Gambling problem severity and psychiatric disorders among Hispanic and white adults: findings from a nationally representative sample

Objective

To examine differences in the associations of gambling problem severity and psychiatric disorders among a nationally representative sample of Hispanic and white adults.

Method

Chi-square tests and multinomial logistic regression analyses were performed on data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions from 31,830 adult respondents (13% Hispanic; 87% white), who were categorized according to three levels of gambling problem severity (i.e., no gambling or low-frequency gambling [NG], low-risk or at-risk gambling [LRG], problem or pathological gambling [PPG]).

Results

Hispanic respondents in comparison to white respondents were more likely to exhibit PPG. Problem gambling severity was associated with past-year Axis I and lifetime Axis II psychiatric disorders in both Hispanic and white respondents, with the largest odds typically observed in association with the most severe gambling pathology. A stronger relationship between subsyndromal gambling and a broad range of Axis I disorders (mood, anxiety and substance use disorders) and Axis II disorders (particularly cluster B) was observed in Hispanic respondents as compared to white ones.

Conclusions

Levels of problem gambling severity are associated with the prevalence of Axis I and Axis II psychiatric disorders in both Hispanics and whites. Differences in the patterns of co-occurring disorders between subsyndromal levels of gambling in Hispanic and white respondents indicate the importance of considering ethnicity/race-related factors related to subthreshold levels of gambling in developing improved mental health prevention and treatment strategies.     

Problem-Gambling Severity,Suicidality, and DSM-IV Axis I Psychiatric Disorders

Studies have examined relationships between suicidality and problem gambling and suicidality and Axis I psychiatric disorders. However, questions remain regarding how suicidality may influence relationships between problem-gambling severity and Axis I disorders. Using a sample of 13,543 participants with mood symptomatology from Wave 1 of the National Epidemiologic Survey of Alcohol and Related Conditions study (NESARC), we examined the relationship between different levels of problem-gambling severity and DSM-IV Axis I psychiatric disorders according to suicidality level. Bivariate analyses were conducted to examine the association between problem-gambling severity, sociodemographic characteristics, and presence or absence of past-year Axis I disorders according to suicidality status. Next, a series of adjusted logistic regression analyses evaluated the relationships between problem-gambling severity and psychopathology according to suicidality level. The relationships between Axis I psychiatric disorders and problem-gambling severity were largely not moderated by suicidal ideation or attempt. A possible exception was observed with panic disorder in which a stronger relationship was observed in the relationship between low-risk gambling (vs low-frequency/non-gambling) in the group with suicide attempts as compared with that without attempt or ideation, suggesting the importance of considering subsyndromal gambling behaviors, particularly among individuals with panic disorder and suicidal tendencies.

     

Problem-gambling severity and psychiatric disorders among American-Indian/Alaska native adults

IntroductionLittle is known about the association between problem-gambling severity and psychiatric disorders among American-Indian/Alaska-Native (AI/AN) individuals. Thus, we examined these factors among a nationally representative sample of AI/AN and other American adults in the USA.MethodUsing the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data, we conducted separate Wald tests and multinomial logistic regression analyses comparing AI/AN to black/African American, white/Caucasian, and all other racial/ethnic groups, respectively.ResultsRelative to other American adults, AI/AN adults were least likely to report non-/low-frequency gambling (NG: AI/AN 66.5%, white/Caucasian 70.5%, black/African American 72.8%, other racial/ethnic group 72.3%) and most likely to report low-risk gambling (LRG: AI/AN 30.1%, white/Caucasian 26.5%, black/African American 23.4%, other racial/ethnic group 24.7%). The association between at-risk/problem-gambling (ARPG) and any past-year Axis-I disorder was stronger among AI/AN versus other American adults. Although ARPG and LRG were associated with multiple past-year Axis-I and lifetime Axis-II psychiatric disorders in both AI/AN and other American adults, LRG was more strongly associated with both Axis-I disorders (particularly major depression, generalized anxiety disorder and nicotine dependence) and Cluster-B Axis-II (particularly antisocial personality disorder) disorders in AI/AN versus other American adults.DiscussionA stronger association between problem-gambling severity and past-year psychiatric disorders among AI/AN relative to other American adults suggests the importance of enhancing mental health and problem-gambling prevention and treatment strategies that may help AI/AN individuals.     

