Crime and psychiatric disorders among youth in the US population: an analysis of the National Comorbidity Survey-Adolescent Supplement.

PubMed

Coker, Kendell L; Smith, Philip H; Westphal, Alexander; Zonana, Howard V; McKee, Sherry A

2014-08-01

Current knowledge regarding psychiatric disorders and crime in youth is limited to juvenile justice and community samples. This study examined relationships between psychiatric disorders and self-reported crime involvement in a sample of youth representative of the US population. The National Comorbidity Survey-Adolescent Supplement (N = 10,123; ages 13-17 years; 2001-2004) was used to examine the relationship between lifetime DSM-IV-based diagnoses, reported crime (property, violent, other), and arrest history. Logistic regression compared the odds of reported crime involvement with specific psychiatric disorders to those without any diagnoses, and examined the odds of crime by psychiatric comorbidity. Prevalence of crime was 18.4%. Youth with lifetime psychiatric disorders, compared to no disorders, had significantly greater odds of crime, including violent crime. For violent crime resulting in arrest, conduct disorder (CD) (odds ratio OR = 57.5; 95% CI = 30.4, 108.8), alcohol use disorders (OR = 19.5; 95% CI = 8.8, 43.2), and drug use disorders (OR = 16.1; 95% CI = 9.3, 27.7) had the greatest odds with similar findings for violent crime with no arrest. Psychiatric comorbidity increased the odds of crime. Youth with 3 or more diagnoses (16.0% of population) accounted for 54.1% of those reporting arrest for violent crime. Youth with at least 1 diagnosis committed 85.8% of crime, which was reduced to 67.9% by removing individuals with CD. Importantly, 88.2% of youth with mental illness reported never having committed any crime. Our findings highlight the importance of improving access to mental health services for youthful offenders in community settings, given the substantial associations found between mental illness and crime in this nationally representative epidemiological sample. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Health Correlates of Insomnia Symptoms and Comorbid Mental Disorders in a Nationally Representative Sample of US Adolescents

PubMed Central

Blank, Madeleine; Zhang, Jihui; Lamers, Femke; Taylor, Adrienne D.; Hickie, Ian B.; Merikangas, Kathleen R.

2015-01-01

Study Objectives: To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. Design: National representative cross-sectional study. Setting: Population-based sample from the US adolescents. Measurements and Results: A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P < 0.05). Conclusions: Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health

Association of Lifetime Mental Disorders and Subsequent Alcohol and Illicit Drug Use: Results From the National Comorbidity Survey-Adolescent Supplement.

PubMed

Conway, Kevin P; Swendsen, Joel; Husky, Mathilde M; He, Jian-Ping; Merikangas, Kathleen R

2016-04-01

To estimate the association of prior lifetime mental disorders with transitions across stages of substance use in a cross-sectional, nationally representative sample of US adolescents. The sample includes 10,123 adolescents aged 13 to 18 years who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A), and who were directly interviewed with the Composite International Diagnostic Interview (CIDI) Version 3.0 that generates criteria for DSM-IV disorders. Adolescents with prior lifetime mental disorders had high rates of both alcohol (10.3%) and illicit drug (14.9%) abuse, with or without dependence. Alcohol and drug abuse were highest among adolescents with prior anxiety disorders (17.3% and 20%, respectively) and behavior disorders (15.6% and 24%, respectively). Any prior disorder significantly increased the risk of transition from nonuse to first use, and from use to problematic use of either alcohol or illicit drugs. Multivariate models attenuated the magnitude of the risk of transition associated with each disorder, although prior weekly smoking and illicit drug use demonstrated significant risks of transitions across the 3 stages of alcohol or drug use, as did behavior disorders. The findings provide the first evidence from a nationally representative sample that prior mental disorders represent risk factors for the transition from nonuse to use, and the progression to drug- and alcohol-related problems. Treatment of primary mental disorders is likely to be an important target for the prevention of secondary substance use disorders in youth. Copyright © 2016. Published by Elsevier Inc.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

PubMed Central

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J.; Kessler, Ronald C.; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.

2012-01-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. PMID:21495110

Medical Comorbidity of Attention-Deficit/Hyperactivity Disorder in US Adolescents.

PubMed

Jameson, Nicole D; Sheppard, Brooke K; Lateef, Tarannum M; Vande Voort, Jennifer L; He, Jian-Ping; Merikangas, Kathleen Ries

2016-10-01

Understanding patterns of medical comorbidity in attention-deficit/hyperactivity disorder (ADHD) may lead to better treatment of affected individuals as well as aid in etiologic study of disease. This article provides the first systematic evaluation on the medical comorbidity of ADHD in a nationally representative sample (National Comorbidity Replication Survey-Adolescent Supplement; N = 6483) using formal diagnostic criteria. Survey-weighted odds ratios adjusted for demographics, additional medical, and mental disorders were calculated for associations between ADHD and medical conditions. Models adjusted for demographics revealed significantly increased odds of allergy, asthma, enuresis, headache/migraine, and serious stomach or bowel problems. After adjusting for comorbidity, across the medical conditions, enuresis and serious stomach problems were the strongest correlates of ADHD. These findings confirm the pervasive medical comorbidity of ADHD reported in previous clinical and community-based studies. The intriguing salience of enuresis and serious stomach or bowel conditions may also provide an important clue to multisystem involvement in ADHD. © The Author(s) 2016.

Differential associations between Social Anxiety Disorder, family cohesion, and suicidality across racial/ethnic groups: Findings from the National Comorbidity Survey-Adolescent (NCS-A).

PubMed

Rapp, Amy M; Lau, Anna; Chavira, Denise A

2017-05-01

The proposed research seeks to introduce a novel model relating Social Anxiety Disorder (SAD) and suicide outcomes (i.e., passive suicidal ideation, active suicidal ideation, and suicide attempts) in diverse adolescents. This model posits that family cohesion is one pathway by which suicide risk is increased for socially anxious youth, and predicts that the relationships between these variables may be of different strength in Latino and White subgroups and across gender. Data from a sample of Latino (n=1922) and non-Hispanic White (hereafter referred to as White throughout) (n=5648) male and female adolescents who participated in the National Comorbidity Survey-Adolescent were used for this study. Analyses were conducted using generalized structural equation modeling. Results showed that the mediation model held for White females. Further examination of direct pathways highlighted SAD as a risk factor unique to Latinos for active suicidal ideation and suicide attempt, over and above comorbid depression and other relevant contextual factors. Additionally, family cohesion showed a strong association with suicide outcomes across groups, with some inconsistent findings for White males. Overall, it appears that the mechanism by which SAD increases risk for suicidality is different across groups, indicating further need to identify relevant mediators, especially for racial/ethnic minority youth. Copyright © 2016 Elsevier Ltd. All rights reserved.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) supplement.

