scholarly journals Effects of severe mental illness on survival of people with diabetes

2010 ◽  
Vol 197 (4) ◽  
pp. 272-277 ◽  
Author(s):  
Yana Vinogradova ◽  
Carol Coupland ◽  
Julia Hippisley-Cox ◽  
Seán Whyte ◽  
Catherine Penny
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Problems ◽  
Survival Rates ◽  
The Other ◽  
Age And Gender ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Increased Risk ◽  
And Gender

BackgroundPeople with mental health problems are more likely to die prematurely than the general population but no study has examined this in individuals with diabetes.AimsTo compare survival rates in people with diabetes with and without schizophrenia or bipolar disorder.MethodA total of 43 992 people with diabetes were drawn from the QRESEARCH database population of over 9 million patients. Survival rates during the study period, between 1 April 2000 and 1 April 2005, and hazard ratios for deaths associated with schizophrenia and bipolar disorder were adjusted by age and gender and additionally for socioeconomic status, obesity, smoking and use of statins.ResultsAmong the participants, we identified 257 people diagnosed with schizophrenia, 159 with bipolar disorder and 14 with both conditions. Although crude survival rates did not show significant differences between the groups during the study period, people with schizophrenia or bipolar disorder and diabetes, compared with those with diabetes alone, had a significantly increased risk of death after adjusting for age and gender, with hazard ratios for schizophrenia of 1.84 (95% CI 1.42–2.40) and for bipolar disorder of 1.51 (95% CI 1.10–2.07). After adjusting for the other factors, hazard ratios were 1.52 (95 CI 1.17–1.97) for schizophrenia and 1.47 (95% CI 1.07–2.02) for bipolar disorder.ConclusionsPeople with schizophrenia or bipolar disorder in addition to diabetes have a relatively higher mortality rate. This suggests that diabetes either progresses more rapidly or is more poorly controlled in these individuals, or that they have higher levels of comorbidity and so are more likely to die of other causes.

scholarly journals Hospital admissions for stress-related presentations among school-aged adolescents during term time versus holidays in England: weekly time series and retrospective cross-sectional analysis

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Ruth Blackburn ◽  
Omotomilola Ajetunmobi ◽  
Louise Mc Grath-Lone ◽  
Pia Hardelid ◽  
Roz Shafran ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Admission ◽  
Incidence Rate ◽  
Cumulative Incidence ◽  
Mental Health Problems ◽  
Hospital Admissions ◽  
Age And Gender ◽  
Self Harm ◽  
And Gender ◽  
Rate Ratios

Background Schools are a potential stressor for adolescents and may contribute to emergency hospital admissions. Aims We describe rates of stress-related presentations (SRPs) among school-aged adolescents (11–17 years) during school terms and holidays, and explore differences by age and gender. Method Using national administrative hospital data, we defined an SRP as an emergency hospital admission with a primary diagnosis related to pain, psychosomatic symptoms (e.g. fatigue) or mental health problems, or with self-harm indicated in any diagnostic position. We estimated incidence rate ratios for weekly SRPs in term time versus holidays from 2014–2015 to 2017–2018, using negative binomial regression models, stratified by age and gender. We estimated the cumulative incidence of any SRP between 11 and 17 years by analysing prior hospital admission histories of adolescents with an SRP in 2017–2018. Results Over the 4-year study period, 305 491 SRPs in 171 013 school-aged adolescents accounted for 31% of emergency admissions for this group. SRPs were predominantly for mental health problems or self-harm (38%), or pain (35%). Weekly admission rates for SRPs were higher in term time than holidays for all ages (age-specific incidence rate ratios were 1.15–1.49 for girls and 1.08–1.60 for boys). Rates were highest for girls aged 14 and 15 years. The estimated cumulative incidence of any SRP between 11 and 17 years was 7.9% for girls and 4.1% for boys. Conclusions Hospital admissions for SRPs are common among adolescents, affecting around two girls and one boy in every classroom. Higher rates in term time than holidays suggest that school factors may contribute.

