scholarly journals Policy initiative to improve access to psychological services for people with affective and anxiety disorders: population-level analysis

2011 ◽  
Vol 198 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Meredith G. Harris ◽  
Philip M. Burgess ◽  
Jane E. Pirkis ◽  
Tim N. Slade ◽  
Harvey A. Whiteford
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Service Use ◽  
Social Inequalities ◽  
Mental Healthcare ◽  
Population Level ◽  
Epidemiological Data ◽  
Psychological Services ◽  
Service Users ◽  
Icd 10

BackgroundIn 2006, Australia introduced new publicly funded psychological services for people with affective and anxiety disorders (the Better Access programme). Despite massive uptake, it has been suggested that Better Access is selectively treating socioeconomically advantaged people, including some who do not warrant treatment, and people already receiving equivalent services.AimsTo explore potential disparities in Better Access treatment using epidemiological data from the 2007 National Survey of Mental Health and Wellbeing.MethodLogistic regression analyses examined patterns and correlates of service use in two populations: people who used the new psychological services in the previous 12 months; and people with any ICD–10 12-month affective and anxiety disorder, regardless of service use.ResultsMost (93.2%) Better Access psychological services users had a 12-month ICD–10 mental disorder or another indicator of treatment need. Better Access users without affective or anxiety disorders were not more socioeconomically advantaged, and received less treatment than those with these disorders. Among the population with affective or anxiety disorders, non-service users were less likely to have a severe disorder and more likely to have anxiety disorder, without a comorbid affective disorder, than Better Access users. Better Access users comprised more new allied healthcare recipients than other service users. A substantial minority of non-service users (13.5%) had severe disorders, but most did not perceive a need for treatment.ConclusionsBetter Access does not appear to be overservicing individuals without potential need or contributing to social inequalities in mental healthcare. It appears to be reaching people who have not previously received psychological care. Treatment rates could be improved for some people with anxiety disorders.

scholarly journals Inequalities in psychiatric service use and mortality by migrant status following a first diagnosis of psychotic disorder: a Swedish cohort study of 1.3m people

2021 ◽  
Author(s):  
Dafni Katsampa ◽  
Syeda F Akther ◽  
Anna-Clara Hollander ◽  
Henrik Dal ◽  
Christina Dalman ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Psychotic Disorder ◽  
Service Use ◽  
Psychiatric Service ◽  
Mental Healthcare ◽  
Migrant Status ◽  
Region Of Origin ◽  
Icd 10 ◽  
Sub Saharan ◽  
First Diagnosis

Abstract It is unclear whether inequalities in mental healthcare and mortality following the onset of psychosis exist by migrant status and region-of-origin. We investigated whether (i) mortality (including by major causes of death); (ii) admission type (in- or out-patient), and; (iii) in-patient length of stay at first diagnosis for psychotic disorder presentation, and; (iv) time-to-readmission for psychotic disorder differed for refugees, non-refugee migrants and by region-of-origin. We established a cohort of 1,335,192 people born 1984-1997 and living in Sweden from 1st January 1998, followed from their 14 th birthday or arrival to Sweden, until death, emigration, or 31 December 2016.People with ICD-10 psychotic disorder (F20-33; N=9,399) were 6.7 (95%CI: 5.9-7.6) times more likely to die than the general population, but this did not vary by migrant status (p=0.15) or region-of-origin (p=0.31). This mortality gap was most pronounced for suicide (adjusted hazard ratio [aHR]: 12.2; 95% CI: 10.4-14.4), but persisted for deaths from other external (aHR: 5.1; 95%CI: 4.0-6.4) and natural causes (aHR: 2.3; 95%CI: 1.6-3.3). Non-refugee (adjusted odds ratio [aOR]: 1.4, 95%CI: 1.2-1.6) and refugee migrants (aOR: 1.4, 95%CI: 1.1-1.8) were more likely to receive inpatient care at first diagnosis. No differences in inpatient length of stay at first diagnosis were observed. Sub-Saharan African migrants with psychotic disorder were readmitted more quickly than their Swedish-born counterparts (adjusted sub-HR: 1.2; 95%CI: 1.1-1.4). Our findings highlight the need to understand the drivers of disparities in psychosis treatment and the mortality gap experienced by all people with disorder, irrespective of migrant status or region-of-origin.

