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Search Results: 1 - 10 of 130436 matches for " V Kovess "
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Differing mental health practice among general practitioners, private psychiatrists and public psychiatrists
N Younès, MC Hardy-Bayle, B Falissard, V Kovess, MP Chaillet, I Gasquet
BMC Public Health , 2005, DOI: 10.1186/1471-2458-5-104
Abstract: All GPs (n = 492), PrPs (n = 82) and PuPs (n = 78) in the South-Yvelines area in France were informed of the implementation of a local mental health program. Practitioners interested in taking part were invited to include prospectively all patients with mental health problem they saw over an 8-day period and to complete a 6-month retrospective questionnaire on their mental health practice. 180 GPs (36.6%), 45 PrPs (54.9%) and 63 PuPs (84.0%) responded.GPs and PrPs were very similar but very different from PuPs for the proportion of patients with anxious or depressive disorders (70% v. 65% v. 38%, p < .001), psychotic disorders (5% v. 7% v. 30%, p < .001), previous psychiatric hospitalization (22% v. 26 v. 61%, p < .001) and receiving disability allowance (16% v. 18% v. 52%, p < .001). GPs had fewer patients with long-standing psychiatric disorders than PrPs and PuPs (52%, 64% v. 63%, p < .001). Time-lapse between consultations was longest for GPs, intermediate for PuPs and shortest for PrPs (36 days v. 26 v. 18, p < .001). Access to care had been delayed longer for Psychiatrists (PrPs, PuPs) than for GPs (61% v. 53% v. 25%, p < .001). GPs and PuPs frequently felt a need for collaboration for their patients, PrPs rarely (42% v. 61%. v. 10%, p < .001).Satisfaction with mental health practice was low for all categories of physicians (42.6% encountered difficulties hospitalizing patients and 61.4% had patients they would prefer not to cater for). GPs more often reported unsatisfactory relationships with mental health professionals than did PrPs and PuPs (54% v. 15% v. 8%, p < .001).GP patients with mental health problems are very similar to patients of private psychiatrists; there is a lack of the collaboration felt to be necessary, because of psychiatrists' workload, and because GPs have specific needs in this respect. The "Yvelines-Sud Mental Health Network" has been created to enhance collaboration.In developed countries, mental health problems, especially anxious an
Level of positive mental health in the European Union: Results from the Eurobarometer 2002 survey
Lehtinen Ville,Sohlman Britta,Kovess-Masfety Viviane
Clinical Practice and Epidemiology in Mental Health , 2005, DOI: 10.1186/1745-0179-1-9
Abstract: Background Few epidemiological studies have focused on the occurrence of positive mental health, and those comparing several countries practically non-existent. This study presents comparative findings of positive mental health in 11 EU countries or regions, based on the Eurobarometer 2002 (autumn) survey. Method The sample (n = 10,878) represents the general population, aged 15 or over, of 11 European countries or regions (all old EU Member States except Denmark, Greece, Ireland, Finland and Great Britain which had to be excluded because of poor response rate, less than 45%). The method of opinion survey was applied using face-to-face interviews. The Energy and Vitality Index (EVI) from the SF-36 questionnaire was use as measure of positive mental health. Results Overall, there were between-country differences in the gender- and age-adjusted EVI mean scores. In general, poorer mental health was found in women, older age groups, those in poor economic position and those experiencing weak social support. Conclusion Methodological biases cannot be fully excluded, and thus, one has to take the presented results with certain caution, especially when comparing the results from the different countries. On the other hand, the results on the determinants of positive mental health are in concordance with most previous studies.
