Differences In Lifetime Prevalence Research Articles

Sex differences in lifetime prevalence of low back pain: A multinational study of opposite-sex twin pairs.

Low back pain (LBP) is more likely to occur in people with a family history of this condition, highlighting the importance of accounting for familial factors when studying the individual risk of LBP. We conducted a study of opposite-sex twin pairs investigating sex differences in LBP while accounting for (genetic and shared environmental) familial factors. We applied a matched co-twin control design to study 795 adult opposite-sex pairs from Australia, Spain, and the United States (US). We used mixed-effects logistic regression to assess the within-pair association between female sex and lifetime prevalence of LBP in unadjusted and adjusted models for body-mass-index, and depression, as well as interactions between female sex and age (<median age vs. ≥median age) in this association. The mean age of the sample was 47.4 years (Standard Deviation = 16.5). The adjusted odds ratio (aOR) of the association between sex and LBP in the merged sample was 1.11 (95% Confidence Interval = 0.88-1.40), with 87.4% of the variance in the studied association explained by between-site heterogeneity (Q test; p = 0.001). Females had 2.37 (95% CI: 1.48-3.78) higher odds of LBP compared to their male co-twins in the Spanish sample (adjusted), but a sex association was not found in the Australian nor US samples. We found no evidence of the association between sex and LBP in our merged sample. Between-population differences (i.e. cultural background or health system characteristics) are likely to be major factors leading to variation in the sex association with LBP when familial factors are accounted for. Our study of adult opposite-sex twin pairs found no evidence of an association between female sex and lifetime prevalence of low back pain after controlling for familial factors in the merged sample from Australia, Spain and USA, contrary to findings from previous studies of unrelated individuals. Our findings indicate potentially relevant between-country genetic, cultural and environmental differences which may need to be considered for optimal and individualized strategies for the prevention and management of low back pain across the lifespan.

Health conditions among farmworkers in the Southwest: An analysis of the National Agricultural Workers Survey.

Agricultural jobs pose many challenges to the health and wellbeing of a disadvantaged population. In the Southwest region, the socioeconomic factors of living along the U.S.-Mexico border, migration patterns, lack of access to health care, low utilization of health care services, lack of health insurance, and highly demanding occupation may uniquely affect health outcomes for farmworkers. This paper presents descriptive information for professionals to improve access to care by tackling barriers afforded by the agricultural industry. The National Agricultural Worker Survey (NAWS) is an employment-based, random-sample survey of U.S. agricultural workers in six regions: East, Southeast, Midwest, Southwest, Northwest, and California. We examined farmworkers' self-reported health conditions, including asthma, diabetes, high blood pressure, other chronic conditions, or any condition by region from 2013 to 2016. We used logistic regression to determine differences in lifetime prevalence of health conditions between farmworkers in the Southwest region (n = 727) and farmworkers in other regions (n = 8,850) using weighted data. After adjusting for age, gender, income, insurance status, and English-speaking ability, the odds of high blood pressure and other condition were similar in all regions. The prevalence of diabetes was almost double in the Southwest (114.2 per 1,000 farmworkers). The odds of diabetes were 1.31 (95% CI 0.99, 1.74) times greater in the Southwest region than in the other regions. Asthma was the only condition that was lower in the Southwest (22 per 1,000 farmworkers) compared to the other regions. The odds of asthma were 0.61 (95% CI 0.36, 1.03) times lower in the Southwest region than in other regions. The results follow previous studies on the prevalence of asthma among the farmworker population and elevated probability of chronic diseases including diabetes among the Latino population in the U.S.

Anticoagulation Use and Outcomes Among Patients with Atrial Fibrillation and Von Willebrand Disease

