Among indigenous populations, there is significant evidence that the rates of completed suicide are much higher than in the general population. The current study examines whether the prevalence and risk factors of suicidal ideation, plans and attempts differ when comparing an American Indian reservation sample to a US general population sample. Data were from the National Comorbidity Survey (n = 5,877) and the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (N = 3,084). The current findings indicate that there are few differences in the likelihood of suicidal behavior in conjunction with particular disorders or traumas. However, American Indians appeared more likely to make a suicide attempt and less likely to have suicidal thoughts in their lifetime when compared with the general population. Although preliminary and exploratory, findings provide evidence that suicide interventions for indigenous populations may require modification based on differential risk factors for suicide. / October 2008

This report presents an overview of the results of the US National Comorbidity Survey (NCS) (Kessler et al., 1994) and future directions based on these results. The NCS is a survey that was mandated by the US Congress to study the comorbidity of substance use disorders and nonsubstance psychiatric disorders in the general population of the US. (...)

Among indigenous populations, there is significant evidence that the rates of completed suicide are much higher than in the general population. The current study examines whether the prevalence and risk factors of suicidal ideation, plans and attempts differ when comparing an American Indian reservation sample to a US general population sample. Data were from the National Comorbidity Survey (n = 5,877) and the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (N = 3,084). The current findings indicate that there are few differences in the likelihood of suicidal behavior in conjunction with particular disorders or traumas. However, American Indians appeared more likely to make a suicide attempt and less likely to have suicidal thoughts in their lifetime when compared with the general population. Although preliminary and exploratory, findings provide evidence that suicide interventions for indigenous populations may require modification based on differential risk factors for suicide.

Among indigenous populations, there is significant evidence that the rates of completed suicide are much higher than in the general population. The current study examines whether the prevalence and risk factors of suicidal ideation, plans and attempts differ when comparing an American Indian reservation sample to a US general population sample. Data were from the National Comorbidity Survey (n = 5,877) and the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (N = 3,084). The current findings indicate that there are few differences in the likelihood of suicidal behavior in conjunction with particular disorders or traumas. However, American Indians appeared more likely to make a suicide attempt and less likely to have suicidal thoughts in their lifetime when compared with the general population. Although preliminary and exploratory, findings provide evidence that suicide interventions for indigenous populations may require modification based on differential risk factors for suicide.

Background: Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods: A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results: 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion: Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.

Abstract The aim of this study was to provide novel information on the change of cognitive performance and its predictors in early midlife between ages of 34 and 43 years. The change in verbal episodic memory between non-psychotic and schizophrenia samples was compared in the Northern Finland Birth Cohort 1966. In the non-psychotic sample, associations between primary school performance, sociodemographic factors and body mass index (BMI), and in the schizophrenia sample, between premorbid school performance and severity of illness with the change in cognitive performance were evaluated. There was no evidence of greater decline in verbal episodic memory in the schizophrenia sample, compared to the non-psychotic sample, though the schizophrenia sample had an overall lower cognitive performance at the baseline. In the non-psychotic sample, male gender, poorer school performance, increases in BMI and having no children predicted a decline in verbal episodic memory; poorer school performance and low vocational education and occupational class predicted a decline in visual episodic memory; and having children predicted a decline in executive function. In the schizophrenia sample, poorer premorbid school performance, but not the later course of illness, was related to a decline in cognitive performance. This study is one of the few studies to investigate the predictors of change in cognitive performance in the early middle-aged general population, and the first to investigate the predictors of cognitive change in early midlife schizophrenia. To summarize; poor cognitive performance in adolescence may be considered as a vulnerability marker for a later impairment in cognitive functioning. In schizophrenia, cognitive ability possibly declines mostly in a normative fashion with aging at the same rate as in the general population rather than as a result of neurodegenerative processes. These results might improve our understanding of midlife change in cognitive functioning and may also help to develop effective interventions of cognitive impairment in schizophrenia. / Tiivistelmä Tutkimuksen tavoitteena oli tuoda uutta tietoa kognitiivisen suoriutumisen muutoksesta sekä siihen liittyvistä tekijöistä varhaisessa keski-iässä ikävuosien 34 ja 43 välillä. Tutkimuksessa verrattiin kielellisessä muistisuoriutumisessa tapahtuvaa muutosta yleisväestön ja skitsofrenia-aineiston välillä Pohjois-Suomen vuoden 1966 syntymäkohortissa. Lisäksi yleisväestössä tutkittiin koulumenestyksen, sosiodemografisten tekijöiden ja painoindeksin yhteyttä ja skitsofrenia-aineistossa koulumenestyksen ja sairauden varhaisen kulun yhteyttä kognitiivisen suoriutumisen muutokseen. Kielellisen muistisuoriutumisen heikentyminen ei ollut skitsofrenia-aineistossa suurempaa verrattuna yleisväestöön, joskin kognitiivisen suoriutumisen lähtötaso oli skitsofrenia-aineistossa alempi. Yleisväestössä miessukupuoli, heikompi koulumenestys peruskoulussa, painoindeksin nousu ja lapsettomuus olivat yhteydessä kielellisen muistisuoriutumisen heikkenemiseen, heikompi koulumenestys peruskoulussa ja matala ammatillinen koulutus ja sosioekonominen asema näönvaraisen muistisuoriutumisen heikkenemiseen ja vanhemmuus toiminnanohjauksellisten taitojen laskuun. Skitsofrenia-aineistossa heikompi menestys peruskoulussa ennusti kognitiivisen suoriutumisen heikkenemistä kielellisen ja näönvaraisen muistin sekä toiminnanohjauksellisten taitojen osa-alueilla. Oireiden vakavuus ja toimintakyky sairastumisen jälkeen eivät liittyneet kognitiivisen suoriutumisen muutokseen. Tämä on yksi harvoista tutkimuksista, joissa on selvitetty kognitiivisen suoriutumisen muutosta ennustavia tekijöitä varhaisessa keski-iässä yleisväestössä, ja ensimmäinen, jossa on tutkittu kognitiivisen suoriutumisen muutosta ennustavia tekijöitä skitsofrenia-aineistossa varhaisessa keski-iässä. Yhteenvetona voidaan todeta, että heikko nuoruusiän koulumenestys voi ennustaa kognitiivisen suoriutumisen heikkenemistä varhaisessa keski-iässä. Kognitiivinen suorituskyky näyttää heikkenevän skitsofreniassa enemmänkin tavanomaisella tavalla ikääntymisen myötä kuin neurodegeneratiivisen prosessin seurauksena. Tämän tutkimuksen tulokset tuovat uutta tietoa kognitiivisen suoriutumisen muutoksesta keski-ikäisessä väestössä. Tuloksia voidaan myös hyödyntää kehitettäessä kognitiivisten häiriöiden hoitoa skitsofreniassa.