PubMed

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J; Kessler, Ronald C; Merikangas, Kathleen R; Sampson, Nancy A; Zaslavsky, Alan M

2011-06-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. Copyright © 2011 John Wiley & Sons, Ltd.

Chronology of Onset of Mental Disorders and Physical Diseases in Mental-Physical Comorbidity - A National Representative Survey of Adolescents

PubMed Central

Tegethoff, Marion; Stalujanis, Esther; Belardi, Angelo; Meinlschmidt, Gunther

2016-01-01

Background The objective was to estimate temporal associations between mental disorders and physical diseases in adolescents with mental-physical comorbidities. Methods This article bases upon weighted data (N = 6483) from the National Comorbidity Survey Adolescent Supplement (participant age: 13–18 years), a nationally representative United States cohort. Onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition lifetime mental disorders was assessed with the fully structured World Health Organization Composite International Diagnostic Interview, complemented by parent report. Onset of lifetime medical conditions and doctor-diagnosed diseases was assessed by self-report. Results The most substantial temporal associations with onset of mental disorders preceding onset of physical diseases included those between affective disorders and arthritis (hazard ratio (HR) = 3.36, 95%-confidence interval (CI) = 1.95 to 5.77) and diseases of the digestive system (HR = 3.39, CI = 2.30 to 5.00), between anxiety disorders and skin diseases (HR = 1.53, CI = 1.21 to 1.94), and between substance use disorders and seasonal allergies (HR = 0.33, CI = 0.17 to 0.63). The most substantial temporal associations with physical diseases preceding mental disorders included those between heart diseases and anxiety disorders (HR = 1.89, CI = 1.41 to 2.52), epilepsy and eating disorders (HR = 6.27, CI = 1.58 to 24.96), and heart diseases and any mental disorder (HR = 1.39, CI = 1.11 to 1.74). Conclusions Findings suggest that mental disorders are antecedent risk factors of certain physical diseases in early life, but also vice versa. Our results expand the relevance of mental disorders beyond mental to physical health care, and vice versa, supporting the concept of a more integrated mental-physical health care approach, and open new starting points for early disease prevention and better treatments, with relevance for various medical disciplines. PMID:27768751

Crime and Psychiatric Disorders Among Youth in the US Population: An Analysis of National Comorbidity Survey-Adolescent Supplement

PubMed Central

Coker, Kendell L.; Smith, Philip H.; Westphal, Alexander; Zonana, Howard V.; McKee, Sherry A.

2014-01-01

Objective Current knowledge regarding psychiatric disorders and crime in youth is limited to juvenile justice and community samples. This study examined relationships between psychiatric disorders and self-reported crime involvement in a sample of youth representative of the US population. Method The National Comorbidity Survey-Adolescent Supplement (N=10,123; ages 13–17; 2001–2004) was used to examine the relationship between lifetime DSM-IV-based diagnoses, reported crime (property, violent, other), and arrest history. Logistic regression compared the odds of reported crime involvement with specific psychiatric disorders to those without any diagnoses, and examined the odds of crime by psychiatric comorbidity. Results Prevalence of crime was 18.4%. Youth with lifetime psychiatric disorders, compared to no disorders, had significantly greater odds of crime, including violent crime. For violent crime resulting in arrest, conduct disorder (CD; OR=57.5; 95% CI=30.4,108.8), alcohol use disorders (OR=19.5; 95% CI=8.8,43.2), and drug use disorders (OR=16.1; 95% CI=9.3,27.7) had the greatest odds with similar findings for violent crime with no arrest. Psychiatric comorbidity increased the odds of crime. Youth with 3 or more diagnoses (16.0% of population) accounted for 54.1% of those reporting arrest for violent crime. Youth with at least 1 diagnosis committed 85.8% of crime, which was reduced to 67.9% by removing those with CD. Importantly, 88.2% of youth with mental illness report never committing any crime. Conclusion Our findings highlight the importance of improving access to mental health services for youthful offenders in community settings given the substantial associations found between mental illness and crime in this nationally representative epidemiological sample. PMID:25062596

The Prevalence and Correlates of Workplace Depression in the National Comorbidity Survey Replication

PubMed Central

Kessler, Ronald C.; Merikangas, Kathleen R.; Wang, Philip S.

2009-01-01

Objective To review evidence on the workplace prevalence and correlates of major depressive episodes, with a particular focus on the National Comorbidity Survey Replication, the most recent national survey to focus on these issues. Method Nationally representative survey of Diagnostic and Statistical Manual, 4th Revision Mental Disorders. Results A total of 6.4% of employed National Comorbidity Survey Replication respondents had 12-month major depressive disorder. An additional 1.1% had major depressive episodes due to bipolar disorder or mania– hypomania. Only about half of depressed workers received treatment. Fewer than half of treated workers received care consistent with published treatment guidelines. Conclusions Depression disease management programs can have a positive return-on-investment from the employer perspective, but only when they are based on best practices. Given the generally low depression treatment quality documented here, treatment quality guarantees are needed before expanding workplace depression screening, outreach, and treatment programs. PMID:18404010

Childhood Abuse, Chronic Pain, and Depression in the National Comorbidity Survey

ERIC Educational Resources Information Center

Sachs-Ericsson, Natalie; Kendall-Tackett, Kathleen; Hernandez, Annya

2007-01-01

Objective: The current study examined the effects of childhood sexual and physical abuse on reports of pain in men and women (N=1,727). Methods: Data from the National Comorbidity Survey, a nationally representative sample, were utilized. Childhood experiences of physical and sexual abuse were assessed, and pain reports in relation to current…

Food Insecurity and Mental Disorders in a National Sample of U.S. Adolescents

ERIC Educational Resources Information Center

McLaughlin, Katie A.; Green, Jennifer Greif; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.