Voice disorders and mental health in teachers: a cross-sectional nationwide study
Eléna Nerrière, Marie-No?l Vercambre, Fabien Gilbert, Viviane Kovess-Masféty
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-370
Abstract: The source data come from an epidemiological postal survey on physical and mental health conducted in a sample of 20,099 adults (in activity or retired) selected at random from the health plan records of the national education system. Overall response rate was 53%. Of the 10,288 respondents, 3,940 were teachers in activity currently giving classes to students. In the sample of those with complete data (n = 3,646), variables associated with voice disorders were investigated using logistic regression models. Studied variables referred to demographic characteristics, socio-professional environment, psychological distress, mental health disorders (DSM-IV), and sick leave.One in two female teachers reported voice disorders (50.0%) compared to one in four males (26.0%). Those who reported voice disorders presented higher level of psychological distress. Sex- and age-adjusted odds ratios [95% confidence interval] were respectively 1.8 [1.5-2.2] for major depressive episode, 1.7 [1.3-2.2] for general anxiety disorder, and 1.6 [1.2-2.2] for phobia. A significant association between voice disorders and sick leave was also demonstrated (1.5 [1.3-1.7]).Voice disorders were frequent among French teachers. Associations with psychiatric disorders suggest that a situation may exist which is more complex than simple mechanical failure. Further longitudinal research is needed to clarify the comorbidity between voice and psychological disorders.Voice disorders cover a wide range of troubles which could be related to various aetiologies, including organic lesion of vocal folds (acquired or congenital), deficient control of breathing, deficient control of laryngeal articulation, as well as psychological difficulties. As highlighted in a recent review of the literature [1], teachers — with others professional voice users such as auctioneers [2], individuals in telesales [3] and aerobics instructors [4,5] — are at particular risk of developing voice disorders.To determine the significance
Needs for care among patients with schizophrenia in six European countries: a one-year follow-up study
Kovess-Masféty Viviane,Wiersma Durk,Xavier Miguel,Caldas de Almeida José Miguel
Clinical Practice and Epidemiology in Mental Health , 2006, DOI: 10.1186/1745-0179-2-22
Abstract: Background This article compares needs for care among patients with schizophrenia across six European countries and examines how this relates to the diversity of psychiatric systems in Europe. Methods A one-year prospective cohort study was set up. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. The patients were assessed for their clinical diagnosis and symptoms using the SCAN interview (Schedules for Clinical Assessment in Neuropsychiatry) and the interventions proposed to them were recorded through the systematic use of the NFCAS (Needs For Care Assessment Schedule). Results 438 patients were included and 391 were followed up. The mean age was 38 years, the mean age at onset was 22 years, and 59% were out-patients, 24% in day care and 15% hospitalized. The populations in the different centres were significantly different for almost all the variables: sociodemographic, clinical and social, and the problems identified remained relatively stable over the year. Comparisons highlighted cultural differences concerning the interventions that were proposed. Centres in Italy, Spain and Portugal proposed many interventions even though they were relatively deprived in terms of resources, and the tendency seems to be the reverse for the Northern European countries. On average, one in four patients suffered from needs that were not adequately met by the mental health service in their region. These needs (on average 6 per patient) varied from psychotic symptoms to managing their own affairs. The number of interventions was not correlated to the need status. The availability of community-based treatment, rehabilitation and residential care seems to predict smaller proportions of patients with unmet needs. Conclusion There appeared to be a systematic relationship between the availability of community-based mental health care and the need status of schizophrenic patients: the fewer out-patient and rehabilitation services available, the more unmet needs there were.
Individual and contextual covariates of burnout: a cross-sectional nationwide study of French teachers
Marie-No?l Vercambre, Pauline Brosselin, Fabien Gilbert, Eléna Nerrière, Viviane Kovess-Masféty
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-333
Abstract: The source data come from an epidemiological postal survey on physical and mental health conducted in 2005 among 20,099 education workers (in activity or retired) selected at random from the health plan records of the national education system. The response rate was 52.4%. Teachers in activity currently giving classes to students who participated in the survey (n = 3,940) were invited to complete a self-administered questionnaire including the Maslach Burnout Inventory. 