Risk Of Physical Health Problems Research Articles

Eating disorders and physical multimorbidity in the English general population

PurposePeople with eating disorders may be at increased risk for physical health problems, but there are no data on the relationship between eating disorders and physical multimorbidity (i.e., ≥ 2 physical conditions) and its potential mediators. Thus, we investigated this association in a representative sample of adults from the UK, and quantified the extent to which this can be explained by various psychological and physical conditions, and lifestyle factors.MethodsCross-sectional data of the 2007 Adult Psychiatric Morbidity Survey were analyzed. Questions from the five-item SCOFF screening instrument were used to identify possible eating disorder. Respondents were asked about 20 physical health conditions. Multivariable logistic regression and mediation analysis were conducted.ResultsData on 7403 individuals aged ≥ 16 years were analyzed [mean (SD) age 46.3 (18.6) years; 48.6% males]. After adjustment, possible eating disorder was associated with 2.11 (95%CI = 1.67–2.67) times higher odds for physical multimorbidity. Anxiety disorder explained the largest proportion this association (mediated percentage 26.3%), followed by insomnia (21.8%), perceived stress (13.4%), depression (13.1%), obesity (13.0%), and alcohol dependence (4.3%).ConclusionFuture longitudinal studies are warranted to understand potential causality and the underlying mechanisms in the association between eating disorder and multimorbidity, and whether addressing the identified potential mediators in people with eating disorders can reduce multimorbidity.

Anxious-Withdrawal and Sleep Problems during Adolescence: The Moderating Role of Peer Difficulties.

Anxious-withdrawal is a well-established individual risk factor for psychosocial difficulties during adolescence. It is unknown, however, whether it also places youth at increased risk for physical health problems, such as sleep difficulties. This study examines the concurrent and prospective associations between anxious-withdrawal and six types of sleep difficulties (i.e., sleeping too much, sleeping too little, talking/walking in sleep, being overtired, nightmares, and general trouble sleeping). We further evaluate whether these associations differ for adolescents who are high versus low in exclusion and victimization. The participants were 395 adolescents (Mage = 13.61 years; 35% ethnic minority) who completed peer nominations of anxious-withdrawal, exclusion, and victimization at Time 1 (T1). Their mothers completed reports of sleep difficulties at T1 and at Time 2 (T2). Path analyses revealed unique associations between anxious-withdrawal and several types of sleep difficulties (e.g., sleeping too much) at T1. Analyses also revealed a significant interaction effect between T1 anxious-withdrawal and exclusion/victimization such that anxious-withdrawal was prospectively associated with trouble sleeping only for those young adolescents who are highly excluded/victimized. Our findings are the first to link anxious-withdrawal to a physical health outcome in adolescence and point to the need for future research to not only examine anxious-withdrawal and physical health but also to include assessments of peer difficulties.

Increased risk of physical health problems among older autistic adults

Increased risk of physical health problems among older autistic adults

Effects of daily peer problems on sleep and the severity of pediatric asthma symptoms.

Although psychosocial stressors in the home environment place children at risk for physical health problems, less is known about whether or how peer stressors contribute to health problems in youth. The current study investigated associations between daily peer problems and asthma symptoms among adolescents with asthma. The possible mediating role of nightly sleep disturbance and the moderating role of adolescent mental health were also examined. Adolescents (N = 297) with asthma reported on peer problems, nighttime awakenings, sleep quality, and asthma symptoms over 4 days. Youth also self-administered daily peak expiratory flow rate (PEFR) assessments, and parents reported on their children's anxious-depressive symptoms. Adolescents encountering more daily peer problems experienced more severe asthma symptoms, but not lower PEFR. Mediation analyses demonstrated that associations between daily peer problems and subjective asthma symptoms were partially explained by more nighttime awakenings and lower sleep quality, even after accounting for potentially confounding demographic factors and adolescents' daily experiences of familial stress. However, these indirect pathways did not vary depending on youth anxious-depressive symptoms. The findings provide novel evidence for everyday peer stress as a developmentally relevant health risk factor among adolescents with asthma. Insofar as daily peer problems were associated with elevated asthma symptoms via impaired sleep, psychosocial interventions focusing on the peer context may help mitigate maladaptive health behaviors and asthma morbidity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association between cannabis use and physical health problems in Norwegian adolescents: a cross-sectional study from the youth survey Ungdata

