Cigarette smoking behaviors among adults with serious mental illness in a nationally representative sample

PurposeThis study updates nationally representative information on cigarette smoking behaviors among adults with mental illness, particularly serious mental illness (SMI), to serve as a new benchmark for smoking cessation initiatives.MethodsData are from the 2008–2012 National Surveys on Drug Use and Health. Prevalence estimates for past month daily smoking, heavy smoking, mean cigarettes consumed per day, nicotine dependence, past month quit ratio, and proportion of cigarettes consumed are presented by mental illness status.ResultsAdults with SMI were more likely than adults with any mental illness (AMI) but not SMI and adults without mental illness to engage in smoking behaviors. Adults with AMI but not SMI were more likely to engage in all smoking behaviors compared with adults without mental illness. The past month quit ratio was significantly lower among adults with SMI and among adults with AMI but not SMI than among adults without mental illness. Adults with SMI comprised 6.9% of past month smokers but consumed 8.7% of all cigarettes.ConclusionsAdults with mental illness engage in more smoking behaviors and are less likely to quit than adults without mental illness. In this high-risk population, continued efforts to promote smoking cessation are needed.     

Factors associated with violence by a current partner in a nationally representative sample of German women

Partner violence is a serious human rights violation and public health issue. Although its pervasiveness is well documented, more research is needed on risk and protective factors to inform interventions. This study is based on a secondary analysis of the first national survey on violence against women in Germany. Women who reported partner violence by their current partner were compared to women who never reported partner violence. The prevalence of physical or sexual violence, or both, by current partners was 17 per cent. Women who experienced violence during their childhood had higher odds of experiencing partner violence. Partner violence was associated with women's drug use in the last 5 years, physical disability or debilitating illness, having more than three children, experiencing violence by a non-partner and feeling socially excluded. The odds of violence also increased if both partners were unemployed or lacked vocational training or if only the woman had vocational skills. Relationships shorter than 5 years or where the man or both partners drank heavily were likewise associated with higher odds of violence. Partner violence interventions should focus on reducing children's exposure to violence and preparing women and men for the job market as well as including interventions that tackle social isolation and substance use.     

Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents

Background  

Early sexual debut among adolescents is associated with considerable negative heath and development outcomes. An understanding of the determinants or predictors of the timing of sexual debut is important for effective intervention, but very few studies to date have addressed this issue in the Nigerian context. The aim of the present study is to examine predictors of adolescent sexual initiation among a nationally representative sample of adolescents in Nigeria.     

The alcohol-related psychosocial and behavioral risks of a nationally representative sample of adolescents

This study, a secondary analysis of the National Longitudinal Study of Adolescent Health, used a representative sample of 7th-through 12th-grade students enrolled in US public schools between April and December 1995. Data were collected in respondents' homes using trained interviewers. A subset of 4,485 adolescents aged 12-17 were surveyed with regard to alcohol-use practices and related health-risk behavior, interpersonal problems, and demographic characteristics. Results showed adolescent males as significantly more likely to drink at high risk than adolescent females. Among those who drank one or more times in the past year, older adolescents were significantly more likely to report high-risk drinking than younger adolescents. Significantly more high-risk adolescents reported having a hangover, vomiting, regretting a behavior, having trouble with parents, regretting a sexual activity, having dating problems, fighting, having trouble with friends, and experiencing school trouble than did low-risk adolescents. These findings underscore the long-range significance of a coordinated school health program; in particular, school health services, school health instruction, and school health environment. Implications for school-based and community-based prevention and intervention programs are presented.     

