scholarly journals The burden of caring for adults with depression and suicidal ideation in five large European countries: analysis from the 2020 National Health and Wellness Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
D. H. Jaffe ◽  
B. L. Balkaran ◽  
L. Yue ◽  
S. Mulhern-Haughey ◽  
J. Anjo
Keyword(s):  
Health Status ◽  
Suicidal Ideation ◽  
National Health ◽  
Economic Burden ◽  
Mixed Models ◽  
Short Form ◽  
Linear Mixed Models ◽  
Unipolar Depression ◽  
European Countries ◽  
Activity Impairment

Abstract Background Suicidal ideation (SI) affects approximately 30–40% of those with major depressive disorder (MDD). To date, studies have examined the substantial humanistic and economic burden to caregivers of persons with MDD, however little is known of the impact of caring for persons with MDD when SI is present. This study examined the additional burden imposed on caregivers for persons with unipolar depression and SI in five major European countries. Methods A retrospective, cross-sectional analysis was conducted in five European countries using 2020 Europe National Health Wellness Survey (France, Germany, Italy, Spain and the United Kingdom) to compare differences in health and economic outcomes between caregivers of adults with unipolar depression and SI (CAUD-SI) and caregivers of adults with unipolar depression without SI (CAUD-nSI). The outcomes assessed included health-related quality of life (HRQoL; Medical Outcomes Study Short Form [SF-12v2]), health status (Short-Form 6 Dimension [SF-6D], EuroQol 5-Dimension 5-Level [EQ-5D-5L]), Work productivity and activity impairment (WPAI) and healthcare resource utilization (HRU). Linear mixed models and generalized linear mixed models adjusted for covariates were used to compare the two groups on outcomes of interest. Results Of 62,319 respondents, 0.89% (n = 554) were CAUD-SI and 1.34% (n = 837) were CAUD-nSI. In adjusted models, CAUD-SI reported greater humanistic burden than CAUD-nSI, with lower HRQoL (PCS: 42.7 vs. 45.0, p < 0.001 and MCS: 37.5 vs. 38.9, p = 0.007) and health status (SF-6D: 0.57 vs 0.60, p < 0.001 and EQ-5D-5L: 0.58 vs 0.66, p < 001). CAUD-SI respondents reported significantly higher economic burden than CAUD-nSI respondents for WPAI (percent activity impairment: 64.9% vs. 52.5%, p = 0.026) and HRU (provider visits: 10.0 vs. 7.9, p < 0.001, emergency room visits: 1.49 vs. 0.73, p < 0.001 and hospitalizations: 1.03 vs. 0.52, p < 0.001). Conclusion In five European countries, caregivers of adults with depression and SI experience additional humanistic and economic burden than caregivers of adults with depression and no SI. Distinguishing caregiver groupings and their unique burden provide important insights for providing targeted support and interventions for both the patient and caregiver.

scholarly journals Self-reported burden of caregiver of adults with depression: a cross-sectional study in five Western European countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
B. L. Balkaran ◽  
D. H. Jaffe ◽  
D. Umuhire ◽  
B. Rive ◽  
R. U. Milz
Keyword(s):  
Health Status ◽  
Economic Burden ◽  
Linear Models ◽  
Work Productivity ◽  
Unipolar Depression ◽  
Cross Sectional Study ◽  
Activity Impairment ◽  
Cross Sectional ◽  
Western European ◽  
The Impact

