Healthcare utilization, psychiatric medication and risk of rehospitalization in suicide-attempting patients with common mental disorders

2019 ◽  
Vol 54 (4) ◽  
pp. 409-422
Author(s):  
Thomas Niederkrotenthaler ◽  
Ellenor Mittendorfer-Rutz ◽  
Stefan Thurner ◽  
Gottfried Endel ◽  
Peter Klimek
Keyword(s):  
Confidence Interval ◽  
Suicide Attempt ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Mean Difference ◽  
Psychiatric Medication ◽  
Lower Contact ◽  
Mental Disorder Diagnosis ◽  
Observation Period

Objective: Common mental disorders are strong risk factors for suicide attempt. We compared common mental disorder patients with and without suicide attempt regarding health care utilization and psychiatric medication, assessed gender differences and identified how psychotropic medication of attempters is associated with subsequent rehospitalization. Methods: We used administrative claims data of 22,276 common mental disorder patients with inpatient care in Lower Austria between 1 January 2006 and 31 December 2011. Suicide attempters (cases, n = 615) and non-attempters (controls, n = 21,661) were compared regarding specific healthcare utilization by calculating mean differences of time-dependent contact probabilities and psychiatric medication (i.e. prescribed defined daily doses) ± 0.5 years around their suicide attempt (cases)/common mental disorder diagnosis (controls). Cluster analysis was used to group suicide attempters according to their psychiatric medication. The risk of rehospitalization 0.5–3 years after the attempt was calculated with regression analysis controlling for sex, age and morbidity-related factors. Results: Contacts with general practitioners were lower for attempters than non-attempters (mean difference of contact probabilities over observation period, males = −0.05, 95% confidence interval = [−0.07, −0.03]; females: mean difference = −0.04, 95% confidence interval = [−0.05, −0.03]). Regarding psychiatrists, female attempters had markedly higher contact probabilities after the attempt compared to female non-attempters (mean difference = 0.02, 95% confidence interval = [0.007, 0.04]); male attempters had lower contact probabilities before the attempt compared to male non-attempters (mean difference = −0.01, 95% confidence interval = [−0.004, −0.02]). Attempters had higher dosages of psychiatric medication across the entire period. Antidepressant and antipsychotic medication peaked at the time of common mental disorder diagnosis/attempt. Benzodiazepine prescriptions were considerably higher for male attempters than their female counterparts and were constantly elevated for male attempters across the observation period. A cluster of attempters with long-term benzodiazepine prescriptions had an increased risk of rehospitalization (adjusted odds ratio = 2.4, 95% confidence interval = [1.1, 5.5]). Conclusion: Despite lower contact probabilities, common mental disorder patients with suicide attempt are prescribed more psychiatric medication, particularly benzodiazepines, with an elevated risk of rehospitalization. Strong sex differences were found.

Mortality in persons with disability pension due to common mental disorders: A cohort study of Swedish construction workers

2019 ◽  
Vol 48 (8) ◽  
pp. 832-838
Author(s):  
Mia Söderberg ◽  
Linus Schiöler ◽  
Mikael Stattin ◽  
Alex Burdorf ◽  
Bengt Järvholm
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Mental Disorder ◽  
Psychiatric Diagnosis ◽  
Disability Pension ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Construction Workers ◽  
Relative Risks

Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971–1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3–3.9) and women (relative risk 2.1; 95% confidence interval 1.6–2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2–2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75–89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1–3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8–3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a ‘lighter’ psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.

scholarly journals Implementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044959
Author(s):  
Christine Sandheimer ◽  
Cecilia Björkelund ◽  
Gunnel Hensing ◽  
Kirsten Mehlig ◽  
Tove Hedenrud
Keyword(s):  
Primary Care ◽  
Treatment Guidelines ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Antidepressant Medication ◽  
Linear Mixed Effects ◽  
Care Manager ◽  
Defined Daily Doses ◽  
Number Of Patients ◽  
Mental Disorder Diagnosis

ObjectiveTo evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines.DesignRegister-based study on PCC level.SettingPrimary care in Region Västra Götaland, Sweden.ParticipantsAll PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42).Outcome measuresProportion of inadequate medication users, defined as number of patients >18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1–179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model.ResultsOverall, all PCCs had about 30%–34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (−6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01).ConclusionsPublic PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.

scholarly journals Associations between common mental disorders and the Mental Illness Needs Index in community settings

2007 ◽  
Vol 191 (2) ◽  
pp. 158-163 ◽  
Author(s):  
David L. Fone ◽  
Frank Dunstan ◽  
Ann John ◽  
Keith Lloyd
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Small Area ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Service Planning ◽  
Individual Risk ◽  
Community Settings

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.

