scholarly journals Factors associated with non-initiation of mental healthcare after detection of poor mental health at a scheduled health check: a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037731
Author(s):  
Christine Geyti ◽  
Kaj Sparle Christensen ◽  
Else-Marie Dalsgaard ◽  
Bodil Hammer Bech ◽  
Jane Gunn ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Short Form ◽  
Mental Component Summary Score ◽  
Mental Healthcare ◽  
Poor Mental Health ◽  
Health Check ◽  
Health Concern ◽  
Factors Associated

IntroductionPoor mental health is an important public health concern, but mental health problems are often under-recognised. Providing feedback to general practitioners (GPs) on their patients’ mental health status may improve the identification of cases in need of mental healthcare.ObjectivesTo investigate the extent of initiation of mental healthcare after identification of poor mental health and to identify factors associated with non-initiation.DesignProspective cohort study with 1-year follow-up.SettingIn a population-based health preventive programme, Check Your Health, we conducted a combined mental and physical health check in Randers Municipality, Denmark, in 2012–2015 in collaboration with local GPs.ParticipantsParticipants were 350 individuals aged 30–49 years old with screen-detected poor mental health who had not received mental healthcare within the past year. The cohort was derived from 14 167 randomly selected individuals of whom 52% (n=7348) participated. Mental health was assessed by the mental component summary score of the 12-item Short-Form Health Survey.OutcomeThe outcome was initiation of mental healthcare. Mental healthcare included psychometric testing by GP, talk therapy by GP, contact with a psychologist, contact with a psychiatrist and psychotropic medication.ResultsWithin 1 year, 22% (95% CI 18 to 27) of individuals with screen-detected poor mental health initiated mental healthcare. Among individuals who initiated mental healthcare within follow-up, one in six had visited their GP once or less in the preceding year. Male sex (OR: 0.49 (95% CI 0.28 to 0.86)) and less impaired mental health (OR: 0.93 (95% CI 0.89 to 0.98)) were associated with non-initiation of mental healthcare. We found no overall association between socioeconomic factors and initiating mental healthcare.ConclusionSystematic provision of mental health test results to GPs may improve the identification of cases in need of mental healthcare, but does not translate into initiation of mental healthcare. Further research should focus on methods to improve initiation of mental healthcare, especially among men.Trial registration numberNCT02028195.

scholarly journals Chronic pain and mental health problems among Syrian refugees: associations, predictors and use of medication over time: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046454
Author(s):  
Elisabeth Marie Strømme ◽  
Jannicke Igland ◽  
Jasmin Haj-Younes ◽  
Bernadette Nirmal Kumar ◽  
Lars T Fadnes ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Cohort Study ◽  
Pharmacological Treatment ◽  
Prospective Cohort ◽  
Mental Health Problems ◽  
Health Problems ◽  
Poor Mental Health ◽  
Syrian Refugees

ObjectivesThis study aims to examine associations, predictors and pharmacological treatment of chronic pain and mental health problems among Syrian refugees in a longitudinal perspective.DesignProspective cohort study.SettingWe collected survey data among Syrian refugees in Lebanon granted resettlement to Norway (self-administered questionnaires) and at follow-up 1 year after arrival in Norway (structured telephone interviews).ParticipantsAdult Syrian refugees attending mandatory pretravel courses in Lebanon in 2017–2018 were invited to participate. In total, 353 individuals participated at both time points.Primary and secondary outcomesWe examined the cross-sectional associations between pain, mental health and migration-related exposures at baseline and follow-up and assessed whether associations changed significantly with time. Furthermore, we investigated the longitudinal association between mental health at baseline and pain at follow-up. We also evaluated temporal changes in use of analgesics and psychotropic drugs.ResultsWhile most refugees reported improved health from the transit phase in Lebanon to the early resettlement phase in Norway, a few had persisting and intertwined health problems. Most migration-related stressors were more closely associated with chronic pain and mental health problems after resettlement as compared with the transit phase. In parallel, poor mental health was associated with chronic pain in the follow-up (adjusted risk ratio (ARR) 1.5 (1.0, 2.2)), but not at baseline (ARR 1.1 (0.8, 1.5)). Poor mental health at baseline was a statistically significant predictor of chronic pain at follow-up among those not reporting chronic pain at baseline. At both timepoints, one in four of those with chronic pain used analgesics regularly. None with mental health problems used antidepressants daily.ConclusionsProviders of healthcare services to refugees should be attentive to the adverse effect of postmigration stressors and acknowledge the interrelations between pain and mental health. Possible gaps in pharmacological treatment of pain and mental health problems need further clarification.

