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Open Access 01-12-2013 | Research article

Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece

Authors: Petros Skapinakis, Stefanos Bellos, Sotirios Koupidis, Ilias Grammatikopoulos, Pavlos N Theodorakis, Venetsanos Mavreas

Published in: BMC Psychiatry | Issue 1/2013

Abstract

Background

No study in Greece has assessed so far the full range of common mental disorders using a representative sample of the population from both mainland and insular regions of the country. The aim of the present paper was to present the results of the first such study.

Methods

The study was carried out between 2009–2010 in a nationally representative sample of 4894 individuals living in private households in Greece. Common mental disorders in the past week were assessed with the revised Clinical Interview Schedule (CIS-R). We also assessed alcohol use disorders (using AUDIT), smoking and cannabis use.

Results

14% of the population (Male: 11%, Female: 17%) was found to have clinically significant psychiatric morbidity according to the scores on the CIS-R. The prevalence (past seven days) of specific common mental disorders was as follows: Generalized Anxiety Disorder: 4.10% (95% CI: 3.54, 4.65); Depression: 2.90% (2.43, 3.37); Panic Disorder: 1.88% (1.50, 2.26); Obsessive-Compulsive Disorder: 1.69% (1.33, 2.05); All Phobias: 2.79% (2.33, 3.26); Mixed anxiety-depression: 2.67% (2.22, 3.12). Harmful alcohol use was reported by 12.69% of the population (11.75, 13.62). Regular smoking was reported by 39.60% of the population (38.22, 40.97) while cannabis use (at least once during the past month) by 2.06% (1.66, 2.46). Clinically significant psychiatric morbidity was positively associated with the following variables: female gender, divorced or widowed family status, low educational status and unemployment. Use of all substances was more common in men compared to women. Common mental disorders were often comorbid, undertreated, and associated with a lower quality of life.

Conclusions

The findings of the present study can help in the better planning and development of mental health services in Greece, especially in a time of mental health budget restrictions.

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Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al: Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380: 2163-2196. 10.1016/S0140-6736(12)61729-2.CrossRefPubMed

World Health Organization: The Global Burden of disease: 2004 update. 2008, Geneva: WHO

Eaton WW, Martins SS, Nestadt G, Bienvenu OJ, Clarke D, Alexandre P: The burden of mental disorders. Epidemiol Rev. 2008, 30: 1-14. 10.1093/epirev/mxn011.CrossRefPubMedPubMedCentral

Skapinakis P, Lewis G: Epidemiology in community psychiatric research: common uses and methodological issues. Epidemiol Psichiatr Soc. 2001, 10: 18-26. 10.1017/S1121189X00008502.CrossRefPubMed

Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jfnsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC: The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011, 21: 655-679. 10.1016/j.euroneuro.2011.07.018.CrossRefPubMed

Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, Ustun TB, Wang PS: The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009, 18: 23-33. 10.1017/S1121189X00001421.CrossRefPubMedPubMedCentral

Madianos MG, Stefanis CN: Changes in the prevalence of symptoms of depression and depression across Greece. Soc Psychiatry Psychiatr Epidemiol. 1992, 27: 211-219. 10.1007/BF00788931.CrossRefPubMed

Madianos M, Economou M, Alexiou T, Stefanis C: Depression and economic hardship across Greece in 2008 and 2009: two cross-sectional surveys nationwide. Soc Psychiatry Psychiatr Epidemiol. 2011, 46: 943-952. 10.1007/s00127-010-0265-4.CrossRefPubMed

Economou M, Madianos M, Peppou LE, Patelakis A, Stefanis CN: Major depression in the Era of economic crisis: A replication of a cross-sectional study across Greece. J Affect Disord. 2012, http://dx.doi.org/10.1016/j.jad.2012.08.008.

10.

Lewis G, Pelosi AJ, Araya R, Dunn G: Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med. 1992, 22: 465-486. 10.1017/S0033291700030415.CrossRefPubMed

11.

Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H: Psychiatric Morbidity Among Adults Living in Private Households. 2001, London: The Stationery Office

12.

Botega NJ, Pereira WA, Bio MR, Garcia CJR, Zomignani MA: Psychiatric morbidity among medical in-patients: a standardized assessment (GHQ-12 and CIS-R) using ‘lay’ interviewers in a Brazilian hospital. Soc Psychiatry Psychiatr Epidemiol. 1995, 30: 127-131. 10.1007/BF00802041.CrossRefPubMed

13.

Araya R, Rojas G, Fritsch R, Acu AJ, Lewis G: Common mental disorders in Santiago, Chile: prevalence and socio-demographic correlates. Br J Psychiatry. 2001, 178: 228-233. 10.1192/bjp.178.3.228.CrossRefPubMed

14.

Liu SI, Mann A, Cheng A, Tjung JJ, Hwang LC: Identification of common mental disorders by general medical doctors in Taiwan. Gen Hosp Psychiatry. 2004, 26: 282-288. 10.1016/j.genhosppsych.2004.03.004.CrossRefPubMed

15.

