R. Graaf - Academia.edu (original) (raw)

Papers by R. Graaf

Research paper thumbnail of Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Acta psychiatrica Scandinavica, 2004

Data on the temporal relationships between duration of depression and recovery and functional dis... more Data on the temporal relationships between duration of depression and recovery and functional disability are sparse. These relationships were examined in subjects from the general population (n = 250) with newly originated episodes of DSM-III-R major depression. The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiological survey in the adult population (n = 7076), using the Composite International Diagnostic Interview (CIDI). Duration of depression and duration of recovery over 2 years were assessed with a life chart interview. Functional disabilities were assessed with the MOS-SF-36 and with absence days from work. Functional disabilities and absence days in depressed individuals were not found to be associated with duration of depression. Functioning in daily activities improved with longer duration of recovery but social functioning not. Functioning deteriorates by actual depressive symptomatology and comorbid anxiety but not by longer duration of dep...

Research paper thumbnail of Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta psychiatrica Scandinavica. Supplementum, 2004

To describe the 12-month and lifetime prevalence rates of mood, anxiety and alcohol disorders in ... more To describe the 12-month and lifetime prevalence rates of mood, anxiety and alcohol disorders in six European countries. A representative random sample of non-institutionalized inhabitants from Belgium, France, Germany, Italy, the Netherlands and Spain aged 18 or older (n = 21425) were interviewed between January 2001 and August 2003. DSM-IV disorders were assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview (WMH-CIDI). Fourteen per cent reported a lifetime history of any mood disorder, 13.6% any anxiety disorder and 5.2% a lifetime history of any alcohol disorder. More than 6% reported any anxiety disorder, 4.2% any mood disorder, and 1.0% any alcohol disorder in the last year. Major depression and specific phobia were the most common single mental disorders. Women were twice as likely to suffer 12-month mood and anxiety disorders as men, while men were more likely to suffer alcohol abuse disorders. ESEMeD is the first study to hi...

Research paper thumbnail of The epidemiology of eating disorders in six European countries: Results of the ESEMeD-WMH project

Journal of Psychiatric Research, 2009

a b s t r a c t A subsample (N = 4139) underwent a detailed investigation on EDs. Lifetime estima... more a b s t r a c t A subsample (N = 4139) underwent a detailed investigation on EDs. Lifetime estimated prevalence of anorexia nervosa, bulimia nervosa, binge eating disorder, sub-threshold binge eating disorder, and any binge eating were 0.48%, 0.51%, 1.12%, 0.72%, and 2.15%, respectively, and they were 3-8 times higher among women for all EDs. However, since people under 18 were excluded from this study, our prevalence should be taken as lower-bound estimate of real frequencies. Indeed, cumulative lifetime prevalence analysis showed that the majority of eating disorders had their initial onset between 10 and 20 years of age. Role impairment and comorbidity with other mental disorders were highly common, yet only small proportions of patients with a lifetime diagnosis of EDs requested medical treatment. It still has to be proven whether early diagnostic identification and access to specialized care can reduce the burden caused by these disorders.

Research paper thumbnail of Suicide ideation across reproductive life cycle of women Results from a European epidemiological study

Journal of Affective Disorders, 2009

Background: The aim of the present study is to compare suicide ideation among women in the pre-, ... more Background: The aim of the present study is to compare suicide ideation among women in the pre-, peri-, and post-menopause using a cross-sectional household survey of non-institutionalised adults from six European countries.