This report presents an overview of the results of the US National Comorbidity Survey (NCS) (Kessler et al., 1994) and future directions based on these results. The NCS is a survey that was mandated by the US Congress to study the comorbidity of substance use disorders and nonsubstance psychiatric disorders in the general population of the US. (...)

Objectives: Quality of life (QOL) is increasingly used as indicator in health research. The aim of this paper was an updated psychometric validation and a new standardization of the German version of the EUROHIS-QOL using a sample of the German general population assessed in 2021. The study focused on socio-economic characteristics and on anxiety and depressiveness as major indicators of mental health. Methods: With 8 items, the EUROHIS-QOL is an economical instrument for self-assessment. Results: Statistical tests revealed good psychometric properties. Gender- and age-group-specific norm values were calculated. The EUROHIS-QOL showed good discriminant validity for anxiety and depression symptoms. Participants without clinically relevant scores for depressiveness and anxiety reported significantly higher QOL. Multiple regression analysis showed that unemployment, younger age, not living with a partner, and an immigrant background were important predictors of lower QOL, whereas higher income, living in one's own home, and a high level of education predicted higher QOL. Conclusion: The EUROHIS-QOL was confirmed as an economical and reliable instrument for assessing QOL in the German general population.

Les objectifs de ce travail étaient d’évaluer la prévalence vie entière des traitements à visée psychotrope et les caractéristiques associées à cet usage dont l’adéquation avec l’existence de troubles psychiatriques. Les travaux ont été réalisés à partir des données issues de l’enquête Santé Mentale en Population Générale sur un échantillon de 36 785 adultes représentatifs de la population générale française. Un tiers des sujets a rapporté avoir fait usage d’au moins un traitement psychotrope au cours de la vie. L’inadéquation diagnostic-traitement est retrouvée dans le sens « usage en l’absence de trouble psychiatrique » aussi bien que dans le sens « absence d’usage en présence de trouble identifié ». Ainsi, seul un tiers des sujets avec un diagnostic de trouble dépressif récurrent a fait usage d’un traitement antidépresseur ou thymorégulateur. Concernant l’utilisation de traitements alternatifs, seuls 1,3 % des personnes rapportent un usage de traitement homéopathique à visée psychotrope. Ces traitements sont principalement utilisés par des personnes présentant un trouble anxieux en association avec un traitement psychotrope conventionnel. Des études ultérieures documentant l’ensemble des traitements à visée psychotrope utilisé dans le traitement des symptômes psychiques permettraient d’affiner les résultats sur l’adéquation diagnostic-traitement et d’estimer le nombre de sujets évitant le recours aux traitements conventionnels par l’utilisation d’alternatives thérapeutiques. / The aims of this work were to assess the lifetime prevalence of psychotropic drug use and the characteristics associated with use, particularly the congruence with psychiatric diagnoses. The studies were performed using the database from the survey Mental Health in the General Population including 36 785 persons representative of the French general population. One out of three subjects reported a lifetime use of psychotropic treatment. The non-congruence between diagnosis and psychotropic drug was observed in the pattern “use without psychiatric disorders” as well as in the pattern “no use with psychiatric disorders”. So, only one out of three persons with recurrent major depressive disorder reported having used an antidepressant or a mood stabilizer. Regarding complementary and alternative medicine use, only 1,3% of persons reported use of homeopathic treatment for psychiatric symptoms. These treatments were mainly used by persons with anxiety symptoms in association with conventional psychotropic drugs. Further studies assessing the all the treatments used for psychiatric symptoms would allow to refine the results on the congruence between diagnosis and psychotropic drug and to estimate the number of persons avoiding use of conventional psychotropic drugs by using complementary and alternative medicine.