Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care

Development and Evaluation of a Measure of Drinking Behavior in Response to Acculturation Stressors for Latinx Adults Entering Alcohol Treatment

Introduction

The current study presents the development of a scale to assess drinking behavior in response to acculturation and immigration stress.

Methods

The 19-item Measure of Immigration and Acculturation Stressors (MIAS) and a parallel assessment, a Measure of Drinking in Response to Immigration and Acculturation Stressors (MDRIAS), were administered at baseline, 6 months, and 12 months in a completed randomized controlled trial testing culturally adapted motivational interviewing to reduce heavy drinking and related problems in Latinx individuals who met criteria for heavy drinking (n=149).

Results

Exploratory factor analysis of the MIAS showed best fit for a four-factor solution (Relational Stress, Perceived Ethnic Discrimination, Attenuated Aspirations, and Sense of Alienation) with 15 items. The MIAS subscales and the four corresponding MDRIAS subscales were shown to have good reliability (i.e., internal consistency, intercorrelations, and test-retest) and criterion-related validity (i.e., concurrent, convergent, and predictive).

Conclusions

These findings suggest that the MIAS can be used to assess different types of immigration and acculturation stressors for Latinx adults and the MDRIAS can be used to assess drinking in response to those experiences. The MIAS and MDRIAS could be used in the future to adapt alcohol interventions to relevant stressors that contribute to Latinx adults' alcohol use.

Clinical characteristics and outcomes of people with severe mental disorders hospitalized due to COVID-19: A nationwide population-based study

OBJETIVE

Hospitalized COVID-19 patients with severe mental illness (SMI) have worse outcomes than counterparts without SMI. Barriers in access to acute care medical procedures among SMI patients may partially explain this phenomenon. Here, we examined differences in critical care admission and in-hospital mortality between hospitalized COVID-19 patients with and without SMI.

METHODS

This population-based study used Spain's nationwide electronic health records. Based on International Classification Diseases, Tenth Revision, ICD-10-CM codes, we identified all patients aged ≥15 years hospitalized due to COVID-19 between July 1st-December 31st, 2020, and compared patients with and without SMI in terms of (i) critical care admission and (ii) in-hospital mortality - overall and stratified by age. We used logistic regression models including sex, age, and comorbidity burden as measured by Charlson Comorbidity Index Score as covariates.

RESULTS

Of 118,691 hospital admissions due to COVID-19 of people aged ≥15 years, 1512 (1.3%) included a diagnosis of SMI. Compared to non-SMI patients, SMI patients had higher in-hospital mortality (OR,95%CI: 1.63,1.42-1.88) and were less frequently admitted to critical care (OR,95%CI: 0.70,0.58-0.85). Admission to critical care in SMI patients was lower than for non-SMI counterparts only among individuals aged ≥60 years. The magnitude of the difference in in-hospital mortality between SMI and non-SMI patients decreased as age increased.

CONCLUSIONS

Individuals with SMI had reduced critical care admission and increased in-hospital mortality compared non-SMI counterparts, suggesting that differences in delivery of acute care medical procedures may partially explain higher risk of negative outcomes among COVID-19 patients with SMI.

Relationship between alcohol consumption, stress, and depression in Ecuadorian workers: the moderating role of social support and sex

This paper aims to analyze the association between alcohol consumption, work stress, and depression and the moderating effect of social support and sex in this relationship. In a sample of workers from an electric generation industry from Ecuador (N = 99), hierarchical linear regressions were conducted to test the direct and moderation effects. Results show that alcohol consumption is positively associated with work stress and depression; social support moderates alcohol consumption's impact on depression but not on stress. This interaction effect is different according to sex. Further, an increase in alcohol consumption is associated with higher stress in women but not in men, and it relates to higher depression in men but not in women. Finally, we discuss the role of sex and social support as key factors to cope with the adverse effects of alcohol on well-being at work.

Working with alcohol prevention in occupational health services: "knowing how" is more important than "knowing that" - the WIRUS OHS study

BACKGROUND

Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels' levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity.

METHODS

In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses.

RESULTS

OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η² = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, β = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units.

CONCLUSIONS

Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.

