Dataset Information

Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort.

ABSTRACT:

Objectives

To assess whether the direction of movement along the social gradient was associated with changes in mental health status.

Design

Longitudinal record-linkage study using a multistate model.

Setting

Caerphilly, Wales, UK between 2001 and 2015.

Participants

The analytical sample included 10 892 (60.8% female) individuals aged 18-74 years.

Primary and secondary outcome measures

Deprivation change at lower super output area level using the 2008 Welsh Index of Multiple Deprivation. Mental health was assessed in 2001 and 2008 using the Mental Health Inventory subscale of the short-form 36 V.2.

Results

Mental health selection was shown whereby individuals with common mental health disorders were less likely to move to areas of lower deprivation but more likely to move to areas of greater deprivation.

Conclusion

Poor mental health seems to drive health selection in a similar way to poor physical health. Therefore, funding targeted at areas of higher deprivation should consider the demand to be potentially higher as individuals with poor mental health may migrate into that area.

SUBMITTER: Greene G

PROVIDER: S-EPMC7045005 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort.

Greene Giles G Gartner Andrea A Farewell Daniel D Trefan Lazlo L Davies Alisha R AR Davies Alisha R AR Bellis Mark A MA Paranjothy Shantini S

BMJ open 20200206 2

<h4>Objectives</h4>To assess whether the direction of movement along the social gradient was associated with changes in mental health status.<h4>Design</h4>Longitudinal record-linkage study using a multistate model.<h4>Setting</h4>Caerphilly, Wales, UK between 2001 and 2015.<h4>Participants</h4>The analytical sample included 10 892 (60.8% female) individuals aged 18-74 years.<h4>Primary and secondary outcome measures</h4>Deprivation change at lower super output area level using the 2008 Welsh In ...[more]

PMID: 32034021

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Project description:BackgroundPsoriasis and atopic eczema are common inflammatory skin diseases. Existing research has identified increased risks of common mental disorders (anxiety, depression) in people with eczema and psoriasis; however, explanations for the associations remain unclear. We aimed to establish the risk factors for mental illness in those with eczema or psoriasis and identify the population groups most at risk.MethodsWe used routinely collected data from the UK Clinical Practice Research Datalink (CPRD) GOLD. Adults registered with a general practice in CPRD (1997-2019) were eligible for inclusion. Individuals with eczema/psoriasis were matched (age, sex, practice) to up to five adults without eczema/psoriasis. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hazards of anxiety or depression in people with eczema/psoriasis compared to people without. We adjusted for known confounders (deprivation, asthma [eczema], psoriatic arthritis [psoriasis], Charlson comorbidity index, calendar period) and potential mediators (harmful alcohol use, body mass index [BMI], smoking status, and, in eczema only, sleep quality [insomnia diagnoses, specific sleep problem medications] and high-dose oral glucocorticoids).ResultsWe identified two cohorts with and without eczema (1,032,782, matched to 4,990,125 without), and with and without psoriasis (366,884, matched to 1,834,330 without). Sleep quality was imbalanced in the eczema cohorts, twice as many people with eczema had evidence of poor sleep at baseline than those without eczema, including over 20% of those with severe eczema. After adjusting for potential confounders and mediators, eczema and psoriasis were associated with anxiety (adjusted HR [95% CI]: eczema 1.14 [1.13-1.16], psoriasis 1.17 [1.15-1.19]) and depression (adjusted HR [95% CI]: eczema 1.11 [1.1-1.12], psoriasis 1.21 [1.19-1.22]). However, we found evidence that these increased hazards are unlikely to be constant over time and were especially high 1-year after study entry.ConclusionsAtopic eczema and psoriasis are associated with increased incidence of anxiety and depression in adults. These associations may be mediated through known modifiable risk factors, especially sleep quality in people with eczema. Our findings highlight potential opportunities for the prevention of anxiety and depression in people with eczema/psoriasis through treatment of modifiable risk factors and enhanced eczema/psoriasis management.

Dataset Information

Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusion

Publications

Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort.

Similar Datasets

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