Primary school teachers in Québec suffer psychological distress, as shown by the Québec Health Survey (M. Gervais, 1993; Santè Québec, 1995). The authors applied and extended the French model (F. Guérin, A. Laville, F. Daniellou, J. Duraffourg, & A. Kerguelen, 1991) of analysis of work activity to observing classroom teaching (14 women in 10 classrooms for a total of 48 hr 24 min) to identify stressful elements. The authors observed a rapid sequence of actions, eye fixations of short duration, little physical or mental relaxation, multiple simultaneous activities, and uncomfortable temperature and humidity levels. Teachers use many strategies to teach, to create a learning environment, and to maintain attention in classrooms under adverse conditions. Examination of these strategies led to recommendations to improve relations between the teachers and their supervisors and to make the classroom an easier place to teach.
This article presents descriptive statistics on the 66 suicides occurring in federal institutions in Canada over a 4-year period. Criminological and institutional factors of those who committed suicide included lengthy involvement in the criminal justice system, a greater likelihood of being incarcerated for robbery or murder, and involvement in institutional incidents of a serious nature. In addition, 62% of the inmates who committed suicide had been transferred from other institutions within 6 months prior to suicide, though 59% evidenced no indicators of suicidal intent and 44% were not considered to be depressed at the time of suicide. Family problems (29%) were the most commonly hypothesized motivating factor in the suicides, followed by denial of a request for appeal, parole, or transfer (26%), fear of other inmates (24%), and substance abuse problems (21%). Current and planned suicide prevention and intervention strategies of the Correctional Service of Canada are discussed in the context of these findings.
There is rapid technological transformation occurring in both work and social life. The results of information technology, such as mobile telephones, computers, and electronic networks, have been looked upon as the key to solving several of the most pressing problems of the Western world. At the same time, numerous studies have shown that the great majority of computerization projects fail to meet their deadlines with the originally specified functionality mainly because human factors are not sufficiently taken into account during the planning and implementation phase of the project. In a study of the bodily, mental, and psychophysiological reactions of employees involved in the design of advanced telecommunications systems and of office employees using regular video display technology, several stress-related psychosomatic disorders have been identified. They include sleep disturbances, psychophysiological stress and somatic complaints. Controlled intervention programs aimed at enhancing organizational structures and individual coping strategies have been proved effective in counteracting the negative effects of working with information technology. The two-way interaction between the external information technology environment and bodily and mental reactions needs to be taken more into account in the design and use of modern information technology. There appears to be an increased awareness of human aspects when the risks and benefits of the rapid spread of information technologies are discussed.
The examined groups included 175 children whose fathers were alcoholics and 73 individuals from nonalcoholic parents. The study group was divided by age into children from infantile age to 15 years and 16-28-year-olds. The wide range of psychopathologic disorders were revealed in children up to 15 years of age: syndrome of hyperactivity, neurotic disturbances, mental retardation, epileptic-like syndrome. Alcoholism was found in sons only (3.77%). Mental disorders were revealed significantly more frequently in sons of alcoholic fathers than in their daughters. Their incidence increased with the age of the sons. The disturbances occurred significantly more frequently in the test group as compared with the control one (19 and 6.38%, respective by). In the older group (16-28-year-olds) the spectrum of mental disorders consisted of alcoholism, mental retardation, psychopathic-like and neurotic disorders. Alcoholism occurred most frequent and its rate depended on the age and sex. Frequency of alcoholism was 66.7% in sons aged 21-28 years and 15.38% in daughters of the same age. The conclusion was made about multiple risk for children of alcoholic fathers. More vulnerable contingent was the sons for which the risk of alcoholism was very high.
