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Comparing sense of coherence, depressive symptoms and anxiety, and their relationships with health in a population-based study
- Authors:
- KONTINEN Hanna, HAUKKALA Ari, UUTELA Anitta
- Journal article citation:
- 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 to bring parallel concepts into the same scientific discussion.
Betting on a different horse: a qualitative analysis of mental health in health promotion policies
- Authors:
- SOLIN Pia, LEHTO Juhani
- Journal article citation:
- Journal of Mental Health Promotion, 3(3), September 2004, pp.8-17.
- Publisher:
- Pavilion
Aims to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy terms. Arguments make the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health problem, socio-economic and individual costs of mental health problems, and the view that mental wellbeing is a crucial element of overall health. However, problems of definition and measurement, and a traditional focus on treatment and care, continue to make mental health promotion problematic for policy makers.
Impact of psychiatric disorders on health-related quality of life: general population survey
- Authors:
- SAARNI Samuli I., et al
- Journal article citation:
- British Journal of Psychiatry, 190(4), April 2007, pp.326-332.
- Publisher:
- Cambridge University Press
Measurement of health-related quality of life (HRQoL) with generic preference-based instruments enables comparisons of severity across different conditions and treatments. This is necessary for rational public health policy. The aim was to measure HRQoL decrement and loss of quality-adjusted life-years (QALYs) associated with pure and comorbid forms of depressive and anxiety disorders and alcohol dependence. A general population survey was conducted of Finns aged 30 years and over. Psychiatric disorders were diagnosed with the Composite International Diagnostic Interview and HRQoL was measured with the 15D and EQ–5D questionnaires. Dysthymia, generalised anxiety disorder and social phobia were associated with the largest loss of HRQoL on the individual level before and after adjusting for somatic and psychiatric comorbidity. On the population level, depressive disorders accounted for 55%, anxiety disorders 30%, and alcohol dependence for 15% of QALY loss identified in this study. Chronic anxiety disorders and dysthymia are associated with poorer HRQoL than previously thought.