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Biomedical subjects

P Bebbington

Publications and source records attributed to P Bebbington.

At least 19 recordsLinked to original sources
PubMed1992

The Dubai Community Psychiatric Survey: I. Prevalence and socio-demographic correlates.

This paper describes the methods and initial sociodemographic findings of the first community psychiatric survey from an Arabian country. It was carried out on a sample of women in Dubai, one of the seven United Arab Emirates. Psychiatric status was established using the PSE-ID-CATEGO system. The overall prevalence of disorder in these women was a high 22.7% (13.7% depressive disorders; 7% anxiety states). There was little association with sociodemographic variables, except that prevalence was high in divorced, widowed and separated women, polygamously married women and single parents. The high prevalence may be related to the rapid sociocultural change in this society. Future reports will examine the influence of sociocultural change at an individual level.

Adolescent↗
PubMed1990

Acculturation and psychiatric disorder: a study of Greek Cypriot immigrants.

Data are presented from a study of acculturation and psychiatric disorder in 291 Greek Cypriot immigrants from the general population of Camberwell, south London. We hypothesized that 'pre-acculturation' would protect against mental disorder, that difficulties in the period immediately after migration would increase the risk of disorder, and that disorder would be least common among those in the middle range of the acculturation spectrum. Of pre-acculturation factors, only previous knowledge of English was associated with reduced prevalence. Difficulties in the settling-in period were clearly related to current disorder. No relationship was apparent between present acculturation and disorder, but this disguised an interesting but unpredicted gender effect: in males, disorder was most prevalent in the highly acculturated; in females, in the least acculturated.

Acculturation↗
PubMed1990

A comparative study of psychiatric services in Japan and England.

Psychiatric services in Japan and England are compared using government statistics. In Japan, the number of in-patients per 100,000 population has increased from the 1950s, while that of England has decreased since 1954. Since 1972 the prevalence of in-patients has been higher in Japan than in England. The admission rate is lower in Japan than in England, and there are more long-stay patients. Most Japanese in-patients are admitted compulsorily, whereas most are admitted voluntarily in England. The attendance at out-patient clinics is higher in Japan than in England, but there are far fewer day-hospital places in Japan. Differing government policies are the main reason for these differences.

Adolescent↗
PubMed1989

The structure and validity of acculturation. Analysis of an acculturation scale.

This paper presents data from a study of acculturation in 291 Greek Cypriot immigrants from the general population of Camberwell, south London. Factor analysis was carried out, and factors were extracted using the maximum likelihood method and subjected to oblique rotation. The best solution was based on two highly correlated factors (0.64), which together explained 28% of the variance. The first factor appeared to represent Cultural Identification, the second, Language Mastery/Ethnocentricism. The construct validity of the factors was substantiated by analyses relating them to a range of other variables likely to be correlated with acculturation. Issues concerning the measurement of acculturation are discussed.

Acculturation↗
PubMed1989

The risk of minor depression before age 65: results from a community survey.

Data from a general population survey of psychiatric disorder in Camberwell were used to calculate the risk of a CATEGO-defined depressive episode before the age of 65, using a modification of Strömgren's method. Current depression was defined as cases within the relevant categories of the CATEGO program and at threshold level or above on the Index of Definition (Wing et al. 1978). A past history of depression was elicited using key symptoms such as persistent tearfulness and depressed mood, already enquired after in the course of the PSE, to identify potential episodes, followed by questions to determine accessory symptoms, duration, and degree of social impairment. Clinical judgement was then used to decide whether the disturbance constituted a significant depressive episode. Risk under one set of assumptions was 46% for men and 72% for women. Using another method based on (untenably) conservative assumptions, it became 16% and 30% respectively. The status and implications of these high values are discussed, particularly for genetic studies.

Adjustment Disorders↗
PubMed1989

Does the act of migration provoke psychiatric breakdown? A study of Greek Cypriot immigrants.