Affective and Anxiety Disorders and their Relationship with Chronic Physical Conditions in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing

2011 ◽  
Vol 45 (11) ◽  
pp. 939-946 ◽  
Author(s):  
Maree Teesson ◽  
Philip B. Mitchell ◽  
Mark Deady ◽  
Sonja Memedovic ◽  
Tim Slade ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
National Survey ◽  
Physical Condition ◽  
Service Use ◽  
Health And Wellbeing ◽  
Physical Conditions ◽  
Chronic Physical Conditions ◽  
Nationally Representative

Objective: The aim of this study was to report nationally representative data on the prevalence and patterns of 12 month comorbidity of chronic physical conditions (diabetes, asthma, coronary heart disease, stroke, cancer, arthritis) and DSM-IV affective and anxiety disorders in Australian adults. Method: The 2007 National Survey of Mental Health and Wellbeing (NSMHWB) was a nationally representative household survey of 8841 Australian adults (16–85 years) assessing symptoms of ICD-10 mental disorders and the presence of chronic physical conditions. Results: Prevalence of at least one National Health Priority Area chronic physical condition was 32.2% (95%CI = 30.9%–33.5%). Among those with chronic physical conditions 21.9% had an affective or anxiety disorder. Affective and anxiety disorders were more common among people with physical conditions than among people without chronic physical conditions (affective OR 1.5; anxiety OR 1.8). Of those with a 12 month affective or anxiety disorder, 45.6% had a chronic physical condition. Physical disorders were more common in those with an affective or anxiety disorder than among people without an affective or anxiety disorder (affective OR 1.6; anxiety OR 2.0). Disability was high in those with an anxiety disorder, an affective disorder and a physical condition and 43.4% were classified as high service users. Conclusions: Comorbidity between chronic physical conditions and affective and anxiety disorders is widespread and is associated with high levels of disability and service use.

scholarly journals Comparing psychotropic medication prescribing in personality disorder between general mental health and psychological services: retrospective cohort study

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Giouliana Kadra-Scalzo ◽  
Jacqueline Garland ◽  
Stephen Miller ◽  
Chin-Kuo Chang ◽  
Marcella Fok ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychotropic Medication ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Service Use ◽  
Mental Healthcare ◽  
Psychological Services ◽  
Sensitivity Analyses ◽  
Healthcare Database ◽  
Medication Prescribing

Background Although no drugs are licensed for the treatment of personality disorder, pharmacological treatment in clinical practice remains common. Aims This study aimed to estimate the prevalence of psychotropic drug use and associations with psychological service use among people with personality disorder. Method Using data from a large, anonymised mental healthcare database, we identified all adult patients with a diagnosis of personality disorder and ascertained psychotropic medication use between 1 August 2015 and 1 February 2016. Multivariable logistic regression models were constructed, adjusting for sociodemographic, clinical and service use factors, to examine the association between psychological services use and psychotropic medication prescribing. Results Of 3366 identified patients, 2029 (60.3%) were prescribed some form of psychotropic medication. Patients using psychological services were significantly less likely to be prescribed psychotropic medication (adjusted odds ratio 0.48, 95% CI 0.39–0.59, P<0.001) such as antipsychotics, benzodiazepines and antidepressants. This effect was maintained following several sensitivity analyses. We found no difference in the risk for mood stabiliser (adjusted odds ratio 0.79, 95% CI 0.57–1.10, P = 0.169) and multi-class psychotropic use (adjusted odds ratio 0.80, 95% CI 0.60–1.07, P = 0.133) between patients who did and did not use psychological services. Conclusions Psychotropic medication prescribing is common in patients with personality disorder, but significantly less likely in those who have used psychological services. This does not appear to be explained by differences in demographic, clinical and service use characteristics. There is a need to develop clear prescribing guidelines and conduct research in clinical settings to examine medication effectiveness for this population.

