Association between use of sedatives or hypnotics, alcohol consumption, or other risk factors and a single injurious fall or multiple injurious falls: a longitudinal general population study.

In this study, we investigated the association between risk factors, including use of sedatives or hypnotics or alcohol consumption, and injurious falls leading to hospitalization or death among 4023 subjects (1828 men and 2195 women) aged 20-89 years in Stockholm County, Sweden. Questionnaire data obtained from the 1984-1985 Stockholm Health of the Population Study (SHPS) were linked to official data registers on hospitalization and mortality. Of the 4023 subjects, 330 (121 men and 209 women) had been treated for or died of injurious falls during the 12-year follow-up period. High age was significantly associated with injurious falls among both men and women. Multivariate analyses showed that women who had used sedatives or hypnotics during the 2 weeks before an injurious fall were at increased risk [relative risk of 1.83 (95% confidence interval, 1.10-3.06)] for two or more injurious falls, but not for a single fall accident. High alcohol consumption and earlier self-reported injurious falls were significantly associated with injurious falls for women younger than 60 years of age and with earlier self-reported falls and living alone for men in the same age category. Among older women (>60 years of age), high alcohol consumption and use of sedatives or hypnotics were significantly associated with injurious falls, whereas living alone and earlier self-reported accidents were significant predictors for men in the same age category. These results support a cautious prescribing policy for sedatives and hypnotics, as well as an awareness of high alcohol consumption and its association with injurious falls.     

Prevalencia de consumo de hipnosedantes en población ocupada y factores de estrés laboral asociados

Objective

To explore the prevalence of the use of hypnotics and sedatives in a sample of the Spanish working population and to examine its association with certain work-related stress factors.

Methods

Using data from the 2007 Spanish Household Survey on Alcohol and Drugs (Encuesta Domiciliaria sobre Alcohol y Drogas en España [EDADES]), we analyzed the distribution of the use of hypnotics and sedatives in the previous month in the working population aged 16 to 64 years old (n = 13,005). Associations with exposure to certain work-related stress factors (noxious working environment, precariousness, workload, and social support) were examined using logistic regression modelling.

Results

The prevalence of the use of hypnotics and sedatives among women in the previous month doubled that of men (6.5% and 3.3%, respectively), while use among the oldest age group was twice that of the youngest group in both sexes (10.2% in women and 5.5% in men older than 45 years), and was four times higher among those reporting poor health (18.9% in women and 11% in men). Concerning work-related stress, exposure to moderate (OR: 1.96; 95%CI: 1.31-2.92) and high (OR: 1.95; 95%CI: 1.14-3.34) levels of precariousness in men and moderate levels in women (OR: 1.43; 95%CI: 1.03-1.99) was associated with the use of hypnotics and sedatives.

Conclusions

The prevalence of the use of hypnotics and sedatives was high in women and in workers older than 45 years. Further research is needed on the relationship between the use of hypnotics and sedatives and workers’ health, and on the role that work-related stress factors play in this association.     

Alcohol dependence and depression among heavy drinkers in Canada

This article describes the prevalence of heavy drinking among the Canadian population and the prevalence of alcohol dependence among heavy drinkers aged 18 or older. It also examines the association of depression to alcohol dependence among the latter group and the correlates of depression and alcohol dependence comorbidity. The data are from a national representative sample of the Canadian population in 2000/01. One in five current drinkers aged 18 or older was classified as a regular heavy drinker. This constituted a significant increase of approximately 2% in the prevalence of heavy drinking from 1996/97 to 2000/01 in Canada (p<0.001). Although men were more likely to be regular heavy drinkers (29.0%) than women (11.1%), male and female heavy drinkers were about equally as likely to be classified as alcohol dependent (11.6% and 11.1%, respectively). While the prevalence of alcohol dependence among men has remained stable, it has decreased by almost 4% among women (p<0.05). Among persons who have experienced a depressive episode in the year prior to their 2000/01 interview, the prevalence of alcohol dependence was estimated at 32.3% while it was 9.5% for persons without depression. When several indicators believed to be risk factors for alcohol dependence including personal characteristics, psychosocial factors, lifestyle behaviours and physical health were included in the logistic regression models, the marked difference in alcohol dependence among depressed and non-depressed heavy drinkers remained. The former had 3.6 times the odds of being classified as alcohol dependent compared to the latter (CI=2.9, 4.3). When the same personal, psychosocial, lifestyle and physical health measures were used to explain comorbidity of depression and alcohol dependence, perceived stress was the only factor that was consistently associated with comorbidity among both men and women.     

