Dataset Information

Genetic influences on treatment-seeking for common mental health problems in the UK biobank.

ABSTRACT: The majority of those who experience clinical anxiety and/or depressive symptoms in the population do not receive treatment. Studies investigating inequalities in treatment outcomes rarely consider that individuals respond differently to their experience of the environment. Much of our environment is under genetic influence, via our behaviour, whereby individuals actively select their experiences. If genes influence who seeks and receives treatment, selection bias will confound genomic studies of treatment response. Furthermore, if some individuals are at high genetic risk of needing but not commencing treatment, then greater efforts could be made to engage them. The role of common genetic variation on four lifetime treatment-seeking behaviours (treatment-seeking, treatment-receipt, self-help, self-medication with alcohol/drugs) was examined in participants of the UK Biobank (sample size range: 48,106 - 75,322). Treatment-related behaviours were only modestly heritable in these data. Nonetheless, genetic correlations reveal substantial genetic overlap between lifetime treatment-related behaviours and psychiatric disorders, symptoms and behavioural traits. To our knowledge, this is the first study to examine genetic influences on treatment-related behaviours. Further work is required to determine whether genetic factors could be used alongside clinical, social and demographic factors to identify at risk groups and inform strategies which target early intervention.

SUBMITTER: Rayner C

PROVIDER: S-EPMC6873796 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Genetic influences on treatment-seeking for common mental health problems in the UK biobank.

Rayner Christopher C Coleman Jonathan R I JRI Purves Kirstin L KL Cheesman Rosa R Hübel Christopher C Gaspar Helena H Glanville Kylie K Krebs Georgina G Morneau-Vaillancourt Genevieve G Breen Gerome G Eley Thalia C TC

Behaviour research and therapy 20190615

The majority of those who experience clinical anxiety and/or depressive symptoms in the population do not receive treatment. Studies investigating inequalities in treatment outcomes rarely consider that individuals respond differently to their experience of the environment. Much of our environment is under genetic influence, via our behaviour, whereby individuals actively select their experiences. If genes influence who seeks and receives treatment, selection bias will confound genomic studies o ...[more]

PMID: 31491689

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Project description:AIM:To develop a questionnaire to measure quantitatively barriers and facilitators to women's disclosure of perinatal mental health problems in UK primary care. To pilot and evaluate the questionnaire for content validity and internal consistency. BACKGROUND:Around 15% of women develop a mental illness in the perinatal period, such as depression, anxiety or post-traumatic stress disorder. In the United Kingdom, 90% of these women will be cared for in primary care, yet currently in as many as 50% of cases, no discussion of this issue takes place. One reason for this is that women experience barriers to disclosing symptoms of perinatal mental illness in primary care. These have previously been explored qualitatively, but no tool currently exists with which to measure these barriers quantitatively. METHODS:Questionnaire items, drawn from qualitative literature and accounts of women's experiences, were identified, refined iteratively and arranged in themes. The questionnaire was piloted using cognitive debriefing interviews to establish content validity. Women completed a refined version online. Responses were analysed using descriptive statistics. Internal consistency of subscales was calculated using Cronbach's alpha. FINDINGS:Cognitive debriefing interviews with five women showed the majority of questionnaire items were relevant, appropriate and easy to understand. The final questionnaire was completed by 71 women, and the majority of subscales had good internal consistency. The barrier scoring most highly was fear and stigma, followed by willingness to seek help and logistics of attending an appointment. Family/partner support and general practitioners' (GPs) reaction were the lowest scoring barriers. Factors facilitating disclosure were GPs being empathetic and non-judgemental and listening during discussions. In the future, this questionnaire can be used to examine which barriers are most important for particular groups of women. This may enable the development of strategies to improve acknowledgement and discussion, and prevent under-recognition and under-treatment, of perinatal mental health problems in primary care.

