scholarly journals Patients’ Self-Reported Disability Weights of Top-Ranking Diseases in Thailand: Do They Differ by Socio-Demographic and Illness Characteristics?

Author(s):  
Jiraluck Nontarak ◽  
Sawitri Assanangkornchai ◽  
Sarah Callinan

Little is known about the impact of methodological decisions on estimating disability weights among patients with mental and physical disorders, and the effects of socio-demographic status on the estimation of these weights. A cross-sectional study was conducted in three hospitals in southern Thailand to describe the disability weights based on different valuation methods. Altogether, 150 patients with major depressive disorder, 150 with alcohol use disorder, and 150 with osteoarthritis with varying levels of severity were recruited. Using a face-to-face interview, all patients completed a visual analogue scale (VAS) and were randomly assigned to complete either the European Quality of Life-5 Dimensions (EQ-5D) or Time-trade-off (TTO) instrument to estimate their current utility score, which was consequently transformed to a disability weight. Significant differences were found between disability weights derived from the three instruments for the same disease, with the VAS providing the highest and EQ-5D the lowest weights. Patients with major depressive disorder had the highest disability weight while those with osteoarthritis had lowest by most methods. Patients’ socio-demographics do not affect how they perceive their disability or health condition. Our findings highlight the importance of carefully selecting methods of valuing disability weights, which can rely on disease specific conditions.

2020 ◽  
Vol 8 (1) ◽  
pp. e001430
Author(s):  
Carola Deischinger ◽  
Elma Dervic ◽  
Michael Leutner ◽  
Lana Kosi-Trebotic ◽  
Peter Klimek ◽  
...  

IntroductionBoth diabetes mellitus and being female significantly increase the risk of being diagnosed with major depressive disorder (MDD). The diagnosis of MDD, combined with diabetes mellitus, can be detrimental in terms of mortality and morbidity. We aimed at investigating the impact of diabetes mellitus on the gender gap in MDD over the course of a human lifetime.Research design and methodsIn a cross-sectional study over the course of 17 years, medical claims data of the general Austrian population (n=8 996 916) between 1997 and 2014 was analyzed. Of these, 123 232 patients with diabetes mellitus were extracted and compared with non-diabetic controls.ResultsIn a cohort of 123 232 patients with diabetes mellitus and 1 933 218 controls (52% females, 48% males), women with diabetes had 2.55 times increased ORs to be diagnosed with MDD compared with women without diabetes (95% CI 2.48 to 2.62, p<0.001) between the age of 30 and 69 years. The effect of diabetes mellitus on the prevalence of MDD was significantly smaller in men (OR=1.85, 95% CI 1.80 to 1.91, p<0.001). Between 0 and 30 years and after age 70 years, the gender gap of MDD was not different between patients with and without diabetes mellitus. The peak of the gender gap in MDD in patients with diabetes mellitus was around the age of 40–49 years. A sensitivity analysis identified overweight, obesity and alcohol dependence as the most potent influencing factors of the widening of the gender gap among patients with diabetes mellitus.ConclusionsDiabetes mellitus is a stronger risk factor for MDD in women than in men, with the greatest width of the gender gap between 40 and 49 years. High-risk patients for MDD, such as overweight female patients with diabetes, should be more carefully assessed and monitored.


2021 ◽  
Vol 30 ◽  
Author(s):  
Annelieke M. Roest ◽  
Ymkje Anna de Vries ◽  
Ali Al-Hamzawi ◽  
Jordi Alonso ◽  
Olatunde O. Ayinde ◽  
...  

Abstract Aims Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes. Methods Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning. Results Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4–1.6) and suicidality (OR = 1.5–2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD. Conclusions These results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.


Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 347-356 ◽  
Author(s):  
Claudia Pisanu ◽  
Emma Lundin ◽  
Martin Preisig ◽  
Mehdi Gholam-Rezaee ◽  
Enrique Castelao ◽  
...  

Objective Migraine and major depressive disorder show a high rate of comorbidity, but little is known about the associations between the subtypes of major depressive disorder and migraine. In this cross-sectional study we aimed at investigating a) the lifetime associations between the atypical, melancholic, combined and unspecified subtype of major depressive disorder and migraine with and without aura and b) the associations between major depressive disorder and its subtypes and the severity of migraine. Methods A total of 446 subjects with migraine (migraine without aura: n = 294; migraine with aura: n = 152) and 2511 controls from the population-based CoLaus/PsyCoLaus study, Switzerland, were included. Associations between major depressive disorder subtypes and migraine characteristics were tested using binary logistic or linear regression. Results Melancholic, combined and unspecified major depressive disorder were associated with increased frequency of migraine with aura, whereas only melancholic major depressive disorder was associated with increased frequency of migraine without aura. Lifetime and unspecified major depressive disorder were associated with severe migraine intensity among subjects with migraine with aura but not migraine without aura, while combined major depressive disorder was associated with higher migraine frequency independently from migraine subtype. Conclusion This study suggests that melancholic but not atypical major depressive disorder is associated with migraine and migraine subtypes. Future studies exploring pathophysiological mechanisms shared between melancholic depression and migraine are warranted.


2017 ◽  
Vol 52 ◽  
pp. 258-264 ◽  
Author(s):  
Janette Z. Canales ◽  
Juliana T. Fiquer ◽  
Rodolfo N. Campos ◽  
Márcio Gerhardt Soeiro-de-Souza ◽  
Ricardo Alberto Moreno

2020 ◽  
pp. 1-9
Author(s):  
Susanne Meinert ◽  
Elisabeth J. Leehr ◽  
Dominik Grotegerd ◽  
Jonathan Repple ◽  
Katharina Förster ◽  
...  

Abstract Background Eighty percent of all patients suffering from major depressive disorder (MDD) relapse at least once in their lifetime. Thus, understanding the neurobiological underpinnings of the course of MDD is of utmost importance. A detrimental course of illness in MDD was most consistently associated with superior longitudinal fasciculus (SLF) fiber integrity. As similar associations were, however, found between SLF fiber integrity and acute symptomatology, this study attempts to disentangle associations attributed to current depression from long-term course of illness. Methods A total of 531 patients suffering from acute (N = 250) or remitted (N = 281) MDD from the FOR2107-cohort were analyzed in this cross-sectional study using tract-based spatial statistics for diffusion tensor imaging. First, the effects of disease state (acute v. remitted), current symptom severity (BDI-score) and course of illness (number of hospitalizations) on fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity were analyzed separately. Second, disease state and BDI-scores were analyzed in conjunction with the number of hospitalizations to disentangle their effects. Results Disease state (pFWE < 0.042) and number of hospitalizations (pFWE< 0.032) were associated with decreased FA and increased MD and RD in the bilateral SLF. A trend was found for the BDI-score (pFWE > 0.067). When analyzed simultaneously only the effect of course of illness remained significant (pFWE < 0.040) mapping to the right SLF. Conclusions Decreased FA and increased MD and RD values in the SLF are associated with more hospitalizations when controlling for current psychopathology. SLF fiber integrity could reflect cumulative illness burden at a neurobiological level and should be targeted in future longitudinal analyses.


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