Lifestyle, Demographic and Socio-Economic Determinants of Mental Health Disorders of Employees in the European Countries

Ensuring the health and well-being of workers should be a top priority for employers and governments. The aim of the article is to evaluate and rank the importance of mental health determinants: lifestyle, demographic factors and socio-economic status. The research study is based on EHIS 2013-2015 data for a sample of N = 140,791 employees from 30 European countries. The results obtained using machine learning techniques such as gradient-boosted trees and SHAPley values show that the mental health of European employees is strongly determined by the BMI, age and social support from close people. The next vital features are alcohol consumption, an unmet need for health care and sports activity, followed by the affordability of medicine or treatment, income and occupation. The wide range of variables clearly indicates that there is an important role for governments to play in order to minimize the risk of mental disorders across various socio-economic groups. It is also a signal for businesses to help boost the mental health of their employees by creating holistic, mentally friendly working conditions, such as offering time-management training, implementing morning briefings, offering quiet areas, making employees feel valued, educating them about depression and burnout symptoms, and promoting a healthy lifestyle.

Race Differences in Opioid Misuse and Adolescent Suicidality

PURPOSE

The rise of the opioid epidemic coincided with the increased risk of suicide as the leading causes of death among adolescents in the United States. Past research has linked non-medical prescription opioid use (NMPOU) with adolescent suicide. Less focus has been placed on race and ethnic differences among adolescents impacted by the opioid epidemic. This study examined the relationship of adolescent NMPOU and suicidality, stratified by race.

METHOD

The 2016 National Survey on Drug Use and Health (NSDUH) was used for this study. Weighted multivariate logistic regression analyses were conducted on a sample of 11,489 adolescent respondents to examine the effect of past-year NMPOU with the odds for serious thoughts of suicide, having a suicide plan, and making a suicide attempt.

RESULTS

Findings indicated a higher prevalence of suicidality among adolescents who engaged in NMPOU compared to non-users. Adolescent opioid misuse was associated with 68% higher odds for having a suicide plan in the past year (OR = 1.68, 95% CI: [1.07, 2.63], p < 0.05). Interaction analysis found that among Asian adolescents, NMPOU was associated with higher odds for having a suicide plan compared to other race groups (OR=1.53, 95% CI: [1.04, 2.23], p < 0.05).

DISCUSSION

Results indicated that adolescent opioid misuse is a risk factor for suicide, and Asians compared to other race groups were at greater risk. Social workers can serve as a nexus point in effectively engaging at-risk adolescents in substance use and mental health prevention and recovery services.

Association between health behaviors and depression: findings from the 2019 Brazilian National Health Survey

OBJECTIVE

To analyze the association of depression with various health behaviors and to verify if they differ according to gender or income.

METHODS

This is a cross-sectional study based on data of 65,803 Brazilian adults (18-59 years old) interviewed in the National Health Survey, conducted in 2019. Presence or absence of depression was evaluated using the Patient Health Questionnaire (PHQ)-9. The prevalence of smoking, alcohol consumption, physical activity, sedentary lifestyle and food indicators were estimated according to the presence of depression. Stratified analyses were made according to sex and income, and prevalence ratios were estimated using the Poisson Regression.

RESULTS

We found a significant association between depression and all indicators studied, except occasional alcohol consumption. Depression was associated with heavy episodic drinking and insufficient consumption of fruits and vegetables only in women. In men, the associations of depression with sedentary lifestyle and with being a former smoker were stronger than in women. The occasional consumption of alcohol was more prevalent only in men without depression. The analysis stratified by income showed that the association of depression with physical inactivity is stronger in the higher-income group, while with heavy episodic drinking is only significant in the lower-income stratum.

CONCLUSION

The results point to the need to consider mental health in programs aimed at reducing harmful health behaviors and the specificity of sociodemographic groups.

No Sex Differences in Psychological Burden and Health Behaviors of Healthcare Workers During the COVID-19 Stay-at-Home Orders

Background: Females with novel coronavirus disease 2019 (COVID-19) state-ordered home isolation were associated with higher anxiety and reduced sleep quality than males. Sex differences in psychobehavioral changes during the COVID-19 stay-at home orders among healthcare workers remained unclear. The purpose of this study was to explore the sex differences in psychological burden and health behaviors among these persons.

Methods: This was a cross-sectional study using online data available in the open Interuniversity Consortium for Political and Social Research (OPENICPSR). Healthcare workers including females and males who transitioned to working from home during the COVID-19 stay-at-home orders were included. Sex differences were compared using the chi-square test and Student's t-test. We performed logistic and linear regression analyses to determine the association of females with psychological burden and health behaviors.

Results: A total of 537 respondents (425 females and 112 males) were enrolled in our study. Sex differences in age (42.1 ± 12.3 years vs. 46.6 ± 15.7 years, t = −2.821, p = 0.005), occupation (χ² = 41.037, p < 0.001), mood change (n = 297, 69.9% vs. n = 61, 54.5%, χ² = 9.482, p = 0.002), bedtime schedule (χ² = 6.254, p = 0.044) and news consumption (n = 344, 80.9% vs. n = 76, 67.9%, χ² = 8.905, p = 0.003) were statistically significant. Logistic regression showed that females was negatively associated with better mood status (OR = 0.586, 95% CI 0.153–2.247, p = 0.436). In addition, linear regression showed that females were not correlated with total sleep time after adjusting for sio-demographics, mental health outcomes and health behaviors (B = 0.038, 95% CI −0.313–0.388, p = 0.833).