This article describes a community psychiatric survey of a random sample (n = 291) of Greek Cypriot immigrants living in London. Over three quarters of the immigrants were first generation. Information from the subject and from hospital case records were used to date previous episodes of psychiatric disorder. Datable episodes had occurred in 52 subjects. There was no evidence that the risk of breakdown was increased in the immediate aftermath of immigration. For 34 subjects who experienced their first illness after migration, the mean interval was 15 years. In only 9% did breakdown occur within 2 years of migration. The age-specific incidence of psychiatric disorder was the same as that seen in a native British sample. Although there were differences in the age of onset of first- and second-generation subjects, this was in the opposite direction to that expected if immigration appreciably provoked breakdown.

Acculturation↗
PubMed1989

Deinstitutionalisation--from hospital closure to service development.

The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.

Chronic Disease↗
PubMed1988

Expressed emotion research in schizophrenia: theoretical and clinical implications.

The expressed emotion (EE) measure is a robust predictor of relapse in schizophrenia. At least twelve studies from a range of cultures have now shown this, although the authors of one maintain their findings are the result of confounding factors. A thirteenth study which failed to demonstrate a predictive effect was seriously weakened by methodological defects. There is now also evidence for the construct validity of EE, which has been shown to reflect ongoing family interactions. High EE relatives display less effective coping responses, and may adversely affect the patient by creating an unpredictable environment. EE may change with time, and probably reflects the interaction of external stresses, the real problems with the patient, and inappropriate coping responses. The association of high EE with arousal in the patient, as indicated by skin conductance abnormalities, has now been replicated. Although the EE phenomenon can be subsumed under a vulnerability-stress model, the way in which it might mediate relapse has not as yet been specified. Interventions have been successful in reducing relapse, and do so by increasing the tolerance and coping skills of the relatives, and by establishing more realistic expectations. As most have also involved the patient in the process of treatment, they have not fully resolved the question of causal direction. Future studies will clarify these issues, but will not detract from the value that EE has already had in energizing research. It has also provided a framework within which clinicians have begun to recognize and deal with the disabling problems that beset schizophrenic patients and their families.

Emotions↗
PubMed1988

The Camberwell Collaborative Depression Study. II. Investigation of family members.

Out of a consecutive series of 130 potential probands with recent onsets of depression, 124 were deemed 'in scope' for a family interview study of social and genetic influences on depression. We were able to interview first-degree relatives of 83 probands (67% of those families 'in scope'). Unexpectedly, interviewed first-degree relatives had, on average, a significantly lower occupational status than the depressed probands. However, the rates of depression among the first-degree relatives were high. Based on a PSE-Catego classification, 17.2% of 244 relatives were current 'cases' of depression at the time of interview. This was significantly greater than the estimated population prevalence. Using a Past History Schedule in combination with the PSE, the lifetime prevalence of depressive illness, expressed as the proportion who had ever fulfilled PSE-Catego case criteria, was 38.9%. High rates of psychiatric treatment were also found in family members. The lifetime prevalence of any form of hospital treatment for depression in 315 first-degree relatives was 15.5%. This gives an age-corrected morbidity risk to age 65 years of 24.6%, as compared with a population estimate of 8.9%. In common with previous studies, significantly higher rates of depression were found among female than among male first-degree relatives for broader categories of disorder, but there was a small and nonsignificant excess of men among those relatives who had received in-patient treatment for depression. This apparent lessening of sex differences with more severe categories was not supported by an examination of 'lifetime ever' depressive symptoms, where severity was expressed as highest ever PSE-Catego-ID level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

The Camberwell Collaborative Depression Study. III. Depression and adversity in the relatives of depressed probands.

The relationship between life events and depressive disorder was assessed in 83 families ascertained through depressed probands. Contrary to expectation and to previous suggestions, we found no inverse relationship between the presence of familial loading and reactivity to stress. Thus the relatives of probands whose onset of depression followed life events or chronic difficulties had slightly higher lifetime rates of depression than the relatives of probands whose onset was not associated with adversity. There was only a weak and non-significant relationship between recent life events and current disorder among relatives, and no apparent tendency for life-event-associated depression to 'breed true' within families. Comparison with a community sample showed that the first-degree relatives of depressives had significantly elevated rates both of current depression and of recent threatening life events. This finding still held when proband-associated life events were discounted, suggesting that both liability to depression and propensity to experience life events are familial.

