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At least 19 recordsLinked to original sources
PubMed1993

Use of services by persons with mental and addictive disorders. Findings from the National Institute of Mental Health Epidemiologic Catchment Area Program.

The use of ambulatory and inpatient mental health and addiction services in the United States was estimated by means of data from the National Institute of Mental Health Epidemiologic Catchment Area Program standardized to the 1980 US census for adults 18 years of age and older. In a 1-year period, 22.8 million people used ambulatory services for mental or addictive disorder treatment; 54% of them had a current Diagnostic Interview Schedule/DSM-III mental disorder and another 37.4% had a history of psychiatric disorder or significant psychiatric symptoms. A total of 325.9 million ambulatory visits were made, and the average number of visits per treated person per year was 14.3. There were 1.4 million persons admitted to at least one inpatient mental health or addiction setting during a 1-year period; 80% of them had a current DIS/DSM-III disorder, and the remainder had a history of psychiatric disorder or significant psychiatric symptoms. Results were determined for specific mental and substance use diagnoses and service settings. Among treated persons with any mental or addictive disorder, the majority of visits were to mental and addictive disorders specialty settings (40.5% of total visits) and to support networks composed of friends, relatives, and self-help groups (37.0% of total visits). Although a large number of persons with mental and substance use disorders were seen in the general medical sector for mental health or addiction problems, they were seen less frequently and therefore made fewer visits to this sector (10.9% of total visits).

Ambulatory Care↗
PubMed1998

Lithium in the over-65s: who is taking it and who is monitoring it? A survey of older adults on lithium in the Cambridge Mental Health Services catchment area.

OBJECTIVES: To determine the prevalence of lithium therapy in the over-65s in the Cambridge Mental Health Services catchment area, to obtain a profile of this group and to find out how well and by whom lithium treatment is being monitored. METHODS: A census was carried out of patients over the age of 65 in the Cambridge Mental Health Services catchment area who were on lithium therapy on 1 February 1995. The records of these patients were examined retrospectively for demographic details, details of lithium therapy, information about lithium monitoring and risk factors associated with lithium treatment. RESULTS: One hundred and forty-eight patients were identified representing a point prevalence of 0.27%. GPs carried out lithium monitoring for the majority of this group and 47% had not been seen by a psychiatrist in the 12 months leading up to the census date. Thirty-two per cent of the group were on thyroxine treatment or had raised TSH levels. CONCLUSIONS: The prevalence of lithium therapy in this study was greater than the prevalences reported in studies of patients of all ages. Standards of monitoring varied widely and were not always better where psychiatrists monitored the treatment, although psychiatrists were more likely than GPs to monitor renal function. There was a high rate of thyroid dysfunction in the study group.

Aged↗
PubMedDate not supplied

[Alcohol dependence syndrome (ADS) among rural population of the health center catchment area in Berzniki].

The Polish version of Michigan Alcoholism Screening Test (MAST), the Alcohol Dependence Inventory, and clinical evaluation were made in the group of 61 male patients aged 18-65 years randomly selected from the population of County Health Center catchment area in Berzniki, province of Suwałki. The study showed a high prevalence of alcohol dependence syndrome in the group studied.

Adolescent↗
PubMed1991

Affective symptoms associated with the onset of major depression in the community: findings from the US National Institute of Mental Health Epidemiologic Catchment Area Program.

This study examined the strength of relationships between forms of depressive symptoms over a one-year period and the onset of major depression. The data analyzed were collected in 4 sites of the US National Institute of Mental Health Epidemiologic Catchment Area Program (NIMH-ECA, 1981-1985). The Diagnostic Interview Schedule's specifications of DSM-III criteria for major depression were employed. Overall, the results indicated a strong positive association between an onset episode and the following depressive symptoms over 1 year: diminished sexual drive, feelings of worthlessness or excessive guilt and trouble concentrating or thinking. Sleep disturbance among women and fatigue among males were also significantly associated with experiencing an onset of major depression. The implications of the findings for secondary prevention efforts are explored.

