Social network as predictor for onset of alcohol use disorder: A prospective cohort study

ObjectiveSocial network has been linked to alcohol use disorder in several studies. However, since the majority of such findings are cross-sectional, causal interpretation is difficult. The aim of the present study was to test if social network characteristics predict alcohol use disorder in a prospective design.MethodsInformation on social network and covariates was obtained from 9589 men and women aged 21–99 years in the Copenhagen City Heart Study, followed for registration of alcohol use disorder in the Danish National Patient Registry and the WINALCO database.ResultsMen who lived alone, were separated or divorced or widowers had a higher risk of developing alcohol use disorder: HR among men living alone vs. men not living alone was 2.28 (95% CI: 1.59–3.27), and HR among separated/divorced men vs. married men was 2.55 (95% CI: 1.33–4.89). No such associations were found among women. Frequency of contact with friends was associated with risk of developing alcohol use disorder among both sexes. For example, the HRs were 1.72 (CI 95%: 0.99–3.01) and 2.59 (95% CI: 1.42–4.71) among women who had contact with friends a couple of times per week and daily, respectively, compared with more rarely. Frequency of contact with family was not associated with risk of developing alcohol use disorder among either sex.ConclusionLiving alone and not being married or cohabiting with a partner were predictors of developing alcohol use disorder among men. Further, frequent contact with friends was associated with higher risk of alcohol use disorder among both sexes.     

Ease of marital communication and depressive symptom severity among men and women in rural Uganda: cross-sectional,whole-population study

Purpose

Depression is a major contributor to the global burden of disease. The extent to which marital communication may influence depression in contexts with little mental health support is unknown.

Methods

We conducted a whole-population study of married adult residents of eight villages in a rural region of southwestern Uganda. Depression symptom severity was measured using a modified version of the Hopkins Symptom Checklist for Depression, with > 1.75 classified as a positive screen for probable depression. Respondents were asked to report about ease of marital communication (‘never easy’, ‘easy once in a while’, ‘easy most of the time’ or ‘always easy’). Sex-stratified, multivariable Poisson regression models were fit to estimate the association between depression symptom severity and marital communication.

Results

Among 492 female and 447 male participants (response rate = 96%), 23 women and 5 men reported communication as ‘never easy’ and 154 women and 72 men reported it as ‘easy once in a while’. Reporting communication as ‘never easy’ was associated with an increased risk of probable depression among women (adjusted relative risk [ARR], 2.06; 95% confidence interval [CI], 1.08–3.93, p = 0.028) and among men (ARR, 7.10; 95% CI 1.70–29.56, p = 0.007).

Conclusion

In this whole-population study of married adults in rural Uganda, difficulty of marital communication was associated with depression symptom severity. Additional research is needed to assess whether communication training facilitated by local leaders or incorporated into couples-based services might be a novel pathway to address mental health burden.

     

Epidemiology of DSM-5 bipolar I disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions – III

BackgroundThe objective of this study was to present 12-month and lifetime prevalence, correlates, comorbidity, treatment and disability of DSM-5 bipolar I disorder.MethodsNationally representative U.S. adult sample (N = 36,309), the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions – III.ResultsPrevalences of 12-month and lifetime DSM-5 bipolar I disorder were 1.5% and 2.1% and did not differ between men (1.6% and 2.2%) and women (1.5% and 2.0%). Prevalences of bipolar I disorder were greater among Native Americans, and lower among Blacks, Hispanics and Asians/Pacific Islanders than whites. Rates were also lower among younger than older individuals, those previously married than currently married and with lower education and income relative to higher education and income. Bipolar I disorder was more strongly related to borderline and schizotypal personality disorders (adjusted odds ratios (AORS) = 2.2–4.7)), than to anxiety disorders (AORs = 1.3–2.9), and substance use disorders (AORs = 1.3–2.1) overall and among men and women. Quality of life was lower among individuals with bipolar I disorder relative to those without the disorder. Treatment rates among individuals with bipolar I disorder were low in the total sample (46%, SE = 2.63), among men (36.7%, SE = 3.82) and among women (55.8%, SE = 3.32).ConclusionsBipolar I disorder continues to be common disabling and highly comorbid disorder among men and women, contributing substantially to low quality of life and burden of disease in our society.     