Intro: Von Willebrand disease (VWD) is a coagulopathy caused by deficiency or dysfunction of von Willebrand factor (VWF), resulting in prolonged and excessive bleeding. Patients are advised to avoid aspirin (ASA), P2Y12 inhibitors, or anticoagulation (AC) so as not to exacerbate this condition. However, typical treatment for atrial fibrillation (AF) includes anticoagulation, particularly if the risk of stroke by CHA 2DS 2-VASC score is 2+. Current recommendations suggest giving necessary antiplatelet (AP) or AC therapy over no treatment with assessment of bleeding risk throughout the course. However, this is a conditional recommendation based on low certainty in evidence, and there are no specific guidelines on treating AF in patients with VWD. This study aims to assess anticoagulation use, bleeding risk, and stroke risk in patients with VWF and AF.Methods: We conducted an IRB-approved analysis of coded data from institutional electronic medical records to select patients with diagnosis of VWD, low ristocetin cofactor level, or any abnormal VWF panel as well as patients with diagnosis of AF or atrial flutter. Three hundred and forty patients met criteria. Patients were manually screened for inclusion criteria and excluded for inaccurate diagnosis or insufficient data. Eighty-nine patients were included in the analysis. Primary endpoint was rate of major bleeding defined by ISTH criteria while on AC or AP. Categorical data were tested using the Fisher exact test at the nominal 0.05 two-sided significance level, and all person-time comparisons are made against the rate of bleeding on AC alone.Results: Most patients were female (64.0%; 57/89), and 28.1% (25/89) were deceased at the time of data collection. Date of diagnosis of AF ranged from 1980-2020. 42.7% (38/89) of patients were ever prescribed ASA, 43.8% (39/89) a P2Y12 inhibitor, 56.2% (50/89) AC, and 23.6% (21/89) had never been prescribed AP or AC. Of patients with a CHA 2DS 2-VASC of 2+, 57.5% (46/80) were ever prescribed AC. 32.0% (16/50) of patients ever prescribed AC and 25.6% (10/39) patients never prescribed AC had at least one major bleeding event (p=0.428). The rate of major bleeding on AC alone was 8.9 events per 100 person-years (32 events/359.2 years), 10.2 events per 100 person-years on AP alone (41 events/402.3 years) (p=0.572), and 1.06 events per 100 person-years (8 events/757.47 years) in patients never prescribed AC or AP (p=<0.0001). Notably, the rate of major bleeding on AC and AP together was 28.07 events per 100 person-years (23 events/81.94 years) (p=<0.0001) occurring in 7 patients, 6 of whom also had a diagnosis of acute coronary syndrome (ACS). Length of time to first major bleed is shown in Figure 1. 16.9% (15/89) of patients had thromboembolic strokes after diagnosis of AF, and 53.3% (8/15) of those strokes occurred when patients were not prescribed AC.Discussion: This retrospective observational study over 40 years characterizes AC and AP use in patients with VWD and AF. Only 57.5% of patients with CHA 2DS 2-VASC of 2+ received standard of care AC despite conditional recommendations to give necessary anticoagulation to patients with VWD. In parallel with the general population, AC use significantly increases the rate of major bleeding in patients with VWD, but there was no difference in bleeding rate between standard AC and AP monotherapy. However, major bleeding rates were notably elevated in patients prescribed concomitant AC and AP which most commonly occurred in the setting of ACS. This analysis is limited by its retrospective nature, the lack of granular details in the coded database, and incomplete data in older charts. Overall, these data do not support the use of AP monotherapy over standard AC to reduce bleeding rates for patients with VWD and AF. Additionally, AC and AP co-administration should be avoided due to high rates of major bleeding, but more studies are required to understand AP and AC strategies in patients with VWD, AF, and ACS. Although the rate of major bleeding is elevated with AC use in patients with VWD, there is no difference in lifetime prevalence of major bleeding events by AC vs no AC use. Finally, over half of thromboembolic strokes occurred when not prescribed AC. Shared decision-making around stroke and bleeding risk is advised in considering AC use for AF in patients with VWD. Prospective studies should further evaluate the risk of major bleeding and stroke in patients with VWD and AF on standard AC vs no AC. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults.

There has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity. Survival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys. Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent. Parental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences.

Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among U.S. Adolescents

To examine differences in lifetime prevalence of mental disorder and service use among U.S. adolescents by both immigrant generation and race/ethnicity. A total of 6,250 adolescents aged 13 to 18 years in the National Comorbidity Survey Replication Adolescent Supplement were assessed for lifetime prevalence of mood and/or anxiety disorders, behavior disorders, and mental health service use. Twelve groups defined by self-identified race/ethnicity (non-Hispanic white, Hispanic, non-Hispanic black, Asian) and immigrant generation (first, second, third, or more) were compared. Differences in prevalence of lifetime mental disorder were most apparent when immigrant generation and race/ethnicity were considered jointly. Compared to third+generation non-Hispanic white adolescents, the odds of mood/anxiety disorder were increased among second-generation Asian (adjusted odds ratio [AOR]= 2.51; 95% CI= 1.22-5.17) and third+generation Hispanic (AOR= 1.28; 95% CI= 1.00-1.63) but reduced among first-generation Asian (AOR= 0.27; 95% CI= 0.10-0.71) and second-generation non-Hispanic white adolescents (AOR= 0.50; 95% CI= 0.30-0.81). The odds of behavior disorder were lower among first-generation Asian (AOR= 0.26; 95% CI= 0.09-0.71) and all generations of non-Hispanic black adolescents (AOR range 0.43-0.55). Adjusting for lifetime disorder, first-generation Hispanic and non-Hispanic white adolescents and all generations of non-Hispanic black adolescents were less likely to receive mental health services (AOR range 0.24-0.55). Variation in risk of disorder by immigrant generation and race/ethnicity underscores the importance of considering social, economic, and cultural influences in etiologic and treatment studies of adolescent psychopathology. Lower rates of service use, particularly among first-generation immigrant adolescents, highlight the need to identify and address barriers to recognition and treatment of mental disorders among adolescents from immigrant and racial/ethnic minority backgrounds.

Lifetime prevalence of injuries in incoming division I collegiate football players

ABSTRACTObjectives: The purpose of this study is to determine the lifetime prevalence of past injuries in incoming first year football players in a Division 1 college football team.Methods: Pre-participation questionnaires from 605 first-year football players over 20 years (1996–2015) were examined to determine the prevalence of concussions, stingers, fractures, and musculoskeletal surgeries sustained before playing at the collegiate level. Players were grouped by position: wide receiver and defensive back (WR/DB), offensive and defensive linemen (OL/DL), all other positions (OP), and unknown (UKN). Prevalence of injuries by year and position was compared using Pearson’s χ2 Test (p < 0.05).Results: The reported lifetime prevalence is as follows: concussion (21%), stinger (23%), musculoskeletal surgery (23%), and fracture (44%). There were no significant differences in lifetime prevalence of concussions (p = 0.49), stingers (p = 0.31), fractures (p = 0.60), or musculoskeletal surgeries (p = 0.97) based on position. There were also no significant differences in the lifetime prevalence of concussions (p = 0.14), musculoskeletal surgeries (p = 0.50), or fractures (p = 0.59) based on year. However, there was a significant difference in the lifetime prevalence of stingers based on year (p < 0.001).Conclusions: There was an expectation to observe an increase in injury prevalence by entering year, but this was not seen. A decrease in stingers was actually observed, but there was no significant difference among any other injury recorded. These results do not support the perception that football injuries are on the rise. Under reporting is a significant concern as players may fear disqualification or that they are evaluated by the coaching staff based on their medical history. More research is needed to confirm lifetime injury prevalence and evaluate differences over time among football players.

Disc degeneration on MRI is more prevalent in young elite skiers compared to controls

PurposeEvidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes.MethodsSeventy-five young elite alpine and mogul skiers, age range 16–20 years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires.ResultsFifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p = 0.027). Schmorl’s nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p < 0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p = 0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0–6) versus 0.6 in controls (median 0, range 0–3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p = 0.026).ConclusionAlpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score.Level of evidenceII.

Allopregnanolone in the bed nucleus of the stria terminalis modulates contextual fear in rats.

Trauma- and stress-related disorders are among the most common types of mental illness affecting the U.S. population. For many of these disorders, there is a striking sex difference in lifetime prevalence; for instance, women are twice as likely as men to be affected by posttraumatic stress disorder (PTSD). Gonadal steroids and their metabolites have been implicated in sex differences in fear and anxiety. One example, allopregnanolone (ALLO), is a neuroactive metabolite of progesterone that allosterically enhances GABAA receptor activity and has anxiolytic effects. Like other ovarian hormones, it not only occurs at different levels in males and females but also fluctuates over the female reproductive cycle. One brain structure that may be involved in neuroactive steroid regulation of fear and anxiety is the bed nucleus of the stria terminalis (BNST). To explore this question, we examined the consequences of augmenting or reducing ALLO activity in the BNST on the expression of Pavlovian fear conditioning in rats. In Experiment 1, intra-BNST infusions of ALLO in male rats suppressed freezing behavior (a fear response) to the conditioned context, but did not influence freezing to a discrete tone conditioned stimulus (CS). In Experiment 2, intra-BNST infusion of either finasteride (FIN), an inhibitor of ALLO synthesis, or 17-phenyl-(3α,5α)-androst-16-en-3-ol, an ALLO antagonist, in female rats enhanced contextual freezing; neither treatment affected freezing to the tone CS. These findings support a role for ALLO in modulating contextual fear via the BNST and suggest that sex differences in fear and anxiety could arise from differential steroid regulation of BNST function. The susceptibility of women to disorders such as PTSD may be linked to cyclic declines in neuroactive steroid activity within fear circuitry.