2012-01-01

Objective: To examine whether food insecurity is associated with past-year "DSM-IV" mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method: Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication…

DSM-III-R generalized anxiety disorder in the National Comorbidity Survey.

PubMed

Wittchen, H U; Zhao, S; Kessler, R C; Eaton, W W

1994-05-01

Nationally representative general population data are presented on the current, 12-month, and lifetime prevalence of DSM-III-R generalized anxiety disorder (GAD) as well as on risk factors, comorbidity, and related impairments. The data are from the National Comorbidity Survey, a large general population survey of persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States. DSM-III-R GAD was assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview. Generalized anxiety disorder was found to be a relatively rare current disorder with a current prevalence of 1.6% but was found to be a more frequent lifetime disorder affecting 5.1% of the US population aged 15 to 45 years. Generalized anxiety disorder was twice as common among women as among men. Multivariate logistic regression analysis showed that being older than 24 years, separated, widowed, divorced, unemployed, and a homemaker are significant correlates of GAD. Consistent with studies in treatment samples, we found that GAD was frequently associated with a wide spectrum of other mental disorders, with a lifetime comorbidity among 90.4% of the people who had a history of GAD. Contrary to the traditional view that GAD is a mild disorder, we found that the majority of people with GAD, whether they were comorbid or not, reported substantial interference with their life, a high degree of professional help seeking, and a high use of medication because of their GAD symptoms. Although lifetime GAD is highly comorbid, the proportion of current GAD that is not accompanied by any other current diagnosis is high enough to indicate that GAD should be considered an independent disorder rather than exclusively a residual or prodrome of other disorders.

The National Adolescent Student Health Survey: Survey Replication Booklet.

ERIC Educational Resources Information Center

American School Health Association, Kent, OH.

The National Adolescent Student Health Survey (NASHS), initiated in 1985, is conducted to examine the health-related knowledge, practices, and attitudes of the nation's youth in the following health areas: AIDS; Nutrition; Consumer Health; Sexually Transmitted Disease; Drug and Alcohol Use; Suicide; Injury Prevention; and Violence. Findings…

Social Phobia and Subtypes in the National Comorbidity Survey-Adolescent Supplement: Prevalence, Correlates, and Comorbidity

ERIC Educational Resources Information Center

Burstein, Marcy; He, Jian-Ping; Kattan, Gabriela; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R.

2011-01-01

Objective: Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and…

Sleep Problems, Comorbid Mental Disorders, and Role Functioning in the National Comorbidity Survey Replication (NCS-R)

PubMed Central

Roth, Thomas; Jaeger, Savina; Jin, Robert; Kalsekar, Anupama; Stang, Paul E.; Kessler, Ronald C.

2007-01-01

Background Little is known about the population prevalence of sleep problems or whether the associations of sleep problems with role impairment are due to comorbid mental disorders. Methods The associations of four 12-month sleep problems (difficulty initiating or maintaining sleep, early morning awakening, nonrestorative sleep) with role impairment were analyzed in the National Comorbidity Survey Replication controlling 12-month DSM-IV anxiety, mood, impulse-control, and substance disorders. The WHO Composite International Diagnostic Interview was used to assess sleep problems and DSM-IV disorders. The WHO Disability Schedule-II (WHO-DAS) was used to assess role impairment. Results Prevalence estimates of the separate sleep problems were in the range 16.4-25.0%, with 36.3% reporting at least one of the four. Mean 12-month duration was 24.4 weeks. All four problems were significantly comorbid with all the 12-month DMS-IV disorders assessed in the survey (median OR: 3.4; 25th-75th percentile: 2.8-3.9) and significantly related to role impairment. Relationships with role impairment generally remained significant after controlling comorbid mental disorders. Nonrestorative sleep was more strongly and consistently related to role impairment than were the other sleep problems. Conclusions The four sleep problems considered here are of public health significance because of their high prevalence and significant associations with role impairment. PMID:16952333

Psychological Dimensions Associated with Suicidal Ideation and Attempts in the National Comorbidity Survey

ERIC Educational Resources Information Center

Cox, Brian J.; Enns, Murray W.; Clara, Ian P.

2004-01-01

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric…

Patterns and predictors of ADHD persistence into adulthood: Results from the National Comorbidity Survey Replication

PubMed Central

Kessler, Ronald C.; Adler, Lenard A.; Barkley, Russell; Biederman, Joseph; Conners, C. Keith; Faraone, Stephen V.; Greenhill, Laurence L.; Jaeger, Savina; Secnik, Kristina; Spencer, Thomas; Üstün, T. Bedirhan; Zaslavsky, Alan M.

2010-01-01

BACKGROUND Despite growing interest in adult ADHD, little is known about predictors of persistence of childhood cases into adulthood. METHODS A retrospective assessment of childhood ADHD, childhood risk factors, and a screen for adult ADHD were included in a sample of 3197 18–44 year old respondents in the National Comorbidity Survey Replication (NCS-R). Blinded adult ADHD clinical reappraisal interviews were administered to a sub-sample of respondents. Multiple imputation (MI) was used to estimate adult persistence of childhood ADHD. Logistic regression was used to study retrospectively reported childhood predictors of persistence. Potential predictors included socio-demographics, childhood ADHD severity, childhood adversity, traumatic life experiences, and comorbid DSM-IV child-adolescent disorders (anxiety, mood, impulse-control, and substance disorders). RESULTS 36.3% of respondents with retrospectively assessed childhood ADHD were classified by blinded clinical interviews as meeting DSM-IV criteria for current ADHD. Childhood ADHD severity and childhood treatment significantly predicted persistence. Controlling for severity and excluding treatment, none of the other variables significantly predicted persistence even though they were significantly associated with childhood ADHD. CONCLUSIONS No modifiable risk factors were found for adult persistence of ADHD. Further research, ideally based on prospective general population samples, is needed to search for modifiable determinants of adult persistence of ADHD. PMID:15950019

Self-criticism and social phobia in the US national comorbidity survey.

