The local burden of emotional disorders. An analysis based on a large health survey in Catalonia (Spain)
ABSTRACT 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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ABSTRACT: This study examined the utility of the 12-item General Health Questionnaire (GHQ-12) to assess the psychological distress of family caregivers. To accomplish this goal, a sample of 172 caregivers, 25 men and 147 women, aged 56.6 (SD = 13.7) completed self-report questionnaires and provided data on demographic factors. Univariate and bivariate models adjust adequately, although the two-factor model (anxiety/depression and social dysfunction) presented a better fit. Relative caregivers scored higher in psychological distress (anxiety and depression levels) on the GHQ-12 than did the normal population. In conclusion, the GHQ-12 is a sensitive instrument to detect the presence of anxiety and depression in relative caregivers, and the external validity of the instrument is generally adequate. The GHQ-12 seems particularly appropriate for research and clinical and health intervention in caregivers. Implications and limitations of these results are discussed, along with suggestions for future research.Behavioral Medicine 04/2014; 40(2):65-70. DOI:10.1080/08964289.2013.847815 · 1.14 Impact Factor
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ABSTRACT: OBJECTIVE The objective was to identify individual or contextual inequalities in visits to psychiatrists in Spain, a country with a regionalized health care system and variable integration of mental health and primary care. METHODS This cross-sectional study used data for the noninstitutionalized population from the 2006 Spanish Health Interview Survey (N=29,478). A score of ≥3 on the General Health Questionnaire represented a need for mental health care. The probability of having visited a psychiatrist in the previous four weeks was analyzed in relation to individual-level variables (age, social class, health insurance, and country of origin) and contextual socioeconomic variables (Gross Domestic Product; a measure of income equality; and characteristics of regional mental health systems, such as human resources, services, and organization). Multilevel logistic regression models were used. RESULTS A total of 161 individuals (.55% of the sample) reported a visit to a psychiatrist during the previous four weeks. Individuals age 65 and older and immigrants from low-income countries were less likely to report a visit. Visits to psychiatrists were more common in regions with higher rates of psychiatrists per hospital (odds ratio [OR]=1.47, 95% confidence interval [CI]=1.18-1.83), more human resources for mental health (OR=1.03, CI=1.01-1.06), and better integration of primary care and specialized mental health care (OR=1.90, CI=1.32-2.76). CONCLUSIONS Individual and contextual inequalities in use of psychiatrists' services exist in Spain. Better coordination between primary and mental health care and greater availability of mental health resources were associated with greater use. Policies seeking better integration of care should be promoted.Psychiatric services (Washington, D.C.) 06/2013; 64(9). DOI:10.1176/appi.ps.201100419 · 1.99 Impact Factor
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ABSTRACT: Rationale. The new area of health system research requires a revision of the taxonomy of scientific knowledge that may facilitate a better understanding and representation of complex health phenomena in research discovery, corroboration and implementation. Method. A position paper by an expert group following and iterative approach. Results. ‘Scientific evidence’ should be differentiated from ‘elicited knowledge’ of experts and users, and this latter typology should be described beyond the traditional qualitative framework. Within this context ‘framing of scientific knowledge’ (FSK) is defined as a group of studies of prior expert knowledge specifically aimed at generating formal scientific frames. To be distinguished from other unstructured frames, FSK must be explicit, standardized, based on the available evidence, agreed by a group of experts and subdued to the principles of commensurability, transparency for corroboration and transferability that characterize scientific research. A preliminary typology of scientific framing studies is presented. This typology includes, among others, health declarations, position papers, expert-based clinical guides, conceptual maps, classifications, expert-driven health atlases and expert-driven studies of costs and burden of illness. Conclusions. This grouping of expert-based studies constitutes a different kind of scientific knowledge and should be clearly differentiated from ‘evidence’ gathered from experimental and observational studies in health system research.Journal of Evaluation in Clinical Practice 11/2014; 20(6). DOI:10.1111/jep.12286 · 1.58 Impact Factor