Disability, Employment and Work Performance Among People with ICD-10 Anxiety Disorders

2005 ◽  
Vol 39 (1-2) ◽  
pp. 55-66 ◽  
Author(s):  
Geoff Waghorn ◽  
David Chant ◽  
Paul White ◽  
Harvey Whiteford
Keyword(s):  
Anxiety Disorders ◽  
Work Performance ◽  
Labour Force ◽  
Secondary Analysis ◽  
Population Level ◽  
Labour Force Participation ◽  
Health Conditions ◽  
Computer Assisted ◽  
Icd 10

Objective: To ascertain at a population level, patterns of disability, labour force participation, employment and work performance among people with ICD-10 anxiety disorders in compar ison to people without disability or long-term health conditions. Method: A secondary analysis was conducted of a probability sample of 42 664 individuals collected in an Australian Bureau of Statistics (ABS) national survey in 1998. Trained lay interviewers using ICD-10 computer-assisted interviews identified household residents with anxiety disorders. Results: Anxiety disorders were associated with: reduced labour force participation, degraded employment trajectories and impaired work performance compared to people without disabilities or long-term health conditions. Conclusion: People with anxiety disorders may need more effective treatments and assistance with completing education and training, joining and rejoining the workforce, developing career pathways, remaining in the workforce and sustaining work performance. A whole-of-government approach appears needed to reduce the burden of disease and increase community labour resources. Implications for clinicians, vocational professionals and policy makers are discussed.

The Classification of Anxiety Disorders

1989 ◽  
Vol 154 (S4) ◽  
pp. 28-32 ◽  
Author(s):  
M. G. Gelder
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Specific Phobia ◽  
Adjustment Disorders ◽  
Generalised Anxiety Disorder ◽  
Phobic Disorders ◽  
Icd 10

The classification of anxiety disorders is a controversial subject, and this controversy is reflected in the differences between the systems adopted in DSM-III-R and in the draft of ICD-10. The scheme in ICD-10 is the simpler: anxiety disorders are divided into phobic disorders and other anxiety disorders, and each is divided further into three subgroups. The three phobic disorders are: agoraphobia, social phobia, and specific phobia. The three subgroups of ‘other anxiety disorders’ are panic disorder, generalised anxiety disorder, and mixed anxiety and depressive disorder. The subdivisions of phobic disorder are those now generally adopted in most countries, and are uncontroversial. The subdivisions of generalised anxiety disorder, and mixed anxiety depressive disorder are also widely accepted, the latter group being particularly frequent among patients seen in general practice and not referred on to psychiatrists. Only the category of panic disorder is controversial. In addition to these categories which are specifically allocated to anxiety disorders, two others are relevant: ‘reactions to severe stress and adjustment disorders’, and anxious personality disorder.

scholarly journals Indian Medical Students with Depression, Anxiety, and Suicidal Behavior: Why Do They Not Seek Treatment?

2021 ◽  
pp. 025371762098232
Author(s):  
Praveen Arun ◽  
Parthasarathy Ramamurthy ◽  
Pradeep Thilakan
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Medical Students ◽  
Mental Health Services ◽  
Health Services ◽  
Anxiety Disorders ◽  
Suicidal Behavior ◽  
Mental Healthcare ◽  
Suicidal Risk ◽  
Healthcare Seeking

Background: Identification of barriers to mental healthcare seeking among medical students will help organize student mental health services in medical colleges across India. This study was conducted to estimate the prevalence of depression, anxiety disorders, and suicidal behavior among medical students and to identify the potential barriers to mental healthcare seeking among them. Methods: In this cross-sectional observational study, the medical students from a medical college in South India were asked to complete a structured pro forma for sociodemographic details, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Questionnaire (GAD-7),and Suicide Behaviors Questionnaire-Revised (SBQ-R). The barriers to mental healthcare seeking were assessed using the mental health subscale of Barriers to Healthcare Seeking Questionnaire for medical students. A cut-off of 15 was used for determining the presence of depression on PHQ-9. A cut-off of 10 on GAD-7 indicated the presence of anxiety disorder, and a cut-off of 7 on SBQ-R indicated suicidal risk. Results: Out of the 425 participants, 59 (13.9%) were found to have depression (moderately severe or severe) and 86 (20.2%) were found to have anxiety disorders (moderate or severe). A total of 126 (29.6%) students were found to have a suicidal risk. Preference for informal consultations, concerns about confidentiality, and preference for self-diagnosis were the most commonly reported barriers to mental healthcare seeking. Students with psychiatric disorders perceived more barriers to mental healthcare seeking than students without psychiatric disorders. Conclusions: One-fourth of the medical students were detected to have depression and/or anxiety disorders. Establishing student mental health services, taking into account the perceived barriers, will go a long way in improving medical students’ mental well-being.

