Howard Meltzer's research while affiliated with University of Leicester and other places

Publications (118)

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Background: The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007. Aims: To evaluate frequency of common mental disorders (CMDs), service contact and treatment. Method: Common mental disorders were identified with the Clinical Interview Schedule - Revised (CIS-R). Service c...
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Suicidal ideation is more strongly associated with suicidal intent in later life, so risk factors may also differ by age. We investigated whether the relationship between suicidal ideation and established correlates varied by age in a representative population. We used data from the 2007 Adult Psychiatric Morbidity Survey of England to assess the r...
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Background Policy and practice guidelines emphasize that responses to children and young people with poor mental health should be tailored to needs, but little is known about the impact on costs. We investigated variations in service-related public sector costs for a nationally representative sample of children in Britain, focusing on the impact of...
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To compare the reported point prevalence of chronic physical illness among children looked after by local authorities with those living in their own homes. Cross-sectional study, using questionnaire data from a national survey. The UK. Random samples of children aged 5-15 years. Children looked after were selected from Department of Health database...
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Teacher-pupil relationships have been found to mediate behavioural, social and psychological outcomes for children at different ages according to teacher and child report, but most studies have been small. To explore later psychiatric disorder among children with problematic teacher-pupil relationships. Secondary analysis of a population-based cros...
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Background Psychotic phenomena appear to form a continuum with normal experience and beliefs, and may build upon common emotional interpersonal concerns. Aims We tested predictions that paranoid ideation is exponentially distributed and hierarchically arranged in the general population, and that persecutory ideas build on more common cognitions of...
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Approximately one in ten children aged 5–15 in Britain has a conduct, hyperactivity or emotional disorder. The British Child and Adolescent Mental Health Surveys (BCAMHS) identified children aged 5–15 with a psychiatric disorder, and their use of health, education and social care services. Service costs were estimated for each child and weighted to...
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Background: Religious participation or belief may predict better mental health but most research is American and measures of spirituality are often conflated with well-being. Aims: To examine associations between a spiritual or religious understanding of life and psychiatric symptoms and diagnoses. Method: We analysed data collected from inter...
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The primary aim of this study is to examine the extent to which running away from home as a child is associated with behavioral problems and victimization during childhood and with suicidal behavior and substance abuse during early adulthood. A random probability sample comprising 7,461 respondents was interviewed for the 2007 survey of psychiatric...
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Purpose: The purpose of this study is to investigate whether minority ethnic people were less likely to receive treatment for mental health problems than the white population were, controlling for symptom severity. Method: We analysed data from 23,917 participants in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. Survey response...
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Purpose Loneliness can affect people at any time and for some it can be an overwhelming feeling leading to negative thoughts and feelings. The current study, based on the Adult Psychiatric Morbidity Survey in England, 2007, quantified the association of loneliness with a range of specific mental disorders and tested whether the relationship was inf...
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The relationship between physical ill health, disability, and depression is not straightforward. Both cross-sectional and longitudinal studies have clearly shown that medical illness and physical disability are strongly associated with depression. To test the hypothesis that disability is associated with an increased prevalence of depression irresp...
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Disability has long-term practical and social consequences, and is associated with mental disorders, in particular with depressive disorder. In this paper we investigate disability in relation to suicide attempts. We hypothesised that such attempts would be more common in people with a disability, and that this would be commensurate with the number...
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Background: Personal debt is now recognized as one of the many factors associated with common mental disorders (CMD). We aim to estimate the prevalence of 'specific' mental disorders based on ICD-10 research diagnostic criteria by type of debt and quantify the additional influence of addictive behaviours. Method: A random probability sample comp...
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To investigate changes over 15 years in the prevalence of insomnia and its association with demographic characteristics and hypnotic medication use. Analysis of 3 cross-sectional national mental health surveys carried out in 1993, 2000, and 2007, which used comparable sampling methods and identical insomnia assessments. Adults living in private hou...