Prevalence and psychiatric correlates of pain interference among men and women in the general population

ObjectiveTo examine gender differences in the associations of levels of pain interference and psychiatric disorders among a nationally representative sample of adult men and women.MethodChi-square tests and multinomial logistic regression analyses were performed on data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions from 42,750 adult respondents (48% men; 52% women), who were categorized according to three levels of pain interference (i.e., no or low pain interference [NPI], moderate pain interference [MPI], severe pain interference [SPI]).ResultsFemale respondents in comparison to male respondents were more likely to exhibit moderate (p < 0.001) or severe pain interference (p < 0.001). Levels of pain interference were associated with past-year Axis I and lifetime Axis II psychiatric disorders in both male and female respondents (p < 0.05), with the largest odds typically observed in association with moderate or severe pain interference. A stronger relationship between MPI and alcohol abuse or dependence (OR = 1.61, p < 0.05) was observed in male participants as compared to female ones, while a stronger relationship between SPI and drug abuse or dependence (OR = 0.57, p < 0.05) was observed in female respondents as compared to male ones.ConclusionsLevels of pain interference are associated with the prevalence of Axis I and Axis II psychiatric disorders in both men and women. Differences in the patterns of co-occurring substance-related disorders between levels of pain interference in male and female respondents indicate the importance of considering gender-related factors associated with levels of pain interference in developing improved mental health prevention and treatment strategies.     

DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population

Type and prevalence of Axis I and Axis II disorders (DSM-III) were assessed in a sample of 298 consecutive psychiatric outpatients. The instruments used were SCID and SIDP. About half of the Axis I diagnoses consisted of different subgroups of depression. Most patients had more than one diagnosis, anxiety being the second most common disorder. Eighty one percent of the subjects met the criteria for a personality disorder diagnosis; half of them obtained more than one Axis II diagnosis. Personality disorder was more common among men than among women. Avoidant and dependent personality disorders constituted the most frequent diagnoses.     

Gender differences in psychiatric comorbidity: a population‐based study of 40 000 adults with attention deficit hyperactivity disorder

Objective

We aimed at determining whether gender modified associations between ADHD and psychiatric comorbidities in adults.

Method

We identified adults with ADHD by linking Norwegian national registries and compared them with the remaining adult population (born 1967–1997, ADHD and bipolar during 2004–2015, other psychiatric disorders 2008–2015). Prevalence differences (PDs) and prevalence ratios (PRs) of psychiatric disorders were determined by Poisson regression. Interaction by gender was evaluated on additive (PDs) and multiplicative (PRs) scales. Proportions of psychiatric disorders attributable to ADHD were calculated.

Results

We identified 40 103 adults with ADHD (44% women) and 1 661 103 adults (49% women) in the remaining population. PDs associated with ADHD were significantly larger in women than in men for anxiety, depression, bipolar and personality disorders, for example depression in women: 24.4 (95% CI, 23.8–24.9) vs. in men: 13.1 (12.8–13.4). PDs were significantly larger in men for schizophrenia and substance use disorder (SUD), for example SUD in men: 23.0 (22.5–23.5) vs. in women: 13.7 (13.3–14.0). Between 5.6 and 16.5% of psychiatric disorders in the population were attributable to ADHD.

Conclusion

The association between ADHD and psychiatric comorbidities differed significantly among men and women. Clinicians treating adults with ADHD should be aware of these frequent and gender‐specific comorbidities, such that early treatment can be offered.     

Comorbid Axis I-disorders among subjects with pathological,problem, or at-risk gambling recruited from the general population in Germany: Results of the PAGE study

The aim of the present study was to analyze comorbid Axis I-disorders in a sample of individuals with at-risk, problem, and pathological gambling. A number of 164 adult gamblers derived from a random sample of 15,023 individuals were compared with a general population sample. The lifetime prevalence of any psychiatric disorder was 93.6% among pathological (five–10 criteria), 83.5% among problem (three or four criteria), and 81.0% among at-risk gamblers (one or two criteria). Substance use disorders were the most common comorbid disorders in gamblers. Logistic regression analyses revealed elevated odds ratios for having a comorbid disorder in at-risk (Conditional Odds Ratio (COR) 3.5, Confidence Interval (CI) 2.6–4.6), problem (COR 4.9, CI 3.3–7.3), and pathological gamblers (COR 4.6, CI 3.0–6.9) compared to the general population. No significant differences were found between at-risk and problem gamblers or problem and pathological gamblers. Compared to at-risk gamblers, pathological gamblers showed elevated rates of comorbid substance use disorders. The data suggest a linear association between gambling disorder severity and comorbid Axis I-disorders. In conclusion, comorbid disorders are very prevalent in individuals with gambling problems. Even at-risk gamblers with one or two DSM-IV criteria show high rates of Axis I-disorders. Therefore, this group should be included in further studies on problematic gambling.     