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2017-07-31T12:38:47Z No. of bitstreams: 1 Aline Cacozzi.pdf: 637267 bytes, checksum: 62c74df1a9b081fcb5148f6cfcd76f38 (MD5) / Made available in DSpace on 2017-07-31T12:38:47Z (GMT). No. of bitstreams: 1 Aline Cacozzi.pdf: 637267 bytes, checksum: 62c74df1a9b081fcb5148f6cfcd76f38 (MD5) Previous issue date: 2017-03-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The objective of this study was to analyze a clinical condition of individuals with depressive disorder in the general population through subjective well-being. It was also sought to verify if the individuals who are in drug treatment have better subjective well-being. METHODS: A household survey was conducted with probabilistic sample (N = 3744) in the cities of São Paulo and Rio de Janeiro between 2007 and 2008. The 'Composite International Diagnostic Interview' (CIDI) and 'Subjetive Well-Being Inventory' were used to obtain a diagnosis of depressive disorder and subjective well-being assessment. The 70 percentile of the worst subjective well-being> 4 (0 to 12) was established as the cut off point. To assess the association between subjective well-being, depressive disorder, other psychiatric diagnoses, and use of medication, poisson regression analyzes were performed by controlling the effect of socio-demographic variables and family history of mental illness. RESULTS: The percentages of depressive disorder and worse subjective well-being in the general population was 11% and 30%. Individuals diagnosed with depressive disorder had the worst subjective well-being when compared as those without diagnosis or with other psychiatric diagnoses. The use of antidepressant medication among individuals with depression was low (4%) and the use of this medication did not influence subjective well-being. CONCLUSION: The unfavorable clinical condition resulting from non-treatment or exclusively drug treatment deserves concern due to the overload of depressive disorder in the life of individuals and society. The care policy, besides being focused on expanding the service offer, should guarantee multidisciplinary care, since the exclusive medical treatment does not guarantee the recovery of the individual. / O objetivo deste trabalho foi analisar a condição clínica de indivíduos com transtorno depressivo na população geral, através do bem-estar subjetivo. Buscou-se também verificar se os indivíduos que estavam em tratamento medicamentoso possuíam melhor bem-estar subjetivo. MÉTODOS: Um inquérito domiciliar foi realizado com amostra probabilística (N=3744) nas cidades de São Paulo e Rio de Janeiro, entre 2007 e 2008. Os instrumentos ¿Composite International Diagnostic Interview¿ (CIDI) e ¿Subjective Well-Being Inventory¿ (SUBI) foram utilizados para obter diagnóstico de transtorno depressivo e de avaliação do bem-estar subjetivo, respectivamente. Estabeleceu-se como ponto de corte o percentil 70 de pior bem-estar subjetivo >4 (0 a 12). Para estimar associação entre bem-estar subjetivo, transtorno depressivo, outros diagnósticos psiquiátricos e uso de medicação foram realizadas análises de regressão de poisson controlando-se o efeito das variáveis sócio demográficas e do histórico familiar de doença mental. RESULTADOS: As prevalências de transtorno depressivo e de pior bem-estar subjetivo na população geral foram de 11% e 30%. Os indivíduos diagnosticados com transtorno depressivo apresentaram o pior bem-estar subjetivo quando comparados como os sem diagnóstico ou com outros diagnósticos psiquiátricos. O uso de medicamento antidepressivo entre os indivíduos com depressão foi baixo (4%) e o uso deste medicamento não influenciou o bem-estar subjetivo. CONCLUSÃO: A condição clínica desfavorável, decorrente do não tratamento ou de tratamento exclusivamente medicamentoso, merece preocupação, devido à sobrecarga do transtorno depressivo na vida dos indivíduos e da sociedade. A política de assistência, além de estar voltada para ampliação da oferta de serviços, deve garantir atendimento multidisciplinar, uma vez que o tratamento medicamentoso exclusivo não garante a recuperação do indivíduo.