Introduktion: Psykisk ohälsa har länge ökat i Sverige. Psykisk ohälsa kan delas upp i psykiska besvär och psykiatriska tillstånd. Psykiatriska tillstånd innefattar en psykiatrisk diagnos. Nästan en av åtta människor lever idag med något slags psykiatriskt tillstånd. Det är vanligt att personer med psykiatriska tillstånd också lever med någon somatisk sjukdom.  Syfte: Syftet var att undersöka hur personer med självrapporterat och/eller diagnostiserat psykiatriskt tillstånd upplever bemötandet från vårdpersonal inom somatisk hälso- och sjukvård. Metod: Litteraturöversikt baserad på tio kvalitativa originalartiklar. Artiklarna identifierades genom sökning i databaserna Pubmed, PsycInfo och CINAHL. Resultat: Sex kategorier identifierades som beskrev hur personer med psykiatriska tillstånd upplevde bemötandet i somatisk hälso- och sjukvård. Personer med psykiatriska tillstånd kände att de inte blev trodda när de sökte vård. De kände att de blev diskriminerade och stigmatiserade av vårdpersonalen vilket gjorde att personer drog sig från att söka vård. Det fanns även personal som respekterade och lyssnade på personer med psykiatriska tillstånd. Detta gjorde att personerna fick mer förtroende för vårdpersonalen.  Slutsats: Personer med psykiatriska tillstånd hade olika upplevelser av bemötandet inom somatisk hälso- och sjukvård. Många hade negativa upplevelser av bemötandet, vilket resulterade i att vissa drog sig för att söka vård. Det behövs mer kunskap och forskning inom detta område för att man ska få en ökad förståelse och för att ge personer med psykiatriska tillstånd ett så bra bemötande som möjligt. / Introduction: Mental illness has long increased in Sweden. Mental illness can be divided into mental disorders and psychiatric conditions. Psychiatric conditions include a psychiatric diagnosis. Almost one in eight people today lives with some psychiatric condition. It is common for people with psychiatric conditions to also live with some somatic illness.  Aim: The aim was to explore how people with self-reported and/or diagnosed psychiatric conditions experience the treatment from health care staff within the somatic care.  Method: Literature review based on ten qualitative original articles. The articles were searched for via the databases Pubmed, PsycInfo and CINAHL. Results: Six categories were identified that described how people with psychiatric conditions experienced the treatment in somatic healthcare. People with psychiatric conditions felt they were not believed when they sought care. They felt that they were discriminated against and stigmatized by the healthcare staff, which made people withdraw from seeking care. There were also staff who respected and listened to people with psychiatric conditions. This meant that the people gained more trust in the healthcare staff. Conclusion: People with psychiatric conditions had different experiences of the treatment within somatic healthcare. Many had negative experiences of the treatment, which made some withdraw from seeking care. More knowledge and research is needed in this area in order to gain an increased understanding and to give people with psychiatric conditions the best treatment possible.

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This study was conducted to determine why counselors use the Diagnostic and Statistical Manual of Mental Disorders (Third Edition, Revised) (DSM-III-R), to describe their opinions regarding the advantages and disadvantages of its use, to determine whether they believe deliberate misdiagnosis of clients occurs, to determine whether they believe they are adequately trained in the use of the DSM-III-R, and to identify counselor characteristics that are significantly related to their evaluations of the DSM-III-R. A mailed questionnaire was used to collect data from a random sample of 550 Certified Clinical Mental Health Counselors. The response rate was 70.7%. Results of the study indicate that the respondents use the DSM-III-R for billing insurance, case conceptualization, treatment planning and communication with other professionals, meeting requirements of employers and external entities such as the courts, and for educational and evaluative functions. These reasons for its use are also considered to be the advantages of using the DSM-III-R. Disadvantages of the using the DSM-III-R identified include possible negative results of its use, bias and labeling, and difficulty in usage as well as difficulty applying it in marriage and family counseling. Respondents believe clients are deliberately misdiagnosed using the DSM-III-R, and a majority of respondents (62.87%) who indicated whether reported they had training in the use of the DSM-III-R and whether they believe they are adequately trained in its use said their training is adequate. Results of canonical correlation analyses indicate that respondents' amounts of training in the use of the DSM-III-R, their work settings, and their clients' being charged for counseling services are significantly related to various aspects of their evaluations of the advantages and disadvantages of the DSM-III-R. / Ph. D.

