Relationships of mental disorders and weight status in the Korean adult population

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.     

Trends in Obesity and Abdominal Obesity in the Older Adult Population of Spain (2000–2010)

ObjectiveThis work examines the trend in obesity and abdominal obesity in the Spanish population aged 60 years and over during the first decade of the 21st century.MethodsWe analyze data from a representative study of the Spanish population aged 60 years and older conducted in 2000–2001 and from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) conducted in 2008–2010.ResultsIn men, the distribution of BMI did not vary in the period 2000–2010. In contrast, in women there was a reduction in both mean BMI – from 29.3 to 28.8 kg/m² – and the prevalence of obesity – from 40.8 to 36.3%. This decline was greatest in women aged 60–69 years. In men, no significant changes were observed in mean waist circumference (WC) or in the prevalence of abdominal obesity. In contrast, WC decreased by 3.6 cm and abdominal obesity prevalence by 12.7% in women. The decline was greatest in women aged 60–69 years, in whom mean WC decreased by 5.1 cm and abdominal obesity prevalence by 18.6%.ConclusionThese findings show that the frequency of obesity has begun to decline in Spanish women aged 60 and over. The causes of this decline are unclear.Key Words: Obesity, Abdominal obesity, Prevalence, Elderly, Spain     

Sleep duration is associated with body fat and muscle mass and waist‐to‐height ratio beyond conventional obesity parameters in Korean adolescent boys

While evidence has supported a strong association between sleep duration and obesity globally, results from studies of children and adolescents have been conflicting, and information about a sex‐specific association has been limited. This study aimed to investigate the association of sleep duration with various parameters of obesity among South Korean adolescents. This population‐based, cross‐sectional study analysed the data obtained from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2009 and 2010. Data of 990 adolescents were analysed. Sleep duration was based on a self‐reported questionnaire. Body mass index (BMI), waist circumference (WC), waist‐to‐height ratio (WHtR), body fat percentage (BFP) and skeletal muscle index (SMI, appendicular skeletal muscle mass as a percentage of body weight) were assessed as parameters of obesity. Mean sleep duration in boys was associated inversely with BMI, WC, WHtR and BFP and positively with SMI. Proportions of the highest quartile of BMI, WC, WHtR and BFP and the lowest quartile of SMI increased significantly with increased sleep duration only in boys. Also, in boys, decreased sleep duration was associated significantly with the increased risk of the highest quartile of BMI, WC, WHtR and BFP and the lowest quartile of SMI, even after adjusting for confounding factors. However, in girls, there was no significant association between sleep duration and obesity parameters except WC. Periodic assessment of sleep duration in relation to body fat or muscle mass in male adolescents may be considered, especially in those who are at risk for obesity or related disorders.     

Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys

BACKGROUND: Prior research on the association between affective disorders and physical conditions has been carried out in developed countries, usually in clinical populations, on a limited range of mental disorders and physical conditions, and has seldom taken into account the comorbidity between depressive and anxiety disorders. METHODS: Eighteen general population surveys were carried out among adults in 17 countries as part of the World Mental Health Surveys initiative (N=42, 249). DSM-IV depressive and anxiety disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions were ascertained via a standard checklist. The relationship between mental disorders and physical conditions was assessed by considering depressive and anxiety disorders independently (depression without anxiety; anxiety without depression) and conjointly (depression plus anxiety). RESULTS: All physical conditions were significantly associated with depressive and/or anxiety disorders but there was variation in the strength of association (ORs 1.2-4.5). Non-comorbid depressive and anxiety disorders were associated in equal degree with physical conditions. Comorbid depressive-anxiety disorder was more strongly associated with several physical conditions than were single mental disorders. LIMITATIONS: Physical conditions were ascertained via self report, though for a number of conditions this was self-report of diagnosis by a physician. CONCLUSIONS: Given the prevalence and clinical consequences of the co-occurrence of mental and physical disorders, attention to their comorbidity should remain a clinical and research priority.     

Indices of central and general obesity and cardiometabolic risk among adolescents in three ethnic groups in north-west China

Abstract

Background: ‘A Body Shape Index-Adolescents’ (ABSI-Adolescents) and waist-to-height ratio are recently proposed indices that quantify central obesity in adolescents.