Research paper thumbnail of P-157 - The association between chronic back pain and psychiatric disorders; results from a longitudinal population-based study

European Psychiatry, 2012

Research paper thumbnail of The association between number of social fears, and health-related quality of life, comorbidity, and help-seeking in subjects with social phobia: A population-based study

j Abstract Objectives Community based data were used to examine the association between social ph... more j Abstract Objectives Community based data were used to examine the association between social phobia and comorbidity, quality of life and service utilization. In addition, the correlations of the number of social fears with these domains were studied. Method Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) (N = 7,076). Social phobia was assessed according to DSM-III-R with the Composite International Diagnostic Interview (CIDI); quality of life was assessed according to the Short-Form-36 Health Survey (SF-36). Results The 12month prevalence of social phobia was 4.8%. Being female, young, low educated, a single parent, living alone, not having a paid job and having a somatic disorder are associated with 12-month social phobia. Mean and median ages of onset of social phobia were 19.1 and 16.0 years, respectively, and mean and median duration were 16.8 and 14.0 years, respectively. 66% of respondents with social phobia had at least one comorbid condition. 12-month social phobia was significantly related to lower quality of life and higher service utilization. The mean number of feared social situations was 2.73 out of the 6 assessed. As the number of social fears increases, comorbidity and service utilization increases, and the quality of life decreases. Conclusions These findings suggest as the number of feared social situations increases, the burden of social phobia rises. In other words, like comorbidity or decreased quality of life, the number of social fears is also an important indicator of the severity of social phobia. We conclude that from a public health perspective, mental health care givers should pay attention to the number of social fears in order to check the severity of social phobia.

Research paper thumbnail of Ethnic composition of schools affects episodic heavy drinking only in ethnic-minority students

Addiction, 2007

To investigate if school-related contextual factors (school alcohol policy and school ethnic comp... more To investigate if school-related contextual factors (school alcohol policy and school ethnic composition) explain episodic heavy drinking by individual students, while taking individual-level variables into account. Data were derived from the 2003 Dutch National School Survey on Substance Use, a nationally representative cross-sectional study with a total of 7324 respondents aged 12-16 years. Student-level data were collected by written questionnaire administered in classroom settings, assessing alcohol and drug use as well as socio-demographic and behavioural variables. School-level data were gathered by written questionnaire completed by the school principal, assessing school policy on substance use and school compositional factors. The data were analysed using a multi-level logistic regression model. The study revealed an association between ethnic composition of the school and episodic heavy drinking: a relatively high percentage of ethnic minorities (10-30%) at the school was associated with a lower probability of episodic heavy drinking, but only in interaction with individual-level ethnicity. Thus, ethnic-minority students attending schools of high minority density had less risk of episodic heavy drinking (OR = 0.69, 95% CI: 0.47-1.00). None of the school policy factors was associated with episodic heavy drinking. Within a school context, peer modelling and reinforcement mechanisms can affect individual students' alcohol use, but a certain level of identification with the group and the resulting social control may be necessary. School policy seems to have no impact on students' alcohol use, possibly because students are faced with these only during special events, including school parties and excursions.

Research paper thumbnail of Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

Research paper thumbnail of Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

Research paper thumbnail of Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an... more and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an computer-assisted interview done at home. The 21 425 participants were asked to report how frequently they consulted formal health services due to their emotions or mental health, the type of professional they consulted and the treatment they received as a result of their consultation in the previous year. Results: An average of 6.4% of the total sample had consulted formal health services in the previous 12 months. Of the participants with a 12-month mental disorder, 25.7% had consulted a formal health service during that period. This proportion was higher for individuals with a mood disorder (36.5%, 95% CI 32.5-40.5) than for those with anxiety disorders (26.1%, 95% CI 23.1-29.1). Among individuals with a 12-month mental disorder who had contacted the health services 12 months previously, approximately two-thirds had contacted a mental health professional. Among those with a 12-month mental disorder consulting formal health services, 21.2% received no treatment. Conclusion: The ESEMeD results suggest that the use of health services is limited among individuals with mental disorders in the European countries studied. The factors associated with this limited access and their implications deserve further research.

Research paper thumbnail of Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

Psychological Medicine, 2014

Ethnic minority position is associated with increased risk for psychotic outcomes, which may be m... more Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways. A cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18-64 years (n = 5927, n = 5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use. The rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71-3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42-3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association. The finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.

