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Document Typology: Report
Methodology addressed by the publication:International Classification of Functioning, Disability and Health
Title of document: Poverty as a Risk Factor of Mental Health Problems
Name of author(s): Dainius Puras
Name of publisher: Nordic Journal of Psychiatry
Language of the publication: English
Language of the review: English

Lithuania, like most post-Communist countries, is in the exciting process of changing approaches in the field of mental health services. As a consequence of former state ideology, psychosocial aspects of mental health and mental disorders have been ignored. In this situation psychopharmacotherapy became the main and, most often, the only modality of treatment for children with mental, developmental, and emotional disorders. The situation started to change dramatically in the late 1980s and early 1990s, with new approaches in child psychiatry. As a demonstration site, Vilnius University Children's Mental Health Center was established in 1991, and in 1994 the National Child Mental Health Program was launched to coordinate development of modern community-based services with the process of training, research, and international collaboration in the field. The study showed that medication is the main method of treatment in the inpatient department of child psychiatry. Psychopharmaco-therapies have been prescribed to 98.5% of patients.
Reviewer's comments on the document:
Poverty and unemployment increased the duration of episodes of common mental disorders but not the likelihood of their onset. Financial strain was a better predictor of future psychiatric morbidity than either of these more objective risk factors though the nature of this risk factor and its relation with poverty and unemployment remain unclear.
To overcome likely colinearity between indices of standard of living, a poverty score comprising seven items was generated from variables previously judged to provide a comprehensive yet frugal assessment of each subject's standard of living. One point was scored for each of the following: (a) annual household income (adjusted for household size and composition b) in the bottom fifth for region of residence (since the cost of living was expected to differ between regions); (b) no household access to car or van, (c) not saving from income (excluding money put by for bills but including life insurance, personal equity plans, share purchases, and holidays); (d) fewer than four domestic household appliances from a list of nine; (e) living in rented accommodation; (f) overcrowded accommodation (more than two household members per bedroom); and, (g) a home with two minor or any major structural problems such as dry rot. Where income sources could not be verified by documentary evidence missing data were imputed by the British household panel survey investigators19 using methods that minimised any tendency to overpredict associations with income. 11 19 Items contributing to the poverty score were not weighted, given the absence of any rationale or method for doing so. Furthermore, cross sectional findings at T1 indicate that individual associations with the prevalence of common mental disorders differed little between items.

Siame straipsnyje analizuojamos psichoneurologines veiklos perspektyvos, siekiant identifikuoti pagrindines jøs paskirtis: socialines paslaugos teikimas, gyventoju integracija i visuomene ar
teisinio, galimybiu ir privatumo veiksniai lyginant su kitu saliu praktika..
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