Suzanne Brownhill

Prevalence and correlates of DSM-IV major depression in an Australian national survey

BACKGROUND Community surveys have reported prevalence of depressive disorders in adult populations since the 1970s. Until recently, no epidemiological studies of the same magnitude have been conducted to provide a profile of the adult population in Australia. This study examines the current (30-day) prevalence and correlates of major depression in the adult Australian population using data from the National Survey of Mental Health and Well-being, and compares the results with other national studies. METHODS Data were derived from a national sample of 10,641 people 18-75+ years of age surveyed using the computerised version of the Composite International Diagnostic Interview Version 2.1. RESULTS The overall weighted prevalence of current (30-day) major depression was 3.2% with the highest rate (5.2%) being found in females in mid life. This rate is between those of the USA National Comorbidity Survey and the Epidemiological Catchment Area study, and similar to the British Psychiatric Morbidity Survey. The strongest correlates for reported current major depression include being unemployed, smoking, having a medical condition, followed by being in mid life, previously married, and female. Living with a partner and drinking 1 to 2 glasses of alcohol per day were least correlated. Some correlates of major depression relate to social disadvantage and lifestyle issues. LIMITATIONS The study design does not allow definition of direction of causality. CONCLUSION Lowering the prevalence rate of major depression will require close attention to public health approaches to address the relationships between smoking, social isolation, poor health, mood and physical well-being. The best focus for this approach may be primary care settings.

Gender differences in depression risk and coping factors in a clinical sample

Objective: To examine gender differences in depression risk and coping factors in a clinical sample of patients with a diagnosis of DSM‐IV major depression.

Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study.

Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of “trust” and “try and see” provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.

Participant perceptions of a community-based lifestyle intervention: The CHIP

ISSUE ADDRESSED The Coronary Health Improvement Project (CHIP) is a community-based educational initiative designed to improve cardiovascular fitness and other health indicators associated with common, lifestyle-related health disorders in developed societies. Evaluations of the CHIP since the late 1990s, though yielding positive statistical results for change in participant physical health indicators, have not included qualitative assessments of the CHIP experience from the perspectives of CHIP participants. METHODS Data were obtained using a mixed methods survey design via a questionnaire completed by 79 respondents (71% female) who had participated in Australian CHIP programs. Responses were analysed using descriptive statistics and thematic analysis. RESULTS Participants commonly undertook the CHIP to fulfil their lifestyle and health aspirations and to target specific health conditions. Improved diet, enhanced exercise and weight loss were the most commonly reported benefits. Participation in the CHIP involves a process of conviction (involving risks and motivation), connection (involving support and reinforcement), challenge (involving control and struggle) and change (involving more and less). CONCLUSION This study offers a model of a change process generated from the perspectives of participants of the CHIP in Australia. Not all participants found CHIP lifestyle recommendations straightforward to adopt, as some encountered resistance from within themselves or from family and friends.