Project description:BackgroundCommunity attitude towards mental health problems and help-seeking behavior plays a major role in designing effective community based mental health interventions. This study aimed to assess the attitude, help-seeking behavior, and associated factors of the Jimma zone community towards mental health and mental health problems.MethodsA community-based cross-sectional study design was employed. A respondent from each of the 423 systematically selected households was interviewed using a pretested, structured, and interviewer-administered questionnaire. Accordingly, a community's attitude towards mental health problems was measured by the adapted version of the "Community Attitude towards Mentally Ill questionnaire (CAMI)" and help-seeking behavior was measured by a general help-seeking questionnaire. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Bivariate and multivariate logistic regression analysis was done to determine the independent predictors of the outcome variable.ResultsAmong the total 420 study participants (197,46.9%) of them had an overall unfavorable attitude towards mental illness. The majority (153,36.4%) of the study participants agreed on avoidance of anyone who has mental health problems and (150,35.7%) participants described marrying a person with a mental health problem or recovered from the problem is foolishness. Moreover, regression analysis showed family monthly income (AOR = 0.24, 95%CI:0.06-0.91) and occupational status (AOR = 0.57, 95%CI:0.34-0.96) were found to be the predictors of community attitude towards mental health problems. The study finding also revealed a significant number of the respondents preferred non- medical treatment approaches.ConclusionAlmost half of the respondents had an unfavorable attitude towards mental health problems and the traditional and religious help-seeking intention was high. This suggests the need for designing effective community based mental health interventions to improve the general public attitude and help-seeking behavior towards mental health problems.

Project description:The association between adversity and cognition varies according to the specific adversity, when the adversity was experienced, and the cognitive domains investigated. Disentangling the effect of adversity and the underlying mechanistic pathway is therefore difficult. The association between adversity (i.e., maltreatment) accumulated over the life course and cognitive flexibility, as well as two potential mediators (i.e., intra-individual variability in reaction time and depression) of this association, were investigated. Data stem from the baseline population of the UK Biobank study (N = 73,489, Mdnage = 56, SDage = 7.628, 55.740% of women). Cumulative life course adversity (specifically maltreatment) was measured with items based on the Childhood Trauma Questionnaire (CTS-5) and items adapted from the British Crime Survey. Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9). Intra-individual variability in reaction time was measured with a reaction time test "snap game" and the Trail Making Test A and B were used as a measure of cognitive flexibility. A path analysis was performed on these data. Higher cumulative adverse experiences were associated with lower performance in cognitive flexibility (β = .016, p < .001, 95% CI [0.009, 0.024]), and this effect was partly mediated by the level of depression (22.727% of the total effect of cumulative life course adversity on cognitive flexibility was mediated by depression (β = .005, p < .001, 95% CI [0.004, 0.007])). No association between cumulative life course adverse experiences and intra-individual variability in reaction time was found, nor was any indirect association between cumulative life course adversity and performance in cognitive flexibility via intra-individual variability in reaction time. The association between cumulative life course adversity, depression, and performance in cognitive flexibility has been highlighted. In contrast, no indirect effect between cumulative life course adversity and performance in cognitive flexibility via intra-individual variability in reaction time was found, suggesting that it is not a potential mechanism underlying the association between cumulative life course adversity and executive function.

Project description:BackgroundIncreasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap.MethodsFive databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19?years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis.ResultsNinety studies meet the inclusion criteria for this review for barrier and facilitators (n?=?54) and interventions (n?=?36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements.ConclusionMost of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.

