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Rachel Jenkins

Publications and source records attributed to Rachel Jenkins.

At least 37 records · Page 2Linked to original sources
PubMed2004

Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review.

OBJECTIVES: To assess the available evidence on the prevalence, aetiology, treatment, and prevention of anxiety and depressive disorders in Pakistan. DESIGN: Systematic review of published literature. STUDIES REVIEWED: 20 studies, of which 17 gave prevalence estimates and 11 discussed risk factors. MAIN OUTCOME MEASURES: Prevalence of anxiety and depressive disorders, risk factors, effects of treatment. RESULTS: Factors positively associated with anxiety and depressive disorders were female sex, middle age, low level of education, financial difficulty, being a housewife, and relationship problems. Arguments with husbands and relational problems with in-laws were positively associated in 3/11 studies. Those who had close confiding relationships were less likely to have anxiety and depressive disorders. Mean overall prevalence of anxiety and depressive disorders in the community population was 34% (range 29-66% for women and 10-33% for men). There were no rigorously controlled trials of treatments for these disorders. CONCLUSIONS: Available evidence suggests a major social cause for anxiety and depressive disorders in Pakistan. This evidence is limited because of methodological problems, so caution must be exercised in generalising this to the whole of the population of Pakistan.

Anxiety Disorders↗
PubMed2004

Risk factors and the prevalence of neurosis and psychosis in ethnic groups in Great Britain.

BACKGROUND: Our aim was to examine whether variations in the prevalence of neurosis and psychosis between ethnic minorities throughout Great Britain are explained by social disadvantage. METHOD: A total of 10,108 adult householders throughout Great Britain were assessed in a two-stage survey with the Revised Clinical Interview Schedule (CIS-R) and Psychosis Screening Questionnaire (PSQ). Respondents with a positive PSQ or who received a diagnosis of, or treatment for, psychosis were examined by a psychiatrist using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Data on respondents' preferred ethnic group were collapsed into four groups: Whites, African-Caribbean or Africans, south Asians and other. RESULTS: Ethnic grouping was strongly associated with: unemployment; lone parent status; lower social class; low perceived social support; poverty (indicated by lack of car ownership) and having a primary social support group of less than three close others. All these associations applied to the group Africans and Afro-Caribbeans, but only some applied to the other groups. No ethnic group had significantly increased rates of neurosis. Only the African-Caribbean group were at significantly increased risk of a psychotic disorder (odds ratio 4.55; 95% CI: 1.13, 18.30). After adjustment for risk factors, the odds of psychosis were lower (odds ratio 2.97; 95% CI: 0.66, 13.36). CONCLUSIONS: The excess of psychosis in Africans and Afro-Caribbeans in Great Britain appears to be partly explained by socio-economic disadvantage, but larger studies are needed to confirm this.

Adolescent↗
PubMed2004

Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity.

BACKGROUND: Adverse early circumstances may be more common in people who later develop psychotic disorders. AIMS: To use data from the second British National Survey of Psychiatric Morbidity to examine associations between psychotic disorders and a number of early victimisation experiences. METHOD: Psychiatric disorders were identified through structured assessment of adults resident in private households in Britain (n=8580). Respondents were asked whether they had experienced selected events displayed on cards. RESULTS: Compared with respondents with other psychiatric disorders or with none, the prevalence of every experience bar one was significantly elevated in those with definite or probable psychosis. The largest odds ratio was for sexual abuse. Controlling for depressed mood somewhat reduced the odds ratios for the individual experiences. CONCLUSIONS: In people with psychosis, there is a marked excess of victimising experiences, many of which will have occurred during childhood. This is suggestive of a social contribution to aetiology.

Accidents↗
PubMed2004

Prevalence and correlates of self-reported psychotic symptoms in the British population.

BACKGROUND: The psychosis phenotype is generally thought of as a categorical entity. However, there is increasing evidence that psychosis exists in the population as a continuum of severity rather than an all-or-none phenomenon. AIMS: To investigate the prevalence and correlates of self-reported psychotic symptoms using data from the 2000 British National Survey of Psychiatric Morbidity. METHOD: A total of 8580 respondents aged 16-74 years were interviewed. Questions covered mental health, physical health, substance use, life events and socio-demographic variables. The Psychosis Screening Questionnaire (PSQ) was used to identify psychotic symptoms. RESULTS: Of the respondents, 5.5% endorsed one or more items on the PSQ. Factors independently associated with psychotic symptoms were cannabis dependence, alcohol dependence, victimisation, recent stressful life events, lower intellectual ability and neurotic symptoms. Male gender was associated with paranoid thoughts, whereas female gender predicted hallucinatory experiences. CONCLUSIONS: Self-reported psychotic symptoms are less common in this study than reported elsewhere, because of the measure used. These symptoms have demographic and clinical correlates similar to clinical psychosis.

Adolescent↗
PubMed2004

Trends in service use and treatment for mental disorders in adults throughout Great Britain.