scholarly journals The association of tissue doppler E/e' ratio with poor survival is modified by gender and is attenuated with advanced age

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y Wasserstrum ◽  
R Gilead ◽  
R Kuperstein ◽  
S Ben-Zekry ◽  
O Vatury ◽  
...  
Keyword(s):  
Cox Regression ◽  
Mitral Annulus ◽  
Tissue Doppler ◽  
Outcome Data ◽  
Poor Survival ◽  
Age And Gender ◽  
Risk Of Death ◽  
Increased Risk ◽  
And Gender

Abstract Introduction Contemporary guidelines recommend a universal cutoff of 14 for the ratio between early mitral flow wave and early diastolic mitral annulus velocity measured by tissue doppler (E/e' ratio). While age-dependent normal E/e' values have been suggested, outcome data is lacking. Purpose We sought to evaluate the modification effect of age and gender on the prognostic value of the E/e' ratio. Methods Consecutive patients who underwent echocardiographic evaluation between 2009 and 2021 (N=104,315) in a single tertiary cardiovascular center. Patients with left or right ventricular dysfunction, any significant valvular disease, structural heart disease or evidence of pulmonary hypertension were excluded. Cancer and mortality data were available for all subjects from national registries. Patients with a metastatic malignancy at baseline or during follow up were excluded. Cox regression models were applied. Results Overall, 44,541 patients were included in the final analysis. Mean age was 55±17, 59% were male and 63% of the exams were performed in an outpatient setting. An elevated E/e' ratio above 14 was documented in 2,598 (7%) patients. During a median follow-up of 5.7 (IQR 2.8–9.1) years, 5,015 (11.3%) patients died. Kaplan Meier survival analysis demonstrated that the cumulative probability of death at 6 years was 23.4% (21.6–25.3) among patients with elevated E/e' ratio compared with 9.7% (9.3–10.0) among patients with E/e'<14 (p Log rank <0.001). This difference was less significant as age progressed (figure 1). Multivariate cox-regression model yielded consistent results such that an elevated E/e' ratio was associated with 2.66-fold increased risk of death during follow up (95% CI 2.44–2.89, p<0.001), and there was a decline in the increased risk and significant as age advanced in both genders (figure 2). Interaction analysis was significant for both gender and age such the association of elevated E/e' ratio with poor survival was more significant among men compared with women and among young vs. older subjects. Among women, elevated E/e' was associated with 2.4-fold increased risk of death versus 2.7-fold increased risk among men. Similarly, the hazard ratio for death associated with elevated E/e' was 2.29 (95% CI 1.74–3.02), 1.8 (95% CI 1.5–2.1), 1.13 (95% CI 0.97–1.31) and 1.07 (95% CI 0.92–1.25) for the age groups of <60, 60–70, 70–80 and >80, respectively. In a sensitivity analysis, similar findings were seen in when excluding patients with mild hypertrophy (maximal wall thickness >12mm) and without any mitral annulus calcification. Conclusion In apparently normal hearts, an elevated E/e' ratio is independently associated with increased mortality. This association is more pronounced among men and is attenuated with increased age. This study supports the need for gender-specific and age-specified outcome data with respect to measures of diastolic dysfunction. FUNDunding Acknowledgement Type of funding sources: None. Survival by age and gender groups E/e' >14 and mortality by age and gender

Lessons from the Mental Health Act Commission for England and Wales: The Limitations of Legalism-Plus-Safeguards

2011 ◽  
Vol 41 (1) ◽  
pp. 61-81 ◽  
Author(s):  
DAVID PILGRIM
Keyword(s):  
Mental Health ◽  
Risk Taking ◽  
Mental Health Problems ◽  
Group Membership ◽  
Social Forces ◽  
Differential Impact ◽  
Age And Gender ◽  
England And Wales ◽  
Mental Health Act ◽  
And Gender