Conclusion: No sex differences in psychological burden and health behaviors of healthcare workers were found during the COVID-19 stay-at-home orders. The COVID-19 state-ordered home isolation may be a potential way to reduce disproportionate effects of COVID-19 pandemic on females and help to minimize sex differences in psychological burden and health behaviors among healthcare workers.

Depression, Healthcare Utilization, Missed Work, and Health Behaviors Among US Young Workers: Data From the 2015 National Health Interview Survey

OBJECTIVE

We examined the prevalence of depression and its impact on healthcare utilization, work absenteeism, and health behaviors among United States (US) young workers.

METHODS

Data of 1053 young workers (ages 18 to 25) from the 2015 US National Health Interview Survey were analyzed to examine these associations.

RESULTS

Seven percent of US young workers reported feeling often depressed (daily or weekly). Often depressed young workers had increased odds for healthcare provider visits, mental healthcare use, 1 to 2 emergency department visits, and 3 to 5 and more than or equal to 6 missed work days, smoking, and sleeping less than 7 hours.

CONCLUSIONS

Our findings suggest that depressed young workers have increased needs for healthcare utilization and are at increased risk for missing work, smoking, and reduced sleep. Resources should be prioritized for depression screening and prevention programs at the workplace and healthcare settings.

The prevalence of hazardous and harmful drinking in the UK Police Service, and their co-occurrence with job strain and mental health problems

AIMS

Due to the stressful nature of policing, police employees are at risk of mental health problems and problematic alcohol use. We aim to determine the prevalence of hazardous and harmful alcohol use in the UK Police Service, and to explore the associations with job strain and mental health problems.

METHODS

Cross-sectional data from the Airwave Health Monitoring Study (N = 40 986) included measures of alcohol consumption (total units in past week), mental health (depression, anxiety and post-traumatic stress disorder [PTSD]) and job strain. The associations between mental health and job strain with alcohol consumption (i.e. abstinence, low-risk [<14 units per week, reference group], hazardous [>14 to 35 units for women, >14 to 50 units for men], harmful [>35 units for women, >50 units for men]), were analysed using multinomial logistic regressions, adjusting for potential confounders (i.e. age, gender, ethnicity, marital status, children under 18, income and smoking status).

RESULTS

A total of 32.6% of police employees reported hazardous drinking, with 3.0% drinking at harmful levels. Compared to those without a mental health problem, police employees with depression, anxiety or PTSD were twice as likely to be harmful drinkers and were also 1.3 times more likely to report abstinence. Those reporting low strain (reference group) were more likely to drink hazardously compared to those reporting high strain, which was statistically moderated by mental health. When the sample was stratified by mental health status, the association between low strain (compared to all other categories) and hazardous drinking, was significant only in those without a mental health problem.

CONCLUSIONS

These findings indicate that police employees may be an occupational group at risk of alcohol harm, with one-third drinking hazardously. The J-shaped relationship between mental health and alcohol use highlights a need for an integration of mental health and alcohol services, tailored for the UK Police Service.

Association of mental disorders with SARS-CoV-2 infection and severe health outcomes: nationwide cohort study

BACKGROUND

Epidemiological data on the association between mental disorders and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) severity are limited.

AIMS

To evaluate the association between mental disorders and the risk of SARS-CoV-2 infection and severe outcomes following COVID-19.

METHOD

We performed a cohort study using the Korean COVID-19 patient database based on national health insurance data. Each person with a mental or behavioural disorder (diagnosed during the 6 months prior to their first SARS-CoV-2 test) was matched by age, gender and Charlson Comorbidity Index with up to four people without mental disorders. SARS-CoV-2-positivity risk and the risk of death or severe events (intensive care unit admission, use of mechanical ventilation and acute respiratory distress syndrome) post-infection were calculated using conditional logistic regression analysis.

RESULTS

Among 230 565 people tested for SARS-CoV-2, 33 653 (14.6%) had mental disorders; 928/33 653 (2.76%) tested SARS-CoV-2 positive and 56/928 (6.03%) died. In multivariable analysis using the matched cohort, there was no association between mental disorders and SARS-CoV-2-positivity risk (odds ratio OR = 0.95; 95% CI 0.87-1.04); however, a higher risk was associated with schizophrenia-related disorders (OR = 1.50; 95% CI 1.14-1.99). Among confirmed COVID-19 patients, the mortality risk was significantly higher in patients with than in those without mental disorders (OR = 1.99, 95% CI 1.15-3.43).