The role of gender in single vs married individuals with bipolar disorder

Background

Despite the importance of marriage as a source of social support, it has been largely neglected in studies of bipolar disorder; and differential effects on men and women have not been explored.

Methods

Data on episodes of depression, mania, and mixed states were collected for the previous 2 years from a sample of 282 bipolar individuals using the National Institute of Mental Health Life Chart Methodology.

Results

Effects unique to women included the following: Bipolar women were significantly more likely to be married. Married women had fewer episodes of depression during the past 2 years than never-married women, and the cumulative severity of depression was lower. There were no differences in diagnostic subtype or age of onset between married and never-married women. Among men, never-married men were more likely to have bipolar I disorder and had an earlier age of onset compared with married men. There were no differences between married and never-married men in frequency, duration, or severity of mood episodes.

Conclusions

Partner selection processes as they relate to bipolar disorder may be different for men and women. The bipolar I diagnostic subtype and early age of onset were associated with a lower likelihood of being married for men, but not for women. Marriage was associated with less depression in women during a 2-year period; but marital status was not associated with disease course differences in men, suggesting that women may be more sensitive to the positive effects of social support available within a stable marital relationship.     

The Age Structures and Marital Status Differences of Married and Not Married Male Suicide Rates: 12 Developed Countries

Male suicide rates, circa 1960, specific to age and marital status for 12 developed countries show married men with lower suicide rates than not married men. This results in differences in the age structures of married and not married suicide rates. We test three explanations of lower married than not married suicide rates: 1) Gibbs and Martin's (1964 Gibbs , J. P. & Martin , W. T. ( 1964 ). Status integration and suicide: A sociological study . Eugene , OR : University of Oregon Books . [Google Scholar]) marital status integration hypothesis; 2) marital status differences in norms regarding the acceptability of suicide; and 3) Durkheim's societal integration theory. All three explanations are supported by multivariate regressions. The strongest support is for societal integration. The models explain over 80% of the variance in both married and not married male age-specific suicide rates. These regression equations generate predicted suicide rates and these predicted rates are then used to see if they account for the observed age structures of married and not married men. They do in 19 of 24 tests.     

Exploring married girls’ subjective experiences of well-being and challenges

IntroductionThe well-being of married girls is often significantly affected by their early transitioning into the institution of marriage. This is accompanied by a normative shift in their focus from education and personal development to family life and motherhood. However, it is important we understand married girls’ perspectives of what their marriage mean to them and how that affects their well-being. Therefore, this study explored the subjective experiences of well-being and challenges among married girls in the Northern region of Ghana.MethodsA phenomenological approach was used to gather data through in-depth interviews. Twenty-one married girls between the ages of 12 and 19 years in Sagnarigu, Tolon and Mion districts of the Northern Region of Ghana were interviewed and data were analysed using thematic analysis.ResultsFindings revealed that girls who perceived their marriage as early reported negative emotions whereas those who perceived their marriage as timely reported positive emotions. Married girls’ positive experiences were characterised by child bearing, higher social status, received social support and satisfaction of needs in their marriage. Challenges identified included poor socio-economic status, inadequate parenting skills, pregnancy and childbirth related distresses.ConclusionsMarried girls expressed more positive outcomes in their marriage than they did for negative outcomes despite their general perception of their marriage being early. Implications for interventions and policy decision making are discussed.     