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Our theoretical model proposes that insomnia, worry, and negative affect are important determinants of paranoid thinking. Anxiety produces anticipation of threat, depression increases the sense of vulnerability, worry leads to implausible ideas, and insomnia exacerbates negative affect and creates an altered perceptual state. The study objective wa...
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we measured subjective memory impairment (SMI) across the whole adult age range in a representative, national survey. Age is the strongest risk factor for dementia and SMI may be a precursor of objective cognitive impairment. We therefore hypothesised that SMI prevalence would rise with age in a non-demented population. we analysed data from the En...
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In the context of increasing concerns for the health of UK armed forces veterans, this study aims to compare the prevalence of current mental, physical and behavioural difficulties in conscripted national service veterans with population controls, and to assess the impact of length of service in the military. The compulsory nature of national servi...
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There are concerns that the prevalence of mental disorder is increasing. To determine whether the prevalence of common adult mental disorders has increased over time, using age-period-cohort analysis. The study consisted of a pseudocohort analysis of a sequence of three cross-sectional surveys of the English household population. The main outcome w...
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A substantial number of prisoners have intellectual disabilities. We analysed data on a sample drawn from all prisons in England and Wales. Intellectual disability was defined as Quick Test scores equivalent to an IQ of ≤65. We found a significantly higher prevalence of probable psychosis, attempted suicide and cannabis use in prisoners with intell...
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To our knowledge, there is no published information on the epidemiology of autism spectrum disorders (ASDs) in adults. If the prevalence of autism is increasing, rates in older adults would be expected to be lower than rates among younger adults. To estimate the prevalence and characteristics of adults with ASD living in the community in England. A...
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A number of studies in a range of samples attest a link between childhood sexual abuse and psychosis. To use data from a large representative general population sample (Adult Psychiatric Morbidity Survey 2007) to test hypotheses that childhood sexual abuse is linked to psychosis, and that the relationship is consistent with mediation by revictimisa...
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Introduction. There is a paucity of evidence from epidemiological studies on the burden of children's emotional and conduct disorders on their parents. The main purpose of this study is to describe the problems experienced by parents of children with conduct and emotional disorders using data from a large national study on the mental health of chil...
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The main ethical issues in conducting psychiatric morbidity surveys are more concerned with respecting the voluntary nature of the exercise and the dignity of survey respondents, and ensuring that information given is confidential and held securely rather than the risk of physical injury. In this chapter, the ethical dimensions of all areas of the...
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Stigma has been conceptualized as comprised of 3 constructs: knowledge (ignorance), attitudes (prejudice), and behaviour (discrimination). We are not aware of a psychometrically tested instrument to assess knowledge about mental health problems among the general public. Our paper presents the results of the development stage and the psychometric pr...
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We investigated for the first time in a national survey whether older people were less likely than younger adults with the same symptom severity to receive treatment for Common Mental Disorders (CMD). We analysed data from the 2007 English Adult Psychiatric Morbidity Survey, representative of people living in private homes. 7461 (57%) people approa...
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It is clinically and theoretically plausible that insomnia contributes to the development and maintenance of paranoid fears. The primary aim of the study was to establish in a large sample whether insomnia and paranoia are associated more strongly than by chance. Cross-sectional data on paranoia, insomnia, anxiety, worry, depression, irritability,...
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The health and well-being of military veterans has recently generated much media and political interest. Estimating the current and future size of the veteran population is important to the planning and allocation of veteran support services. Data from a 2007 nationally representative residential survey of England (the Adult Psychiatric Morbidity S...
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There is now considerable evidence that witnessing domestic violence can have adverse consequences for children. Our aim is to present the socio-demographic correlates of children witnessing domestic violence and its association with childhood mental disorders. The biographic, socio-demographic and socio-economic characteristics of 7865 children an...
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The purpose of this study was to utilize data from the 2000 British National Survey of Psychiatric Morbidity, a randomized cross-sectional survey of the British population that included questions relating to the phenomena of suicidality and sexual abuse, to test the hypothesis that suicide attempts in women are significantly associated with a histo...