2,558 teachers provided complete data (64.9%). Variables associated with high emotional exhaustion (highest quartile of score), high depersonalization (highest quartile), and reduced personal accomplishment (lowest quartile) were evaluated using multivariate logistic regression. Studied variables referred to demographic characteristics, socio-professional environment, job dissatisfaction, experienced difficulties at work, and teaching motivations.Different variables were associated with each burnout dimension. Female teachers were more susceptible to high emotional exhaustion and reduced personal accomplishment, whereas male teachers were more susceptible to high depersonalization. Elementary school teachers were more susceptible to high emotional exhaustion, but less susceptible to high depersonalization and reduced personal accomplishment than their higher school level counterparts. Experienced difficulties with pupils were associated with all three dimensions. A socio-economically underprivileged school neighbourhood was also related to high emotional exhaustion and high depersonalization.Programs to enhance teaching environment might be an interesting approach to try to prevent burnout. It would be useful to take the different dimensions into account in planning the intervention."Burnout" is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment which arises in response to chronic stress in jobs where individuals work with people [1]. Emotional exhaustion refer
Do teachers have more health problems? Results from a French cross-sectional survey
Viviane Kovess-Masféty, Christine Sevilla-Dedieu, Carmen Rios-Seidel, Eléna Nerrière, Christine Chan Chee
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-101
Abstract: A cross-sectional postal survey was conducted among a sample of 3,679 teachers and 1,817 non-teachers aged 20 to 60 years old.No lifetime prevalence of any psychiatric disorder (with the exception of undifferentiated somatoform disorder in men) or mean scores of psychological distress were found to be significantly higher in teachers. However, multiple analyses, adjusted for all confounding variables, revealed a higher risk of lifetime anxiety disorders in male teachers. On the other hand, significant differences were observed for some physical ailments: a higher lifetime prevalence of rhinopharyngitis/laryngitis in both male and female teachers, of conjunctivitis and lower urinary tract infection in male teachers and of bronchitis, eczema/dermatitis and varicose veins in female teachers. No significant difference was found for chronic pain between the two groups.Teachers do not seem to have poorer mental health. However, their physical condition is characterized by a higher prevalence of health problems related to the ENT tract, and to a lesser extent, depending on the gender, to skin, eyes, legs and lower urinary tract.The idea that teachers suffer from an excessively high rate of mental health problems is widely accepted among not only the general public, but among teachers themselves [1]. Teachers report they are exposed to a high risk of stress and occupational "burnout" [2] (i.e., syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do "people-work" [3]) which they claim leads them to suffer from psychiatric disorders more than the average. However, this seems to run contrary to well-established epidemiological data in psychiatry which show that the middle classes (where the majority of teachers fall) are relatively better protected against psychiatric disorders than underprivileged classes of society where the highest prevalence rates are found [4-7]. In contrast, when it comes to their physical health, we could assume th
General Practitioners' opinions on their practice in mental health and their collaboration with mental health professionals
Nadia Younes, Isabelle Gasquet, Pierre Gaudebout, Marie-Pierre Chaillet, Viviane Kovess, Bruno Falissard, Marie-Christine Hardy Bayle
BMC Family Practice , 2005, DOI: 10.1186/1471-2296-6-18
Abstract: All GPs in the South Yvelines area in France (n = 492) were informed of the implementation of a local mental health program. GPs interested in taking part (n = 180) were invited to complete a satisfaction questionnaire on their practice in the field of Mental Health and to include prospectively all PMHP consultants over an 8-day period (n = 1519). For each PMHP, data was collected on demographic and clinical profile, and on needs (met v. unmet) for collaboration with MHPro.A majority of GPs rated PMHP as requiring more care (83.4%), more time (92.3%), more frequent consultations (64.0%) and as being more difficult to refer (87.7%) than other patients. A minority of GPs had a satisfactory relationship with private psychiatrists (49.5%), public psychiatrists (35%) and social workers (27.8%). 53.9% had a less satisfactory relationship with MHPro than with other physicians.Needs for collaboration with a MHPro were more often felt in caring for PMHP who were young, not in employment, with mental health problems lasting for more than one year, with a history of psychiatric hospitalization, and showing reluctance to talk of psychological problems and to consult a MHPro.Needs for collaboration were more often met among PMHP with past psychiatric consultation or hospitalization and when the patient was not reluctant to consult a MHPro. Where needs were not met, GP would opt for the classic procedure of mental health referral for only 31.3% of their PMHP.GPs need targeted collaboration with MHPro to support their management of PMHP, whom they are willing to care for without systematic referral to specialists as the major therapeutic option.In developed countries, mental health problems, especially anxious and depressive disorders, are frequent and a leading cause of disability [1-4]. Since they are potentially remediable when adequately treated, they represent a major public health challenge [5,6]. A major obstacle to the instatement of adequate care is that when people do se
