***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Personal debt is now recognized as one of the many factors associated with common mental disorders ( CMD ) . We aim to estimate the prevalence of ' specific ' mental disorders based on ICD-10 research diagnostic criteria by type of debt and quantify the additional influence of addictive behaviours . METHOD A r and om probability sample comprising 7461 respondents were interviewed for the third national survey of psychiatric morbidity of adults in Engl and carried out in 2007 . The prevalence of CMD was estimated from the administration of the CIS-R. Respondents were asked about sources of debt and their borrowing choices . RESULTS In 2007 , 8.5 % of adults were in arrears . Adults in debt were three times more likely than those not in debt to have CMD . The increased likelihood of CMD among those in arrears was found for all CMD and was irrespective of source of debt -- housing , utilities and purchases on credit . The situation was exacerbated among those with addictive behaviours -- alcohol or drug dependence or problem gambling . Those with multiple sources of debt and who had to obtain money from pawnbrokers and moneylenders had the highest rate of CMD , ≈ 50 % . CONCLUSIONS Debt is one of the major risk factors for CMD . This has practical implication s for both health services and financial services , which both need to be alert to the association and adapt and train their respective services accordingly so that people in debt can access help for mental disorders and people with mental disorders can access help for debt BACKGROUND Social factors have been shown to be predictors of suicide . It is not known whether these factors vary between countries . AIMS To present a first European overview of socio-economic inequalities in  suicide mortality among men and women . METHOD We used a prospect i ve follow-up of censuses matched with vital statistics in ten European population s.  Directly st and ardised rates of suicide were computed for each country . RESULTS In men , a low level of educational attainment was a risk factor for suicide in eight out of ten countries . Suicide inequalities were smaller and less consistent in women . In most countries , the greater the socio-economic disadvantage , the higher is the risk of suicide .  The population of Turin evidence d no socio-economic inequalities . CONCLUSIONS Socio-economic inequalities in suicide are a generalised phenomenon in western Europe , but the pattern and magnitude of these inequalities vary between countries . These inequalities call for improved access to psychiatric care for lower socio-economic groups OBJECTIVE This study was conducted to determine the population -attributable risk ( PAR ) of completed suicide  among Hong Kong Chinese with axis I psychiatric diagnoses . METHODS With a case-control psychological autopsy method , 150 suicide decedents aged 15 - 59 were compared for axis I psychiatric diagnoses and psychosocial variables with 150 r and omly selected age- and gender-matched persons living in the community . RESULTS In the presence of other , non-disease-related social risk factors ( unemployment and unmanageable debt ) , past suicide attempt independently accounted for 44 % of the PAR of suicide , followed by current major depressive disorder ( 27 % ) , schizophrenia spectrum disorders ( 22 % ) , and substance use disorder or pathological gambling ( 16 % ) . Other diagnoses ( such as anxiety and phobic disorders , dysthymia , adjustment disorders , and past major depressive episode ) accounted for 24 % of PAR . CONCLUSIONS Psychiatric morbidity remains the major risk factor for suicide in Hong Kong despite well-developed psychiatric services . Mental health policy should be refined to target clinical groups at high risk of suicide Perceived control has convincingly been suggested to be a key concept in explaining socioeconomic differences in health.1 Some empirical evidence exists of a higher prevalence of low control beliefs ( such as powerlessness or fatalism ) in lower socioeconomic groups and that this is relevant to socioeconomic inequalities in general health.2 However , a systematic examination of the extent to which perceived control contributes to socioeconomic inequalities in mortality is lacking . This is important , as attention has recently shifted towards psychological and psychosocial explanations of socioeconomic inequalities in health . Data were collected in 1991 within the framework of a general population study of the health and living conditions of the population of Eindhoven and its surroundings ( the GLOBE study ) .3 We invited a r and om sub sample for interview . The response rate was 80 % and not related to demographic characteristics . Interview data were available for 1220 men and 1242 women aged 25 - 74 ( 51 on Abstract Objectives To describe the prevalence of and risk factors for chronic fatigue in a developing country ; in particular , to determine the association of