scholarly journals Prevalence of Mental Disorders and Suicidality in Canadian Provinces

2019 ◽  
Vol 64 (11) ◽  
pp. 761-769
Author(s):  
Joshua Palay ◽  
Tamara L. Taillieu ◽  
Tracie O. Afifi ◽  
Sarah Turner ◽  
James M. Bolton ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Service Providers ◽  
The Past ◽  
Canadian Provinces

Objective: There is limited information to guide health-care service providers and policy makers on the burden of mental disorders and addictions across the Canadian provinces. This study compares interprovincial prevalence of major depressive disorder (MDD), bipolar disorder, generalized anxiety disorder (GAD), alcohol use disorder, substance use disorders, and suicidality. Method: Data were extracted from the 2012 Canadian Community Health Survey—Mental Health ( n = 25,113), a representative sample of Canadians over the age of 15 years across all provinces. Cross tabulations and logistic regression were used to determine the prevalence and odds of the above disorders for each province. Adjustments for provincial sociodemographic factors were performed. Results: The past-year prevalence of all measured mental disorders and suicidality, excluding GAD, demonstrated significant interprovincial differences. Manitoba exhibited the highest prevalence of any mental disorder (13.6%), reflecting high prevalence of MDD and alcohol use disorder compared to the other provinces (7.0% and 3.8%, respectively). Nova Scotia exhibited the highest prevalence of substance use disorders (2.9%). Quebec and Prince Edward Island exhibited the lowest prevalence of any mental disorder (8.5% and 7.7%, respectively). Manitoba also exhibited the highest prevalence of suicidal ideation (5.1%); however, British Columbia and Ontario exhibited the highest prevalence of suicidal planning (1.4% and 1.3%, respectively), and Ontario alone exhibited the highest prevalence of suicide attempts (0.7%). Conclusions: Significant interprovincial differences were found in the past-year prevalence of mental disorders and suicidality in Canada. More research is necessary to explore these differences and how they impact the need for mental health services.

scholarly journals Smoking among inpatients in treatment for substance use disorders: prevalence and effect on mental health and quality of life

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lars Lien ◽  
Ingeborg Bolstad ◽  
Jørgen G. Bramness
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Mental Distress ◽  
Drop Out

Abstract Background Smoking is still prevalent among people with substance use disorders. The objective of this study was to investigate the prevalence of smoking among patients in treatment for substance use disorders and to analyze the effect of smoking both at baseline and follow-up on drop-out, mental health and quality of life. Methods One hundred and twenty-eight inpatients (26% female), mainly with alcohol use disorder, staying at three different rehabilitation clinics in Eastern Norway, were interviewed at admission, and at 6 weeks and 6 months follow-up. The interview contained mental health-related problems, trauma, questions on alcohol and other substances and quality of life. Non-parametric tests were used to test group differences and unadjusted and adjusted linear regression to test the associations between smoking and the main outcome variables, while logistic regression was used to test the association between smoking and drop-out. Results At admission, 75% were daily smokers. Compared to non-smokers at baseline, the smokers had higher drop-out rates (37% vs. 13%), more mental distress, and lower quality of life from baseline up to 6 months follow-up. Those quitting smoking while admitted improved in mental distress and quality of life at the same rate as non-smokers. Alcohol-related factors did not differ between smokers and non-smokers. Conclusions Smoking was associated with mental distress, quality of life and treatment drop-out among patients in primary alcohol use disorder treatment. The results indicate that smoking cessation should be recommended as an integral part of alcohol use treatment both before and during inpatient treatment to reduce drop-out.

Suicidality and Treatment Experience Among Young People Who Inject Drugs

2020 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Lawrence J. Ouellet
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Treatment ◽  
People Who Inject Drugs ◽  
Multivariable Analysis ◽  
Psychiatric Research ◽  
Health Treatment ◽  
The Past

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.