The CIDI Short Form is a brief survey instrument designed to identify episodes of major depression. The instrument was developed for inclusion in the US National Health Interview Survey, but has also been used in the Canadian National Population Health Survey (NPHS). In this study, data deriving from use of the CIDI Short Form in the NPHS are compared to published data from the Mental Health Supplement of the Ontario Health Survey, which utilized a fully validated structured interview: the Composite International Diagnostic Interview (CIDI). In an additional analysis, the sensitivity and specificity of the Short Form were evaluated in relation to the full CIDI mood disorders section in a clinical sample of 122 psychiatric in-patients. Relative to published data from the Ontario Health Survey, application of the CIDI Short Form in the NPHS resulted in an overestimation of major depression prevalence by approximately 50%. In the clinical sample, the CIDI Short Form was highly sensitive (98.4%), but not highly specific (72.7%). Active medical conditions, substance use disorders and dysthymia were frequently observed among subjects with false positive CIDI Short Form ratings. The CIDI Short Form appears to overestimate the 12-month period prevalence of major depression when it is applied in community samples. Since the Short Form does not make exclusions for organically induced symptoms, it is probable that some subjects with depressive symptoms secondary to physical illnesses and/or drug exposures score above the instrument's threshold, perhaps leading to an elevation in period prevalence rates.
Mental health was examined in two representative selections of urban adolescents of 15-17 years old: with nondelinquent (n = 624) and delinquent (n = 106) behaviour. The complex of sociomedical, psychological, sociological and statistic methods was applied. High frequency of mental pathology as well as a low level of mental health were revealed in the groups examined, especially in delinquent adolescents. There were determined some differences between the groups in frequencies of separate forms of mental disorders. In nondelinquent adolescents there were most frequently observed borderline mental disorders of subclinical level as well as neuroses; there weren't observed the states of borderline intellectual insufficiency in such individuals. Pathocharacterological personal development, alcoholism, neurotic- and psychopathic-like disorders were more frequently observed in delinquent teenagers. There was determined the leading role of personal psychological behavioral factors in development of considerable mental disorders in adolescents.
The mental health funding cuts and the block grant shift of the last decade have placed an increased emphasis on fee-generating services. In already underserved rural areas, this has generated immense challenges for mental health professionals on how to provide services to persons other than those with chronic mental illness. This chapter has discussed alternatives and innovations that have proven successful. Linkages with primary care physicians and indigenous residents who have been trained to provide basic mental health services under the supervision of mental health professionals are just two of the ways in which mental health professionals have risen to meet the challenges placed before them. A review of the literature produced few articles about rural programs addressing the issues of substance abuse, services to women, children, the elderly, those with severe mental illness or developmental disability, and the homeless, or crisis intervention programs. Much work needs to be done to provide adequate services to these special rural populations. It is hoped that the renewed interest in rural areas generated by the farm crisis will produce additional programs addressing the needs of these often underserved populations.
This study was designed to explain changes in work ability through occupational and life-style factors.
Work ability was measured by an index describing workers' health resources in regard to their work demands. The work factors mainly included physical and mental demands, social organization and the physical work environment. The life-style factors covered smoking, alcohol consumption, and leisure-time physical exercise. The first questionnaire study was done in 1981 and it was repeated in 1992. The subjects (N = 818) were workers in the 44- to 51-year-old age group in the beginning of the study who were active during the entire follow-up. The improvement and, correspondingly, the decline in work ability were analyzed by logistic regression models.
Both the improvement and the decline in work ability were associated more strongly with changes in work and life-style during the follow-up than with their initial variation. The model for improved work ability included improvement of the supervisor's attitude, decreased repetitive movements at work, and increased amount of vigorous leisure-time physical exercise. Deterioration in work ability was explained by a model which included a decrease in recognition and esteem at work, decrease in workroom conditions, increase in standing at work, and decrease in vigorous leisure-time physical exercise.
Social relations at work can promote or impair the work ability of elderly workers. Although the work ability of elderly workers generally declined with aging, both older and younger workers were also able to improve their work ability.
Changes in the work ability of active employees were followed over a period of 11 years.