BACKGROUND: Trends in health treatments and outcomes in the general population may be used to monitor achievement of health targets. AIMS: To investigate changes in mental health services and treatment in Britain over a 7-year period. METHOD: National surveys of psychiatric morbidity were completed in 1993 and 2000 in households throughout Great Britain. Standardised interviews were used to establish psychiatric case status and service and treatment utilisation in adults aged 16-64 years. RESULTS: Use of psychotropic medication doubled in those designated as psychiatric cases. In the non-case-status population antidepressant use rose from 0.16% in 1993 (95% CI 0.07-0.25) to 2.02% in 2000 (95% CI 1.69-2.35). However, the overall prevalence of neurotic and psychotic disorder hardly changed from 1993 to 2000. Use of specialised 'talking treatments'did not increase significantly, except in the non-case group. CONCLUSIONS: Treatment with psychotropic medication alone is unlikely to improve the overall mental health of the nation. A policy based almost exclusively on treatment of identified cases should be augmented by preventive approaches.

Adolescent↗
PubMed2003

Social capital.

Explore the source record for details and available documents.

Health Policy↗
PubMed2003

Social inequalities and the common mental disorders: a systematic review of the evidence.

BACKGROUND: Of two large-scale government-commissioned studies of common mental disorders in the UK, one found occupational social class to be the strongest marker of risk while the other showed no clear relationship. This study reviews the published evidence on the links between conventional markers of social position and the common mental disorders in developed countries. METHODS: Inclusion criteria covered general population based studies with broad social class variation; samples of 3,000 or more adults of working age; identification of mental illness by validated instruments; social position identified by explicit standard markers; fieldwork undertaken since 1980; published output on key areas of interest. Incompatible study methods and concepts made statistical pooling of results invalid. RESULTS: Of nine studies, eight provide evidence of an association between one or more markers of less privileged social position and higher prevalence of common mental disorders. For some individual indicators in particular studies, no clear trend was evident, but no study showed a contrary trend for any indicator. The more consistent associations were with unemployment, less education and low income or material standard of living. Occupational social class was the least consistent marker. CONCLUSIONS: Common mental disorders are significantly more frequent in socially disadvantaged populations. More precise indicators of education, employment and material circumstances are better markers of increased rates than occupational social class.

Humans↗
PubMed2003

Social position and the common mental disorders with disability: estimates from the National Psychiatric Survey of Great Britain.

BACKGROUND: Published studies linking the common mental disorders with social disadvantage lack basic comparability. This project aimed to estimate effect sizes and independence of social position markers as risk factors for common mental disorders. Disorders with disability were examined to identify groups with high clinical and policy priority. METHODS: Data from the 1993 household survey of psychiatric morbidity in Great Britain were analysed using logistic regression models, using traditional and more specific markers of social position. RESULTS: Of those with a common mental disorder, 22 % reported difficulty doing at least one activity of daily living, linked to their mental symptoms. In comprehensive statistical analyses, having two or more physical illnesses was associated with an odds ratio of 6.42 (95 % CI 4.34-9.51) for common mental disorder with disability, while odds ratios of 3 or more were present for being economically inactive or having had two or more recent adverse life events. Occupational social class was not an independent marker of raised rates of disorder. Similar patterns of result were present for common mental disorders irrespective of disability, although odds ratios were smaller. CONCLUSIONS: Several specific markers of less privileged status are independently associated with raised rates of common mental disorders, with or without disability. There may be scope to target specific high-risk groups within comprehensive programmes to reduce mental health inequalities.

Activities of Daily Living↗
PubMed2003

Predictors of efficacy in depression prevention programmes. Meta-analysis.

BACKGROUND: Worldwide, 340 million people are affected by depression, with high comorbid, social and economic costs. AIMS: To identify potential predictors of effect in prevention programmes. METHOD: A meta-analysis was made of 69 programmes to reduce depression or depressive symptoms. RESULTS: The weighted mean effect size of 0.22 was effective for different age groups and different levels of risk, and in reducing risk factors and depressive or psychiatric symptoms. Programmes with larger effect sizes were multi-component, included competence techniques, had more than eight sessions, had sessions 60-90 min long, had a high quality of research design and were delivered by a health care provider in targeted programmes. Older people benefited from social support, whereas behavioural methods were detrimental. CONCLUSIONS: An 11% improvement in depressive symptoms can be achieved through prevention programmes. Single trial evaluations should ensure high quality of the research design and detailed reporting of results and potential predictors.

Adolescent↗
PubMed2002

The National Survey of Psychiatric Morbidity among prisoners and the future of prison healthcare.

It has long been known that psychiatric disorders are highly prevalent among prisoners (Coid, 1984; Gunn et al., 1991; Maden et al., 1995; Joukamaa, 1995; Bland et al., 1998; Lamb and Weinberger, 1998). However, the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (Singleton et al., 1998) represents a considerable advance on earlier surveys. By using the same standardized psychiatric assessment procedures, and similar questions on medication, service use and social functioning, its findings can be compared with previous national surveys of adults living in private households (Meltzer et al., 1995), residents in institutions (Meltzer et al., 1996), homeless persons (Gill et al., 1996), and with the forthcoming household survey in England, Wales and Scotland. It should also inform the future organisation of healthcare for prisoners, following recent recommendations from a joint Home Office/Department of Health Working Party that Health Authorities must work with prisons in their catchment areas to carry out joint health needs assessments, agree prison healthcare improvement strategies and jointly plan and commission services (HM Prison Service and NHS Executive 1999). The ultimate test of the survey will be whether it provides a benchmark to evaluate the future effectiveness of the new policy changes.