Effectiveness and Availability of Treatment for Substance Use Disorders

2018 ◽  
Author(s):  
Dominic Hodgkin ◽  
Hilary S. Connery
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
The United States ◽  
Treatment Programs ◽  
Future Research ◽  
Dissemination And Implementation ◽  
Major Focus ◽  
Medication Treatment

Drug and alcohol use disorders, also called substance use disorders (SUD), are among the major health problems facing many countries, contributing a substantial burden in terms of mortality, morbidity, and economic impact. A considerable body of research is dedicated to reducing the social and individual burden of SUD. One major focus of research has been the effectiveness of treatment for SUD, with studies examining both medication and behavioral treatments using randomized, controlled clinical trials. For opioid use disorder, there is a strong evidence base for medication treatment, particularly using agonist therapies (i.e., methadone and buprenorphine), but mixed evidence regarding the use of psychosocial interventions. For alcohol use disorder, there is evidence of modest effectiveness for two medications (acamprosate and naltrexone) and for various psychosocial treatments, especially for less severe alcohol use disorder syndromes. An important area for future research is how to make treatment more appealing to clients, given that client reluctance is an important contributor to the low utilization of effective treatments. A second major focus of research has been the availability of medication treatments, building on existing theories of how innovations diffuse, and on the field of dissemination and implementation research. In the United States, this research identifies serious gaps in both the availability of SUD treatment programs and the availability of effective treatment within those programs. Key barriers include lack of on-site medical staff at many SUD treatment programs; restrictive policies of private insurers, states, and federal authorities; and widespread skepticism toward medication treatment among counseling staff and some administrators. Emerging research is promising for providing medication treatment in settings other than SUD treatment programs, such as community mental health centers, prisons, emergency departments, and homeless shelters. There is still considerable room to make SUD treatment approaches more effective, more available, and—most importantly—more acceptable to clients.

The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS)

2017 ◽  
Vol 48 (3) ◽  
pp. 473-487 ◽  
Author(s):  
H. Yin ◽  
G. Xu ◽  
H. Tian ◽  
G. Yang ◽  
K. J. Wardenaar ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Age Of Onset ◽  
Male Gender ◽  
Immigrant Status ◽  
Sociodemographic Correlates ◽  
Mental Health Survey

BackgroundTo effectively shape mental healthcare policy in modern-day China, up-to-date epidemiological data on mental disorders is needed. The objective was to estimate the prevalence, age-of-onset (AOO) and sociodemographic correlates of mental disorders in a representative household sample of the general population (age ⩾ 18) in the Tianjin Municipality in China.MethodsData came from the Tianjin Mental health Survey (TJMHS), which was conducted between July 2011 and March 2012 using a two-phase design. 11 748 individuals were screened with an expanded version of the General Health Questionnaire and 4438 subjects were selected for a diagnostic interview by a psychiatrist, using the Structured Clinical Interview for the Diagnostic and Statistical Manual – fourth edition (SCID).ResultsThe lifetime and 1-month prevalence of any mental disorder were 23.6% and 12.8%, respectively. Mood disorders (lifetime: 9.3%; 1-month: 3.9%), anxiety disorders (lifetime: 4.5% 1-month: 3.1%) and substance-use disorders (lifetime: 8.8%; 1-month: 3.5%) were most prevalent. The median AOO ranged from 25 years [interquartile range (IQR): 23–32] for substance-use disorders to 36 years (IQR: 24–50) for mood disorders. Not being married, non-immigrant status (i.e. local ‘Hukou’), being a farmer, having <6 years of education and male gender were associated with a higher lifetime prevalence of any mental disorder.ConclusionResults from the current survey indicate that mental disorders are steadily reported more commonly in rapidly-developing urban China. Several interesting sociodemographic correlates were observed (e.g. male gender and non-immigrant status) that warrant further investigation and could be used to profile persons in need of preventive intervention.

