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      Predictors of high and low mental well-being and common mental disorders: findings from a Danish population-based study

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          Abstract

          Background

          Mental well-being is fundamental for a good life. Previous literature has examined the predictors of mental disorders and continuous measures of positive mental health. Very few studies have specifically focused on the predictors of different levels of mental well-being, but those that have suggest a different picture. This study aimed to compare socioeconomic and relational/recreational behaviour predictors of different levels of mental well-being as well as common mental disorders (CMDs).

          Methods

          Data from 3508 adults aged 16+ years old from the Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale, and information on CMDs was assessed using the Patient Health Questionnaire (PHQ-4). Regression analyses were conducted to estimate the predictors of low and high mental well-being compared to moderate mental well-being and also of CMDs.

          Results

          Lower socioeconomic position (education, income and employment status) was associated with increased odds of low mental well-being and the presence of CMDs, but did not significantly predict high mental well-being. Relational/recreational behaviours (informal and formal social participation, social support and recreational activity) were associated with reduced odds of low mental well-being and CMDs, and also with increased odds of high mental well-being.

          Conclusions

          Socioeconomic predictors of high mental well-being do not mirror those of low mental well-being and CMDs, whereas relational/recreational predictors of high mental well-being do mirror those of low mental well-being and CMDs. These findings have important implications for public mental health strategies.

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          Most cited references15

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          The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.

          Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. Copyright 2010. Published by Elsevier Inc.
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            Preventive strategies for mental health

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              Leading a meaningful life at older ages and its relationship with social engagement, prosperity, health, biology, and time use

              Significance Ratings of the meaningfulness of life have been adopted in UK national surveys and are advocated internationally. This study demonstrates the value of a simple rating of the extent to which people feel that the things they do in life are worthwhile, by documenting positive associations with social relationships and broader social engagement, economic prosperity, mental and physical health, biomarkers, health-related behaviors, and time use. These associations were observed both cross-sectionally and longitudinally, suggesting that feeling life is worthwhile contributes to subsequent well-being and human flourishing at older ages. Given the widely recognized policy importance of promoting subjective well-being at older ages, a wider adoption of worthwhile ratings in large-scale surveys would provide valuable policy-relevant evidence internationally.
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                Author and article information

                Journal
                Eur J Public Health
                Eur J Public Health
                eurpub
                The European Journal of Public Health
                Oxford University Press
                1101-1262
                1464-360X
                June 2020
                27 February 2020
                27 February 2020
                : 30
                : 3
                : 532-538
                Affiliations
                [c1 ] The National Institute of Public Health, University of Southern Denmark , Copenhagen, Denmark
                [c2 ] University of Southern Denmark , Odense, Denmark
                [c3 ] Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM , Barcelona, Spain
                [c4 ] ICREA , Barcelona, Spain
                [c5 ]Division of Health Sciences, Warwick Medical School, University of Warwick , Coventry, UK
                Author notes
                Correspondence: Don Ziggi Ivan Santini, The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark, Tel: +45 65507723, e-mail: ziggi.santini@ 123456gmail.com
                Article
                ckaa021
                10.1093/eurpub/ckaa021
                7292340
                32104898
                9b2d8659-02a6-42e2-b3c8-ca110b5fe8d4
                © The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 7
                Categories
                Mental Health

                Public health
                Public health

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