Aims: To investigate the scaling exponents to standardise waist circumference (WC) for body mass index (BMI) and height and to investigate the association between BMI, WC-based indices and cardiometabolic outcomes in adolescents of three ethnic groups.

Subjects and methods: A cross-sectional study of 1755 adolescents (516 Hans, 565 Uygurs, 674 Kazakhs) was conducted in north-west China. Correlation between indices of obesity and blood pressure (BP) and fasting blood glucose (FBG) were estimated and compared.

Results: Two ethnic groups (Han and Kazakh) had WC-BMI-height profiles different from the previously proposed ABSI-Adolescents and, therefore, required different scaling exponents for WC standardization. After adjustment for age and gender, WC and BMI have similar associations with BP and FBG. After further adjustment for BMI, WC remained significantly associated with FBG in all three ethnic groups (each p?<?0.01) and with BP in Han and Kazakh adolescents (each p?<?0.05).

Conclusion: Body proportionality varied between the ethnic groups. WC and WC-based indices were associated with blood pressure and fasting blood glucose in adolescents of three ethnicities. The WC-based indices did not out-perform WC per se.     

Trends in general and abdominal obesity among Korean adults: findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys

We examined trends in obesity among Korean adults, using body mass index (BMI) and waist circumference (WC) as reported in national surveys. Data (10,043 men and 12,758 non-pregnant women) were derived from four waves of the Korea National Health and Nutrition Examination Survey conducted in 1998, 2001, 2005, and 2007. Between 1998 and 2007, the distribution of BMI and WC showed shifts toward the right among men. Mean values of BMI and WC and the corresponding overweight (includes obesity) and obesity prevalences showed increasing trends in men but not in women. Women aged 60+ showed significant increases in obesity measures, including mean BMI and WC, and the associated prevalences. Among women aged 20-39, the prevalence of underweight increased significantly between 1998 and 2007, and BMI showed a decreasing tendency. These time trends in young women were the reverse of the trends in young men. In conclusion, policy efforts to abate overweight and obesity trends need to be exercised among men and older women. In addition, more national studies regarding potential increases in underweight among young women are warranted.     

Mental disorders in adolescents with celiac disease

A high prevalence of depressive symptoms, hypothetically related to serotonergic dysfunction, has been reported among adults with celiac disease. The authors used semistructured psychiatric interviews and symptom measurement scales to study mental disorders in 29 adolescents with celiac disease and 29 matched comparison subjects. Relative to the comparison subjects, the celiac disease patients had significantly higher lifetime prevalences of major depressive disorder (31% versus 7%) and disruptive behavior disorders (28% versus 3%). In most cases these disorders preceded the diagnosis of celiac disease and its treatment with a gluten-free diet. The prevalence of current mental disorders was similar in both groups. Celiac disease in adolescents is associated with an increased prevalence of depressive and disruptive behavioral disorders, particularly in the phase before diet treatment.     

Obesity and regional fat distribution in Kenyan populations: Impact of ethnicity and urbanization

Background: Obesity is increasing rapidly in Africa, and may not be associated with the same changes in body composition among different ethnic groups in Africa.

Objective: To assess abdominal visceral and subcutaneous fat thickness, prevalence of obesity, and differences in body composition in rural and urban Kenya.

Subjects and methods: In a cross-sectional study carried out among Luo, Kamba and Maasai in rural and urban Kenya, abdominal visceral and subcutaneous fat thicknesses were measured by ultrasonography. Height and weight, waist, mid-upper arm circumferences, and triceps skinfold thickness were measured. Body mass index (BMI), arm fat area (AFA) and arm muscle area (AMA) were calculated.

Results: Among 1430 individuals (58.3% females) aged 17–68 years, abdominal visceral and subcutaneous fat, BMI, AFA and waist circumference (WC) increased with age, and were highest in the Maasai and in the urban population. AMA was only higher with increasing age among males. The prevalence of overweight (BMI ≥ 25) (39.8% vs. 15.8%) and obesity (BMI ≥ 30) (15.5% vs. 5.1%) was highest in the urban vs. rural population.

Conclusion: Abdominal visceral and subcutaneous fat thickness was higher with urban residency. A high prevalence of overweight and obesity was found. The Maasai had the highest overall fat accumulation.     