PubMed

Cox, Brian J; Fleet, Claire; Stein, Murray B

2004-10-15

This study sought to extend findings from a preliminary clinical investigation [J. Affect. Disord. 57 (2000) 223] by examining relations between the personality dimension of self-criticism and diagnostic prevalence of social phobia in a large nationally representative sample. Participants were from the national comorbidity survey Part II [n=5877; Arch. Gen. Psychiatry 51 (1994) 8]. Psychiatric diagnoses were made using a modified version of the composite international psychiatric interview. Personality dimensions and distress were assessed using brief self-report measures with strong psychometric properties. Self-criticism was elevated in NCS respondents with a diagnosis of social phobia, even in cases of only past history of social phobia (i.e. >1 year ago), compared to individuals with no psychiatric disorder. The highest levels of self-criticism were reported by people with the complex subtype of social phobia, both with and without comorbid major depression. These levels were significantly greater compared to those observed in another anxiety disorder (panic disorder), the pure speaking subtype of social phobia, and cases of major depression alone. In a regression analysis that controlled for current emotional distress, the broad personality trait of neuroticism, and lifetime histories of mood, anxiety, and substance use disorders, self-criticism remained significantly associated with lifetime prevalence of social phobia. The cross-sectional design of the study does not permit causal inferences. Findings from this general population mental health survey demonstrated that self-criticism is robustly associated with social phobia. It may represent an important core psychological process in the complex subtype of this anxiety disorder.

Major Depressive Disorder with Sub-threshold Bipolarity in the National Comorbidity Survey Replication

PubMed Central

Angst, Jules; Cui, Lihong; Swendsen, J. Joel; Rothen, S.; Cravchik, Anibal; Kessler, Ronald; Merikangas, Kathleen

2011-01-01

Objectives There is growing clinical and epidemiologic evidence indicating that major mood disorders form a spectrum from Major Depressive Disorder (MDD) to pure mania. The present investigation examined the prevalence and clinical correlates of MDD with sub-threshold bipolarity vs. pure MDD in the National Comorbidity Survey Replication (NCS-R). Methods The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February, 2001 and April, 2003. Lifetime history of mood disorders, symptoms and clinical indicators of severity were collected using version 3.0 of the WHO Composite International Diagnostic Interview, a fully structured lay-administered diagnostic interview. Results Nearly 40% of study participants with a history of major depressive disorder had a history of sub-threshold hypomania. This subgroup had a younger age of disorder onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania, and lower levels of clinical severity than those with bipolar II disorder. Conclusions The findings demonstrate heterogeneity of major depressive disorder and support the validity of inclusion of sub-threshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice. PMID:20713498

Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

ERIC Educational Resources Information Center

Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

2008-01-01

This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

Social Fears and Social Phobia in the United States: Results from the National Comorbidity Survey Replication

PubMed Central

Ruscio, Ayelet Meron; Brown, Timothy A.; Chiu, Wai Tat; Sareen, Jitender; Stein, Murray B.; Kessler, Ronald C.

2008-01-01

Background Despite heightened awareness of the clinical significance of social phobia, information is still lacking about putative subtypes, functional impairment, and treatment-seeking. New epidemiologic data on these topics are presented from the National Comorbidity Survey Replication (NCS-R). Methods The NCS-R is a nationally representative household survey fielded in 2001–2003. The WHO Composite International Diagnostic Interview (CIDI 3.0) was used to assess 14 performance and interactional fears and DSM-IV social phobia. Results The estimated lifetime and 12-month prevalence of social phobia are 12.1% and 7.1%. Performance and interactional fears load onto a single latent factor, and there is little evidence for distinct subtypes based either on the content or number of fears. Social phobia is associated with significant psychiatric comorbidity, role impairment, and treatment-seeking, all of which have a dose-response relationship with number of social fears. However, social phobia is the focus of clinical attention in only about half of cases where treatment is obtained. Among non-comorbid cases, those with the most fears were least likely to receive social phobia treatment. Conclusions Social phobia is a common, under-treated disorder that leads to significant functional impairment. Increasing numbers of social fears are associated with increasingly severe manifestations of the disorder. PMID:17976249

Determining accurate vaccination coverage rates for adolescents: the National Immunization Survey-Teen 2006.

PubMed

Jain, Nidhi; Singleton, James A; Montgomery, Margrethe; Skalland, Benjamin

2009-01-01

Since 1994, the Centers for Disease Control and Prevention has funded the National Immunization Survey (NIS), a large telephone survey used to estimate vaccination coverage of U.S. children aged 19-35 months. The NIS is a two-phase survey that obtains vaccination receipt information from a random-digit-dialed survey, designed to identify households with eligible children, followed by a provider record check, which obtains provider-reported vaccination histories for eligible children. In 2006, the survey was expanded for the first time to include a national sample of adolescents aged 13-17 years, called the NIS-Teen. This article summarizes the methodology used in the NIS-Teen. In 2008, the NIS-Teen was expanded to collect state-specific and national-level data to determine vaccination coverage estimates. This survey provides valuable information to guide immunization programs for adolescents.

Ecstasy Use and Suicidal Behavior among Adolescents: Findings from a National Survey

ERIC Educational Resources Information Center

Kim, Jueun; Fan, Bin; Liu, Xinhua; Kerner, Nancy; Wu, Ping

2011-01-01

The relationship between ecstasy use and suicidal behavior among adolescents in the United States was examined. Data from the adolescent subsample (ages 12-17, N = 19,301) of the 2000 National Household Survey on Drug Abuse were used in the analyses. Information on adolescent substance use, suicidal behaviors, and related sociodemographic, family,…

The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication

PubMed Central

Kessler, Ronald C.; Chiu, Wai Tat; Jin, Robert; Ruscio, Ayelet Meron; Shear, Katherine; Walters, Ellen E.

