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introduction of IC, though at a slower rate than if IC had
not existed.
Conclusion The introduction of a national target resulted in
a reduction of delayed days. After factoring out this reduc-
tion, IC was responsible for a further reduction in delayed
days of 18%. The rate of days delayed continued to increase
over time after the introduction of IC, though at a slower
rate.
P53 THE ASSOCIATIONS BETWEEN COMMON MENTAL
DISORDERS (ANXIETY AND DEPRESSION) AND SOCIO-
ECONOMIC AND DEMOGRAPHIC FACTORS IN TWO
RUSSIAN CITIES
1
S Cook*,
2
AV Kudryavtsev,
1
N Bobrova,
3,4
S Malyutina,
1,5
DA Leon.
1
Department of Non-
Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine,
London, UK;
2
Central Scientific Research Laboratory, Northern State Medical University,
Arkhangelsk, Russia;
3
Research Institute of Internal and Preventive Medicine –Branch of
ICandG SB RAS, Novosibirsk, Russia;
4
Novosibirsk State Medical University, Ministry of
Health of Russia, Novosibirsk, Russia;
5
Department of Community Medicine, Arctic
University of Norway, UiT, Tromsø, Norway
10.1136/jech-2018-SSMabstracts.177
Background Common mental disorders (anxiety and depres-
sion) are important public health concerns worldwide. There
is very little evidence about the risk factors for these in Rus-
sia despite high rates of associated markers: suicide and alco-
hol-attributable mortality. The aim of this study was to
investigate the associations between common mental disorders
and socio-demographic factors in the Russian adult
population.
Methods Data were from two population-based cross-sec-
tional surveys conducted in 2016–17 among men and
women aged 35–69 years old resident in the Russian cities
of Arkhangelsk and Novosibirsk as part of the Interna-
tional Project on Cardiovascular Disease in Russia
(IPCDR). Participants were recruited and interviewed in
their homes. Information collected included questions on
socio-demographic factors (marital status, education,
employment and financial status). Depression was defined
as a score of 10 on the PHQ-9 instrument and anxiety
as a score of 10 on the GAD-7 instrument. Financial sta-
tus was on a 5-point scale from not enough money for
food to no financial constraints. Logistic regression was
used to estimate effects of socio-demographic factors on
anxiety and depression adjusting for age, sex and city and
then for all other socio-demographic variables. Volume of
alcohol consumed per year and problem drinking defined
as CAGE score 2 were entered into the models at the
last step in order to assess the effect on the associations of
interest.
Results After adjustment for all socio-demographic variables
depression was more prevalent among women (OR 1.93
95% CI 1.53, 2.44),those who were divorced or separated
compared to married (OR 1.46 95% CI 1.10, 1.92), and
not in regular employment (OR 1.49 95% CI 1.18, 1.88).
There was a monotonic increase in risk of depression across
the 5 categories of financial status from poorest to most
affluent (p-value trend £0.001),withanOR>6frombot-
tom vs top category. Anxiety was more prevalent in women
(OR 1.93 95% CI 1.42, 2.62). As with depression financial
status also showed a strong inverse trend in risk (p<0.001).
Education was inversely associated with depression and
anxiety after adjustment for age, sex, and city but not after
adjustment for other socio-demographic variables. The pat-
tern of results remained similar after additional adjustment
for alcohol use.
Conclusion Degree of financial hardship was strongly asso-
ciated with symptoms of anxiety and depression even
after adjustment for education, employment status and
alcohol use. These findings underline the importance of
considering social circumstances in addressing poor mental
health.
P54 DOES THE LENGTH OF STAY IN PSYCHIATRIC
INPATIENT UNITS AFFECTS THE SOCIAL INTEGRATION
OF SEVERE MENTALLY-ILL PATIENTS? A STUDY IN FIVE
EUROPEAN COUNTRIES
P Smith*, P Nicaise, V Lorant. Institute of Health and Society, Université Catholique de
Louvain, Brussels, Belgium
10.1136/jech-2018-SSMabstracts.178
Background During the last three decades, in high-income
countries, a transition from institutional psychiatric care to
community care and a reduction in the hospital length of stay
has taken place to provide community care and promote
patients’social integration. However, the impact of length of
stay in psychiatric inpatient unit on the different dimensions
of patients’social integration remains unclear. The aim of this
study is to determine whether longer length of stay in psychi-
atric inpatient unit decreases the social integration of Severe
Mentally-Ill (SMI) patients.
Methods Within the European COFI study (prospective cohort
study), data were collected for 7302 SMI patients hospitalised
in 2015 in the UK, Italy, Germany, Poland and Belgium.
Social integration was measured using the SIX index in base-
line and at one year of follow-up. The SIX index includes the
following dimensions of social integration: employment, hous-
ing, living situation and contacts with friends. Correlation and
regressions models were performed to test the association
between length of stay in psychiatric inpatient unit and
patients’social integration.
Results The average score of social integration of SMI patients
in baseline was 3.8/6 (SD=1.39) and decreased by 0.14
(SD=1.29) one year later. We found a small but significant
negative correlation between length of stay in hospital and
social integration of patients at one year (r=-0.04, p=0.03).
This association remained significant when adjusting for
patient characteristics and hospitals as a random intercept. At
one year, the most correlated dimensions of social integration
with length of stay were housing (b=–6.3, p<0.0001) and
employment (b=–1.8, p=0.01).
Conclusion This study supports the importance of policies and
interventions to reduce the length of stay in psychiatric inpa-
tient unit for SMI patients to preserve their social integration.
Housing and employment are the main dimensions of social
integration negatively impacted by length of stay. Therefore,
special attention must be given to help SMI patients to find
and retain housing and employment during psychiatric
hospitalisations.
Abstracts
A84 J Epidemiol Community Health 2018;72(Suppl 1):A1–A93
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