Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a ‘Horizontal Epidemiology’ Approach

PLOS ONE, Dec 2019

Background Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders. Methods Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson’s disease. Random forest regression and classical linear regression were used in the analyses. Results 722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family. Conclusions The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24.

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Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a ‘Horizontal Epidemiology’ Approach

December Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a 'Horizontal Epidemiology' Approach Carla Sabariego 0 1 2 3 Michaela Coenen 0 1 2 3 Carolina Ballert 0 1 2 3 Maria Cabello 0 1 2 3 Matilde Leonardi 0 1 2 3 Marta Anczewska 0 1 2 3 Tuuli Pitkänen 0 1 2 3 Alberto Raggi 0 1 2 3 Blanca Mellor 0 1 2 3 Venusia Covelli 0 1 2 3 Piotr Świtaj 0 1 2 3 Jonna Levola 0 1 2 3 Silvia Schiavolin 0 1 2 3 Anna Chrostek 0 1 2 3 Jerome Bickenbach 0 1 2 3 Somnath Chatterji 0 1 2 3 Alarcos Cieza 0 1 2 3 0 Data Availability Statement: Due to ethical restrictions imposed by Järvenpää Addiction Hospital, one of the partner institutions of the PARADISE consortium of which the authors are a part, data are available upon request to Dr. Alarcos Cieza at a 1 Editor: Xuchu Weng, Zhejiang Key Laborotory for Research in Assesment of Cognitive Impairments , CHINA 2 1 Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich , Munich, Germany, 2 Swiss Paraplegic Research, Nottwil , Switzerland , 3 Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Madrid , Spain , 4 Department of Psychiatry, Universidad Autónoma de Madrid , Madrid, Spain, 5 Neurology , Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation , Milan , Italy , 6 Department of Psychiatry, Institute of Psychiatry and Neurology , Warsaw , Poland , 7 A-Clinic Foundation , Helsinki , Finland , 8 Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare , Helsinki , Finland , 9 Division of Neurosurgery II, Neurological Institute Carlos Besta (IRCCS) Foundation , Milan , Italy , 10 Department of Measurement and Health Information Systems, Multi-Country Studies, World Health Organization , Geneva , Switzerland , 11 Faculty of Social and Human Sciences, School of Psychology, University of Southampton , Southampton , United Kingdom 3 Funding: The PARADISE project is supported by the Coordination Theme 1 (Health) of the European Community's FP7 , Grant Agreement No. HEALTH- F2-2009-241572 - OPEN ACCESS Background Methods in the analyses. Results 722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, Competing Interests: The authors have declared that no competing interests exist. personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family. Conclusions The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24. Introduction Brain disorders, such as dementia, stroke, Parkinson’s Disease (PD), depression and schizophrenia, are mostly chronic neurological or psychiatric disorders of long duration which exert a high degree of burden on daily life. Affected persons often react with distress when receiving the diagnosis, have difficulties living with the illness, are often forced to dramatically change their lifestyles and are at risk of being stigmatised [ 1 ]. Persons with brain disorders also experience significant psychosocial difficulties (PSD), ranging from problems with attention and memory, emotional lability and listlessness to problems with managing their daily routines, problems interacting with significant others and difficulties at work [ 2–6 ]. The severity of these PSDs depends on many factors in the close and extended environments, including social, physical and political environments. This understanding coincides with the biopsychosocial model proposed in the International Classification of Functioning, Disability and Health (ICF) (Fig 1), where functioning is defined as a continuum encompassing body functions and structures and activities and participation and determined by interactions between health conditions and contextual factors (environmental and personal factors) [ 7, 8 ]. According to the ICF model, PSDs have recently been specifically defined as impairments in mental functions and body functions under nervous-system control, activity limitations and participation restrictions resulting from interactions among the brain disorder, the environment and personal factors [9]. In this sense, living in the countryside, the availability of adequate treatment, having a supportive work e (...truncated)


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Carla Sabariego, Michaela Coenen, Carolina Ballert, Maria Cabello, Matilde Leonardi, Marta Anczewska, Tuuli Pitkänen, Alberto Raggi, Blanca Mellor, Venusia Covelli, Piotr Świtaj, Jonna Levola, Silvia Schiavolin, Anna Chrostek, Jerome Bickenbach, Somnath Chatterji, Alarcos Cieza. Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a ‘Horizontal Epidemiology’ Approach, PLOS ONE, 2015, 12, DOI: 10.1371/journal.pone.0141322