Risk factors for legal involvement among a nationally representative sample of Hispanic adolescents

Adolescent legal involvement is a public health concern nationwide. Despite the existing national limits of arrest data by Hispanic origin, previous research has found that minority youth are at increased risk for being confined. The purpose of our study was to investigate whether sex, age, authoritarian parenting, school experiences, depression, recent alcohol use, binge drinking and perceived social norms predicted legal involvement among Hispanic adolescents aged 12–17 years old nationwide. Legal involvement was operationally defined as ever being arrested, on parole or on probation. A secondary data analysis of the 2012 National Survey on Drug Use and Health (NSDUH) was conducted including a total of 3,457 U.S. Hispanic adolescents. First, unadjusted odds ratios were computed by conducting a univariate logistic regression analyses. Then, all variables that were significant in the univariate logistic regression analyses were retained and included in a final multiple logistic regression model. A total of 7.6% of Hispanic adolescents reported legal involvement. Unadjusted odds ratios indicated that sex, age, authoritarian parenting, school experiences, depression, recent alcohol use, binge drinking and perceived student use of alcohol were statistically significant predictors of legal involvement. All variables were subsequently retained and included in the final multiple regression models. The final multiple regression model significantly predicted legal involvement. Specifically, results indicated Hispanic adolescents at increased risk for legal involvement were males, aged 16–17 years, experienced authoritarian parenting, had negative school experiences and recently used alcohol. The combined influence of predictors on legal involvement for Hispanic adolescents was explored. Based on study findings, intervention programs should target all Hispanic youth, especially males and aged 14–17 years, to effectively address this problematic behaviour. Families, schools, communities and juvenile justice systems should work together to decrease illegal involvement among Hispanic adolescents.     

Subfecundity and anxiety in a nationally representative sample

Research thus far on the psychological consequences of impaired fecundity in developed countries has relied heavily on clinic-based samples. This study uses a nationally representative sample of American women regardless of fecundity status or treatment status. I analyze reports of fecundity status and anxiety from a 1995 sample of almost 11,000 respondents. The results show consistent positive effects of subfecundity on the odds of fulfilling the diagnostic criteria for Generalized Anxiety Disorder and the incidence rate of symptoms among those who would be so diagnosed, even when controlling for potential confounding factors. Whether a subfecund respondent currently desires to have a child does not moderate the likelihood of being anxious, but does moderate the number of symptoms reported. The lack of a moderating effect of seeking treatment suggests that past research on clinic-based samples is generalizable to all subfecund women.     

Psychiatric symptoms and substance use disorders in a nationally representative sample of American adolescents involved with foster care

PurposeTo ascertain the prevalence of psychiatric symptoms and substance use disorders among adolescents with a lifetime history of foster care placement, using data from a nationally representative sample of U.S. adolescents.MethodsWe studied adolescents aged 12–17 years in the public use file of the 2000 National Household on Drug Abuse (n = 19,430, including 464 adolescents with history of foster care placement). Psychiatric symptoms and substance use disorders were ascertained through direct interviewing of adolescents. Logistic regression analyses were used to estimate the odds of past-year psychiatric symptoms and substance use disorders among adolescents involved with foster care, as compared to those without a lifetime history of foster care placement (comparison group).ResultsAdolescents involved with foster care had more past-year psychiatric symptoms, and especially more conduct symptoms, and past-year substance use disorders than those never placed in foster care. Adolescents involved with foster care were about four times more likely to have attempted suicide in the preceding 12 months (adjusted odds ratio [AOR] 3.95; 95% confidence interval [CI] 2.78, 5.61), and about five times more likely to receive a drug dependence diagnosis in the same period (AOR 4.81; 95% CI 3.22, 7.18).ConclusionsAdolescents involved with foster care have a higher prevalence of psychiatric symptoms and drug use disorders than those never placed in foster care. Additionally, the results of this study suggest that they may be at elevated risk for suicide attempts.     