CONCLUSIONS

Mental disorders are likely contributing factors to mortality following COVID-19. Although the infection risk was not higher for people with mental disorders overall, those with schizophrenia-related disorders were more vulnerable to infection.

Prevalence of common mental disorders and associated factors among adults with Glaucoma attending University of Gondar comprehensive specialized hospital tertiary eye care and training center, Northwest, Ethiopia 2020

PURPOSE

This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit.

METHODS

An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders.

RESULT

Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4-33.3). Female sex (AOR = 3.79, 95% CI: 1.66-8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26-16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79-38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74-39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07-7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30-4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65-6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders.

CONCLUSION

Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.

The prevalence of and factors associated with depressive symptoms in the Korean adults: the 2014 and 2016 Korea National Health and Nutrition Examination Survey

PURPOSE

This study was performed to investigate the prevalence of and factors associated with depressive symptoms in the Korean adult population.

METHODS

10,710 participants in the 2014 and 2016 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed in this study. Assessment of depressive symptoms was performed using the self-administered nine-item Patient Health Questionnaire (PHQ-9).

RESULTS

The weighted prevalence of clinically relevant depression (PHQ-9 score ≥ 10) in the Korean adult population was 6.1% [5.5-6.8%]. Female sex, adults aged 19-29 years, elementary school graduation, living alone were significantly associated with clinically relevant depression. Having a household income ≤ 24th percentile was associated with a 2.26 (CI 1.49-3.45, p < 0.001)-fold higher prevalence of clinically relevant depression compared to having a household income ≥ 75th percentile. Regarding occupation, treating managers and professionals as controls, we found that unemployed individuals (OR 2.36, 95% CI 1.52-3.65, p < 0.001) had an increased risk of clinically relevant depression. Alcohol consumption < 30 g/day was reversely associated with clinically relevant depression (OR 0.75, 95% CI 0.62-0.93, p = 0.007), when abstain from alcohol was treated as control. Current smokers (OR 3.42, 95% CI 2.54-4.60, p < 0.001) and ex-smokers (OR 1.73, 95% CI 1.24-2.42, p = 0.001) had a higher risk of clinically relevant depression than never-smokers.

CONCLUSIONS

The estimated prevalence of depressive symptoms in a representative sample of the Korean adult population was 6.1%. This study suggests that younger age, female sex, elementary school graduation, living alone, low household income, current smoking, and being unemployed are associated with depressive symptoms.

Prevalence and correlates of major depressive disorder: a systematic review

OBJECTIVES

Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD.

METHODS

A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018.

RESULTS

Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies.

CONCLUSIONS

MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.

Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study

BACKGROUND

Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups.

METHODS

We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels.

RESULTS

The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77).

CONCLUSION

Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.

Current practices and perceived implementation barriers for working with alcohol prevention in occupational health services: the WIRUS OHS study

BACKGROUND

Alcohol is associated with detrimental health and work performance outcomes, and one to three out of ten employees may benefit from interventions. The role of occupational health services (OHS) in alcohol prevention has received little attention in research. The primary aims of this study were to explore current practices of alcohol prevention targeting employees in occupational health settings, and examine whether and which perceived implementation barriers were associated with alcohol prevention activity. The secondary aim was to explore whether barriers were differentially associated with primary, secondary and tertiary prevention activities.

METHODS

In this cross-sectional study, survey data were collected from 295 OHS professionals in Norway in 2018. Data were analysed by means of descriptive statistics, one-way analysis of variance, paired samples t-tests, and multivariate linear regression analyses.

RESULTS

Overall, seven out of ten OHS professionals worked with alcohol-related cases less than monthly, while only one out of ten did so on a weekly basis. Their activities were more focused on tertiary prevention than on primary and secondary prevention. Physicians, psychologists and nurses reported to handle alcohol-related issues more often than occupational therapists and physical therapists. Higher levels of implementation barriers internal to the OHS' organisation (competence, time and resources) were associated with lower alcohol prevention activity. Barriers external to the OHS' organisation (barriers concerning employers and employees) were not. This pattern was evident for primary, secondary and tertiary prevention activities. A majority of OHS professionals agreed that employees' alcohol consumption constitute a public health challenge, and that OHS' should focus more on alcohol prevention targeting employees.