Barriers to comorbidity service delivery: the complexities of dual diagnosis and the need to agree on terminology and conceptual frameworks

2010 ◽  
Vol 34 (3) ◽  
pp. 262 ◽  
Author(s):  
Rachel Canaway ◽  
Monika Merkes
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Service Delivery ◽  
Substance Use Disorders ◽  
Service Provision ◽  
Service Providers ◽  
Complex Problem ◽  
Conceptual Frameworks ◽  
Treatment Service ◽  
Variable Nature

This paper draws from a literature review commissioned as part of a larger project evaluating comorbidity treatment service models, which was funded by the Australian Government Department of Health and Ageing as part of the National Comorbidity Initiative. The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. This paper outlines conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, particularly around the variable nature of comorbidity, and the impacts of the separation of the mental health (MH) and alcohol and other drug (AOD) sectors with their differing institutional cultures, aetiological concepts, philosophical underpinnings, educational requirements, administrative arrangements, and screening and treatment approaches. Issues pertaining to the lack of consistent definitions and conceptual frameworks for comorbidity are discussed, particularly in relation to the reported lack of communication, collaboration, and linkages between the sectors. It is suggested that the adoption of consistent terminology and conceptual frameworks may provide a valuable step towards consistency in service provision and research and could lead to improved capacity to address the many issues relating to comorbidity service provision and treatment efficacy. What is known about the topic?The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. However, the service system is not sufficiently developed and coordinated to serve clients with comorbid problems well. What does this paper add?This paper summarises the issues pertaining to conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, including the different aetiologies of comorbidity and types and settings of service providers. What are the implications for practitioners?There is a need for practitioners and other stakeholders to agree on consistent terminology and framework(s) relevant to comorbidity to overcome the barriers and complexities that currently limit service delivery and access to treatment.

scholarly journals Proportion of patients without mental disorders being treated in mental health services worldwide

2015 ◽  
Vol 206 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Ronny Bruffaerts ◽  
Jose Posada-Villa ◽  
Ali Obaid Al-Hamzawi ◽  
Oye Gureje ◽  
Yueqin Huang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Dose Response ◽  
Mental Health Treatment ◽  
World Health ◽  
Health Treatment ◽  
The Past ◽  
The World ◽  
Dsm Iv

BackgroundPrevious research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.AimsTo examine the association of past-year mental health treatment with DSM-IV disorders.MethodThe World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.ResultsRoughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.ConclusionsThe vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.

scholarly journals Mental Health in UK Biobank Revised – development, implementation and results from an online questionnaire completed by 157,366 participants

2019 ◽  
Author(s):  
Katrina A. S. Davis ◽  
Jonathan R. I. Coleman ◽  
Mark Adams ◽  
Naomi Allen ◽  
Gerome Breen ◽  
...  
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Mental Disorders ◽  
Alcohol Use Disorder ◽  
Bipolar Affective Disorder ◽  
Face Validity ◽  
Common Finding ◽  
Uk Biobank ◽  
Post Traumatic Stress ◽  
Mental Health Questionnaire

AbstractThis paper corrects and updates a paper published in BJPsych Open 2018 “Mental Health in UK Biobank” (https://doi.org/10.1192/bjo.2018.12) that was voluntarily retracted following the finding of errors in the coding of the variable for alcohol use disorder. Notably, the percentage of participants reaching threshold for alcohol use disorder on the Alcohol Use Disorder Identification Tool increased from 7% to 21%.BackgroundUK Biobank is a well-characterised cohort of over 500,000 participants that offers unique opportunities to investigate multiple diseases and risk factors. An online mental health questionnaire completed by UK Biobank participants expands the potential for research into mental disorders.MethodsAn expert working group designed the questionnaire, using established measures where possible, and consulting with a service user group regarding acceptability. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and alcohol use disorders.Results157,366 completed online questionnaires were available by August 2017. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was the most common finding in 24% of participants (37,434), with current alcohol use disorder criteria met by 21% (32,602), while other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.ConclusionsThe questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed due to selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.

