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Biomedical subjects

H Orn

Publications and source records attributed to H Orn.

At least 19 recordsLinked to original sources
PubMed1997

Age and remission of psychiatric disorders.

OBJECTIVE: To examine the relationship between remission of psychiatric disorders and age. METHODS: We interviewed 3258 randomly selected adult residents of Edmonton using the Diagnostic Interview Schedule (DIS), which yielded DIS/DSM-III diagnoses. Remission was defined as being free of symptoms of the index lifetime disorder in the year preceding the interview, this being the difference between the lifetime and one-year prevalence. For each age group, the proportion of cases with and without symptoms in the preceding year was calculated. Numbers and proportions of cases were estimated after adjusting to the census population and weighting for household size. Only the more common disorders were examined; any comorbidities were ignored. RESULTS: Drug abuse or dependence, antisocial personality disorder (in both sexes), and alcohol abuse or dependence (in men) all showed remission rates that increased with age. Panic disorder and obsessive-compulsive disorder (OCD) showed a decreased likelihood of remission with increasing age. Major depression and phobias showed little tendency to remission with age. Considering all disorders together, the one-year remission rate for all ages combined was only 33.2%, with a tendency for lower remission rates to be found in those aged 55 to 64. CONCLUSIONS: As may be expected, antisocial personality, drug abuse or dependence, and alcohol abuse or dependence tend to show increased remission rates with increasing age. In OCD and panic disorder, the low rates of remission found in all age groups indicate that these disorders produce significant long-term morbidity. For depression, which had an overall remission rate of less than 50%, the stable low rate of remission probably indicates not only the difficulties of treatment but also the low rates at which cases get treated.

Adolescent↗
PubMed1997

Help-seeking for psychiatric disorders.

OBJECTIVE: To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categories of professionals are sought by those who get care. METHOD: A 2-stage random sample of 3956 adult residents of Edmonton, Alberta, Canada was interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS) (73% completion rate). An average of 2.8 years later, a systematic random sample of 1964 subjects was reinterviewed (an 86% completion rate) using the DIS and a health care utilization questionnaire. After adjusting for age and sex, the reinterview sample was representative of those with and without a diagnosis at the first interview. RESULTS: Of the 1964 subjects, 570 (31%) met criteria for a DIS/DSM-III diagnosis in the year preceding the interview (one-year prevalence rate). These diagnoses included generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). For those with a diagnosis, sex, age, marital status, education, employment, and income were examined as determinants of help-seeking. Only sex (female) and age (under 45) were significant predictors. Comorbidity was highly significant: the help-seeking rate for those with one diagnosis was 20.3%; for those with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi 2 = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis saw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis made a difference: 46.7% of those with a major depressive episode sought help, but only 16.0% of those with alcohol abuse or dependence sought care. CONCLUSION: Major determinants of help-seeking are sex (female), age (under 45), severity of the illness, and comorbidity. A surprisingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DSM-III disorder.

Adolescent↗
PubMed1993

Epidemiology of pathological gambling in Edmonton.

Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were identified when 7,214 randomly selected household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The lifelong prevalence of pathological gambling was 0.42% (ratio of males to females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates of comorbidity with other psychiatric disorders. They were likely to have made suicide attempts (13.3%), to have been convicted of offences (26.7%), to be spouse and child abusers (23.3% and 16.7% respectively) and to have spent long periods unemployed (40%). In addition, 80% had trouble at home or work because of gambling, and 60% borrowed or stole to gamble.

Adolescent↗
PubMed1990

Health care utilization for emotional problems: results from a community survey.

A survey was conducted in which 865 randomly selected adult household residents of Edmonton, Alberta were interviewed to obtain information about health care in the preceding year. Eighty percent of the sample had seen a family physician, and eight percent of visits to family physicians involved a mental or emotional problem. Thirteen percent of the sample received professional help for a mental or emotional problem from some type of caregiver. The most frequently consulted professional was the family physician (eight percent of the sample), followed by psychologists and psychiatrists (each seeing two percent of the sample). Family physicians accounted for the greatest number of consultations for mental or emotional problems (41%), followed by psychologists (16%), social workers (12%) and psychiatrists (nine percent). Women were 27% more likely to seek a consultation than men, and consultation rates were highest in the group ranging in age from 35 to 44 years. There was also a strong relationship between having recent psychiatric symptoms and having had a consultation in the past year.

Adult↗
PubMed1990

Prevalence of psychiatric disorders and suicide attempts in a prison population.

