Artículos de revista
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Item The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder(ELSEVIER SCIENCE INC, 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA, 2010) Karam, Elie George; Andrews, Gavin; Bromet, Evelyn; Petukhova, María; Ruscio, Ayelet Meron; Salamoun, Mariana; Sampson, Nancy; Stein, Dan J.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias; Demyttenaere, Koen; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Kaminer, Debra; Kotov, Roman; Lee, Sing; Lepine, Jean-Pierre; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José; Sagar, Rajesh; Shalev, Arieh Y.; Takeshima, Tadashi; Tomov, Toma; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA.; kessler@hcp.med.harvard.eduItem Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Levinson, Daphna; Lakoma, Matthew D.; Petukhova, María; Schoenbaum, Michael; Zaslavsky, Alan M.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Maria Haro, Josep; Hu, Chiyi; Karam, Aimee N.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Browne, Mark Oakley; Okoliyski, Michail; Posada-Villa, José; Sagar, Rajesh; Viana, María Carmen; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduItem Cross-National Comparisons of Sex Differences in Opportunities to Use Alcohol or Drugs, and the Transitions to Use(INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND, 2011) Wells, J. Elisabeth; Maria Haro, Josep; Karam, Eli; Lee, Sing; Lepine, Jean-Pierre; Medina-Mora, Ma. Elena; Nakane, Hideyuki; Posada, José; Anthony, James C.; Cheng, Hui; Degenhardt, Louisa; Angermeyer, Matthias; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Glantz, Meyer; Gureje, Oye; Univ Otago, Dept Publ Hlth & Gen Practice, Christchurch Mail Ctr, Christchurch 8140, New Zealand; elisabeth.wells@otago.ac.nzSex differences in opportunities to use alcohol or drugs, and transition to use, were investigated in 15 surveys, in 2001--2004 (Europe 6; Americas 3; Africa 2, Asia 3; Oceania 1). The paper focuses on 18--29 year olds (N == 9,873). The World Mental Health Survey Initiative oversaw the surveys; each country obtained its own funding. A complex picture emerged with different results for alcohol and for drugs and for opportunity to use and the transition to use. Sex differences in opportunity to use alcohol were small except in Lebanon and Nigeria, whereas for drugs, the largest differences were in Mexico and ColombiaItem Smoking estimates from around the world: data from the first 17 participating countries in the World Mental Health Survey Consortium(B M J Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England, 2010) Storr, Carla L.; Cheng, Hui; Alonso, Jordi; Angermeyer, Matthias; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Karam, Elie G.; Kostyuchenko, Stanislav; Lee, Sing; Lepine, Jean-Pierre; Medina Mora, María Elena; Myer, Landon; Neumark, Yehuda; Posada-Villa, José; Watanabe, Makoto; Wells, J. Elisabeth; Kessler, Ronald C.; Anthony, James C.; Univ Maryland, Sch Nursing, Dept Family & Community Hlth, Baltimore, MD 21201 USA; cstor002@son.umaryland.eduObjective To contribute new multinational findings on basic descriptive features of smoking and cessation, based upon standardised community surveys of adults residing in seven low-income and middle-income countries and 10 higher-income countries from all regions of the world. Methods Data were collected using standardised interviews and community probability sample survey methods conducted as part of the WHO World Mental Health Surveys Initiative. Demographic and socioeconomic correlates of smoking are studied using cross-tabulation and logistic regression approaches. Within-country sample weights were applied with variance estimation appropriate for complex sample survey designs. Results Estimated prevalence of smoking experience (history of ever smoking) and current smoking varied across the countries under study. In all but four countries, one out of every four adults currently smoked. In higher-income countries, estimated proportions of former smokers (those who had quit) were roughly double the corresponding estimates for most low-income and middle-income countries. Characteristics of smokers varied within individual countries, and in relation to the World Bank's low-medium-high gradient of economic development. In stark contrast to a sturdy male-female difference in the uptake of smoking seen in each country, there is no consistent sex-associated pattern in the odds of remaining a smoker (versus quitting). Conclusion The World Mental Health Surveys estimates complement existing global tobacco monitoring efforts. The observed global diversity of associations with smoking and smoking cessation underscore reasons for implementation of the Framework Convention on Tobacco Control provisions and prompt local adaptation of prevention and control interventions.Item Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London SW1X 8PG, England, 2010) Kessler, Ronald C.; McLaughlin, Katie A.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; De Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Maria Haro, Josep; Hu, Chi-yi; Karam, Elie G.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tsang, Adley; Uestuen, T. Bedirhan; Vassilev, Svetlozar; Viana, María Carmen; Williams, David R.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduBackground: Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims: To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method: Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results: Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions: Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.Item Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Levinson, Daphna; Lakoma, Matthew D.; Petukhova, María; Schoenbaum, Michael; Zaslavsky, Alan M.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Maria Haro, Josep; Hu, Chiyi; Karam, Aimee N.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Browne, Mark Oakley; Okoliyski, Michail; Posada-Villa, José; Sagar, Rajesh; Viana, María Carmen; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduBackground: Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims: To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method: The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results: Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions: These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.Item Childhood adversities as risk factors for onset and persistence of suicidal behaviour(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Bruffaerts, Ronny; Demyttenaere, Koen; Borges, Guilherme; Maria Haro, Josep; Chiu, Wai Tat; Hwang, Irving; Karam, Elie G.; Kessler, Ronald C.; Sampson, Nancy; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Horiguchi, Itsuko; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Sagar, Rajesh; Scott, Kate; Tsang, Adley; Vassilev, Svetlozar M.; Williams, David R.; Nock, Matthew K.; Univ Hosp Gasthuisberg, Dept Psychiat, B-3000 Louvain, Belgium; ronny.bruffaerts@med.kuleuven.beBackground: Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood. Aims: To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide. Method: Respondents from nationally representative samples (n = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour. Results: Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2-5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents' lifetime mental disorder status. Conclusions: Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.Item Chronic Physical Conditions and Their Association With First Onset of Suicidal Behavior in the World Mental Health Surveys(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2010) Scott, Kate M.; Hwang, Irving; Chiu, Wai-Tat; Kessler, Ronald C.; Sampson, Nancy A.