Introdução: Pouco se conhece sobre Transtorno Específico de Aprendizagem (TEA), principalmente em países de baixa e média renda (PBMR) e muito menos em amostras representativas de escolas de cidades pequenas fora de grandes centros urbanos. Poucos estudos enfatizaram os novos critérios do DSM-5 para TEA. Investigamos a prevalência do Transtorno Específico de Aprendizagem de acordo com a nova classificação do DSM-5, suas comorbidades e correlatos em amostras escolares de alunos do 2º ao 6º ano que moram em cidades de tamanho médio de quatro regiões geográficas do Brasil (norte, nordeste, centro-oeste e sudeste). Métodos: O rendimento acadêmico foi medido pelo Teste de Desempenho Escolar. Os diagnósticos psiquiátricos foram avaliados pelo K-SADS-PL com informações obtidas do cuidador primário e o QI foi estimado por subtestes do WISC-III. Resultados: Um total de 1.618 crianças e adolescentes foram incluídas no estudo. As taxas de prevalência encontradas de Transtorno Específico de Aprendizagem foram: 7,6% para comprometimento global, 5,4% para comprometimento na escrita, 6,0% para comprometimento na área da aritmética, e 7,5% para comprometimento na leitura. Diferenças significativas foram detectadas nas taxas de prevalência entre as cidades (p < 0,001). O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) foi o único transtorno mental comórbido com associação significativa com TEA com comprometimento global (8,2%; p=0,031). Transtornos de ansiedade, TDAH e o grupo Qualquer Transtorno Mental foram associados com TEA com comprometimento na aritmética (13,8% com p=0,008; 12,4% com p < 0,001; 25,6% com p < 0,001, respectivamente). Inúmeros correlatos sóciodemográficos (idade (p=0,018), cidade (p=0,004), status sócio-econômico (p=0,007), gênero (p=0,011), e QI (p < 0,001)) foram associados com Transtorno Específico de Aprendizagem com comprometimento global na amostra. Conclusões: A validação e normatização de instrumentos que avaliem o desempenho acadêmico é ainda um grande problema em inúmeros países, mas principalmente naqueles de baixa e média renda (PBMR). Como esperado, foi encontrado uma significativa heterogeneidade nas taxas de prevalência de TEA entre as diferentes regiões geográficas do Brasil, sendo esse um país com forte diversidade. TEA com comprometimento global e em aritmética foram significativamente associados com comorbidades psiquiátricas. Todos correlatos avaliados (idade, cidade, status sócioeconômico, gênero, e QI) foram significativamente associados com TEA com comprometimento global / Introduction: Little is known about Specific Learning Disorder (SLD) in Low and Middle Income Countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the 2nd to 6th grades living in median cities from 4 different geographic regions in Brazil (north, northeast, central and southeast). Methods: A national test for academic performance (TDE) covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver, and IQ was estimated by WISC-III subtests. Results: A total of 1,618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6% for global impairment, 5.4% for writing, 6.0% for arithmetic and 7.5% for reading impairment. Significant differences were detected in prevalence rates among cities (p < 0.001). Attention-deficit/Hyperactivity Disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (8.2%; p=0.031). Anxiety Disorders, ADHD and the group Any Mental Disorder (13.8% with p=0.008; 12.4% with p < 0.001; 25.6% with p < 0.001, respectively) were associated with SLD with arithmetic impairment. Several socio-demographic correlates (age (p=0.018), city (p=0.004), socioeconomic status (p=0.007), gender (p=0.011), and IQ (p < 0.001)) were significantly associated with SLD with global impairment in our sample. Conclusions: Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment were significantly associated with psychiatric comorbidities. All correlates investigated (age, city, socioeconomic status, gender, and IQ) were significantly associated with SLD with global impairment

