Prevalence and trends of common mental disorders - NEMESIS (Ten Have, Tuithof et al) Flashcards
welke wave was dit
3e
wat voor sample
- nationally representative
- 18-64
- 6646 subject
wat voor methode
face to face interview, composite international diagnostic interview 3.0 (CIDI) gebaseerd op de dsm 5 (en dsm 4 werd ook in meegenomen)
Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by …
comparing these rates between NEMESIS-3 and NEMESIS-2
wat was de lifetime prevalentie van anxiety disorders
28.6%
wat was de lifetime prevalentie van mood disorders
27.6%
wat was de lifetime prevalentie van substance use disorders
16.7%
wat was de lifetime prevalentie van attention deficit/hyperactivity disorder
3.6%
wat was de 12-month prevalentie van anxiety disorders
15.2%
wat was de 12-month prevalentie van mood disorders
9.8%
wat was de 12-month prevalentie van substance use disorder
7.1%
wat was de 12-month prevalentie van ADHD
3.2%
wat was het verschil in 12 maanden prevalentie voor en na covid
er was geen significant verschil, voor alle 4 de disorder categorieen:
voor = 26.7%
tijdens = 25.7%
(hierbij was ook gecontrolleerd voor verschillen in socio-demographic characteristics of the respondents interviewed in these two periods)
wat was het verschil tussen 2007-2009 en 2019-2022 van the 12-month prevalence rate of any DSM-IV disorder
this significantly increased from 17.4% to 26.1%.
(dus vanaf 2007 tot 2022 hebben mensen significant meer DSM 4 disorders)
voor wie was de sterkte increase in prevalence
- studenten
- younger adults (18-34 years)
- city dwellers (=stadsbewoner)
wat laat deze data zien?
- These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic.
- The already high mental disorder risk of young adults has particularly further increased in recent years.
er is nog niet echt consensus over of er nou een stijging is, studies vinden verschillende dingen
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wat is een limiet aan die studies
focussen vooral op mdd (niet op substance & anxiety), en gebruiken vaak self report en geen fully structured diagnostic interviews
wat voor factoren hebben de prevalentie van mental disorders in the general population of western countries veranderd
- the economic crisis that started in 2008
- the increased income inequality
- the further individualization of society
- the recent COVID-19 pandemic.
the reported rise in mental health care use might indicate that the prevalence has increased, but…
may also be explained by:
- improved accessibility
- efficiency
- capacity of care
wat was de lifetime prevalentie van dsm 5 mood/anxiety/substance/adhd? (dus in totaal)
48.4%
(ongeveer de helft)
wat was de 12 maanden prevalentie van al deze disorders
25.9%
(dus een kwart)
wat zijn de trends in hoe mensen de zorg gebruiken?
- increase in use of specialized mental health care (6.2% tot 10.0%)
- increase in unmet need for care (1.8% tot 4.0%)
hoe vergelijkt NL hierin tot andere landen
lifetime & 12 month prevalence is gelijk aan die reported in de US, maar hoger dan die van andere europese landen
US showed similar rates of DSM-5 mood and anxiety disorders, but higher rates of substance use disorders.These findings show that mental disorders are quite common in the general population. It is important to recognize, though, that not all mental disorders are severe. Mild and moderate cases are nonetheless meaningful, because even mild disorders can be impairing and
often evolve into severe mental disorders over time.
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wat zijn de kenmerken van mensen met 12 month DSM 5 disorders in NEMESIS 3 (meer dan net)
- young age
- sex: female = anxiety & mood, male = substance and ADHD
- living alone
- unemployed
- low education or low income
- higher degree of urbanization
post hoc analysen lieten zien dat de increase in prevalence started before the initiation of nemesis 3
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waarom denken ze dat studenten & jongere mensen meer zijn gehit door de 12 month prevalence (vergeleken met mensen met betaalde baan en ouder dan 35)
- meer affected by individualization of society
- social media
- increasing pressure to succeed
- social problems (housing and climate change)
- difficulty coping with setbacks (zoals successfull job and house)
- retired people minder want zij worden waarschijnlijk minder geraakt door societal problems zoals economic crisis or current social problems than the employed
- beter in herkennen en toegeven van mentale problemen
Living in a city may come with more dis-
advantages today than before.
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Among retired people, a smaller increase in disorder prevalence was found, perhaps because …
they have been less affected by the long-term consequences of the economic crisis that started in 2008, or are less adversely affected by current social problems than the employed.
the increase in mood & anxiety could be due to….
people being more likely to recognize and admit mental health problems (maar niet zo’n groot effect wss, omdat ze vroegen naar symptomen in plaats van naar de disorder: minder een taboe)
wat was het enige verschil dat ze zagen door de covid pandemic
substance abuse ging heel erg omlaag in 6 month prevalence
wss door de lockdown
wat waren de limitaties
- cidi 3.0 aanpassingen niet getest
- retrospective recall (= underreporting)
- survey non-response could lead to bias (want dat zijn een bepaald soort mensen, maar hiervoor gechecked en niet echt groot verschil)
- geen mensen die niet goed NL kunnen, geen huisadres hadden en institutionalized werden niet meegenomen
To conclude, the present study shows that the mental state of a population is subject to gradual changes, probably related to long-
term sociocultural developments, and that youngsters and city dwellers seem to be more sensitive to these developments. The study also shows that adversities of shorter duration (such as the COVID-19 pandemic) have little or no effect on that mental state. This could suggest effective resilience and adaptation, although time-lag effects of the pandemic may yet be felt. These findings
reaffirm the role of social determinants as risk factors for common mental disorders, and the need to develop and implement effective mental health promotion programmes, and to ensure timely access to mental health care, especially for young people.
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wat was het doel van dit artikel
- prevalentie en trends onderzoeken van common mental disorders in the nederlands, van 2007-2022
- lifetime and 12 month prevalence rates van depression, anxiety and substance use disorders
- impact van covid 19 pandemic
wat voor sampling procedure
stratified, random
wanneer was first wave van NEMESIS 3 uitgevoerd
voor en tijdens covid
which explanations were ruled out
- small difference in clinical assessment tools between nemesis 2 and nemesis 3: they both used similar questions
- nemesis 3 conducted assessment via videocalling, but there is no significant difference between 12 month and lifetime prevalences between face to face interviewed and video interviewed
- the change in population structure: to small compared to the sharp increase in prevalence of mental disorders
- covid 19 pandemic: the pandemic was not associated with a higher prevalence of mental disorders in the general population
limitations of the study
- validity and reliability of the cidi 3.0 were not formally tested
- prevalence rates are based on retrospective recall (diagnosing within the lifetime, but not within the past 12 months) which could result in underreporting
- non-responses could lead to bias
- representative of the dutch population but there were a few exclusion criteria (no dutch, no permanent residential adress, long term institutionalization)