Prevalence of parameter indicators of obesity and its relationship with metabolic syndrome in urban Moroccan women

This study aimed to examine the relationship between metabolic syndrome (MS) and different types of obesity in urban Moroccan women. On 213 women aged 25–55 years, Triglycerides (TG), total cholesterol, high‐density lipoprotein cholesterol (HDL‐c), lower‐density lipoprotein cholesterol (LDL‐c), and fasting blood glucose levels were assessed. Body mass index (BMI), waist to hip ratio (WHR), Waist circumference (WC), and blood pressure (BP) were also measured. Globally 36.6% of women were overweight (25 ≤ BMI < 30 m²), 23.9% obese (BMI > 30 m²), 19.7% had WHR > 0.85 and 28.8% had WC ≥ 88 cm. Indicators of obesity increased with age and the prevalence of co‐morbid factors increased with obesity. The women with android obesity (WHR > 0.85) and central obesity (WC ≥ 88 cm) had greater risk compared to those with overweight and general obesity. The prevalence of MS was 17.8% and increased (31.49%) with high BMI and high WHR (50%). MS and its co‐morbidity factors are prevalent among Moroccan women aged 35years and over. The exaggerated influence of obesity in this prevalence suggests that the prevention of obesity could prevent MS and its complications. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.     

Central Obesity in Africans: Anthropometric Assessment of Abdominal Adiposity and its Predictors in Urban Nigerians

Objective

To assess the occurrence of central obesity and identify its predictors in urban Africans using anthropometric tools. Another objective was to evaluate the anthropometric indices and their interaction with various cardiovascular risk factors.

Physical and Mental Factors Associated with Obesity in Individuals with Mental Disorders Attending Psychiatric Day-Care Facilities

Background

Individuals with mental disorders have increased rates of obesity and metabolic syndrome. Here we evaluated factors influencing obesity in individuals with mental disorders who were attending psychiatric day-care facilities on an outpatient basis.

Methods

The subjects (n = 108) were outpatients attending hospital-based rehabilitation programs. We assessed body fat, weight, height, waist circumference, body mass index (BMI), blood pressure, Geriatric Depression Scale-15 (GDS) scores, frequency of day-care visits, satisfaction with body shape, physical comorbidity and lifestyle habits. Lifestyle habits were evaluated using Breslow''s health index based on health-related choices.

Results

The subjects were divided into 2 groups: obese group (BMI ≥ 25 kg/m²) and non-obese group (BMI < 25 kg/m²). The physical parameters and attributes of both groups were compared, and factors related to BMI were statistically analyzed. The prevalence of obesity was 47.2% in all patients, 42.4% in males and 54.8% in females. Weight, waist circumference, body fat and systolic and diastolic blood pressure were significantly higher in the obese group than in the non-obese group. Body fat, waist circumference, systolic blood pressure and diastolic blood pressure exhibited significant positive correlations with BMI, whereas the frequency of day-care visits, satisfaction with body shape, GDS score and Breslow''s health index exhibited significant negative correlations with BMI.

Conclusion

The present results showed that the prevalence of obesity was high in outpatients with mental disorders. Improvement in lifestyle choices is necessary to prevent obesity and the onset of metabolic syndrome in such patients.     

Association of Subjective and Objective Socioeconomic Status with Subjective Mental Health and Mental Disorders Among Japanese Men and Women

Background

An inverse association between socioeconomic status (SES) and mental health has been previously well reported, but the evidence is limited in Asian populations.

Purpose

We therefore investigated the association of SES and subjective mental health and prevalence of any mental disorders in the general population of Japan.

Method

We used data from the World Mental Health Japan Survey of 1,496 randomly selected people aged 20 years and older in Japan. Information on education level and household income were used as objective SES indicators, and subjective social status (SSS) was measured by responses to a question regarding social position. We calculated odds ratios of SES indicators for poor subjective mental health and 12-month prevalence of any mental disorders.

Results

The adjusted odds ratio (OR) (95 % confidence interval (CI)) of respondents who rated themselves as lower than middle status in the country (low SSS group) for poor subjective mental health was 2.24 (95 % CI: 1.41, 3.57) with reference to those who rated themselves as higher than middle status (high SSS group). Similarly, inverse associations of education level and household income with poor subjective mental health were identified. A J-shaped association was confirmed between SSS and 12-month prevalence of any mental disorders. The adjusted OR (95 % CI) of SSS for any mental diseases was 0.53 (95 % CI: 0.32, 0.86) for the middle SSS group and 1.61 (95 % CI: 0.96, 2.72) for the low SSS group, compared with the high SSS group. Those associations were not attenuated when objective SES indicators were adjusted.