Adolescent↗
PubMed1993

Prevention of cardiovascular disease within the primary health care system--feasibility of a prevention programme within the Sollentuna primary health care catchment area.

OBJECTIVE: To integrate prevention of cardiovascular disease within the primary health care. DESIGN: A prevention programme which combines population and individual high-risk strategy. SETTING: The Primary Health Care in Sollentuna, Stockholm, Sweden. MAIN OUTCOME MEASURE: Characteristics of, and risk factor prevalence among, persons registered in the prevention programme. RESULTS: During the first year more than 2000 persons, representing every tenth visitor and 6% of the population aged 15-60 years, were registered in the prevention programme. 90% were < or = 60 years and 62% were women. A large proportion (70%) had risk factors that required advice, treatment, and follow up. 24% of the men and 27% of the women were smokers, 68% and 62% respectively, had serum cholesterol > or = 5.2 mmol/l, and 33% and 22% had a diastolic blood pressure > or = 90 mmHg. CONCLUSION: The present study implies that it is possible to integrate a large scale prevention programme in the existing primary health care organization. The prevalence of risk factors in those who enter the prevention programme is high, which places great demands for treatment and follow up.

Adolescent↗
PubMed1991

[Differences in health care provision between 11 ENT partnership practices in 2 health insurance catchment areas].

Medical insurance organizations possess a large amount of production data from individual health care providers and from institutions. These data give insight into the type and amount of health care delivered. The number of admissions, patient days, inpatient and outpatient procedures and three specific procedures, per 100 referred patients and per 1000 insured persons, from 1986 were compared for 11 partnerships of ENT specialists located in the regions of two medical insurance organizations. The raw data were corrected for percentage of persons aged 65 years and older, the percentage of women, the referral practice of the general practitioners in the treated patient population and the number of specialists in each partnership. The differences between the partnerships with the largest and those with the smallest number of items of service amount to a factor 2.9 (admissions per 1000 insured persons) to 6.7 (septum corrections per 1000 insured persons). After introduction of the independent variables, substantial differences still exist, the lowest factor being 1.8 (hearing improvement operations per 1000 insured persons) and the highest 5.6 (outpatient procedures per 1000 insured persons). There is hardly any difference between the groups regarding a procedure with a supposedly clear indication and two procedures with a less defined indication. Further study of the causes of these differences on the individual patient level is necessary.

Catchment Area, Health↗
PubMed1979

Phasing down state hospitals: integrated versus nonintegrated services.

Two mental health catchment areas in Massachusetts that were in the process of phasing down state hospitals and building up community care provided an opportunity for studying the effectiveness of an integrated service delivery model and a nonintegrated model. The area that integrated state hospital and community services was more successful in the phase-down. It had a lower admission rate, the patients who were readmitted did not stay as long, and patients discharged spent more time in the community. Specific adminstrative and clinical structures that facilitated the patients' progress included investing community-based, administrative authority in one person; having a centralized intake and referral system; and using case managers to follow the clients through the service delivery system.

Catchment Area, Health↗
PubMed1984

Assessing rural community resources for health care: the use of health services catchment area economic marketing studies.

A relatively simple method for estimating the ability of rural communities to support health provider personnel services, the utilization of this tool is described and illustrated. Special aspects of the approach include: (1) its application on a systematic basis to an entire state, utilizing identified economic marketing areas and local determination of data; (2) the use of the finished product, or study, as a focus for community discussion and decision making; (3) its use as a recruitment device for physicians as well as communities; and (4) its use for long term state health and educational planning. Within this broad approach, the specific figures and conclusions are less important than the interpretation, application and use of the method.

Catchment Area, Health↗
PubMedDate not supplied

Expanding tuberculosis case detection by screening household contacts.

