Self-reported Illness Research Articles

Trajectories of depressive symptoms during the transition to young adulthood: The role of chronic illness

BackgroundLittle is known about the natural course of depressive symptoms among youth with chronic illness during their transition from adolescence to young adulthood. MethodsA representative epidemiological sample of 2825 youth aged 10–11 years from the National Longitudinal Survey of Children and Youth were followed until 24–25 years of age. Presence of chronic illness was measured using self-report and symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Multilevel modeling was used to investigate trajectories of depressive symptoms, adjusting for family environment and sociodemographic characteristics during the transition to young adulthood. ResultsTrajectories showed cubic change over time – increasing from early to mid-adolescence, decreasing to early young adulthood, increasing again to late young adulthood. Youth with chronic illness (n=753) had significantly less favorable trajectories and significantly higher proportions of clinically relevant depressive symptoms over time compared to their peers without chronic illness (n=2072). LimitationsThis study is limited by selective attrition, self-reported chronic illness and no assessment of illness severity, and mediating effects of family environment factors could not be examined. ConclusionsFindings support the diathesis-stress model; chronic illness negatively influenced depressive symptoms trajectories, such that youth with chronic illness had higher depression scores and less favorable trajectories over time. The health and school system are uniquely positioned to support youth with chronic illness navigate this developmental period in an effort to prevent declines in mental health.

Response: Influence of sleep disorders on television viewing time, diabetes and obesity

We thank Gandolphi and colleagues 1 for raising important issues about diabetes-related comorbidities, such as sleep disorders as possible confounding factors in relation to our recently published work 2. In addition they emphasize the importance of our study, which evaluated television (TV) viewing time as a risk factor for diabetes mellitus, a global health issue. Gandolphi et al. 1 have stated that TV exerts great influence on individuals’ behaviors, including biological and psychological mechanisms, and in particular suggested that sleep disorders are highly associated with TV viewing. The association between TV viewing and sleep remains relatively unexplored in older adults. In a small sample of 711 adults, TV viewing was associated with later bed time but was not associated with sleep duration (the interval between bedtime and rise time) or tiredness 3. Previous data from a controlled trial designed to reduce TV viewing did not observe any effects on sleep duration or awakenings 4 although this was perhaps not unexpected given that all participants demonstrated normal sleeping patterns at study entry. We agree that verifying the presence of sleep disorders in the present sample may provide additional insights. Thus we have explored the association between TV and sleep in the current cohort of older adults from the English Longitudinal Study of Ageing, previously described (2). Sleep duration was measured by an open-ended question asking participants how many hours they slept on an average week night. Responses were coded into ‘‘ 8 h’’. Sleep disturbance was assessed with three questions enquiring about difficulties falling sleep, staying asleep, and feeling tired upon waking up. These items were rated on a 4-point scale (ranging from 1 = ‘‘not during the last month’’ to 4 = ‘‘three or more times a week’’). Sleep disturbance (three or more times a week) was commonly reported; 15.1% reported difficulty falling asleep, 49.0% reported problems with waking up in the night, 19.5% reported being tired when waking up. TV viewing was associated with sleep disturbances in a dose-response manner, particularly with difficulties in falling asleep (Table​(Table1).1). We observed a ‘U-shaped’ association between sleep duration and TV viewing, suggesting that both short ( 8 hrs) was associated with more TV time (Figure​(Figure1).1). In fully adjusted models, participants that reported 6 – 7 hrs sleep per night displayed the lowest TV time (−0.57, 95% CI, −0.89, −0.25 hrs/d) in relation to those reporting < 5 hrs sleep. In summary, our results do demonstrate an association between TV viewing and sleep disturbance in older adults. Table 1 The association between TV viewing and sleep disturbance in men and women (N = 7,190; aged 65.1 ± 9.3 yrs) from the English Longitudinal study of Ageing. Figure 1 Association between sleep duration and TV viewing. Data are displayed as means ± SEM, adjusted for age, sex, cigarette smoking, alcohol intake, physical activity, self-reported chronic illness, disability, depressive symptoms, ... As our data are cross-sectional it is difficult to interpret the direction of the association, that is, if TV viewing displaces and disrupts sleep or if people watch TV if they cannot sleep. Indeed, the association between TV/sitting and obesity may also be explained by reverse causation 5. We agree that TV viewing is associated with numerous risk factors, including poor diet, lower socio economic status, obesity, smoking, depressive symptoms, and comorbidity. However, it remains unknown if excessive TV viewing is a causal factor in explaining disease risk or whether it simply reflects a cluster of unhealthy behaviors. Sleep disturbance might be important in explaining the association between TV viewing and adverse health, although the temporal sequence cannot be established using the present study design. Numerous health behaviours, such as physical activity, sleep, and diet, are often imprecisely measured in large scale epidemiological studies, thus the inclusion of objective measures such as polysomnography examinations in the near future may greatly improve our understanding in this area.

