British Journal of Psychiatry, 188(5), May 2006, pp.465-471.
Publisher:
Cambridge University Press
... interviewed (response rate 79.9%), 12.1% had a lifetime rate of at least one DSM–IV disorder and 5.8% had 12-month disorders. Anxiety disorders were the most common (5.7% lifetime, 4.1% 12-month rates) but virtually no generalised anxiety or post-traumatic stress disorder were identified. Of the 23% who had seriously disabling disorders, only about 8% had received treatment in the preceding 12 months.
Large-scale community studies of the prevalence of mental disorders using standardised assessment tools are rare in sub-Saharan Africa. There was a Multistage stratified clustered sampling of households in the Yoruba-speaking parts of Nigeria. Face-to-face interviews used the World Mental Health version of the Composite International Diagnostic Interview (WMH–CIDI). Of the 4984 people interviewed (response rate 79.9%), 12.1% had a lifetime rate of at least one DSM–IV disorder and 5.8% had 12-month disorders. Anxiety disorders were the most common (5.7% lifetime, 4.1% 12-month rates) but virtually no generalised anxiety or post-traumatic stress disorder were identified. Of the 23% who had seriously disabling disorders, only about 8% had received treatment in the preceding 12 months. Treatment was mostly provided by general medical practitioners; only a few were treated by alternative practitioners such as traditional healers. The observed low rates seem to reflect demographic and ascertainment factors. There was a large burden of unmet need for care among people with serious disorders.
Subject terms:
post traumatic stress disorder, assessment, anxiety, demographics;
Social Science and Medicine, 66(12), June 2008, pp.2401-2412.
Publisher:
Elsevier
The strong negative correlations observed between the sense of coherence (SOC) scale and measures of depression and anxiety raise the question of whether the SOC scale inversely measures the other constructs. The main aim of the present study was to examine the discriminant validity of the three measures by comparing their associations with health indicators and behaviours. The participants were 25 to 74-year-old Finnish men (n = 2351) and women (n = 2291) from the National Cardiovascular Risk Factor Survey conducted in 1997. The SOC scale had high inverse correlations with both depression (r = −0.62 among both men and women) and anxiety measures (r = −0.57 among the men and r = −0.54 among the women). Although confirmatory factor analyses suggested that it was possible to differentiate between SOC, cognitive depressive symptoms and anxiety, the estimated correlations were even higher than those mentioned above. Education was related only to SOC, but the associations of SOC, cognitive depressive symptoms and anxiety with self-reported and clinically measured health indicators (body mass index, blood pressure, cholesterol) and health behaviours were almost identical. The variation in the lowest SOC tertile was more strongly associated with health variables than in the highest tertile. To conclude, the size of the overlap between the SOC and depression scales was the same as between depression and anxiety measures. This indicates that future studies should examine the discriminant validity of different psychosocial scales more closely, and should compare them in health research in order
The strong negative correlations observed between the sense of coherence (SOC) scale and measures of depression and anxiety raise the question of whether the SOC scale inversely measures the other constructs. The main aim of the present study was to examine the discriminant validity of the three measures by comparing their associations with health indicators and behaviours. The participants were 25 to 74-year-old Finnish men (n = 2351) and women (n = 2291) from the National Cardiovascular Risk Factor Survey conducted in 1997. The SOC scale had high inverse correlations with both depression (r = −0.62 among both men and women) and anxiety measures (r = −0.57 among the men and r = −0.54 among the women). Although confirmatory factor analyses suggested that it was possible to differentiate between SOC, cognitive depressive symptoms and anxiety, the estimated correlations were even higher than those mentioned above. Education was related only to SOC, but the associations of SOC, cognitive depressive symptoms and anxiety with self-reported and clinically measured health indicators (body mass index, blood pressure, cholesterol) and health behaviours were almost identical. The variation in the lowest SOC tertile was more strongly associated with health variables than in the highest tertile. To conclude, the size of the overlap between the SOC and depression scales was the same as between depression and anxiety measures. This indicates that future studies should examine the discriminant validity of different psychosocial scales more closely, and should compare them in health research in order to bring parallel concepts into the same scientific discussion.
Subject terms:
mental health problems, anxiety, demographics, depression, health needs;
International Journal of Geriatric Psychiatry, 22(11), November 2007, pp.1141-1146.
