386 research outputs found

    The distribution of the common mental disorders: social inequalities in Europe

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    BACKGROUND: The social class distribution of the common mental disorders (mostly anxiety and/or depression) has been in doubt until recently. This paper reviews the evidence of associations between the prevalence of the common mental disorders in adults of working age and markers of socio-economic disadvantage. METHODS: Work is reviewed which brings together major population surveys from the last 25 years, together with work trawling for all European population studies. Data from more recent studies is examined, analysed and discussed. Because of differences in methods, instruments and analyses, little can be compared precsiely, but internal associations can be examined. FINDINGS: People of lower socio-economic status, however measured, are disadvantaged, and this includes higher frequencies of the conditions now called the 'common mental disorders' (mostly non-psychotic depression and anxiety, either separately or together). In European and similar developed populations, relatively high frequencies are associated with poor education, material disadvantage and unemployment. CONCLUSION: The large contribution of the common mental disorders to morbidity and disability, and the social consequences in working age adults would justify substantial priority being given to addressing mental health inequalities, and deprivation in general, within national and European social and economic policy

    Are structured interviews truly able to detect and diagnose Bipolar II disorders in epidemiological studies? The king is still nude!

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    Introduction A research commentary published in 2005 pointed out that the apparently low prevalence of Bipolar Disorder diagnosis as reported by epidemiological studies may be related to the under-estimate of bipolar disorder cases generally yielded by methodological instruments that are applied in such investigations. New data apparently challenge this notion More recent publications have presented new results that apparently contradict the issues raised by the commentary, stating that the CIDI interview, which is used in the most important epidemiological studies is not only valid but highly reliable in identifying bipolar disorders. Commentary This paper analyzes the new data and concludes that they do not give a clear indication as to how reliably the CIDI can recognize undiagnosed bipolar disorder cases. Further research studies are needed on larger "negative" (to the CIDI) samples before the field will be persuaded that CIDI really does what it is supposed to do

    A method for modelling GP practice level deprivation scores using GIS

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    <p>Abstract</p> <p>Background</p> <p>A measure of general practice level socioeconomic deprivation can be used to explore the association between deprivation and other practice characteristics. An area-based categorisation is commonly chosen as the basis for such a deprivation measure. Ideally a practice population-weighted area-based deprivation score would be calculated using individual level spatially referenced data. However, these data are often unavailable. One approach is to link the practice postcode to an area-based deprivation score, but this method has limitations. This study aimed to develop a Geographical Information Systems (GIS) based model that could better predict a practice population-weighted deprivation score in the absence of patient level data than simple practice postcode linkage.</p> <p>Results</p> <p>We calculated predicted practice level Index of Multiple Deprivation (IMD) 2004 deprivation scores using two methods that did not require patient level data. Firstly we linked the practice postcode to an IMD 2004 score, and secondly we used a GIS model derived using data from Rotherham, UK. We compared our two sets of predicted scores to "gold standard" practice population-weighted scores for practices in Doncaster, Havering and Warrington. Overall, the practice postcode linkage method overestimated "gold standard" IMD scores by 2.54 points (95% CI 0.94, 4.14), whereas our modelling method showed no such bias (mean difference 0.36, 95% CI -0.30, 1.02). The postcode-linked method systematically underestimated the gold standard score in less deprived areas, and overestimated it in more deprived areas. Our modelling method showed a small underestimation in scores at higher levels of deprivation in Havering, but showed no bias in Doncaster or Warrington. The postcode-linked method showed more variability when predicting scores than did the GIS modelling method.</p> <p>Conclusion</p> <p>A GIS based model can be used to predict a practice population-weighted area-based deprivation measure in the absence of patient level data. Our modelled measure generally had better agreement with the population-weighted measure than did a postcode-linked measure. Our model may also avoid an underestimation of IMD scores in less deprived areas, and overestimation of scores in more deprived areas, seen when using postcode linked scores. The proposed method may be of use to researchers who do not have access to patient level spatially referenced data.</p

    Work, identity and health

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