Browsing by Author "Von Korff, M."
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Item Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2008) Scott, K.M.; Von Korff, M.; Alonso, J.; Angermeyer, M.; Bromet, E.J.; Bruffaerts, R.; De Girolamo, G.; De Graaf, R.; Fernández, A.; Gureje, O.; He, Y.; Kessler, R.C.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Mneimneh, Z.; Browne, M.A. Oakley; Posada-Villa, J.; Tachimori, H.; Williams, D.; Univ Otago, Dept Psychol Med, Wellington, New Zealand; kate.scott@otago.ac.nzBackground. Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity. Method. Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n = 42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity. Results. Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups. Conclusions. CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders.Item Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys(WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA, 2008) Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J.P.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Tachimori, H.; Mneimneh, Z.N.; Medina-Mora, M.E.; Ormel, J.; Scott, K.M.; Gureje, O.; Haro, J.M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R.C.; Von Korff, M.; Hosp Mar, Inst Municipal Invest Med, Hlth Serv Res Unit, PRBB, Barcelona 08003, Spain; jalonso@imim.esObjective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Mental disorders were assessed with Composite International Diagnostic Interview (CIDI) 3.0. Chronic conditions were ascertained by self-report. Household-residing adults (80 737) participated in 17 population surveys in 16 countries. Results: Perceived stigma was present in 13.5% (22.1% in developing and 11.7% in developed countries). Suffering from a depressive or an anxiety disorder (vs. no mental disorder) was associated with about a twofold increase in the likelihood of stigma, while comorbid depression and anxiety was even more strongly associated (OR 3.4, 95%CI 2.7-4.2). Chronic physical conditions showed a much lower association. Conclusion: Perceived stigma is frequent and strongly associated with mental disorders worldwide. Efforts to alleviate stigma among individuals with comorbid depression and anxiety are needed.Item Mental disorders among persons with arthritis: results from the World Mental Health Surveys(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2008) He, Y.; Zhang, M.; Lin, E.H.B.; Bruffaerts, R.; Posada-Villa, J.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Uda, H.; Mneimneh, Z.; Benjet, C.; De Graaf, R.; Scott, K.M.; Gureje, O.; Seedat, S.; Haro, J.M.; Bromet, E.J.; Alonso, J.; Kovess, V.; Von Korff, M.; Kessler, R.; Shanghai Mental Hlth Ctr, Shanghai 200030, Peoples R China; heyl2001@yahoo.com.cnItem Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2009) Scott, K.M.; Von Korff, M.; Alonso, J.; Angermeyer, M.C.; Bromet, E.; Fayyad, J.; De Girolamo, G.; Demyttenaere, K.; Gasquet, I.; Gureje, O.; Haro, J.M.; He, Y.; Kessler, R.C.; Levinson, D.; Medina Mora, M.E.; Oakley Browne, M.; Ormel, J.; Posada-Villa, J.; Watanabe, M.; Williams, D.; Univ Otago, Dept Psychol Med, Wellington, New Zealand; kate.scott@otago.ac.nzBackground. The relationship between mental and physical disorders is well established, but there is less consensus as to the nature of their joint association with disability, in part because additive and interactive models of co-morbidity have not always been clearly differentiated in prior research. Method. Eighteen general population surveys were carried out among adults as part of the World Mental Health (WMH) Survey Initiative (n = 42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions (arthritis, heart disease, respiratory disease, chronic back/neck pain, chronic headache, and diabetes) were ascertained using a standard checklist. Severe disability was defined as on or above the 90th percentile of the WMH version of the World Health Organization Disability Assessment Schedule (WHODAS-II). Results. The odds of severe disability among those with both mental disorder and each of the physical conditions (with the exception of heart disease) were significantly greater than the sum of the odds of the single conditions. The evidence for synergy was model dependent: it was observed in the additive interaction models but not in models assessing multiplicative interactions. Mental disorders were more likely to be associated with severe disability than were the chronic physical conditions. Conclusions. This first cross-national study of the joint effect of mental and physical conditions on the probability of severe disability finds that co-morbidity exerts modest synergistic effects. Clinicians need to accord both mental and physical conditions equal priority, in order for co-morbidity to be adequately managed and disability reduced.Item Obesity and mental disorders in the general population: results from the world mental health surveys(NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, 2008) Scott, K.M.; Bruffaerts, R.; Simon, G.E.; Alonso, J.; Angermeyer, M.; De Girolamo, G.; Demyttenaere, K.; Gasquet, I.; Haro, J.M.; Karam, E.; Kessler, R.C.; Levinson, D.; Medina Mora, M.E.; Browne, M.A. Oakley; Ormel, J.; Villa, J.P.; Uda, H.; Von Korff, M.; Univ Otago, Wellington Sch Med & Hlth Sci, Wellington, New Zealand; kate.scott@otago.ac.nzObjectives: (1) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (2) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design: Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects: Household residing adults, 18 years and over (n = 62 277). Measurements: DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results: Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.5) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. Conclusions: The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population.