Publisher:
Wiley
... aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.
Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.
British Journal of Psychiatry, 192(3), March 2008, pp.171-177.
Publisher:
Cambridge University Press
The public health significance of mixed anxiety–depressive disorder (MADD) and the distinctiveness of its phenomenology have yet to be established. The aim was to determine the public health significance of MADD, and to compare its phenomenology with ICD–10 anxiety, depressive, and comorbid anxiety and depressive disorders. Weighted analysis of data from the Great Britain National Psychiatric Morbidity survey was conducted with a representative household sample of 8580 persons aged 16–74 years. The 1-month prevalence of MADD was 8.8%. A fifth of all days off work in Britain occurred in this group. The symptom profile of MADD was similar to ‘pure’ ICD–10 anxiety and depression, but with a lower overall symptom count. The disorder was associated with significant impairment of health-related quality of life. Differences in health-related quality of life measures between diagnostic groups were accounted for by overall symptom severity, which remained strongly associated with health-related quality of life measures after adjusting for diagnostic group. The finding that half of the anxiety, depression and MADD cases and a third of the comorbid depression and anxiety cases grouped into a single latent class challenges the notion of these conditions as having distinct phenomenologies. Mixed presentations may be the norm in the population. The data support the pathological significance of MADD in its negative impact upon population health. Dimensional approaches to classification may provide a more parsimonious description of anxiety and depressive disorders compared with categorical
The public health significance of mixed anxiety–depressive disorder (MADD) and the distinctiveness of its phenomenology have yet to be established. The aim was to determine the public health significance of MADD, and to compare its phenomenology with ICD–10 anxiety, depressive, and comorbid anxiety and depressive disorders. Weighted analysis of data from the Great Britain National Psychiatric Morbidity survey was conducted with a representative household sample of 8580 persons aged 16–74 years. The 1-month prevalence of MADD was 8.8%. A fifth of all days off work in Britain occurred in this group. The symptom profile of MADD was similar to ‘pure’ ICD–10 anxiety and depression, but with a lower overall symptom count. The disorder was associated with significant impairment of health-related quality of life. Differences in health-related quality of life measures between diagnostic groups were accounted for by overall symptom severity, which remained strongly associated with health-related quality of life measures after adjusting for diagnostic group. The finding that half of the anxiety, depression and MADD cases and a third of the comorbid depression and anxiety cases grouped into a single latent class challenges the notion of these conditions as having distinct phenomenologies. Mixed presentations may be the norm in the population. The data support the pathological significance of MADD in its negative impact upon population health. Dimensional approaches to classification may provide a more parsimonious description of anxiety and depressive disorders compared with categorical approaches.
Subject terms:
public health, survey design, anxiety, demographics, depression, diagnosis;
British Journal of Psychiatry, 192(2), February 2008, pp.112-117.
Publisher:
Cambridge University Press
... Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups. Lifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.
Data on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances. A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups. Lifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.
Subject terms:
mental health problems, policy, substance misuse, anxiety, demographics, evidence-based practice;
Journal of Adolescence, 30(6), December 2007, pp.1071-1076.
Publisher:
Academic Press
A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. The 12-month prevalence for all anxiety disorders was 15.0% (females=19.6%; males=11.4%). There were significant gender differences in the prevalence for all anxiety disorders and social anxiety disorder and significant age difference in the prevalence of separation anxiety disorder. The prevalence of anxiety disorders in Nigerian secondary school adolescents was comparable to the rates found in the western world. Health policies must integrate adolescents’ anxiety as a disorder of public health significance. Further studies are needed to evaluate the factors associated with anxiety disorders amongst adolescents
A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. The 12-month prevalence for all anxiety disorders was 15.0% (females=19.6%; males=11.4%). There were significant gender differences in the prevalence for all anxiety disorders and social anxiety disorder and significant age difference in the prevalence of separation anxiety disorder. The prevalence of anxiety disorders in Nigerian secondary school adolescents was comparable to the rates found in the western world. Health policies must integrate adolescents’ anxiety as a disorder of public health significance. Further studies are needed to evaluate the factors associated with anxiety disorders amongst adolescents in this region.
Subject terms:
psychiatry, adolescence, anxiety, demographics, cultural identity, gender;
Journal of Aggression Maltreatment and Trauma, 9(1/2), 2004, pp.201-212.
