[Associations between early-onset mental disorders and educational attainment in Belgium; a population study]. / Effect van vroege psychische stoornissen op opleidingsniveau in België; een bevolkingsstudie.

BACKGROUND: There is no sufficient knowledge on the association between early-onset mental disorders and subsequent school dropout on the level of the Belgian general population. AIM: To investigate the associations between early-onset mental disorders and subsequent school dropout. METHOD: As part of the European Study on the Epidemiology of Mental Disorders of the World Mental Health Surveys of the World Health Organization, a representative random sample of non-institutionalised Belgians aged 18 or older (n = 1,043) were interviewed between April 2001 and June 2002. With the Composite International Diagnostic Interview (version 3.0), respondents were assessed for the presence and age of onset of 15 dsm-iv mental disorders. Logistic regression analyses were performed in order to investigate the association between mental disorders and subsequent failure to complete elementary and/or secondary education, failure to proceed to tertiary education (when holding a secondary education leaving certificate) and failure to completion of tertiary education. RESULTS: Mood disorders were significantly associated with premature termination of secondary education (or = 2.4). Anxiety disorders (or = 2.0), drug abuse disorders (or = 11.2), and drug dependence disorders (or = 19.4) were significantly associated with failure to proceed to tertiary education. The cumulative proportion of early school terminations attributable to earlyonset mental disorders was estimated at 6.3%. CONCLUSION: Early-onset mental disorders have a considerable impact on school termination prior to completion in Belgium.

Pain and depression in older people: comorbidity and patterns of help seeking.

BACKGROUND: Chronic pain and mood disorders are common in older people. Their relationship however remains unclear. Only a few studies have investigated the role of pain in mental health service use and received psychopharmacological treatment. METHODS: Cross-sectional study of the 65+ subsample from the European Study on the Epidemiology of Mental Disorders (ESEMeD). 4401 non-institutionalized individuals were interviewed using the third version of the Composite International Diagnostic Interview (CIDI-3.0). RESULTS: Painful physical symptoms (PPS) were more likely in people with a 12-month major depressive episode (MDE) than in those without (OR=2.0). Help seeking for emotional problems was uncommon, but PPS were a significant predictor of help-seeking (OR=1.7). Respondents with MDE more frequently used benzodiazepines than antidepressants. The presence of PPS in respondents without depression resulted in a significant increase in the use of psychotropic medication. CONCLUSIONS: PPS were strongly and independently associated with major depressive disorder. Their presence had an influence on help seeking behavior and use of psychotropic medication. LIMITATIONS: The cross-sectional nature of this study does not allow determination of direction of causality.

[The epidemiology of depression in Belgium. A review and some reflections for the future]. / Het voorkomen van depressie in België. Stand van zaken en reflecties voor de toekomst.

BACKGROUND: Little is known on epidemiological aspects of depression in the Belgian general population, despite the fact that this disorder is known as a burdensome disorder. AIM: To present the results of a systematic literature search on the epidemiological aspects of depression in Belgium: prevalence, impact on daily life, and service use. METHOD: A systematic literature search was performed using 'epidemiology', 'prevalence' and 'depression', 'Belgium' in PubMed, PsychInfo, International Bibliography of the Social Sciences (IBSS), the (interactive) database of the National Health Survey and in so-called 'grey literature'. results Twenty two reports were included in the study. Depression is a common disorder that yields an enormous impact on daily life, on both work loss and suicidality. The proportion of persons seeking help was generally very low, with only 14% making a first treatment contact in the year of the disorder onset. Lifetime treatment rates were about 94%. CONCLUSION: Despite the high prevalence and significant impact of depression in daily life, delays between disorder onset and seeking help are impressive. Primary prevention of depression seems rather limited. Secondary preventative strategies may be focused on the delays in helpseeking.

[The prevalence of ADHD in the Belgian general adult population: an epidemiological explanatory study]. / ADHD in de Belgische volwassen bevolking; een epidemiologische exploratieve studie.