Sleep-disordered breathing symptoms among African-Americans in the Jackson Heart Study

BackgroundSleep-disordered breathing (SDB) is an increasingly recognized risk factor for cardiovascular disease (CVD). Limited data are available from large African American cohorts.MethodsWe examined the prevalence, burden, and correlates of sleep symptoms suggestive of SDB and risk for obstructive sleep apnea (OSA) in the Jackson Heart Study (JHS), an all-African-American cohort of 5301 adults. Data on selected daytime and nighttime sleep symptoms were collected using a modified Berlin questionnaire during the baseline examination. Risk of OSA was calculated according to published prediction model. Age and multivariable-adjusted logistic regression models were used to examine the associations between potential risk factors and measures of sleep.ResultsSleep symptoms, burden, and risk of OSA were high among men and women in the JHS and increased with age and obesity. Being married was positively associated with sleep symptoms among women. In men, poor to fair perceived health and increased levels of stress were associated with higher odds of sleep burden, whereas prevalent hypertension and CVD were associated with higher odds of OSA risk. Similar associations were observed among women with slight variations. Sleep duration <7 h was associated with increased odds of sleep symptoms among women and increased sleep burden among men. Moderate to severe restless sleep was consistently and positively associated with odds of adverse sleep symptoms, sleep burden, and high risk OSA.ConclusionsSleep symptoms in JHS had a strong positive association with features of visceral obesity, stress, and poor perceived health. With increasing obesity among younger African Americans, these findings are likely to have broad public health implications.     

Methamphetamine and Poly-Substance Use Among Gym-Attending Men Who Have Sex with Men in New York City

Background Methamphetamine and other drug use has been documented among men who have sex with men (MSM). Patterns of use may be influenced by point of recruitment into these studies. Purpose The aim of this study is to describe patterns of methamphetamine and other drug use and to delineate psychosocial and demographic factors which accompany these patterns of use in a sample of MSM attending gyms in New York City. Methods Active recruitment strategies were implemented to ascertain a sample of 311 MSM. Participants completed a one-time survey regarding both health risks and health promotion. Results Methamphetamine use in the last 6 months was reported by 23.8% of men. Inhalation and smoking were the most common modes of administration, and 84% of men reported more than one mode of use. Study participants also indicated a variety of other substances used, including but not limited to alcohol, inhalant nitrates, and 3,4 methylenedioxymethamphetamine (MDMA). Compared to nonusers, methamphetamine users were more likely to report being black or Latino, depressed, HIV-positive, perceiving more benefits of unprotected sex, and understanding masculinity in sexual terms. Conclusions These data suggest that health-risk behaviors are common among MSM who are regularly using a gym and are indicative of the complexities of health issues for this segment of the population. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Center for Disease Control and Prevention.     

Mental health of single fathers living in an urban community in South Korea

ObjectiveThe aims of this study were to understand the mental health of single fathers relative to married fathers as the population of single fathers continues to increase and to use the resultant data for the establishment of public health policies.MethodsWe evaluated the mental health of 58 single fathers and 256 married fathers living in an urban community in South Korea. Self-reported questionnaires including the Global Assessment of Recent Stress, Center for Epidemiologic Studies–Depression, Scale for Suicidal Ideation, the Korean version of the Alcohol Use Disorder Identification Test, and the World Health Organization Quality of Life Assessment Instrument were used for evaluation. The mental health scale scores and the prevalence of mental health problems were compared between the single and the married fathers. We also assessed the factors associated with poor QOL, depressive symptoms, and severe stress among single fathers.ResultsThe single fathers had poorer quality of life (OR 7.30, 95% CI 2.82–18.74), more depressive symptoms (OR 3.85, 95% CI 1.29–11.45), and more stress (OR 3.36, 95% CI 1.25–8.98) than did the married fathers even after controlling for socio-demographic factors. Among the single fathers, poor socioeconomic conditions, such as no house ownership, manual occupations, having two or more children, and having a youngest child in elementary school or middle school, were significantly associated with poorer mental health.ConclusionsThis study demonstrated that single fathers have poorer mental health than do married fathers. Single parenthood was significantly associated with their mental health. Therefore, we should attempt to provide practical support to reduce the social burden and offer earlier psychological interventions to reduce distress in single fathers.     

Depression and aggression in never-married men in China: a growing problem

Purpose

China has the highest excess of male births in the world at 118 to every 100 female, with a current excess of 20 million men of reproductive age. The impact on the psychological well-being of the large numbers of men who will never marry is unclear. This study was carried out to test the hypothesis that older never-married men are more predisposed to depression, low self-esteem and aggression.