Non-suicidal self-injury and identity distress in Flemish adolescents: Exploring gender differences and mediational pathways

There is an increasing amount of research that examines non-suicidal self-injury (NSSI) in relation to identity formation in adolescents. However, little or no research to date has explored associations between NSSI and identity distress in specific domains. To address this shortcoming, we assessed NSSI, identity distress, anxiety, and depression using self-report questionnaires in 568 high school students. Gender differences in NSSI were found with lifetime prevalence of NSSI being twice as high in females as compared to males. Gender differences in terms of identity domains were also significant; adolescent females showed higher levels of distress in the identity domains of career goals, friendship, and group loyalties as compared to males. Adolescents engaging in NSSI showed higher distress in domains of long-term goals, friendship, sexual orientation and behavior, values and beliefs. Results indicated that it was not distress in specific domains as such but the impairment due to daily impact of identity distress that explained additional variance in lifetime prevalence of NSSI above and beyond gender, age, depression, and anxiety. We also demonstrated that gender differences in lifetime prevalence of NSSI were mediated by differences in such identity impairment. Clinical implications of these findings are discussed.

Genetic and environmental risk for major depression in African-American and European-American women.

It is unknown whether there are racial differences in the heritability of major depressive disorder (MDD) because most psychiatric genetic studies have been conducted in samples comprised largely of white non-Hispanics. To examine potential differences between African-American (AA) and European-American (EA) young adult women in (1) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) MDD prevalence, symptomatology, and risk factors, and (2) genetic and/or environmental liability to MDD, we analyzed data from a large population-representative sample of twins ascertained from birth records (n = 550 AA and n = 3226 EA female twins) aged 18-28 years at the time of MDD assessment by semi-structured psychiatric interview. AA women were more likely to have MDD risk factors; however, there were no significant differences in lifetime MDD prevalence between AA and EA women after adjusting for covariates (odds ratio = 0.88, 95% confidence interval [CI]: 0.67-1.15). Most MDD risk factors identified among AA women were also associated with MDD at similar magnitudes among EA women. Although the MDD heritability point estimate was higher among AA women than EA women in a model with paths estimated separately by race (56%, 95% CI: 29-78% vs. 41%, 95% CI: 29-52%), the best fitting model was one in which additive genetic and non-shared environmental paths for AA and EA women were constrained to be equal (A = 43%, 33-53% and E = 57%, 47-67%). In spite of a marked elevation in the prevalence of environmental risk exposures related to MDD among AA women, there were no significant differences in lifetime prevalence or heritability of MDD between AA and EA young women.

Changes in the lifetime prevalence of suicidal feelings and thoughts among Norwegian doctors from 2000 to 2010: a longitudinal study based on national samples

BackgroundThinking about suicide is an indicator of suicide risk. Suicide rates are higher among doctors than in the population. The main aims of this study are to describe the changes in the lifetime prevalence of suicidal feelings from 2000 to 2010 and the possible predictors of serious suicidal thoughts in 2010 among Norwegian doctors. Differences in lifetime prevalence of suicidal feelings between Norwegian doctors in 2010 and German doctors in 2006 will be also described.MethodsLongitudinal and cross-sectional study based on questionnaire data from 2000 and 2010, including approximately 1,600 Norwegian doctors. In Germany, cross-sectional study based on questionnaire data from 2006 among a sample of 3,295 doctors. The main outcome measures were the lifetime prevalence of suicidal feelings (felt life was not worth living, wished own death, had thoughts of taking own life).ResultsThe prevalences in 2000 and 2010 of ever had feelings of life not worth living were 48 (44 to 52) % and 45 (41 to 49) %, of ever wished own death 27 (23 to 30) % and 23 (20 to 26) %, and of ever had thoughts of taking own life 29 (16 to 33) % and 24 (21 to 27) %. Paired t-tests among those who responded both in 2000 and 2010 show significant reductions for felt life not worth living (t = −3.4; p = 0.001), wished own death (t = −3.1; p = 0.002) and had thoughts of taking own life (t = −3.5; p < 0.0001). In 2010, significant predictors of serious suicidal thoughts in a multivariate model were low subjective well-being (OR 0.68; 95% CI 0.52-0.90), poor or average self-rated health (2.36; 1.25-4.45) and high psychosocial work stress (1.92; 1.06-3.46), controlled for age, gender, speciality and job satisfaction. Norwegian doctors in 2010 compared with their German counterparts in 2006 reported quite similar prevalences of suicidal feelings.ConclusionsSuicidal feelings among Norwegian doctors decreased from 2000 to 2010. Individual and work-related factors may to certain explain these findings. Compared with other professionals in Norway and doctors in Germany, Norwegian doctors showed no higher risk of suicidal thoughts.

