Is the prevalence of psychiatric disorders associated with urbanization?

Objectives In many countries, the total rate of psychiatric disorders tends to be higher in urban areas than in rural areas. The relevance of this phenomenon is that it may help in identifying environmental factors that are important in the pathogenesis of mental disorders. Moreover, urban preponderance suggests that the allocation of funds and services should take urbanization levels into account. Method The Netherlands Mental Health Survey and Incidence Study (NEMESIS) used the Composite International Diagnostic Interview (CIDI) to determine the prevalence of DSM-III-R disorders in a sample of 7,076 people aged 18–64. The sample was representative of the population as a whole. The study population was assigned to five urbanization categories defined at the level of municipalities. The association between urbanization and 12-month prevalence rates of psychiatric disorders was studied using logistic regression taking several confounders into account. Results The prevalence of psychiatric disorders gradually increased over five levels of urbanization. This pattern remained after adjustment for a range of confounders. Comorbidity rates also increased with level of urbanization. Conclusion This study confirms that psychiatric disorders are more common and more complex in more urbanized areas. This should be reflected in service allocation and may help in identifying environmental factors of importance for the aetiology of mental disorders. j Key words population survey – psychiatric epidemiology – mental disorders – urbanizatio

Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Item does not contain fulltextObjective: Data on the temporal relationships between duration of depression and recovery and functional disability are sparse. These relationships were examined in subjects from the general population (n = 250) with newly originated episodes of DSM-III-R major depression. Method: The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiological survey in the adult population (n = 7076), using the Composite International Diagnostic Interview (CIDI). Duration of depression and duration of recovery over 2 years were assessed with a life chart interview. Functional disabilities were assessed with the MOS-SF-36 and with absence days from work. Results: Functional disabilities and absence days in depressed individuals were not found to be associated with duration of depression. Functioning in daily activities improved with longer duration of recovery but social functioning not. Conclusion: Functioning deteriorates by actual depressive symptomatology and comorbid anxiety but not by longer duration of depression. After symptomatic recovery, functioning improves to premorbid level, irrespective of the length of the depression. Improvements in daily activities and work can be expected with longer duration of recovery

Hallucinatory experiences and onset of psychotic disorder: evidence that the risk is mediated by delusion formation

Item does not contain fulltextTo examine the hypothesis that the risk for onset of psychotic disorder in individuals with self-reported hallucinatory experiences (HE) would be higher in those who developed delusional ideation (DE) than in those who did not. Method: A population sample of 4673 individuals were interviewed with the Composite International Diagnostic Interview at baseline and 1 and 3 years later. At year 3, clinical re-interview took place to identify onset of psychotic disorder. Results: Given the presence of HEs at baseline, the increase in risk of having the psychosis outcome at year 3 was much higher in those with DE at year 1 than in those without DE (risk difference between individuals with and without DE: 18.72%, 95% CI: 2.22–35.23, 2 = 4.94, df = 1, P = 0.026). Conclusion: The results are in line with current psychological theories stating that clinical outcome of psychosis-like experiences is related to the development of secondary beliefs and appraisals

Parental lack of care and overprotection

Contains fulltext : 56499.pdf (publisher's version ) (Closed access)This study served to replicate and extend the findings from the National Comorbidity Survey [Enns MW, Cox BJ, Clara I (2002) Psychol Med 32:997-1008], in examining associations between recalled parental bonding and the prevalence and incidence of mental disorders in adulthood. Data were used from 4,796 adults aged 18-64, who had participated in three waves (i.e., 1996, 1997, and 1999) of a large-scale Dutch epidemiological study. Parental lack of care and overprotection were significantly associated with both prevalence and incidence of DSM-III-R disorders. However, the impact of parental bonding was modest, explaining only 1-5% of the variance in the occurrence and onset of psychopathology. Chi-square tests demonstrated there were no differences between the impact of paternal and maternal rearing behaviors on mental disorders, or between lack of care and overprotection in the prediction of mental disorders. Overall, individuals' recollections of parental lack of care and overprotection appear to be non-specifically, modestly related to the prevalence and incidence of DSM-III-R disorders in adults from the general population. Future research may examine indirect or mediated links between parental bonding and (clinical diagnoses of) mental health problems.7 p

The association between number of social fears, and health-related quality of life, comorbidity, and help-seeking in subjects with social phobia: A population-based study.

Community based data were used to examine the association between social phobia and comorbidity, quality of life and service utilization. In addition, the correlations of the number of social fears with these domains were studied. Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) ( N = 7,076). Social phobia was assessed according to DSM-III-R with the Composite International Diagnostic Interview (CIDI); quality of life was assessed according to the Short-Form-36 Health Survey (SF-36). The 12-month prevalence of social phobia was 4.8%. Being female, young, low educated, a single parent, living alone, not having a paid job and having a somatic disorder are associated with 12-month social phobia. Mean and median ages of onset of social phobia were 19.1 and 16.0 years, respectively, and mean and median duration were 16.8 and 14.0 years, respectively. 66% of respondents with social phobia had at least one comorbid condition. 12-month social phobia was significantly related to lower quality of life and higher service utilization. The mean number of feared social situations was 2.73 out of the 6 assessed. As the number of social fears increases, comorbidity and service utilization increases, and the quality of life decreases. These findings suggest as the number of feared social situations increases, the burden of social phobia rises. In other words, like comorbidity or decreased quality of life, the number of social fears is also an important indicator of the severity of social phobia. We conclude that from a public health perspective, mental health care givers should pay attention to the number of social fears in order to check the severity of social phobia