BACKGROUND: Despite growing interest in attention deficit and hyperactivity disorders (ADHD) in adults in Belgium, little is known about its prevalence in the Belgian general population. AIM: To estimate the prevalence of ADHD in adults (aged 18 to 44) in Belgium, to study its comorbidity with other mental disorders and its impact on daily living and to find out the extent to which professional help is sought. METHOD: A representative sample (n = 486) taken from the Belgian population was studied by means of an ADHD screening questionnaire which is included in the third version of the Composite International Diagnostic Interview. RESULTS: The prevalence of ADHD in adults in the Belgian population was estimated to be 4.1%. The disorder started in early childhood (median age 7 years) and developed fastest between the ages of 7 and 9. ADHD was comorbid with anxiety disorders (adjusted odds ratio: 7.5; 95% ci: 1.2-45.2) and alcohol-related disorders (adjusted odds ratio: 7.6; 95% ci: 1.1-52.5), and results in a suboptimal daily functioning on about 7.7 days a month. Only one person in five had sought professional help in the 12 month period prior to the screening test. CONCLUSION: This is the first study to estimate the prevalence of ADHD in adults in Belgium. ADHD is a relatively frequent disorder that starts early in life, and has a considerable impact on the way in which an individual functions in daily life. In spite of this, few persons with this disorder seek professional help.

[Prevention of psychiatric disorders and suicide in the Belgium population older than 60 years. Results of the European Study on Epidemiology of Mental Disorders (ESEMeD)]. / Het voorkomen van psychische stoornissen en suïcidaliteit in de Belgische bevolking ouder dan 60 jaar. Resultaten van de European Study on Epidemiology of Mental Disorders (ESEMeD).

PURPOSE: This study aimed to examine the 12-month and lifetime prevalence rates of pure and comorbid mental disorders (mood, anxiety and alcohol disorders) in Belgian home-dwelling elderly. METHODS: A representative random sample of 665 non-instutionalized older adults (60+) from Belgium was interviewed in 2000 and 2001. DSM-IV disorders were assessed by interviewers trained to use a revised version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) of the World Health Organization. RESULTS: Twenty percent of the respondents reported a lifetime history of at least one mental disorder; 5% met criteria for a a mental disorder in the past twelve months. Mood and anxiety disorders were the most common mental disorders. Almost 5% of the respondents reported suicidal ideation in their lifetime, while 0.22% had suicidal ideation in the past twelve months preceding the interview. CONCLUSIONS: Mental disorders are not uncommon in the Belgian home-dwelling elderly. The results of this study imply that in 2000-2001 at least five percent of the older adults living in the community had at least one mental disorder. Two in thousand older adults reported suicidal ideations in the 12 months preceding the interview.

[Psychotropic drug use in the Belgian non-institutionalized population]. / Consommation de médicaments psychotropes dans la population belge. Résultats de l'European Study of the Epidemiology of Mental Disorders (ESEMeD).

OBJECTIVE: To assess psychotropic drug utilization in the general population of Belgium, and the pattern of use in individuals with mental disorders. METHOD: A representative random sample of non-institutionalized inhabitants from Belgium aged 18 or older (n = 2419) were interviewed between April 2001 and June 2002. Individuals were asked about any psychotropic drug use in the past 12 months, even if they used the drug(s) just once. The interview took place by means of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI). RESULTS: Slightly more than 19% reported that they had used any psychotropic drug in the past 12 months; 11% had a 12-month mental disorder. The extent of psychotropic drug utilization varied according to the nature of the disorders: 60% in mood disorders, 53% in alcohol disorders, and 39% in anxiety disorders. Thirty nine percent of the respondents with a mood disorder consumed an antidepressant drug in the past year; 23% of the respondents with an anxiety disorder consumed an anxiolytic drug in the past 12 months. Among those who reported that they used antidepressants, selective serotonin reuptake inhibitors were most commonly consumed (SSRI). CONCLUSION: These data do not provide evidence for any over-consumption of psychopharmacological agents in Belgium. By contrast, they question the appropriateness of pharmacological treatments, in which under-treatment seems to be coupled with a high use of non-specific medications.