England↗
PubMed2002

Ethnic differences in prisoners. 1: criminality and psychiatric morbidity.

BACKGROUND: In England and Wales, persons of African-Caribbean origin are more likely to be both imprisoned and admitted to secure hospitals. AIMS: To estimate population-based rates of imprisonment in different ethnic groups, and compare criminal behaviour and psychiatric morbidity. METHOD: We examined Home Office data on all persons in prison, and carried out a two-stage cross-sectional survey of 3142 remanded and sentenced, male and female, prisoners in all penal establishments in England and Wales in 1997. RESULTS: We confirmed high rates of imprisonment for Black people and lower rates for South Asians. Different patterns of offending and lower prevalence of psychiatric morbidity were observed in Black prisoners. CONCLUSIONS: Despite increased risks of imprisonment, African-Caribbeans show less psychiatric morbidity than White prisoners. This contrasts with the excess of African-Caribbeans in secure hospitals, an inconsistency possibly in part due to the effects of ethnic groups on admission procedures.

Adult↗
PubMed2002

Ethnic differences in prisoners. 2: risk factors and psychiatric service use.

BACKGROUND: The high rates of psychiatric morbidity in prisoners vary between ethnic groups. AIMS: To compare early environmental risks, stressful daily living experiences and reported use of psychiatric services in prisoners from different ethnic groups. METHOD: Cross-sectional survey of 3142 prisoners in all penal establishments in England and Wales in 1997. RESULTS: Fewer Black and South Asian male prisoners reported childhood traumas and conduct disorder, and fewer Black prisoners experienced stressful prison experiences, than White prisoners. Fewer Black women had received previous psychiatric treatment, and fewer Black men had their psychiatric problems identified in prison. Black prisoners were less likely to have received psychiatric treatment than Whites. CONCLUSIONS: The lower prevalence of psychiatric morbidity observed in Black prisoners corresponds with reduced exposure to risk factors. Higher rates of imprisonment might be explained by higher rates of conduct disorder, adolescent-onset criminality and disadvantage within the criminal justice system.

Adolescent↗
PubMedDate not supplied

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation.

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network--the International Consortium on Mental Health Policy and Services--are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

Consensus↗
PubMedDate not supplied

The mental health policy template: domains and elements for mental health policy formulation.

Mental disorders are a major and rising cause of disease burden in all countries. Even when resources are available, many countries do not have the policy and planning frameworks in place to identify and deliver effective interventions. The World Health Organization (WHO) and the World Bank have emphasized the need for ready access to the basic tools for mental health policy formulation, implementation and sustained development. The Analytical Studies on Mental Health Policy and Service Project, undertaken in 1999-2001 by the International Consortium for Mental Health Services and funded by the Global Forum for Health Research aims to address this need through the development of a template for mental health policy formulation. A mental health policy template has been developed based on an inventory of the key elements of a successful mental health policy. These elements have been validated against a review of international literature, a study of existing mental health policies and the results of extensive consultations with experts in the six WHO regions of the world. The Mental Health Policy Template has been revised and its applicability will be tested in a number of developing countries during 2001-2002. The Mental Health Policy Template and the work of the Consortium for Mental Health Services will be presented and the future role of the template in mental health policy development and reform in developing countries will be discussed.

Developed Countries↗
PubMedDate not supplied

The appropriateness and use of focus group methodology across international mental health communities.

The ability to interpret collected data across international mental health communities often proves to be difficult. The following paper reports on the use and appropriateness of focus group methodology in helping to clarify issues that could help substantiate data collection and comparison across different cultures and regions. Field tests of the focus group methodology were undertaken in different regions and this paper describes an overview of the final field test in Sofia, Bulgaria. The findings and experiences with utilizing this methodology were incorporated in subsequent data collections.

Attitude to Health↗
PubMedDate not supplied

The mental health country profile: background, design and use of a systematic method of appraisal.

This article describes the construction and use of a systematic structured method of mental health country situation appraisal, in order to help meet the need for conceptual tools to assist planners and policy makers develop and audit policy and implementation strategies. The tool encompasses the key domains of context, needs, resources, provisions and outcomes, and provides a framework for synthesizing key qualitative and quantitative information, flagging up gaps in knowledge, and for reviewing existing policies. It serves as an enabling tool to alert and inform policy makers, professionals and other key stakeholders about important issues which need to be considered in mental health policy development. It provides detailed country specific information in a systematic format, to facilitate global sharing of experiences of mental health reform and strategies between policy makers and other stakeholders. Lastly, it is designed to be a capacity building tool for local stakeholders to enhance situation appraisal, and multisectorial policy development and implementation.

Africa↗