Abstract Background Caregiving in depression imposes a complex health and economic burden. Moreover, there is a paucity of studies examining the impact of caregiving for adult relatives with unipolar depression (CG-UD). This study assessed the burden among CG-UD in five western European (EUR5) countries (France, Germany, Italy, Spain and the United Kingdom) compared with caregivers of adults with other chronic comorbidities (CG-OD) and general non-caregiving (non-CG) population. Methods A retrospective observational study was conducted using the 2016 National Health and Wellness Survey (NHWS) in EUR5. Differences in humanistic burden (health status and health-related quality of life [HRQoL]) and economic burden (work productivity and activity impairments, health care resource utilization [HRU]) were assessed between CG-UD and CG-OD respondents. Caregiver-specific burden (caregiving responsibilities and caregiver reaction assessment [CRA]) was assessed between caregiver groups. Generalized linear models were used to compare between the groups on the outcomes after adjusting for potential confounders. Results Of the 77,418 survey respondents examined, 1380 identified as CG-UD, 6470 as CG-OD and 69,334 as non-CG. Compared to CG-OD and non-CG, CG-UD, reported significantly lower health status (e.g., EuroQoL-5 Dimensions-5 Levels [EQ-5D-5L]: CG-UD = 0.63, CG-OD = 0.67, and non-CG = 0.73, p < 0.001) and HRQoL (e.g., mental component score: CG-UD = 35.0, CG-OD = 37.8, and non-CG = 40.7, p < 0.001). Although effect sizes were small (d < 0.2), minimal clinically important differences (MCID) were apparent for HRQoL and health status. Increased economic-related burden was observed for work and activity impairment (e.g., absenteeism: CG-UD = 32.6%, CG-OD = 26.5%, and non-CG = 14.8%, p < 0.001) and HRU (e.g., healthcare provider [HCP; mean, past 6 months]: CG-UD = 10.5, CG-OD = 8.6, and non-CG = 6.8, p < 0.001). Caregiving-specific burden was associated with experiencing a greater lack of family support (CG-UD: 2.9 vs CG-OD: 2.8, p < 0.01), impact on finances (CG-UD: 3.0 vs CG-OD: 2.9, p = 0.036), and on the caregiver’s schedule (CG-UD: 3.1 vs CG-OD: 3.0, p = 0.048). Conclusion Caregivers of persons with chronic disease experience an excess humanistic and economic burden compared to the general population, with a greater burden confronting caregiver for adults with depression. These findings illustrate the far-reaching burden of depression on both the patient and the relatives who care for them.

Investigating the Dynamics of Suicidal Ideation

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Nina Hallensleben ◽  
Lena Spangenberg ◽  
Thomas Forkmann ◽  
Dajana Rath ◽  
Ulrich Hegerl ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Small Sample Size ◽  
Unipolar Depression ◽  
Small Sample ◽  
History Of ◽  
Severity Of Depression ◽  
Ecological Momentary ◽  
Depressive Episodes ◽  
Ema Method ◽  
Shed Light

Abstract. Background: Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. Aim: To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). Method: Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. Results: Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. Limitations: Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. Conclusion: The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.

scholarly journals PMH54 ADHD Among Adults in Five Western European Countries: An Analysis of National Health and Wellness Survey Data

2012 ◽  
Vol 15 (7) ◽  
pp. A343-A344 ◽  
Author(s):  
S.L. Able ◽  
V. Haynes ◽  
K. Annunziata ◽  
H. Upadhyaya ◽  
W. Deberdt
Keyword(s):  
Survey Data ◽  
National Health ◽  
European Countries ◽  
Health And Wellness ◽  
Western European

scholarly journals Heat, Hills and the High Season: A Model-Based Comparative Analysis of Spatio-Temporal Factors Affecting Shared Bicycle Use in Three Southern European Islands

2021 ◽  
Vol 13 (6) ◽  
pp. 3274
Author(s):  
Suzanne Maas ◽  
Paraskevas Nikolaou ◽  
Maria Attard ◽  
Loukas Dimitriou
Keyword(s):  
Correlation Analysis ◽  
Mixed Models ◽  
Linear Mixed Models ◽  
Positive Association ◽  
Sustainable Mobility ◽  
Weather Factors ◽  
Gran Canaria ◽  
Bivariate Correlation ◽  
Temporal Factors

