclusionComorbid arthritis among individuals with a mental disorder was associated with an increased perceived need for mental healthcare, especially in men, underscoring the importance of understanding the role of masculinity in health seeking. Assessing the mental health of patients with arthritis continues to be essential for clinical care.

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Tobacco smoking and mental disorders in Australian adolescents

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211009617 ◽

2021 ◽

pp. 000486742110096

Author(s):

David Lawrence ◽

Sarah E Johnson ◽

Francis Mitrou ◽

Sharon Lawn ◽

Michael Sawyer

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Tobacco Smoking ◽

Mental Health Problems ◽

Health Problems ◽

Major Depressive ◽

Current Smoking ◽

Self Harm ◽

Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

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Natural kinds of mental disorder

Synthese ◽

10.1007/s11229-021-03239-9 ◽

2021 ◽

Author(s):

Sander Werkhoven

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Natural Kinds ◽

Health Problems ◽

Abnormal Behaviour ◽

Diagnostic Categories ◽

Socially Constructed

AbstractAre mental disorders (autism, ADHD, schizophrenia) natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases.

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Economic burden of silent mental disorders: a case study of agnosia in schizophrenia

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175821 ◽

2017 ◽

Vol 5 (1) ◽

pp. 401

Author(s):

Vijay Kumar Chattu ◽

Paula Mahon

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Action Plan ◽

Developed Countries ◽

World Health ◽

Economic Output ◽

The World

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.

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Staff resilience and coping behavior as protective factors for mental health among construction tradesmen

Journal of Engineering Design and Technology ◽

10.1108/jedt-11-2020-0464 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Janet Mayowa Nwaogu ◽

Albert P.C. Chan ◽

Mershack Opoku Tetteh

Keyword(s):

Mental Health ◽

Suicide Ideation ◽

Survey Design ◽

Coping Behavior ◽

Cross Sectional Survey ◽

Coping With Stress ◽

Essential Point ◽

Cross Sectional ◽

Content Type ◽

And Coping

Purpose Construction tradesmen are exposed to high levels of stress that can worsen mental health, negatively impacting safety compliance and organization productivity. Hence, effectively coping with stress to prevent mental ill-health becomes an essential point of reference. Thus, this study aims to examine the role of factors such as resilience and coping strategies in protecting tradesmen against mental ill-health. Design/methodology/approach Using a cross-sectional survey design, 110 tradesmen from 65 construction companies were surveyed using the Patient Health Questionnaire, Generalized Anxiety Disorder, Brief Resilience Scale and Ways of Coping Questionnaire. Findings The results were analyzed using descriptive statistics and logistic regression analysis. With a 74.5%, 36.4% and 14.6% prevalence rate of self-reported depression, anxiety and suicide ideation among the tradesmen, only positive reappraisal, accepting responsibility coping behaviors and resilience would mitigate the likelihood of developing mental ill-health symptoms. Originality/value This study has extended existing literature by providing information vital to building interventions to deal with stressors effectively. This information would benefit individuals, organizations and the economy and equip policymakers with a deeper knowledge base toward improving mental health.

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The scale of the problem

Psychiatry ◽

10.1093/oso/9780198754008.003.0006 ◽

2019 ◽

Author(s):

Rebecca McKnight ◽

Jonathan Price ◽

John Geddes

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Clinical Medicine ◽

Well Being ◽

World Health ◽

The Social ◽

Definition Of ◽

Health Organization

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting criteria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental disorder on yourself or your family are greater still. It is often difficult for the general public and clinicians outside psychiatry to think of mental health disorders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For example, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ulcers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined as a state of well- being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.

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A repeated cross-sectional survey assessing university students' stress, depression, anxiety, and suicidality in the early stages of the COVID-19 pandemic in Poland

Psychological Medicine ◽

10.1017/s003329172000392x ◽

2020 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Agata Debowska ◽

Beata Horeczy ◽

Daniel Boduszek ◽

Dariusz Dolinski

Keyword(s):

Mental Health ◽

University Students ◽

Adult Students ◽

Mental Health Problems ◽

Health Problems ◽

Medical Psychology ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Early Stages ◽

Increased Risk

Abstract Background The time of widespread outbreaks of infectious diseases can lead to elevated stress and mental health problems among all persons affected, and in particular those sub-groups of the population that are at an increased risk of mental health problems. One such vulnerable group constitutes university students. The aim of this study is to assess stress, depression, anxiety, and suicidality among different groups of university students (medical, psychology, and other). Methods Using a repeated cross-sectional study design, we collected survey data among a large sample of 7228 university students from Poland (mean age = 22.78, s.d. = 4.40; 81% female). Data were collected in five waves, during the first 2 months of the COVID-19 pandemic in Europe (March and April 2020). Results The results demonstrate a significant increase in depression levels as the pandemic was progressing. We also found that female students scored significantly higher than male students on depression, anxiety, and stress. Psychology students recorded the lowest scores on depression and anxiety. Young adult students (aged 18–24 years) had more symptoms of depression, anxiety, and suicidality than adult students (⩾25 years). Conclusions These results provide insights into stress and mental health among university students during the early stages of the COVID-19 pandemic. Findings can be used for a more effective identification of students who may struggle during next stages of the pandemic and future crises.

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Depression and experience of incarceration in North Central Nigeria: a situation analysis at Makurdi medium security prison

International Journal of Mental Health Systems ◽

10.1186/s13033-020-00408-0 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Emeka Nwefoh ◽

Chinyere M. Aguocha ◽

Grace Ryan ◽

Philip Ode ◽

Festus O. Ighagbon ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorder ◽

Well Being ◽

Prison Inmates ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health And Social Care ◽

Medium Security

Abstract Background Human rights watchdogs have described conditions in Nigerian correctional facilities and detention centers as damaging to the physical and mental health of inmates. While the prevalence of mental disorders is high, access to appropriate healthcare is grossly inadequate. Understanding the current state of prison inmates’ mental health and well-being is an essential first step to addressing this important issue. This study aims to document the mental health and experiences of incarceration of inmates of the largest medium security prison in Nigeria’s Benue State. Methods A cross-sectional survey and descriptive analysis was carried out with a random sample of 381 prison inmates of Benue State Makurdi Medium Security Prison. Survey tools included: (1) a structured questionnaire on participants’ experiences in prison, and (2) the Patient Health Questionnaire (PHQ-9), a screening tool for depression. Results Most participants were young men (95.5%, mean age 27.95) and had completed secondary school (63.5%). While prison authorities had identified only 27 participants as having a mental disorder, 144 (37.8%) screened positive for depression. Twenty six had received professional counseling while in prison. Of the six participants who were already taking a psychotropic medication at the time of imprisonment, four received medication after being imprisoned. Approximately half, (52%) of participants were dissatisfied with prison health care. Conclusions Despite the high prevalence of depression among prison inmates, few cases are detected and treated. Prison staff may not recognize depression as a mental disorder, and the mental health care available is generally poor. Inadequate mental health and social care not only affects prison inmates’ well-being, but may also impact recidivism and health outcomes upon release. Prison inmates should be screened routinely for depression and other less-commonly recognized mental health conditions, and appropriate treatment made available.

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