2007-01-01

Context Only limited information exists about the epidemiology of DSM-IV panic attacks and panic disorder. Objective To present nationally representative data on the epidemiology of panic attacks and panic disorder with or without agoraphobia based on the National Comorbidity Survey Replication (NCS-R). Design and Setting Nationally representative face-to-face household survey conducted using the fully structured WHO Composite International Diagnostic Interview (CIDI). Participants 9282 English-speaking respondents ages 18 and older. Main Outcome Measures DSM-IV panic attacks (PA) and panic disorder (PD) with and without agoraphobia (AG). Results Lifetime prevalence estimates are 22.7% for isolated panic without agoraphobia (PA-only), 0.8% for PA with agoraphobia without PD (PA-AG), 3.7% for PD without AG (PD-only), and 1.1% for PD with AG (PD-AG). Persistence, number of lifetime attacks, and number of years with attacks all increase monotonically across these four subgroups. All four subgroups are significantly comorbid with other lifetime DSM-IV disorders, with the highest odds for PD-AG and the lowest for PA-only. Scores on the Panic Disorder Severity Scale are also highest for PD-AG (86.3% moderate-severe) and lowest for PA-only (6.7% moderate-severe). Agoraphobia is associated with substantial severity, impairment, and comorbidity. Lifetime treatment is high (from 96.1% PD-AG to 61.1% PA-only), but 12-month treatment meeting published treatment guidelines is low (from 54.9% PD-AG to 18.2% PA-only). Conclusions Although the major societal burden of panic is due to PD and PA-AGG, isolated panic attacks also have high prevalence and meaningful role impairment. PMID:16585471

School Start Time and Adolescent Sleep Patterns: Results From the US National Comorbidity Survey—Adolescent Supplement

PubMed Central

Paksarian, Diana; Rudolph, Kara E.

2015-01-01

Objectives. We estimated associations between school start time and adolescent weeknight bedtime, weeknight sleep duration, and weekend compensatory sleep and assessed whether associations differ by age, sex, or urbanicity. Methods. We used a subsample of a nationally representative, cross-sectional survey of 7308 students aged 13 to 18 years attending 245 schools to estimate associations of school start time, reported by school principals, with weeknight bedtime and sleep duration and weekend compensatory sleep, reported during adolescent face-to-face interviews. Results. Start time was positively associated with weeknight bedtime. Associations between start time and weeknight sleep duration were nonlinear and were strongest for start times of 8:00 am and earlier. Associations differed by sex and urbanicity, with the strongest association among boys in major metropolitan counties. Start time was negatively associated with sleep duration among boys in nonurban counties. Start time was not associated with weekend compensatory sleep. Conclusions. Positive overall associations between school start time and adolescent sleep duration at the national level support recent policy recommendations for delaying school start times. However, the impact of start time delays may differ by sex and urbanicity. PMID:25973803

The prevalence and correlates of DSM-IV Intermittent Explosive Disorder in the National Comorbidity Survey Replication

PubMed Central

Kessler, Ronald C.; Coccaro, Emil F.; Fava, Maurizio; Jaeger, Savina; Jin, Robert; Walters, Ellen

2007-01-01

Context Little is known about the epidemiology of Intermittent Explosive Disorder. Objective To present nationally representative data on the prevalence and correlates of DSM-IV Intermittent Explosive Disorder. Design The WHO Composite International Diagnostic Interview was used to assess DSM-IV anxiety disorders, mood disorders, substance use disorders, and impulse-control disorders. Setting The National Comorbidity Survey Replication (NCS-R), a face-to-face household survey carried out in 2001–03. Participants A nationally representative sample of 9282 people ages 18+ Main outcome variable Diagnoses of DSM-IV Intermittent Explosive Disorder (IED) Results Lifetime and 12-month prevalence estimates of DSM-IV IED are 7.3% and 3.9%., with a mean 43 lifetime attacks resulting in $1359 property damage. IED-related injuries occurred 180 times per 100 lifetime cases. Mean age of onset was 14. Socio-demographic correlates were uniformly weak. IED was significantly comorbid with most DSM-IV mood, anxiety, and substance disorders. Although the majority of people with IED (60.3%) obtained professional treatment for emotional or substance problems at some time in their life, only 28.8% ever received treatment for their anger, while only 11.7% of 12-month cases received treatment for their anger in the 12 months before interview. Conclusions IED is a much more common condition than previously recognized. The early age of onset, significant associations with comorbid mental disorders that have later ages of onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment. PMID:16754840

The prevalence and correlates of DSM-IV intermittent explosive disorder in the National Comorbidity Survey Replication.

PubMed

Kessler, Ronald C; Coccaro, Emil F; Fava, Maurizio; Jaeger, Savina; Jin, Robert; Walters, Ellen

2006-06-01

Little is known about the epidemiology of intermittent explosive disorder (IED). To present nationally representative data on the prevalence and correlates of DSM-IV IED. The World Health Organization Composite International Diagnostic Interview was used to assess DSM-IV anxiety disorders, mood disorders, substance use disorders, and impulse control disorders. The National Comorbidity Survey Replication, a face-to-face household survey carried out in 2001-2003. A nationally representative sample of 9282 people 18 years and older. Diagnoses of DSM-IV IED. Lifetime and 12-month prevalence estimates of DSM-IV IED were 7.3% and 3.9%, with a mean 43 lifetime attacks resulting in 1359 dollars in property damage. Intermittent explosive disorder-related injuries occurred 180 times per 100 lifetime cases. Mean age at onset was 14 years. Sociodemographic correlates were uniformly weak. Intermittent explosive disorder was significantly comorbid with most DSM-IV mood, anxiety, and substance disorders. Although the majority of people with IED (60.3%) obtained professional treatment for emotional or substance problems at some time in their life, only 28.8% ever received treatment for their anger, while only 11.7% of 12-month cases received treatment for their anger in the 12 months before interview. Intermittent explosive disorder is a much more common condition than previously recognized. The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment.

Chronic obstructive pulmonary disease, hospital visits, and comorbidities: National Survey of Residential Care Facilities, 2010.

PubMed

Wheaton, Anne G; Ford, Earl S; Cunningham, Timothy J; Croft, Janet B

2015-04-01

To characterize the prevalence of chronic obstructive pulmonary disease (COPD) among residential care facility (RCF) residents in the United States, and to compare patterns of hospital visits and comorbidities with residents without COPD. Resident data from the 2010 National Survey of Residential Care Facilities were analyzed. Medical history and information on past-year hospital visits for 8,089 adult residents were obtained from interviews with RCF staff. COPD prevalence was 12.4%. Compared with residents without COPD, emergency department visits or overnight hospital stays in the previous year were more prevalent (p < .05) among residents with COPD. Less than 3% of residents with COPD had no comorbidities. Arthritis, depression, congestive heart failure (CHF), diabetes, coronary heart disease, and asthma were more common (p < .05) among residents with COPD than those without COPD, but Alzheimer's disease was less common. COPD is associated with more emergency department visits, hospital stays, and comorbidities among RCF residents. © The Author(s) 2014.