anaemia , mental health , and gender disadvantage factors with chronic fatigue . Design Community survey . Setting Primary health centre catchment area in Goa , India . Participants 3000 r and omly sample d women aged 18 to 50 years . Main outcome measures Data on the primary outcome ( reporting of fatigue for at least six months ) and psychosocial exposures elicited by structured interview ; presence of anaemia determined from a blood sample . Results 2494 ( 83 % ) women consented to participate ; 12.1 % ( 95 % confidence interval 10.8 to 13.4 % ) complained of chronic fatigue . In multivariate analyses , older women ( P = 0.03 ) and those experiencing socioeconomic deprivation — less education ( P < 0.001 ) , families in debt ( P = 0.09 ) , or hunger in the past three months ( P = 0.03)—were more likely to report chronic fatigue . After adjustment for these factors , factors indicating gender disadvantage ( notably sexual violence by the husb and ; P < 0.001 ) and poor mental health ( P < 0.001 ) were strongly associated with chronic fatigue . Although women with a high body mass index had a reduced risk , suggesting an influence of poor nutrition , no association was found between chronic fatigue and haemoglobin concentrations . Conclusions Chronic fatigue was commonly reported by women in this community study from India . The strongest associations with chronic fatigue were for psychosocial factors indicative of poor mental health and gender disadvantage Depression is common among women with young children , and is strongly associated with financial adversity . Debt is a common feature of such adversity , yet its relationship with depression has not been examined before . We have used longitudinal data , collected over six months , on 271 families with young children , to examine this relationship . Multiple regression was used to identify independent predictors of the total Edinburgh Post-natal Depression Scale score from a range of socioeconomic , demographic , social support and child health related variables . Worry about debt was the strongest independent socioeconomic predictor of the depression score at both initial and follow-up occasions . To account for the possibility of reverse causation , i.e. depression causing worry about debt , alternative regression models are reported which show that owing money by itself predicts depression and earlier debt worries predicts depression six months later . We were unable to show that earlier debt worries independently predicted subsequent depression scores after the initial depression score had been taken into account in the analysis . Although debt has not been shown to be an independent prospect i ve predictor of depression , our results suggest it has a central place in the association between socioeconomic hardship and maternal depression . Evidence from qualitative studies on poverty and from studies on the causes of depression support this hypothesis . The implication s for policy are that strategies to enable families to control debt should be an explicit part of wider antipoverty measures which are design ed to reduce depression and psychological distress among mothers of young children Background The main objective of this study was to determine the prevalence and factors associated with mental illness in Oyo State at community level using the general health question naire as a screening tool . Method This cross-sectional , community- based survey was carried out among adults in three r and omly selected LGAs using multi-stage sampling technique . Results A total of 1105 respondents were assessed in all . The overall prevalence of psychiatric morbidity  in Oyo state Nigeria was found to be 21.9 % , ( 18.4 % in the urban areas and 28.4 % in the rural areas , p = 0.005 ) .  Young age ≤ 19 yrs ( X2 = 20.41 , p = 0.00013 ) , Unemployment ( X2 = 11.86 p = 0.0005 ) , living condition below average ( X2 = 12.21 , p = 0.00047 ) , physical health ( X2 = 6.07 , p = 0.014 ) , and large family size ( X2 = 14.09 p = 0.00017 ) were associated with increase risk for psychiatric morbidity . Following logistic regression analysis , Unemployment ( C.I = 1.18–3.70 , OR -2.1 ) and living conditions perceived to be above average ( C.I = 1.99–5.50 , OR-3.3 ) were significant predictors of mental illness while family size less than 6 ( C.I = 0.86–0.97 , OR-0.91 ) was protective . Conclusion The teenagers and the rural population s are in greater need of mental health promotional services . Family planning should be made freely available in order to reduce the family size and hence incidence of mental illness in the African population Financial stress is widely believed to cause health problems . However , policies seeking to relieve financial stress by limiting debt levels of poor households may directly worsen their economic well-being . We evaluate an alternative policy – increasing the repayment flexibility of debt contracts . A field experiment r and omly assigned  microfinance clients to