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Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress

Published online by Cambridge University Press:  25 November 2011

B. P. Bunting ,
S. D. Murphy ,
S. M. O'Neill  and
F. R. Ferry
B. P. Bunting*
Affiliation:
Psychology Research Institute, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, UK
S. D. Murphy
Affiliation:
Psychology Research Institute, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, UK
S. M. O'Neill
Affiliation:
Psychology Research Institute, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, UK
F. R. Ferry
Affiliation:
Psychology Research Institute, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, UK
*
*Address for correspondence: Professor B. P. Bunting, Psychology Research Institute, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, UK. (Email: bp.bunting@ulster.ac.uk)
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Abstract

Background

The current study provides the first epidemiological estimates of lifetime mental disorders across NI based on DSM-IV criteria. Risk factors, delays in treatment and the experience of conflict are also examined.

Method

Nationally representative face-to-face household survey of 4340 individuals aged ⩾18 years in NI using the Composite International Diagnostic Interview. Analyses were implemented using SAS and STATA software.

Results

Lifetime prevalence of any disorder was 39.1% while projected lifetime risk was 48.6%. Individuals who experienced conflict were more likely to have had an anxiety, mood or impulse-control disorder. Treatment delays were substantial for anxiety and substance disorders.

Conclusions

Results from this study show that mental disorders are highly prevalent in Northern Ireland. The elevated rates of post-traumatic stress disorder in relation to other countries and the association of living ‘in a region of terror’ disorders suggests that civil conflict has had an additional impact on mental health. Given substantial delays in treatment, further research is required to investigate the factors associated with failure and delay in treatment seeking.

Keywords

EpidemiologyNorthern Irelandmental healthtreatment delay
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 8 , August 2012 , pp. 1727 - 1739
Copyright
Copyright © Cambridge University Press 2011

