Previous studies 20,21 have shown that depressive and anxiety disorders have a strong impact on HRQoL.
Recursos En Español | Anxiety and Depression Association of America, ADAA
This study confirms these findings from a health policy perspective and stresses that the associated burden reached substantial values even when the impact on mortality was not measured. The sensitivity analyses generated distinct results but do not alter the broad message that these disorders substantially impair quality of life. The relevance of these findings on the effect of these mental health conditions on individuals' lives is reinforced by the fact that the analysis controls for the influence of sociodemographic variables and chronic health conditions on HRQoL.
The representativeness and soundness of the findings are supported by the data employed: These results highlight the need for global policies, not just from the mental health field, aiming to reduce this burden.
The Mental Health Plan of Catalonia in 22 recognized this need and interventions with this objective e. The negative relationship found in this study between HRQoL and depressive and anxiety disorders has previously been shown using large health survey data. Indeed, in the other study with a general population sample 4 the prevalence of the mental health conditions analyzed was lower. The factor with the highest impact on HRQoL among those included in the model was emotional disorders.
The presence of chronic lumbar or dorsal back pain implied a reduction of 0. This finding is reflected by figures and comparisons of population impact, with chronic lumbar or dorsal back pain implying a burden of 1, QALYs per , inhabitants and chronic cervical pain a burden of 1, compared with the result of 1, QALYs per , inhabitants for emotional disorders. Comparison with similar studies highlights the main limitation of this analysis: The GHQ was initially developed to screen for general mental disorders but proved to be more effective in screening for depression and anxiety than other psychiatric disorders.
However, analysis of data from the GHQ for policy decision making is controversial, particularly in countries where the specific predictive validity of this instrument for assessing emotional disorders has yet to be published, as is the case in Spain. On the one hand, the GHQ has shown a three-dimensional structure in its Spanish validation: One strategy has been to use a series of survey questions related to depression and anxiety despite the low reliability of this method.
The following questions have been considered: Participants who gave positive answers to questions 1, 2, and 3 or to all questions were considered "depression sufferers" and those giving positive answers to questions 1, 2, and 4 were considered "anxiety sufferers". A further option, previously used in the Catalan Health Survey of , was to rank the order of probability of being a psychiatric case according to the GHQ rating, by using a logistic regression analysis 31 but, according to the officers of the Catalan Department of Health, the information obtained with this option was of limited utility for informed policy making.
The combined use of the GHQ and EQ5-D has previously been used in the Canary Islands and the findings enabled health-state values to be derived from GHQ scores for populations in which utilities had not, or could not, be measured directly. Criticisms of the combined use of both measures are based on the low reliability and predictive validity of the diagnosis of depression and anxiety disorders in health surveys and the inadequate use of screening instruments in these surveys. Based on these criticisms, GHQ information provided in annual health surveys in Spain, both nationally and regionally, should not be used to generate information relevant for policy making.
These criticisms overlook the fact that levels of accuracy are related to the aim of the analyses. Obviously, if the analysis is intended to select among treatment alternatives, high accuracy and focus on specific childhood categories e. However when the analysis is related to general priority setting 32 broader parent categories may be more useful e. In this scenario, estimation of the annual ratio of emotional disorders as a proxy measure of the combined prevalence of anxiety and depressive disorders may be highly relevant when combined with EQ-5 data to estimate the relative burden of this grouping of psychiatric disorders in relation to groupings of other health conditions.
This decision was made in agreement with the experts who standardized the Spanish GHQ scales in Spain, 14 as the cut-off point is not a fixed value and can be adjusted depending on the aim of the study, in the present case to reduce false-positives and to increase specificity in order to provide a conservative estimate of the comparative burden of emotional disorders in Catalonia.
This approach may improve the combined analysis of results from short-form scales and QoL scales in health survey studies. The use of quality of life scales such as the SF or EQ-5D, 34 combined with data on quasi-specific health conditions, and calculation of global indexes such as QALYs provides substantial information to rank health priorities and either support or dismiss health policy programs in highly complex areas such as mental health.
