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Understanding the impact of brain disorders: towards a horizontal epidemiology of psychosocial difficulties and their determinants

Understanding the impact of brain disorders: towards a horizontal epidemiology of psychosocial difficulties and their determinants
Understanding the impact of brain disorders: towards a horizontal epidemiology of psychosocial difficulties and their determinants
OBJECTIVE:

To test the hypothesis of 'horizontal epidemiology', i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders.

STUDY DESIGN:

A multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson's disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented.

SETTING:

The data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe.

RESULTS:

57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders.

CONCLUSION:

This is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.
1932-6203
e0136271-[24pp]
Cieza, Alarcos
a0df25c5-ee2c-4580-82b3-d0a75591580e
Anczewska, Marta
8aa77251-49fa-4915-9741-40e15fb0fac5
Ayuso-Mateos, Jose Luis
53dfd6e8-b1cb-4df9-abf6-d6cbac75ff17
Baker, Mary
2afdb6d8-6fa9-4948-8b12-506dfe94156e
Bickenbach, Jerome
3fd44204-4cfa-40b4-a459-71f436094fcc
Chatterji, Somnath
a285ff42-8a0c-4136-a89a-3f64f364b6ea
Hartley, Sally
35d0280f-935d-4d01-b095-a0c25d91d2c6
Leonardi, Matilde
0cb9e8e2-0a5e-483b-ace9-b5b8f7d6231e
Pitkänen, Tuuli
afe1a6bb-78c9-41ae-8df2-1ef3e86be120
Cieza, Alarcos
a0df25c5-ee2c-4580-82b3-d0a75591580e
Anczewska, Marta
8aa77251-49fa-4915-9741-40e15fb0fac5
Ayuso-Mateos, Jose Luis
53dfd6e8-b1cb-4df9-abf6-d6cbac75ff17
Baker, Mary
2afdb6d8-6fa9-4948-8b12-506dfe94156e
Bickenbach, Jerome
3fd44204-4cfa-40b4-a459-71f436094fcc
Chatterji, Somnath
a285ff42-8a0c-4136-a89a-3f64f364b6ea
Hartley, Sally
35d0280f-935d-4d01-b095-a0c25d91d2c6
Leonardi, Matilde
0cb9e8e2-0a5e-483b-ace9-b5b8f7d6231e
Pitkänen, Tuuli
afe1a6bb-78c9-41ae-8df2-1ef3e86be120

Cieza, Alarcos, Anczewska, Marta and Ayuso-Mateos, Jose Luis et al. (2015) Understanding the impact of brain disorders: towards a horizontal epidemiology of psychosocial difficulties and their determinants. PLoS ONE, 10 (9), e0136271-[24pp]. (doi:10.1371/journal.pone.0136271). (PMID:26352911)

Record type: Article

Abstract

OBJECTIVE:

To test the hypothesis of 'horizontal epidemiology', i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders.

STUDY DESIGN:

A multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson's disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented.

SETTING:

The data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe.

RESULTS:

57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders.

CONCLUSION:

This is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.

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Accepted/In Press date: 2 August 2015
e-pub ahead of print date: 9 September 2015
Published date: 9 September 2015
Organisations: Psychology

Identifiers

Local EPrints ID: 382870
URI: http://eprints.soton.ac.uk/id/eprint/382870
ISSN: 1932-6203
PURE UUID: 66562bb4-1f0b-4cc4-b22d-7c64f6007d9e

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Date deposited: 04 Nov 2015 10:22
Last modified: 14 Mar 2024 21:34

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Contributors

Author: Alarcos Cieza
Author: Marta Anczewska
Author: Jose Luis Ayuso-Mateos
Author: Mary Baker
Author: Jerome Bickenbach
Author: Somnath Chatterji
Author: Sally Hartley
Author: Matilde Leonardi
Author: Tuuli Pitkänen

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