Gambling level and psychiatric and medical disorders in older adults: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: This study examined the association between gambling level and psychiatric and medical disorders in a nationally representative sample of older adults. METHOD: Data on 10,563 U.S. older adults (age 60 or older) were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions. RESULTS: A total 28.74% of older adults were lifetime recreational gamblers and 0.85% were lifetime disordered gamblers. Compared with older adults without a history of regular gambling, recreational gamblers had significantly elevated rates of alcohol (30.1% versus 12.8%), nicotine (16.9% versus 8.0%), mood (12.6% versus 11.0%), anxiety (15.0% versus 11.6%), and personality disorders (11.3% versus 7.3%) and obesity (25.6% versus 20.8%), but were less likely to have past-year diagnoses of arteriosclerosis (4.7% versus 6.0%) or cirrhosis (0.2% versus 0.4%). Disordered gamblers were significantly more likely than older adults without a history of regular gambling to have alcohol (53.2% versus 12.8%), nicotine (43.2% versus 8.0%), drug (4.6% versus 0.7%), mood (39.5% versus 11.0%), anxiety (34.5% versus 11.6%), and personality (43.0% versus 7.3%) disorders, and to have past-year diagnoses of arthritis (60.2% versus 44.3%) or angina (22.7% versus 8.8%). These results remained significant even after controlling for demographic, psychiatric, and behavioral risk factors. CONCLUSIONS: Lifetime recreational gamblers were more likely than nonregular gamblers to have psychiatric disorders but were less likely to have some medical conditions. Lifetime disordered gamblers had a range of lifetime psychiatric disorders and were more likely than nonregular gamblers to have past-year diagnoses of angina and arthritis.     

Diagnoses, Psychosocial Stressors and Adaptive Functioning in Attempted Suicide

A systematic sample of 78 suicide attempters (37 men and 41 women), of whom 83% were hospitalized, were interviewed according to SCID I and II and Axes III-V according to DSM-III-R. Mood disorders were most common (56%). Forty-four suicide attempters (56%) suffered from comorbid diagnoses on Axis I-II. Borderline personality disorder was more common among women then men (56% vs. 24%, respectively, p = 0.01). Axis III disorders were confirmed for 45%. Sixty-two percent of the suicide attempters had severe psychosocial stressors (Axis IV). When comparing subjects with only Axis I disorders to those with Axis I and II disorders, no difference with respect to psychosocial stressor grade was observed. Moreover, those with only Axis I disorders were not impaired in their adaptive functioning (Axis V) even if severe psychosocial stressors were present. In contrast, an association (p = 0.02) was found between high stress and low functioning in patients with both Axis I and Axis II disorders. The data suggest that in clinical practice, beside evaluation of Axis I and Axis II disorders, also stressors and global functioning should be included in the assessment of suicide risk after attempted suicide.     

Mental health and gender dysphoria: A review of the literature

Abstract

Studies investigating the prevalence of psychiatric disorders among trans individuals have identified elevated rates of psychopathology. Research has also provided conflicting psychiatric outcomes following gender-confirming medical interventions. This review identifies 38 cross-sectional and longitudinal studies describing prevalence rates of psychiatric disorders and psychiatric outcomes, pre- and post-gender-confirming medical interventions, for people with gender dysphoria. It indicates that, although the levels of psychopathology and psychiatric disorders in trans people attending services at the time of assessment are higher than in the cis population, they do improve following gender-confirming medical intervention, in many cases reaching normative values. The main Axis I psychiatric disorders were found to be depression and anxiety disorder. Other major psychiatric disorders, such as schizophrenia and bipolar disorder, were rare and were no more prevalent than in the general population. There was conflicting evidence regarding gender differences: some studies found higher psychopathology in trans women, while others found no differences between gender groups. Although many studies were methodologically weak, and included people at different stages of transition within the same cohort of patients, overall this review indicates that trans people attending transgender health-care services appear to have a higher risk of psychiatric morbidity (that improves following treatment), and thus confirms the vulnerability of this population.     