Sociodemographic differences in depressed mood: results from a nationally representative sample of high school adolescents

BACKGROUND: Research on adolescent mental health suggests that prevalence rates for depressed mood are not uniformly distributed across all populations. This study examined demographic difference in depressed mood among a nationally representative sample of high school adolescents. METHODS: The 2003 National Youth Risk Behavior Survey was utilized to examine the association between depressed mood and demographic variables. To examine demographic associations, chi-square and follow-up logistic regression models were created for the sample of high school adolescents (N = 15,214). RESULTS: Caucasians and African Americans were significantly less likely to report depressed mood when compared to Hispanics and Others. Women were also more likely than men to report depressed mood. No significant differences were observed among levels of urbanicity and age. CONCLUSIONS: An understanding of the difference in the prevalence and correlates of depressed mood among adolescents of various ethnic/racial and gender groups deserves increased attention. Given the fact that challenges with depressed mood in adolescents can be substantial and relatively unrecognized, there is an increased need to identify these adolescents early and intervene with culturally appropriate interventions.     

Obesity and the risk for mental disorders in a representative German adult sample

BACKGROUND: A systematic approach to examining associations among obesity and socio-demographic determinants, psychological problems, and mental disorders in epidemiological samples is missing. METHODS: Within the representative German Health Interview and Examination Survey and its Mental Health Supplement (GHS-MHS), 4181 subjects (age 18-65 years) took part in a physical examination (including measurement of body weight and height) and a standardized psychological interview (M-CIDI). Obesity (BMI > 30 kg/m(2)), somatic diseases, socio-economic variables, health-related quality of life (SF-36), and mental disorders (DSM-IV) were assessed. Data were analysed by logistic regression analyses. RESULTS: Prevalence of obesity was 18.5%. There was a strong association between obesity and somatic conditions, as well as to low socio-economic status (SES). No psychosocial disadvantages (e.g. regarding social relationships, impairment due to mental health problems, depressed feelings) for the obese individuals were found. With the exception of a higher prevalence of anxiety disorders in obese men (12.5 versus 8.5%, OR = 1.53, CI = 1.06-2.21, disappearing when controlled for number of somatic conditions), obese persons showed no elevated rates of mental disorders. Discussion: Obesity is associated with a low SES and some somatic disadvantages but not with other social or emotional disadvantages that have been often assumed to be very prevalent in that group. From the population-based perspective, obesity per se seems not to be associated with a higher risk for suffering from mental disorders, whereas relations between specific aspects of obesity and specific types of psychopathology still need further study.     

Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18-79 years

ABSTRACT: BACKGROUND: Overweight has increased in many countries over the past 20 years and excessive body weight is an established risk factor for adverse health outcomes and chronic diseases. This study aimed to determine comorbidity associated with overweight and obesity in a nationally representative sample of German adults. METHODS: In the German National Health Interview and Examination Survey 1998 standardized measures of body weight, height and waist circumference (WC) were obtained for 7,124 men and women 18 to 79 years of age. Information on pre-existing health conditions, health-related behaviors, and sociodemographic characteristics was collected using physician-administered computer-assisted interviews and self-administered questionnaires. World Health Organization (WHO) cut-off criteria were applied to define overweight (BMI: 25.0-29.9 kg/m2) and obesity (BMI [GREATER-THAN OR EQUAL TO]30.0 kg/m2) and abdominal obesity (men: WC [GREATER-THAN OR EQUAL TO]102 cm; women: WC [GREATER-THAN OR EQUAL TO]88 cm). RESULTS: The crude prevalence of persons with cardio metabolic risk factors, diabetes mellitus, cardiovascular disease (CVD), gall bladder disease, and osteoarthritis showed a significant stepwise increase from the lowest to the highest BMI category in both sexes. In multiple logistic regression models adjusting for age, social status, and smoking, significant associations with overweight and obesity persisted for cardio metabolic risk factors and osteoarthritis. For example, obese persons had a three- to fourfold higher chance of having any cardio metabolic risk factor compared to normal weight persons (odds ratio (OR) = 4.07, 95% CI: 3.16-5.25 for men; OR = 3.40 (2.60-4.46) for women). Only in women, overweight and obesity as well as abdominal obesity, independent of BMI category, were significantly and consistently associated with diabetes (overweight: OR = 1.85 (1.03-3.30); obesity: OR = 2.94 (1.63-5.31); abdominal obesity: OR = 1.44 (1.08-1.92) and gall bladder disease (overweight: OR = 1.65 (1.22-2.25); obesity: OR = 3.06 (2.26-4.14); abdominal obesity: OR = 1.73 (1.25-2.39)). CONCLUSION: Current estimates of disease burden underline the public health importance and clinical relevance related to overweight and obesity and needs to take into account comorbidity aspects.     