Psychotropic drug use among persons with mental distress symptoms: a population-based study in Norway

AIMS: To explore psychotropic drug use in the general population and in particular among non-institutionalized persons with mental distress symptoms. METHODS: A total of 14,139 women and 11,665 men participating in the Oslo Health Study or the Oppland/Hedmark Study 2000-2001 submitted a self-administered questionnaire on health status and drug use, lifestyle, and socioeconomic factors. Respondents using antidepressants, hypnotics, and/or anxiolytics during the last four weeks were defined as users. A high Hopkins Symptoms Checklist-10 score indicated mental distress. The 15% with the highest score in each gender and age group (adults: 30/40/45 years; elderly: 60 years) were studied. RESULTS: The prevalence of antidepressant use among those with mental distress was, for women: adults 21%; elderly 30%; and for men, adults 15%; elderly 15%. These figures were nearly four times higher than in the general population. Not participating in the labour market was the main factor associated with use of antidepressants for subjects with mental distress: adult women (odds ratio (OR) 3.5; 95% confidence interval (CI) 2.5-5.0); elderly women (OR 5.2; CI 2.7-10.2); adult men (OR 4.7; CI 3.0-7.3); and elderly men (OR 2.9; CI 1.4-6.0). Use of analgesics was the main factor associated with use of anxiolytics/hypnotics: adult women (OR 2.4; CI 1.7-3.4); elderly women (OR 2.3; CI 1.4-3.8); adult men (OR 2.1; CI 1.3-3.3); and elderly men (OR 3.4; CI 1.9-6.0). CONCLUSIONS: Among individuals with mental distress, not participating in the labour market and regular use of analgesics were the main factors associated with use of psychotropics in both genders regardless of age.     

Smoking initiation and nicotine dependence symptoms in Ukraine: findings from the Ukraine World Mental Health survey

OBJECTIVES: Cigarette smoking is a major cause of morbidity and mortality in former Soviet countries. This study examined the personal, familial and psychiatric risk factors for smoking initiation and development of nicotine dependence symptoms in Ukraine. STUDY DESIGN: Cross-sectional survey. METHODS: Smoking history and dependence symptoms were ascertained from N=1711 adults in Ukraine as part of a national mental health survey conducted in 2002. Separate analyses were conducted for men and women. RESULTS: The prevalence of lifetime regular smoking was 80.5% in men and 18.7% in women, with median ages at initiation among smokers of 17 and 18, respectively. Furthermore, 61.2% of men and 11.9% of women were current smokers; among the subgroup of lifetime smokers, 75.9% of men and 63.1% of women currently smoked. The youngest female cohort (born 1965-1984) was 26 times more likely to start smoking than the oldest. Smoking initiation was also linked to childhood externalizing behaviors and antecedent use of alcohol in both genders, as well as marital status and personal alcohol abuse in men, and childhood urbanicity and birth cohort in women. Dependence symptoms developed in 61.7% of male and 47.1% of female smokers. The rate increased sharply in the first four years after smoking initiation. Dependence symptoms were related to birth cohort and alcohol abuse in both genders, as well as growing up in a suburb or town and childhood externalizing behaviors in men, and parental antisocial behavior in women. CONCLUSIONS: Increased smoking in young women heralds a rising epidemic in Ukraine and underscores the need for primary prevention programs, especially in urban areas. Our findings support the importance of childhood and alcohol-related risk factors, especially in women, while pre-existing depression and anxiety disorders were only weakly associated with starting to smoke or developing dependence symptoms.     