Prevalence and determinants of Common Mental Disorder among pregnant women In Debre Berhan town: Highland in Central Ethiopia

2020 ◽  
Author(s):  
Kefyalew Dagne Gizachew ◽  
Gashaw Andargie Biks ◽  
Abate Dargie Wubetu
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Pregnant Women ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Significant Risk ◽  
Medical Illness ◽  
Debre Berhan ◽  
Self Reporting Questionnaire

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.

scholarly journals Prevalence of Common Mental Disorder and Its Association with Khat Chewing among Ethiopian College Students: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Birhanie Mekuriaw ◽  
Abriham Zegeye ◽  
Alemayehu Molla ◽  
Robel Hussen ◽  
Solomon Yimer ◽  
...  
Keyword(s):  
University Students ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Data Extraction ◽  
Meta Analysis ◽  
Test Statistics ◽  
Analysis Model ◽  
Khat Chewing ◽  
Pooled Prevalence

Background. Mental disorder is a global burden that affects all groups of people. Young people, particularly college/university students, are more vulnerable to common mental disorders than the general population. Thus, students may use khat to gain immediate relief from their psychological distress which may worsen again after longer time of chewing. In Ethiopia, there are studies showing discrepant and inconsistent results of common mental disorder among college/university students. Therefore, this review sought to determine the prevalence of common mental disorder and its association with khat chewing among Ethiopian college/university students. Methods. Different kinds of literature were searched from the databases of Google Scholar, PubMed/Medline, ScienceDirect, and PsycINFO. A total of 10 primary studies which report the prevalence of common mental disorder among Ethiopian college/university students were included in the review. The data were extracted using a standardized data extraction format prepared in Microsoft Excel. STATA version 14 statistical software was used for analysis. Cochran’s Q test statistics and I2 test were used to assess heterogeneity. A random effects meta-analysis model was used to estimate the pooled prevalence of common mental disorder due to the variability of the studies. Lastly, the association between common mental disorder and khat chewing was conducted. Results. The pooled prevalence of common mental disorder among Ethiopian college/university students was 37.73% (95% CI: 30.43, 45.03). The subgroup analysis showed the highest [51.9% (95% CI: 30.19, 73.70)] and lowest [33.28% (95% CI: 19.95, 46.60)] prevalences of common mental disorder among Ethiopian college/university students found in Amhara and South Nation Nationality and People regions, respectively. The pooled effect (odds ratio) of khat chewing on common mental disorder was 2.01 (95% CI: 1.38, 2.95). Conclusions. In our review, it is found that more than one-third of college/university students suffered from common mental disorder. Khat chewers were found to be twofolds more vulnerable to develop common mental disorder than nonchewers.

Poverty, psychological disorder and disability in primary care attenders in Goa, India

1998 ◽  
Vol 172 (6) ◽  
pp. 533-536 ◽  
Author(s):  
Vikram Patel ◽  
Jerson Pereira ◽  
Livia Countinho ◽  
Romaldina Fernandes ◽  
John Fernandes ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Low Income ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Female Gender ◽  
Psychological Disorder ◽  
Low Income Countries ◽  
Health Clinic ◽  
Primary Health

BackgroundThis study examined the association of common mental disorders in primary health clinic attenders with indicators of poverty and disability in Goa, India.MethodAdult attenders (n=303) in two primary health clinics were recruited.ResultsThere were 141 (46.5%) cases of common mental disorder. The following were associated with common mental disorder: female gender; inability to buy food due to lack of money; and being in debt. Cases scored significantly higher on all measures of disability. Primary health clinic staff recognised a third of the morbidity but used multiple oral drugs, injectable vitamins and benzodiazepines to treat common mental disorders.ConclusionsPoverty is closely associated with common mental disorder which in turn is associated with deprivation and despair. Primary mental health care priorities in low-income countries need to shift from psychotic disorders which often need specialist care to common mental disorders. Health policy and development agencies need to acknowledge the intimate association of female gender and poverty with these disorders.

scholarly journals Gender differences in mental health expectancies in early- and midlife in six European countries

2013 ◽  
Vol 202 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Traolach S. Brugha ◽  
Ruth Matthews ◽  
Jordi Alonso ◽  
Gemma Vilagut ◽  
Tony Fouweather ◽  
...  
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Mental Disorders ◽  
Life Expectancy ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Mortality Data ◽  
Male Population ◽  
Female Population

BackgroundHealth expectancies, taking into account both quality and quantity of life, have generally been based on disability and physical functioning.AimsTo compare mental health expectancies at age 25 and 55 based on common mental disorders both across countries and between males and females.MethodMental health expectancies were calculated by combining mortality data from population life tables and the age-specific prevalence of selected common mental disorders obtained from the European Study of the Epidemiology of Mental Disorders (ESEMeD).ResultsFor the male population aged 25 (all countries combined) life expectancy was 52 years and life expectancy spent with a common mental disorder was 1.8 years (95% CI 0.7-2.9),3.4% of overall life expectancy. In comparison, for the female population life expectancy at age 25 was higher (57.9 years) as was life expectancy spent with a common mental disorder (5.1 years, 95% CI 3.6-6.6) and as a proportion of overall life expectancy, 8.8%. By age 55 life expectancy spent with a common mental disorder had reduced to 0.7 years (males) and 2.3 years (females).ConclusionsAge and gender differences underpin our understanding of years spent with common mental disorders in adulthood. Greater age does not mean living relatively more years with common mental disorder. However, the female population spends more years with common mental disorders and a greater proportion of their longer life expectancy with them (and with each studied separate mental disorder).

