Background. The German National Health Interview and Examination Survey (GHS) is the first government mandated nationwide study to investigate jointly the prevalence of somatic and mental disorders within one study in the general adult population in Germany. This paper reports results from its Mental Health Supplement (GHS-MHS) on 4-week 12-month, and selected lifetime prevalence of a broad range of DSM-IV mental disorders, their co-morbidity and correlates in the community. Methods. The sample of the GHS-MHS (n=4181; multistage stratified random sample drawn from population registries ; conditional response rate: 87.6%) can be regarded as representative for the German population aged 18–65. Diagnoses are based on fully structured computer assisted clinical interviews (M-CIDI), conducted by clinically trained interviewers. Results. 12-month prevalence for any DSM-IV study disorder is 31% (lifetime: 43%; 4-week: 20%) with anxiety disorders, mood disorders and somatoform syndromes being the most frequent diagnoses. Retrospective age of onset information reveals that most disorders begin early in life. Comorbidity rates among mental disorders range from 44% to 94%. Correlates of increased rates of mental disorders and co-morbidity were: female gender (except for substance disorders), not being married, low social class, and poor somatic health status. Health care utilization for mental disorders depended on co-morbidity (30% in ‘pure’, 76% in highly co-morbid cases) and varied from 33% for substance use disorders to 75% for panic disorder. Conclusions. Results confirm and extend results from other national studies using the same assessment instruments with regard to prevalence, co-morbidity and sociodemographic correlates, covering a broader range of DSM-IV disorders [i.e. somatoform disorders, all anxiety disorders (except PTSD), mental disorders due to substance or general medical factor, eating disorders]. Intervention rates were higher than in previous studies, yet still low overall.

The aim is to study the trends of cigarette smoking from 2001 to 2012 using a California representative sample in the US. Data was taken from the California Health Interview Survey (CHIS) from 2001 to 2012, which is a population-based, biennial, random digit-dial telephone survey of the non-institutionalized population. The CHIS is the largest telephone survey in California and the largest state health survey in the US. 282,931 adults (n = 184,454 with age 18–60 and n = 98,477 with age >60) were included in the analysis. Data were weighted to be representative and adjusted for potential covariance and non-response biases. During 2001–2012, the prevalence of current smoking decreased from 18.86 to 15.4 % among adults age 18–60 (β = −0.8, p = 0.0041). As for adults age >60, the prevalence of current smoking trend decreased with variations, started from 9.66 % in 2001, slightly increased to 9.74 % in 2003, but then gradually decreased, falling to 8.18 % in 2012. In 2012, there was a 14 % reduction of daily smoking adults age 18–60 (OR 0.84, 95 % CI 0.76–0.93, p = 0.0006) compared to 2001, while no significant reduction of daily smoking was observed for those age >60. The reductions of smoking prevalence for adults younger than 60 are encouraging. However, there is a concern for smoking cessation rates among those older than 60 years of age, particularly for African Americans.

Background. The German National Health Interview and Examination Survey (GHS) is the first government mandated nationwide study to investigate jointly the prevalence of somatic and mental disorders within one study in the general adult population in Germany. This paper reports results from its Mental Health Supplement (GHS-MHS) on 4-week 12-month, and selected lifetime prevalence of a broad range of DSM-IV mental disorders, their co-morbidity and correlates in the community. Methods. The sample of the GHS-MHS (n=4181; multistage stratified random sample drawn from population registries ; conditional response rate: 87.6%) can be regarded as representative for the German population aged 18–65. Diagnoses are based on fully structured computer assisted clinical interviews (M-CIDI), conducted by clinically trained interviewers. Results. 12-month prevalence for any DSM-IV study disorder is 31% (lifetime: 43%; 4-week: 20%) with anxiety disorders, mood disorders and somatoform syndromes being the most frequent diagnoses. Retrospective age of onset information reveals that most disorders begin early in life. Comorbidity rates among mental disorders range from 44% to 94%. Correlates of increased rates of mental disorders and co-morbidity were: female gender (except for substance disorders), not being married, low social class, and poor somatic health status. Health care utilization for mental disorders depended on co-morbidity (30% in ‘pure’, 76% in highly co-morbid cases) and varied from 33% for substance use disorders to 75% for panic disorder. Conclusions. Results confirm and extend results from other national studies using the same assessment instruments with regard to prevalence, co-morbidity and sociodemographic correlates, covering a broader range of DSM-IV disorders [i.e. somatoform disorders, all anxiety disorders (except PTSD), mental disorders due to substance or general medical factor, eating disorders]. Intervention rates were higher than in previous studies, yet still low overall.