Methods

The study was a cross-sectional survey using a self-completion questionnaire conducted in high sex ratio rural areas of Yunnan and Guizhou provinces. The tools used were the Beck Depression Inventory, Rosenberg’s Self-Esteem Scale and the Bryant-Smith Aggression questionnaire.

Results

A total of 1,059 never-married men and 1,066 married men aged 30–40 completed questionnaires. Never-married men were financially poorer and had lower education levels than married ones. After adjusting for age, education and income, never-married men were significantly more likely to have lower self-esteem scores (P < 0.001), higher depression scores (P < 0.001), higher aggression scores (P < 0.001) and were more likely to have suicidal thoughts or wishes (P < 0.001) than married men.

Conclusion

The high prevalence of severe depression and suicide ideation in these men is of particular concern. In rural China mental health services are currently very sparse, but rural doctors could be trained to use a check score to identify severe depression, and refer as appropriate to specialist services.     

Gender differences in suicide methods

Introduction

Gender differences in suicide completion rates have been attributed to the differences in lethality of suicide methods chosen by men and women, but few empirical studies have investigated factors other than demographic characteristics that might explain this differential.

Methods

Data from the 621 suicides in Summit County, Ohio during 1997–2006 were disaggregated by gender to compare known correlates of suicide risk on three methods of suicide—firearm, hanging and drug poisoning.

Results

Compared to women, men who completed suicide with firearms were more likely to be married and committed the act at home. Unmarried men were likelier to hang themselves than married men, but unmarried women were less likely to hang themselves than married women. Men with a history of depression were more likely to suicide by hanging, but women with depression were half as likely to hang themselves compared to the women without a history of depression. Men with a history of substance abuse were more likely to suicide by poisoning than men without such history, but substance abuse history had no influence on women’s use of poisoning to suicide. For both sexes, the odds of suicide by poisoning were significantly higher for those on psychiatric medications.     

The difference between single and married mothers in the 12-month prevalence of major depressive syndrome,associated factors and mental health service utilization

Abstract. Background: Previous studies suggest that single mothers are at a higher risk of major depression and more likely to use mental health services than are married mothers. The objectives of this analysis were to provide estimates of the prevalence of major depressive syndrome among single and married mothers, to investigate the factors which may affect the difference in the prevalence of major depressive syndrome among single and married mothers and to estimate the health care service utilization by single and married mothers. Methods: This was a cross-sectional study using the data from the 1996–97 Canadian National Population Health Survey (NPHS). Major depressive syndrome was evaluated using the Composite International Diagnostic Interview—Short Form for major depression. The prevalence of major depressive syndrome was calculated among 3030 single and 10195 married mothers. The effects of demographic, socioeconomic and biological variables on the association between single-mother status and major depressive syndrome were evaluated by stratified analyses. Results: In the NPHS, the difference between single and married mothers in the prevalence of major depressive syndrome was found among women who were between the ages of 25 and 50. The association in this age group depended on race and on whether they had one or more jobs. Education,problem drinking, daily smoking, having one or more long-term medical illnesses, financial hardship and social support did not affect the association between single-mother status and major depressive syndrome. Single mothers were more likely to visit health professionals for mental problems than were married mothers. Conclusion: The difference between single and married mothers in the prevalence of major depression is age-specific. Single mothers who reported having had one or more jobs and who are non-white had an increased risk of having major depressive syndrome, compared to married mothers. Future studies need to replicate the findings of this analysis and investigate why single mothers with ethnic minority backgrounds and those who are working are at high risk of having depressive disorders.     

Is the association between social network types,depressive symptoms and life satisfaction mediated by the perceived availability of social support? A cross-sectional analysis using the Canadian Longitudinal Study on Aging

Abstract

Objectives: The objectives of this study were to examine: 1) whether the relationship between social network types, depressive symptoms and life satisfaction is mediated by different types of perceived social support; and, 2) whether social support plays a mediational role for married versus unmarried older adults.