CONCLUSIONS

Occupational health settings at workplaces may be particularly serviceable for alcohol prevention programmes since the majority of the population is employed and the majority of employees consume alcohol. An increase in overall prevention activity, and a shift from mainly focusing on tertiary prevention to an increased emphasis on primary and secondary prevention, may both hinge on increased training of OHS professionals, emphasising knowledge on the importance of working with alcohol prevention, and training in administering alcohol prevention programmes. Making alcohol prevention a priority may also require increased allocation of time and resources.

Longitudinal Associations of Modifiable Lifestyle Factors With Positive Depression-Screen Over 2.5-Years in an International Cohort of People Living With Multiple Sclerosis

Background: Depression is common and has a significant impact on quality of life for many people with multiple sclerosis (MS). A preventive management approach via modification of lifestyle risk factors holds potential benefits. We examined the relationship between modifiable lifestyle factors and depression risk and the change in depression over 2.5 years. Methods: Sample recruited using online platforms. 2,224 (88.9%) at baseline and 1,309 (93.4%) at 2.5 years follow up completed the necessary survey data. Depression risk was measured by the Patient Health Questionnaire-2 (PHQ-2) at baseline and Patient Health Questionniare-9 (PHQ-9) at 2.5-years follow-up. Multivariable regression models assessed the relationships between lifestyle factors and depression risk, adjusted for sex, age, fatigue, disability, antidepressant medication use, and baseline depression score, as appropriate. Results: The prevalence of depression risk at 2.5-years follow-up in this cohort was 14.5% using the PHQ-2 and 21.7% using the PHQ-9. Moderate alcohol intake, being a non-smoker, diet quality, no meat or dairy intake, vitamin D supplementation, omega 3 supplement use, regular exercise, and meditation at baseline were associated with lower frequencies of positive depression-screen 2.5 years later. Moderate alcohol intake was associated with greater likelihood of becoming depression-free and a lower likelihood of becoming depressed at 2.5-years follow-up. Meditating at least once a week was associated with a decreased frequency of losing depression risk, against our expectation. After adjusting for potential confounders, smoking, diet, physical activity, and vitamin D and omega-3 supplementation were not associated with a change in risk for depression. Conclusion: In a large prospective cohort study of people with MS and depression, in line with the emerging treatment paradigm of early intervention, these results suggest a role for some lifestyle factors in depression risk. Further studies should endeavor to explore the impact of positive lifestyle change and improving depression in people living with MS.

The influence of hazardous drinking on psychological functioning, stress and sleep during and after treatment in patients with mental health problems: a secondary analysis of a randomised controlled intervention study

OBJECTIVES

Hazardous drinking could negatively affect health and lead to alcohol use disorders, but it is unclear how hazardous drinking affects treatment outcomes of depression and anxiety and stress-related mental health problems. The aim of this study was to examine whether hazardous drinking, measured by Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), influences the outcomes of repeated assessments of psychological functioning (Outcome Questionnaire-45), stress (Perceived Stress Scale) and sleep (Karolinska Sleep Questionnaire), during and after treatment in patients with mental ill health.

METHODS

The study was conducted within REGASSA, a randomised controlled trial aimed at comparing Internet-based cognitive-behaviour therapy and physical exercise with treatment as usual on primary care patients with mental ill health. The study involved 871 participants who completed the AUDIT at baseline and who were assessed repeatedly during and after treatment on psychological functioning, stress and sleep by interactive voice response, a computerised, automated telephone technology.

RESULTS

At baseline, hazardous drinkers were more depressed and had lower scores on psychological functioning than non-hazardous drinkers, while there were no differences on stress and sleep. During the follow-ups, hazardous drinking negatively influenced perceived stress, that is, hazardous drinkers seemed to have less treatment effect on stress, and the results remained after controlling for depression. There were no differences during the follow-ups regarding psychological functioning and sleep.

CONCLUSIONS

Hazardous drinking negatively influenced perceived stress. The findings of the study emphasise the importance of screening for alcohol habits in mental ill-health patients, since risky drinking may affect the outcomes of treatment.

TRIAL REGISTRATION NUMBER

DRKS00008745; Post-results.

Testing bidirectional relationships between alcohol use and depressive symptoms: What is the role of the serotonin transporter gene?