Pez O, Gilbert F, Bitfoi A, Carta MG, Jordanova V, Garcia-Mahia C, Mateos-Alvarez R, Prince M, Tudorache B, Blatier C, Kovess-Masfety V: Validity across translations of short survey psychiatric diagnostic instruments: CIDI-SF and CIS-R versus SCID-I/NP in four European countries. Soc Psychiatry Psychiatr Epidemiol. 2010, 45: 1149-1159. 10.1007/s00127-009-0158-6.CrossRefPubMed

16.

Lewis G, Pelosi AJ, Glover E, Wilkinson G, Stansfeld SA, Williams P, Shepherd M: The development of a computerized assessment for minor psychiatric disorder. Psychol Med. 1988, 1988 (18): 737-745.CrossRef

17.

Skapinakis P, Anagnostopoulos F, Bellos S, Magklara K, Lewis G, Mavreas V: An empirical investigation of the structure of anxiety and depressive symptoms in late adolescence: cross-sectional study using the Greek version of the revised clinical interview schedule. Psychiatry Res. 2011, 186: 419-426. 10.1016/j.psychres.2010.08.023.CrossRefPubMed

18.

Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the alcohol Use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction. 1993, 88: 791-804. 10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMed

19.

Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). alcohol use disorders identification test. Arch Intern Med. 1998, 158: 1789-1795. 10.1001/archinte.158.16.1789.CrossRefPubMed

20.

Aalto M, Alho H, Halme JT, Seppd K: AUDIT and its abbreviated versions in detecting heavy and binge drinking in a general population survey. Drug Alcohol Depend. 2009, 103: 25-29. 10.1016/j.drugalcdep.2009.02.013.CrossRefPubMed

21.

Reinert DF, Allen JP: The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res. 2007, 31: 185-199. 10.1111/j.1530-0277.2006.00295.x.CrossRefPubMed

22.

The EuroQol Group: EuroQol–a new facility for the measurement of health-related quality of life. Health Policy. 1990, 16: 199-208.CrossRef

23.

Kontodimopoulos N, Pappa E, Niakas D, Yfantopoulos J, Dimitrakaki C, Tountas Y: Validity of the EuroQoL (EQ-5D) instrument in a Greek general population. Value Health. 2008, 11: 1162-1169. 10.1111/j.1524-4733.2008.00356.x.CrossRefPubMed

24.

Stata Corporation: Stata Reference Manual, release 10.0. 2007, College Station, Texas: Stata Press

25.

Helzer JE, Robins LN, McEvoy LT, Spitznagel EL, Stoltzman RK, Farmer A, Brockington IF: A comparison of clinical and diagnostic interview schedule diagnoses: physician reexamination of lay-interviewed cases in the general population. Arch Gen Psychiatry. 1985, 42: 657-666. 10.1001/archpsyc.1985.01790300019003.CrossRefPubMed

26.

Jordanova V, Wickramesinghe C, Gerada C, Prince M: Validation of two survey diagnostic interviews among primary care attendees: a comparison of CIS-R and CIDI with SCAN ICD-10 diagnostic categories. Psychol Med. 2004, 34: 1013-1024. 10.1017/S0033291703001727.CrossRefPubMed

27.

Brugha TS, Bebbington PE, Jenkins R: A difference that matters: comparisons of structured and semi-structured diagnostic interviews of adults in the general population. Psychol Med. 1999, 29: 1013-1020. 10.1017/S0033291799008880.CrossRefPubMed

28.

Skapinakis P, Zissi A, Savidou M, Tseloni M, Chiou M: Prevalence and sociodemographic associations of psychiatric morbidity in rural communities of the North Aegean. Arch Hell Med. 2007, 24 (s1): 30-36.

29.

Tseloni A, Zissi A, Skapinakis P: Psychiatric morbidity and social capital in rural communities of the Greek North Aegean islands. J Community Psychol. 2010, 38: 1023-1041. 10.1002/jcop.20414.CrossRef

30.

Stylianidis S, Skapinakis P, Pantelidou S, Chondros P, Avgoustaki A, Ziakoulis M: Prevalence of common psychiatric disorders in an island region. Arch Hell Med. 2010, 27: 675-683.

31.

Mavreas VG, Beis A, Mouyias A, Rigoni F, Lyketsos GC: Prevalence of psychiatric disorders in Athens. A community study. Soc Psychiatry. 1986, 21: 172-181. 10.1007/BF00583997.CrossRefPubMed

32.

Evans M, Kessler D, Lewis G, Peters TJ, Sharp D: Assessing mental health in primary care research using standardized scales: can it be carried out over the telephone?. Psychol Med. 2004, 34: 157-162. 10.1017/S0033291703008055.CrossRefPubMed

33.

Pazarlis P, Mauri D, Cortinovis I, Katsigiannopoulos K, Alevizaki P, Koukourakis G, Casazza G, Kamposioras K, Chatziioannou I, Milousis A, Papakonstantinou A, Karathanasi I, Alexiou G, Proiskos A, Mitrogianni Z, Peponi C: Socio-demographic status and alcohol drinking patterns among Greek healthy adults. Cent Eur J Public Health. 2006, 14: 160-167.PubMed

34.