Methods: The study was based on national, baseline data (Tracking Cohort) from the Canadian Longitudinal Study on Aging for participants aged 65 to 85 (N?=?8782). Five social network types derived from cluster analysis were used as predictors in the mediation analyses, with the four social support subscales of the Medical Outcomes Survey (MOS) Social Support Survey (tangible, emotional, positive social interactions, and affectionate) included as mediators, and depressive symptoms and life satisfaction as outcome variables. Socio-demographic and physical health variables were included as covariates.

Results: Significant indirect effects emerged, with less diverse social network structures generally associated with less social support which, in turn, was related to more depressive symptoms and lower life satisfaction. However, different findings emerged for different types of social support, for participants who were married and unmarried, and for depressive symptoms versus life satisfaction.

Conclusion: Our findings suggest that restricted social networks that are reflective of social isolation, as well as those that are intermediate in terms of their diversity can create gaps in perceived social support and, consequently, can negatively impact mental health and life satisfaction.     

Demographic risk factors, mediators, and moderators in youths’ diabetes metabolic control

Background: Socioeconomic status (SES) is one of the most frequently identified and potent predictors of disease morbidity and mortality. It also predicts diabetes care and metabolic control, yet it is often confounded with parental marital status and ethnicity in pediatric samples.Purpose: Key demographic risk factors for poorer metabolic control in adolescents with type I diabetes are examined to distinguish their relative effects, along with disease care mediators and family environment moderators.Methods and Results: When SES, ethnicity, and marital status are considered simultaneously with path analysis, living with married biological parents is the sole predictor of better metabolic control in a predominantly middle-class sample. Specifically, adolescents who lived with their biologic parents had glycosylated hemoglobin levels that were approximately .5% lower on average than those who lived in alternative family arrangements (i.e., blended and single-parent families). More frequent meals and snacks and more blood glucose monitoring mediates this effect. Under favorable conditions of greater familial harmony, children from married biologic families experience a stronger beneficial health effect, with average glycohemoglobin levels that are approximately .81% lower in less conflicted families and .62% lower in more cohesive families.Conclusions: In toto, marital status eclipsed the well known effects of SES in the prediction of metabolic control in a primarily middle-class sample of children with diabetes. The 8.0% average glycohemoglobin level of youths from married biologic families is similar to that of intensively treated adolescents in the Diabetes Control and Complications Trial and, if maintained, should be associated with clinically significant reductions in disease complications.     

To be or not to be married – that is the question of quality of life in men with schizophrenia

Background The association of gender and marital status with quality of life (QoL) was studied in a representative national sample of long-term schizophrenia patients. Methods The study sample consisted of 1,750 male and 1,506 female 15- to 64-year-old schizophrenia patients discharged from mental hospitals in 1986, 1990 and 1994 in Finland. Comprehensive data were collected from hospital and out-patient case records and the psychiatric teams carried out a structured interview regarding the patients' socio-demographic background, living places, living situation, psycho-social state and functioning and life satisfaction three years after the index discharge. Results Female patients were older, more often married, had been ill for a longer time and had moved after discharge from hospital to live alone or with their spouse more often than men. Women and married patients had migrated more often than men and single patients, but single men had more often remained living in a remote rural area than others. The QoL of single men was poorer than others in almost all the areas in which it was measured: housing conditions, working, daily functioning, number of confidants and psycho-social state. Differences between single women and married men or women were much smaller. Women, independently of their marital status, were more satisfied with their life, had more close interpersonal relationships and had done useful work more often than men. Conclusions Single male patients with schizophrenia seem to have dropped out of the development of society. They remain living in their birthplace and are more dependent than other patients. Single women migrate more consistently into urban areas, which may be favourable for their QoL. Married patients with schizophrenia, possibly partly helped by their spouse, can best follow changes in the society. Female gender also seems to have an independent association with life satisfaction and interpersonal aspects of the QoL. The results of this study strongly emphasise that the associations between gender, marital status and QoL to a great extent depend on the study sample and may also vary by study area. Accepted: 16 July 2001     

Has depression surpassed HIV as a burden to gay and bisexual men’s health in the United States? A comparative modeling study

Background

While advances in HIV prevention and treatment have changed the epidemic for gay and bisexual men, another epidemic faces this population. Gay and bisexual men represent one of the highest risk groups for depression, which potentially poses quality-of-life and public health challenges comparable to those of HIV. The present study seeks to inform comprehensive care for sexual minority men by estimating and comparing the morbidity of HIV and depression for US gay and bisexual men.