The effect of living in flats on mental health A general practice survey

Summary From the literature it appears that most people prefer not to live in flats. That there, however, a high prevalence of psychological problems among flat dwellers does not come out clearly. The present study describes a cross-sectional survey carried out to determine the effect of living in flats on the general practice.It turns out that in flats the contact rate with the general practitioner is higher than in regular houses. The difference in contact rate cannot be explained by an increased contact rate for psychological or psychosomatic problems. However, in flats twice as many women contact their general practitioner for contraceptive advise. The two groups investigated have been matched in age, sex, family situation and profession. After the matching procedure the prevalence of psychological problems and the use of sedatives and hypnotics appeared surprisingly to be lower among flatdwellers. In psychosomatic problems no differences were found.     

Changes in the prevalence of overweight and obesity and their risk factors in Spain, 1987-1997.

BACKGROUND: The aim of this study was to examine the relationship of the changes in the prevalence of overweight and obesity with the changes in some of their risk factors in Spain from 1987 to 1997. METHODS: Data were obtained from three interview-based health surveys, covering representative samples of the noninstitutionalized Spanish population aged 16 years and over and undertaken in 1987 (n = 17,434), 1995 (n = 4,736), and 1997 (n = 4,678). To compensate for the different sample sizes, the 1995 and 1997 surveys were combined. Risk factors for obesity and overweight considered in this study were age, educational level, physical activity at work, physical activity during leisure time, tobacco use, alcohol consumption, and civil status. Data analysis was performed with logistic regression. RESULTS: The prevalence of overweight and obesity (body mass index >or= 25 kg/m(2)) rose from 35.6% in 1987 to 40.9% in 1995/1997 among women and from 47.1 to 56.2% among men. In the period 1987-1995/1997, the proportion of persons with secondary or university education increased by 11.3% in women and 10.8% in men. Similarly, the prevalence of intense or regular leisure-time physical activity increased by 5.7 and 6.2% in women and men, respectively. The remaining risk factors for overweight and obesity registered no substantial change in prevalence over the study period. The prevalence of overweight and obesity expected in 1995/1997, had educational level and leisure-time physical activity been the same as in 1987, is higher than the observed figures; for educational level, expected figures are 7.3 and 1.4% higher than those observed among women and men, respectively, while for leisure-time physical activity corresponding values are 2.8 and 1.6%. CONCLUSIONS: The rise in the prevalence of overweight and obesity in Spain from 1987 to 1997 may have been attenuated by an increase in leisure-time physical activity and by an improvement in educational level, particularly among women. The contribution to overweight and obesity trends attributable to physical activity at work or to tobacco and alcohol consumption appears to be small or null.     

Smoking prevalence in the United States and Taipei City, Taiwan

Although there are extensive antismoking efforts in the United States, smoking is a largely ignored health issue in Taiwan. In fact, tobacco advertising has increased dramatically since U.S. tobacco was first imported in 1987. We compared estimates of smoking prevalence of 83,281 Americans and 5,023 persons in Taipei, Taiwan, in 1986-1988. Among men, current smoking prevalence was higher in Taipei (49%) than in the United States (29%). In contrast, former smoking prevalence among men was substantially lower in Taipei (5%) than in the United States (32%). Young adults and those with lower and middle education levels had the highest smoking prevalence in both surveys. Among women, the current smoking prevalence was only 8% in Taipei, compared to 25% in the United States. The former smoking prevalence among Taipei women (1%) was also lower than among U.S. women (18%). Our findings indicate the need for expanding antismoking efforts in Taiwan, especially among men and among persons with lower and middle education levels.     