The burden and determinants of self-reported acute gastrointestinal illness in an Indigenous Batwa Pygmy population in southwestern Uganda.

Acute gastrointestinal illness (AGI) is an important public health priority worldwide. Few studies have captured the burden of AGI in developing countries, and even fewer have focused on Indigenous populations. This study aimed to estimate the incidence and determinants of AGI within a Batwa Pygmy Indigenous population in southwestern Uganda. A retrospective cross-sectional survey was conducted in January 2013 via a census of 10 Batwa communities (n = 583 participants). The AGI case definition included any self-reported symptoms of diarrhoea or vomiting in the past 2 weeks. The 14-day prevalence of AGI was 6·17% [95% confidence interval (CI) 4·2-8·1], corresponding to an annual incidence rate of 1·66 (95% CI 1·1-2·2) episodes of AGI per person-year. AGI prevalence was greatest in children aged <3 years (11·3%). A multivariable mixed-effects logistic regression model controlling for clustering at the community level indicated that exposure to goats [odds ratio (OR) 2·6, 95% CI 1·0-6·8], being a child aged <3 years (OR 4·8, 95% CI 1·2-18·9), and being a child, adolescent or senior Batwa in the higher median of wealth (OR 7·0, 95% CI 3·9-9·2) were significantly associated with having AGI. This research represents the first Indigenous community-census level study of AGI in Uganda, and highlights the substantial burden of AGI within this population.

Exploring consumer understanding and preferences for pharmacy quality information.

To describe consumer understanding of pharmacy quality measures and consumer preferences for pharmacy quality information. Semi-structured focus group design was combined with survey methods. Adults who filled prescription medications for self-reported chronic illnesses at community pharmacies discussed their understanding of Pharmacy Quality Alliance approved quality measures. Questions examined preference of pharmacy quality information rating systems (e.g. stars versus percentages) and desired data display/formats. During the focus group, participants completed a survey examining their understanding of each pharmacy quality measure. All focus group discussions were transcribed verbatim. Data were analyzed using thematic analysis and descriptive statistics. Thirty-four individuals participated (mean age= 62.85; SD=16.05). Participants were unfamiliar with quality measures information and their level of understanding differed for each quality measure. Surveys indicated 94.1% understood "Drug-Drug Interactions" and "Helping Patients Get Needed Medications" better than other measures (e.g., 76.5% understood "Suboptimal Treatment of Hypertension in Patients with Diabetes"). Qualitative analysis indicated participants preferred an overall pharmacy rating for quick access and use. However, participants also wanted quality measures information displayed by health conditions. Participants favored comparison of their pharmacy to city data instead of state data. Most participants liked star ratings better than percentages, letter grades, or numerical ratings. Individuals who have a chronic illness and regularly use community pharmacies are interested in pharmacy quality measures. However, specific quality measures were not understood by some participants. Participants had specific preferences for the display of pharmacy quality information which will be helpful in the design of appropriate quality report systems.

Is the process for selecting indigents to receive free care in Burkina Faso equitable?

