Mental–physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys

Scott, Kate M.; Korff, Michael Von; Alonso, Jordi; Angermeyer, Matthias C.; Bromet, Evelyn J.; Fayyad, John; Girolamo, Giovanni de; Demyttenaere, Koen; Gasquet, Isabelle; Gureje, Oye; Haro, Josep María; He, Yulong; Kessler, Ronald C.; Levinson, Daphna; Mora, María Elena Medina; Browne, Mark Oakley; Ormel, Johan; Posada‐Villa, José; Watanabe, Makoto; Williams, Daniel

doi:10.1017/s0033291708003188

Cited by 253 publications

(190 citation statements)

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“…Similarly in the US there is currently $660 billion in outstanding credit card debt (Federal Reserve Bank of New York, 2013) DEBT AND HEALTH There has been a previous review into personal debt and mental health (Fitch, Hamilton, Bassett, & Davey, 2011). However this did not examine relationships with physical health, although the literature shows a strong relationship between physical and mental health (Scott, et al, 2009), and did not examine relationships with substance use. This systematic review therefore aims to review all studies which examine the relationship between personal unsecured debt and physical and mental health, suicide and substance use.…”

Section: Introductionmentioning

confidence: 99%

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

Richardson

Elliott

Roberts

2013

Clinical Psychology Review

354

278

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This paper systematically reviews the relationship between personal unsecured debt and health. Psychinfo, Embase and Medline were searched and 52 papers were accepted. A hand and citedby search produced an additional 13 references leading to 65 papers in total. Panel surveys, nationally representative epidemiological surveys and psychological autopsy studies have examined the relationship, as have studies on specific populations such as university students, debt management clients and older adults. Most studies examined relationships with mental health and depression in particular. Studies of physical health have also shown a relationship with self-rated health and outcomes such as obesity. There is also a strong relationship with suicide completion, and relationships with drug and alcohol abuse. The majority of studies found that more severe debt is related to worse health; however causality is hard to establish. A meta-analysis of pooled odds ratios showed a significant relationship between debt and mental disorder (OR=3.24), depression (OR=2.77), suicide completion (OR=7.9), suicide completion or attempt (OR=5.76), problem drinking (OR=2.68), drug dependence (OR=8.57), neurotic disorder (OR=3.21) and psychotic disorders (OR=4.03). There was no significant relationship with smoking (OR=1.35, p>.05). Future longitudinal research is needed to determine causality and establish potential mechanisms and mediators of the relationship.Dr Bellack, Please find attached a response to the reviewer's comments and an amended manuscript. We hope that these changes address the concerns raised, and the paper can now be accepted for -This relationship is especially strong for mental health in particular depression.-There are also relationships with substance use and suicide.-Research suffers from inconsistent use of standardised measures.-A lack of longitudinal studies makes it difficult to demonstrate causality. *Highlights (for review)We would like to thank the reviewer for their detailed comments. In relation to these we have made the following changes, which have all been marked in the main manuscript via track changes:-We have now clarified in the title, abstract, introduction, discussion and highlights that this examines personal unsecured debt specifically.-In the Method, Search Procedure we have changed "Classes" into "Classed" -In Appendix B (Characteristics of Panel Surveys) we have added "years" to 4-6. The formatting of the tables meant that some words were cut off: this has now been corrected for all the tables.-Page 17, fifth line of first paragraph, "self-related" has been changed to "self-rated." -Page 19, second paragraph, a new paragraph has been started after the line beginning "The advantage." -Page 20, first line of second paragraph, "somewhat unclear" has been changed to "unclear".-Page 21, second paragraph, the first line has been amended to specify about "personal, unsecured debt".-Page 5: more detail has been added to justify why studies on secured loans and mortgage debt were excluded.-Resul...

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Section: Introductionmentioning