Associations between Peer Victimization, Self-Reported Depression and Social Phobia among Adolescents: The Role of Comorbidity

ERIC Educational Resources Information Center

Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Pelkonen, Mirjami; Marttunen, Mauri

2009-01-01

Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression…

The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication

PubMed Central

Kessler, Ronald C.; Adler, Lenard; Barkley, Russell; Biederman, Joseph; Conners, C. Keith; Demler, Olga; Faraone, Stephen V.; Greenhill, Laurence L.; Howes, Mary J.; Secnik, Kristina; Spencer, Thomas; Ustun, T. Bedirhan; Walters, Ellen E.; Zaslavsky, Alan M.

2010-01-01

OBJECTIVE Despite growing interest in adult attention-deficit/hyperactivity disorder (ADHD), little is known about prevalence or correlates. METHODS A screen for adult ADHD was included in a probability sub-sample (n = 3199) of 18–44 year old respondents in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 NCS-R respondents, over-sampling those with a positive screen. Multiple imputation (MI) was used to estimate prevalence and correlates of clinician-assessed adult ADHD. RESULTS Estimated prevalence of current adult ADHD is 4.4%. Significant correlates include being male, previously married, unemployed, and Non-Hispanic White. Adult ADHD is highly comorbid with many other NCS-R/DSM-IV disorders and is associated with substantial role impairment. The majority of cases are untreated, although many obtain treatment for other comorbid mental and substance disorders. CONCLUSIONS Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD. PMID:16585449

High psychiatric comorbidity in adolescents with dissociative disorders.

PubMed

Bozkurt, Hasan; Duzman Mutluer, Tuba; Kose, Cigdem; Zoroglu, Salih

2015-06-01

The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version. A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%). High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

The association of Ecstasy use and academic achievement among adolescents in two U.S. national surveys

PubMed Central

Martins, Silvia S.; Alexandre, Pierre K.

2008-01-01

The association of ecstasy (3, 4-methylenedioxymethamphetamine, MDMA) use with low academic achievement was examined in two nationally representative surveys of adolescents. We tested whether associations with low academic achievement were of similar magnitude or of stronger magnitude for ecstasy versus marijuana use (without ecstasy use), alcohol/tobacco use (without other drug use) and non-drug use in adolescence. Data from the adolescents in the 2002–2005 National Survey of Drug Use and Health (NSDUH, n= 65,294) and from the 2001–2003 Youth Risk Behavior Survey (YRBS, n= 27,592) were analyzed via weighted logistic regression models. Ecstasy, marijuana, and alcohol/tobacco use were associated with moderate and low academic achievement among adolescents in both surveys. Moreover, ecstasy was more strongly associated with low academic achievement and reporting that school gave no grades than alcohol/tobacco in both samples and than marijuana (NSDUH sample only). Prevention programs should inform adolescents that ecstasy use might impair their academic achievement. PMID:18778898

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

PubMed

Bühren, K; Schwarte, R; Fluck, F; Timmesfeld, N; Krei, M; Egberts, K; Pfeiffer, E; Fleischhaker, C; Wewetzer, C; Herpertz-Dahlmann, B

2014-01-01

Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self-harm behaviour in adolescent patients with a first onset of AN. In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM-IV), depressive symptoms, suicidality and self-injurious behaviour were assessed. Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge-purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self-injurious behaviour. The severity of eating disorder-specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Psychiatric comorbidity in childhood and adolescence headache.

PubMed

Dyb, Grete; Stensland, Synne; Zwart, John-Anker

2015-03-01

Primary headaches among children and adolescents have a substantial impact on quality of life, daily activities, social interaction, and school performance in combination with psychopathological symptoms. The main purpose of the present paper is to summarize clinical and epidemiological evidence for psychiatric comorbidity among children and adolescents with headaches, to describe how evidence in headache research suggest different pathways involved in the development and maintenance of these comorbid conditions, and finally suggest some elements professionals may find helpful to assess the scope of complaints, related functional impairment, and potential precipitating factors in planning of more targeted treatments.

Are Canadian Adolescents Happy? A Gender-Based Analysis of a Nationally Representative Survey

ERIC Educational Resources Information Center

Weaver, Robert D.; Habibov, Nazim N.

2010-01-01

In this study, the authors analyzed data from a nationally representative survey of youth to study happiness amongst Canadian adolescents aged 12-17. Testing for differences in the level of happiness between female and male adolescents was conducted. Following this, multivariate analysis was employed to determine which factors were associated with…

The National Adolescent Student Health Survey. A Report on the Health of America's Youth.

ERIC Educational Resources Information Center

American School Health Association, Kent, OH.

The National Adolescent Student Health Survey (NASHS) was designed to assess students' health-related knowledge, attitudes, and behaviors in eight areas of critical importance to the health of youth. Two grade levels, eighth and tenth, were chosen to be the focus of the study. The survey provides a national profile of students at these two grade…

Empirically Derived Subtypes of Lifetime Anxiety Disorders: Developmental and Clinical Correlates in U.S. Adolescents

ERIC Educational Resources Information Center

Burstein, Marcy; Georgiades, Katholiki; Lamers, Femke; Swanson, Sonja A.; Cui, Lihong; He, Jian-Ping; Avenevoli, Shelli; Merikangas, Kathleen R.

2012-01-01

Objective: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. Method: The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for "Diagnostic and Statistical Manual of…

Associations between peer victimization, self-reported depression and social phobia among adolescents: the role of comorbidity.