Associations of self-reported oral health with physical and mental health in a nationally representative sample of HIV persons receiving medical care

Background: The impact of oral health on HIV patients has not been sufficiently documented. Objective: To estimate the associations between measures of oral and generic health-related quality of life in persons receiving medical care for HIV. Design: This is a longitudinal study of interview data collected in a probability sample of adults with HIV receiving health care in the US. The data were collected at three points in time. Patients: Two thousand eight hundred and sixty-four HIV-infected adults using medical care. Measurements: Physical and mental health were assessed using 28 items and oral health was assessed using seven items on oral-related pain and discomfort, worry, appearance, and function. Clinical measures included CD4 count, oral symptoms, physical symptoms, and stage of HIV. Physical functioning and emotional well-being were measured on a 0–100 scale with higher scores indicating better health. Oral health was measured using seven items with a five point scale. Results: In multivariate analyses, oral symptoms had the strongest association with oral health-related quality of life. Each additional oral symptom was associated with an average decrease in oral health (0–100 possible range) of 3.97 points (p = 0.000). In addition, oral health was significantly associated with both physical and mental health. A one-point increase in oral health was associated with a 0.05 (p = 0.000) increase in mental health and 0.02 increase in physical health (p = 0.031). Conclusions: Oral health is strongly associated with physical and mental health but provides noteworthy unique information in persons with HIV infection. Thus, physical and mental health measures of HIV patients should incorporate indicators of oral functioning and well-being.     

The Association of Oral Contraceptive Use with Plasma 25-hydroxyvitamin D Levels

Objective: This analysis was conducted to compare wintertime 25-hydroxyvitamin D (25OHD) levels of young women who did and did not use oral contraceptives (OC).

Methods: The subjects were 66 Caucasian women aged 20 through 40 recruited from the Boston area. Plasma 25OHD was measured in February or March and again 1 year later. Other measurements included height, weight and vitamin D intake from diet and supplements.

Results: The initial mean 25OHD level of the 26 OC users was 41% higher than those of nonusers before adjustment for age and vitamin D intake (83±40 (sd) nmol/L compared with 59±22), and 39% higher after adjustment (p=0.003). Five women who discontinued OC use during the year following their initial measurement all had decreases in their 25OHD levels (mean change was ?25.5±17.7 (SD) nmol/L), whereas levels in women whose OC use or non-use was constant did not change.

Conclusion: OC use increases circulating levels of 25OHD, and should be considered when interpreting values obtained for clinical evaluatin or nutrition research.     

Diet quality in an ethnically diverse sample of children and adolescents with autism spectrum disorder compared with nationally representative data

BackgroundChildren with developmental disabilities are at an increased risk of unhealthy eating habits, which may contribute to compromised growth and development. Children with autism spectrum disorder (ASD) exhibit unique risk factors for unhealthy dietary patterns, including sensory issues and cognitive rigidity at mealtimes.ObjectiveThis cross-sectional study examined diet quality in a sample of children with ASD in Florida compared to nationally representative National Health and Nutrition Examination Survey (NHANES) 2009–2014/2013-2014 data using the Healthy Eating Index-2015 (HEI-2015).MethodsA 24-h food record was completed by 41 parents of children with ASD aged 2–17 years, and food and beverage items consumed by each child were reported per standardized 24-h recall protocol. Two models were used to compare mean total and component HEI-2015 scores to NHANES means: (1) comparing means for our full sample to published NHANES means for children aged 2–18 years and (2) a matched model with subjects matched 1:1 by age, gender, race/ethnicity, and parent education level.ResultsHEI component scores were significantly lower (poorer) in children with ASD for whole fruit, total vegetables, dairy, total protein foods, and seafood and plant protein. Whole grains, fatty acids, added sugars, and refined grains scores were higher (better) in our sample. However, total HEI scores and HEI scores for all 13 components were similar among children with ASD and the matched cases from the NHANES data.ConclusionsThere are potential discrepancies in diet quality between children with ASD and general population. Further research with a larger sample size, reporting both total and component HEI scores, is needed.     