Low-Back Pain Ratings for Lifetime, 1-Month Period, and Point Prevalences in a Large Occupational Population

This manuscript systematically quantifies multiple measures of low-back pain (LBP) prevalence by pain rating in a large, multisite cohort of workers. Published LBP prevalence rates vary. Studies rely on one measure of LBP and none report prevalence stratified by pain rating. Cross-sectional analyses of baseline data from a multicenter prospective cohort study were performed to evaluate differences in lifetime prevalence, 1-month period prevalence, and point prevalence of LBP. Workers were from 28 different employment settings in 4 diverse U.S. states. All workers completed computerized questionnaires and structured interviews. LBP prevalence measures were stratified by pain ratings. A total of 828 subjects had complete health data at baseline. Lifetime prevalence, 1-month period prevalence, and point prevalence for any LBP (> or = 1/10) were 63.4%, 44.0%, and 20.8% respectively. Prevalence of LBP decreased with increasing pain ratings. As an example, using a threshold of LBP > or = 3/10 pain, prevalence measures were 61.0%, 37.6%, and 16.7% respectively. A threshold of LBP > or = 5/10 had prevalence measures of 51.2%, 22.9%, and 9.9% respectively. Age, systolic and diastolic blood pressure, high cholesterol, high blood pressure, and tobacco use were statistically significantly related to lifetime prevalence of LBP. Lifetime LBP prevalence, 1-month period prevalence, and point prevalence stratified by pain ratings demonstrate a wide variation of prevalence measures of LBP and self-reported pain ratings. Higher pain rating thresholds yield lower prevalence measures and may impact assessments of risk factors. Differences in pain ratings may allow for focused surveillance within an occupational cohort.

Low back pain in childhood and adolescence: assessment of sports activities

A cross-sectional study that targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective of the study was to evaluate the association between sports activities and low back pain (LBP) in childhood and adolescence in Japan. Regarding risk factors of LBP, a large number of studies have been conducted that have examined gender differences, height and weight, body mass index, sports time, differences in lifestyle, family history, and mental factors; however, no definitive conclusion has yet been made. A questionnaire survey was conducted using 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067). 26,766 pupils who were determined to have valid responses (valid response rate 61.3%) were analyzed. Among the 26,766 pupils with valid responses, 2,591 (9.7%) had LBP at the time of the survey, and 8,588 (32.1%) had a history of LBP. The pupils were divided between those who did not participate in sports activities except the physical education in school (No sports group: 5,486, 20.5%) and those who participated in sports activities (Sports group: 21,280, 79.5%), and the difference in lifetime prevalence between No sports group and Sports group was examined. The odds ratio for LBP according to sports activity was calculated by multiple logistic regression analysis adjusted for gender, age, and body mass index. In addition, the severity of LBP was divided into three levels (Level 1: no limitation in any activity, Level 2: necessary to refrain from participating in sports and physical activities, and Level 3: necessary to be absent from school), and Levels 2 and 3 were defined as severe LBP; the severity was compared between No sports group and Sports group and in each sport's items. Moreover, in Sports group, the amount of time spent participating in sports activities were divided into three groups (Group 1: less than 6h per week, Group 2: 6-12h per week, and Group 3: 12.1h per week or more), and the dose-response between the amount of time spent participating in sports activities and the occurrence of LBP were compared. In No sports group, 21.3% experienced a history of LBP; in Sports group, 34.9% experienced LBP (P<0.001). In comparison to No sports group, the odds ratio was significantly higher for Sports group (1.57), and also significantly higher for most of the sports items. The severity of LBP was significantly higher in Sports group (20.1 vs. 3.2%, P<0.001). The amount of time spent participating in sports activities averaged 9.8h per week, and a history of LBP significantly increased in the group which spent a longer time participating in sports activities (odds ratio 1.43 in Group 3). These findings suggest that sports activity is possible risk factors for the occurrence of LBP, and it might increase the risk for LBP in childhood and adolescence.