scholarly journals Factors associated with impaired physical functioning and mental health in working-age patients attending a post–intensive care follow-up clinic three months after hospital discharge

2019 ◽  
Vol 47 (2) ◽  
pp. 160-168
Author(s):  
Miikka Niittyvuopio ◽  
Janne H Liisanantti ◽  
Jaana Pikkupeura ◽  
Michael B Spalding ◽  
Sinikka Sälkiö ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Critical Illness ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Physical Functioning ◽  
Poor Mental Health ◽  
Factors Associated ◽  
Poor Physical Functioning

Patients recovering from critical illness are often suffering from remarkable limitations in their everyday life. The purpose of this study was to find factors associated with poor physical functioning and mental health after critical illness. The study was conducted among patients who met the inclusion criteria of our post–intensive care unit follow-up clinic. The patients were invited to the follow-up clinic three months after hospital discharge. The participants filled out a RAND-36 questionnaire, underwent a clinical examination and were stratified to those with good or poor recovery according to physical functioning and emotional wellbeing. Altogether 332 out of 351 follow-up clinic attendees had data available for analysis. In physical functioning 40% of patients achieved a poor outcome. In mental health the percentage was 8%. The patients with poor physical functioning had a longer hospital stay and were more likely to have received vasopressors. Eleven out of 16 (69%) multitrauma patients had poor physical functioning. Patients with poor physical functioning had more memories of pain, achieved worse results in a six-minute walk test and were less likely to be able to move independently. The patients with poor mental health had higher delirium incidence and fewer memories of relatives’ visits and of nurses. The conclusions of this study were that the memories of pain, multitrauma and longer hospital stay were associated with a poor physical functioning outcome. Delirium and a lack of memories of relatives and nurses were associated with a poor mental health outcome.

scholarly journals Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study

2008 ◽  
Vol 2 (2) ◽  
pp. 77-86 ◽  
Author(s):  
David Abramson ◽  
Tasha Stehling-Ariza ◽  
Richard Garfield ◽  
Irwin Redlener
Keyword(s):  
Mental Health ◽  
Hurricane Katrina ◽  
Gulf Coast ◽  
Short Form ◽  
Mental Component Summary Score ◽  
Health Study ◽  
Health Distress ◽  
Mental Health Distress

ABSTRACTBackground: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting.Methods: A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted: a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability.Results: More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health.Conclusions: Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes Katrina and Rita. As time progresses postdisaster, social and psychological factors may play greater roles in accelerating or impeding recovery among affected populations. Efforts to expand disaster recovery and preparedness policies to include long-term social re-engagement efforts postdisaster should be considered as a means of reducing mental health sequelae. (Disaster Med Public Health Preparedness. 2008;2:77–86)

scholarly journals Parental mental health and risk of poor mental health and death by suicide in offspring

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Aideen Maguire ◽  
Foteini Tseliou ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Poor Mental Health ◽  
Health Concern ◽  
Parental Mental Health ◽  
Risk Of Death ◽  
Increased Risk ◽  
Child Suicide ◽  
Multi Level

BackgroundSuicide is a major public health concern. Identifying those most at risk is vital for effective targeting of interventions. Mental health (MH) has a genetic component and parental MH is associated with child’s MH. However, little is known onthe effect of parental MH on a child’s risk of death by suicide. MethodsData from 2011 Northern Ireland Census was linked to 5 years’ death records (2011-2015) to construct multi-level regression models to determine if children living with parents with poor self-rated MH are at an increased risk of poor MH themselves and an increased risk of death by suicide. Results618,970 individuals live with their parents; with almost 1 in 7 (13.7%) living with parents with poor MH and 225 (0.1%) dying by suicide during follow-up. Interim results suggest after full adjustment, children with 2 parents with poor MH were5 times more likely to have poor MH themselves (OR=5.30, 95% CI 4.62,6.09), and children with 1 parent with poor MH were 67% more likely to die by suicide compared to children of parents with good MH (OR=1.67, 95%CI 1.19, 2.33). ConclusionsParental MH is associated with child suicide risk even after adjustment for their own MH status.

scholarly journals Prognostic factors for the improvement of pain and disability following multidisciplinary rehabilitation in patients with chronic neck pain