a monthly or a traditional weekly installment schedule ( N = 200 ) . We used cell phones to gather survey data on income , expenditure , and financial stress every 48 hours over seven weeks . Clients repaying monthly were 51 percent less likely to report feeling “ worried , tense , or anxious ” about repaying , were 54 percent more likely to report feeling confident about repaying , and reported spending less time thinking about their loan compared to weekly clients . Monthly clients also reported higher business investment and income , suggesting that the flexibility encouraged them to invest their loans more profitably , which ultimately reduced financial stress BACKGROUND Personal debt is one of many factors associated with  anxiety  ,  depression and suicidality . The aim of this study was to examine the relationship between personal debt and suicidal ideation in the context of sociodemographic factors , employment and income , lifestyle behaviours , and recently experienced traumatic events . METHOD Interviews were conducted with a r and om probability sample comprising 7461 respondents for the third national survey of psychiatric morbidity of adults in Engl and . Fieldwork was carried out throughout 2007 . The prevalence of suicidal thoughts in the past week , past year and lifetime was assessed and current sources of debt were recorded . RESULTS In 2007 , 4.3 % of adults in Engl and had thought about taking their own life in the past 12 months , ranging from 1.8 % of men aged ≥ 55 years to 7.0 % of women aged 35 - 54 years . Those in debt were twice as likely to think about suicide after controlling for sociodemographic , economic , social and lifestyle factors . Difficulty in making hire purchase or mail order repayments and paying off credit card debt , in addition to housing-related debt ( rent and mortgage arrears ) , was strongly associated with suicidal thoughts . Feelings of hopelessness partially mediated the relationship between debt and suicidal ideation . CONCLUSIONS The number of debts , source of the debt and reasons for debt are key correlates of suicidal ideation . Individuals experiencing difficulties in repaying their debts because they are unemployed or have had a relationship breakdown or have heavy caring responsibilities may require psychiatric evaluation in addition to debt counselling PURPOSE : To determine correlations between residents ' scores on psychological inventories and their demographics and personal histories . METHOD : The authors followed all family practice residents in South Carolina from July 1993 to January 1996 . They invited the residents to take a battery of psychological inventories every July and January during the study . The inventories included the Beck Depression Inventory ( BDI ) and the Profile of Mood States ( POMS ) . The participating residents also filled out personal and family history question naires at each test administration . RESULTS : Of the 350 residents in family practice training during the study , 284 took the BDI at least once and 280 took the POMS at least once . Cross-sectional data indicated that 3 % of those taking the BDI and 7 % of those taking the POMS showed significant depressive or mood-disturbance symptoms , levels similar to those found in previous studies . Analyses found correlations between residents ' descriptions of poor physical or emotional health , unhappy childhoods , current high stress in training , or doubt about specialty choice and high scores on the two inventories . No such correlation was found between high inventory scores and age , sex , race , duration of training , season of the year , exercise pattern , recent life events , income , or level of indebtedness . CONCLUSIONS : Although the results of this study may not be generalizable , medical educators and those who counsel physicians during graduate training may want to take note of the correlations between certain answers to questions about personal history and higher levels of depression and mood disturbance as measured by psychological inventories BACKGROUND Economic recessions are characterized by job insecurity and rising unemployment . The relationship between job insecurity and poor mental health is known . However , we do not know how this relationship is affected by individual socio-economic circumstances . METHOD A r and om probability sample comprising 3581 respondents (  
    Output:
    
Panel surveys , nationally representative epidemiological surveys and psychological autopsy studies have examined the relationship , as have studies on specific population s such as university students , debt management clients and older adults .
Studies of physical health have also shown a relationship with self-rated health and outcomes such as obesity .
There is also a strong relationship with suicide completion , and relationships with drug and alcohol abuse .
The majority of studies found that more severe debt is related to worse health ; however causality is hard to establish .