Is there a gender difference in associates of adolescents' lifetime illicit drug use in Tehran, Iran?

IntroductionInformation regarding gender differences in drug use of adolescents is essential for designing gender-specific drug prevention policies. This study was conducted in high school students in Tehran, Iran, in 2007. Here, we report the gender differences in lifetime prevalence as well as psychosocial associates of drug use.Material and methodsThis was a gender analysis of the data collected in a drug use survey conducted in a random sample of high school adolescents (573 boys and 551 girls) in Tehran, Iran, 2007. Demographic characteristics, parental and peers’ substance use, school performance, religious beliefs, attachment, self-esteem and emotional intelligence (EI) were entered in logistic regression analyses to predict the lifetime illicit drug use in boy and girls, separately.ResultsBoys were more likely to report lifetime illicit drug use than girls (10.1% vs. 6.4%, p = 0.023). Differences in the risk profile associated with lifetime illicit drug use by gender included history of substance use in the family, higher score of attachment, and having an employed mother as predictors of substance use in boys, but not girls.ConclusionsUnderstanding this gender difference in predictors of lifetime use of illicit drugs in high school adolescents facilitates the design of gender-sensitive drug use preventive programmes. It seems that family variables may have more value in prevention of illicit drug use in male adolescents.

Correspondence Between Secular Changes in Alcohol Dependence and Age of Drinking Onset Among Women in the United States

Several lines of evidence suggest that the lifetime prevalence of alcohol dependence among women has increased in recent decades, but has not risen significantly for men. Early age at onset of drinking (AOD) is strongly correlated with risk for alcohol dependence and there is evidence that mean AOD has also decreased, particularly for women. The present report sought to confirm the trends in AOD and to determine the extent to which they might account for secular trends in alcohol dependence. Repeated cross-sectional analyses of data from 2 large, national epidemiological surveys were conducted to enable estimates of cross-cohort differences while controlling for age-related factors. Regression analyses were used to compute risk for alcohol dependence associated with birth cohort membership, before and after inclusion of AOD as a covariate. Both men and women born between 1944 and 1963 had earlier ages of onset for drinking than did the earliest birth cohort analyzed (1934-43). However, the net decrease in AOD was twice as large for women (3.2 years) than that for men (1.6 years). After adjusting for AOD, differences in lifetime prevalence between different birth cohorts of women were rendered nonsignificant, indicating that AOD accounts for a substantial portion of change in the lifetime prevalence of alcohol dependence. These results suggest that a decrease in AOD accounts for much of the increase in lifetime alcohol dependence among women. AOD is likely to be an indicator of dynamic, and therefore modifiable risk behaviors impacting risk for alcohol dependence.

Service Utilization Differences for Axis I Psychiatric and Substance Use Disorders Between White and Black Adults

Although studies have shown disparities between black and white populations in service utilization for mental disorders, little information exists on whether such disparities apply equally across disorders. The objective of this study was to examine racial differences in lifetime prevalence of service utilization for mood and anxiety disorders and for alcohol and drug use disorders, with controls for predisposing, enabling, and need-for-service variables unequally distributed between racial-ethnic groups. Data were from a face-to-face epidemiologic survey of 32,752 non-Hispanic white or black adults ages 18 and older residing in households and group quarters in the United States. Main outcome measures were treatment for mood, anxiety, and alcohol and drug use disorders. White adults were consistently more likely than black adults to have had treatment for mood disorders (odds ratio [OR]=2.16, 95% confidence interval [CI]=1.80-2.59) and anxiety disorders (OR=1.77, 95% CI=1.43-2.19) after adjustment for predisposing and enabling factors and need for service (severity of disorder). In contrast no evidence of lower service utilization for treatment of alcohol use disorders emerged among black respondents (OR=.87, 95% CI=.69-1.10). Moreover, white respondents with drug use disorders were significantly less likely than black respondents to receive treatment for a drug problem (OR=.64, 95% CI=.47-.88). Differences in treatment between black and white adults depended on the specific disorder and type of treatment considered. Prevention and intervention strategies should address disorder-specific disparities in services received.

Depression among Latinos in the United States: A meta-analytic review.