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Martin Weigl ◽  
Josefine Letzel ◽  
Felix Angst
Keyword(s):  
Mental Health ◽  
Prognostic Factors ◽  
Neck Pain ◽  
Short Form ◽  
Psychosocial Rehabilitation ◽  
Chronic Neck Pain ◽  
Rehabilitation Programme ◽  
Factors Associated ◽  
Pain Disability

Abstract Background Recent clinical studies have demonstrated the effectiveness of specific, multidisciplinary, bio-psychosocial, rehabilitation programmes for chronic neck pain. However, prognostic factors for the improvement of pain and disability are mostly unknown. Therefore, the aim of this study was to explore prognostic factors associated with improvements in chronic neck pain following participation in a three-week, multidisciplinary, bio-psychosocial, rehabilitation programme. Methods In this observational, prospective cohort study, a total of 112 patients were assessed at the beginning, end, and 6 months following the completion of a multidisciplinary, bio-psychosocial, rehabilitation programme. Inclusion for participation in the rehabilitation programme depended upon an interdisciplinary pain assessment. The primary outcome was neck pain and disability, which was measured using the Northern American Spine Society questionnaire for pain+disability and was quantified with effect sizes (ES). Multivariable linear regression analyses were used to explore potential prognostic factors associated with improvements in pain and disability scores at discharge and at the 6-month follow-up period. Results The mean age of the patients was 59.7 years (standard deviation = 10.8), and 70.5% were female. Patients showed improvement in pain+disability at discharge (ES = 0.56; p < 0.001), which was sustained at the 6-month follow-up (ES = 0.56; p < 0.001). Prognostic factors associated with improvement in pain+disability scores at discharge included poor pain+disability baseline scores (partial, adjusted correlation r = 0.414, p < 0.001), older age (r = 0.223, p = 0.024), a good baseline cervical active range-of-motion (ROM) (r = 0.210, p < 0.033), and improvements in the Short-form 36 mental health scale (r = 0.197; p = 0.047) and cervical ROMs (r = 0.195, p = 0.048) from baseline values. Prognostic factors associated with improvements in pain+disability at the 6-month follow-up were similar and included poor pain+disability baseline scores (partial, adjusted correlation r = 0.364, p < 0.001), improvements in the Short-form 36 mental health scale (r = 0.232; p = 0.002), cervical ROMs (r = 0.247, p = 0.011), and better cervical ROM baseline scores. However, older age was not a factor (r = 0.134, p = 0.172). Conclusions Future prognostic models for treatment outcomes in chronic neck pain patients should consider cervical ROM and mental health status. Knowledge of prognostic factors may help in the adoption of individualized treatment for patients who are less likely to respond to multidisciplinary rehabilitation.

scholarly journals Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Real World ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Healthcare Services ◽  
International Consultation ◽  
The Mean

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

scholarly journals Emotional and Cognitive Empathy in Caregivers of People With Neurodegenerative Disease: Relationships With Caregiver Mental Health

2021 ◽  
pp. 216770262097436
Author(s):  
Alice Y. Hua ◽  
Jenna L. Wells ◽  
Casey L. Brown ◽  
Robert W. Levenson
Keyword(s):  
Mental Health ◽  
Neurodegenerative Disease ◽  
Mental Health Problems ◽  
Emotional Responses ◽  
Cognitive Empathy ◽  
Poor Mental Health ◽  
Risk Indicators ◽  
Health Concern ◽  
Emotional Empathy ◽  
People With Dementia

Caregiving for a person with dementia or neurodegenerative disease is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. In the present study, we assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person and providing continuous ratings of the valence of another person’s changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of people with dementia or neurodegenerative disease. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.

scholarly journals Prognosis and Course of Disability in Patients With Chronic Nonspecific Low Back Pain: A 5- and 12-Month Follow-up Cohort Study

2013 ◽  
Vol 93 (12) ◽  
pp. 1603-1614 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Martijn W. Heymans ◽  
Inge Ronchetti ◽  
Annelies L. Pool-Goudzwaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Short Form ◽  
Low Back ◽  
Multidisciplinary Therapy ◽  
Patient Reported ◽  
Specific Disability

Background Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain (CNSLBP). Objective The purpose of this study was to describe the course of disability and identify clinically important prognostic factors of low-back-pain–specific disability in patients with CNSLBP receiving multidisciplinary therapy. Design A prospective cohort study was conducted. Methods A total of 1,760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course of disability and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups. Recovery was defined as 30% reduction in low back pain–specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis. Results Mean patient-reported disability scores on the QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2), and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a shorter duration of complaints was a positive predictor, and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up. Limitations Missing values at 5- and 12-month follow-ups were 11.1% and 45.2%, respectively. Conclusion After multidisciplinary treatment, the course of disability in patients with CNSLBP continued to decline over a 12-month period. At 5- and 12-month follow-ups, prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.