Substance Use Disorders in the Elderly

2017 ◽  
Author(s):  
Michael Burgard ◽  
Robert Kohn
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Illicit Drugs ◽  
Nursing Home Residents ◽  
The Elderly ◽  
The United States ◽  
Driving Under The Influence

Substance use disorders in older adults remains lower than in younger adults; however, the prevalence is rising in the elderly population. In the United States, the lifetime prevalence of an alcohol use disorder among persons age 65 and older is 16.1%. Studies of Veteran’s Administration nursing home residents have found that 29% to 49% of those admitted have a lifetime diagnosis of alcohol use disorder. A sizable proportion of the elderly acknowledge driving under the influence. In 2013, 1.5% of the elderly had used illicit drugs. The number requiring treatment for substance abuse is expected to double by 2020. The populations with the fastest increase in opiate mortality are those age 55 and older, including those 65 and older. This chapter presents the epidemiology of substance use among older adults and discusses issues related to elders’ substance use, including use in nursing homes, impaired driving and arrests, use of non-prescription medications, screening for substance use, and treatment.

scholarly journals O7.1. ASSOCIATION BETWEEN PATTERNS OF COMORBID MENTAL DISORDERS AND MORTALITY-RELATED ESTIMATES. A NATIONWIDE, REGISTER-BASED COHORT STUDY BASED ON 7.5 MILLION INDIVIDUALS LIVING IN DENMARK

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Oleguer Plana-Ripoll ◽  
Natalie Momen ◽  
Nanna Weye ◽  
John McGrath
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Neurotic Disorders ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common – individuals with one type of mental disorder are at increased risk of subsequently developing other types of disorders. Previous studies are usually restricted to temporally-ordered pairs of disorders. While more complex patterns of comorbidity have been described (e.g. internalizing and externalizing disorders), there is a lack of detailed information on the nature of the different sets of comorbid mental disorders. Additionally, mental disorders are associated with premature mortality, and people with two or more types of mental disorders have a shorter life expectancy compared to those with exactly one type of mental disorder. The aims of this study were to: (a) describe the prevalence and demographic correlates of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995–2016. Information on mental disorders and mortality was obtained from national registers. First, we described the most common combinations of mental disorders defined by the ICD-10 F-subchapters (substance use disorders, schizophrenia spectrum disorder, mood disorders, neurotic disorders, etc.). Then, we investigated excess mortality using mortality rate ratios (MRRs) and differences in life expectancy after disease diagnosis compared to the general population of same sex and age. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one type of disorder, 2.7% with exactly two, 1.1% with exactly three, and 0.5% with four or more types. The most prevalent mental disorders were neurotic disorders (4.6%) and mood disorders (3.8%), even when looking particularly at persons with a specific number of disorders (exactly one type, exactly two types, etc.). We observed 616 out of 1,024 possible sets of disorders, but the 52 most common sets (with at least 1,000 individuals each) represented 92.8% of all persons with diagnosed mental disorders. Mood and/or neurotic disorders, alone or in combination with other disorders, were present in 64.8% of individuals diagnosed with mental disorders. People with all combinations of mental disorders had higher mortality rates than those without any mental disorder diagnosis, with MRRs ranging from 1.10 (95% CI 0.67 – 1.84) for the two-disorder set of developmental-behavioral disorders to 5.97 (95% CI 5.52 – 6.45) for the three-disorder set of schizophrenia-neurotic-substance use disorders. Additionally, any combination of mental disorders was associated with shorter life expectancies compared to the general population, with estimates ranging from 5.06 years [95% CI 5.01 – 5.11] for the one-disorder set of organic disorders to 17.46 years [95% CI 16.86 – 18.03] for the three-disorder set of schizophrenia-personality-substance use disorders. Discussion Within those with mental disorders, approximately 2 out of 5 had two more types of mental disorders. Our study provides prevalence estimates of the most common sets of mental disorders – mood disorders (e.g. depression) and neurotic disorders (e.g. anxiety) commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality-related estimates revealed the prominent role of substance use disorders with respect to both elevated mortality rates and reduced life expectancies. Substance use disorders are relatively common, and these disorders often feature in sets of mental disorders. In light of the substantial contribution to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

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