Conclusion

We found inversely linear associations between subjective and objective SES and poor subjective mental health among Japanese men and women. SSS was not significantly associated with 12-month prevalence of any mental disorders. Substantial social inequalities in mental health were identified in Japan, which has been considered an egalitarian society with relatively few inequalities in health.     

Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey

BACKGROUND:This paper describes the 12-month prevalence, severity and demographic correlates of 16 DSM-IV psychiatric disorders and service utilization in the Mexican urban population aged 18-65 years of age. This is representative of 75% of the national adult population.METHOD:The sample design was a strict probability selection scheme. The response rate was 76.6%. The World Mental Health Survey version of the Composite International Diagnostic Interview was installed on laptops and administered by lay interviewers. An international WHO task force carried out its translation into Spanish.RESULTS: The 12-month prevalence of any disorder was 12.1%. The most common disorders were specific phobia (4.0%), major depressive disorder (3.7%) and alcohol abuse or dependence (2.2%). The 12-month prevalence of very severe disorders was 3.7% of which only 24% used any services. Age was the only variable associated with any 12-month disorder, with the younger more likely to report any disorder. Income was associated with severity, with low and low-average incomes more likely to report a 12-month disorder. Females were more likely to report a mood and anxiety disorder, but less likely to report a substance disorder. The group of separated/widowed/divorced was more likely to report a mood and an impulse-control disorder.CONCLUSIONS:The results show that while psychiatric disorders are common in the Mexican population, very severe mental disorders are less common and there is extreme under-utilization of mental health services.     

Obesity in Older Adults and Associations with Cardiovascular Structure and Function

IntroductionBody mass index (BMI), despite being widely used as a marker of obesity, fails to fully capture cardiovascular risks as it is an insufficient biomarker of abdominal adiposity, unlike waist circumference (WC). We aimed to characterize associations between BMI and WC with cardiovascular structure and function in older adults.MethodsAmong an observational cohort study of a community of older adults, transthoracic echocardiography determined cardiovascular structure and function, while aerobic capacity was determined by peak oxygen uptake (VO₂) metrics. The cut-offs for obesity were 27.5 kg/m² for BMI, and >90 cm for males and >80 cm for females for WC.ResultsOf 970 older adults without cardiovascular disease (mean age 73 ± 4 years, 432 [44%] males), 124 (12.8%) were obese by BMI definition while 347 (35.7%) were obese by WC definition. Inter-definitional agreement was fair (Cohen''s κ = 0.345). Unlike the BMI definition, participants defined as obese by WC were more likely to be women (65% vs. 50%, p < 0.001), older (65 ± 11 vs. 63 ± 14 years, p = 0.007), and had lower handgrip strength (24 ± 0.6 vs. 26 ± 0.4 kg, p = 0.022). Across BMI categories, high WC was associated with more impaired myocardial relaxation (E/A), and VO₂ measurements (all p < 0.05). Among those with low BMI, high WC was associated with larger left atrial (LA) volumes (p = 0.003). WC, but not BMI, was independently associated with E/A (β = −0.114, SE −0.114 ± 0.024, p < 0.001) in regression analysis.ConclusionWC identified a higher prevalence of obesity, possibly related to central adiposity. Across BMI categories, WC identified more adverse measurements in E/A, aerobic capacity, and LA structure.Trial RegistrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02791139","term_id":"NCT02791139"}}NCT02791139.     

Does waist indicate dyslipidemia better than BMI in Korean adult population?