Gender differences in adolescent gambling.

BACKGROUND: Although adolescent gambling has been linked to a wide array of risk behaviors, little is known regarding the correlates of gambling in adolescent girls as compared with adolescent boys. METHODS: We examined by logistic regression a nationally representative U.S. sample (n = 534) of 16- and 17-year-olds from the 1998 Gambling Impact and Behavior Study (GIBS) (1) to investigate the influence of gender on: 1) the association between gambling and psychiatric symptomatology; and, 2) gambling attitudes and behaviors. RESULTS: Gambling was associated with elevated rates of alcohol use and abuse/dependence in both boys and girls, and dysphoria/depression in girls only. Boy gamblers reported heavier gambling and higher rates of gambling problems than did girl gamblers. CONCLUSIONS: Adolescent gambling may be associated with more severe psychiatric symptoms in girls than in boys, though future research will be needed to replicate and extend these findings. Gender considerations are important in understanding youth gambling and the relationship between gambling and psychiatric disorders in adolescents.     

Alcohol use disorders among US college students and their non-college-attending peers

BACKGROUND: Heavy/binge drinking among college students has become a major public health problem. There is consistent evidence suggesting that young adults in college are drinking more than their non-college-attending peers, but it is still not clear whether they are more likely to suffer from clinically significant alcohol use disorders. OBJECTIVE: To compare the prevalence of alcohol use disorders and alcohol use disorder symptoms in college-attending young adults with their non-college-attending peers within the same study in a large and representative US national sample. DESIGN: Cross-sectional survey. SETTING: Civilian, noninstitutionalized US population. PARTICIPANTS: Young adults (n = 6352) from the 2001 National Household Survey on Drug Abuse (19-21 years of age, 51% female, 66% white, 14% African American, 14% Hispanic). MAIN OUTCOME MEASURES: Lifetime, past-year, and past-month drinking, past-year and past-month weekly drinking, past-month weekly binge drinking, past-month daily drinking, typical quantity consumed in the past month, and past-year DSM-IV alcohol dependence and abuse diagnoses. RESULTS: Eighteen percent of US college students (24% of men, 13% of women) suffered from clinically significant alcohol-related problems in the past year, compared with 15% of their non-college-attending peers (22% of men, 9% of women; overall odds ratio = 1.32). The association between past-year alcohol use disorder and college attendance was stronger among women (odds ratio = 1.70) than men (odds ratio = 1.14). College students were more likely to receive a diagnosis of DSM-IV alcohol abuse than their peers not attending college; despite the fact that those in college were drinking more, they were not more likely to receive a diagnosis of DSM-IV alcohol dependence. CONCLUSIONS: College students suffer from some clinically significant consequences of their heavy/binge drinking, but they do not appear to be at greater risk than their non-college-attending peers for the more pervasive syndrome of problems that is characteristic of alcohol dependence.     

Axis I and Axis II diagnoses in women with PCOS

Objective

The objective was to determine the current prevalence of Axis I and Axis II psychiatric diagnoses in patients with polycystic ovary syndrome (PCOS).

Method

The study sample included 73 patients with PCOS and 73 control subjects. Psychiatric disorders were determined by structured clinical interviews.

Results

The rate of any Axis I psychiatric disorder (28.8% vs. 15.1%), social phobia (13.7% vs. 2.7%), generalized anxiety disorder (11.0% vs. 1.4%), any Axis II psychiatric disorder (23.3% vs. 9.6%) and avoidant personality disorder (12.3% vs. 1.4%) was significantly more common in the patient group compared to the control group.Of women with PCOS, 21 (28.8%) had at least one Axis I and 17 (23.3%) had at least one Axis II diagnosis. The most common Axis I disorder was social phobia (13.7%) and the most common Axis II disorder was avoidant personality disorder (12.3%) in women with PCOS. Social phobia, generalized anxiety disorder, and avoidant personality disorder were significantly more common in the patient group compared to the control group.

Conclusion

Our results suggest that a considerable proportion of women with PCOS also present with anxiety and personality disorders.     