Research paper thumbnail of Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Acta psychiatrica Scandinavica, 2004

Data on the temporal relationships between duration of depression and recovery and functional dis... more Data on the temporal relationships between duration of depression and recovery and functional disability are sparse. These relationships were examined in subjects from the general population (n = 250) with newly originated episodes of DSM-III-R major depression. The Netherlands Mental Health Survey and Incidence Study is a prospective epidemiological survey in the adult population (n = 7076), using the Composite International Diagnostic Interview (CIDI). Duration of depression and duration of recovery over 2 years were assessed with a life chart interview. Functional disabilities were assessed with the MOS-SF-36 and with absence days from work. Functional disabilities and absence days in depressed individuals were not found to be associated with duration of depression. Functioning in daily activities improved with longer duration of recovery but social functioning not. Functioning deteriorates by actual depressive symptomatology and comorbid anxiety but not by longer duration of dep...

Research paper thumbnail of Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta psychiatrica Scandinavica. Supplementum, 2004

To describe the 12-month and lifetime prevalence rates of mood, anxiety and alcohol disorders in ... more To describe the 12-month and lifetime prevalence rates of mood, anxiety and alcohol disorders in six European countries. A representative random sample of non-institutionalized inhabitants from Belgium, France, Germany, Italy, the Netherlands and Spain aged 18 or older (n = 21425) were interviewed between January 2001 and August 2003. DSM-IV disorders were assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview (WMH-CIDI). Fourteen per cent reported a lifetime history of any mood disorder, 13.6% any anxiety disorder and 5.2% a lifetime history of any alcohol disorder. More than 6% reported any anxiety disorder, 4.2% any mood disorder, and 1.0% any alcohol disorder in the last year. Major depression and specific phobia were the most common single mental disorders. Women were twice as likely to suffer 12-month mood and anxiety disorders as men, while men were more likely to suffer alcohol abuse disorders. ESEMeD is the first study to hi...

Research paper thumbnail of The epidemiology of eating disorders in six European countries: Results of the ESEMeD-WMH project

Journal of Psychiatric Research, 2009

a b s t r a c t A subsample (N = 4139) underwent a detailed investigation on EDs. Lifetime estima... more a b s t r a c t A subsample (N = 4139) underwent a detailed investigation on EDs. Lifetime estimated prevalence of anorexia nervosa, bulimia nervosa, binge eating disorder, sub-threshold binge eating disorder, and any binge eating were 0.48%, 0.51%, 1.12%, 0.72%, and 2.15%, respectively, and they were 3-8 times higher among women for all EDs. However, since people under 18 were excluded from this study, our prevalence should be taken as lower-bound estimate of real frequencies. Indeed, cumulative lifetime prevalence analysis showed that the majority of eating disorders had their initial onset between 10 and 20 years of age. Role impairment and comorbidity with other mental disorders were highly common, yet only small proportions of patients with a lifetime diagnosis of EDs requested medical treatment. It still has to be proven whether early diagnostic identification and access to specialized care can reduce the burden caused by these disorders.

Research paper thumbnail of Suicide ideation across reproductive life cycle of women Results from a European epidemiological study

Journal of Affective Disorders, 2009

Background: The aim of the present study is to compare suicide ideation among women in the pre-, ... more Background: The aim of the present study is to compare suicide ideation among women in the pre-, peri-, and post-menopause using a cross-sectional household survey of non-institutionalised adults from six European countries.