Schizophrenia and quality of life: a one-year follow-up in four EU countries
Viviane Kovess-Masféty, Miguel Xavier, Berta Moreno Kustner, Agnieszka Suchocka, Christine Sevilla-Dedieu, Jacques Dubuis, Elisabeth Lacalmontie, Jacques Pellet, Jean-Luc Roelandt, Dermot Walsh
BMC Psychiatry , 2006, DOI: 10.1186/1471-244x-6-39
Abstract: A one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up.We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items.The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.This article compares the quality of life of patients with schizophrenia in seven centres in four European countries: France (with centres in Lille, Lyon, La Verrière and St Etienne), Ireland (Dublin), Portugal (Lisbon) and Spain (Granada), and relates this to social and clinical c
What makes people decide who to turn to when faced with a mental health problem? Results from a French survey
Viviane Kovess-Masféty, Delphine Saragoussi, Christine Sevilla-Dedieu, Fabien Gilbert, Agnieszka Suchocka, Nathalie Arveiller, Isabelle Gasquet, Nadia Younes, Marie-Christine Hardy-Bayle
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-188
Abstract: 441 adults aged 18 to 70 were randomly selected from the general population of two suburban districts near Paris and agreed to participate in the study (response rate = 60.4%). The 412 respondents with no mental health problems based on the CIDI-SF and the CAGE, who had not consulted for a mental health problem in the previous year, were asked in detail about their intentions to seek help in case of a psychological disorder and about their opinion of mental health treatments. The links between the respondents' characteristics and intentions and opinions were explored.More than half of the sample (57.8%) would see their general practitioner (GP) first and 46.6% would continue with their GP for follow-up. Mental health professionals were mentioned far less than GPs. People who would choose their GP first were older and less educated, whereas those who would favor mental health specialists had lower social support. For psychotherapy, respondents were split equally between seeing a GP, a psychiatrist or a psychologist. People were reluctant to take psychotropic drugs, but looked favorably on psychotherapy.GPs are often the point of entry into the mental health care system and need to be supported. Public information campaigns about mental health care options and treatments are needed to educate the public, eliminate the stigma of mental illness and eliminate prejudices.There has been major concern about the unequal use of mental health care, even in countries with universal coverage such as Canada [1] where, despite such coverage, people from higher socioeconomic backgrounds receive more psychiatric care than those from lower socioeconomic backgrounds for equivalent mental health problems.In addition to universal coverage, mental health literacy has been established as an important factor in the provision of adequate care, not only for people to be able to recognize specific disorders, but also for them to believe help is possible and available. People need to have the
Parental Smoking in the Vicinity of Children and Tobacco Control Policies in the European Region
Viviane Kovess, Daniel J. Pilowsky, Anders Boyd, Ondine Pez, Adina Bitfoi, Mauro Carta, Ceyda Eke, Dietmar Golitz, Rowella Kuijpers, Sigita Lesinskiene, Zlatka Mihova, Roy Otten, Ezra Susser
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0056783
Abstract: Objective To ascertain patterns of parental smoking in the vicinity of children in Eastern and Western Europe and their relation to Tobacco Control Scale (TCS) scores. Methods Data on parental smoking patterns were obtained from the School Child Mental Health Europe (SCMHE), a 2010 cross-sectional survey of 5141 school children aged 6 to 11 years and their parents in six countries: Germany, Netherlands, Lithuania, Romania, Bulgaria and Turkey ranked by TCS into three level categories toward tobacco control policies. Results A slightly higher proportion of Eastern compared to Western European mothers (42.4 vs. 35.1%) were currently smoking in but the difference was not statistically significant after adjusting for maternal age and maternal educational attainment. About a fifth (19.3%) and a tenth (10.0%) of Eastern and Western European mothers, respectively, smoked in the vicinity of their children, and the difference was significant even after adjustment for potential confounders (p<0.001). Parents with the highest educational attainment were significantly less likely to smoke in the vicinity of their children than those with the lowest attainment. After control of these covariates lax tobacco control policies, compared to intermediate policies, were associated with a 50% increase in the likelihood of maternal smoking in the vicinity of children adjusted odds ratio (AOR) = 1.52 and 1.64. Among fathers, however, the relationship with paternal smoking and TCS seems more complex since strict policy increases the risk as well AOR = 1,40. Only one country, however belongs to the strict group. Significance Tobacco control policies seem to have influenced maternal smoking behaviors overall to a limited degree and smoking in the vicinity of children to a much greater degree. Children living in European countries with lax tobacco control policies are more likely to be exposed to second hand smoking from maternal and paternal smoking.
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