The local burden of emotional disorders. An analysis based on a large health survey in Catalonia (Spain)

Centre for the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, King's College, London, UK.
Gaceta Sanitaria (Impact Factor: 1.19). 11/2011; 26(1):24-9. DOI: 10.1016/j.gaceta.2011.05.019
Source: PubMed


Mental health conditions are associated with a significant burden on individuals. Using data from a large population health survey, the present study aimed to quantify the burden of emotional disorders (depression and anxiety) on health-related quality of life (HRQoL) in the region of Catalonia (Spain) for evidence-informed policy making.
Regression models were used to estimate the impact of emotional disorders on HRQoL, controlling by socioeconomic factors and somatic health problems. The rate of emotional disorders was based on the General Health Questionnaire (GHQ-12) and quality of life scores were based on the EQ-5D.
The impact of emotional disorders on HRQoL was equal to a reduction of 0.17 in the EQ-5D score. Translation of this individual impact to population figures yielded a total loss of 78,742 quality-adjusted life years (QALYs) for 2006. This strong impact highlights the need for global policies aiming to reduce this burden.
The negative relation between emotional disorders and the HRQoL of individuals was confirmed and quantified for the population of Catalonia. The use of quality of life scales such as the SF or EQ-5D, combined with data on quasi-specific health conditions provides substantial information for prioritizing and planning health programs.

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    • "It is not possible to infer individual level relationship from relationship observed at the aggregate level due to the ecological fallacy [38,39]. The analysis of the Catalonia Health Survey indicates that the local burden of depression is associated with a low educational level and living alone [40]. The ESEMeD project shows the relationship between the prevalence of depression and sex, unemployment, civil status and disabilities [34]. "
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    ABSTRACT: Background Spatial analysis is a relevant set of tools for studying the geographical distribution of diseases, although its methods and techniques for analysis may yield very different results. A new hybrid approach has been applied to the spatial analysis of treated prevalence of depression in Catalonia (Spain) according to the following descriptive hypotheses: 1) spatial clusters of treated prevalence of depression (hot and cold spots) exist and, 2) these clusters are related to the administrative divisions of mental health care (catchment areas) in this region. Methods In this ecological study, morbidity data per municipality have been extracted from the regional outpatient mental health database (CMBD-SMA) for the year 2009. The second level of analysis mapped small mental health catchment areas or groups of municipalities covered by a single mental health community centre. Spatial analysis has been performed using a Multi-Objective Evolutionary Algorithm (MOEA) which identified geographical clusters (hot spots and cold spots) of depression through the optimization of its treated prevalence. Catchment areas, where hot and cold spots are located, have been described by four domains: urbanicity, availability, accessibility and adequacy of provision of mental health care. Results MOEA has identified 6 hot spots and 4 cold spots of depression in Catalonia. Our results show a clear spatial pattern where one cold spot contributed to define the exact location, shape and borders of three hot spots. Analysing the corresponding domain values for the identified hot and cold spots no common pattern has been detected. Conclusions MOEA has effectively identified hot/cold spots of depression in Catalonia. However these hot/cold spots comprised municipalities from different catchment areas and we could not relate them to the administrative distribution of mental care in the region. By combining the analysis of hot/cold spots, a better statistical and operational-based visual representation of the geographical distribution is obtained. This technology may be incorporated into Decision Support Systems to enhance local evidence-informed policy in health system research.
    International Journal of Health Geographics 08/2012; 11(1):36. DOI:10.1186/1476-072X-11-36 · 2.62 Impact Factor
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    • "Gender inequalities were found in the current study, replicating findings form others studies done in Spain (Palència et al. 2011) and in Catalonia (Borrell et al. 2001, 2011; Fernandez et al. 1999: Sabes-Figuera et al. 2012), which also found that women were more likely to use health services. Higher use of specialized mental health care in women have been also described in other countries (Andrade et al. 2008; Burgess et al. 2009; Codony et al. 2009; Ngamini Ngui et al. 2012; Parslow and Jorm 2000; Wang et al. 2007). "
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    ABSTRACT: The aim of this study was to analyze individual and contextual inequalities in psychiatrist and psychologist visits in Catalonia. This is a multilevel cross-sectional study using data from the 2006 Catalan Health Interview Survey (n = 15,554). 5.3 % of men and 9.0 % of women visited a psychologist and/or psychiatrist in the last 12 months. People aged 65 years or over were less likely to have visited these professionals and those with a supplemental private health insurance had a higher proportion of having visited. Moreover, people living in lower density regions were less likely to have visited, independently of their level of need. There is a need to develop policies for reducing inequalities in access by people with public health insurance and living in lower density areas.
    Administration and Policy in Mental Health and Mental Health Services Research 06/2012; 40(5). DOI:10.1007/s10488-012-0426-8 · 3.44 Impact Factor
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    ABSTRACT: Background Cost of illness (COI) studies are carried out under conditions of uncertainty and with incomplete information. There are concerns regarding their generalisability, accuracy and usability in evidence-informed care. Aims A hybrid methodology is used to estimate the regional costs of depression in Catalonia (Spain) following an integrative approach. Methods The cross-design synthesis included nominal groups and quantitative analysis of both top-down and bottom-up studies, and incorporated primary and secondary data from different sources of information in Catalonia. Sensitivity analysis used probabilistic Monte Carlo simulation modelling. A dissemination strategy was planned, including a standard form adapted from cost-effectiveness studies to summarise methods and results. Results The method used allows for a comprehensive estimate of the cost of depression in Catalonia. Health officers and decision-makers concluded that this methodology provided useful information and knowledge for evidence-informed planning in mental health. Conclusions The mix of methods, combined with a simulation model, contributed to a reduction in data gaps and, in conditions of uncertainty, supplied more complete information on the costs of depression in Catalonia. This approach to COI should be differentiated from other COI designs to allow like-with-like comparisons. A consensus on COI typology, procedures and dissemination is needed.
    Journal of Mental Health 01/2013; 22(2). DOI:10.3109/09638237.2012.745185 · 1.01 Impact Factor
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