BackgroundCannabis use is increasing among young Norwegians and several studies show a high incidence of common physical health problems. An association has previously been found between cannabis use and mental health problems. Since physical and mental health problems often co-occur, the aim of this study is to explore the relationship between cannabis use and physical health problems.MethodsIn 2017–2019, the Norwegian youth survey Ungdata collected data from 249,100 Norwegian adolescents, which equalled around 80% of all lower secondary school pupils (13–15 years) and about 50% of upper secondary pupils (16–19 years) in Norway. Descriptive analysis was used to calculate the prevalence of cannabis use and bi- and multivariate logistic regression analysis to examine the association between cannabis use and physical health problems, controlled for sociodemographics and mental health problems.ResultsAlmost 10% of Norwegian adolescents had used cannabis once or more in the previous 12 months. The use of cannabis increased with age and it was more prevalent among boys. There is a clear connection between physical health problems and cannabis use (OR = 1.582 (CI: 1.527–1.638)) even after adjusting for sociodemographic variables and mental health problems (OR = 1.366 (CI: 1.312–1.423)).ConclusionMore studies are needed to explore if there might a bidirectional relationship between cannabis use and physical health problems where physical problems increase cannabis use and cannabis use increases the risk of physical health problems. More knowledge on the effect of and motivation for cannabis use are important for policy makers and health care professionals involved in young people.

Psychopathy.

Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.

Sleep disturbances and physical health problems in caregivers of children with ASD

ObjectivesCaregivers of children with autism spectrum disorder self-report more physical health problems than controls. Sleep disturbances are also more prevalent in caregivers, and are positively associated with physical health problems. The negative impact of caring for a child with ASD on physical health therefore, might occur indirectly via poorer sleep. MethodsParticipants, of which n = 43 were caregivers and n = 17 were controls, completed self-report measures of physical health problems and, to capture objective measures of sleep, wore an actigraphy device. ResultsPhysical health problems were greater in caregivers, as were subjective reports of disturbed sleep. Objectively, waking after sleep onset (WASO) and average number of awakenings were higher, as was sleep latency, and sleep efficiency was poorer, in caregivers. Total sleep time however, was greater in caregivers, as was time in bed. Physical health problems, while unrelated to actigraphy measures, were positively associated with self-reported sleep disturbances. Caregivers’ increased risk for physical health problems occurred indirectly via greater self-reports of disturbed sleep. ConclusionsInterventions that help alleviate caregivers’ sleep disturbances might be effective, by reducing physical health problems, for improving quality of provided care, and this might be explored in future research.

Complex PTSD symptoms mediate the association between childhood trauma and physical health problems

The ICD-11 reconceptualized Posttraumatic Stress Disorder (PTSD) as a narrowly defined fear-based disorder, and introduced Complex PTSD (CPTSD) as a new diagnosis comprised of PTSD symptoms and symptoms of ‘Disturbances in Self-Organization’ (DSO) that are more reflective of general dysphoria. Previous research suggests that PTSD symptoms mediate the association between childhood trauma and physical health problems, including cardiovascular disease. No study has yet assessed how posttraumatic stress symptoms, as outlined in the ICD-11, influence the association between childhood trauma and somatic problems in adulthood. ObjectiveThis cross-sectional descriptive study examined whether PTSD and DSO symptoms mediated the associations between childhood physical and sexual abuse and childhood emotional abuse and neglect and somatic problems and cardiovascular diseases (CVD) load in adulthood. MethodsGeneral adult population samples from Ireland (N = 1020) and the United Kingdom (N = 1051) completed self-report questionnaires online. ResultsStructural equation modelling results indicated that PTSD and DSO symptoms fully mediated the association between both forms of childhood trauma and somatic problems, and that PTSD symptoms but not DSO symptoms fully mediated the association between childhood trauma and CVD load. ConclusionPsychological interventions that effectively treat CPTSD symptoms may have the added benefit of reducing risk of physical health problems.

Main and Interactive Effects of Nicotine Product Type on Sleep Health Among Dual Combustible and E-Cigarette Users.