Project description:AimsThe aim of the study was to evaluate the prevalence and temporal trend of common mental health problems (CMHPs) in the UK by industrial classification from 2012-2014 to 2016-2018 while evaluating the corresponding gender disparities.MethodsWe used data from the Health Survey for England. CMPH was judged by a 12-item General Health Questionnaire. Industrial classifications were defined using the UK Standard Industrial Classification of Economic Activities. Data were fitted by the logistic models.ResultsIn this study, 19,581 participants covering 20 industries were included. In total, 18.8% of participants screened positive for CMHP in 2016-2018, which significantly increased from 16.0% in 2012-2014 [adjusted OR (AOR) = 1.17, 95% CI 1.08-1.27]. In 2016-2018, the prevalence of CMHP ranged from 6.2% in the industry of mining and quarrying to 23.8% in the industry of accommodation and food service activities. From 2012-2014 to 2016-2018, none of the 20 industries studied experienced significant decreases in the above prevalence; conversely, three industries saw significant increases, including wholesale and retail trade, repair of motor vehicles and motorcycles (AOR for trend = 1.32, 95% CI 1.04-1.67), construction (AOR for trend = 1.66, 95% CI 1.23-2.24), and other service activities, which cannot be classified (AOR for trend = 1.94, 95% CI 1.06-3.55). In total, 11 of the 20 industries studied had significant gender disparities against women, with the smallest gap being in the industry of transport and storage (AOR = 1.47, 95% CI 1.09-2.0) and the highest in the industry of arts, entertainment, and recreation (AOR = 6.19, 95% CI 2.94-13.03). From 2012-2014 to 2016-2018, gender disparities were narrowed only in two industries, including human health and social work activities (AOR for trend = 0.45, 95% CI 0.27-0.74), and transport and storage (AOR for trend = 0.5, 95% CI 0.27-0.91).ConclusionThe prevalence of CMHPs has increased and had a wide variation across industries in the UK. There were disparities against women, and the gender disparities have been keeping almost no improvement from 2012-2014 to 2016-2018.

Project description:ObjectiveTo compare prevalent and incident morbidity and mortality between those with the HFE p.C282Y genetic variant (responsible for most hereditary haemochromatosis type 1) and those with no p.C282Y mutations, in a large UK community sample of European descent.DesignCohort study.Setting22 centres across England, Scotland, and Wales in UK Biobank (2006-10).Participants451 243 volunteers of European descent aged 40 to 70 years, with a mean follow-up of seven years (maximum 9.4 years) through hospital inpatient diagnoses and death certification.Main outcome measureOdds ratios and Cox hazard ratios of disease rates between participants with and without the haemochromatosis mutations, adjusted for age, genotyping array type, and genetic principal components. The sexes were analysed separately as morbidity due to iron excess occurs later in women.ResultsOf 2890 participants homozygous for p.C282Y (0.6%, or 1 in 156), haemochromatosis was diagnosed in 21.7% (95% confidence interval 19.5% to 24.1%, 281/1294) of men and 9.8% (8.4% to 11.2%, 156/1596) of women by end of follow-up. p.C282Y homozygous men aged 40 to 70 had a higher prevalence of diagnosed haemochromatosis (odds ratio 411.1, 95% confidence interval 299.0 to 565.3, P<0.001), liver disease (4.30, 2.97 to 6.18, P<0.001), rheumatoid arthritis (2.23, 1.51 to 3.31, P<0.001), osteoarthritis (2.01, 1.71 to 2.36, P<0.001), and diabetes mellitus (1.53, 1.16 to 1.98, P=0.002), versus no p.C282Y mutations (n=175 539). During the seven year follow-up, 15.7% of homozygous men developed at least one incident associated condition versus 5.0% (P<0.001) with no p.C282Y mutations (women 10.1% v 3.4%, P<0.001). Haemochromatosis diagnoses were more common in p.C282Y/p.H63D heterozygotes, but excess morbidity was modest.ConclusionsIn a large community sample, HFE p.C282Y homozygosity was associated with substantial prevalent and incident clinically diagnosed morbidity in both men and women. As p.C282Y associated iron overload is preventable and treatable if intervention starts early, these findings justify re-examination of options for expanded early case ascertainment and screening.

Dataset Information

Genetic influences on treatment-seeking for common mental health problems in the UK biobank.

Publications

Genetic influences on treatment-seeking for common mental health problems in the UK biobank.

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