BackgroundIn Burkina Faso, patients are required to pay for healthcare. This constitutes a barrier to access for indigents, who are the most disadvantaged. User fee exemption systems have been created to facilitate their access. A community-based initiative was thus implemented in a rural region of Burkina Faso to select the worst-off and exempt them from user fees. The final selection was not based on pre-defined criteria, but rather on community members’ tacit knowledge of the villagers. The objective of this study was to analyze the equitable nature of this community-based selection process.MethodBased on a cross-sectional study carried out in 2010, we surveyed 1,687 indigents. The variables collected were those that determine healthcare use according to the Andersen-Newman model (1969): sociodemographic variables; income; occupation; access to financial, food or instrumental assistance; presence of chronic illness; and disabilities related to vision, muscle strength, or mobility. Bivariate analyses and logistic regression were performed.ResultsUser fee exemptions were given mainly to indigents who were widowed (OR = 1.40; CI 95% [1.10–1.78]), had no financial assistance from their household for healthcare (OR = 1.58; CI 95% [1.26–1.97], lived alone (OR = 1.28; CI 95% [1.01–1.63]), lived with their spouses, (OR = 2.00; CI 95% [1.35-2.96], had vision impairments (OR = 1.45; CI 95% [1.14–1.84]), or had poor muscle strength and good mobility (OR = 1.73; CI 95% [1.28–2.33]). The indigent selection was not determined by household income, self-reported chronic illness, or previous use of services.ConclusionThe community selection process took into account factors related to social vulnerability and functional limitations. However, we cannot affirm that the selection process was perfectly equitable, as it was very restrictive due to the limited budget available and the State’s lack of engagement in this matter. Exemption processes should be temporary solutions, and the State should make a commitment to move toward universal healthcare coverage.

Primary Drinking Water Source and Acute Gastrointestinal Illness: New Mexico, 2007

The objectives of this study are to characterize New Mexico residents’ primary drinking water sources, consumption, and filter use by demographic characteristics, and to compare the 30-day prevalence of self-reported acute gastrointestinal illness (AGI) by water sources. We analyzed data on 6,600 adults surveyed in the 2007 New Mexico Behavioral Risk Factor Surveillance System. We estimated population frequencies and evaluated associations using chi-square tests and weighted multivariable logistic regression modeling. Over half (55 %) of individuals used public water as their primary drinking water source, 18 % used private wells, and 27 % used bottled water. Overall, 43 % of residents said they filtered their home tap water, which did not differ significantly by source. Compared to public water users, private well users had key demographic differences, including age, marital status, race, and education. The overall 30-day prevalence of AGI was 15 %. In models adjusted for demographic characteristics and health status indicators, individuals using well water had a non-significantly decreased odds of reporting AGI and seeking medical attention for AGI (odds ratio (OR) 0.83, 95 % CI 0.65–1.06 and OR 0.85, 95 % CI 0.41–1.80). This baseline measure suggests private well users are not uniformly distributed throughout the New Mexico population. This information is useful when planning educational outreach to targeted populations. Our cross-sectional analyses did not reveal significant associations between primary drinking water source and AGI. Future epidemiologic studies including children and measuring the duration of exposure and water quality are needed to fully understand the health impacts of drinking untreated or undertreated water.

Association between Classroom Relative Humidity Levels and Incidence of Influenza-Like Illness among Teachers

Under laboratory conditions, seasonal influenza, a group of viruses typically having the most activity during the winter, is most stable at low relative humidity (RH) levels. During an epidemic, transmission of influenza within a community is increased when school is in session. Thus, decreasing the spread of influenza in schools is of utmost importance. We examined the association between classroom RH levels and self-reported influenza-like illness (ILI) among a cohort of teachers (n=122) followed for up to 12 weeks during the school year. Data were analyzed using modified Poisson regression models for correlated binary data, clustered by participant. On days when the buildings were occupied, classroom RH observations taken during the heating season (outdoor temperature: &lt;15oC) had higher risk of low RH (&lt;30%) compared to observations taken during transitional periods (outdoor temperature: 15-23oC) [Risk Ratio (RR): 4.32 (95% Confidence Interval (CI): 3.73, 5.00)]. Teachers in classrooms with low RH had 1.20 (95% CI: 0.29, 4.95) times the risk of ILI compared to teachers in classrooms with recommended RH. Low classroom relative humidity levels during the heating season may allow influenza to be easily transmissible.

Patient communication self-efficacy, self-reported illness symptoms, physician communication style and mental health and illness in hospital outpatients.

In this cross-sectional study, we investigated the associations between patient communication self-efficacy and self-reported symptoms in doctor-patient communication, as perceived by patients, and the mental health and illness of hospital outpatients. Using data from a sample of 74 outpatients (mean age = 37.58 years, standard deviation = 12.54), a structural equation model was calculated. The results showed that communication self-efficacy and respectful behaviour were associated with mental health and illness. Furthermore, self-reported symptoms were correlated with mental illness. Gender and educational differences also occurred. The findings suggest that enhancing patients' communication skills could benefit outpatients in general, but female and less educated patients in particular.

Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study

ObjectiveWe compared the distribution by wealth of self-reported illness burden (estimated from validated scales, biomarker and reported symptoms) for angina, cataract, depression, diabetes and osteoarthritis, with the distribution of self-reported...

Diverging trends in smoking behaviors according to mental health status.

People with mental health disorders are much more likely to smoke compared to those who do not. This study investigates recent trends in smoking behaviors among both these populations in England. We used survey responses from adults (aged 16 years and older) living in households in England who participated in the Health Survey for England from 1993 to 2011 (n = 11,300 per year on average). Linear regression was used to quantify annual changes over the time period in smoking prevalence, daily cigarette consumption, and desire to quit among respondents with and without 2 indicators of mental disorder (self-reported longstanding mental illness and recent use of psychoactive medication). Among survey respondents who did not report a longstanding mental illness, there were long-term declines in smoking prevalence (-0.48% per year, 95% confidence interval [CI] = -0.56 to -0.40) and daily cigarette consumption (-0.14% per year, 95% CI = -0.17 to -0.11). Similar declines were also seen among respondents not taking psychoactive medications. However, there were no long-term changes in smoking prevalence and cigarette consumption among respondents who reported these indicators of mental disorder, although smoking prevalence among those taking psychoactive medications may have declined during the later part of the study period. Smokers both with and without the 2 indicators of mental disorder showed similar levels of desire to quit smoking. Smoking is largely unchanged since 1993 among those with indicators of longstanding mental disorders or recent psychoactive medication usage, although declines have been observed among those without such indicators of mental disorder.

Peripheral labour market position and risk of disability pension: a prospective population-based study

ObjectiveTo investigate what impact individuals’ position in a labour market core–periphery structure may have on their risk of disability pension (DP) in general and specifically on their risk of DP...

Automated telehealth for managing psychiatric instability in people with serious mental illness

Background: Serious mental illness (SMI) with psychiatric instability accounts for disproportionately high use of emergency room visits and hospitalizations.Aim: To evaluate the effectiveness of an automated telehealth intervention supported by nurse health care management for improving psychiatric illness management and reducing acute service use among individuals with SMI and psychiatric instability.Methods: Thirty-eight individuals with SMI received the automated telehealth intervention for 6 months. Psychiatric symptoms, illness self-management, and self-reported service use (emergency room visits and hospital admissions) were collected at baseline, 3- and 6-months. Measures of quality of life, health indicators, and subjective health status were also collected.Results: Participants demonstrated improvements in self-reported psychiatric symptoms and illness self-management skills, an 82% decrease in hospital admissions (from 76 to 14 hospitalizations, p < 0.001) and a 75% decrease in emergency room visits (from 63 to 16 visits, p < 0.001). Improvements were also observed in quality of life, severity of depressive symptoms, and mental health status.Conclusion: These highly promising findings support the use of an automated telehealth device monitored by a nurse care manager for people with SMI, and highlight the potential for cost savings through reductions in acute health care utilization.

Risk behaviors and self-reported illnesses among Pacific Northwest surfers.

Although surfers have high incidental exposure to marine waters, no studies have investigated if surfer risk behaviors (such as surfing during advisories, near an outfall, during a rain event, or use of personal protective equipment) increase or decrease the risk of acquiring waterborne illnesses. We used a web-based survey to assess the association between risk-based behaviors and self-reported illnesses among Pacific Northwest surfers. Commonly reported illnesses include: ear infection or discharge (38%), sore throat or a cough (28%), diarrhea (16%), fever (10.5%), and vomiting (7%). Surfing often during rain events was associated with an increased likelihood of diarrhea (OR = 2.7; 95% CI: 1.4-5.47), sore throat (OR = 1.26; 95% CI: 1.01-2.05), and ear infection (OR = 1.39; 95% CI: 1.01-2.32). Surfing during a health advisory was associated with increased likelihood of diarrhea (OR = 1.94; 95% CI: 1.03-4.64) and sore throat (OR = 2.32; 95% CI: 1.23-4.40). Other behaviors associated with increased illnesses include body surfing, surfing near an outfall, frequency of surfing, and use of ear plugs. Approximately 40% of surfers were unaware if they had surfed during an active health advisory and 29% knowingly surfed during advisories, suggesting the need to engage this population about potential harm and behaviors that may increase health risk.

Utilizing syndromic surveillance data for estimating levels of influenza circulation.