Obesity is an independent and modifiable risk factor for cardiovascular disease, and known as a core of the metabolic syndrome. Obesity has been largely diagnosed based upon anthrompometric measurements like waist circumference (WC) and body mass index (BMI). We sought to determine associations between anthropometric measurements and dyslipidemia in a community adult sample composed of 1,032 community residents (356 men, 676 women) aged 50 yr and over in Namwon, Korea. Blood tests for lipid profiles, including total cholesterol (TC) and HDL cholesterol (HDL) were performed, and dyslipidemia was defined as TC/HDL greater than 4. Anthropometric measurements included WC, waist-to-height ratio (WHtR), waist-to-hip ratio, and BMI. All anthropometric measures were categorized into quartiles and evaluated for associations with dyslipidemia. TC/HDL showed the significant associations with the anthropometric measures, independently of potential confounders. In women, increases of obesity indexes by quartile analyses showed linear increases of odds ratios for dyslipidemia (p values <0.01 by trend test). In men, except BMI, same patterns of association were noted. WC and WHtR were significantly associated with dyslipidemia in Korean adult population. As a simple and non-invasive method for a detection of obesity and dyslipidemia, anthropometric measurements could be efficiently used in clinical and epidemiologic fields.     

Asthma and depressive and anxiety disorders among young persons in the community

BACKGROUND: The objectives of the study were to examine linkages between asthma and depressive and anxiety disorders in a birth cohort of over 1000 young persons studied to the age of 21 years. Specifically, the study aimed to ascertain the extent to which associations between asthma and depressive and anxiety disorders could be explained by non-observed fixed confounding factors. METHOD: Asthma and depressive and anxiety disorders were measured prospectively over the course of a 21-year longitudinal study. Fixed effects logistic regression models were used to determine the relationship between asthma and depressive and anxiety disorders, adjusting for potentially confounding factors. RESULTS: Asthma in adolescence and young adulthood was associated with increased likelihood of major depression (OR 1.7, 95 % CI 1.3-2.3), panic attacks (OR 1.9, 95 % CI 1.3-2.8), and any anxiety disorder (OR 1.6, 95% CI 1.2-2.2). Associations between asthma and depressive and anxiety disorders were adjusted for confounding factors using a fixed effects regression model which showed that, after control for fixed confounding factors, asthma was no longer significantly related to major depression (OR 1.1), panic attacks (OR 1.1), or any anxiety disorder (OR 1.2). Additional post hoc analyses suggested that exposure to childhood adversity or unexamined familial factors may account for some of the co-morbidity of asthma and depressive and anxiety disorders. CONCLUSIONS: These results confirm and extend previous findings by documenting elevated rates of depressive and anxiety disorders among young adults with asthma, compared with their counterparts without asthma, in the community. The weight of the evidence from this study suggests that associations between asthma and depressive and anxiety symptoms may reflect effects of common factors associated with both asthma and depressive and anxiety disorders, rather than a direct causal link. Future research is needed to identify the specific factors underlying these associations.     

Low prevalence of depression and anxiety is linked to statutory retirement ages rather than personal work exit: a national survey

BACKGROUND: Common mental disorder prevalence decreases substantially around the conventional retirement age for men in the UK, but trends for older women are more continuous. Prevalence changes in depression and anxiety around retirement are less clear, as is the role of risk factors. The aim of this study was to establish whether work status, age or other known risk factors account for the reduced prevalence of depressive episode and anxiety disorder around retirement ages for men and for women. METHOD: The British Psychiatric Morbidity Survey (BPMS) 2000 was analysed, including 1875 men and 2253 women aged 45-75 years. Diagnoses were from the Revised Clinical Interview Schedule (CIS-R). Logistic models were adjusted for sociodemographic factors, social network, work status, life events, physical illness and disability. RESULTS: There are marked reductions in the prevalence of depressive episode after 60 years for women [60% lower prevalence, 95% confidence interval (CI) 40-80] and 65 years for men (90% lower prevalence, 95% CI 70-100), compared to the youngest age groups. For anxiety disorder, the reduction in prevalence was 80% (95% CI 60-90) for men and 40% (95% CI 20-60) for women. In fully adjusted multivariate models, the strong association between diagnoses and age groups remained, for both genders. Work status was a significant factor for men but not for women. CONCLUSION: There is a discontinuity in the prevalence of depressive episode for both men and women, coinciding with statutory retirement ages. No studied risk factor reduced the associations between age group and disorders. This population scale recovery may provide a model for understanding non-genetic factors.     

One-month prevalence of depression and other DSM-IV disorders among young adults.