PubMed

Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Pelkonen, Mirjami; Marttunen, Mauri

2009-02-01

Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression (Beck Depression Inventory), SP (Social Phobia Inventory), and selected background variables were assessed. Frequency of overt and covert peer victimization was examined among four groups: (1) adolescents with depression non-comorbid with SP (DEP), (2) those with SP non-comorbid with depression (SP), (3) those with both SP and depression (SP+DEP), and (4) controls, with neither. A logistic regression analysis controlling for confounding familial (family moving, parental unemployment), and psychopathology (delinquency, aggressiveness, general anxiety) covariates was conducted to confirm the associations between peer victimization and the four groups. Among boys the comorbid SP+DEP group reported the highest rates of both overt and covert victimization, these being significantly higher than among both DEP and SP groups. Among girls covert victimization was again most frequent in the SP+DEP group, but overt victimization was not more frequent in the comorbid group than it was in the DEP and SP groups. In the logistic regression analysis depression without SP did not maintain an independent association with either type of victimization. Instead, SP without depression with ORs from 2.8 to 4.3, and SP comorbid with depression, with ORs between 3.2 and 11.4 had independent associations with peer victimization. In conclusion, overt and covert peer victimization seem to be associated with SP, rather than depression, among adolescents.

ADHD and comorbid conduct problems among adolescents: associations with self-esteem and substance use.

PubMed

Glass, Kerrie; Flory, Kate; Martin, Amber; Hankin, Benjamin L

2011-03-01

Attention-deficit/hyperactivity disorder (ADHD) is a common child and adolescent disorder that is associated with negative outcomes (e.g., emotional and behavioral problems, substance use) and is often comorbid with Conduct Problems (CP). Research findings are mixed as to whether youth with ADHD alone or comorbid ADHD/CP suffer from low self-esteem. Research has also shown links between low self-esteem and ADHD (alone and with CP) with substance use; yet, no research has examined the links between self-esteem and substance use in adolescents with ADHD and CP. The current study examined the relation between ADHD with and without comorbid CP and self-esteem, and whether self-esteem moderated the relation between ADHD and ADHD/CP with substance use among adolescents. We hypothesized that adolescents with comorbid ADHD/CP would experience lower self-esteem than adolescents with ADHD alone or with neither disorder and that self-esteem would moderate the association between ADHD, CP, and substance use. Participants were 62 adolescents who completed the laboratory-based study with a parent. Results suggested that adolescents with comorbid ADHD and CP had significantly lower self-esteem than adolescents with ADHD alone or neither disorder. Self-esteem was not significantly different for adolescents with ADHD alone versus those in the control group. There was one marginally significant interaction between ADHD and self-esteem predicting substance use, such that individuals with comorbid ADHD/CP who also had low self-esteem tended to use more substances. Results have implications for treatments that target adolescents with ADHD and comorbid CP, as these adolescents are at risk for many deleterious outcomes.

Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders.

PubMed

Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Kiviruusu, Olli; Heilä, Hannele; Holi, Matti; Kettunen, Kirsi; Tuisku, Virpi; Tuulio-Henriksson, Annamari; Törrönen, Johanna; Marttunen, Mauri

2006-06-01

To compare selected characteristics (age, sex, age of onset for depression, impairment, severity of depression, somatic comorbidity, and treatment status) of adolescents with currently comorbid and non-comorbid depression. A sample of 218 consecutive adolescent (13-19 years) psychiatric outpatients with depressive disorders, and 200 age- and sex-matched school-attending controls were interviewed for DSM-IV Axis I and Axis II diagnoses. Current comorbidity, most commonly with anxiety disorders, was equally frequent (>70%) in outpatients and depressed controls. Younger age (OR 0.20; 95% CI 0.08, 0.51) and male gender (OR 0.02; 95% CI 0.09, 0.55) were associated with concurrent disruptive disorders. Current comorbidity with substance use disorders (SUD) was independent of age (OR 1.13; 95% CI 0.51, 2.49) and sex (OR 0.51; 95% CI 0.22, 1.17). Personality disorders associated with older age (OR 2.06; 95% CI 1.10, 3.86). In multivariable logistic regression analysis, impairment (GAF comorbidity (OR 3.13; 95% CI 1.53, 6.45), while severity of depression and lifetime age of onset for depression were not. Adolescent depression presents with age- and sex-dependent patterns of multiple co-occurring problem areas. While many clinical characteristics of adolescent depression are not affected by comorbidity, comorbidity associates with increased impairment.

Neuroanatomical Correlates of Heterotypic Comorbidity in Externalizing Male Adolescents

ERIC Educational Resources Information Center

Sauder, Colin L.; Beauchaine, Theodore P.; Gatzke-Kopp, Lisa M.; Shannon, Katherine E.; Aylward, Elizabeth

2012-01-01

Children and adolescents with externalizing behavior disorders including attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) often present with symptoms of comorbid internalizing psychopathology. However, few studies have examined central nervous system correlates of such comorbidity. We evaluated interactions between…

Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication.

PubMed

Ruscio, Ayelet Meron; Lane, Michael; Roy-Byrne, Peter; Stang, Paul E; Stein, Dan J; Wittchen, Hans-Ulrich; Kessler, Ronald C

2005-12-01

Excessive worry is required by DSM-IV, but not ICD-10, for a diagnosis of generalized anxiety disorder (GAD). No large-scale epidemiological study has ever examined the implications of this requirement for estimates of prevalence, severity, or correlates of GAD. Data were analyzed from the US National Comorbidity Survey Replication, a nationally representative, face-to-face survey of adults in the USA household population that was fielded in 2001-2003. DSM-IV GAD was assessed with Version 3.0 of the WHO Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-IV criteria for GAD were compared with respondents who met full GAD criteria as well as with other survey respondents to consider the implications of removing the excessiveness requirement. The estimated lifetime prevalence of GAD increases by approximately 40% when the excessiveness requirement is removed. Excessive GAD begins earlier in life, has a more chronic course, and is associated with greater symptom severity and psychiatric co-morbidity than non-excessive GAD. However, non-excessive cases nonetheless evidence substantial persistence and impairment of GAD, high rates of treatment-seeking, and significantly elevated co-morbidity compared with respondents without GAD. Non-excessive cases also have sociodemographic characteristics and familial aggregation of GAD comparable to excessive cases. Individuals who meet all criteria for GAD other than excessiveness have a somewhat milder presentation than those with excessive worry, yet resemble excessive worriers in a number of important ways. These findings challenge the validity of the excessiveness requirement and highlight the need for further research into the optimal definition of GAD.

Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British Psychiatric Morbidity Survey.