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bruffaerts, Ronny; De Graaf, Ron; Florescu, Silvia; Fukao, Akira; Haro, Josep Maria; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Scocco, Paolo; Nock, Matthew K.; Univ Otago, Dept Psychol Med, Sch Med & Hlth Sci, Wellington, New Zealand; kate.scott@otago.ac.nzObjective: To investigate the association of a range of temporally prior physical conditions with the subsequent first onset of suicidal ideation, plans, and attempts in large, general population, cross-national sample. The associations between physical conditions and suicidal behavior remain unclear due to sparse data and varied methodology. Methods: Predictive associations between 13 temporally prior physical conditions and first onset of suicidal ideation, plans, and attempts were examined in a 14-country sample (n = 37,915) after controlling for demographic, socioeconomic, and psychosocial covariates, with and without adjustment for mental disorders. Results: Most physical conditions were associated with suicidal ideation in the total sample; high blood pressure, heart attack/stroke, arthritis, chronic headache, other chronic pain, and respiratory conditions were associated with attempts in the total sample; epilepsy, cancer, and heart attack/stroke were associated with planned attempts. Epilepsy was the physical condition most strongly associated with the suicidal outcomes. Physical conditions were especially predictive of suicidality if they occurred early in life. As the number of physical conditions increased, the risk of suicidal outcomes also increased, however the added risk conferred was generally smaller with each additional condition. Adjustment for mental disorders made little substantive difference to these results. Physical conditions were equally predictive of suicidality in higher and lower income countries. Conclusions: The presence of physical conditions is a risk factor for suicidal behavior even in the absence of mental disorder.Item Evaluating the drug use "gateway" theory using cross-national data: Consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys(ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, 2010) Degenhardt, Louisa; Dierker, Lisa; Chiu, Wai Tat; Medina-Mora, María Elena; Neumark, Yehuda; Sampson, Nancy; Alonso, Jordi; Angermeyer, Matthias; Anthony, James C.; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Karam, Aimee N.; Kostyuchenko, Stanislav; Lee, Sing; Lepine, Jean-Pierre; Levinson, Daphna; Nakamura, Yosikazu; Posada-Villa, José; Stein, Dan; Wells, J. Elisabeth; Kessler, Ronald C.; Univ New S Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW 2052, Australia; l.degenhardt@unsw.edu.auBackground: It is unclear whether the normative sequence of drug use initiation, beginning with tobacco and alcohol, progressing to cannabis and then other illicit drugs, is due to causal effects of specific earlier drug use promoting progression, or to influences of other variables such as drug availability and attitudes. One way to investigate this is to see whether risk of later drug use in the sequence, conditional on use of drugs earlier in the sequence, changes according to time-space variation in use prevalence. We compared patterns and order of initiation of alcohol, tobacco, cannabis, and other illicit drug use across 17 countries with a wide range of drug use prevalence. Method: Analyses used data from World Health Organization (WHO) World Mental Health (WMH) Surveys, a series of parallel community epidemiological surveys using the same instruments and field procedures carried out in 17 countries throughout the world. Results: Initiation of "gateway" substances (i.e. alcohol, tobacco and cannabis) was differentially associated with subsequent onset of other illicit drug use based on background prevalence of gateway substance use. Cross-country differences in substance use prevalence also corresponded to differences in the likelihood of individuals reporting a non-normative sequence of substance initiation. Conclusion: These results suggest the "gateway" pattern at least partially reflects unmeasured common causes rather than causal effects of specific drugs on subsequent use of others. This implies that successful efforts to prevent use of specific "gateway" drugs may not in themselves lead to major reductions in the use of later drugs. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Item DSM-IV personality disorders in the WHO World Mental Health Surveys(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London SW1X 8PG, England, 2009) Huang, Yueqin; Kotov, Roman; De Girolamo, Giovanni; Preti, Antonio; Angermeyer, Matthias; Benjet, Corina; Demyttenaere, Koen; De Graaf, Ron; Gureje, Oye; Karam, Aimee Nasser; Lee, Sing; Lepine, Jean Pierre; Matschinger, Herbert; Posada-Villa, José; Suliman, Sharain; Vilagut, Gemma; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduBackground: Little is known about the cross-national population prevalence or correlates of personality disorders. Aims: To estimate prevalence and correlates of DSM-IV personality disorder clusters in the World Health organization World Mental Health (WMH) Surveys. Method: International Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses. Prevalence and correlates were estimated using multiple imputation. Results: Prevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and 3.6% (s.e.= 0.3), 1.5% (s.e.= 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B and C respectively. Personality disorders are significantly elevated among males, the previously married (Cluster C), unemployed (Cluster C), the young (Clusters A and B) and the poorly educated. Personality disorders are highly comorbid with Axis I disorders. Impairments associated with personality disorders are only partially explained by comorbidity. Conclusions: Personality disorders are relatively common disorders that often co-occur with Axis I disorders and are associated with significant role impairments beyond those due to comorbidity.
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