OBJECTIVES: Tuberculosis (TB) case detection remains low in many countries, compromising the efficacy of TB control efforts. Current global TB control policy emphasizes case finding through sputum smear microscopy for patients who self-report to primary health centers. Our objective was to assess the feasibility and yield of a simple active case finding strategy in a high incidence population in northern Lima, Peru. METHODS: We implemented this pilot strategy in one health center's catchment area. Health workers visited household contacts of new TB case subjects to identify symptomatic individuals and collect sputum for screening. Neighboring households were screened in the same manner. Secondary analyses measured risk of TB by (1) sputum smear status of the index case subject, (2) compliance with testing, and (3) risk factors for disease detected through active contact tracing in contrast to self-report. RESULTS: The TB prevalence detected through combined active and passive case finding among 1,094 household contacts was 0.91% (914 per 100,000), much higher than with passive case finding alone (0.18%; 183 per 100,000; p=0.02). Among 2,258 neighbors, the combined strategy detected a TB prevalence of 0.22% (221 per 100,000) in contrast to 0.08% (80 per 100,000) detected through passive case finding alone (p=0.25). Risk factors for being diagnosed through active case finding in contrast with self-report included age >55 years (odds ratio [OR]=5.5; 95% confidence interval [CI] 1.2, 22.8) and female gender (OR=3.9; 95% CI 0.99, 22.3). CONCLUSIONS: Risk of active TB among symptomatic household contacts of active case subjects in this community is very high. Results suggest that contact tracing in such settings may be a powerful means of improving case detection rates for active TB disease.

Adolescent↗
PubMed1984

Utilization of health and mental health services. Three Epidemiologic Catchment Area sites.

Utilization of health and mental health services by non-institutionalized persons aged 18 years and older is examined based on interviews with probability samples of 3,000 to 3,500 persons in each of three sites of the National Institute of Mental Health Epidemiologic Catchment Area (ECA) program: New Haven, Conn, Baltimore, and St Louis. In all three ECAs, 6% to 7% of the adults made a visit during the prior six months for mental health reasons; proportions were considerably higher among persons with recent DSM-III disorders covered by the Diagnostic Interview Schedule (DIS) or severe cognitive impairment. Between 24% and 38% of all ambulatory visits by persons with DIS disorders were to mental health specialists. In seeking mental health services, men were more likely to turn to the specialty sector than to the generalist; women used both sectors about equally. The aged infrequently received care from mental health specialists. Visits for mental health reasons varied considerably depending on specific types of DIS disorder.

Adolescent↗
PubMed1978

A social systems model of nursing home use.

Causal modeling (path analysis) was applied to data from the 39 mental health catchment areas of Massachusetts to analyze the effects of sociocultural and health-resource variables on long-term-care utilization. The variables chosen explained 53 percent of the variance of long-term-care use by persons 60 and older: 41 percent was explained by the sociocultural variables and 12 percent by the health-resource variables. With data adjusted for age, the major determinant of long-term-care use was ethnicity: less long-term care was used in areas with more persons who were foreign-born or had a foreign-born parent. The effects of other health resources (supply of primary care physicians and use of mental and general (short-term) hospitals) were small and negative.

Aged↗
PubMed1987

The prevalence of adult sexual assault. The Los Angeles Epidemiologic Catchment Area Project.

Data were collected as a supplement to the Los Angeles Epidemiologic Catchment Area project, one of five field sites of a National Institute of Mental Health-initiated program. The authors used a two-stage probability sampling technique to interview 3,132 Los Angeles residents of two mental health catchment areas during the period January 1983-August 1984. Hispanics and non-Hispanic whites were about equally represented in the sample, as were males and females. Respondents were asked, "In your lifetime has anyone ever tried to pressure or force you to have sexual contact? By sexual contact I mean their touching your sexual parts, your touching their sexual parts, or sexual intercourse?" Persons who reported an assault were asked additional questions, including information about the most recent assault. Lifetime prevalence of sexual assault during adulthood (at or after age 16 years) was estimated at 10.5% for the entire sample. Women, non-Hispanic whites, and young people (less than age 40 years) reported higher rates of sexual assault than men, Hispanics, and older people. Highest rates were reported by young non-Hispanic white women with some college education (26.3%). In the most recent sexual assault, three-fourths of respondents knew their assailant, over half experienced harm or the threat of harm, and half experienced sexual contact including but not limited to intercourse.

Adolescent↗