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References

Alonso, J, Kessler, RC (2008). Prevalence and treatment of mental disorders in Germany: results from the European study of the epidemiology of mental disorders (ESEMeD) survey. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 331–345. Cambridge University Press: New York.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental disorders. 4th edn. American Psychiatric Association: Washington DC.Google Scholar
Anthony, AJ, Folstein, M, Romanoski, AJ, Vonkorff, MR, Nestadt, GR, Chahal, R, Merchant, A, Brown, CH, Shapiro, S, Kramer, M, Gruenberg, EM (1985). Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis – experience in Eastern Baltimore. Archives of General Psychiatry 42, 667–675.CrossRefGoogle Scholar
Arababzadeh-Bouchez, S, Gasquet, I, Kovess-Masfety, V, Negres-Pages, L, Lépine, J-P (2008). The prevalence of mental disorders and service use in France: results from a national survey 2001–2002. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 305–330. Cambridge University Press: New York.Google Scholar
Borges, G, Wang, PS, Medina-Mora, ME, Lara, C, Chiu, WT (2007). Delay of first treatment of mental and substance use disorders in Mexico. American Journal Public Health 97, 1638–1643.Google Scholar
Bromet, EJ, Gluzman, SF, Tintle, NL, Paniotto, VI, Webb, CPM, Zakhozha, V, Havenaar, JM, Gutkovich, Z, Kostyuchenko, S, Schwartz, JE (2008). The state of mental health and alcoholism in Ukraine. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), p. 431–445. Cambridge University Press: New York.Google Scholar
Brown, MN, Lapane, KL, Luisi, AF (2002). The management of depression in older nursing home residents. Journal of the American Geriatrics Society 50, 69–76.CrossRefGoogle ScholarPubMed
Bruffaerts, R, Bonnewyn, A, Demyttenaere, K (2007). Delays in seeking treatment for mental disorders in the Belgian general population. Social Psychiatry Psychiatric Epidemiology 42, 937–944.Google Scholar
Bruffaerts, R, Bonneywyn, A, Demyttenaere, K (2008). Mental health in Belgium: current situation and future perspectives. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 279–304. Cambridge University Press: New York.Google Scholar
Brugha, T, Jenkins, R, Taub, N, Meltzer, H, Bebbington, P (2001). A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Psychological Medicine 31, 1001–1013.Google Scholar
Cannell, CF, Marquis, KH, Laurent, A (1977). A summary of studies of interviewing methodology. Vital Health Statistics 2 69, 1–78.Google Scholar
Cunningham, JA, Sobell, LC, Sobell, MB, Agrawal, S, Toneatto, T (1993). Barriers to treatment: why alcohol and drug abusers delay or never seek treatment. Addictive Behaviors 18, 347–353.Google Scholar
de Girolamo, G, Morosini, P, Gigantesco, A, Delmonte, S, Kessler, RC (2008). The prevalence of mental disorders and service use in Italy: results from the national health survey 2001–2003. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 364–387. Cambridge University Press: New York.Google Scholar
de Graaf, R, Ormel, J, ten Have, M, Burger, H, Buist-Bouwman, M (2008). Mental disorders and service use in the Netherlands: results from the European study of the epidemiology of mental disorders (ESEMeD). In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology Of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 388–405. Cambridge University Press: New York.Google Scholar
Department of Health and Social Services and Public Safety (2007). NI Health and Social Wellbeing Survey 2005/6 (http://archive.nics.gov.uk/dfp/070129b-dfp.htm). Accessed February 2010.Google Scholar
Fay, MT, Morrissey, M, Smyth, M, Wong, T (1999). The Cost of the Troubles Study: Report on the NI Survey. The Experience and Impact of the Troubles. INCORE: Derry/Londonderry.Google Scholar
Ferry, F, Bolton, D, Bunting, B, Devine, B, McCann, S, Murphy, S (2008). Trauma, Health and Conflict in Northern Ireland. A Study of the Epidemiology of Trauma Related Disorders and Qualitative Investigation of the Impact of Trauma on the Individual. NI Centre for Trauma and Transformation and University of Ulster Psychology Research Institute: Londonderry.Google Scholar
Gresenz, CR, Sturm, R, Tang, L (2001). Income and mental health: unraveling community and individual level relationships. Journal of Mental Health Policy and Economics 4, 197–203.Google Scholar
Gureje, O, Adeyemi, O, Enyidah, N, Ekpo, M, Udofia, O, Uwakwe, R, Wakil, A (2008). Mental disorders among adult Nigerians: risks, prevalence and treatment. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 211–237. Cambridge University Press: New York.Google Scholar
Gunn, J, Maden, A, Swinton, M (1991). Treatment needs of prisoners with psychiatric disorders. British Medical Journal 303, 338–341.Google Scholar
Halli, SS, Rao, KV (1992). Advanced Techniques of Population Analysis. Plenum: New York.CrossRefGoogle Scholar
Haro, JM, Alonso, J, Pinto-Meza, A, Vilagut Saiz, G, Fernandez, A, Codony, M, Martinez, M, Domingo, A, Torres, JV, Almansa, J, Ochoa, S, Autonell, J (2008). The epidemiology of mental disorders in the general population of Spain. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 406–430. Cambridge University Press: New York.Google Scholar
Herman, AA, Williams, D, Stein, DJ, Seedat, S, Heeringa, SG, Moomal, H (2008). The South African health and stress study (SASH): a foundation for improving mental health care in South Africa. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 238–264. Cambridge University Press: New York.Google Scholar
Huang, Y, Liu, Z, Zhang, M, Shen, Y, Tsang, CHA, He, Y, Lee, S (2008). Mental disorder and service use in China. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 447–473. Cambridge University Press: New York.Google Scholar
Jenkins, R, Bhugra, D, Bebbington, P, Brugha, TS, Farrell, M, Coid, J, Fryers, T, Weich, S, Singleton, N, Meltzer, H (2008). Debt income and mental disorder in the general population. Psychological Medicine 38, 1485–1493.CrossRefGoogle ScholarPubMed