AbstractIn 2009, the Mental Health Act Commission for England and Wales was closed down and its functions subsumed in separate organisations in the two countries. Its final biennial report, issued that year, focused on coercion and consent. This article uses some aspects of the report to discuss the implications of lawful psychiatric coercion being predicted by social group membership (correlated with race, age and gender). The work of the Commission furnished useful information in this regard, but its framework for data collection could not, and so did not, illuminate a more established picture of the class gradient in mental health problems. With the latter literature in mind, material adversity may explain the racial patterning of psychiatric populations coercively detained. However, normative aspects of risk-taking in the community and in hospital may better predict the findings on age and gender. The article concludes by querying the ameliorative impact of government appointed ‘visitorial’ bodies. Legalism-plus-safeguards is a questionable basis for meaningfully bringing discriminatory powers to book, or for reversing the differential impact of pathogenic social forces.

scholarly journals Renal hyperfiltration is independently associated with increased all-cause mortality in individuals with type 2 diabetes: a prospective cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e001481
Author(s):  
Giuseppe Penno ◽  
Emanuela Orsi ◽  
Anna Solini ◽  
Enzo Bonora ◽  
Cecilia Fondelli ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Prospective Cohort ◽  
Age And Gender ◽  
Death Rates ◽  
Risk Of Death ◽  
Renal Hyperfiltration ◽  
Increased Risk ◽  
And Gender

IntroductionIn addition to favoring renal disease progression, renal ‘hyperfiltration’ has been associated with an increased risk of death, though it is unclear whether and how excess mortality is related to increased renal function. We investigated whether renal hyperfiltration is an independent predictor of death in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian multicenter study.Research design and methodsThis observational, prospective cohort study enrolled 15 773 patients with type 2 diabetes consecutively attending 19 Italian diabetes clinics in 2006–2008. Serum creatinine, albuminuria, cardiovascular risk factors, and complications/comorbidities were assessed at baseline. Vital status on 31 October 2015 was retrieved for 15 656 patients (99.26%). Patients were stratified (A) by absolute estimated glomerular filtration rate (eGFR) values in eGFR deciles or Kidney Disease: Improving Global Outcomes (KDIGO) categories and (B) based on age-corrected thresholds or age and gender-specific 95th and 5th percentiles in hyperfiltration, hypofiltration, and normofiltration groups.ResultsThe highest eGFR decile/category and the hyperfiltration group included (partly) different individuals with similar clinical features. Age and gender-adjusted death rates were significantly higher in deciles 1, 9, and 10 (≥103.9, 50.9–62.7, and <50.9 mL/min/1.73 m2, respectively) versus the reference decile 3 (92.9–97.5 mL/min/1.73 m2). Mortality risk, adjusted for multiple confounders, was also increased in deciles 1 (HR 1.461 (95% CI 1.175 to 1.818), p=0.001), 9 (1.312 (95% CI 1.107 to 1.555), p=0.002), and 10 (1.976 (95% CI 1.673 to 2.333), p<0.0001) versus decile 3. Similar results were obtained by stratifying patients by KDIGO categories. Death rates and adjusted mortality risks were significantly higher in hyperfiltering and particularly hypofiltering versus normofiltering individuals.ConclusionsIn type 2 diabetes, both high-normal eGFR and hyperfiltration are associated with an increased risk of death from any cause, independent of confounders that may directly impact on mortality and/or affect GFR estimation. Further studies are required to clarify the nature of this relationship.Trial registration numberNCT00715481.

scholarly journals Exhausted due to the pandemic: Validation of Coronavirus Stress Measure and COVID-19 Burnout Scale in a Polish sample

2021 ◽  
Author(s):  
Marcin Moroń ◽  
Murat Yildirim ◽  
Łukasz Jach ◽  
Justyna Nowakowska ◽  
Karina Atlas
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Internal Consistency Reliability ◽  
Factor Solution ◽  
Age And Gender ◽  
Confirmatory Factor ◽  
Stress Measure ◽  
High Internal Consistency ◽  
And Gender ◽  
High Internal Consistency Reliability