Psychiatric disorders are associated with hospital care utilization in persons with hypertension

Background  Psychiatric disorders and hypertension both independently increase risk for heart disease, cardiac events, and healthcare utilization. However, the contribution of specific psychiatric disorders to healthcare utilization in persons with hypertension is unknown. Objective  To evaluate associations between psychiatric disorders and receipt of hospital care in people with hypertension. Design  Cross-sectional epidemiologic survey. Subjects  A total of 8,812 hypertensive individuals drawn from a randomly selected sample of 43,093 US adults. Main outcomes  Participants were assessed in-person for a range of mental disorders (using the Diagnostic and Statistical Manual of Mental Disorders-IV), hypertension status (self-report), and past-year occurrence of emergency room treatment and overnight hospital stay (self-report). Results  After controlling for demographics and clinical variables, persons having any lifetime mood, anxiety, or personality disorders had increased likelihood of emergency room treatment [odds ratios (ORs) = 1.26, 1.18, and 1.47, respectively]. Persons having any mood or personality disorder had increased likelihood of overnight hospital stay (ORs  = 1.24 and 1.31, respectively). The specific disorders significantly associated with emergency room treatment were lifetime major depression, lifetime manic disorder, past-year major depression, past-year manic disorder, past-year panic disorder without agoraphobia, and paranoid, histrionic, antisocial, obsessive–compulsive personality disorders, with ORs ranging from 1.25 to 2.41. The specific disorders significantly associated with overnight hospital stay were lifetime dysthymia, lifetime manic disorder, past-year major depression, past-year manic disorder, and histrionic, antisocial, and paranoid personality disorders, with ORs ranging from 1.40 to 1.87. Conclusion  Results suggest that addressing mental health problems in persons with hypertension may decrease healthcare utilization.     

Gender differences in pathological gambling

BACKGROUND: To determine the differences in clinical presentation, gambling behavior, and psychiatric comorbidity of male and female treatment-seeking pathological gamblers. METHOD: Sixty-nine consecutive individuals with DSM-IV pathological gambling (47 men and 22 women) applying to a specialized out-patient treatment program were evaluated with structured interviews, self-report questionnaires, and psychological scales. RESULTS: Sixty-seven percent of men (N = 26) versus 25% of women (N = 5) had been exposed to gambling in adolescence. Women had a later age at first bet and a faster evolution of the disorder. Female pathological gamblers were more likely to play bingo, whereas men tended to prefer slot machines. Male and female pathological gamblers had similar gambling severity and overall rates of psychiatric comorbidity. However, male pathological gamblers had higher rates of alcohol abuse/dependence and antisocial personality disorder, whereas women had higher rates of affective disorders and history of physical abuse. CONCLUSION: There are substantial gender differences in the clinical presentation and comorbidity of pathological gambling. These gender differences should be incorporated in the selection and planning of treatment for pathological gamblers.     

Validation of the self-report questionnaire DIP-Q in diagnosing DSM-IV personality disorders: a comparison of three psychiatric samples

The DSM-IV section of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) was used to screen for personality disorders in 448 subjects from three clinical samples (general and forensic psychiatric patients and candidates for psychotherapy) and a sample of 139 healthy volunteers. Differences between the samples with regard to patterns of personality pathology in relation to concurrent Axis I disorders and sociodemographic variables were analysed. The prevalence of personality disorders according to DIP-Q was 14% among the healthy volunteers, compared to 59% in the general psychiatric sample, 68% in the forensic psychiatric sample and up to 90% among psychotherapy candidates. Moreover, from a dimensional perspective (i.e. the number of fulfilled Axis II criteria), all clinical groups differed significantly from the control group in all specified personality dimensions and clusters. Dimensional DIP-Q cluster scores also discriminated significantly between the three clinical samples. Unexpectedly, the odds ratio for an Axis II disorder was nearly five times higher among psychotherapy applicants than among general psychiatric patients, independent of concomitant Axis II disorders, gender or age. The strongest association between DIP-Q score and Axis I disorders was found for depressive disorders, which more than doubled the odds ratio for a personality disorder diagnosis. This association could result from high true comorbidity, but could also be due to the fact that a concomitant depressive state can increase self-reported personality difficulties. The high prevalence among psychotherapy candidates may to some extent reflect help-seeking exaggeration of problems. These are aspects to consider when using the DIP-Q, which overall appears to discriminate well between different samples.     