Alcohol abuse often co-exists with a major depressive disorder. In order to understand the development of this comorbidity, it is important to concentrate on the preceding process. It has been suggested that the link between alcohol use and depressive symptoms is a result of an interaction with genetic factors. The aim of this study was to longitudinally examine the effect of the 5-HTTLPR genotype on the association between depressive symptoms and alcohol use in a Dutch community sample. Following a stepwise approach, bivariate correlations, longitudinal regression analyses, and latent growth curve analyses were separately conducted for 316 males and 321 females. A positive correlation between depressive symptoms and alcohol use was shown in female carriers of the 5-HTTLPR short allele. In addition, latent growth curve analyses showed a positive association between alcohol use and the intercept of depressive symptoms (but not the slope), but only in female carriers of the 5-HTTLPR short allele. These findings show that alcohol use may be positively related, at least cross-sectionally, to depressive symptoms in female carriers of the 5-HTTLPR S allele, and indicate that moderators such as SLC6A4 genotype and sex need to be taken into account when examining associations between depressive symptoms and drinking behavior. In order to gain insight into the longitudinal association between alcohol use and depressive symptoms, studies should concentrate on earlier stages and focus on more fine-grained research designs that allow day-to-day changes in both alcohol use and depressive symptoms.

Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study

Objective:

To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population.

Methods:

This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI).

Results:

Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk.

Conclusion:

These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

The behavioral and physiological effects of high-fat diet and alcohol consumption: Sex differences in C57BL6/J mice

BACKGROUND AND OBJECTIVE

Animal studies can be a great tool to investigate sex differences in a variety of different ways, including behavioral and physiological responses to drug treatments and different "lifestyle variables" such as diets. Consumption of both high-fat diets and alcohol is known to affect anxiety behaviors and overall health. This project investigated how high-fat diet and alcohol access and its combination affected the behavior and physiology of male and female C57BL/6J mice.

METHOD

Mice were separated into three food groups: high-fat diet, 10% fat diet, and regular chow, and each group was paired with either water or 10% alcohol. Behavioral assays included diet and alcohol preference, light-dark box, open field, and feeding and drinking measurements. Physiological measures included glucose tolerance tests and measurement of brain-derived neurotrophic factor, insulin, and leptin levels.

RESULTS

Females and males differed in the open field, as male mice decreased activity, while females increased activity when consuming high-fat diet. While females consumed more ethanol than males, alcohol consumption was able to improve glucose tolerance and increase anxiety in both sexes. Lastly, females were more resistant to the physiological changes caused by high-fat diet than males, as females consuming high-fat diet exhibited decreased insulin secretion, less change to brain-derived neurotrophic factor levels, and better glucose tolerance than males consuming high-fat diet.

CONCLUSION

These results suggest that the response to high-fat diet and alcohol consumption is sex dependent and that males are more affected both behaviorally and physiologically by high-fat diet compared to females.

Maternal alcohol and tobacco consumption and the association with their 9 to 14-year-old children’s Body Mass Index

Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents’ body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children’s body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low–moderate drinkers (scores 1–4) and 22.3% were harmful drinkers (scores ⩾5). There were statistically significant associations between currently smoking mothers and children’s overweight (RR=1.36; 95% CI: 1.05–1.76). There was an inverse association between maternal former smoking and children’s underweight (RR=0.70; CI: 0.56–0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low–moderate mothers (RR=1.57; 95% CI: 1.03–2.41). Conclusions: Current smoker mothers were associated with children’s overweight and former-smoker mothers were inversely associated with the children’s underweight. Being an abstainer mother was associated with the children’s underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.

Evaluation of a retrospective diary for peri-conceptual and mid-pregnancy drinking in Scotland: a cross-sectional study

INTRODUCTION

Heavy episodic ("binge") drinking among women in Scotland is commonplace; prepregnancy drinking is associated with continued antenatal drinking. Evidence for effectiveness of standardized antenatal alcohol assessment is lacking. Alcohol-exposed pregnancies may be missed. We assessed peri-conceptual and mid-pregnancy consumption using a week-long retrospective diary and standard alcohol questionnaires, and evaluated the agreement between these instruments.

MATERIAL AND METHODS

Cross-sectional study in two Scottish health board areas involving 510 women attending mid-pregnancy ultrasound scan clinics. Face-to-face administration of alcohol retrospective diary and AUDIT or AUDIT-C assessed weekly and daily alcohol consumption levels and patterns. Depression-Anxiety-Stress Scale (DASS-21) assessed maternal wellbeing. A sub-sample (n = 30) provided hair for alcohol metabolite analysis. Pearson's correlation coefficient investigated associations between questionnaires and alcohol metabolite data.

RESULTS

The response rate was 73.8%. The retrospective diary correlated moderately with AUDIT-C and AUDIT but elicited reports of significantly higher peri-conceptual consumption, (median unit consumption on "drinking days" 6.8; range 0.4-63.8). Additional "special occasions" consumption ranged from 1 to 125 units per week. Correlations between DASS-21 and retrospective diary were weak. Biomarker analysis identified three instances of hazardous peri-conceptual drinking.