E-cigarette use is associated with concurrent use of combustible cigarettes among adults and may increase the risk of future combustible cigarette use in adolescents and young adults. Detrimental effects of combustible cigarette use on sleep health are well documented, but little is known about the additive effects of concurrent e-cigarette use. The current study examined the main and interactive effects of daily nicotine product frequency on various components of sleep health. Two hundred and twenty-seven dual-product users (54.2% female, Mage = 36.89, SD = 10.17) completed questionnaires regarding demographic information, average number of cigarettes smoked per day, average number of times e-cigarettes used per day, and sleep health. Combustible cigarette frequency uniquely predicted shorter sleep duration, whereas e-cigarette frequency uniquely predicted increased daytime dysfunction due to sleepiness. Further, there was an interactive effect of combustible and electronic cigarettes on the use of sleeping medications. Findings may suggest differential adverse effects on sleep, depending on the type of nicotine product used, and highlight potential intervention targets for users. Future work should examine these associations prospectively and/or use objective measurements of sleep and nicotine use to further elucidate the nature of these relationships. This is the first study to explore the main and interactive effects of dual-product use on various dimensions of subjective sleep quality. This is important to investigate, given that dual nicotine users are at greater risk for physical health problems as well as the adverse effects of nicotine on sleep health. (Am J Addict 2020;00:00-00).

Caring Near and Far by Connecting Community-Based Clients and Family Member/Friend Caregivers Using Passive Remote Monitoring: Protocol for a Pragmatic Randomized Controlled Trial.

BackgroundSignificant chronic disease challenges exist among older adults. However, most older adults want to remain at home even if their health conditions challenge their ability to live independently. Yet publicly funded home care resources are scarce, private home care is expensive, and family/friend caregivers have limited capacity. Many older adults with chronic illness would require institutional care without the support from family member/friend caregivers. This role raises the risk of physical health problems, stress, burnout, and depression. Passive remote monitoring (RM), the use of sensors that do not require any action by the individual for the system to work, may increase the older adult’s ability to live independently while also providing support and peace of mind to both the client and the family member/friend caregiver.ObjectiveThis paper presents the protocol of a study conducted in two provinces in Canada to investigate the impact of RM along with usual home care (the intervention) versus usual home care alone (control) on older adults with complex care. The primary outcome for this study is the occurrence of and time to events such as trips to emergency, short-term admission to the hospital, terminal admission to the hospital awaiting admission to long-term care, and direct admission to long-term care. The secondary outcomes for this study are (1) health care costs, (2) client functional status and quality of life in the home, (3) family/friend caregiver stress, and (4) family/friend caregiver functional health status.MethodsThe design for this study is an unblinded pragmatic randomized controlled trial (PRCT) with two parallel arms in two geographic strata (Ontario and Nova Scotia). Quantitative and qualitative methodologies will be used to address the study objectives. This PRCT is conceptually informed by the principles of client-centered care and viewing the family as the client and aims at providing supported self-management.ResultsThis study is supported by the Canadian Institutes for Health Research. A primary completion date is anticipated in fall 2022.ConclusionsFindings from this real-world rigorous randomized trial will support Canadian decision-makers, providers, and clients and their caregivers in assessing the health, well-being, and economic benefits and the social and technological challenges of integrating RM technologies to support older adults to stay in their home, including evaluating the impact on the burden of care experienced by family/friend caregivers. With an aging population, this technology may reduce institutionalization and promote safe and independent living for the elderly as long as possible.Trial RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN) 79884651; http://www.isrctn.com/ISRCTN79884651International Registered Report Identifier (IRRID)DERR1-10.2196/15027

Physical health assessment and medicines reconciliation on admission to an acute mental health unit: a quality improvement project

Individuals with mental health disorders are at greater risk of physical health problems. Medicines reconciliation reduces medication errors on admission. The aim of this project was to improve compliance with the completion of physical health assessments and medicines reconciliation forms by using a set standard stating that all patients must have the above completed at the point of admission to an acute mental health unit. The notes for all inpatients were reviewed for evidence of completed physical assessments and medicines reconciliation forms. This was done at three different time points: baseline, 2 months after the introduction of recommendations (1st intervention) and 2 months later when an online system of record keeping was trialled (2nd intervention). At baseline (n=33), 16 (49%) had a physical examination, 15 (46%) had an ECG, 17 (52%) had baseline bloods and 4 (12%) had a completed medicine reconciliation form. After the 2nd intervention (n=31), 25 (81%) had a physical examination, 25 (81%) had an ECG, 23 (74%) had baseline bloods and 23 (74%) had a completed medicine reconciliation form. Physical health assessments and medicines reconciliation are important aspects of patient care. The interventions introduced have improved the quality of practice at an acute mental health unit.