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A more refined way of evaluating the rate of physical health conditions would be to improve the analysis. The self-reported measures used include past and present health problems, a method that most probably has lower validity than a physical examination by a health professional. Additionally, the analysis was based on a survey that did not collect information on institutionalized individuals or on the impact of the conditions analyzed on mortality.
Finally, cross-sectional data were used and therefore the method employed relies on the assumption that the results are representative for the month period. In conclusion, the present study used data from more than 15, individuals and highlights the substantial impact of emotional disorders on the lives of affected individuals; this negative association was confirmed and quantified for the population of Catalonia.
Health policy makers should consider this impact when developing strategies to reduce the burden of health conditions on individuals and society. The quantification of this burden for the population of Catalonia using a large population health survey can be used for evidence-informed policy making. The present study confirms and quantifies the substantial negative impact of emotional disorders on the lives of affected individuals, using data from Catalonia.
The results highlight the need for global policies, not just from the mental health field, aiming to reduce this burden.
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Sabes-Figuera performed the data analysis, participated in the interpretation of the data and drafted the manuscript. Salvador-Carulla reviewed the analysis, participated in the interpretation of the data and in the drafting of the manuscript. Mompart-Penina reviewed the analysis and participated in the interpretation of the data.
All authors have read and approved the final manuscript. The contributions of the members of the following expert groups were invaluable. Pueyo and Roser Vicente one of the authors of the study, A. Mompart, was also member of this group. The measurement of health-related quality of life for use in resource allocation decisions in health care. Handbook of Health Economics. The global burden of disease series.
Harvard School of Public Health; The global burden of disease, update. Impact of psychiatric disorders on health-related quality of life: Health Res Policy Syst. Generalitat de Catalunya; Costs of depression in Catalonia Spain. Epub ahead of print. Encuesta de Salud de Catalunya Goldberg D, Williams P.
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Determinants of psychological distress among migrants from Ecuador and Romania in a Spanish City. Int J Soc Psychiatry. The Spanish version of EuroQol: European Quality of Life Scale. Domingo A, Marcos J. Estimation of relationships for limited dependent variables. Marginal effects for the tobit model. Mendlowicz M, Stein M. Quality of life in individuals with anxiety disorder. Long-term follow-up of depression among patients in the community and in family practice settings.
Master plan on mental health and addictions. Departament de Salut, Generalitat de Catalunya; General health and quality-of-life measures in active, recent, and comorbid mental disorders: The relationship among mental health status GHQ , health related quality of life EQ-5D and health-state utilities in a general population. Burden of chronic physical conditions and mental disorders in primary care. Measuring the mental health status of a population: Mental health and physical activity in the European Union.
Skip to main content. You are here Home. La demencia y los cuidadores Los investigadores han comprobado que las personas que cuidan a un paciente de demencia tienen el doble de probabilidades de deprimirse que quienes cuidan a pacientes que no son dementes. Cuidar a un paciente de demencia puede ser demasiado agobiante.
No es igual a otros tipos de cuidado. Las mujeres, principalmente las esposas e hijas, forman el grueso de los cuidadores. Muchos cuidadores se sienten deprimidos al ingresar al paciente, y algunos se siguen sintiendo deprimidos por mucho tiempo. Su objetivo es hacer que afloren los sentimientos conflictivos profundos, con el fin de conocerlos y comprenderlos mejor. Los MAOI son medicamentos que elevan el nivel de neurotransmisores en el cerebro. Se emplean mayormente cuando otros medicamentos no resultan eficaces o no se toleran.
Tratamientos complementarios y alternativos Hierba de San Juan. El pago del tratamiento Por lo general, los seguros privados y Medicare cubren el costo de algunos tipos de tratamiento mental. Estrategias de autoayuda Los trastornos depresivos pueden provocar que uno se sienta agotado, inerme y sin esperanzas.
Trate de conversar con otras personas y de confiar en alguien; por lo general eso es mejor que estar solo y ocultar lo que uno siente. Permita que sus familiares y amistades le ayuden. Lecturas recomendadas The Caregiver Helpbook: Wednesday, February 20, Una Crisis de la Salud Desconocida Spanish A Growing Mental Health Concern The Single Mother and Daughter. Education and Events Calendar December Smart Patients Caregivers Community In partnership with.