Publisher:
Taylor and Francis
... of a traumatic event. Of those, 39.5 percent suffered from posttraumatic stress disorder, 23.3 percent from a mood disorder (depression), 38.5 percent from an anxiety disorder (e.g., panic disorder or phobia), and 8.7 percent from somatoform disorder. Healing would necessitate a concerted, collaborative effort, with much greater resources and leadership provided by governmental and civil institutions.
Since 1990, Algerians have suffered from the effects of radical Islamist terrorism. The official estimate of 150,000 massacred terrorism victims seems low and includes only direct victims. Epidemiological research conducted in 1999-2000 found that the Algerian population has suffered enormously. A random sample of the adult population showed 91.9 percent of these adults were victims of a traumatic event. Of those, 39.5 percent suffered from posttraumatic stress disorder, 23.3 percent from a mood disorder (depression), 38.5 percent from an anxiety disorder (e.g., panic disorder or phobia), and 8.7 percent from somatoform disorder. Healing would necessitate a concerted, collaborative effort, with much greater resources and leadership provided by governmental and civil institutions.
Subject terms:
Islam, post traumatic stress disorder, terrorism, anxiety, collaboration, demographics, depression;
British Journal of Psychiatry, 184(4), April 2004, pp.289-290.
Publisher:
Cambridge University Press
There has been a tendency in the UK, as well as elsewhere, to fund serial cross-sectional surveys rather than genuinely prospective research. If not more cross-sectional surveys, then what? First, the time has probably come to embrace dimensional models of non-psychotic morbidity, particularly given consistent evidence that even mild and moderate levels of anxiety and depression (which
There has been a tendency in the UK, as well as elsewhere, to fund serial cross-sectional surveys rather than genuinely prospective research. If not more cross-sectional surveys, then what? First, the time has probably come to embrace dimensional models of non-psychotic morbidity, particularly given consistent evidence that even mild and moderate levels of anxiety and depression (which are the most prevalent in all community surveys) are associated with adverse outcomes. Second, research is needed that is prospective, population-based and hypothesis-driven. Third, population-based research is needed that integrates epidemiology and neurobiology. This research is needed to elucidate the processes that link deprivation and morbidity, and to discover why the common mental disorders are characterised by recurrence and relapse. Fourth, even if countries and funding agencies are unable or unwilling to fund costly longitudinal research, the evidence accumulated so far indicates with sufficient certainty that psychiatric disorders exist all over the world.
Subject terms:
life expectancy, psychiatry, research methods, surveys, anxiety, demographics, depression;
Indian Journal of Social Work, 58(1), January 1997, pp.1-12.
Publisher:
Tata Institute of Social Sciences
Women drawn from working women's hostels in Bangalore city were studied for their anxiety as related to selected variables. Reports on statistics and the factors contributing to their anxiety. Results imply the necessity of using hostel rules and regulations with discretion and empathy along with improvement in services and living conditions in the hostels.
Women drawn from working women's hostels in Bangalore city were studied for their anxiety as related to selected variables. Reports on statistics and the factors contributing to their anxiety. Results imply the necessity of using hostel rules and regulations with discretion and empathy along with improvement in services and living conditions in the hostels.
International Journal of Geriatric Psychiatry, 11(11), November 1996, pp.987-990.
Publisher:
Wiley
One hundred and fifty-eight consecutive patients attending a university memory clinic were assessed using variety of standardized instruments. Dementia was diagnosed according to DSM-III-R criteria. One hundred and nine patients had DSM-II-R dementia. None of the cognitive or demographic variables were significantly associated with the presence of anxiety symptoms. Three main categories of anxiety symptoms were evident - anxiety related to depression, anxiety related to psychosis and anxiety to interpersonal situations.
One hundred and fifty-eight consecutive patients attending a university memory clinic were assessed using variety of standardized instruments. Dementia was diagnosed according to DSM-III-R criteria. One hundred and nine patients had DSM-II-R dementia. None of the cognitive or demographic variables were significantly associated with the presence of anxiety symptoms. Three main categories of anxiety symptoms were evident - anxiety related to depression, anxiety related to psychosis and anxiety to interpersonal situations.
Subject terms:
mental health problems, older people, assessment, anxiety, dementia, demographics, diagnosis;