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Articles
by
R Sagar |
Total Records (
4 ) for
R Sagar |
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S Lee
,
A Tsang
,
R. C Kessler
,
R Jin
,
N Sampson
,
L Andrade
,
E. G Karam
,
M. E. M Mora
,
K Merikangas
,
Y Nakane
,
D. G Popovici
,
J Posada Villa
,
R Sagar
,
J. E Wells
,
Z Zarkov
and
M. Petukhova
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Background
The epidemiology of rapid-cycling bipolar disorder in the community is
largely unknown.
Aims
To investigate the epidemiological characteristics of rapid-cycling and
non-rapid-cycling bipolar disorder in a large cross-national community
sample.
Method
The Composite International Diagnostic Interview (CIDI version 3.0) was
used to examine the prevalence, severity, comorbidity, impairment,
suicidality, sociodemographics, childhood adversity and treatment of
rapid-cycling and non-rapid-cycling bipolar disorder in ten countries
(n = 54 257).
Results
The 12-month prevalence of rapid-cycling bipolar disorder was 0.3%. Roughly
a third and two-fifths of participants with lifetime and 12-month bipolar
disorder respectively met criteria for rapid cycling. Compared with the
non-rapid-cycling, rapid-cycling bipolar disorder was associated with younger
age at onset, higher persistence, more severe depressive symptoms, greater
impairment from depressive symptoms, more out-of-role days from
mania/hypomania, more anxiety disorders and an increased likelihood of using
health services. Associations regarding childhood, family and other
sociodemographic correlates were less clear cut.
Conclusions
The community epidemiological profile of rapid-cycling bipolar disorder
confirms most but not all current clinically based knowledge about the
illness. |
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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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