Age Factors↗
PubMed1987

A comparison between the Present State Examination and the Composite International Diagnostic Interview.

Item-by-item interrater agreement, CATEGO syndrome and class agreement, and agreement for Index of Definition were compared for the Present State Examination (PSE) and for the PSE items included in the Composite International Diagnostic Interview. Both interviews were given to 30 subjects representing a wide range of diagnoses, including hospitalized psychotic patients and outpatients with milder neurotic symptoms. Although agreement over individual questions was disappointing, when broader issues, such as syndrome classification, diagnostic class, and severity, were considered, agreement between interviews attained statistical significance.

Ambulatory Care↗
PubMed1987

Hazard, heredity and depression. A family study.

The relationship between proband characteristics and familial aggregation of depression was assessed in an interview study of 83 families ascertained via probands who had a recent onset of depression. Contrary to expectations and to previous reports in the literature there were no differences between the frequencies of depression in the first degree relatives of probands who had or had not experienced adversity prior to the onset of their illness. Depression was actually slightly more common among the first degree relatives of probands who had experienced a threatening life event compared with the relatives of those who had not. Early onset of depression (before 32 yr) and a neurotic pattern of symptoms in probands were associated with significantly higher rates of current illness in relatives. However, both these differences disappeared when lifetime prevalence or morbid risk to age 65 were considered. Indeed the morbid risk of severe depression in the relatives of endogenously depressed probands was nearly twice that in the relatives of neurotic probands.

Adjustment Disorders↗
PubMed1987

The buffer theory of social support--a review of the literature.

The buffer theory postulates that social support moderates the power of psychosocial adversity to precipitate episodes of illness. In this paper, we review the theory as applied to minor affective disturbances. Research in this area suffers because of the many disparate conceptualizations of social support and the resulting difficulty of deciding on the content of measures. Moreover, the meaning of the term buffering is itself unclear. These problems have not, however, inhibited research, and many cross-sectional and longitudinal studies have now been carried out. Our review leads to the conclusion that evidence for a buffering role of social support is inconsistent, reflecting methodological differences between studies but probably also indicating that buffering effects are not of dramatic proportions. Moreover, it is possible that the observed relationships are the result of spurious association or contamination of measures.

Adaptation, Psychological↗
PubMed1987

Marital status and depression: a study of English national admission statistics.

Data are presented from the English national statistics for first admissions with affective disorders during the years 1982-1985. Overall rates per 10(5) of the population aged over 15 years were 36.1 for men and 59.1 for women. The peak incidence for depressive neurosis was middle adulthood, that for affective psychosis much later. The widowed and divorced showed much higher rates than the single and married for all types of disorder. Marriage appeared less protective for women than for men. The age-incidence relationship among the divorced and widowed was exaggerated for depressive neurosis and reversed for psychosis. The results are interpreted in terms of a (possibly biological) releasing effect of age upon affective psychosis that could be overwhelmed by severely adverse social circumstances. The findings support the validity of the distinction between affective psychoses and depressive neurosis.

Age Factors↗
PubMed1987

Misery and beyond: the pursuit of disease theories of depression.

Psychiatric phenomena can usefully be studied by the establishment of syndromes which can then be used as the basis of investigations of aetiology, treatment and so on. The delineation of syndromes of affective illness has a long history. It implies a distinction from normal lowering of mood. This distinction has been related to the concepts of diathesis and disregulation. However, studies of psychosocial adversity have not been able to add greatly to the concept of affective illness. It is concluded that for it to be maintained that the distinction between simple distress and affective illness is useful, major aetiological differences must be demonstrated. It is likely that this can only be done through multidisciplinary studies.

Depression↗