Men and women in the same occupation (N = 818) in 1981-1992 assessed their work ability according to an index on current work ability, physical and mental work demands, diagnosed diseases, work impairment from disease, sickness absence, work ability prognosis, and psychological resources. Their mean initial age was 46.9 (range 44-51) years. The means and standard deviations of the work ability index and the prevalence rates of 4 work ability categories were followed with respect to age, gender, and job content.
The mean work ability index declined significantly in 11 years for both genders. Its association with age and work was strong. Age of > or = 51 years and physical work load were critical factors affecting the work ability of both genders. At the mean age of 58 years, at least 25% of the installation, auxiliary, or transport workers had a poor work ability rating, as did the women doing kitchen supervision, auxiliary, and home care work. The annual rate of decline in work ability was highest for women aged 51 years at the onset of the study. Female teachers showed a less dramatic decline in work ability than male teachers.
Work does not seem to prevent a decline in the work ability of men and women as they age. Therefore, measures to promote work ability should be started before the age of 51 years, especially for workers in physically demanding jobs.
This study evaluated perceived changes in stress symptoms and the relationship of these changes to work during an 11-year period.
The sample consisted of municipal workers in different occupational groups who had remained in the same occupation during 1981-1992 (N = 924, 350 men and 574 women, 14.8% of the original sample in 1981). The age range was 44-51 years in 1981. Changes in the physical and mental stress symptoms and changes at work were analyzed with the aid of a structured questionnaire in 1981 and 1992.
The questionnaire surveys revealed that stress symptoms were markedly increased, especially aches and pain in the upper and lower limbs, but also respiratory and cardiovascular symptoms. Avoidance reactions, including sense of apathy in general and desire to stay at home in the morning, were the most increased psychological symptoms. The women experienced a greater increase in symptoms than the men. Changes in symptoms were associated with changes at work in that, in general, the more symptoms had increased, the more the work had also been changed.
The results suggest that the impact of work on the functional capacity and symptoms of workers might start even earlier than the age of 45 years. This finding is of crucial importance when preventive measures and policies are being planned in regard to stress and physical and mental load at work. Results on the relationship of changes in cardiorespiratory symptoms and work tentatively suggest that, by developing job content and social support, even a positive impact on physical symptoms is possible.
Perceived changes in mental and physical work demands and work content were evaluated longitudinally.
Municipal workers (N = 924) in the same job from 1981 (mean age 47 years) to 1992 (mean age 58 years) in the work content groups of mental, mixed mental and physical, or physical work responded to a questionnaire in both 1981 and 1992.
The workers reported that the physical and mental demands of their jobs had mainly increased from 1981 to 1992, especially muscular work and use of knowledge. In 1992 the women still perceived higher physical demands than the men but felt they had greater possibilities to develop. The use of knowledge had increased, especially among the women, and was on the same level for both genders. The perception of changes differed in the 3 work content groups.
Perceived work demands increase with age. Although the 3 work content categories differ somewhat as to perceived changes over time, in general, the changes may be more connected to personal factors than work factors. Older persons seem to work at a relatively higher capacity than younger workers, and this higher work load may be a risk factor for early work disability. Work demands and stress factors should therefore be surveyed and balanced according to the capacity of the aging worker. On the other hand, workers' perception of possibilities to develop seem to increase with age. The differences between men and women may especially diminish at a later age.
Data collected through the Canadian Study of Health and Aging were analyzed to estimate the reliability of the Modified Mini-Mental State (3MS) Examination when used in the context of a two-phase community prevalence study. During the screening phase of the study, subjects were tested in their home by a lay interviewer, either in English or French. All subjects scoring 77 or under on the 3MS and a sub-sample of those scoring over 77 were reassessed by a nurse during a clinical examination, following which subjects were classified as normal, cognitively impaired but not demented, or demented. Results indicate substantial reproducibility of the 3MS, slightly higher than that of the Mini-Mental State Examination from which it is derived. The english versions of these tests appear slightly more reproducible than their French counterparts.