scholarly journals Pathways to Mental Health–Related Treatment Among Caregiving Spouses

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 358-358
Author(s):  
Hyojin Choi ◽  
Kristin Litzelman ◽  
Molly Maher ◽  
Autumn Harnish
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Healthcare ◽  
Health Condition ◽  
Future Research ◽  
Provider Type ◽  
Hospital Emergency Room ◽  
Health Related ◽  
Nationally Representative

Abstract Spouses of cancer survivors are 33% less likely to receive guideline-concordant depression treatment than other married adults. However, depression is only one of many manifestations of psychological distress for caregivers. This exploratory study sought to assess the paths by which caregivers access mental health-related treatment. Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based versus outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other). In addition, we assessed the health condition(s) associated with the treatment. The findings indicate that a plurality of caregivers accessed mental health-related treatment through an office-based visit (90%) with a primary care provider (47%). A minority accessed this care through a psychologist or psychiatrist (11%) or a physician with another specialty (12%) or other provider types. Nearly a third accessed treatment as part of a regular check-up (32%). These patterns did not differ from the general population after controlling for sociodemographic characteristics. Interestingly, mental health-related treatments were associated with a mental health diagnosis in only a minority of caregivers. The findings confirm the importance of regular primary care as a door way to mental healthcare, and highlight the range of potential paths to care. Future research will examine the correlates of accessing care across path types.

scholarly journals How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fatemeh Nouri ◽  
Awat Feizi ◽  
Hamidreza Roohafza ◽  
Masoumeh Sadeghi ◽  
Nizal Sarrafzadegan
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cohort Study ◽  
Physical Health ◽  
Social Relationships ◽  
Rural Areas ◽  
Clinical Symptoms ◽  
Short Form ◽  
Environmental Condition

Abstract Background and objectives A short form of the General Health Questionnaire (GHQ-12) is a useful screening instrument for assessing mental health. Furthermore, Quality of life (QoL) is a critical treatment outcome in many clinical and health care research settings. This study aimed to reassess the dimensionality of GHQ-12 using Multidimensional Graded Response Model (MGRM) and evaluate how its extracted dimensions are associated with the QoL's domains. Methods Isfahan Cohort Study 2 (ICS2) is a population-based, ongoing prospective cohort study among adults aged 35 years and older who were free of cardiovascular diseases (CVDs) at the beginning of the study in 2013. A total of 1316 participants, all living in urban and rural areas of Isfahan and Najafabad, Iran was completed the GHQ-12 and WHO QoL-brief version at baseline. Five competing MGRMs with different latent structures were specified for GHQ-12. Factor scores derived from the best fitted model were used to associate with various domains of QoL. Results: The Three-Dimensional model for GHQ-12 was the best-fitted model explaining the Social Function (SF), Self Confidence (SC), and Anxiety/Depression (A/D) as three correlated yet different latent dimensions of mental health. Our findings in full adjusted multivariate regression models showed that a one-SD increase in dimensions of SC and SF was associated with a 38- to 48%-SD and 27- to 38%-SD increase in the domains scores of QoL, respectively. Moreover, for each one‐SD increase in score of A/D dimension, the domains scores of QoL decreased by 29- to 40%-SD. The highest to the lowest standardized coefficients for all latent dimensions of mental health were respectively related to the psychological, physical health, social relationships, and environmental condition domains of QoL. Furthermore, SC, A/D, and SF dimensions of GHQ-12 showed the highest to the lowest degree of association with all domains of QoL. Conclusions Our findings confirm that the GHQ-12 as a multidimensional rather than unitary instrument measures distinct dimensions of mental health. Furthermore, all aspects of QoL changed when the intensity of latent dimensions of mental health increased. Moreover, the psychological domain of QoL is the most affected by all latent dimensions of mental health, followed by physical health, social relationships, and environmental condition domains. It seems that in an attempt to full recovery as assessed by improved QoL outcomes, treatment of clinical symptoms may not be sufficient. Identifying and differentiating the structures of mental health in each community as well as implementing intervention programs aimed at focusing on specific dimensions may help in the prevention of further deterioration of mental health and improved QoL in the community.

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