Social inequalities in alcohol use and misuse in the german general population

This paper investigates social inequalities in drinking behaviour in a sample of the German general population aged 25 to 59 years. The prevalence of several indicators of alcohol use and misuse were examined by socio-economic status (SES). Odds ratios were calculated to examine the relative effect of socio-economic status on the various alcohol misuse indicators. Abstinence showed a clear negative gradient with social status. When age was controlled, no differences were found in the prevalence of hazardous drinking. In comparison with men of high SES, men of middle SES had increased odds of consuming five or more drinks per day at least weekly and of a positive score on the AUDIT hazardous use measure, while men of lower SES had higher odds for dependence symptoms. Women of middle SES had significantly lower odds for reporting items of the CAGE alcohol screening instrument and DSM-IV alcohol abuse criteria in comparison to women of high SES. Thus, women of lower and higher SES resemble each other in drinking behaviour. For men, no identifiable pattern was found. The lack of clear social inequalities among the consuming German general population may be due to the widespread integration of alcohol drinking in everyday life.     

Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland

In the German Health Interview and Examination Survey (DEGS1), current depressive symptoms were assessed with the “Patient Health Questionnaire” (PHQ-9) in a representative population-based sample of 7,988 adults 18–79 years old. In addition, previously diagnosed depression was assessed by physician interview. The prevalence of current depressive symptoms (PHQ-9 ≥?10 points) is 8.1?% (women: 10.2?%; men: 6.1?%). For both sexes, the prevalence is highest among 18- to 29-year-olds and decreases with age. Persons with higher socioeconomic status (SES) are less likely to have current depressive symptoms. The lifetime prevalence of diagnosed depression is 11.6?% (women: 15.4?%; men: 7.8?%) and is highest among persons 60–69 years old. The 12 month prevalence is 6.0?% (women: 8.1?%; men: 3.8?%) and is highest among 50- to 59-year-olds. In women, but not in men, prevalences decrease with increasing SES. The results describe the distribution of two important aspects of depression among the adult population in Germany and confirm previously observed associations with age, gender and SES. An English full-text version of this article is available at SpringerLink as supplemental.     

Size estimation of injecting drug users (IDU) using multiplier method in five Districts of India

Background

Earlier results concerning alcohol consumption of bereaved persons are contradictory. The aim of the present study was to analyze the relationship between bereavement and alcohol consumption accounting for time and gender differences on a nationally representative sample from Hungary ("Hungarostudy Epidemiological Panel Survey", N = 4457)

Methods

Drinking characteristics of mourning persons (alcohol consumption, dependence symptoms, and harmful consequences of alcohol use) in the first three years of grief were examined among persons between 18-75 years using the Alcohol Use Disorders Identification Test (AUDIT).

Results

Men bereaved for one year scored higher on two dimensions of AUDIT (dependence symptoms and harmful alcohol use), while men bereaved for two years scored higher on all three dimensions of AUDIT compared to the non-bereaved. The rate of men clinically at-risk concerning alcohol consumption among the non-bereaved is 12.9%, and among men bereaved for one year is 18.4% (a non-significant difference), while 29.8% (p < 0.001, OR = 2,781) among men bereaved for two years. However, men bereaved for three years did not differ from the non-bereaved in their drinking habits. In case of bereaved women, again no difference was found with respect to alcohol use compared to the non-bereaved.

Conclusion

Among bereaved men, the risk of alcohol related problems tends to be higher, which can be shown both among men bereaved for one year as well as men bereaved for two years. Considering the higher morbidity and mortality rates of bereaved men, alcohol consumption might play a mediator role. These facts draw attention to the importance of prevention, early recognition, and effective therapy of hazardous drinking in bereaved men.     

Prevalence and socioeconomic characteristics of alcohol disorders among men and women in the Eastern Cape Province,South Africa