[The impact of mental disorders on daily functioning in the Belgian community. Results of the study "European Study on Epidemiology of Mental Disorders" (ESemeD)]. / Impact des troubles mentaux sur le fonctionnement quotidien de la population belge. Résultats de l'etude "European Study on Epidemiology of Mental Disorders" (ESemeD).

AIMS: This study reports the impact of mental disorders on daily functioning in the Belgian population. MATERIAL AND METHOD: A representative sample of 2419 non-institutionalised Belgian adults (18+) was interviewed between 2001 and 2002 using the Composite International Diagnostic Interview of the World Mental Health Surveys of the World Health Organisation (WMH-CIDI). Common mental disorders (mood, anxiety, and alcohol disorders--according to DSM-IV) and functional disabilities (according to the World Health Organization Disablement Assessment Scale--WHO-DAS-2) were assessed. RESULTS: Mood and anxiety disorders were associated with substantial levels of disability: social, emotional and physical domains were affected. Mood disorders were found to exert the largest impact in different domains of daily functioning, although the social life was most affected. Anxiety disorders were, on the contrary, more associated with emotional and physical discomfort. Persons with a alcohol disorder reported a substantially low impact on their daily functioning. CONCLUSIONS: Mental disorders affect several domains of daily functioning, with considerable limitations in personal and social life, but also with dramatic cutbacks in work productivity.

[Patterns of service use for mental health disorders in Belgium. Results of the European Study on Epidemiology of Mental Disorders (ESEMeD)]. / Recours au soins pour les troubles mentaux en Belgique. Résultats de la European Study on Epidemiology of Mental Disorders (ESEMeD).

OBJECTIVE: To describe patterns of service use for emotional reasons or mental health in adult, non-institutionalised Belgians. METHOD: A representative random sample of non-institutionalised inhabitants from Belgium aged 18 or older (N = 2419) were interviewed between April 2001 and June 2002. The interview was performed by lay interviewers using the most recent version of the Composite International Diagnostic Interview (CIDI-2000). Apart from assessing mental disorders, the participants were asked to report their formal health services utilization due to their emotions or mental health in the past 12 months. RESULTS: About 11% reported the presence of a mental disorder in the past 12 months, of which one in three consulted a formal health service. Persons with a mood disorder were most likely to seek help (43%), followed by those with anxiety (38%) or an alcohol disorder (17%). General practitioners were consulted most often, sometimes combined with a psychiatrist. Among those who sought help, the majority received pharmacological treatment (sometimes combined with psychological treatment), and up to 25% did not receive any treatment. CONCLUSION: The utilization of formal health services for emotional raisons or mental health is very limited in Belgium. Moreover, a considerable proportion of those who sought help, did not get an appropriate treatment.

[Prevalence of pure and comorbid mental disorders in Belgium]. / Prévalence des troubles mentaux dans la population Belge. Résultats de l'European Study on Epidemiology of Mental Disorders (ESEMeD).

OBJECTIVE: To describe the 12-month and lifetime prevalence rates of pure and comorbid mental disorders in Belgium. METHOD: A representative random sample of non-institutionalized inhabitants from Belgium aged 18 or older (N = 2419) was interviewed between April 2001 and June 2002. DSM-IV disorders were assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview (CIDI-2000). RESULTS: More than 27% reported a lifetime history of at least one mental disorder; one in nine reported the presence of a mental disorder in the past 12 months. Major depressive disorder (MDD) and alcohol abuse were the most common lifetime disorders; MDD and specific phobia were most common in the past 12 months. Psychiatric comorbidity was also a common condition. CONCLUSION: Psychiatric disorders in Belgium are frequent. More than two million Belgians have had a mental disorders at a certain moment in their life; more than 800,000 have had a mental disorder in the past 12 months.