| 1. |
- Andersson, Lena, 1965, et al.
(författare)
-
Can avilability to psychiatric care explain regional differences in disability pension due to psychiatric disorders?
- 2005
-
Ingår i: Europen Journal of Public Health.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background In previous studies we have found regional differences in rates of sick leave and disability pension (DP) with psychiatric diagnosis. Age and sex composition of the populations could not explain these differences. The aim of this study was to more closely study associations between availability of psychiatric health care staff and regional differences in DP due to psychiatric disorders in Norway. Methods The study base was all individuals 16-67 years in Norway (n = 2 668 827 in 2000) and six southern regions in 1990, 1995, 2000. As indicators of psychiatric health care we used numbers of psychiatrists, psychologists and psychiatric nurses/10 000 and numbers of in-patient beds, hospitalization days and numbers of discharges/10 000 in each region. A multiple linear regression model was used for the statistical analysis. Results Regional differences in disability pension with psychiatric diagnoses remained after controlling for availability to psychiatric care. In two semi rural regions the relative risk increased while it decreased in the capitol Oslo after control for availability for psychiatric care. There was an association between the frequency of DP:s and number of psychiatrists and other physicians (RR 1,49 (95%CI 1,37-1,61), psychologists (RR 1,29 (95% CI 1,23-1,36) and associated nurses (RR 0,84, 95%CI 0,80-0,88). No association was found between DP frequency and number of psychiatric nurses (RR 1,03 95% CI 1,00-1,06). Conclusions Incidence rates of DP with psychiatric diagnoses in different regions were associated with the number of psychiatric health care staff. Possible explanations to found positive associations can be an improved identification of psychiatric cases but future studies are needed regarding the role of professional psychiatric staff in vocational rehabilitation.
|
|
| 2. |
|
|
| 3. |
- Zammit, Stanley, et al.
(författare)
-
Individuals, Schools, and Neighborhood. A Multilevel Longitudinal Study of Variation in Incidence of Psychotic Disorders
- 2010
-
Ingår i: Archives of General Psychiatry. ; 67:9, s. 914-922
-
Tidskriftsartikel (refereegranskat)abstract
- Context Incidence of schizophrenia and other nonaffective psychoses is greater in urban than rural areas, but the reason is unclear. Few studies have examined whether both individual and neighborhood characteristics can explain this association. Furthermore, as has been shown for ethnicity, the effect of individual characteristics may depend on neighborhood context. Objectives To examine (1) whether individual, school, or area characteristics are associated with psychosis and can explain the association with urbanicity and (2) whether effects of individual characteristics on risk of psychosis vary according to school context (reflecting both peer group and neighborhood effects). Design Multilevel longitudinal study of all individuals born in Sweden in 1972 and 1977. Diagnoses were identified through linkage with the Swedish National Patient Register until December 31, 2003. Setting Population-based. Participants A total of 203 829 individuals with data at individual, school, municipality, and county levels. Main Outcome Measures Any nonaffective psychosis, including schizophrenia (881 subjects; 0.43% cumulative incidence). For the study of interactions, the outcome was any psychosis (1944 subjects; 0.95% cumulative incidence). Results Almost all the variance in risk of nonaffective psychosis was explained by individual-level rather than higher-level variation. An association between urbanicity and nonaffective psychosis was explained by higher-level characteristics, primarily school-level social fragmentation. We observed cross-level interactions between individual- and school-level markers of ethnicity, social fragmentation, and deprivation on risk of developing any psychotic disorder, all with qualitative patterns of interaction. Conclusions The association between urbanicity and psychosis appears to be a reflection of increased social fragmentation present within cities. The qualitative interactions observed are consistent with a hypothesis that certain characteristics that define individuals as being different from most other people in their local environment may increase risk of psychosis. These findings have potentially important implications for understanding the etiology of psychotic disorders and for informing social policy.
|
|