A Remarkable Legacy: The Wayne F. Placek Fund Grant Program

ABSTRACTGregory M. Herek, PhD, made an important professional contribution through his service as chair of the Scientific Review Committee of the Wayne F. Placek Fund of the American Psychological Foundation (APF). The scholars funded by this grant benefited from the prestige of the grant, which provided an important credential for early career professional development. Many of them went on to become significant researchers in the field of sexual and gender minorities. The studies funded by the Placek Grant also had important political and social effects, such as on legalizing adoption by lesbian and gay parents, passage of same-sex marriage, and demonstrating that lesbians and gay men were at elevated risk for physical health problems. The purpose of the present article is to document the history and impact of the Placek Grant and to describe Greg Herek’s central role in this grant program.

Consumers at the centre: interprofessional solutions for meeting mental health consumers’ physical health needs

ABSTRACTInterprofessional care and consumer-oriented services are embodied in modern healthcare policy and practice. The views, needs, and values of consumers are essential to ensuring translation of policy to practice. This is particularly pertinent for people diagnosed with mental illness who experience a higher risk of physical health problems and premature death. A qualitative, exploratory research project was conducted, involving focus groups with members of a mental health consumer group in the Australian Capital Territory. Participants were asked about their experiences and opinions in relation to physical health and care and treatment provided. Focus group transcripts were thematically analysed.Three themes arose via analysis: (1) Meeting diverse physical healthcare needs, where mental health consumers connect with many types of healthcare providers, conventional and non-conventional, (2) centre of the interprofessional team for holistic care, where there is preference for a consumer-centred group effort in addressing health issues as the model of care, and (3) more gateways, less gatekeeping, where points of access were affected by cost, place and gatekeepers could be enabling. People with mental illness seek enhanced collaboration between a broader range of health professionals, with potential to contribute to their overall health and well-being.

Mental and Physical Health among Homeless Sexual and Gender Minorities in a Major Urban US City.

Sexual and gender minorities have been shown to have greater rates of mental health, substance use disorders, and specific types of health problems compared to heterosexuals. Among the homeless population in several US urban areas, sexual and gender minorities are overrepresented but few studies have examined the mental and physical health status of homeless sexual and gender minorities, with studies on homeless gender minorities being particularly hard to find. Using survey data obtained from the city and county of San Francisco (2015 Homeless Survey), this study examined differences in causes of homelessness, physical and mental health problems, and domestic violence among homeless sexual and gender minorities and their heterosexual and cisgender (i.e., non-transgender) counterparts, respectively. Lesbians and bisexual women, and gay and bisexual men did not differ from their cisgender heterosexual counterparts. Cisgender men who identified as queer or "other" in response to sexual orientation questions had higher rates of psychiatric problems and posttraumatic stress disorder, while cisgender women who identified as queer or "other" had higher rates of psychiatric problems and drug and alcohol use. Transgender men who were homeless were found to be particularly at risk for physical health problems, mental health problems, and domestic violence or abuse. Transgender women were more likely to report posttraumatic stress disorder. This study suggests that transgender men and cisgender sexual minority men and women who identify as queer or "other" are groups among the homeless that may benefit from increased outreach and services.

Occurrence of Medical Concerns in Psychiatric Outpatients with Intellectual Disabilities

ABSTRACTDespite the fact that adults with both intellectual disabilities (ID) and psychiatric disorders are at increased risk for physical health problems, few studies have described their medical concerns specifically. This study reports on the rates of physical health issues and completion of recommended health screenings among 78 adult outpatients with ID in a specialized psychiatric service. We conducted a retrospective chart review of physical health information gathered by the psychiatric nurse using a standardized head-to-toe assessment tool and compared findings from nursing assessments to health information collected at intake based on patient and caregiver perspectives. Psychiatric outpatients with ID had at least one physical health issue and most had multiple concerns flagged through nursing assessments, the majority of which were not documented at intake. Our findings highlight the important role of the psychiatric nurse in management of patients with ID and indicate the need for more comprehensive health monitoring.