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder and Panic Disorder and to observe if co-morbid illnesses such as Hypertension and Diabetes affect this association. Methods: A cross-sectional secondary data analysis was conducted using the 2008 National Health Interview Survey. There were 20,593 adult respondents (over 18 years of age) who were included in the study. Logistic regression models were weighted to account for the complex weighting scheme. Main Determinant measures: Based on their BMI, the participants were classified into 5 groups: Underweight (BMI <18.50), Normal Weight (BMI 18.50 – 24.99), Overweight (BMI 25.00 – 29.99), Obese (BMI 30.00-39.99) and Morbidly Obese (BMI > 40.00). Main Outcome Measures: Presence or absence of Depression, Anxiety Disorder or Panic Disorder based on self-report. Results: People who were obese or morbidly obese had higher odds of suffering from depression, anxiety disorder and panic disorder compared to people who were normal weight. Obese individuals were 35% as likely to suffer from depression, 22% as likely to suffer from anxiety disorder and 36% as likely to suffer from panic disorder relative to normal weight persons. Morbidly obese people were 85% as likely to suffer from depression, 27% as likely to suffer from anxiety disorder and 34% as likely to suffer from panic disorder. No interactions were observed based on the presence of hypertension or diabetes. Conclusion: Obesity is associated with an increased prevalence of depression, anxiety disorder and panic disorder. With obesity rates steadily increasing, understanding the impact of obesity on the occurrence of mental disorders is important.

Bakgrund: Psykisk ohälsa bland barn och ungdomar är ett växande problem i Sverige. Skolan arbetar för att främja hälsa och lärande och skolsköterskan har en viktig roll i att identifiera psykisk ohälsa. Att identifiera elever med psykisk ohälsa kan vara avgörande för att dessa elever inte ska utveckla psykisk sjukdom. Forskningen visar att det finns ett tydligt samband mellan skolprestationer och psykisk ohälsa. Därför är det viktigt att alla som arbetar inom skolan strävar efter att försöka identifiera elever så tidigt som möjligt. Skolsköterskan har en viktig roll i detta då det är hen som träffar alla elever oftast vid flera tillfällen under skoltiden. Syfte: Studiens syfte är att beskriva skolsköterskans arbete med att identifiera psykisk ohälsa hos elever. Metod: Kvalitativ metod med induktiv ansats. Det insamlade data materialet analyserades enligt kvalitativ innehållsanalys. Enskilda intervjuer genomfördes med fem skolsköterskor. Resultat: Resultatet visar på fyra huvudkategorier: att möta eleven, vikten av att vinna elevernas förtroende, att samarbeta mot gemensamma mål, att synliggöra könsskillnader. Konklusion: I arbetet med att identifiera psykisk ohälsa krävs att skolsköterskan har kompetens inom flera olika områden och samarbetar med andra professioner och föräldrar samt en medvetenhet om könsskillnader och könsspecifika strategier vid psykisk ohälsa. / Background: Mental illness among children is a growing problem in Sweden. In order to promote health and learning, school nurse has an important role to identify mental illness. Research shows that there is a clear connection between school performance and mental health. Therefore, it is important for the school staff to cooperate and strives to identify mental illness in an early stage. The school nurse has an important role, she meets the students on several occasions during school. Purpose: To describe how school nurses work on identifying mental illness among pupils. Method: Qualitative method with inductive approach has been used and the data has been analysed according to qualitative content analysis. Individual interviews were conducted with five school nurses. Result: From the analysis four main categories with subcategories emerged: to meet the pupil, the importance of gaining the pupils’ confidence, to cooperate towards common objectives and to make gender differences visible. Conclusion: In order to identify mental illness the school nurse need competence in several different areas and to cooperate with other professions and parents, as well as knowledge of gender differences and gender-specific strategies in the case of mental illness.