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To test the hypothesis that the association previously reported between moderate alcohol use and better cognition is an artefact of confounding by (a) higher premorbid education and socioeconomic status; (b) a lifestyle of moderation (using smoking as a risk marker); and (c) decreased alcohol consumption in people with physical illnesses. Data were...
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Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). U...
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Panos Vostanis, Guv Bassi, Howard Meltzer, Tamsin Ford and Robert Goodman examine data from the England survey on the use of services by looked after children with behavioural problems (or conduct disorders - CD). Of the total 1,039 looked after children who participated, 384 (37%) fulfilled criteria for CD, of whom 57 (or 17% of children with CD)...
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Suicide rates vary by occupation but this relationship has not been frequently studied. To identify the occupations with significantly high suicide rates in England and Wales in 2001-2005 and to compare these with rates from previous decades. Mortality data from death registrations in England and Wales over the calendar years 2001-2005 were used to...
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Past studies have documented rising levels of conduct problems among UK adolescents in the last quarter of the twentieth century, and increased rates of emotional difficulties between the 1980s and 1990s. We used parent, teacher and youth ratings from two large scale, nationally representative studies of 5-15 year-old carried out in 1999 and 2004 t...
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Background: Most previous studies of service use in relation to mental health have examined services in the USA. We wanted to provide up-to-date findings from a general population sample of British schoolchildren. Method: A total of 2461 children aged 5-15 from the 1999 British Child and Adolescent Mental Health Survey were followed up for 3 yea...
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The aim of the Foresight Project on Mental Capital and Wellbeing(www.foresight.gov.uk) is to advise the Government on how to achieve the best possible mental development and mental wellbeing for everyone in the UK in the future. The starting point of the Project was to generate an understanding of the science of mental capital and wellbeing (MCW) a...
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Many studies have described associations between adult psychiatric disorder among adults and their biographic, socio-demographic and social capital characteristics. Fewer studies have focused on children, and most of these have looked at structural indicators of the neighbourhood. Our objective was to examine one aspect of social capital--perceived...
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Whilst the correlates of child mental health problems are well understood, less is known about factors that operate to maintain healthy or unhealthy functioning, or that contribute to change in functioning. A range of factors may be of interest here, including relatively stable characteristics of children or their environment, that may have long-la...
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Henderson and Andrews have written a timely paper to examine the yield from national surveys, and pose questions of value for money, survey methods, delineation of pathology by categorical boundaries rather than dimensions, and breadth of risk factors examined. We would like to address the points they raise, exemplified by the purposes (Jenkins et...
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To examine patterns of drinking in the UK Armed Forces, how they vary according to gender and other demographics, and to make comparisons with the general population. Large cross-sectional postal questionnaire study (response rate 60%). United Kingdom. A random representative sample of the regular UK Armed Forces who were in service in March 2003 (...
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Psychiatric morbidity among the physically ill is an important issue, particularly in the light of research documenting the difficulties in accurately diagnosing and effectively treating psychiatric disorders in this group. The objectives of this study were: (1) To compare psychiatric morbidity in 11 physical conditions and a healthy comparison gro...
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Life events (LEs) are recognised to be important risk factors for common mental disorders (CMD). Their prominence may vary across age groups but this issue has received little systematic investigation. Data were analysed from the 2000 UK National Survey of Psychiatric Morbidity comprising 8,580 participants aged 16-74 years. A history of recent lif...
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For several reasons, many individuals with obsessive-compulsive disorder (OCD) do not seek treatment. However, data on treatment seeking from community samples are scant. This study analyzed service use by adults with OCD living in private households in Great Britain. Data from the British Survey of Psychiatric Morbidity of 2000, in which 8,580 ind...
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Previous studies have examined suicidal ideation in older populations and emphasized the strong association with the presence of psychiatric disorder. However, associations with the presence of psychiatric disorder across the age range are unclear. Representative epidemiological estimates are needed. In a national survey of psychiatric morbidity in...