CONCLUSIONS

Women reported higher consumption levels when completing the retrospective diary, especially regarding peri-conceptual "binge" drinking. Routine clinical practice methods may not capture potentially harmful or irregular drinking patterns. Given the association between prepregnancy and antenatal drinking, and alcohol's known teratogenic effects, particularly in the first trimester, the retrospective diary may be a useful low-tech tool to gather information on alcohol intake patterns and levels.

Longitudinal association between different levels of alcohol consumption and a new onset of depression and generalized anxiety disorder: Results from an international study in primary care

BACKGROUND

Several studies that have examined the full range of alcohol consumption have pointed to a possible non-linear association between alcohol use and the common mental disorders. Most of these studies are cross sectional and assessed psychiatric morbidity using non-specific instruments. Our aim was to investigate the longitudinal association between varying levels of alcohol consumption at baseline and the new-onset of depression and generalized anxiety disorder (GAD), in a large international primary care sample.

METHODS

The sample consisted of 3201 primary care attenders from 14 countries in the context of WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use at baseline was assessed using AUDIT and the mental disorders were assessed with the Composite International Diagnostic Interview.

RESULTS

Light to moderate alcohol consumption at baseline was associated with a lower incidence of depression and GAD compared to abstinence while excessive alcohol consumption was associated with a higher incidence of depression but not GAD. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables.

CONCLUSION

Any causal interpretation of this association is difficult in the context of an observational study and further combined and consistent evidence from different sources is needed.

Depression and anxiety were low amongst virally suppressed, long-term treated HIV-infected individuals enrolled in a public sector antiretroviral program in Thailand

HIV/AIDS and anxiety/depression are interlinked. HIV-infected patients suffering from depression may be at risk for poor adherence which may contribute to HIV disease progression. Additionally, an HIV diagnosis and/or using certain antiretroviral agents may trigger symptoms of anxiety/depression. The objective of the study was to assess the prevalence and factors associated with anxiety and depression in HIV-infected patients from the Thai National HIV Treatment Program. This cross-sectional study was performed from January 2012 to December 2012 in HIV-infected out-patients, aged ≥18 years, from three HIV referral centers. Symptoms of anxiety and depression were measured using the Thai-validated Hospital Anxiety and Depression Scale (HADS). A score of ≥11 was defined as having anxiety and depression. Associated factors were assessed by multivariate logistic regression. Totally 2023 (56% males) patients were enrolled. All patients received antiretroviral therapy (ART) for a mean duration of 7.7 years. Median CD4 was 495 cells/mm³. Ninety-five percent had HIV-RNA < 50 copies/ml. Thirty-three percent were currently on efavirenz (EFV)-based ART. The prevalence of anxiety and depression were 4.8% and 3.1%, respectively. About 1.3% had both anxiety and depression. In multivariate logistic models, the female sex [OR = 1.6(95%CI 1.1-2.3), p = .01], having adherence <90% [OR = 2.2(95%CI 1.5-3.4), p < .001], fair/poor quality of life (QOL) [OR = 7.2 (95%CI 3.6-14.2), p < .001] and EFV exposure [OR = 1.6(95%CI 1.1-2.3), p = .01], were independently associated with having anxiety or depression. Our findings demonstrated that prevalence of depression and anxiety was low amongst virally suppressed, long-term antiretroviral-treated HIV-infected individuals. Some key characteristics such as the female sex, poor adherence, poor/fair QOL and EFV exposure are associated with anxiety and depression. These factors can be used to distinguish who would need a more in-depth evaluation for these psychiatric disorders.

Binge drinking and subsequent depressive symptoms in young women in Australia

BACKGROUND

The long-term impact of binge drinking on subsequent depressive symptoms is unclear. The aims were to identify longitudinal patterns of binge drinking and whether binge drinking preceded depressive symptoms in the short-term (1-6 years) and long-term (10-15 years).

METHODS

Longitudinal data from 1996, 2000 and 2009 mailed surveys of 8,197 women in the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Latent class analysis was used to identify binge drinking patterns and logistic regression to estimate associations with subsequent depressive symptoms.

RESULTS

Five binge drinking trajectories were identified with predicted proportions of women who were very infrequent (24%), fluctuating infrequent (17%), frequent (17%), very frequent (26%) or extremely frequent binge drinkers (16%) between 16 and 21 years. At 22-27 years, depressive symptoms were significantly higher for extremely frequent binge drinkers (31% versus 21% in the short-term; 22% versus 16%-18% in the long-term) than for less frequent bingers. Unadjusted odds of depressive symptoms were 1.70 (95%CI:1.38;2.08) times for extremely frequent binge drinkers than very infrequent bingers and were 1.30 (95%CI:1.04;1.63) after adjusting for demographics, relationships and experience of violence. At 31-36 years, the odds of depressive symptoms were 1.34 (95%CI:1.09-1.64) times for extremely frequent than very infrequent binge drinkers, but were not significant after adjusting for relationships and violence.