Comorbid Mental and Physical Health and Health Access in Cambodian Refugees in the US

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

Analyse de la proportion de tumeurs mammaires HER2 positives, de leurs caractéristiques clinicopathologiques ainsi que de leur évolution entre 1998 et 2008. Étude mono-institutionnelle sur 2396 patientes résidant dans le seul département français couvert par un registre spécialisé

The purpose of this study was to examine the implications of childhood community contexts in the U.S. for physical health problems related to impaired metabolic conditions, and coronary/cardiovascular diseases during young adulthood. Data came from Waves 1 and 4 (1995 and 2008) of the National Longitudinal Study of Adolescent Health (N = 11,845). Multilevel logistic-normal regression was used to examine the relative risk or odds ratios of physical health problems in young adulthood (2008), based on both 1990 census level and 1995 survey data. Childhood community disadvantage and minority concentration increased the risk of young adult obesity, hypertension, diabetes, and high cholesterol. However, the influence of both community disadvantage and minority concentration on young adult physical health outcomes differed by race/ethnicity. Our findings clearly point to the increased risk of physical health problems related to coronary and cardiovascular diseases when a child is raised in an adverse and minority concentrated community. This influence of the community was pervasive and independent of family characteristics. Programs should combat adverse community conditions and enhance resiliencies of youth and families living in such communities.

Association Between Psychopathology and Physical Health Problems Among Youth in Residential Treatment

Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to residential treatment. This study examines the association between youth psychopathology and physical health problems in a sample of 606 youth entering a large residential treatment program between 2003 and 2010. As a part of the intake process, youth psychopathology symptoms were assessed using the parent-report form of the Child Behavior Checklist, and youth physical health problems were assessed in a medical evaluation by a licensed child health professional. Results indicated that higher levels of youth psychopathology, particularly internalizing problems, were associated with greater risk for physical health problems and more prescription medications. Psychopathology comorbidity was also associated with physical health problems. These findings suggest an interplay between physical and mental health among youth entering residential treatment, highlighting the need for integrated assessment and intervention services that address psychological and medical needs within this population.

Back to basics: Informing the public of co-morbid physical health problems in those with mental illness

Those with mental illness are at increased risk of physical health problems. The current study aimed to examine the information available online to the Australian public about the increased risk and consequences of physical illness in those with mental health problems and the services available to address these co-morbidities. A structured online search was conducted with the search engine Google Australia (www.google.com.au) using generic search terms 'mental health information Australia', 'mental illness information Australia', 'depression', 'anxiety', and 'psychosis'. The direct content of websites was examined for information on the physical co-morbidities of mental illness. All external links on high-profile websites [the first five websites retrieved under each search term (n = 25)] were examined for information pertaining to physical health. Only 4.2% of websites informing the public about mental health contained direct content information about the increased risk of physical co-morbidities. The Australian Government's Department of Health and Ageing site did not contain any information. Of the high-profile websites, 62% had external links to resources about physical health and 55% had recommendations or resources for physical health. Most recommendations were generic. Relative to the seriousness of this problem, there is a paucity of information available to the public about the increased physical health risks associated with mental illness. Improved public awareness is the starting point of addressing this health inequity.

Early community influence on young adult physical health: Race/ethnicity and gender differences

Abstract The purpose of this study was to examine the implications of childhood community contexts in the U.S. for physical health problems related to impaired metabolic conditions, and coronary/cardiovascular diseases during young adulthood. Data came from Waves 1 and 4 (1995 and 2008) of the National Longitudinal Study of Adolescent Health (N = 11,845). Multilevel logistic-normal regression was used to examine the relative risk or odds ratios of physical health problems in young adulthood (2008), based on both 1990 census level and 1995 survey data. Childhood community disadvantage and minority concentration increased the risk of young adult obesity, hypertension, diabetes, and high cholesterol. However, the influence of both community disadvantage and minority concentration on young adult physical health outcomes differed by race/ethnicity. Our findings clearly point to the increased risk of physical health problems related to coronary and cardiovascular diseases when a child is raised in an adverse and minority concentrated community. This influence of the community was pervasive and independent of family characteristics. Programs should combat adverse community conditions and enhance resiliencies of youth and families living in such communities.