There is growing concern about alcohol problems in low‐ and middle‐income countries. More research is required, particularly among the younger generation. The aim of this study was to investigate the prevalence of alcohol disorders and associated socioeconomic characteristics among young men and women living in the Eastern Cape Province, South Africa. This was a cross‐sectional population‐based study of 977 participants (52% male and 48% female) aged 18–40, the majority of whom lived in low‐income areas. Data collection was carried out in 2012 by trained fieldworkers. The Mini International Neuropsychiatric Interview (DSM‐IV) was used to investigate the prevalence of alcohol dependence (increased tolerance to alcohol, failed attempt to cut down, risk of physical and mental effects) and alcohol abuse (harmful use, consistent intoxication, risk behaviour, physically hazardous, social problems). A high 12‐month prevalence of alcohol dependence was found (26.5% in total; 39.0% among men and 19.1% among women) as well as of alcohol abuse (9% in total; 19.0% among men and 6.0% among women). Few socioeconomic differences emerged among the men, except older men (OR 1.94, CI 1.11–3.42) and those supported by social grants (OR 2.28, CI 1.06–4.93), who presented higher odd ratios for alcohol dependence than the reference groups. Among the women, more differences emerged: women who were widowed/single (OR 2.35, CI 1.20–4.62), had no education (OR 3.41, CI 1.04–11.21), had a low income (OR 3.26, CI 1.55–6.80) and had no social support from friends when ill presented higher odd ratios (OR 1.73, CI 1.07–2.80). In the adjusted model, marital status and low income remained statistically significant. With regard to alcohol abuse, fewer socioeconomic differences emerged. Interventions need to address the early onset of alcohol misuse in order to meet both current needs and long‐standing mental and physical illness.     

Epidemiological study of preferable life style for psychological health promotion

OBJECTIVE: We sought to examine relationships of lifestyle factors, including diet, physical activity, sleep, alcohol consumption and smoking, with perceived stress and depressive symptoms. METHODS: Between 2001 and 2002, 7,947 men and women (mean 52.4 years) took part in examinations at the Osaka Medical Center for Health Science and Promotion. Lifestyle factors were determined by structured interview or by self-administered questionnaire. Associations of life style factors with perceived stress and depressive symptoms were tested by stepwise logistic regression analyses. RESULTS: Higher proportions of persons with depressive symptoms tended to be associated with higher proportions of persons with perceived stress. Among both men and women, low physical activity, lack of regular physical exercise, short sleeping time, to skip breakfast frequently, and having dinner within a couple of hours before going to bed were associated with both perceived stress and depressive symptoms. Men reporting between-meal or midnight snacks and having eating until they were full had higher odds ratios for perceived stress, while men conducting regular physical exercise and consuming 3 or more dishes of vegetables per day had lower odds ratios for depressive symptoms. For women, high odds ratios for depressive symptoms and perceived stress were observed among those who tended to have salty foods (or frequent use of soy sauce) and a lower odds ratio for perceived stress was noted among persons who had soy products every day. CONCLUSION: Lifestyle facets such as skipping breakfast, low physical activity, and short sleeping time, appear to be associated with psychological health status of Japanese men and women.     

Violent victimization of women and men: physical and psychiatric symptoms

BACKGROUND: Our objectives for this exploratory study were (1) to assess the prevalence in a family practice of violent victimization of women and men by partners, friends, families, and strangers, and (2) to compare the physical symptoms, depression, alcohol use problems, and social support of women and men who were or were not victimized in the previous 12 months. METHODS: We conducted a cross-sectional, multicenter study of family practice patients (1999-2000). One-thousand twenty-four patients, including 679 women and 345 men from 18 to 64 years of age completed a standard health history and a demographic questionnaire. The health history questionnaire included a question about violent victimization. RESULTS: Violent victimization was reported by 9.9% of the women and 10.9% of the men. Patients who were victimized were grouped into those who were victimized by partners (4.9% of women and 3.0% of men); by friends, or family, or strangers (2.3% of women and 5.0% of men); or by more than one category of persons other than partners (2.6% of women and 3.0% of men). Almost one third of patients victimized by partners were also victimized by another person. Women who were victimized had more physical symptoms than women who were not victimized. Women who were victimized and men who were victimized by their partners had more depressive symptoms than other women and men. Patients who were victimized by more than one category of other victimizers reported more alcohol use problems than other patients. Patients who were victimized reported less social support than patients who were not victimized. CONCLUSIONS: Both women and men report violent victimization in response to a screening question. Violence by partners and by others is related to physical and psychiatric symptoms in women and in men.     

