Age-related differences in the associations among at-risk drinking, alcohol use disorder, and psychological distress across the adult lifespan: a nationwide representative study in South Korea

Health behaviors according to the ability to understand health information in Korean adults

This study aimed to verify the relationship between the level of understanding of health information and health behaviors among Korean adults. In total, 228 984 adults who participated in the 2021 Korea Community Health Survey were included. Participants were divided into three groups according to age (19-44, 45-64 and 65+). The ability to understand verbal and written health information was included, and its association with health behaviors, including smoking, alcohol consumption and preventive health service uptake, was assessed. Associations between the ability to understand health information and health behaviors were analyzed using chi-squared tests and multiple logistic regression analyses. Approximately 22.7% and 20% of the participants responded that verbal and written health information were easy to understand, respectively, with significant differences by age group. Compared to those with easy-to-understand verbal health information, those with difficulty in understanding had a higher risk of current cigarette smoking and monthly drinking and were less likely to engage in more than moderate physical activity, walking, influenza vaccination in 1 year, cancer examination in 2 years and medical examination in 2 years. Difficulty in understanding or no interest in written health information was also associated with unhealthy behaviors. A strong ability to understand health information is related to positive health behaviors. However, there are differences in the associations by age group, which should be considered when establishing a health literacy improvement strategy. These findings could promote health literacy and ultimately contribute to helping individuals make better choices for positive health behaviors.

Associations of Psychological Distress and Alcohol Use Patterns Among Older Adults of Sexual Minority Status and Heterosexual Peers

BACKGROUND

There is limited research investigating sexual-orientation-related differences in older adults and their relationship with alcohol use.

OBJECTIVE

The purpose of this study was to determine if sexual minority status moderates the relationship between psychological distress and alcohol drinking patterns.

METHODS

This study was a secondary analysis of data from the 2017-2018 National Survey on Drug Use and Health. Health outcomes among lesbian, gay, and bisexual (LGB) older adults (N = 462) aged 50 years or older were compared with heterosexual (N = 16,856) peers using univariate analyses and logistic regressions. Interaction terms evaluated the influence of sexual orientation on psychological distress and alcohol consumption.

RESULTS

Sexual orientation was a predictor of alcohol use in the past year, past month, and at any time (p < .001) but was not a predictor of alcohol dependence or misuse, binge drinking, or heavy drinking. Heterosexual older adults were less likely to consume alcohol than those who identified as LGB. Respondents not reporting psychological distress were less likely to engage in problematic drinking. However, there was no evidence that sexual minority status moderates the relationship between psychological distress and alcohol use.

CONCLUSION

Limited evidence supports higher rates of alcohol use and alcohol-related problems among sexual minority persons than heterosexuals. Prediction models for alcohol use were not improved by using sexual orientation and psychological distress as interaction terms. Future research should examine the underlying causes of impaired health in the older LGB population. Those findings should be used to research methods of preventing and minimizing alcohol misuse.

Associations between game use and mental health in early adulthood: A nationwide study in Korea

BACKGROUND

The number of digital game users is increasing, and so is attention to digital gaming's effects on mental health. We aimed to reveal if risky (game addiction) and usual game use (non-risky) are associated with mental health in early adulthood.

METHODS

Using data from the nationwide cross-sectional Korean Epidemic Catchment Area study for psychiatric disorders, 415 participants aged 18-30 years were divided into "non-game," "usual game," and "risky game" user groups based on the previous month's game use and cut-off value of game overuse screening questionnaire. Multiple linear and logistic regressions revealed the association between game use groups, perceived mental health, and lifetime prevalence of clinical mental disorders including suicidal ideation.

RESULTS

Among the 415 participants, 167 were non-game users, 175, usual game users, and 73, risky game users. Risky game users self-reported decreased satisfaction and happiness, and a significantly higher lifetime prevalence of major depressive disorder, alcohol dependence, and suicidal ideation. Usual game users were significantly associated with higher lifetime prevalence of alcohol dependence and suicidal ideation. Self-reported happiness partially mediated between game use and lifetime suicidal ideation in risky, but not usual game users.

LIMITATIONS

This study is a cross-sectional observational study which was not possible to define the temporal relationship.

CONCLUSIONS

Both risky and usual game use are associated with mental health problems in early adulthood, indicating the need for careful mental health screening on not only risky game users but also usual game users.

Validation of the screening test for at-risk drinking in an emergency department using a tablet computer

BACKGROUND

The Alcohol Use Disorder Identification Test (AUDIT) is widely used and validated in primary care settings for alcohol screening, yet practical challenges in conducting it in crowded clinics exist. Recently, a new abbreviated version of the AUDIT, was presented: the Screening Test for At-risk Drinking (STAD). This study aimed to evaluate the performance of STAD compared to other abbreviated versions of AUDIT for patients visiting the emergency department (ED).

METHODS

This cross-sectional survey was conducted with 543 patients in the urban tertiary academic hospital ED in South Korea We diagnosed at-risk drinking using the entire AUDIT score. The optimal cut-off values, sensitivity, specificity, and the area under the receiver operating characteristics (AUROC) of the STAD were analyzed. We compared the AUROC with AUDIT-C and AUDIT-QF, which are previously abbreviated versions of AUDIT.

RESULTS

For males, the optimal cut-off value in the STAD test was 3 points with 83.1% sensitivity (95% CI: 75.3-89.2) and 95.9% specificity (95% CI: 91.2-98.5). For females, the optimal cut-off value was 2 points with 95.9% sensitivity (95% CI: 88.5-99.1) and 89.1% specificity (95% CI: 83.9-93.0). The AUROC curves for STAD were 0.964 (95% CI: 0.934-0.983) for males and 0.980 (95% CI: 0.965-0.993) for females.

CONCLUSIONS

The STAD is a simple and useful test to screen at-risk drinking in the ED, and its assisted applications will enable faster and more efficient screening and management of at-risk drinking.

Psychological Stressors Predicting Increased Drinking During the COVID-19 Crisis: A Longitudinal National Survey Study of Workers in Finland

AIMS

The global crisis caused by the outbreak of a novel coronavirus rapidly increased working remotely in many countries. The aim of this study was to analyze psychological stressors predicting increased drinking during the COVID-19 crisis. Also, individual and socio-demographic differences were analyzed.

METHODS

A nationally representative sample of Finnish workers (N = 1308) was collected before the crisis in September-October 2019 and 82.02% of them responded to a follow-up survey conducted in March-April 2020. Increased drinking was the outcome variable and it was measured with the AUDIT-C before and during the COVID-19 crisis. Predictors measured before the crisis included cyberbullying victimization at work, psychological distress, burnout and work climate. Additional measures included personality factors, socio-demographic factors and occupational information.

RESULTS

One-fourth of Finnish workers (25.37%) reported increased drinking during the COVID-19 crisis. Cyberbullying victimization at work and psychological distress before the crisis predicted increased drinking during the crisis. Conscientious workers and those working in educational and health and welfare sectors were less likely to increase drinking, while increased drinking was most common among workers under 30 years of age.

CONCLUSIONS

Psychological stressors are risk factors for increased drinking in unusual times such as the COVID-19 crisis. Cyberbullying victimization at work and psychological distress were found as major risk factors. The results suggest that preventive work should be done at workplaces. This is particularly important if alcohol consumption is used as a means of coping during a stressful time.