Leung Siu-Ngan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 72-74). / Abstracts in English and Chinese. / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Background --- p.1 / Chapter 1.2 --- Structure and Contents of Data Sets --- p.6 / Chapter 2 --- Estimation of Prevalence of Mentally Disorders --- p.10 / Chapter 2.1 --- Likelihood Function Approach --- p.10 / Chapter 2.2 --- Maximum Likelihood Estimation via EM Algorithm --- p.13 / Chapter 2.3 --- The SEM Algorithm --- p.16 / Chapter 3 --- Estimation of Lifetime Comorbidity --- p.24 / Chapter 3.1 --- What is Comorbidity? --- p.24 / Chapter 3.2 --- Likelihood Function Approach --- p.25 / Chapter 3.2.1 --- Likelihood Function Model --- p.27 / Chapter 3.2.2 --- Maximum Likelihood Estimation via EM Algorithm --- p.28 / Chapter 3.2.3 --- Odds Ratio --- p.31 / Chapter 4 --- Logistic Regression --- p.35 / Chapter 4.1 --- Imputation Method of Missing Values --- p.35 / Chapter 4.1.1 --- Hot Deck Imputation --- p.35 / Chapter 4.1.2 --- A logistic Regression Imputation Model for Dichotomous Response --- p.40 / Chapter 4.2 --- Combining Results from Different Imputed Data Sets --- p.47 / Chapter 4.3 --- Itemization on Screening --- p.60 / Chapter 4.3.1 --- Methods of Weighting on the Screening Questions --- p.61 / Chapter 4.3.2 --- Statistical Analysis --- p.62 / Chapter 5 --- Conclusion and Discussion --- p.68 / Appendix: SRQ Questionnaire --- p.69 / Bibliography --- p.72

Introdução: Pouco se conhece sobre Transtorno Específico de Aprendizagem (TEA), principalmente em países de baixa e média renda (PBMR) e muito menos em amostras representativas de escolas de cidades pequenas fora de grandes centros urbanos. Poucos estudos enfatizaram os novos critérios do DSM-5 para TEA. Investigamos a prevalência do Transtorno Específico de Aprendizagem de acordo com a nova classificação do DSM-5, suas comorbidades e correlatos em amostras escolares de alunos do 2º ao 6º ano que moram em cidades de tamanho médio de quatro regiões geográficas do Brasil (norte, nordeste, centro-oeste e sudeste). Métodos: O rendimento acadêmico foi medido pelo Teste de Desempenho Escolar. Os diagnósticos psiquiátricos foram avaliados pelo K-SADS-PL com informações obtidas do cuidador primário e o QI foi estimado por subtestes do WISC-III. Resultados: Um total de 1.618 crianças e adolescentes foram incluídas no estudo. As taxas de prevalência encontradas de Transtorno Específico de Aprendizagem foram: 7,6% para comprometimento global, 5,4% para comprometimento na escrita, 6,0% para comprometimento na área da aritmética, e 7,5% para comprometimento na leitura. Diferenças significativas foram detectadas nas taxas de prevalência entre as cidades (p < 0,001). O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) foi o único transtorno mental comórbido com associação significativa com TEA com comprometimento global (8,2%; p=0,031). Transtornos de ansiedade, TDAH e o grupo Qualquer Transtorno Mental foram associados com TEA com comprometimento na aritmética (13,8% com p=0,008; 12,4% com p < 0,001; 25,6% com p < 0,001, respectivamente). Inúmeros correlatos sóciodemográficos (idade (p=0,018), cidade (p=0,004), status sócio-econômico (p=0,007), gênero (p=0,011), e QI (p < 0,001)) foram associados com Transtorno Específico de Aprendizagem com comprometimento global na amostra. Conclusões: A validação e normatização de instrumentos que avaliem o desempenho acadêmico é ainda um grande problema em inúmeros países, mas principalmente naqueles de baixa e média renda (PBMR). Como esperado, foi encontrado uma significativa heterogeneidade nas taxas de prevalência de TEA entre as diferentes regiões geográficas do Brasil, sendo esse um país com forte diversidade. TEA com comprometimento global e em aritmética foram significativamente associados com comorbidades psiquiátricas. Todos correlatos avaliados (idade, cidade, status sócioeconômico, gênero, e QI) foram significativamente associados com TEA com comprometimento global / Introduction: Little is known about Specific Learning Disorder (SLD) in Low and Middle Income Countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the 2nd to 6th grades living in median cities from 4 different geographic regions in Brazil (north, northeast, central and southeast). Methods: A national test for academic performance (TDE) covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver, and IQ was estimated by WISC-III subtests. Results: A total of 1,618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6% for global impairment, 5.4% for writing, 6.0% for arithmetic and 7.5% for reading impairment. Significant differences were detected in prevalence rates among cities (p < 0.001). Attention-deficit/Hyperactivity Disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (8.2%; p=0.031). Anxiety Disorders, ADHD and the group Any Mental Disorder (13.8% with p=0.008; 12.4% with p < 0.001; 25.6% with p < 0.001, respectively) were associated with SLD with arithmetic impairment. Several socio-demographic correlates (age (p=0.018), city (p=0.004), socioeconomic status (p=0.007), gender (p=0.011), and IQ (p < 0.001)) were significantly associated with SLD with global impairment in our sample. Conclusions: Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment were significantly associated with psychiatric comorbidities. All correlates investigated (age, city, socioeconomic status, gender, and IQ) were significantly associated with SLD with global impairment

Both diabetes and behavioral health disorders (mental and substance use disorders) are significant health issues in the United States. While previous studies have shown worse health outcomes in people with diabetes and co-occurring behavioral health disorders (BHDs) than those with diabetes alone, it is unclear whether the quality of diabetes care was poorer in the presence of co-occurring BHDs. Although previous research has observed a trend of positive outcomes in people with comprehensive diabetes care, there is a lack of evidence about whether that mode of care delivery can improve outcomes in people with co-occurring BHDs. Therefore, further studies are necessary. Using a combined dataset from Medicare and Medicaid claims for Massachusetts residents, this study compared the quality of diabetes care (e.g., having at least 1 hemoglobin A1c test) and diabetes outcomes (e.g., eye complications) among Medicare and Medicaid beneficiaries with diabetes and co-occurring BHDs to those with diabetes alone in Massachusetts in 2005. The results showed a mixed picture on the relationships between BHDs and diabetes outcomes. While substance use disorders had adverse impact on adherence to quality measures (e.g., 20% less likely to attain full adherence, p0.05). Findings from this dissertation research suggest that disparities exist in the quality of diabetes care and health outcomes between people with substance use disorders and those without. The mode of care delivery needs to be further examined so that interventions can be designed to improve the outcomes of people with diabetes.

The purpose of this study was to examine parents’ management styles when caring for adult children with serious mental illness (SMI), as well as parents’ perspectives on what type of community-based mental health interventions would support and/or enhance overall family functioning. This qualitative descriptive study was undergirded by Knafl and Deatrick’s Family Management Style Framework. Thirty parents (N = 30) caring for adult children with SMI over age 18 were recruited as participants. Demographic data included age, gender, ethnicity, educational level, annual income, and National Alliance on Mental Illness membership. Parents were interviewed in their homes or other private setting. Verbal informed consent was obtained. Audio-recorded, individual, semistructured interviews were conducted until redundancy was achieved. Data were analyzed using qualitative content analysis. Four major themes emerged from the data. These themes described prolonged, difficult, and confusing phases that parents and the family undergo in caring for an adult child with SMI. These phases have a progressive nature, moving from parents recognizing that their child has a SMI to redefining family life as a result of caring for an adult child with SMI. Successful management of these phases must include increasing access to mental health information, mental health screening, early interventions, violence prevention, and various treatment options for adult children and their families.