CONCLUSIONS

Extremely frequent binge drinking (more than weekly) in late adolescence appears to elevate the risk of subsequent depressive symptoms in young women in their early twenties and thirties, emphasising the need for preventive strategies to curb binge drinking.

Epidemiology of depression at Traditional Chinese Medicine Hospital in Shanghai, China

BACKGROUND

Though Chinese Traditional Medicine (TCM) is one of the most important parts of health care system in China, studies on the epidemiology of depression in TCM are scarce and mental health issues in TCM have been neglected for longtime.

METHODS

This was an interview-based survey. The prevalence of depression and suicidal risk in outpatients at a TCM hospital was identified by a one-stage diagnosing process using the Mini International Neuropsychiatric Interview. Associated risk factors, role impairment, and service utility were also assessed.

RESULTS

A total of 2000 outpatients aged from 18 to 65years completed the survey with a response rate of 87.0%. The estimated prevalence of major depressive disorder was 13.2% for lifetime and 4.9% for current. No significant gender differences were found. Depression was more common in patients who lacked social support, experienced family economic burden and health burden, and underwent negative life events, poor self-rated health, or with moderate/severe sleep problem than in their correspondents; all with statistical significance (OR: 1.83-6.82). Patients with depression reported a mean of 82.7days and 99.3days of sick leave due to their physical and mental condition, respectively, which was much longer than those without depression (24.8days and 25.8days, respectively). Only 30.0% of patients with depression sought professional help from psychiatrists/psychologists or used antidepressants.

LIMITATIONS

The recall bias could not be ruled out in this study and could have led to an underestimation of true prevalence and the unmet need for treatment. Since this study was cross-sectional, the causal relationships between sociodemographic factors and depression cannot be determined.

CONCLUSIONS

Depression is common at TCM hospitals. The impairments due to depression are striking, and unmet needs for treatment are pervasive. Consequently, mental health services in TCM should not be neglected any longer.

The ADH gene cluster SNP rs1789891 and temperamental dimensions in patients with alcohol dependence and affective disorders

This study had three objectives: (1) to assess the relationship between the single nucleotide polymorphism (SNP) rs1789891 in the alcohol dehydrogenase gene cluster and alcohol dependence and affective disorders; (2) to assess the differences in the Regulative Theory of Temperament (RTT) traits between an alcohol dependent group, an affective disorders group, and a healthy group; and (3) to assess the relationship between rs1789891 and temperament traits in a healthy group, taking into account the interaction of genotype and sex. The SNP rs1789891 was genotyped in a group of 194 alcohol dependent men, aged 21 to 71 years; 137 patients with affective disorders, including 51 males and 86 females, aged 19 to 85 years; and a group of 207 healthy individuals, including 89 males and 118 females, aged 18 to 71 years. Temperament traits (briskness, perseveration, sensory sensitivity, emotional reactivity, endurance, and activity) were assessed in all groups using the Formal Characteristics of Behaviour-Temperament Inventory. The comparative analysis of genotypic frequencies showed no significant differences between patients with alcoholism or affective disorders and those in the control group. Alcohol dependent men and the affective disorder group were characterised by higher levels of emotional reactivity (p-value 1.4e-5 and 9.84e-7, respectively) and lower levels of briskness, sensory sensitivity, endurance, and activity (p-value from 3.76e-8 to 0.012) when compared to the healthy group. The rs1789891 polymorphism was associated with briskness (p = 0.02), sensory sensitivity (p = 0.036), and activity (p = 0.049). None of the results were statistically significant after Bonferroni correction.

Neighborhood characteristics associated with the availability of alcohol outlets in quebec, Canada

Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest metropolitan areas of the province of Quebec (Montréal and Québec City). Within 1000 metres, alcohol outlets are more available in neighbourhoods with the following characteristics: highest concentration of men, least materially deprived highest concentration of persons aged 20 years or more, and location either in a metropolitan area or in a small town. Finally, the number of bars with video lottery terminals increases with the level of social and material deprivation. Conclusion. In Québec, there is no rule governing the location of alcohol outlets. Thus, there is an abundant literature indicating that the regulation of alcohol outlet density could be an effective means of controlling risk attributable to alcohol consumption.