The availability of weekly Web-based participatory surveillance data on self-reported influenza-like illness (ILI), defined here as self-reported fever and cough/sore throat, over several influenza seasons allows for estimation of the incidence of influenza infection in population cohorts. We demonstrate this using syndromic data reported through the Influenzanet surveillance platform in the Netherlands. We used the 2011-2012 influenza season, a low-incidence season that began late, to assess the baseline rates of self-reported ILI during periods of low influenza circulation, and we used ILI rates above that baseline level from the 2012-1013 season, a major influenza season, to estimate influenza attack rates for that period. The latter conversion required estimates of age-specific probabilities of self-reported ILI given influenza (Flu) infection (P(ILI | Flu)), which were obtained from separate data (extracted from Hong Kong, China, household studies). For the 2012-2013 influenza season in the Netherlands, we estimated combined influenza A/B attack rates of 29.2% (95% credible interval (CI): 21.6, 37.9) among survey participants aged 20-49 years, 28.3% (95% CI: 20.7, 36.8) among participants aged 50-60 years, and 5.9% (95% CI: 0.4, 11.8) among participants aged ≥61 years. Estimates of influenza attack rates can be obtained in other settings using analogous, multiseason surveillance data on self-reported ILI together with separate, context-specific estimates of P(ILI | Flu).

Demographic, laboratory, and therapeutic contributing factors of non-dipper blood pressure patterning in diabetes: the Hygia Project

1. Many organizations are exploring innovative employee wellness programs to improve workforce health. Prehypertension is a risk factor for the development of hypertension and an independent risk factor for cardiovascular (CV) disease. Hypertension is highly prevalent and leads to increased healthcare costs, but literature on the prevalence of prehypertension in the workplace is lacking. The purpose of our study was to evaluate prevalence of prehypertension and assess CV risk factors among the University’s staff. 2. Participants were recruited via campus-wide email sent to all employees. A health history questionnaire and physical activity questionnaire (PAR-Q) was used to exclude participants with any self-reported chronic illnesses, including any form of CV disease, diabetes, lung, liver or renal disease. Forty one (11Males/30Females, 50 6yrs) apparently healthy nonsmoking but sedentary participants were included. Office blood pressure (BP) was measured in the right arm, in duplicates with 5min intervals, using an aneroid sphygmomanometer, and the average was calculated, after the participants rested for 5min in a seated position. Fasting blood glucose and lipid profile were analyzed using Cholestech LDX analyzer. Height and weight were measured to calculate body mass index (BMI). 3. The prevalence of normotension, prehypertension, and hypertension were 21/41 (w51%), 17/41 (w41%) and 3/41 (w8%), respectively. Normotension vs. prehypertension (Mean SD) for systolic BP (109.4 6.6 vs. 126.8 7.4mmHg; p<0.001), diastolic BP (71.8 4.2 vs. 82.3 3.1mmHg; p<0.001), weight (74.9 13.1 vs. 86.9 18.5kg; p1⁄40.026), BMI (26.8 2.8 vs. 30.0 6.6 kg/m2; p1⁄40.040) and fasting blood glucose (94.8 6.1 vs. 102.8 10.1 mg/dL; p1⁄40.004). There were no statistically significant differences in lipid profiles between the groups. 4. Our preliminary findings indicate that prehypertension has high prevalence (41%) in the University workforce. Compared to normotensive participants, prehypertensives were more likely to be obese and have impaired fasting glucose. This suggests that prehypertension is associated with other CV risk factors and heightens CV risk of the University employees. Therefore, early and effective lifestyle modification strategies may help to decrease long-term CV risk.