Research paper thumbnail of P-157 - The association between chronic back pain and psychiatric disorders; results from a longitudinal population-based study

European Psychiatry, 2012

Research paper thumbnail of The association between number of social fears, and health-related quality of life, comorbidity, and help-seeking in subjects with social phobia: A population-based study

j Abstract Objectives Community based data were used to examine the association between social ph... more j Abstract Objectives Community based data were used to examine the association between social phobia and comorbidity, quality of life and service utilization. In addition, the correlations of the number of social fears with these domains were studied. Method Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) (N = 7,076). Social phobia was assessed according to DSM-III-R with the Composite International Diagnostic Interview (CIDI); quality of life was assessed according to the Short-Form-36 Health Survey (SF-36). Results The 12month prevalence of social phobia was 4.8%. Being female, young, low educated, a single parent, living alone, not having a paid job and having a somatic disorder are associated with 12-month social phobia. Mean and median ages of onset of social phobia were 19.1 and 16.0 years, respectively, and mean and median duration were 16.8 and 14.0 years, respectively. 66% of respondents with social phobia had at least one comorbid condition. 12-month social phobia was significantly related to lower quality of life and higher service utilization. The mean number of feared social situations was 2.73 out of the 6 assessed. As the number of social fears increases, comorbidity and service utilization increases, and the quality of life decreases. Conclusions These findings suggest as the number of feared social situations increases, the burden of social phobia rises. In other words, like comorbidity or decreased quality of life, the number of social fears is also an important indicator of the severity of social phobia. We conclude that from a public health perspective, mental health care givers should pay attention to the number of social fears in order to check the severity of social phobia.

Research paper thumbnail of Ethnic composition of schools affects episodic heavy drinking only in ethnic-minority students

Addiction, 2007

To investigate if school-related contextual factors (school alcohol policy and school ethnic comp... more To investigate if school-related contextual factors (school alcohol policy and school ethnic composition) explain episodic heavy drinking by individual students, while taking individual-level variables into account. Data were derived from the 2003 Dutch National School Survey on Substance Use, a nationally representative cross-sectional study with a total of 7324 respondents aged 12-16 years. Student-level data were collected by written questionnaire administered in classroom settings, assessing alcohol and drug use as well as socio-demographic and behavioural variables. School-level data were gathered by written questionnaire completed by the school principal, assessing school policy on substance use and school compositional factors. The data were analysed using a multi-level logistic regression model. The study revealed an association between ethnic composition of the school and episodic heavy drinking: a relatively high percentage of ethnic minorities (10-30%) at the school was associated with a lower probability of episodic heavy drinking, but only in interaction with individual-level ethnicity. Thus, ethnic-minority students attending schools of high minority density had less risk of episodic heavy drinking (OR = 0.69, 95% CI: 0.47-1.00). None of the school policy factors was associated with episodic heavy drinking. Within a school context, peer modelling and reinforcement mechanisms can affect individual students' alcohol use, but a certain level of identification with the group and the resulting social control may be necessary. School policy seems to have no impact on students' alcohol use, possibly because students are faced with these only during special events, including school parties and excursions.

Research paper thumbnail of Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

Research paper thumbnail of Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

Research paper thumbnail of Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project

Acta Psychiatrica Scandinavica, 2004

and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an... more and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an computer-assisted interview done at home. The 21 425 participants were asked to report how frequently they consulted formal health services due to their emotions or mental health, the type of professional they consulted and the treatment they received as a result of their consultation in the previous year. Results: An average of 6.4% of the total sample had consulted formal health services in the previous 12 months. Of the participants with a 12-month mental disorder, 25.7% had consulted a formal health service during that period. This proportion was higher for individuals with a mood disorder (36.5%, 95% CI 32.5-40.5) than for those with anxiety disorders (26.1%, 95% CI 23.1-29.1). Among individuals with a 12-month mental disorder who had contacted the health services 12 months previously, approximately two-thirds had contacted a mental health professional. Among those with a 12-month mental disorder consulting formal health services, 21.2% received no treatment. Conclusion: The ESEMeD results suggest that the use of health services is limited among individuals with mental disorders in the European countries studied. The factors associated with this limited access and their implications deserve further research.

Research paper thumbnail of Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

Psychological Medicine, 2014

Ethnic minority position is associated with increased risk for psychotic outcomes, which may be m... more Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways. A cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18-64 years (n = 5927, n = 5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use. The rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71-3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42-3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association. The finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.