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Articles
by
O Gureje |
Total Records (
5 ) for
O Gureje |
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Y Huang
,
R Kotov
,
G de Girolamo
,
A Preti
,
M Angermeyer
,
C Benjet
,
K Demyttenaere
,
R de Graaf
,
O Gureje
,
A. N Karam
,
S Lee
,
J. P Lepine
,
H Matschinger
,
J Posada Villa
,
S Suliman
,
G Vilagut
and
R. C. Kessler
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Background
Little is known about the cross-national population prevalence or
correlates of personality disorders.
Aims
To estimate prevalence and correlates of DSM–IV personality disorder
clusters in the World Health Organization World Mental Health (WMH)
Surveys.
Method
International Personality Disorder Examination (IPDE) screening questions
in 13 countries (n = 21 162) were calibrated to masked IPDE clinical
diagnoses. Prevalence and correlates were estimated using multiple
imputation.
Results
Prevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and
3.6% (s.e. = 0.3), 1.5% (s.e. = 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B
and C respectively. Personality disorders are significantly elevated among
males, the previously married (Cluster C), unemployed (Cluster C), the young
(Clusters A and B) and the poorly educated. Personality disorders are highly
comorbid with Axis I disorders. Impairments associated with personality
disorders are only partially explained by comorbidity.
Conclusions
Personality disorders are relatively common disorders that often co-occur
with Axis I disorders and are associated with significant role impairments
beyond those due to comorbidity. |
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P Sharan
,
C Gallo
,
O Gureje
,
E Lamberte
,
J. J Mari
,
G Mazzotti
,
V Patel
,
L Swartz
,
S Olifson
,
I Levav
,
A de Francisco
,
S Saxena
and
the World Health Organization Global Forum for Health Research Mental Health Research Mapping Pro
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Background
Studies suggest a paucity of and lack of prioritisation in mental health
research from low- and middle-income (LAMI) countries.
Aims
To investigate research priorities in mental health among researchers and
other stakeholders in LAMI countries.
Method
We used a two-stage design that included identification, through literature
searches and snowball technique, of researchers and stakeholders in 114
countries of Africa, Asia, Latin America and the Caribbean; and a mail survey
on priorities in research.
Results
The study identified broad agreement between researchers and stakeholders
and across regions regarding research priorities. Epidemiology (burden and
risk factors), health systems and social science ranked highest for type of
research. Depression/anxiety, substance use disorders and psychoses; and
children and adolescents, women, and people exposed to violence/trauma were
prioritised among the disorders and population groups respectively. Important
criteria for prioritising research were burden of disease, social justice, and
availability of funds. Stakeholder groups differed in the importance they gave
to the personal interest of researchers as a criterion for prioritising
research. Researchers’ and stakeholders’ priorities were
consistent with burden of disease estimates, however suicide was
underprioritised compared with its burden. Researchers’ and
stakeholders’ priorities were also largely congruent with the
researchers’ projects.
Conclusions
The results of this first ever conducted survey of researchers and
stakeholders regarding research priorities in mental health suggest that it
should be possible to develop consensus at regional and international levels
regarding the research agenda that is necessary to support health system
objectives in LAMI countries. |
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R Bruffaerts
,
K Demyttenaere
,
G Borges
,
J. M Haro
,
W. T Chiu
,
I Hwang
,
E. G Karam
,
R. C Kessler
,
N Sampson
,
J Alonso
,
L. H Andrade
,
M Angermeyer
,
C Benjet
,
E Bromet
,
G de Girolamo
,
R de Graaf
,
S Florescu
,
O Gureje
,
I Horiguchi
,
C Hu
,
V Kovess
,
D Levinson
,
J Posada Villa
,
R Sagar
,
K Scott
,
A Tsang
,
S. M Vassilev
,
D. R Williams
and
M. K. Nock
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Background
Suicide is a leading cause of death worldwide, but the precise effect of
childhood adversities as risk factors for the onset and persistence of
suicidal behaviour (suicide ideation, plans and attempts) are not well
understood.