Global Estimates of the Burden of Injury and Illness at Work in 2012

This article reviews the present indicators, trends, and recent solutions and strategies to tackle major global and country problems in safety and health at work. The article is based on the Yant Award Lecture of the American Industrial Hygiene Association (AIHA) at its 2013 Congress. We reviewed employment figures, mortality rates, occupational burden of disease and injuries, reported accidents, surveys on self-reported occupational illnesses and injuries, attributable fractions, national economic cost estimates of work-related injuries and ill health, and the most recent information on the problems from published papers, documents, and electronic data sources of international and regional organizations, in particular the International Labor Organization (ILO), World Health Organization (WHO), and European Union (EU), institutions, agencies, and public websites. We identified and analyzed successful solutions, programs, and strategies to reduce the work-related negative outcomes at various levels. Work-related illnesses that have a long latency period and are linked to ageing are clearly on the increase, while the number of occupational injuries has gone down in industrialized countries thanks to both better prevention and structural changes. We have estimated that globally there are 2.3 million deaths annually for reasons attributed to work. The biggest component is linked to work-related diseases, 2.0 million, and 0.3 million linked to occupational injuries. However, the division of these two factors varies depending on the level of development. In industrialized countries the share of deaths caused by occupational injuries and work-related communicable diseases is very low while non-communicable diseases are the overwhelming causes in those countries. Economic costs of work-related injury and illness vary between 1.8 and 6.0% of GDP in country estimates, the average being 4% according to the ILO. Singapore's economic costs were estimated to be equivalent to 3.2% of GDP based on a preliminary study. If economic losses would take into account involuntary early retirement then costs may be considerably higher, for example, in Finland up to 15% of GDP, while this estimate covers various disorders where work and working conditions may be just one factor of many or where work may aggravate the disease, injury, or disorders, such as traffic injuries, mental disorders, alcoholism, and genetically induced problems. Workplace health promotion, services, and safety and health management, however, may have a major preventive impact on those as well. Leadership and management at all levels, and engagement of workers are key issues in changing the workplace culture. Vision Zero is a useful concept and philosophy in gradually eliminating any harm at work. Legal and enforcement measures that themselves support companies and organizations need to be supplemented with economic justification and convincing arguments to reduce corner-cutting in risk management, and to avoid short- and long-term disabilities, premature retirement, and corporate closures due to mismanagement and poor and unsustainable work life. We consider that a new paradigm is needed where good work is not just considered a daily activity. We need to foster stable conditions and circumstances and sustainable work life where the objective is to maintain your health and work ability beyond the legal retirement age. We need safe and healthy work, for life.

Determinants factors of dipper phenomenoms and morning blood pressure

1. Many organizations are exploring innovative employee wellness programs to improve workforce health. Prehypertension is a risk factor for the development of hypertension and an independent risk factor for cardiovascular (CV) disease. Hypertension is highly prevalent and leads to increased healthcare costs, but literature on the prevalence of prehypertension in the workplace is lacking. The purpose of our study was to evaluate prevalence of prehypertension and assess CV risk factors among the University’s staff. 2. Participants were recruited via campus-wide email sent to all employees. A health history questionnaire and physical activity questionnaire (PAR-Q) was used to exclude participants with any self-reported chronic illnesses, including any form of CV disease, diabetes, lung, liver or renal disease. Forty one (11Males/30Females, 50 6yrs) apparently healthy nonsmoking but sedentary participants were included. Office blood pressure (BP) was measured in the right arm, in duplicates with 5min intervals, using an aneroid sphygmomanometer, and the average was calculated, after the participants rested for 5min in a seated position. Fasting blood glucose and lipid profile were analyzed using Cholestech LDX analyzer. Height and weight were measured to calculate body mass index (BMI). 3. The prevalence of normotension, prehypertension, and hypertension were 21/41 (w51%), 17/41 (w41%) and 3/41 (w8%), respectively. Normotension vs. prehypertension (Mean SD) for systolic BP (109.4 6.6 vs. 126.8 7.4mmHg; p<0.001), diastolic BP (71.8 4.2 vs. 82.3 3.1mmHg; p<0.001), weight (74.9 13.1 vs. 86.9 18.5kg; p1⁄40.026), BMI (26.8 2.8 vs. 30.0 6.6 kg/m2; p1⁄40.040) and fasting blood glucose (94.8 6.1 vs. 102.8 10.1 mg/dL; p1⁄40.004). There were no statistically significant differences in lipid profiles between the groups. 4. Our preliminary findings indicate that prehypertension has high prevalence (41%) in the University workforce. Compared to normotensive participants, prehypertensives were more likely to be obese and have impaired fasting glucose. This suggests that prehypertension is associated with other CV risk factors and heightens CV risk of the University employees. Therefore, early and effective lifestyle modification strategies may help to decrease long-term CV risk.