Conduct disorder and adult psychiatric diagnoses: associations and gender differences in the U.S. adult population

The authors' objective was to examine the presence of Axis I and II psychiatric disorders among adult males and females with a history in childhood and/or adolescence of conduct disorder (CD). Data were derived from a large national sample of the U.S. population. Face-to-face interviews of more than 34,000 adults ages 18 years and older were conducted during 2004-2005 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. After adjusting for sociodemographic characteristics and psychiatric comorbidity, CD was associated with all Axis I and II disorders, particularly substance use disorders (SUD), bipolar disorder, and histrionic personality disorders. After adjusting for gender differences in the general population, men had significantly greater odds of social anxiety disorder and paranoid personality disorder, whereas women were more likely to have SUD. Furthermore, there was dose-response relationship between number of CD symptoms and risk for most psychiatric disorders. From a clinical standpoint, knowledge of the gender differences in associations of CD with other psychiatric disorders in adulthood may be informative of developmental pathways of the disorder, and of possible gender-specific risk factors. Early recognition and treatment of CD may help prevent the development of adult-onset disorders.     

Gambling Behavior Among Hong Kong College and University Students

This study examined gambling behavior and correlates of pathological gambling among college and university students in Hong Kong. A survey questionnaire was administered to 510 Chinese students (302 men, 208 women) recruited from twelve tertiary institutions. The standardized questionnaire included questions on socio-demographic background, preferred lifetime and past-year gambling forms, attitudes towards gambling, perceived life satisfaction, social influence, intention to seek help, and a gambling screen to assess problematic gambling. The response rate is 86%. Results indicate the prevalence rate of lifetime and past-year gambling are 79.6% and 41.8% respectively with male domination. Many (60%) started gambling before 18 years. The estimate of lifetime vulnerability to pathological gambling is 14.7%. Pathological gambling is associated with the male gender, Internet gambling, monthly gambling expenditure, gambling attitude, betting on a great variety of games, and life dissatisfaction. Survey results have implications for campus awareness programs and future research.

     

Examination of Gender in Pathologic Grooming Behaviors

Trichotillomania and pathologic skin picking are pathologic versions of grooming behaviors. Although mentioned in the psychiatric literature for decades, little is known about how gender influences clinical presentation of these behaviors. Seventy-seven adult subjects (12 men) with trichotillomania or pathologic skin picking were examined on a variety of clinical measures including symptom severity, functioning, and comorbidity. There were more similarities than differences between men and women with these behaviors. Some significant differences, however, were that men with grooming disorders had a later age of onset of the behaviors, had greater functional impairment due to the behaviors, and were more likely to suffer from a co-occurring anxiety disorder. This study suggests that gender may be an important clinical factor when assessing and treating these disorders. Further research is needed to validate our findings and identify whether treatments should be specially tailored differently for men and women with grooming disorders.     

Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample

Objective

To determine whether obesity is associated with a variety of psychiatric outcomes after taking into account physical health conditions.

Methods

Data came from the public use dataset of the Canadian Community Health Survey Cycle 1.2 (age 15 years and older, N=36,984). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric diagnoses of major depressive disorder, mania, panic attacks, panic disorder, social phobia, agoraphobia, alcohol dependence, and drug dependence were examined, as was suicidal behavior (ideation or attempts). Multiple logistic regression was utilized to examine the association between obesity (defined as body mass index ≥30) and mental health outcomes. Covariates in the regressions included sociodemographic factors and a measure of physical illness burden (the Charlson Comorbidity Index).

Results

In adjusted models, obesity was positively related to several lifetime psychiatric disorders (depression, mania, panic attacks, social phobia, agoraphobia without panic disorder), any lifetime mood or anxiety disorder, suicidal ideation, and suicide attempts [adjusted odds ratio (AOR) range: 1.22-1.58]. Obesity was similarly positively associated with past-year depression, mania, panic attacks, social phobia, any anxiety disorder, and suicidal ideation (AOR range: 1.24-1.52), and negatively associated with past-year drug dependence (AOR=0.53, 95% CI 0.31-0.89). Most of these associations were found to be specific to women, while some were also present in men.

Conclusion

Independent of physical health conditions, obesity was associated with psychiatric disorders and suicidal behavior in the Canadian population. Possible mechanisms and clinical implications of these findings are considered.