AbstractThis study validated Polish versions of the Coronavirus Stress Measure (CSM) and the COVID-19 Burnout Scale (COVID-19-BS) to measure stress and burnout associated with COVID-19. Participants were 431 Polish young adults (72.6% female; Meanage = 26.61 ± 12.63). Confirmatory factor analysis verified a one-factor solution for both the CSM and the COVID-19-BS. Both scales had high internal consistency reliability. Coronavirus stress and COVID-19 burnout were positively related to depression, anxiety, and stress and negatively related to resilience. The coronavirus stress and COVID-19 burnout were correlated with elevated levels of depression, anxiety, and stress over and beyond resilience, age, and gender. Findings suggest that the Polish versions of the CSM and the COVID-19-BS are valid scales to measure stress and burnout related to COVID-19. Findings also demonstrated that the coronavirus stress and COVID-19 burnout experienced during the later stages of the pandemic might be a permanent risk factor for mental health problems.

Sexual and gender minority populations and suicidal behaviours

2021 ◽  
pp. 353-360
Author(s):  
Helen Keeley ◽  
Fiachra Ó Súilleabháin ◽  
Máire Leane
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Well Being ◽  
Minority Populations ◽  
Sexual Diversity ◽  
Gender Minority ◽  
Increased Risk ◽  
Gender Status ◽  
Sexual And Gender Minority ◽  
And Gender

Despite the sociolegal changes that have signalled greater acceptance of sexual diversity and gender expansive identities in the twenty-first century, worldwide studies highlight the increased risk of mental health problems and suicidality for those with a sexual and/or gender minority status. This chapter discusses this increased risk of suicidality among sexual and gender minority populations across the life course. A recurring theme is that those who are less sure of their status, are most at risk. Therefore, the capacity of an individual to overcome internalized minority stress, stigma, guilt, and shame, and to reconcile, even take pride, in their sexual/gender status, is a significant issue. While sociolegal, cultural, and familial norms may seem beyond the remit of mental health professionals, affirmative and inclusive actions can be taken to support questioning youth, unsure adults, and distrustful older people, and to help improve the resilience and well-being of their LGBTQ+ service-users.

scholarly journals COVID-19 and mortality risk in patients with psychiatric disorders

2021 ◽  
Author(s):  
George Kirov ◽  
Emily Baker
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Life Expectancy ◽  
Psychiatric Disorders ◽  
Mortality Risk ◽  
Mental Health Problems ◽  
Cardiovascular Disorders ◽  
Uk Biobank ◽  
Increased Risk ◽  
The Uk

COVID-19 has already caused the deaths of over 2.5 million people worldwide. Patients with certain medical conditions and severe psychiatric disorders are at increased risk of dying from it. However, such people have a reduced life expectancy anyway, raising the question whether COVID-19 incurs a specific risk for such patients for dying, over and above the risk of dying from other causes. We analysed the UK Biobank data of half a million middle-aged participants from the UK. From the start of 2020 up to 24th January 2021, 894 participants had died from COVID-19 and another 4,562 had died from other causes. We demonstrate that the risk of dying from COVID-19 among patients with mental health problems, especially those with dementia, schizophrenia, or bipolar disorder, is increased compared to the risk of dying from other causes. This increase among patients with severe psychiatric disorders cannot be explained solely by the higher rate of diabetes or cardiovascular disorders.

Low Physical Activity in Adolescence is Associated with Increased Risk for Mental Health Problems

2009 ◽  
Vol 13 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Karin Monshouwer ◽  
Margreet ten Have ◽  
Mireille Van Poppel ◽  
Han Kemper ◽  
Wilma Vollebergh
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Problems ◽  
Health Problems ◽  
Increased Risk

Family Type Predicts Mental Health Problems in Young Adults: A Survey of Students at a University in Botswana

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Problems ◽  
Single Mother ◽  
Health Problems ◽  
Family Type ◽  
Cross Sectional ◽  
Intact Family ◽  
Increased Risk ◽  
Family Types

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.

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