title: Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a 'Horizontal Epidemiology' Approach.
abstract: BACKGROUND
  Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders.
  
  
  METHODS
  Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson's disease. Random forest regression and classical linear regression were used in the analyses.
  
  
  RESULTS
  722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family.
  
  
  CONCLUSIONS
  The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24.
authors.affiliation: Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.
authors.forename: Carla
authors.initials: C
authors.lastname: Sabariego
authors.affiliation: Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Coenen
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ballert
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.|Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Cabello
authors.affiliation: Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.affiliation: Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Anczewska
authors.affiliation: A-Clinic Foundation, Helsinki, Finland.
authors.forename: Tuuli
authors.initials: T
authors.lastname: Pitkänen
authors.affiliation: Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.|Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Mellor
authors.affiliation: Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy.
authors.forename: Venusia
authors.initials: V
authors.lastname: Covelli
authors.forename: Piotr
authors.initials: P
authors.lastname: Świtaj
authors.affiliation: A-Clinic Foundation, Helsinki, Finland.|Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Jonna
authors.initials: J
authors.lastname: Levola
authors.affiliation: Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy.|Division of Neurosurgery II, Neurological Institute Carlos Besta (IRCCS) Foundation, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Schiavolin
authors.affiliation: Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Chrostek
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland.
authors.forename: Jerome
authors.initials: J
authors.lastname: Bickenbach
authors.affiliation: Department of Measurement and Health Information Systems, Multi-Country Studies, World Health Organization, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.affiliation: Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.|Swiss Paraplegic Research, Nottwil, Switzerland.|Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom.
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004777:Environment; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012307:Risk Factors; D011795:Surveys and Questionnaires