饮酒行为对我国9省成年居民高血压患病的影响研究

目的探讨饮酒行为对我国9省成年居民高血压患病的影响。方法利用2006年“中国居民健康与营养调查”数据,对我国9省9111名成年居民的饮酒频率、饮酒类型以及饮酒量和高血压患病的关系进行横断面分析。结果男性、女性成年居民的饮酒率分别为58．3％和8．1％。男、女饮酒者每Et平均酒精摄入量分别为（33．3±34．1）和（15．0±16．2）g,男、女饮酒率和饮酒量的差异均有统计学意义（P〈0．01）。男性和女性高血压患病率分别为26．3％和22．1％,差异有统计学意义（P〈0．01）。男性居民饮酒者和不饮酒者高血压患病率分别为27．1％和25．0％,差异无统计学意义;女性居民饮酒者和不饮酒者高血压患病率分别为17．7％和22．5％,饮酒者高血压患病率低于不饮酒者,差异有统计学意义（P〈0．05）。无论男性和女性,高饮酒频率者高血压患病要高于低饮酒频率者（P〈0．05）。随着酒精摄人量的增加,男性居民高血压患病率未出现明显的规律性变化,但饮酒各组的高血压患病率均高于不饮酒组;女性居民每日酒精摄入量低于15g时,高血压患病率最低,而随后出现升高的趋势。结论我国男性和女性的饮酒率以及饮酒量不同,饮酒可升高我国9省男性居民的高血压患病率,而对女性居民的影响呈现出J型曲线的特点。     

2018―2019年广东省城市居民慢性病前瞻性队列设计和基线特征

  目的  研究广东省城市居民健康相关因素的分布情况,为进一步揭示广东省城市居民慢性非传染性疾病的流行特征及发病规律奠定基础。  方法  2018年3月1日―2019年10月30日在广东省广州市、东莞市及深圳市开展基线调查,包括问卷调查、体格检查、生物样本采集和实验室检测,建立了包含34 764名30~84岁研究对象的基线数据库和生物样本库。  结果  34 764名调查对象的年龄为(53.31±12.61)岁,男性占41.1%。调查对象目前吸烟率男性为34.4%,女性0.4%;有饮酒习惯的男性比例为16.7%,女性为1.9%;BMI≥24 kg/m2的男性占54.4%,女性占44.4%;男性腰围≥90 cm的比例为35.8%,女性腰围≥85 cm的比例为34.0%;调查时男性血压超过正常范围(SBP≥140 mm Hg或DBP≥90 mm Hg)的比例为34.8%,女性的比例为28.8%。  结论  广东省城市居民中饮食、吸烟、饮酒及肥胖等慢性非传染性疾病相关因素在不同性别和年龄人群中存在不同的分布特征。     

Interdependence of associations of physical activity, smoking, and alcohol and coffee consumption with serum high-density lipoprotein and non-high-density lipoprotein cholesterol--a population study in eastern Finland

The interdependence of the associations of physical activity, smoking, and consumption of alcohol and coffee with serum high-density lipoprotein and non-high-density lipoprotein cholesterol concentrations was studied in 9,347 persons ages 25-64 years from east and southwest Finland. In covariance analyses with corrections for age, body mass index, saturated fat index, and fasting time, the mean adjusted serum high-density lipoprotein to non-high-density lipoprotein cholesterol ratio was high among physically active male non-smokers but not among smokers (P = 0.024 for two-way interaction). The cholesterol ratio was lower among both men (P = 0.010 for two-way interaction) and women (P = 0.030 for two-way interaction) reporting no or very little use of alcohol, and this association was stronger among smokers and women with high coffee consumption (P less than 0.001 for two-way interaction). Our data suggest that the elevating effect of regular physical exercise on serum high-density lipoprotein cholesterol may be absent in smokers, whereas that of alcohol is greater in smokers than nonsmokers. High coffee consumption associates with decreased serum high-density lipoprotein cholesterol levels in smokers but increased levels in non-smokers.