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| 33. |
- Caldera, Trinidad, et al.
(författare)
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Psychological impact of the hurricane Mitch in Nicaragua in a one-year perspective
- 2001
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 36:3, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Whereas natural disasters more commonly occur in low-income countries, almost all studies on psychological consequences have been conducted in the Western world. In countries where resources are poor it is of importance to know which groups should be targeted for early intervention after a disaster. The study aims at assessing the prevalence of post-traumatic stress disorder PTSD and of post-traumatic symptoms among people afflicted by hurricane Mitch in Nicaragua and at identifying risk factors for PTSD symptoms 6 months following a disaster. METHOD: At four primary health care centres, 496 consecutive adult patients were interviewed 6 months after hurricane Mitch regarding PTSD symptoms (Harvard Trauma Questionnaire, HTQ), disaster experiences and post-disaster help-seeking. RESULTS: All individuals resident in the area during Mitch were judged to have experienced a trauma fulfilling A criteria for PTSD. Regarding more specific traumas, 39% reported a close relative to be dead or seriously injured and 72% had their house partly or completely destroyed. Prevalence of PTSD ranged from 9.0% in the worst afflicted area to 4.5% in a less damaged area. From a dimensional perspective, PTSD symptoms according to HTQ 6 months after the disaster were significantly associated with the death of a relative (beta-coefficient 0.257, P = 0.000), a house destroyed (beta-coefficient 0.148, P = 0.001), female sex (beta-coefficient 0.139, P = 0.001), previous mental health problems (beta-coefficient 0.109, P = 0.009) and illiteracy (beta-coefficient 0.110, P = 0.009). Those with previous mental health problems (OR = 4.84; 95% CI = 3.04-7.66) were more likely than others to seek from help, any source whereas the opposite was true for illiterate people (OR = 0.38; 95% CI = 0.21-0.69). Of all respondents, 8.5% reported that they had thought of taking their lives, and illiterates (OR 2.84; 95% CI = 1.12-4.37) and those with previous mental health problems (OR 2.84; 95% CI = 1.12-4.57) were at particular risk for suicidal problems. One year after Mitch, half of those identified as PTSD cases at 6 months still fulfilled the criteria for a PTSD diagnosis. CONCLUSION: PTSD represents a serious mental health problem after a disaster. Those with illiteracy, females and those with previous mental health problems should be targets for early post-disaster intervention.
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| 36. |
- Cedereke, Marie, et al.
(författare)
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Patients' needs during the year after a suicide attempt A secondary analysis of a randomised controlled intervention study.
- 2002
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 37:8, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We first studied whether changes of needs were influenced by randomly allocated telephone interventions between 1 and 12 months after a suicide attempt in addition to treatment as usual. These were aimed at improving motivation for professional treatment. As a secondary analysis we investigated the frequency and changes of needs during this period and if changes were related to other outcome measures. Method One month after a suicide attempt 216 patients were randomised to two telephone interventions or to no such interventions within 1 year. The Camberwell Assessment of Need (CAN) was used to evaluate 22 different need areas at 1 and 12 months. Other outcome measurements used were Global functioning axis V (GAF), psychological symptoms (SCL-90, GSI) and scale of suicide ideation (SSI). Results Of 178 patients who were followed up, 140 had been rated by CAN at both 1 and 12 months. Changes of needs did not differ between the randomised groups. At 1 month the patients had a mean number of 5.1 +/- 2.4 needs and 2.4 +/- 1.5 of these were considered as unmet. The most frequently reported needs concerned health aspects, basic needs and social needs. At 12 months needs concerning health aspects were significantly reduced, while basic needs and social needs were not. Changes of GAF explained 21 % and changes of GSI 4 % of the variance of the reduction of needs. Conclusions After 12 months, needs in health aspects, basic needs and social needs were still common. A structured evaluation of the patient's needs seems to be helpful when planning treatment after a suicide attempt.
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- Csajbók, Zsófia, et al.
(författare)
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Sex differences in the association of childhood socioeconomic position and later-life depressive symptoms in Europe : the mediating effect of education
- 2021
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 56, s. 1091-1101
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We aimed to study sex differences in the association of childhood socioeconomic position (SEP) with later-life depressive symptoms, the mediating effect of education and explore regional differences across Europe.Methods: The study included 58,851 participants (55% women, mean age 65 years) from the multicentre, population-based Survey on Health, Ageing and Retirement in Europe. Interviews were conducted in six waves and included measurements of childhood SEP (household characteristics at the age of 10) and depressive symptoms (EURO-D scale). Linear regression was used to study the association of childhood SEP with depressive symptoms, adjusting for covariates, and structural equation modelling assessed the mediating effect of education.Results: In the fully adjusted model, higher childhood SEP was associated with lower depressive symptoms with a greater magnitude in women (B = − 0.07; 95% CI − 0.08, − 0.05) than in men (B = − 0.02; 95% CI − 0.03, − 0.00). Relative to men, childhood SEP had 3 times greater direct effect on depressive symptoms in women, and education had 3.7 times stronger mediating effect against childhood SEP. These associations and the sex differences were particularly pronounced in Southern, Central and Eastern Europe.Conclusion: Growing up in poor socioeconomic conditions is a stronger risk factor for the development of depressive symptoms for women than for men. Education may have a stronger preventive potential for women in reducing the adverse effects of childhood socioeconomic hardship. Central and Eastern European populations experience disproportionately higher risk of later-life depression due to lower SEP and greater sex differences.
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