The authors conducted a meta-analytic review to assess the prevalence of major depressive disorder and depressive symptoms among Latinos compared with non-Latino Whites in the United States using community-based data. Random-effects estimates were calculated for 8 studies meeting inclusion criteria that reported lifetime prevalence of major depressive disorder (combined N = 76,270) and for 23 studies meeting inclusion criteria that reported current prevalence of depressive symptoms (combined N = 38,997). Findings did not indicate a group difference in lifetime prevalence of major depressive disorder (odds ratio = 0.89, 95% confidence interval = 0.72, 1.10). Latinos reported more depressive symptoms than non-Latino Whites (standardized mean difference = 0.19, 95% confidence interval = 0.12, 0.25); however, this effect was small and does not appear to suggest a clinically meaningful preponderance of depressive symptoms among Latinos. Findings are examined in the context of theories on vulnerability and resilience, and recommendations for future research are discussed.

Mapping genes of complex psychiatric diseases in Daghestan genetic isolates.

Genetic isolates, which provide outstanding opportunities for identification of susceptibility genes for complex diseases, can be classified as primary (having an ancient demographic history in a stable environment) or secondary (having a younger demographic history) Neel [1992: Minority populations: Genetics, demography, and health, pp. 1-13]. Daghestan contains 26 out of 50 indigenous Caucasus ethnicities that have been in existence for hundreds of generations in the same highland region. The ethnic groups are subdivided into numerous primary isolates. The founder effect and gene drift in these primary isolates may have caused aggregation of specific haplotypes with limited numbers of pathogenic alleles and loci in some isolates relative to others. These are expressed as inter-population differences in lifetime prevalence and features of certain complex clinical phenotypes and in patterns of genetic linkage and linkage disequilibrium (LD). Stable highland and ethnic-cultural environments have led to increased penetrance and a reduced number of phenocopies, which typically hamper the identification of any susceptibility genes for complex diseases. Owing to these characteristics of the primary isolates, a comparative linkage study in the primary isolates allows us to define the number of susceptibility genes for any complex disease and to identify the source of variability and non-replication of linkage analysis results. As part of an ongoing study, seven extended schizophrenia and one nonspecific mental retardation kindreds have been ascertained from Daghestan isolates. Lifetime morbid risk for schizophrenia in the isolates varied from 0 to 5%. A genome scan with markers spaced 10 cM apart was carried out on these pedigrees and linkage analysis was performed using descent graph methods, as implemented in Simwalk2. To identify regions containing susceptibility genes within these kindreds, we followed up those regions with non-parametric and parametric linkage analyses, with the choice of genetic model guided by the results obtained in the NPL. While the analyses are ongoing, the most positive findings were made in different isolated pedigrees on chromosomes 17p11, 3q24, and 22q for schizophrenia and on chromosome 12q for nonspecific mental retardation.

Longitudinal study assessing the joint effects of socio-economic status and birth risks on adult emotional and nervous conditions.

Previous investigations into the impact of birth complications and social environment have generally followed their subjects only at young ages. To assess the long-range impact of socio-economic status (SES) and birth risks on the development of emotional and nervous conditions through adulthood. The Johns Hopkins Pathways Study interviewed 1824 subjects born between 1960 and 1965. The median household income of the children at age 7-8 years was used to divide the cohort into high and low income categories. Differences in life time prevalence of emotional and nervous conditions through adulthood between the two income groups were identified. Children in the lower income group were 1.86 times more likely to report an emotional or nervous condition as adults. Boys in the lower income group at age 7-8 years were 3.2 times more likely to do so. The risks of difficult birth for adult mental disturbance were accentuated in the low-income group. Children who experience birth complications are at increased risk of developing adult mental disturbances; this increase is mitigated by higher SES.

An adoption study comparing the prevalence of psychiatric illness in women who have adoptive and natural children compared with women who have adoptive children only

The current study compares the current and lifetime prevalence of affective disorder in women who have adopted and have natural children ( n = 110) with women who only have adopted children ( n = 176). There was no difference in lifetime prevalence of psychiatric disorder between the two groups and a nonsignificant trend for women who had born children to have had a major depressive episode during their lifetime 48 (44%) cf 62 (35%). The increased prevalence of psychiatric illness in married women with children cannot be explained by the biological fact of bearing children. None of the social variables related to child-rearing which were examined influenced the lifetime prevalence of psychiatric disorder.