scholarly journals Risk factors for common mental disorders in women

2006 ◽  
Vol 189 (6) ◽  
pp. 547-555 ◽  
Author(s):  
Vikram Patel ◽  
Betty R. Kirkwood ◽  
Sulochana Pednekar ◽  
Helen Weiss ◽  
David Mabey
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Low Income ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Psychological Symptom ◽  
Population Based ◽  
Physical Illness ◽  
Chronic Physical Illness ◽  
Incident Cases

BackgroundThe determinants of common mental disorders in women have not been described in longitudinal studies from a low-income country.MethodPopulation-based cohort study of 2494 women aged 18 to 50 years, in India. The Revised Clinical Interview Schedule was used for the detection of common mental disorders.ResultsThere were 39 incident cases of common mental disorder in 2166 participants eligible for analysis (12-month rate 1.8%, 95% CI 1.3–2.4%). The following baseline factors were independently associated with the risk for common mental disorder: poverty (low income and having difficulty making ends meet); being married as compared with being single; use of tobacco; experiencing abnormal vaginal discharge; reporting a chronic physical illness; and having higher psychological symptom scores at baseline.ConclusionsProgrammes to reduce the burden of common mental disorder in women should target poorer women, women with chronic physical illness and who have gynaecological symptoms, and women who use tobacco.

scholarly journals Common mental disorders and its determinants among epileptic patients at an outpatient epileptic clinic in Felegehiwot Referral Hospital, Bahirdar, Ethiopia: cross-sectional study

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Mengesha Birkie Wubie ◽  
Mogesie Necho Alebachew ◽  
Asmare Belete Yigzaw
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Medical Illness ◽  
Cross Sectional ◽  
Epileptic Patients

Abstract Background Epilepsy is a chronic neurological condition that is highly predisposed to a variety of mental health problems due to its huge biological, social and psychological burdens. Despite this, there is a paucity of research in this area. Therefore, assessing common mental disorders and its determinants among epileptic patients would be of great importance. Objective This study was aimed to asses prevalence and associated factors of common mental disorders among people with epilepsy attending Felegehiwot Referral Hospital, Bahirdar, Ethiopia, 2019. Methods Institutional based analytic cross-sectional study design was utilized from January to February 2019 at Felegehiwot Referral Hospital among 422 epileptic patients who were diagnosed clinically and on follow up treatment. Systematic random sampling was applied to recruit participants. Interviewer based and pretested Self Reporting Questionnaire‐20 was used to screen common mental illness with a cut-off point 7 and above as having a common mental disorder. Bivariate and multivariable logistic regression analysis with 95% CI were computed and variables with p < 0.05 in the final model were considered as associated factors for common mental disorders. Result Four hundred twenty-two patients with epilepsy were included in our study with a response rate of 100% and 64.5% were males. The mean age of participants was 59 ± 13.37 years. Common mental disorder among epileptic patients was found to be 35.8%. There was a statistically significant association between marital status, comorbid medical illness, nicotine dependence, alcohol misuse, and medication non-adherence with common mental disorders at p < 0.05. Conclusion The prevalence of common mental distress was high (35.8%) suggesting that it is a public health issue. Marital status, comorbid medical illness, nicotine dependence, alcohol misuse, and medication non-adherence were the factors having an association with a common mental disorder. Therefore, early screening and recognition of mental distress symptoms should be a routine activity while managing epileptic patients.

scholarly journals Common mental disorders among patients attending monk healers and primary health care centres in Thailand: a cross-sectional study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Somatization Disorder ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Health Centres

Abstract Background This study aimed to assess the rate of common mental disorders in patients consulting monk healers or health centres in Thailand. Methods Patients consecutively consulting monk healers or health centres were assessed with screening measures of three common mental disorders (major depressive, general anxiety and somatization disorder). Results The prevalence of any common mental disorder was significantly higher in patients attending monk healers (31.1%) than those attending primary care health centres (22.3%) (P < 0.001). Likewise, the prevalence of each common mental disorder was significantly higher in clients attending monk healers (major depressive disorder 21.0%, generalized anxiety disorder 8.1%, and somatization disorder 19.0%) than in patients attending health centres (major depressive disorder 15.8%, generalized anxiety disorder 3.5%, and somatization disorder 12.5%). In adjusted logistic regression analysis among patients of monk healers, female sex, being single, divorced, separated or widowed, and low social support were associated with any common mental disorder. Among patients of a health centre, lower education, not employed, high debt status and low social support were associated with any common mental disorder. Conclusion The study found a higher prevalence of common mental disorders in patients consulting monk healers than primary care centre attendees, calling for integrated management of common mental disorders.

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