233 patients (53 men and 180 women) at the age of 60 years and older were treated in day gerontopsychiatric out-patient clinic for 5 years. 60-69 year old patients prevailed (146 individuals). Nearly all mental diseases characteristic for the old age were found in such patients; majority of patients suffered from schizophrenia (31.3%) and affective pathology (25.8%). Vascular form of dementia prevailed among the patients with dementia while atrophic degenerative dementia was rarely observed (2 patients). Syndromological distribution revealed that the main groups were formed by patients with depressions (41.6%) as well as individuals with neurosis- and psychopathic-like conditions (37.3%). Mental disorders with paranoid syndromes were observed in 8.6% of the patients. It is shown that day gerontopsychiatric out-patient clinic had some preferences in comparison with usual mental hospitals and psychoneurological out-patient clinic.
Epidemiology study of patients in primary care settings has shown prevalence of borderline mental disorders (41.58 per 1000 population) in comparison with patients of psychiatric outpatient clinic (11.4 per 1000). The question arises were those undetected by psychiatric out-patient clinics (those who didn't visit psychiatrist for individual reasons) or they represented another contingent. Comparative analysis of groups standardized on nosological, syndromal and educational levels revealed that there were various contingents of patients. The main difference was determined by different duration of disease before the first visit to psychiatrist, that reflected various severity of the disease (less severity of the disease was observed in patients of primary care institutions).
A stratified random sample of 750 males in Calgary, Canada, aged 18-27 years, were given questions on sexual activity and orientation. Mental health questions included a measure of suicidality and of acts of deliberate self-harm. A computerized response format, which has been established as a good method for eliciting sensitive personal data, ensured anonymity. Almost 13% of the males were classified as homosexual or bisexual on the basis of being currently homosexually active or by self-identification. Significantly higher rates of previous suicidal ideas and actions were reported by homosexually oriented males than by heterosexual males. Homosexually oriented males accounted for 62.5% of suicide attempters. These findings, which indicate that homosexual and bisexual males are 13.9 times more at risk for a serious suicide attempt, are consonant with previous findings. The predominant reason for the suicidality of these young males may be linked to the process of "coming out," especially for those who currently have high levels of depression. These results underscore the need for qualified services rarely available to homosexually oriented youth.
The aim of the present study was to investigate the relationships between personality disorders (PD) and various psychosocial factors in a random sample (n = 229) of suicides with psychological autopsy-based DSM-III-R diagnoses representing the total 1-year suicide population in Finland. Background social factors and social interaction factors for 56 suicide victims with a PD diagnosis were compared with those of 56 age- and sex-matched non-PD diagnosis victims. The groups were similar with regard to marital status, socio-economic status, parental divorce, broken home before the age of 16 years, parental suicide attempts, and proportion of subjects living with parents. The PD suicide victims had more commonly had a companion of the opposite sex, lived alone, and resided in an urban area, but had less often experienced parental psychiatric hospitalization during their childhood. Although the groups did not differ with regard to complaints of loneliness before suicide, the lonely PD suicide victims had experienced more interpersonal loss and/or conflict than the lonely non-PD suicide victims. The PD suicide victims were very similar with regard to psychosocial factors, irrespective of sex, age, Axis-I comorbidity, or the cluster type of the PD. Only living alone was more common in young PD suicide victims, and male PD subjects had less often had confidants or friends with whom they shared common interests.
This study examines whether cognitive markers at prior examinations are indicative of subsequent dementia and mortality. The sample was composed of subjects aged 84-90 at baseline who were reexamined three times over a 6-year period on a comprehensive biobehavioral battery. Dementia was evaluated at each examination using DSM-III-R criteria. Results indicated that incident cases of dementia had lower cognitive scores both 2 and 4 years prior to diagnosis, compared to non-demented survivors. Evidence for terminal decline was also found, as people who subsequently died also had lower cognitive performance at prior examinations, compared to non-demented survivors. The findings suggest that mild cognitive dysfunction is an important clinical finding among the oldest old and may herald either the onset of dementia or mortality.