Kokkevi A, Fotiou A, Richardson C: Drug use in the general population of Greece over the last 20 years: results from nationwide household surveys. Eur Addict Res. 2007, 13: 167-176. 10.1159/000101553.CrossRefPubMed

35.

Filippidis FT, Vardavas CI, Loukopoulou A, Behrakis P, Connolly GN, Tountas Y: Prevalence and determinants of tobacco use among adults in Greece: 4 year trends. Eur J Public Health. 2012, http://dx.doi.org/10.1093/eurpub/cks148.

36.

Wittchen HU, Jacobi F: Size and burden of mental disorders in Europe - a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005, 15: 357-376. 10.1016/j.euroneuro.2005.04.012.CrossRefPubMed

37.

Andrade L, Walters EE, Gentil V, Laurenti R: Prevalence of ICD-10 mental disorders in a catchment area in the city of S o Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol. 2002, 37: 316-325. 10.1007/s00127-002-0551-x.CrossRefPubMed

38.

Jacobi F, Wittchen HU, Holting C, Hffler M, Pfister H, M ller N, Lieb R: Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German health interview and examination survey (GHS). Psychol Med. 2004, 34: 597-611. 10.1017/S0033291703001399.CrossRefPubMed

39.

Mavreas VG, Kontea M, Dikeos D, Neroutsos E, Sfikaki M, Aritzi S, Stefanis CN: Results from the Athens centre. Mental Ilness in General Health Care. Edited by: Ustun and Sartorious. 1995, Chichester: John Wiley & Sons Ltd

40.

Chishti P, Stone DH, Corcoran P, Williamson E, Petridou E, EUROSAVE Working Group: Suicide mortality in the European Union. Eur J Public Health. 2003, 13: 108-114. 10.1093/eurpub/13.2.108.CrossRefPubMed

41.

Pappa E, Kontodimopoulos N, Niakas D: Validating and norming of the Greek SF-36 health survey. Qual Life Res. 2005, 14: 1433-1438. 10.1007/s11136-004-6014-y.CrossRefPubMed

42.

Bijl RV, Ravelli A, van Zessen G: Prevalence of psychiatric disorder in the general population: results of The Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol. 1998, 33: 587-595. 10.1007/s001270050098.CrossRefPubMed

43.

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005, 62: 593-602. 10.1001/archpsyc.62.6.593.CrossRefPubMed

44.

Sareen J, Cox BJ, Clara I, Asmundson GJ: The relationship between anxiety disorders and physical disorders in the U.S. National comorbidity survey. Depress Anxiety. 2005, 21: 193-202. 10.1002/da.20072.CrossRefPubMed

45.

Stein MB, Cox BJ, Afifi TO, Belik SL, Sareen J: Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective. Psychol Med. 2006, 36: 587-596. 10.1017/S0033291706007239.CrossRefPubMed

46.

Papathanassoglou ED, Karanikola MN, Kalafati M, Giannakopoulou M, Lemonidou C, Albarran JW: Professional autonomy, collaboration with physicians, and moral distress among European intensive care nurses. Am J Crit Care. 2012, http://dx.doi.org/10.4037/ajcc2012205.

47.

Montgomery SM, Cook DG, Bartley MJ, Wadsworth ME: Unemployment pre-dates symptoms of depression and anxiety resulting in medical consultation in young men. Int J Epidemiol. 1999, 28: 95-100. 10.1093/ije/28.1.95.CrossRefPubMed

48.

Bambra C: Yesterday once more? Unemployment and health in the 21st century. J Epidemiol Community Health. 2010, 64: 213-215. 10.1136/jech.2009.090621.CrossRefPubMed

49.

Bebbington PE, Brugha TS, Meltzer H, Jenkins R, Ceresa C, Farrell M, Lewis G: Neurotic disorders and the receipt of psychiatric treatment. Psychol Med. 2000, 30: 1369-1376. 10.1017/S0033291799002974.CrossRefPubMed

50.

Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, Van Audenhove C, van Weeghel J, Reneses B, Germanavicius A, Economou M, Lanfredi M, Ando S, Sartorius N, Lopez-Ibor JJ, Thornicroft G, The ASPEN/INDIGO Study Group: Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet. 2012, http://dx.doi.org/10.1016/S0140-6736(12)61379-8.

51.

Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet. 2007, 370: 859-877. 10.1016/S0140-6736(07)61238-0.CrossRefPubMed

52.

Men T, Brennan P, Boffetta P, Zaridze D: Russian mortality trends for 1991–2001: analysis by cause and region. BMJ. 2003, 327: 964-970. 10.1136/bmj.327.7421.964.CrossRefPubMedPubMedCentral

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/13/163/prepub

Title: Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece
Authors: Petros Skapinakis
Stefanos Bellos
Sotirios Koupidis
Ilias Grammatikopoulos
Pavlos N Theodorakis
Venetsanos Mavreas
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/1471-244X-13-163

At a glance: The STEP trials

Springer Medicine

Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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