BACKGROUND: We aimed to provide prevalence data on depression and other current mental disorders, impairment, need of psychiatric care and use of mental health services among young adults. METHODS: Based on a semi-structured clinical interview, current DSM-IV disorders, impairment, need of psychiatric care and use of mental health services were evaluated in a sample of 20-24-year-old young urban adults (N = 245), mean age 21.8, screened from a baseline population of 706. One-month prevalence estimates for disorders were calculated by the double sampling method, using various additional criteria to identify cases. RESULTS: One in four young adults (23.8%) suffered from a current mental disorder, the most prevalent being depressive (10.8%), anxiety (6.9%), substance use (6.2%) and personality disorders (6.0%). Prevalence estimates varied substantially according to the use of additional diagnostic criteria. Impairment (GAF < 61) together with DSM-IV symptom criteria produced an overall disorder prevalence of 10.3%, and 5.5% for depression. Prevalences were higher for females than males, except for alcohol abuse and personality disorders. Current co-morbidity was found in 39% of subjects with any disorder, and in more than half of those with depression. One-third of subjects with a current disorder reported an associated contact with psychiatric services and 16% had an ongoing contact. CONCLUSIONS: Our findings support the use of additional criteria to produce clinically relevant prevalence data. Co-morbidity should receive special attention due to its amplification of both need for psychiatric care and severity of impairment. Finally, our results show disturbed young adults to be severely undertreated.     

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

BACKGROUND: Epidemiologic studies have consistently demonstrated the association between high body mass index (BMI) and asthma, yet the relationship between asthma and the alternative central obesity phenotypes, waist circumference (WC) and waist-to-hip ratio (WHR), has not been assessed in a representative population sample. OBJECTIVE: To determine the strength of the association of WC and WHR with current asthma and whether the association is modified by atopic status in a representative population sample. METHODS: The North West Adelaide Health Study, a biomedical population study of n = 4060, assessed current asthma, respiratory symptoms, and participant demographics by self-completed questionnaire. Clinic assessment included measures of WC and WHR, spirometry, and skin prick tests to a panel of allergens. RESULTS: Logistic regression analysis showed a significant, marginal increased adjusted risk of asthma associated with obese levels of WC and WHR and BMI > or =35.0 kg/m2 in female subjects only. When the association was considered stratified according to atopic status, the relationship between obese levels of WC and WHR with asthma held only for the nonatopic population in both males (WC: odds ratio [OR] 5.7, 95% confidence interval [CI] 1.1-28.8; WHR: OR 6.2, 95% CI, 1.1-32.9) and females (WC: OR 2.3, 95% CI, 1.2-4.4; WHR: OR 3.0, 95% CI, 1.5-5.9). BMI > or =35.0 kg/m2 showed an inconsistent pattern in the association with asthma. CONCLUSION: Central obesity was significantly associated with an increased risk of nonatopic asthma only. The causal pathway is unknown, but this study suggests the involvement of different pathophysiological mechanisms requiring further investigation. CLINICAL IMPLICATIONS: Asthma should be considered in older, nonatopic, centrally obese, symptomatic individuals.     

Can gender differences in the prevalence of mental disorders be explained by sociodemographic factors?

Summary Background and aims: Epidemiological studies throughout the world consistently reported higher rates of depression and anxiety disorders in women, whereas men consistently show higher rates of substance and antisocial disorders. The present study examined factors potentially contributing to these gender differences using general population data.Methods: The sample was drawn from population registries (N=4181) and can be regarded as representative for the adult German population aged 18–65. Mental disorders (DSM-IV) were assessed with a diagnostic interview (CIDI) carried out by clinically trained interviewers. A range of sociodemographic variables was analysed within men, within women, and between genders.Results: The prevalence of common mental disorders (mood, anxiety, substance use and somatoform disorders) is higher among females, with the exception of substance use disorders. Young age was related to substance disorders both in women and in men. Not being married and being unemployed were associated with increased rates of mental disorders in both sexes, but in men stronger than in women. Being retired was associated with depression only in women, whereas belonging to a higher social class, working fulltime and having children appeared to be protective factors for men only. Other sociodemographic factors (concerning education, employment and family status) were not associated with increased rates of mental disorders both in women and men.Conclusion: Overall the emotional advantages or disadvantages of marital status, employment status, number of children, parenthood and social class apply equally to men and women. We cannot explain the female preponderance in most mental disorders by detecting specific unfavourable patterns of sociodemographic correlates, suggesting that determinants of gender differences in common mental disorders are still far from being understood.