Results from a community survey in a sample of high-unemployment census tracts in southeastern Michigan showed significant elevations of depression, anxiety, somatization, and self-reported physical illness among the currently unemployed. These adverse effects were largely reversed by reemployment. Subsequent analyses documented modifying effects of social support, self-concept, and coping. We also found two mediating processes that account for the overall effects of current unemployment: (a) the intervening effects of financial strain, and (b) an influence of unemployment in creating heightened vulnerability to other stressful life events. The implications of these results for the design and implementation of preventive interventions are briefly discussed.
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"Around one third of patients reported depression, stress and anxiety among the reported ADRs. Findings showed that unemployment is one of the causes of mental health problems
[21,22]. We deduced that more of the reactions were of short lasting and their impact on adherence and treatment change were less likely. "
[Show abstract][Hide abstract] ABSTRACT: Background
Patients on antiretroviral therapy have higher risk of developing adverse drug reactions (ADRs). The impact of ADRs on treatment adherence, treatment outcomes and future treatment options is quiet considerable. Thus, the purpose of this study was to describe the common self-reported ADRs and their impact on antiretroviral treatment.
Cross-sectional study was conducted at antiretroviral therapy (ART) clinic of Gondar University Hospital. Semi-structured interview questionnaire was used to extract self-reported ADRs, socio-demographic, and psycho-social variables. Variables related to antiretroviral medication, laboratory values and treatment changes were obtained from medical charts. Chi-square and odds ratio with 95% confidence interval were used to determine the associations of dependent variables.
A total of 384 participants were enrolled. At least one adverse drug reaction was reported by 345 (89.8%) study participants and the mean number of ADRs reported was 3.7 (±0.2). The most frequently reported ADRs were nausea (56.5%) and headache (54.9%). About 114 (31.0%) participants considered antiretroviral therapy to be unsuccessful if ADRs occurred and only 10 (2.6%) decided to skip doses as ADRs were encountered. Based on chart review, treatment was changed for 78 (20.3%) patients and from which 79% were due to documented ADRs (p = 0.00). Among them, CNS symptoms (27.4%) and anemia (16.1%) were responsible for the majority of changes. Around four percent of patients were non-adherent to ART. Non-adhered participants and those on treatment changes were not statistically associated with self-reported ADRs. Only unemployment status (AOR = 1.76 (1.15 - 2.70), p = 0.01) and ADR duration of less than one month (AOR = 1.95 (1.28-2.98), p = 0.001) were significantly associated with self-reported adverse effects of three or more in the multivariate analysis.
Self-reported ADRs to antiretroviral therapy are quite common. More of the reactions were of short lasting and their impact on adherence and treatment change were less likely. However, documented ADRs were the most prevalent reasons for ART switch. Moreover, the level of unemployment was a strong predictor of self-reported ADRs.
"Uit dat onderzoek blijkt dat werkloosheid negatieve gevolgen met zich meebrengt voor het welzijn van de werkloze. Zo lopen ze een groter risico op symptomen van depressie en angst (Kessler et al., 1988), en hun zelfwaarde (Sheeran et al., 1995) en levenstevredenheid liggen lager dan bij wer‐ kenden (Lucas et al., 2004). Bij de studie van de werkloosheidsbeleving werd vooral uitgegaan van de latente deprivatietheorie van Jahoda (1982; Lagrou, 1983). "
"Within this context, an important question involves the extent to which the economic downturn is associated with psychological distress and related outcomes. Prior work concerning the Great Depression and other economic downturns, for example, suggests that individuals who are unemployed or underemployed in tough economic times experience higher levels of depression and anxiety, as well as increased alcohol use, compared with those who are adequately employed (Catalano, 1991; Dooley and Prause, 1997; Elder, 1974; Kessler et al., 1988; Luoto et al., 1998; Montgomery et al., 1999). However, research in this tradition has tended to concentrate on the effects of unemployment alone, perhaps underestimating the full breadth of diffi cult exposure, psychological distress, and drinking patterns are related. "
[Show abstract][Hide abstract] ABSTRACT: Given the recent downturn in the U.S. economy, we considered in this study the processes linking economic stressors, psychological distress, and two alcohol-related outcomes (past-month drinking and problematic drinking).
Data were drawn from a mail survey of a national sample of 663 respondents. Structural equation modeling was used to assess whether psychological distress mediates the associations between economic stressors and the alcohol-related outcomes considered and whether these associations varied by gender.
Controlling for correlations among the outcomes and the effects of the sociodemographic control variables, psychological distress was found to partly explain the association between economic stressors and problematic drinking. The mediating effects on problematic drinking were significantly greater for men than women.
The findings demonstrate the utility of considering interrelationships among alcohol-related outcomes and, in this context, reveal the circumstances in which gender matters most for understanding the associations among economy-related stressors, psychological distress, and drinking.
Full-text · Article · Sep 2012 · Journal of studies on alcohol and drugs