Association between housing affordability and mental health: a longitudinal analysis of a nationally representative household survey in Australia

Evidence about the mental health consequences of unaffordable housing is limited. The authors investigated whether people whose housing costs were more than 30% of their household income experienced a deterioration in their mental health (using the Short Form 36 Mental Component Summary), over and above other forms of financial stress. They hypothesized that associations would be limited to lower income households as high housing costs would reduce their capacity to purchase other essential nonhousing needs (e.g., food). Using fixed-effects longitudinal regression, the authors analyzed 38,610 responses of 10,047 individuals aged 25-64 years who participated in the Household, Income, and Labour Dynamics in Australia (HILDA) Survey (2001-2007). Respondents included those who remained in affordable housing over 2 consecutive waves (reference group) or had moved from affordable to unaffordable housing over 2 waves (comparison group). For individuals living in low-to-moderate income households, entering unaffordable housing was associated with a small decrease in their mental health score independent of changes in equivalized household income or having moved house (mean change = -1.19, 95% confidence interval: -1.97, -0.41). The authors did not find evidence to support an association for higher income households. They found that entering unaffordable housing is detrimental to the mental health of individuals residing in low-to-moderate income households.     

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

Purpose

The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.

Methods

The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).

Results

The overall prevalence of WRSP was 5.1  % (95  % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).

Conclusion

The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.     

The relationship between type of mental health provider and met and unmet mental health needs in a nationally representative sample of HIV-positive patients

This study examined mental health service utilization among a nationally representative sample of adults with HIV and psychiatric disorders or perceived need for mental health services. Data are from the HIV Cost and Services Utilization Study (HCSUS) mental health survey (n = 1489) conducted in 1997–1998. Most (70%) needed mental healthcare. Of these, 30% received no mental health services in the previous 6 months, 16% received services from general medical providers (GMPs) only, and 54% used mental health specialists. Clients with perceived need for care were more likely to receive any mental health services and services from mental health specialists (versus GMPs) than clients having mental disorders without perceived need. More patients using specialists versus GMPs received psychotherapeutic medications and psychiatric hospitalizations, controlling for psychiatric symptom severity. The findings underscore that the differential mental health service provision between specialists and GMPs existing in the general population also is present among persons with HIV.     

Monitoring food and nutrient availability in a nationally representative sample of Bolivian households

The study objective was to estimate food and nutrient availability in Bolivian households using data from the nationally representative under the Programme for the household surveys undertaken yearly from 1999 to 2002 Improvement of Surveys and the Measurement of Living Conditions in Latin America and the Caribbean (MECOVI). In the present study, we analysed data from four repeated, cross-sectional surveys and applied European Data Food Networking (DAFNE) methodology for post-harmonising the data. Raw data of 19 483 households in Bolivia (3035 in 1999, 4857 in 2000, 5845 in 2001 and 5746 in 2002) were retrieved from the databases of the national household surveys. Results showed that the Bolivian diet is characterised by higher availability of foods of plant origin (cereals, fruits, potatoes and vegetables). Meat, milk and their products follow in the dietary preferences of Bolivians. Disparities in food availability within the country were also observed. Rural households systematically recorded lower amounts of food available, in comparison with the urban ones. Households of higher social status recorded higher availability values for all food groups, except for potatoes and cereals. Findings suggest that Bolivian households of lower socio-economic status prefer energy-dense and cheaper food sources. We concluded the dietary and socio-demographic data collected in the MECOVI household surveys could serve nutrition surveillance purposes. In addition, the application of DAFNE methodology for post-harmonising the data allows both national and international comparisons.