confidence: 99%

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

Richardson

Elliott

Roberts

2013

Clinical Psychology Review

354

278

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“…This cut-off was chosen pragmatically, being sufficiently stringent as a marker of severity yet ensuring that statistical analyses would have reasonable power. A similar approach has been adopted elsewhere (Scott et al 2009). …”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the potential impact of such interventions would be little diminished if they were targeted only at people with LTCs rather than at everyone with CMD. This reflects the large gradient in rates of disability among those with multiple LTCs, interactions between CMDs and LTCs in their association with disability (Scott et al 2009) and the conservative nature of our comparison with people who were not cases of Table 4. Estimated percentage reduction in the prevalence of severe disability (PAFs) where risks for people with CMDs to be reduced to that of people currently in receipt of mental health treatment but who were not CMD cases at interview (' treated non-cases ') a Outcome and target group PAF, % (95 % CI) b Treated CMD Untreated CMD All CMD All respondents 10.9 (7.9-13.9) 11.0 (5.2-16.4) 21.8 (13.9-28.9) Respondents with one LTC 3.5 (1.2-5.8) 7.5 (2.1-12.6) 11.0 (3.6-17.8) Respondents with two LTCs 2.6 (1.2-3.9) 4.8 (2.4-7.1) 7.4 (3.9-10.7) Respondents with any LTCs 6.1 (2.9-9.3) 12.3 (4.8-19.2) 18.4 (7.7-27.9) PAF, Population-attributable risk fraction ; CMD, common mental disorder ; CI, confidence interval ; LTC, long-term condition ; BMI, body mass index.…”

Section: Main Findingsmentioning

confidence: 97%

“…Most LTCs are associated with increased rates of the common mental disorders (CMDs) such as anxiety and depressive disorders, both cross-sectionally (Egede, 2007) and longitudinally (Patten, 2001 ;Karakus & Patton, 2011). For almost all LTCs the presence of CMDs reduces quality of life (Moussavi et al 2007), increases disability (Scott et al 2009), impairs outcome and increases utilization of health care (Frasure-Smith et al 2000 ;Katon & Ciechanowski, 2002). Such links have been demonstrated in coronary artery disease (Penninx et al 2001 ;Stafford et al 2007), chronic obstructive pulmonary disease (COPD) (Ng et al 2007 ;Eisner et al 2010) and diabetes (Schram et al 2009 ;Ali et al 2010).…”

Section: Introductionmentioning

confidence: 99%

“…LTCs and mental disorders almost certainly influence each other through a reciprocating, perpetuating causal ring, in which causes become consequences and consequences become causes (see Fig. 1) (Scott et al 2009 ;Eisner et al 2010). These influences include physical and psychological processes, and may be mediated by health behaviours (Leventhal et al 2008).…”

Section: Introductionmentioning

confidence: 99%

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The population impact of common mental disorders and long-term physical conditions on disability and hospital admission

Weich

Bebbington²,

Rai³

et al. 2012

Psychol. Med.

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Background. Long-term physical conditions (LTCs) consume the largest share of healthcare budgets. Although common mental disorders (CMDs) and LTCs often co-occur, the potential impact of improved mental health treatment on severe disability and hospital admissions for physical health problems remains unknown. Method.A cross-sectional study of 7403 adults aged 16-95 years living in private households in England was performed. LTCs were ascertained by prompted self-report. CMDs were ascertained by structured clinical interview. Disability was assessed using questions about problems with activities of daily living. Population impact and potential preventive gain were estimated using population-attributable fraction (PAF), and conservative estimates were obtained using ' treated non-cases ' as the reference group.Results. Of the respondents, 20.7 % reported at least one LTC. The prevalence of CMDs increased with the number of LTCs, but over two-thirds (71.2 %) of CMD cases in people with LTCs were untreated. Statistically significant PAFs were found for CMDs and recent hospital admission [13.5 %, 95 % confidence intervals (CI) 6.6-20.0] and severe disability (31.3 %, 95 % CI 27.1-35.2) after adjusting for LTCs and other confounders. Only the latter remained significant when using the most conservative estimate of PAF (21.8 %, 95 % CI 14.0-28.9), and this was reduced only slightly when considering only participants with LTCs (18.5 %, 95 % CI 7.9-27.9).Conclusions. Better treatments for CMDs in people with LTCs could achieve almost the same population health gain in terms of reducing severe disability as those targeted at the entire population. Interventions to reduce the prevalence of CMDs among people with LTCs should be part of routine medical care.

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Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic

et al. 2023

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ImportanceThere is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased.ObjectiveTo synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic.Data SourcesMedline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022.Study SelectionIncluded studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal.Data Extraction and SynthesisIn total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included.Main Outcomes and MeasuresStandardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic.ResultsThe analysis included 40 807 children and adolescents represented in pre–COVID-19 studies and 33 682 represented in during–COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income.ConclusionsThis systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.

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Mental–physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys

Cited by 253 publications

References 45 publications

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

The population impact of common mental disorders and long-term physical conditions on disability and hospital admission

Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic

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