Poster #M151 A MULTIMODAL BIOMARKER TO PREDICT THE ONSET OF SCHIZOPHRENIA

Subjects with psychoses have significantly increased rates of physical illnesses, but the nature of the relationship remains largely unknown.The present study is part of the European Prediction of Psychosis Study (EPOS). Data were collected from 245 help-seeking individuals from six European centers (age 16–35) who met criteria for ultra-high risk of psychosis criteria. This paper seeks to investigate self-reported physical ill health and its associations with psychiatric symptoms and disorders, risk factors, and onset of psychosis during 48 months of follow-up.In multivariate analysis, lifetime panic disorder (OR = 2.43, 95%CI: 1.03–5.73), known complications during pregnancy and delivery (OR = 2.81, 95%CI: 1.10–7.15), female gender (OR = 2.88, 95%CI: 1.16–7.17), family history of psychosis (OR = 3.08, 95%CI: 1.18–8.07), and having a relationship (OR = 3.44, 95%CI: 1.33–8.94) were significantly associated with self-reported physician-diagnosed illness. In the Cox proportional hazard model we found no significant differences between those who had undergone a transition to psychosis and those who had not.The physical health of patients defined to be at ultra-high risk of psychosis seems to be commonly impaired and associated with female gender, marital status, complications during pregnancy and birth, lifetime panic disorder, and genetic risk of psychosis.

Comparison of cardiovascular risk factors between prehypertension and normotension in a university workplace setting

1. Many organizations are exploring innovative employee wellness programs to improve workforce health. Prehypertension is a risk factor for the development of hypertension and an independent risk factor for cardiovascular (CV) disease. Hypertension is highly prevalent and leads to increased healthcare costs, but literature on the prevalence of prehypertension in the workplace is lacking. The purpose of our study was to evaluate prevalence of prehypertension and assess CV risk factors among the University’s staff. 2. Participants were recruited via campus-wide email sent to all employees. A health history questionnaire and physical activity questionnaire (PAR-Q) was used to exclude participants with any self-reported chronic illnesses, including any form of CV disease, diabetes, lung, liver or renal disease. Forty one (11Males/30Females, 50 6yrs) apparently healthy nonsmoking but sedentary participants were included. Office blood pressure (BP) was measured in the right arm, in duplicates with 5min intervals, using an aneroid sphygmomanometer, and the average was calculated, after the participants rested for 5min in a seated position. Fasting blood glucose and lipid profile were analyzed using Cholestech LDX analyzer. Height and weight were measured to calculate body mass index (BMI). 3. The prevalence of normotension, prehypertension, and hypertension were 21/41 (w51%), 17/41 (w41%) and 3/41 (w8%), respectively. Normotension vs. prehypertension (Mean SD) for systolic BP (109.4 6.6 vs. 126.8 7.4mmHg; p<0.001), diastolic BP (71.8 4.2 vs. 82.3 3.1mmHg; p<0.001), weight (74.9 13.1 vs. 86.9 18.5kg; p1⁄40.026), BMI (26.8 2.8 vs. 30.0 6.6 kg/m2; p1⁄40.040) and fasting blood glucose (94.8 6.1 vs. 102.8 10.1 mg/dL; p1⁄40.004). There were no statistically significant differences in lipid profiles between the groups. 4. Our preliminary findings indicate that prehypertension has high prevalence (41%) in the University workforce. Compared to normotensive participants, prehypertensives were more likely to be obese and have impaired fasting glucose. This suggests that prehypertension is associated with other CV risk factors and heightens CV risk of the University employees. Therefore, early and effective lifestyle modification strategies may help to decrease long-term CV risk.

General Self-efficacy and Its Relationship to Self-reported Mental Illness and Barriers to Care: A General Population Study

Given the prevalence of mental illness worldwide, it is important to better understand the dynamics of mental health help-seeking behavior to improve access to care. The aim of this study was to investigate if general self-efficacy (GSE) was associated with self-reported mental illness and help-seeking behavior and barriers to care in a randomized population. This study utilized a mailed questionnaire completed by 3,981 persons aged 19-64 years who resided in Western Sweden. GSE was measured and logistic regression models calculated, controlling for various sociodemographic variables. Results showed that 25% of men and 43% of women reported a lifetime prevalence of mental illness that they felt could have benefitted from treatment. Of those, 37% of the men and 27% of the women reported barriers to care. Men and women with low GSE were more likely to suffer from mental illness compared with persons high in GSE, but GSE did not enhance help-seeking behavior or perceived barriers to care. The most prevalent barriers to care for both sexes were beliefs that the illness will pass by itself, doubt whether treatment works, lack of knowledge of where to go and feelings of shame. Overall, GSE scores did not differ among those who experienced various barriers to care with the exception of two barriers only among women.