Background: Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low- to middle-income countries in the World Mental Health Survey Initiative. Methods: Major depressive episodes (MDE) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. Results: The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2:1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low- to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions: MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH. ; The Brazil Megacity Mental Health Survey is supported by the State of Brazil Research Foundation (FAPESP) Thematic Project Grant 03/00204-3. The Chinese World Mental Health Survey Initiative is supported by the Pfizer Foundation. The Colombian National Study of Mental Health (NSMH) is supported by the Ministry of Social Protection. The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP) and other local agencies, and by an unrestricted educational grant from GlaxoSmithKline. The Epidemiological Study on Mental Disorders in India was funded jointly by Government of India and WHO. The Israel National Health Survey is funded by the Ministry of Health with support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-Shogai-023, H14-Tokubetsu-026, H16-Kokoro-013) from the Japan Ministry of Health, Labour and Welfare. The Lebanese National Mental Health Survey (LEBANON) is supported by the Lebanese Ministry of Public Health, the WHO (Lebanon), Fogarty International, anonymous private donations to IDRAAC, Lebanon, and unrestricted grants from Janssen Cilag, Eli Lilly, GlaxoSmithKline, Roche and Novartis. The Mexican National Comorbidity Survey (M-NCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544-H), with supplemental support from the PanAmerican Health Organization (PAHO). Te Rau Hinengaro: The New Zealand Mental Health Survey (NZMHS) is supported by the New Zealand Ministry of Health, Alcohol Advisory Council and the Health Research Council. The South Africa Stress and Health Study (SASH) is supported by the USA National Institute of Mental Health (R01-MH059575) and National Institute of Drug Abuse with supplemental funding from the South African Department of Health and the University of Michigan. The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the USA National Institute of Mental Health (RO1-MH61905). The USA National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trusts
Posttraumatic Stress Disorder (PTSD) is a chronic, under-detected and under-treated psychiatric consequence of trauma that is often linked to new-onset medical and psychological conditions, impaired quality of life and long-term disability across the globe. This book is the first systematic analysis of the rates, risk factors, consequences and global burden of trauma and PTSD across a variety of wealthy and underdeveloped settings. An analysis of a global survey conducted by the World Health Organization and featuring findings from over 70,000 participants around the world, this text demonstrates a unique perspective on the prevalence of exposure to trauma and PTSD and the impact it has on population health. The findings inside this text underscore the urgent need for policymakers and healthcare providers to prioritize interventions aimed at reducing the burden of trauma, PTSD and its consequences
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"PTSD is a chronic, under-detected and under-treated psychiatric consequence of trauma that is often linked to new-onset medical and psychological conditions, impaired quality of life and long-term disability across the globe. This book is the first systematic analysis of the rates, risk factors, consequences and global burden of trauma and PTSD across a variety of wealthy and underdeveloped settings. An analysis of a global survey conducted by the World Health Organisation and featuring findings from over 70,000 participants around the world, this text demonstrates a unique perspective on the prevalence of exposure to trauma and PTSD and the impact it has on population health. The findings inside this text underscore the urgent need for policymakers and healthcare providers to prioritize interventions aimed at reducing the burden of trauma, PTSD and its consequences"--Provided by publisher
Background: The Chornobyl nuclear power plant explosion in April 1986 was one of the worst ecological disasters of the 20th century. As with most disasters, its long-term mental health consequences have not been examined. Aims: This study describes the psychological well-being and risk perceptions of exposed women 19–20 years later and the risk factors associated with mental health. Methods: We assessed Chornobyl-related post-traumatic stress disorder (PTSD), major depressive episode (MDE) and overall distress among three groups of women in Kyiv, Ukraine ( N = 797): mothers of small children evacuated to Kyiv in 1986 from the contaminated area near the plant (evacuees); mothers of their children's classmates (neighbourhood controls); and population-based controls from Kyiv. Risk perceptions and epidemiologic correlates were also obtained. Results: Evacuees reported poorer well-being and more negative risk perceptions than controls. Group differences in psychological well-being remained after adjustment for epidemiologic risk factors but became non-significant when Chornobyl risk perceptions were added to the models. Conclusions: The relatively poorer psychological well-being among evacuees is largely explained by their continued concerns about the physical health risks stemming from the accident. We suggest that this is due to the long-term, non-resolvable nature of health fears associated with exposure.
Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.
Background: Distrust in authorities has negative effects on mental health. Aims: In this study, we aimed to explore whether the impact of distrust in government on mental health became stronger in the area heavily affected by the 2011 Fukushima nuclear power plant accident. Methods: We examined the effects of distrust in the national government on depressive symptoms three years after the accident among community residents in Fukushima prefecture using those in the Kanto area (the area surrounding Tokyo) as a control. A questionnaire survey was administered to a random sample of 1000 residents in Fukushima prefecture and 1650 residents in the Kanto area. Distrust in the national government was assessed using a four-point single-item scale. Depressive symptoms were measured using the Patient Health Questionnaire-9. The associations of residential area (i.e. living in Fukushima prefecture or in the Kanto area) and distrust in the national government with depressive symptoms were examined, controlling for socio-demographic characteristics and disaster-related experiences using multivariate linear regression analyses. We used the interaction term of residential area and distrust in the government to explore the difference in the association between the respondents in Fukushima prefecture and those in the Kanto area. Results: Valid responses were obtained from 976 (36.8%) residents. Distrust in the government was associated with depressive symptoms and the association was stronger in Fukushima prefecture than in the Kanto area. Conclusion: The deleterious effects of distrust in the government on mental health may become more serious after a nuclear power plant accident and require careful attention during support activities in an affected area.
We aimed to explore the effects of prolonged radiation risk perceptions on mental health after the Fukushima nuclear power plant accident occurred in 2011. We investigated the longitudinal associations of radiation risk perceptions five years after the accident with psychological distress and posttraumatic stress symptoms two years later among non-evacuee community residents of Fukushima prefecture. A two-wave questionnaire survey was administered for 4,900 randomly sampled residents in 49 municipalities of Fukushima prefecture excluding the evacuation area designated by the Japanese government. Radiation risk perceptions were assessed with a seven-item scale. Psychological distress and posttraumatic stress symptoms were measured by the K6 and the six-item abbreviated version of the Posttraumatic Stress Disorder Checklist-Specific version, respectively. We investigated the associations of radiation risk perceptions in the first survey conducted in 2016 with psychological distress and posttraumatic stress symptoms in the follow-up survey conducted in 2017–18, controlling for the baseline level of distress or symptoms using multivariate logistic regression analyses. Valid responses were obtained from 1,148 residents (23.4%). Higher risk perceptions of radiation exposure in the first survey predicted later posttraumatic stress symptoms but not psychological distress after controlling for baseline symptoms or distress. High risk perceptions of radiation exposure after nuclear power plant accidents can lead to posttraumatic stress symptoms.
This article describes the development of a manualized, eight-session multiple health behavior change program which addresses sleep, exercise, nutrition, substance use, and working with one's healthcare team. Our goal was to design a structured, evidence-based program that could be facilitated by a single health professional and could act as an active, credible control for mind-body intervention studies. Psychoeducational content was adapted from the latest government and peer-reviewed guidelines. Preliminary work suggests the program is acceptable and feasible for use in patients of varying ages with heterogeneous mental and physical health problems and is adaptable for both face-to-face and online delivery.
In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA), Band 40, Heft 4, S. 327-335