Bicycle sharing systems (BSSs) have been implemented in cities worldwide in an attempt to promote cycling. Despite exhibiting characteristics considered to be barriers to cycling, such as hot summers, hilliness and car-oriented infrastructure, Southern European island cities and tourist destinations Limassol (Cyprus), Las Palmas de Gran Canaria (Canary Islands, Spain) and the Valletta conurbation (Malta) are all experiencing the implementation of BSSs and policies to promote cycling. In this study, a year of trip data and secondary datasets are used to analyze dock-based BSS usage in the three case-study cities. How land use, socio-economic, network and temporal factors influence BSS use at station locations, both as an origin and as a destination, was examined using bivariate correlation analysis and through the development of linear mixed models for each case study. Bivariate correlations showed significant positive associations with the number of cafes and restaurants, vicinity to the beach or promenade and the percentage of foreign population at the BSS station locations in all cities. A positive relation with cycling infrastructure was evident in Limassol and Las Palmas de Gran Canaria, but not in Malta, as no cycling infrastructure is present in the island’s conurbation, where the BSS is primarily operational. Elevation had a negative association with BSS use in all three cities. In Limassol and Malta, where seasonality in weather patterns is strongest, a negative effect of rainfall and a positive effect of higher temperature were observed. Although there was a positive association between BSS use and the number of visiting tourists in Limassol and Malta, this is predominantly explained through the multi-collinearity with weather factors rather than by intensive use of the BSS by tourists. The linear mixed models showed more fine-grained results and explained differences in BSS use at stations, including differences for station use as an origin and as a destination. The insights from the correlation analysis and linear mixed models can be used to inform policies promoting cycling and BSS use and support sustainable mobility policies in the case-study cities and cities with similar characteristics.

scholarly journals Confidence, prediction, and tolerance in linear mixed models

2019 ◽  
Vol 38 (30) ◽  
pp. 5603-5622 ◽  
Author(s):  
Bernard G. Francq ◽  
Dan Lin ◽  
Walter Hoyer
Keyword(s):  
Mixed Models ◽  
Linear Mixed Models

Power for balanced linear mixed models with complex missing data processes

2021 ◽  
pp. 1-19
Author(s):  
Kevin P. Josey ◽  
Brandy M. Ringham ◽  
Anna E. Barón ◽  
Margaret Schenkman ◽  
Katherine A. Sauder ◽  
...  
Keyword(s):  
Missing Data ◽  
Mixed Models ◽  
Linear Mixed Models

l2-Penalized temporal logit-mixed models for the estimation of regional obesity prevalence over time

2021 ◽  
pp. 096228022110175
Author(s):  
Jan P Burgard ◽  
Joscha Krause ◽  
Ralf Münnich ◽  
Domingo Morales
Keyword(s):  
Parameter Estimation ◽  
Medical Treatment ◽  
Mixed Models ◽  
Generalized Linear Mixed Models ◽  
Linear Mixed Models ◽  
Obesity Prevalence ◽  
Model Parameter ◽  
Model Parameter Estimation ◽  
Public Health Reporting ◽  
Over Time

Obesity is considered to be one of the primary health risks in modern industrialized societies. Estimating the evolution of its prevalence over time is an essential element of public health reporting. This requires the application of suitable statistical methods on epidemiologic data with substantial local detail. Generalized linear-mixed models with medical treatment records as covariates mark a powerful combination for this purpose. However, the task is methodologically challenging. Disease frequencies are subject to both regional and temporal heterogeneity. Medical treatment records often show strong internal correlation due to diagnosis-related grouping. This frequently causes excessive variance in model parameter estimation due to rank-deficiency problems. Further, generalized linear-mixed models are often estimated via approximate inference methods as their likelihood functions do not have closed forms. These problems combined lead to unacceptable uncertainty in prevalence estimates over time. We propose an l2-penalized temporal logit-mixed model to solve these issues. We derive empirical best predictors and present a parametric bootstrap to estimate their mean-squared errors. A novel penalized maximum approximate likelihood algorithm for model parameter estimation is stated. With this new methodology, the regional obesity prevalence in Germany from 2009 to 2012 is estimated. We find that the national prevalence ranges between 15 and 16%, with significant regional clustering in eastern Germany.

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