A survey was conducted in which 180 randomly selected male prisoners ages 18 to 44 were interviewed using the Diagnostic Interview Schedule and other questionnaires. A comparison was made with 1,006 similarly aged male residents of Edmonton who were interviewed using the same instruments. Compared to the general population, prisoners were less likely to be married and were less well educated. There was a higher proportion of Native Indians in the prison sample and lower proportions of Oriental and other racial groups. Prisoners were twice as likely to have a lifetime psychiatric disorder compared with the general population, and all individual disorders investigated were more common in the prison population. Six month prevalence showed even greater rates compared with the general population, indicating recent symptoms. The number of individual disorders per prisoner was also higher than for the general population. Lifetime suicide attempts were seven times more frequent in prisoners than in the general population.

Adult↗
PubMed1988

Design and field methods of the Edmonton survey of psychiatric disorders.

This paper describes aspects of the study design and field methods used in a survey of psychiatric disorders carried out in Edmonton, Alberta, Canada. Between January 1983 and May 1986, information was gathered on 3,258 community residents using the Diagnostic Interview Schedule and the General Health Questionnaire - 30 item version. The survey had a response rate of 71.6%. The nature of the sampling strategy used, features of the study instruments chosen, the selection and training of interviewers, and the approach to data analysis are briefly described.

Alberta↗
PubMed1988

Lifetime prevalence of psychiatric disorders in Edmonton.

3,258 randomly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). Lifetime prevalence for 16 DIS/DSM III diagnoses are given. Overall 33.8% of the population had one or more diagnoses and, excluding substance use disorders, one fifth of the population had a diagnosis. The most common lifetime diagnosis was alcohol abuse/dependence, followed by phobia and major depressive episode. Men were more likely to have had substance use disorders and antisocial personality disorder and women more likely to have had major depressive episode, dysthymia, agoraphobia and simple phobia. Those who were married had generally lower lifetime prevalences. Those over age 65 had the lowest prevalence of any age groups.

Adolescent↗
PubMed1988

Period prevalence of psychiatric disorders in Edmonton.

3,258 randomly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). Six-month prevalence figures for DIS/DSM III diagnoses are given, and selected figures for the one-month and one-year prevalence, and the one-year symptom-free rates. The six-month prevalence for any diagnosis is 17.1%, comparable to findings from other population studies using DSM III derived diagnoses, but lower than studies using the PSE. The prevalence rates for most disorders tended to be lowest in the elderly, but this was not as marked as the drop in lifetime prevalence. Men had higher prevalence for substance use disorders than women, but women had higher rates for affective disorders and anxiety/somatoform disorders. Prevalences for all disorders were either similar or lower in those who were married or living as though married, than in those who were not cohabiting. One-year symptom-free rates were highest for those with substance use disorders and lowest for those with anxiety/somatoform disorders - largely due to the persistence of phobias.

Adolescent↗
PubMed1988

Age of onset of psychiatric disorders.

Age of onset of psychiatric disorders was determined from a random sample of 3,258 household residents who were administered the DIS by trained lay interviewers. Onset was determined by the subject's recall of the age of the first symptom in those who met lifetime criteria for a diagnosis (DSM III without exclusions). The peak age of risk for most disorders was from the teens to 30 years, however a number of schizophrenics showed first symptoms before age 10. Few cases of any disorder had an onset in old age. The ages of onset are generally lower than those usually given from series of treated or hospitalized cases.

Adolescent↗
PubMed1988

Morbidity risk of psychiatric disorders.

Lifetime morbidity risks and percentiles of the age of onset distribution are given for a series of psychiatric disorders based on data collected as part of a community survey in Edmonton, Canada. The Diagnostic Interview Schedule (DIS) was used to gather information from 3,258 community residents between January 1983 and May 1986. Using a recently developed method of estimating morbidity risks from survey data, the lifetime morbidity risks for depression (male 16.4%, female 22.3%), schizophrenia (male 1.2%, female, 1.0%), and other disorders were calculated. These results are consistent with previously published reports.

Adolescent↗
PubMed1988

Prevalence of psychiatric disorders in the elderly in Edmonton.

Prevalence rates (six month and lifetime) for a random sample (N = 358) of the elderly living at home, are compared to the rates for a sample (N = 3,258) of the whole adult population of Edmonton and found to be generally lower in the elderly, except for cognitive impairment. These household resident results are similar to those reported from the United States using similar methods. A sample (N = 199) of the elderly living in institutions was found to have a very high overall prevalence of illness, mostly consisting of cognitive impairment (69%). It is estimated that over half of all cases of cognitive impairment live in institutions. This has considerable implications for the programs in institutions for the elderly, and also the need for institutions in the future, unless alternate means of care can be developed.

Aged↗
PubMed1988

Suicide attempts and psychiatric disorders in Edmonton.

