Is any female preponderance in depression secondary to a primary female preponderance in anxiety disorders?

OBJECTIVE: National community studies consistently identify higher rates of both depressive and anxiety disorders in women. The female preponderance in depression could be primary or, alternatively, a sex difference in anxiety could determine the differential depression rates. We therefore pursue whether the female preponderance in depression is secondary to a female preponderance in anxiety disorders in a community sample. METHOD: We analyse relevant data from the National Comorbidity Study (NCS) database, examining in particular whether sex differences in anxiety (here those meeting criteria for panic disorder, agoraphobia without panic disorder, generalized anxiety and social phobia) influenced sex differences in the prevalence of both major depression and dysthymia. RESULTS: Survival analyses indicated that, for both major depression and dysthymia, and within subsamples of those with early onset and late onset depression, both female sex and a preceding anxiety disorder made significant contributions, with preceding anxiety making the consistently stronger contribution of the two. CONCLUSION: A proportion of the female preponderance in major depression and dysthymia in the general community appears determined by a primary sex difference in anxiety.     

Prevalence of restless legs syndrome in a Japanese elderly population

ObjectiveTo estimate the prevalence of restless leg syndrome (RLS) in elderly Japanese people by means of a population-based survey of subjects aged ≥65 years.BackgroundStudies conducted worldwide have revealed large variations in the prevalence of RLS among different populations. However, few studies have been done in Japan.MethodsA population-based survey was carried out from 2003 to 2006 through a local healthcare project in the small town of Ajimu in a rural area of southern Japan. A Japanese translation of the questionnaire covering the four features of RLS as defined by the International RLS Study Group in 1995 was used to confirm the diagnosis of RLS. All participants aged ≥65 years were invited to fill out the questionnaire. Subjects with positive results underwent face-to-face interviews.ResultsA total of 1251 persons (men, 35%; mean age, 75.0 ± 6.1 years) answered the questionnaire. Of these 1251 participants, 70 (5.6%) (men, 20%; mean age, 75 ± 4.9 years) answered the questions on RLS positively. Face-to-face interviews and examination confirmed the diagnosis of RLS in 12 subjects. Therefore the overall prevalence of RLS in the elderly Japanese population was estimated at 0.96%, with a higher prevalence in women (1.23%) than in men (0.46%).ConclusionThe overall prevalence of RLS among inhabitants of Ajimu aged ≥65 years is 0.96%. Most of the subjects identified were women. The prevalence of RLS is lower in Japan than in studies conducted in European and North American populations.     

Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. CONCLUSION: It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.     

Survey of psychiatric morbidity in a semi-urban population in Sri Lanka

This paper reports a survey of psychiatric morbidity in a semiurban community (population 7,653) in Sri Lanka. The entire population was first screened by social workers using a standardized interview. Probable cases were then examined by psychiatrists. Each psychiatric disorder identified was rated on four different parameters of severity, and only those rating moderate or severe were labelled as cases. The socio-demographic characteristics of the cases and the population at risk, and the frequency and nature of psychiatric disorders are presented in Tables. The 6-month period prevalence for all psychiatric disorders was 45.5 per 1,000, with psychoses amounting to 6.9 (males 5.5; females 8.4) per 1,000, and neuroses to 25.2 (males 9.9; females 40.6) per 1,000. The large majority of disorders were chronic and had not received psychiatric treatment. The relevance of these surveys in the provision of psychiatric services in developing countries is discussed.     

Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients

BACKGROUND: Stable angina is a growing problem worldwide. Diagnostic methods and treatment regimens are established but data on actual practice are sparse and pre-date current guidance. OBJECTIVES: To compare diagnosis and treatment information with guideline recommendations, and to assess impact on quality of life. METHODS: This international epidemiological survey recruited patients through primary and secondary care clinicians from China, Czech Republic, Greece, Hungary, Portugal, Russia and Slovak Republic. Participants experienced at least one episode of stable angina within the previous four weeks. Outcomes included use of diagnostic techniques, pharmacological treatments, surgical intervention, secondary prevention and quality of life. RESULTS: The study included 7074 patients, average age 63.3 (sd 10.3). Diagnosis of angina was most frequently as a result of chest pains (87.4%) with confirmation by resting ECG in only 54.9%. Advice regarding risk factors was frequently given although secondary prevention was often ineffective with 41% of treated hypertensives lacking effective control. 97% of patients were taking at least one of the primary therapies for stable angina recommended by the guidelines with rates of individual therapies varying greatly across countries. Quality of life was lowest in countries with low rates of surgical intervention and poor observance of guidelines on pharmaceutical therapy. CONCLUSION: Results show that the management of patients with stable angina does not meet recommended standards, although the appropriateness of these guidelines in poorer countries needs further investigation. Overall, the survey indicates that improved medical care and risk factor management would enhance prognosis and improve quality of life.     

Deprivation and AIDS in a southern European city: different patterns across transmission group

OBJECTIVE: To analyse deprivation and AIDS among three AIDS transmission groups (men who have sex with men--MSM, heterosexuals, and intravenous drug users--IDUs) in Barcelona, Spain, during the period 1990-95. METHODS: This is an ecological study, the unit of analysis being the neighbourhoods. Included were AIDS cases residents in Barcelona. The association among AIDS rate and deprivation was studied using Spearman correlation coefficients and Poisson regression. RESULTS: For MSM, inner city neighbourhood residence meant a greater risk of AIDS; but lower educational level was inversely related with AIDS rates. For heterosexuals, variables related with AIDS rates were younger age, inner city areas and social unrest for women, and extreme poverty for men. Among UDIs variables related with AIDS were unemployment and social unrest for both sexes. CONCLUSION: The association between AIDS rates and deprivation differs across transmission groups in a southern European city.     

