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Articles by R de Graaf
Total Records ( 4 ) for R de Graaf
  P Cuijpers , F Smit , B. W. J. H Penninx , R de Graaf , M ten Have and A. T. F. Beekman
 

Context  The importance of neuroticism for mental health care use and public health is well established. However, most research has focused on the association between neuroticism and a single specific disorder or health outcome, and the overall effect of neuroticism on use of somatic and mental health care and on society is not clear.

Objective  To examine the economic costs of neuroticism to get an impression of the overall effect of neuroticism on mental health care and on society in general.

Design  Cross-sectional population-based study.

Setting  General population.

Participants  A large representative sample (N = 5504) of the Dutch general population.

Main Outcome Measures  The costs (health service uptake in primary and secondary mental health care, out-of-pocket costs, and production losses) associated with neuroticism.

Results  The total per capita excess costs were $12 362 per year for the reference year 2007 in the 5% highest scorers of neuroticism, $8243 in the 10% highest scorers, and $5572 in the 25% highest scorers. The per capita excess costs of neuroticism are considerably higher than those of mental disorders. The total excess costs of neuroticism per 1 million inhabitants resulting from the 25% highest scorers ($1.393 billion) were approximately 2.5 times as high as the excess costs of common mental disorders ($585 million).

Conclusions  The economic costs of neuroticism are enormous and exceed those of common mental disorders. We should start thinking about interventions that focus not on each of the specific negative outcomes of neuroticism but rather on the starting point itself.

  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
 

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.

  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
 

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.

  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
 

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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