Aims
To examine the associations between childhood adversities as risk factors
for the onset and persistence of suicidal behaviour across 21 countries
worldwide.
Method
Respondents from nationally representative samples (n = 55 299)
were interviewed regarding childhood adversities that occurred before the age
of 18 years and lifetime suicidal behaviour.
Results
Childhood adversities were associated with an increased risk of suicide
attempt and ideation in both bivariate and multivariate models (odds ratio
range 1.2–5.7). The risk increased with the number of adversities
experienced, but at a decreasing rate. Sexual and physical abuse were
consistently the strongest risk factors for both the onset and persistence of
suicidal behaviour, especially during adolescence. Associations remained
similar after additional adjustment for respondents’ lifetime mental
disorder status.
Conclusions
Childhood adversities (especially intrusive or aggressive adversities) are
powerful predictors of the onset and persistence of suicidal behaviours. |
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D Levinson
,
M. D Lakoma
,
M Petukhova
,
M Schoenbaum
,
A. M Zaslavsky
,
M Angermeyer
,
G Borges
,
R Bruffaerts
,
G de Girolamo
,
R de Graaf
,
O Gureje
,
J. M Haro
,
C Hu
,
A. N Karam
,
N Kawakami
,
S Lee
,
J. P Lepine
,
M. O Browne
,
M Okoliyski
,
J Posada Villa
,
R Sagar
,
M. C Viana
,
D. R Williams
and
R. C. Kessler
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Background
Burden-of-illness data, which are often used in setting healthcare
policy-spending priorities, are unavailable for mental disorders in most
countries.
Aims
To examine one central aspect of illness burden, the association of serious
mental illness with earnings, in the World Health Organization (WHO) World
Mental Health (WMH) Surveys.
Method
The WMH Surveys were carried out in 10 high-income and 9 low- and
middle-income countries. The associations of personal earnings with serious
mental illness were estimated.
Results
Respondents with serious mental illness earned on average a third less than
median earnings, with no significant between-country differences
(2(9) = 5.5–8.1, P = 0.52–0.79). These
losses are equivalent to 0.3–0.8% of total national earnings. Reduced
earnings among those with earnings and the increased probability of not
earning are both important components of these associations.
Conclusions
These results add to a growing body of evidence that mental disorders have
high societal costs. Decisions about healthcare resource allocation should
take these costs into consideration. |
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R. C Kessler
,
K. A McLaughlin
,
J. G Green
,
M. J Gruber
,
N. A Sampson
,
A. M Zaslavsky
,
S Aguilar Gaxiola
,
A. O Alhamzawi
,
J Alonso
,
M Angermeyer
,
C Benjet
,
E Bromet
,
S Chatterji
,
G de Girolamo
,
K Demyttenaere
,
J Fayyad
,
S Florescu
,
G Gal
,
O Gureje
,
J. M Haro
,
C. y Hu
,
E. G Karam
,
N Kawakami
,
S Lee
,
J. P Lepine
,
J Ormel
,
J Posada Villa
,
R Sagar
,
A Tsang
,
T. B Ustun
,
S Vassilev
,
M. C Viana
and
D. R. Williams
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Background
Although significant associations of childhood adversities with adult
mental disorders are widely documented, most studies focus on single childhood
adversities predicting single disorders.
Aims
To examine joint associations of 12 childhood adversities with first onset
of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21
countries.
Method
Nationally or regionally representative surveys of 51 945 adults assessed
childhood adversities and lifetime DSM–IV disorders with the WHO
Composite International Diagnostic Interview (CIDI).
Results
Childhood adversities were highly prevalent and interrelated. Childhood
adversities associated with maladaptive family functioning (e.g. parental
mental illness, child abuse, neglect) were the strongest predictors of
disorders. Co-occurring childhood adversities associated with maladaptive
family functioning had significant subadditive predictive associations and
little specificity across disorders. Childhood adversities account for 29.8%
of all disorders across countries.
Conclusions
Childhood adversities have strong associations with all classes of
disorders at all life-course stages in all groups of WMH countries. Long-term
associations imply the existence of as-yet undetermined mediators. |
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