Past studies often find that, upon arrival U.S. immigrants generally have favorable health profiles than native-born persons, but their health deteriorates with prolonged stay. The classical explanations of this phenomenon are healthy immigrant selection and negative acculturation. With the number of foreign-born people living in the United States reaching an all-time high, the health and financial costs of this “negative acculturation” is substantial. Meanwhile, the negative duration effect on health is contradictory to expectations from classic assimilation theory and what has been observed by labor economists. This study aims to empirically study the effect of duration on immigrant health, with particular attention given to how socioeconomic status differentiates the duration-health relationship. Results based on two national datasets confirmed that immigrants, especially recent arrivals, have a considerably lower risk of worse health relative to native-born adults. I also found that socioeconomic status plays an essential role in the varying level of initial health selectivity among immigrants. The analysis of the interaction effect between duration and SES reveals that duration effects on health vary significantly by socioeconomic status. High SES immigrants tend to experience a non-negative duration effect regardless of their length of U.S. residence, while immigrants with lower socioeconomic standing are more likely to experience a negative duration effect on health with longer duration. Moreover, this study also shows that the initial foreign-born advantages in health are typically larger for persons with low SES than for persons with high SES. However, little evidence suggests there is a health convergence between long-term immigrants and their native-born counterparts with similar socioeconomic status. Potential explanations and implications of these findings are also discussed. / text

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

No description available.

Nach Befunden des Bundes-Gesundheitssurveys 1998/99 (Zusatzsurvey „Psychische Störungen“) litten im Jahr der Erhebung 32% (=15,6 Millionen) der erwachsenen deutschen Bevölkerung im Alter von 18–65 unter einer oder mehreren psychischen Störungen. Jeder dritte Betroffene (36%) steht oder stand im Jahr vor der Erhebung wegen der psychischen Störung in Kontakt mit ambulanten oder stationären psychiatrisch/psychotherapeutischen Diensten oder seinem Hausarzt. Der Anteil von Betroffenen, die eine im weitesten Sinne adäquate Therapie nach modernen wissenschaftlichen Kriterien erhalten, kann konservativ auf ca.10% geschätzt werden. Die niedrige Versorgungsquote betrifft dabei nicht alle spezifischen Störungsgruppen in gleichem Ausmaß; niedrige Versorgungsraten ergaben sich insbesondere für somatoforme und Suchterkrankungen. Ferner ergaben sich zum Teil markante regionale Unterschiede (z.B. besonders schlechte Versorgungslage in Regionen, die weder über eine nahe Universität noch über psychotherapeutische Weiterbildungsinstitutionen verfügen).Ungeachtet unterschiedlich weiter oder enger Definitionen des Begriffs Behandlungsbedarf, zeigt sich eine gravierende Unterversorgung von Personen mit psychischen Erkrankungen. Quantitativ bedeutsame Hinweise auf eine Fehl- oder Überversorgung von Betroffenen lassen sich nicht aufzeigen. / Data from the German Health Interview and Examination Survey, Mental Health Supplement (N=4181) reveal that 32% (15,6 million people) of the adult population between 18 and 65 years of age suffer from one or more mental disorders. Among those only 36% receive treatment which also varies in type, duration, and adequacy. The proportion of cases receiving “adequate evidence- based treatments” was estimated to be about 10%.Lowest treatment rates were found for somatoform disorders and substance abuses, highest for psychotic disorders, panic disorder, generalised anxiety disorder, and dysthymia. The data reveal substantial regional differences with regard to treatment rates (e.g. lower rates in regions without universities or institutions offering postgraduate mental health education).The paper concludes that, depending on the diagnosis, a considerable degree of unmet medical needs exist for the majority of people affected by mental disorders. No evidence was found for an excessive supply of health care for the patients suffering from mental disorders or for treatments without an existing clinical need.