The relationship between lifetime histories of attempting suicide, psychiatric disorders and other social problems was assessed by examining data from a random sample of 3,258 household residents of Edmonton who were administered the Diagnostic Interview Schedule (DIS) and the Goldberg General Health Questionnaire (GHQ) by trained lay interviewers. While the overall lifetime rate for suicide attempt was 3.6%, of particular interest was the finding that a lifetime history of a psychiatric disorder was 2.6 times more frequent in those who had made a suicide attempt than in those who had not. Alcoholism, major depressive episode and antisocial personality disorder carried the highest lifetime prevalence rates for male attempters, whereas major depressive episode, alcoholism and phobic disorder were the most common disorders in female attempters. Having thoughts and feelings about wanting to die and committing suicide were strongly associated with having made a suicide attempt in both males and females. GHQ results indicated that in comparison to nonattempters those who attempted suicide were most likely to have high current symptom levels.

Adolescent↗
PubMed1988

Psychiatric disorders and unemployment in Edmonton.

Significant relationships were found between unemployment in the last five years and a lifetime history of psychiatric disorder. These results are based on interviews of 3,258 randomly selected non-institutionalized adult residents of Edmonton, conducted by trained lay interviewers using the Diagnostic Interview Schedule (DIS) and the Goldberg General Health Questionnaire (GHQ, 30-item). Having a lifetime history of a psychiatric disorder increased the odds of being unemployed 2.8 times. Disorders carrying the highest risk for unemployment were anorexia, antisocial personality disorder, schizophrenia, and substance use disorders. GHQ results indicated that those experiencing periods of unemployment are also likely to have higher current symptom and stress levels than those who are employed.

Adolescent↗
PubMed1987

Schizophrenia: lifetime co-morbidity in a community sample.

Twenty persons with schizophrenia were identified in a community sample of 2144 adult household residents interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The hierarchy-free lifetime prevalence for a variety of psychiatric disorders is compared in those with and without schizophrenia. Those with schizophrenia were found to have increased chances of having other disorders, all except one having had at least one other disorder. Major depressive episodes, obsessive compulsive disorder, phobia, alcohol abuse/dependence and drug abuse/dependence, each occurred in over half of the schizophrenics, and panic disorder, antisocial personality, and mania were each found in one sixth to one quarter of the schizophrenics. Although current diagnostic systems generally lack an empirical basis for hierarchies, the practical significance of co-morbidity must be determined from outcome studies, familial morbid risk data and possible differential effects of treatments.

Adult↗
PubMed1986

Recurrent and nonrecurrent depression. A family study.

The morbidity risks for unipolar depression were determined from all 763 first-degree relatives of 75 probands with unipolar depression who had been followed up for 12 to 18 years after their first lifetime admission. Significant independent differences were found according to the proband's age at onset and whether the proband had had a single episode or recurrent depression. The lowest morbidity risk in the relatives (3.4%) was associated with single-episode depression with late age at onset in the probands and the highest risk (17.4%) with early age at onset and recurrent depression, other results being intermediate. These findings offer a subclassification of unipolar depression based on age at onset and on whether the illness is single episode or recurrent, and they may explain some of the variability in morbidity risk found in well-conducted studies where these factors were not considered.

Adult↗
PubMed1986

Family violence and psychiatric disorder.

The relationship between family violence and psychiatric disorders was examined using standardized diagnostic interviews of 1200 randomly selected residents of a large Canadian city. The results showed that higher than expected proportions of those exhibiting violent behavior had a psychiatric diagnosis and the rate of violent behaviors in those with diagnoses (54.4%) significantly (p less than .0001) exceeds the rate in the remainder of the sample (15.5%). Particularly high rates of violence are found in those where alcoholism is combined with antisocial personality disorder and/or recurrent depression (80-93%). Also at high risk for violence are those who have made suicide attempts (over 50%) and those who have been arrested for non-traffic offences (two-thirds). These data suggest that psychiatric disorders have a strong relationship to violent behavior, and are not in agreement with the predominantly sociological explanations of family violence.

Adolescent↗
PubMed1984

Boom town mental health.

Population surveys were conducted, examining nonpsychotic psychiatric symptoms, life events, and problems in community living in Primrose, a community experiencing rapid growth in anticipation of the construction of a heavy oil extraction plant, and in Wolf Creek, a stable rural town. Psychiatric symptom levels were lower in the boom town than in Wolf Creek, but the Primrose symptom levels were comparable to those in Saskatchewan. More life events were experienced by Primrose residents who, despite lower symptom levels, had seen their physician more often for minor illnesses. The complaints about living in the town of Primrose matched those of boom town residents from elsewhere. There was no evidence to support the popular view that living in a boom town creates more nonpsychotic psychiatric symptomatology. The higher proportion of the boom town population using physician services for minor illnesses, the higher level of life events reported, and the high frequency of reported problems for families living in the boom town support suggestions that stress is associated with these conditions.

Adolescent↗