Methods

In 2018, weighted counts of gay and bisexual men living with HIV and depression were derived from the CDC’s Medical Monitoring Project and the National Survey on Drug Use and Health, respectively. Years lived with disability for HIV and depression were calculated using the Global Burden of Disease Study’s disability weights.

Findings

Among gay and bisexual adult men in the US, the prevalence of past-year major depressive episodes is 14.17%, while the prevalence of HIV is 11.52%. We estimate that in calendar year 2015, major depressive episodes imposed 85,361 (95% CI 58,293–112,212) years lived with disability among US adult gay and bisexual men, whereas HIV posed 42,981 (95% CI 36,221–49,722) years lived with disability.

Interpretation

This analysis shows that depression morbidity currently exceeds that for HIV among US adult gay and bisexual men. While gay and bisexual men are frequently understood to be a high-risk population for HIV, including in guidelines for HIV prevention and treatment, the present analysis suggests that this population should also be considered high-risk for depression.

     

Suicide in Nigeria: observations from the content analysis of newspapers

BackgroundSuicide is a global public health problem and Nigeria is one of the epicentres of suicide in the world. However, there is a dearth of research exploring the epidemiological aspects of suicide in Nigeria.AimTo examine the demographic information and precipitating events for suicides in Nigeria by analysing the contents of newspaper reports of suicide.MethodsWe searched, collected, and analysed published news reports about suicide from 10 English newspapers in Nigeria. A total of 350 suicide reports were assessed between January 2010 and December 2019 after screening and sorting.ResultsThe mean (SD) age of the reported cases was 36.33 (15.48) years. Majority of the reported cases were male (80.6%), married (51.8%), students (33.6%), living in a semi-urban area (40.3%) and among the age group of 25–34 (25.3%). Hanging (48.6%) and poisoning (32.2%) were the most commonly reported methods of suicide. Financial constraints and marital conflicts were most commonly assumed precipitating factors.ConclusionThis study suggests that being male, married, or living in semi-urban areas are associated with suicide in Nigeria. Further community-based studies are warranted to generalise the findings and adopt appropriate preventive strategies.     

Prognoses after self-harm in youth: exploring the gender factor

Purpose

Gender differences in youth self-harm are sparsely studied regarding long-term prognoses. We aimed to study the gender differences in effects of adolescent self-harm in early adult life in four domains: 1/family situation, 2/education and employment, 3/mental illness and suicidal behaviour, and 4/suicide and all-cause mortality.

Method

A register-based cohort study including all Swedish residents aged 20 during 2001–2005 was performed. Exposure was self-harm at ages 10–20, and outcomes were death and suicide and past-year records of self-harm, marital status/children, education/employment, and mental health at age 30. We used logistic regression for dichotomous outcomes, and Cox regression models for time-dependent outcomes. An interaction term was introduced to detect significant gender effects, in which case we performed stratified analyses.

Results

Subjects with self-harm before age 20 had a poorer prognosis for all studied outcomes, and risk estimates were similar for men and women for most outcomes including suicide. Significant interaction terms (ITs) were found, revealing gender differences, for being married (p_IT 0.0003; OR_men 0.6, OR_women 0.9), being a parent (p_IT < 0.0001; OR_men 0.7, OR_women 1.1), receiving unemployment support (p_IT < 0.0001; OR_men 2.4, OR_women 1.8), and death from any cause (p_IT 0.006; OR_men 10.6, OR_women 7.4).

Conclusions

Adolescent self-harm was associated with later life adversities and affected men more than women regarding prognoses for unemployment and certain aspects of the family situation. We found no gender difference for the effect of self-harm on the risk of suicide. Future suicide risk should not be underestimated in young self-harming women.