Search

Objective: To examine disability associated with community cases of the more commonly occurring eating disorders and with particular eating disorder behaviours. Method: Self-report questionnaires, which included measures of eating disorder symptoms and impairment in everyday functioning, were completed by 495 female residents of the Australian Capital Territory region aged between 18 and 45 years. A structured interview for the assessment of eating disorders was completed by a subgroup (n=208) of participants. Discriminant function analysis was used to identify cases of eating disorders in the total sample (n=495) based on the characteristics of individuals interviewed. Impairment in functioning, as measured by the Medical Outcomes Study Short Form, was compared among eating disorder cases and non-cases, among subgroups of participants engaging in particular eating disorder behaviours, and among community cases of anxiety and affective disorders identified from the Australian National Survey of Mental Health and Well-Being. Results: Community cases of eating disorders (n=31; 6.3%) were associated with substantial impairment in functioning, comparable with that of community cases of anxiety and affective disorders. Among eating disorder behaviours, the use of extreme weight-control behaviours, in particular self-induced vomiting, was associated with the highest levels of impairment, although the occurrence of regular episodes of overeating was also associated with considerable impairment. Conclusions: The burden on the community of the more commonly occurring eating disorders may be substantial. Improving women's recognition of the adverse effects of eating disordered-behaviour on functioning, as well as their knowledge of effective treatments, will be important in reducing this burden.

Objective: To investigate the association of obesity with anxiety, depression and emotional well-being (positive and negative affect) in three age groups. Methods: A cross-sectional survey was carried out in Canberra and the neighbouring town of Queanbeyan, Australia, with a random sample from the electoral roll of 2,280 persons aged 20-24, 2,334 aged 40-44, and 2,305 aged 60-64. Results: Self-reported height and weight were used to classify participants as underweight (body mass index of less than 18.5), acceptable weight (18.5 to less than 25), overweight (25 to less than 30) or obese (30 and over). Obesity in women was associated with more anxiety and depression symptoms and less positive affect, but there were only weak and inconsistent associations in men. When factors that might mediate any association were controlled (physical ill health, lack of physical activity, poorer social support, less education and financial problems), a different picture emerged, with the underweight women having more depression and negative affect and the obese and overweight women tending to have better mental health than the acceptable weight group. Controlling for physical ill health alone accounted for the association of obesity with anxiety and depression in women. Conclusions: Obesity has an association with anxiety, depression and lower well-being in women, but not in men. The results are consistent with physical ill health playing a mediating role. Implication: Reducing obesity in the population is unlikely to have any direct effect on mental health or emotional well-being.

Research indicates that the Common Cause Factor (CCF) is correlated not only with cognitive function in aging but also with grip strength and visual discrimination. Studies were conducted on subjects between 77.4 and 98.7 years of age, with cross-sectional categories for age, gender and apolipoprotein E.

Introduction Two recent cross-sectional studies have shown that cognitive impairment in old age, as measured by the Mini-Mental State Examination (MMSE) [1], varies across occupational groups. A French study classified [...]

Introduction There is a widespread belief, particularly among elderly people, that activity prevents cognitive decline in old age and protects against the onset of dementia. This view is reflected in [...]

A close relationship may exist between mental illness and physical disability across cultures. Researchers studied 5447 patients aged 15 to 65 in fourteen countries. Disability measures included physical and occupational limitations. Disability levels in all countries were four to five times higher in patients with psychiatric disorders than in psychologically well persons. Common categories, such as neurasthenia, major depression, generalized anxiety, and panic disorder were most strongly linked to disability. Rates of patient-reported disabilities, rates of physician assessments and rates of disability days were consistent across diverse cultures, socioeconomic conditions, and psychiatric care settings., Objective. - To examine the impact of common mental illness on functional disability and the cross-cultural consistency of this relationship while controlling for physical illness. A secondary objective was to determine the level of disability associated with specific psychiatric disorders. Design. - A cross-sectional sample selected by two-stage sampling. Setting. - Primary health care facilities in 14 countries covering most major cultures and languages. Patients. - A total of 25 916 consecutive attenders of these facilities were screened for psychopathology using the General Health Questionnaire (96% response). Screened patients were sampled from the General Health Questionnaire score strata for the second-stage Composite international Diagnostic Interview administered to 5447 patients (62% response). Main Outcome Measures. - Patient-reported physical disability, number of disability days, and interviewer-rated occupational role functioning. Results. - After controlling for physical disease severity, psychopathology was consistently associated with increased disability. Physical disease severity was an independent, although weaker, contributor to disability. A dose-response relationship was found between severity of mental illness and disability. Disability was most prominent among patients with major depression, panic disorder, generalized anxiety, and neurasthenia; disorder-specific differences were modest after controlling for psychiatric comorbidity. Results were consistent across disability measures and across centers. Conclusions. - The consistent relationship of psychopathology and disability indicates the compelling personal and socioeconomic impact of common mental illnesses across cultures. This suggests the importance of impairments of higher-order human capacities (eg, emotion, motivation, and cognition) as determinants of functional disability. (JAMA. 1994;272:1741-1748)

Abstract Background The loss of participants in longitudinal studies due to non-contact, refusal or death can introduce bias into the results of such studies. The study described here examines reasons for refusal over three waves of a survey of persons aged ≥ 70 years. Methods In a longitudinal study involving three waves, participants were compared to those who refused to participate but allowed an informant to be interviewed and to those who refused any participation. Results At Wave 1 both groups of Wave 2 non-participants had reported lower occupational status and fewer years of education, had achieved lower verbal IQ scores and cognitive performance scores and experienced some distress from the interview. Those with an informant interview only were in poorer physical health than those who participated and those who refused. Depression and anxiety symptoms were not associated with non-participation. Multivariate analyses found that verbal IQ and cognitive impairment predicted refusal. Results were very similar for refusers at both Waves 2 and 3. Conclusions Longitudinal studies of the elderly may over estimate cognitive performance because of the greater refusal rate of those with poorer performance. However, there is no evidence of bias with respect to anxiety or depression.