Validation of self-rated mental health.
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This article assesses the association between self-rated mental health and selected World Mental Health-Composite International Diagnostic Interview (WMH-CIDI)-measured disorders, self-reported diagnoses of mental disorders, and psychological distress in the Canadian population.Data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being. Weighted frequencies and cross-tabulations were used to estimate the prevalence of each mental morbidity measure and self-rated mental health by selected characteristics. Mean self-rated mental health scores were calculated for each mental morbidity measure. The association between self-rated mental health and each mental morbidity measure was analysed with logistic regression models.In 2002, an estimated 1.7 million Canadians aged 15 or older (7%) rated their mental health as fair or poor. Respondents classified with mental morbidity consistently reported lower mean self-rated mental health (SRMH) and had significantly higher odds of reporting fair/poor mental health than did those not classified with mental morbidity. Gradients in mean SRMH scores and odds of reporting fair/poor mental health by recency of WMH-CIDI-measured mental disorders were apparent. A sizeable percentage of respondents classified as having a mental morbidity did not perceive their mental health as fair/poor.Although self-rated mental health is not a substitute for specific mental health measures it is potentially useful for monitoring general mental health.Keywords:
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This study compared the associations of individual mental health disorders, self-rated mental health, disability, and perceived need for care with the use of outpatient mental health services in the United States and the Canadian province of Ontario.A cross-sectional study design was employed. Data came from the 1990 US National Comorbidity Survey and the 1990 Mental Health Supplement to the Ontario Health Survey.The odds of receiving any medical or psychiatric specialty services were as follows: for persons with any affective disorder, 3.1 in the United States vs 11.0 in Ontario; for persons with fair or poor self-rated mental health, 2.7 in the United States vs 5.0 in Ontario; for persons with mental health-related disability. 3.0 in the United States vs 1.5 in Ontario. When perceived need was controlled for, most of the between country differences in use disappeared.The higher use of mental health services in the United States than in Ontario is mostly explained by the combination of a higher prevalence of mental morbidity and a higher prevalence of perceived need for care among persons with low mental morbidity in the United States.
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Abstract The widely‐used Kessler K6 non‐specific distress scale screens for severe mental illness defined as a K6 score ≥ 13, estimated to afflict about 6% of US adults. The K6, as currently used, fails to capture individuals struggling with more moderate mental distress that nonetheless warrants mental health intervention. The current study determined a cutoff criterion on the K6 scale indicative of moderate mental distress based on mental health treatment need and assessed the validity of this criterion by comparing participants with identified moderate and severe mental distress on relevant clinical, impairment, and risk behavior measures. Data were analyzed from 50,880 adult participants in the 2007 California Health Interview Survey. Receiver operating characteristic curve analysis identified K6 ≥ 5 as the optimal lower threshold cut‐point indicative of moderate mental distress. Based on the K6, 8.6% of California adults had serious mental distress and another 27.9% had moderate mental distress. Correlates of moderate and serious mental distress were similar. Respondents with moderate mental distress had rates of mental health care utilization, impairment, substance use and other risks lower than respondents with serious mental distress and greater than respondents with none/low mental distress. The findings support expanded use and analysis of the K6 scale in quantifying and examining correlates of mental distress at a moderate, yet still clinically relevant, level. Copyright © 2012 John Wiley & Sons, Ltd.
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Objective: The study examined the association of self-rated mental health (SRMH) with three measures of depressive symptoms (the short form CES-D, GDS-SF, and PHQ-9) in Korean American older adults. Method: The sample consisted of 420 community-dwelling Korean American older adults (M age = 71.6, SD = 7.59) in the New York City metropolitan area. Hierarchical regression models of SRMH were estimated with an array of predictors: (a) sociodemographic characteristics, (b) physical health-related variables, and (c) each of the three depressive symptom measures. Results: The three measures of depressive symptoms were interrelated, and each of them made a significant contribution to the multivariate models of SRMH. The amount of variance explained by the short-form CES-D, GDS-SF, and PHQ-9 was 11%, 10%, and 16%, respectively. Conclusion: Findings show a moderately strong linkage between the measures of depressive symptoms and SRMH and invite further research on SRMH in diverse populations.
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Abstract This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH‐CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio‐demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12‐month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer‐assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper‐and‐pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD‐10 and DSM‐IV criteria. Elaborate CD‐ROM‐based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection. Copyright © 2004 Whurr Publishers Ltd.
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OBJECTIVES: To determine whether the association between self‐rated health (SRH) and 4‐year mortality differs between black and white Americans and whether education affects this relationship. DESIGN: Prospective cohort. SETTING: Communities in the United States. PARTICIPANTS: Sixteen thousand four hundred thirty‐two subjects (14,004 white, 2,428 black) enrolled in the 1998 wave of the Health and Retirement Study (HRS), a population‐based study of community‐dwelling U.S. adults aged 50 and older. MEASUREMENTS: Subjects were asked to self‐identify their race and their overall health by answering the question, “Would you say your health is excellent, very good, good, fair, or poor?” Death was determined according to the National Death Index. RESULTS: SRH is a much stronger predictor of mortality in whites than blacks ( c ‐statistic 0.71 vs 0.62). In whites, poor SRH resulted in a markedly higher risk of mortality than excellent SRH (odds ratio (OR)=10.4, 95% confidence interval (CI)=8.0–13.6). In blacks, poor RSH resulted in a much smaller increased risk of mortality (OR=2.9, 95% CI=1.5–5.5). SRH was a stronger predictor of death in white and black subjects with higher levels of education, but differences in education could not account for the observed race differences in the prognostic effect of SRH. CONCLUSION: This population‐based study found that the relationship between SRH and mortality is stronger in white Americans and in subjects with higher levels of education. Because the association between SRH and mortality appears weakest in traditionally disadvantaged groups, SRH may not be the best measure to identify vulnerable older subjects.
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