Karam, EG, Mneimneh, ZN, Karam, AN, Fayyad, JA, Nasser, SC, Dimassi, H, Salamoun, MM (2008). Mental disorders and war in Lebanon. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 265–278. Cambridge University Press: New York.Google Scholar
Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Anthony, JC, Berglund, P, Chatterji, S, de Girolamo, G, de Graaf, R, Demyttenaere, K, Gasquet, I, Gluzman, SF, Gruber, MJ, Gureje, O, Haro, JM, Heeringa, SG, Karam, AN, Kawakami, N, Lee, S, Levinson, D, Medina-Mora, ME, Oakley-Browne, MA, Pennell, B-E, Petukhova, M, Posada-Villa, J, Ruscio, A, Stein, DJ, Tsang, CHA, Üstün, TB (2008). Lifetime prevalence and age of onset distributions of mental disorders in the world mental health survey initiative. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 511–521. Cambridge University Press: New York.Google Scholar
Kessler, RC, Berglund, PA, Chiu, WT, Demlar, O, Glantz, M, Lane, MC, Jin, R, Merikangas, KR, Nock, M, Olfson, M, Pincus, HA, Walters, EE, Wang, PS, Wells, KB (2008). The national comorbidity survey replication (NCS-R): the cornerstone in improving mental health and mental health care in the United States. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 165–210. Cambridge University Press: New York.Google Scholar
Kessler, RC, Berglund, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, BE, Walters, EE, Zaslavsky, A, Zheng, H (2004). The US national comorbidity survey replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 69–92.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Kessler, RC, Üstün, TB (2008). The world health organization composite international diagnostic interview. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 58–90. Cambridge University Press: New York.Google Scholar
Kish, L (1965). Survey Sampling. John Wiley and Sons, Inc.: New York.Google Scholar
Lamb, HR, Weinberger, LE (1998). Persons with severe mental illness in jails and prisons: a review. Psychiatric Services 49, 483–492.CrossRefGoogle ScholarPubMed
Lee, S, Zhang, MY, Shen, YC, Huang, YQ, Fung, SC, Tsang, A, Liu, ZR, Shen, YC, Kessler, RC (2007). Delay in initial treatment contact after first onset of mental disorders in metropolitan China. Acta Psychiatrica Scandanavica 37, 61–71.Google Scholar
Levinson, D, Lerner, Y, Zilber, N, Levav, I, Polakiewicz, J (2008). The prevalence of mental disorders and service use in Israel: results from the national health survey, 2003–2004. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 346–363. Cambridge University Press: New York.Google Scholar
McConnell, P, Bebbington, P, McClelland, R, Gillespie, K, Houghton, S (2002). Prevalence of psychiatric disorder and the need for psychiatric care in Northern Ireland: population study in the district of Derry. British Journal of Psychiatry 181, 214–219.Google Scholar
Medina-Mora, ME, Borges, G, Lara, C, Benjet, C, Fleiz, C, Rojas, E, Zambrano, J, Villatoro, JB, Aguilar-Gaxiola, S, Kessler, RC (2008). The Mexican national comorbidity survey (M-NCS): overview and results. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 144–164. Cambridge University Press: New York.Google Scholar
Muldoon, O, Schmid, K, Downes, C, Kremer, J, Trew, K (2003). The Legacy of the Troubles: Experience of the Troubles, Mental Health and Social Attitudes. Queen's University: Belfast.Google Scholar
National Collaborating Centre for Mental Health (2010). Depression: The Treatment and Management of Depression in Adults (updated edition). The British Psychological Society and The Royal College of Psychiatrists: London.Google Scholar
Olfson, M, Kessler, RC, Berglund, PA, Lin, E (1998). Psychiatric disorder onset and first treatment contact in the United States and Ontario. American Journal of Psychiatry 155, 1415–1422.CrossRefGoogle ScholarPubMed
O'Reilly, D, Stevenson, M (2003). Mental health in Northern Ireland: have the ‘troubles’ made it worse? Journal Epidemiology Community Health 57, 488–492.Google Scholar
Pampel, FC (2000). Logistic Regression: A Primer. Sage university papers series on quantitative applications in the social science, 07–132. Sage: Thousand Oaks, CA.CrossRefGoogle Scholar
Posada-Villa, J, Rodríquez, M, Duque, P, Garzón, A, Aguilar-Gaxiola, S, Breslau, J (2008). Mental disorders in Columbia: results from the world mental health survey. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 131–143. Cambridge University Press: New York.Google Scholar
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, Farmer, A, Jablenski, A, Pickens, R, Regier, DA, Sartorius, N, Towle, LH (1988). The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle ScholarPubMed
Sareen, J, Jagdeo, A, Cox, BJ, ten-Have, M, Clara, IP, Belik, S-L, de Graaf, R, Stein, MB (2007). Perceived barriers toward mental health service utilization: a comparison of the United States, Ontario and the Netherlands. Psychiatric Services 58, 357–364.Google Scholar
SAS Institute (2001). SAS/STAT Software: Changes and Enhancements, Release 8.2. SAS Publishing: Cary, NC.Google Scholar
StataCorp (2007). Statistical Software. Release 10.0. Stata: College Station, TX.Google Scholar
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bruffaerts, R, Chatterji, S, Chiu, W-T, de Girolamo, G, Fayyas, JA, Gureje, O, Haro, JM, Heeringa, SG, Huang, Y, Kessler, RC, Kovess-Masfety, V, Levinson, D, Nakane, Y, Oakley-Browne, MA, Ormel, J, Pennell, B-E, Posada-Villa, J, Üstün, TB (2008). Delay and failure in treatment seeking after first onset of mental disorders in the world mental health survey initiative. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, R. C. and Üstün, T. B.), pp. 522–533. Cambridge University Press: New York.Google Scholar
Wang, PS, Berglund, PA, Olfson, M, Kessler, RC (2004). Delays in initial treatment contact after first onset of a mental disorder. Health Services Research 39, 393–415.Google Scholar
Wang, PS, Berglund, PA, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the national comorbidity replication survey. Archives of General Psychiatry 62, 603–613.Google Scholar