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Resilience Among the Long-Term Ill

People who have a long-term, debilitating physical illness demonstrate mental resilience according to “Understanding Society,” the world’s largest longitudinal household study. The first findings reveal that people diagnosed with cancer, diabetes, respiratory, or cardiovascular disease report similar mental health scores to those without physical illness. The survey’s findings suggest that those people who may not be able to function well physically because of an illness do not necessarily suffer problems with their mental health—for example with their concentration, confidence, and feelings of strain.

Another surprise finding from the study is that more than half (52 percent) of those indicating high levels of distress and anxiety—and therefore identified as at risk of suffering minor mental illness—still report fairly positive overall mental well-being.

Initial analysis of the data collected in the first survey also found that:

  • There are no differences between males and females, with 50 percent rating their overall health as either “excellent” or “very good.”
  • Asthma, arthritis, and high blood-pressure are the three most prevalent conditions, each affecting over 10 percent of the sample.
  • Overall figures indicate that 7 percent of the total population (approximately 25,000 respondents) have at some point in their lives been diagnosed with clinical depression and that of those people, the majority (69 percent), currently suffer from depression.

Understanding Society is following 40,000 households in the United Kingdom over many years and will revisit health, family life, employment, and a range of other aspects of people’s lives.

Sources: Early findings, as well as the chapter on Health, Chapter 9, entitled, “Health Over the Life Course: Associations Between Age, Employment Status and Well-Being."

Antidepressant Use Is Increasing Among Individuals  With No Psychiatric Diagnosis

During the last 20 years, Americans’ use of antidepressants has grown significantly. A new study attributes much of this growth to a substantial increase in antidepressant prescriptions by non-psychiatrist providers without any accompanying psychiatric diagnosis. 

“Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent, and the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007,” said Ramin Mojtabai, MD, PhD, MPH, lead author of the study and an associate professor with the Bloomberg School’s Department of Mental Health.

Researchers found that in the general medicine practice, antidepressant use was concentrated among people with less severe and poorly defined mental health conditions.

“To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers’ prescribing practices, revamp drug formularies, or undertake broad reforms of the healthcare system that will increase communication between primary care providers and mental health specialists,” adds Mojtabai. 

The results are featured in the August 2011 issue of Health Affairs. 
Click here for more information.

CDC Report: Mental Illness Prevalence Among U.S. Adults

A new report issued by the Centers for Disease Control and Prevention is the first agency-wide compilation of data from selected surveillance and information systems that measure the prevalence and effects of mental illness in the U.S. adult population. Released in September, the report issued these findings:

  • Data from the CDC 2005–2008 National Health and Nutrition Examination Survey indicate that 6.8 percent of adults had moderate to severe depression in the two weeks before completing the survey.
  • Data from the CDC 2006 Behavioral Risk Factor Surveillance System indicate that the prevalence of moderate to severe depression was generally higher in Southeastern states compared with other states.
  • Two other CDC surveys on ambulatory care services, the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, indicate that during 2007–2008, approximately 5 percent of ambulatory-care visits involved patients with a diagnosis of a mental health disorder, and most of these were classified as depression, psychoses, or anxiety disorders.

Future surveillance should pay particular attention to changes in the prevalence of depression both nationwide and at the state and county levels. In addition, national and state-level mental illness surveillance should measure a wider range of psychiatric conditions and should include anxiety disorders. Many mental illnesses can be managed successfully, and increasing access to and use of mental health treatment services could substantially reduce the associated morbidity.

The CDC report explains that numerous chronic diseases are associated with mental illnesses, such as cardiovascular disease, diabetes, and obesity. In such instances, treatment of the mental illness also can reduce the effect of the chronic disease. Authors say that increased mental health surveillance efforts will provide vital data needed to guide effective mental illness prevention and treatment programs.

“We know that mental illness is an important public health problem in itself and is also associated with chronic medical diseases such as cardiovascular disease, diabetes, obesity, and cancer,” said Ileana Arias, PhD, principal deputy director of CDC. “The report’s findings indicate that we need to expand surveillance activities that monitor levels of mental illness in the United States in order to strengthen our prevention efforts.”

The CDC plans to issue a similar report in 2012 focusing on childhood mental illness.

Click here for more information.