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The objective of this study was to describe the incidence, prevalence, risk factors, and prognosis of fatigue, chronic fatigue, and chronic fatigue syndrome in 11- to 15-year-olds. A random general population sample (n = 842) of British adolescents and their parents were assessed at baseline and 4 to 6 months later. The main outcomes were fatigue,...
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Children looked after by local authorities are at higher risk of poor psychosocial outcomes than children living in private households, but nationally representative and random samples of the two groups of children have not previously been compared. To find explanations for the increased prevalence of psychiatric disorder in children looked after b...
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Previous studies suggest that worry content and prevalence may vary as a function of age, but evidence is limited. Cross-sectional national survey of 8580 householders in Great Britain aged between 16 and 74 years. This analysis examined the relationship between age, worry content (relationships/family, financial/housing, work, health, miscellaneou...
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There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking. Data from the British N...
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To compare age-group differences in somatic/psychiatric comorbidity, impact, and pharmacotherapy associated with sleep disturbance across a broad adult age range. Cross-sectional national mental health survey. Adults living in private households in England, Scotland, and Wales. 8,580 people aged 16 to 74 years. Insomnia (4 symptom/syndrome definiti...
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Previous studies indicate that most individuals with obsessive-compulsive disorder (OCD) have comorbid personality disorders (PDs), particularly from the anxious cluster. However, the nature and strength of this association remains unclear, as the majority of previous studies have relied heavily on clinical populations. We analysed the prevalence o...
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Method: A third of the children from the 1999 British Child and Adolescent Mental Health Survey were followed-up over 3 years. Parents provided summary information on service contacts in relation to mental health; selected subgroups provided more detailed information by telephone interview. Results: Common overlaps in service use were between healt...
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Parental and child psychiatric disorders have been found to be associated, and this association can be mediated by other psychosocial variables, including parenting attitudes and strategies. As most previous studies included clinical samples, the purpose of this study was to establish the relationship between parental psychopathology and parenting...
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Scarce longitudinal data exist on the occurrence of psychotic symptoms in the general population. To estimate the incidence of, and risk factors for, self-reported psychotic symptoms in Great Britain. Data from the 18-month follow-up of a national survey were used. Incident cases were those who endorsed one or more items on the Psychosis Screening...
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To describe the self-reported history of health service utilization and help-seeking to those who are drug-dependent in the period of time prior to imprisonment. A cross-section survey of 3142 sentenced or remand prisoners in English prisons completed private, face-to-face interviews with trained Office for National Statistics staff covering a full...
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To examine sex differences in correlates of disruptive behavior disorders (DBDs) in preadolescent children using indicators of a wide range of well-established risk factors for DBDs and outcomes 3 years after initial assessment. Analyses were based on data for 5- to 10-year-olds (n = 5,913) from the British Child and Adolescent Mental Health Survey...
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Childhood psychiatric disorders are common and are associated with heavy use of health services.1 Up to a third of children and adolescents attending primary care and paediatric outpatient departments have clinically significant psychopathology.2 3 Only a minority of these children reach specialist mental health services, partly because the present...
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Longitudinal studies have been in conclusive in identifying alcohol as a risk factor for anxiety and depression. To examine whether excessive alcohol consumption is a risk factor for anxiety and depression in the general population, and whether anxiety and depression are risk factors for excessive alcohol consumption. Data were analysed from the 18...
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To examine the impact on contraceptive practice of making emergency hormonal contraception available over the counter. Analysis of data on contraceptive practice for women aged 16-49 years in the period 2000-2 from the Omnibus Survey, a multipurpose survey in which around 7600 adults living in private households are interviewed each year. Private h...
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Structural characteristics of social networks such as primary group size have received less attention than measures of perceived social support. Previous research suggests that associations between social network size and later common mental disorder status may differ according to sex and initial mental state. Adults participating in the 2000 Briti...
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Literacy difficulties show high levels of comorbidity with both disruptive and emotional disorders, but questions remain over the nature and specificity of these links. Relationships between specific literacy difficulties and psychiatric disorder were investigated in a large-scale national sample of children aged 9 to 15 years. Specific literacy di...