浙江遂昌县一起风疹疫情的流行病学分析及控制策略初探

目的 分析浙江遂昌县2005年2～6月爆发的一起风疹疫情的流行规律、流行特征及其不同控制措施的效果,为制定防治策略提供依据.方法 实验室以酶联免疫吸附试验(ELISA)法检测病例血清的风疹IgM抗体,以逆转录-聚合酶链反应(RT-PCR)法检测风疹病毒核酸,对病例进行流行病学个案调查,并选择采取不同防治措施的两所中学,对比分析其防治效果.结果 本次流行疫情累计发病996例,发病率为440.34/10万,历时4个月,高峰集中于3月中旬至4月中旬,男女性别比为1.11:1,主要集中于中小学,中学生占71.89%,小学生占21.18%,年龄分布10～岁占36.55%,15～岁组占55.62%.结论 在低年龄组儿童中开展风疹疫苗接种后,婴幼儿及小学生发病率明显降低,中学生及成人成为风疹爆发的重点人群,建议将免疫对象范围扩大到中学生和成人,流行期可应急接种.采取应急接种的控制效果要好于采取一般性综合防治措施.     

The influence of white matter lesions on neuropsychological functioning in demented and non-demented 85-year-olds

White matter lesions on computed tomography of the head were studied in relation to neuropsychological functioning in subjects from a representative sample of non-demented ( n = 134) and demented ( n = 98) 85-year-olds. Non-demented subjects with white matter lesions ( n = 46) scored significantly lower in tests of verbal ability (Synonyms), spatial ability (Block Design, Clock Test), perceptual speed (Identical forms), secondary memory (Thurstone Picture Memory), basic arithmetic (Coin Test) and the global cognitive screening test Mini-Mental State Examination than non-demented subjects without white matter lesions ( n = 88). Demented subjects with white matter lesions ( n = 67) scored significantly lower in tests of spatial ability (Block Design and Clock Test) and secondary memory (free recall in the MIR memory test, Ten-word memory test I and II) and in the Mini-Mental State Examination than demented subjects without white matter lesions ( n = 31). It is concluded that white matter lesions contribute to cognitive decline in both non-demented and demented elderly subjects.     

关于印发流感样病例暴发疫情处置指南(2012年版)

  目的  分析中国大陆地区2016 — 2017监测年度流感暴发疫情的流行病学特征,为科学制定流感相关防控政策提供参考依据。  方法  收集“中国流感监测信息系统”和“突发公共卫生事件管理信息系统”中上报的2016 — 2017监测年度流感暴发疫情数据,对该监测年度的流感流行病学特征进行描述性分析。  结果  中国大陆地区2016 — 2017监测年度共报告流感暴发疫情643起,累计报告发病数为17 657例,死亡2例,病死率为0.11 ‰;南、北方片区全年流感最高峰均出现在2016年12月,南方片区在2017年3月流感疫情又开始显著呈上升趋势;南方片区报告流感暴发疫情556起（发病数为15 849例）,多于北方片区报告流感暴发疫情的87起（发病数为1 808例）;流感暴发疫情报告较多的前3个地区依次为江苏（122起,占19.0 %）、广西（89起,占13.8 %）和安徽省（74起,占11.5 %）;流感暴发场所主要为中小学和幼托机构（612起,占95.2 %）;流感暴发规模以10～29例病例为主（521起,占81.0 %）;2016 — 2017监测年度流感暴发的优势株为A（H3N2）型（327起,占50.9 %）和B型（181起,占28.1 %）。  结论  中国大陆地区2016 — 2017监测年度流感暴发疫情具有明显的季节性,冬春季为疫情报告的高峰期,南方地区是流感暴发的高发地区。     

无锡市2001年～2002年度流感监测分析

目的：监测分析我市流行性感冒的流行和流感病毒变异情况．为流感防治对策提供理论依据。方法：①疫情监测,设立哨点医院．在内科、儿科门诊监测流感样病例和肺炎病例;②病原学监测,用鸡胚双腔对监测标本做病毒分离,用微量血凝抑制试验(HI)进行型别鉴定;③血清学监测,采集不同年龄组的自然人群血清．检测甲1型、甲3型和乙型流感病毒抗体水平。以血凝抑制抗体滴度≥1：10判为阳性,滴度≥1：40判为有保护性作标准。结果：监测期间疫情基本平稳,2001年冬曾出现一个流感样病例发病高峰,同时伴随肺炎发病增高。发病构成≤14岁占90．71％．≥60岁较低。2001年10月～2002年3月分离出2株甲1型流感病毒．型别为A1／沪防／7／99;2002年10月～2003年3月分离出流感病毒7株。型别均为B型,其中6株为B／Yamanashi／166／98,1株为B／Victoria。毒株分离出时间与流感样病例发病高峰相一致,标本源于13岁以下患者。人群抗体监测,甲3型流感抗体水平较高,抗体阳性率≥87．05％;甲1型抗体阳性率偏低≤27．38％;乙型抗体阳性率2002年为21．13％。明显低于2001年的74．85％。结论：本地人群对甲1和乙型流感缺乏免疫力,下一流行季节存在甲1和乙型流感流行的可能。