Psychiatric morbidity among adults in The Netherlands: the NEMESIS-Study. II. Prevalence of psychiatric disorders. Netherlands Mental Health Survey and Incidence Study
To determine the prevalence of psychiatric disorders in non-institutionalised Dutch adults.
Trimbos Institute, Utrecht, the Netherlands.
A representative sample of 7076 adults (18-64 years) in the Netherlands' population were interviewed in 1996 to determine the prevalence of mental disorders ever, in the previous 12 months and in the previous month. Objectives and study design are described in the previous article (1997: 2448-52). The 'Composite international diagnostic interview' (CIDI) was used to assess the following mental disorders according to Diagnostic and statistical manual of mental disorders, 3rd revised edition (DSM-III-R): affective disorders, anxiety disorders, eating disorders, schizophrenia and other non-affective psychoses, substance dependence and substance abuse.
Mental disorders were common in the general population: the prevalence 'ever' of all disorders was 41.2%, the 12-month prevalence 23.5%, without sex differences. Depression, anxiety disorders and alcohol abuse and dependence showed high prevalence and comorbidity. The prevalence 'ever' of schizophrenia and other non-affective psychoses was low (0.4%).
Available from: Liberty Fajutrao
- "Two French studies demonstrated high direct medical costs for mania episodes, including hospitalizations, regardless of study design [38,39] Reported costs ranged from €2.75 to £4.59 billion. UK and Dutch studies tried to demonstrate the indirect costs using NHS registry and epidemiological data, respectively [36,48,49]. The yearly UK estimate for indirect costs was £1510 million for unemployment while the Dutch estimate was US$1370 million including absence and inefficiency. "
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ABSTRACT: Bipolar disorder is recognized as a major mental health issue, and its economic impact has been examined in the United States. However, there exists a general scarcity of published studies and lack of standardized data on the burden of the illness across European countries. In this systematic literature review, we highlight the epidemiological, clinical, and economic outcomes of bipolar disorder in Europe.
A systematic review of publications from the last 10 years relating to the burden of bipolar disorder was conducted, including studies on epidemiology, patient-related issues, and costs.
Data from the UK, Germany, and Italy indicated a prevalence of bipolar disorder of ~1%, and a misdiagnosis rate of 70% from Spain. In one study, up to 75% of patients had at least one DSM-IV comorbidity, commonly anxiety disorders and substance/alcohol abuse. Attempted suicide rates varied between 21%-54%. In the UK, the estimated rate of premature mortality of patients with bipolar I disorder was 18%. The chronicity of bipolar disorder exerted a profound and debilitating effect on the patient. In Germany, 70% of patients were underemployed, and 72% received disability payments. In Italy, 63%-67% of patients were unemployed. In the UK, the annual costs of unemployment and suicide were pound1510 million and pound179 million, respectively, at 1999/2000 prices. The estimated UK national cost of bipolar disorder was pound4.59 billion, with hospitalization during acute episodes representing the largest component.
Bipolar disorder is a major and underestimated health problem in Europe. A number of issues impact on the economic burden of the disease, such as comorbidities, suicide, early death, unemployment or underemployment. Direct costs of bipolar disorder are mainly associated with hospitalization during acute episodes. Indirect costs are a major contributor to the overall economic burden but are not always recognized in research studies.
Available from: Inger Plaisier
- "NEMESIS is an epidemiological study in the Dutch general population to determine the prevalence, incidence and course of psychiatric disorders with waves in 1996, 1997 and 1999 (Bijl et al., 1997). A representative sample of 7076 adults, aged 18–64 years, was interviewed with the Composite International Diagnostic Interview (CIDI, Robins et al., 1988a), designed to assess mental disorders according to the Diagnostic and Statistical Manual of mental disorders, (DSM-III-R). "
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ABSTRACT: The effect of social roles (partner, parent, worker) on mental health may depend on the total number or the quality of the individual occupied social roles. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of the number and quality of occupied social roles on mental health over three years was examined among 2471 men and women aged 25-55 years without mental disorders at baseline. Mental health was assessed using 3-year change in the SF-36 mental health scale as well as using the 3-year incidence of anxiety and depressive disorders defined by DSM-III criteria. The quality of social roles was assessed by the GQSB (Groningen Questionnaire Social Behavior). The number of social roles had no significant effect on the risk of developing depressive and anxiety disorders, but particularly the partner-role had a significant positive effect on mental health (beta of mental health=1.19, p=0.01; HR of incident disorders=0.75, 95% CI:0.51-1.00, p=0.05). A good quality of each of the three social roles was associated with higher levels of mental health and lower risks of incident disorders over 3 years. More than the number of social roles, knowledge about social role quality might provide opportunities for prevention of depressive and anxiety disorders.
Available from: Richard van Dyck
- "Recent studies investigating the patterns of comorbidity of anxiety disorders have revealed that comorbidity is the rule rather than the exception (i) among the anxiety disorders [Bijl et al., 1997; Brown and Barlow, 1992; van Balkom et al., 2000] and (ii) between anxiety and mood disorders [Bijl et al., 1997; Brown and Barlow, 1992; Pirkola et al., 2005; van Balkom et al., 2000]. This finding has led to criticism of the present diagnostic system by European and Australian clinicians [Andrews, 1996; Tyrer et al., 2004; May, 2005] who contend that the so-called ''comorbidity'' is actually a consequence of the splitting of the neurosis concept into several anxiety and mood disorders, effected with the introduction of DSM-III in 1980, and the subsequent proliferation of the number of diagnostic categories in later versions of the DSM system. "
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ABSTRACT: Influence of type of comorbidity was studied over the course of 1 year in a sample of 141 outpatients with panic disorder with or without agoraphobia and generalized anxiety disorder, who were receiving different forms of cognitive behavior therapy. Influence of type of comorbidity was determined on the basis of change scores (linear regression analysis) and remission data (Kaplan-Meier survival analysis). Three categories, as assessed at baseline, were compared: no comorbidity, comorbidity among anxiety disorders, and comorbidity with mood disorders. Primary outcome variable: State-Trait Anxiety Inventory State subscale measured at four assessments (0, 12, 24, and 52 weeks). Analyses of change and remission indicated that comorbidity with mood disorders led to (i) less improvement and (ii) a lower remission rate than comorbidity among anxiety disorders and no comorbidity. Because comorbidity has a critical influence on prognosis, it seems to be important to make a reliable diagnosis of the disorders present.
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