Comparison of the DSM–5 and ICD–10: panic and other anxiety disorders

CNS Spectrums ◽  
2017 ◽  
Vol 22 (5) ◽  
pp. 404-406 ◽  
Author(s):  
Borwin Bandelow
Keyword(s):  
Anxiety Disorder ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Selective Mutism ◽  
International Classification Of Diseases ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Anxiety disorders are the most prevalent mental disorders and are associated with substantial healthcare costs and a high burden of disease. In this article, changes in the new Diagnostic and Statistical Manual for Mental Disorders (the DSM–5) with respect to panic disorder/agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and selective mutism are compared with the International Classification of Diseases (ICD–10) system.

scholarly journals Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Vishal Bhavsar ◽  
Sarah Dorrington ◽  
Craig Morgan ◽  
Stephani L. Hatch ◽  
Philip McGuire ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Service Use ◽  
Common Mental Disorders ◽  
Psychological Treatment ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Mental Health Service Use ◽  
Psychotic Experiences ◽  
Cross Sectional

Abstract Background Co-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health. Methods We linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions. Results In all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49–3.27] and 3.46 (95% CI 1.52–7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15–1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22–20.44) among those with PTSD with psychotic experiences. Conclusions Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.

scholarly journals Associations between schizophrenia genetic risk, anxiety disorders and manic/hypomanic episode in a longitudinal population cohort study

2018 ◽  
Vol 214 (2) ◽  
pp. 96-102 ◽  
Author(s):  
Alexander Richards ◽  
John Horwood ◽  
Joseph Boden ◽  
Martin Kennedy ◽  
Ruth Sellers ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Negative Symptoms ◽  
Population Level ◽  
Risk Scores ◽  
Clinical Samples ◽  
Generalised Anxiety Disorder ◽  
Hypomanic Episode

BackgroundStudies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence.AimsWe examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia.MethodSchizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and – using linear regression – total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children).ResultsSchizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode.ConclusionsThe relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias.Declarations of interestNone.

scholarly journals Study of Emotional Disorders among Children with Poor Academic Performance

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Dr. Jitendra Mugali ◽  
Dr. S S Chate ◽  
Dr. Nitin Pattanashetty ◽  
Dr. Shivam Gupta ◽  
Dr. Sushruth V ◽  
...  
Keyword(s):  
Academic Performance ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Separation Anxiety ◽  
Poor Performance ◽  
Final Diagnosis ◽  
Phobic Anxiety ◽  
Poor Academic Performance ◽  
Icd 10

Objectives: 1. To study the nature and prevalence of emotional disorder among children with poor academic performance., 2. To study the associated Psychiatric co-morbidities among children with poor academic performance were presenting with emotional disorders. Material and Methods: Total of 1480 children studying in 3 CBSE schools, aged between 6 and 12 years were screened. 312 children were found to be performing poor in academics. After simple randomization and further screening procedure 115 children were included in the study. Each child was assessed by interviewing with MINI-KID Questionnaire and CBCL and final diagnosis made by using ICD-10 DCR criteria. Statistical analysis was done using Epi Info 7 software.   Results: The prevalence of poor academic performers was found to be 21.08%. The prevalence of emotional disorders among children with poor academic performance was found to be 22.61%. Majority of poor academic performers having phobic anxiety disorders of childhood accounts to be 9.57%. Other emotional disorders like, social anxiety disorder of childhood, sibling rivalry disorder and separation anxiety disorders of childhood accounts to be 6.96%, 6.09% and 3.48% respectively. Conclusion: Emotional disorders in school going children leads to poor performance in academics and school drop outs. Prevalence of emotional disorders were more in girls. Phobic anxiety disorder (Exam phobia /anxiety) is the most common type of emotional disorders presented by the children.

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