PubMed

Shevlin, Mark; Houston, James E; Dorahy, Martin J; Adamson, Gary

2008-01-01

Previous research has shown that traumatic life events are associated with a diagnosis of psychosis. Rather than focus on particular events, this study aimed to estimate the effect of cumulative traumatic experiences on psychosis. The study was based on 2 large community samples (The National Comorbidity Survey [NCS], The British Psychiatric Morbidity Survey [BPMS]). All analyses were conducted using hierarchical binary logistic regression, with psychosis diagnosis as the dependent variable. Background demographic variables were included in the first block, in addition to alcohol/drug dependence and depression. A variable indicating the number of traumas experienced was entered in the second block. Experiencing 2 or more trauma types significantly predicted psychosis, and there appeared to be a dose-response type relationship. Particular traumatic experiences have been implicated in the etiology of psychosis. Consistent with previous research, molestation and physical abuse were significant predictors of psychosis using the NCS, whereas for the BPMS, serious injury or assault and violence in the home were statistically significant. This study indicated the added risk of multiple traumatic experiences.

Cumulative Traumas and Psychosis: an Analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey

PubMed Central

Shevlin, Mark; Houston, James E.; Dorahy, Martin J.; Adamson, Gary

2008-01-01

Previous research has shown that traumatic life events are associated with a diagnosis of psychosis. Rather than focus on particular events, this study aimed to estimate the effect of cumulative traumatic experiences on psychosis. The study was based on 2 large community samples (The National Comorbidity Survey [NCS], The British Psychiatric Morbidity Survey [BPMS]). All analyses were conducted using hierarchical binary logistic regression, with psychosis diagnosis as the dependent variable. Background demographic variables were included in the first block, in addition to alcohol/drug dependence and depression. A variable indicating the number of traumas experienced was entered in the second block. Experiencing 2 or more trauma types significantly predicted psychosis, and there appeared to be a dose-response type relationship. Particular traumatic experiences have been implicated in the etiology of psychosis. Consistent with previous research, molestation and physical abuse were significant predictors of psychosis using the NCS, whereas for the BPMS, serious injury or assault and violence in the home were statistically significant. This study indicated the added risk of multiple traumatic experiences. PMID:17586579

Psychiatric Comorbidity in Gender Dysphoric Adolescents

ERIC Educational Resources Information Center

de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.

2011-01-01

Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…

Food insecurity and mental disorders in a national sample of U.S. adolescents.

PubMed

McLaughlin, Katie A; Green, Jennifer Greif; Alegría, Margarita; Jane Costello, E; Gruber, Michael J; Sampson, Nancy A; Kessler, Ronald C

2012-12-01

To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture's Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Conducting Anonymous, Incentivized, Online Surveys With Sexual and Gender Minority Adolescents: Lessons Learned From a National Polyvictimization Study.

PubMed

Sterzing, Paul R; Gartner, Rachel E; McGeough, Briana L

2018-03-01

Sexual and gender minority adolescents represent an understudied and hard-to-reach population who experience higher rates of mental and behavioral health problems in comparison to their cisgender, heterosexual peers. Online surveys and the proliferation of Internet-connected devices among adolescents offer an exciting opportunity for researchers to begin addressing research gaps and past methodological limitations with these hard-to-reach populations. The purpose of this article is to provide guidance to researchers who are designing and implementing anonymous, incentivized, online surveys by examining the following critical domains-(a) recruitment and engagement: means of leveraging social media and videos to recruit and engage a more nationally representative sample; (b) safety and protection: strategies for administering informed consent and protecting participant anonymity and well-being; and (c) data integrity: mechanisms to detect dishonest and repeat responders. To facilitate discussion of these aims, concrete examples are used from SpeakOut-a 3-year, national study funded by the National Institute of Justice that utilized an anonymous, incentivized, online survey with a large sample of sexual and gender minority adolescents ( N = 1,177) to identify the prevalence, incidence, and correlates of polyvictimization. The article concludes with lessons learned from this national study and recommendations for technological innovations and future research that will strengthen the utility of anonymous, incentivized, online surveys to study sexual and gender minority adolescents and other hard-to-reach populations.

Inhalant Use, Abuse, and Dependence among Adolescent Patients: Commonly Comorbid Problems.

ERIC Educational Resources Information Center

Sakai, Joseph T.; Hall, Shannon K.; Mikulich-Gilbertson, Susan K.; Crowley, Thomas J.

2004-01-01

Objective: Little is known about adolescents with DSM-IV-defined inhalant abuse and dependence. The aim of this study was to compare comorbidity among (1) adolescents with inhalant use disorders, (2) adolescents who reported using inhalants without inhalant use disorder, and (3) other adolescent patients drawn from an adolescent drug and alcohol…

Food Insecurity and Mental Disorders in a National Sample of U.S. Adolescents

PubMed Central

McLaughlin, Katie A.; Green, Jennifer Greif; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.

2013-01-01

Objective To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method Data were drawn from 6,483 adolescent–parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture’s Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Results Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14%increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Conclusions Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. PMID:23200286

Has Adolescent Suicidality Decreased in the United States? Data from Two National Samples of Adolescents Interviewed in 1995 and 2005

ERIC Educational Resources Information Center

Wolitzky-Taylor, Kate B.; Ruggiero, Kenneth J.; McCart, Michael R.; Smith, Daniel W.; Hanson, Rochelle F.; Resnick, Heidi S.; de Arellano, Michael A.; Saunders, Benjamin E.; Kilpatrick, Dean G.

2010-01-01

We compared the prevalence and correlates of adolescent suicidal ideation and attempts in two nationally representative probability samples of adolescents interviewed in 1995 (National Survey of Adolescents; N = 4,023) and 2005 (National Survey of Adolescents-Replication; N = 3,614). Participants in both samples completed a telephone survey that…

Self-reported comorbid pains in severe headaches or migraines in a US national sample.

PubMed

Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2012-06-01

To compare prevalence of self-reported comorbid temporomandibular joint muscle disorder-type, neck, back, and joint pains in people with severe headache or migraine; and analyze these self-reported pains in the 2000-2005 US National Health Interview Survey by gender and age for non-Hispanic whites, Hispanics, and non-Hispanic blacks (African Americans). National Health Interview Survey data included information on gender, age, race, ethnicity, health status, and common pain types: severe headache or migraine, temporomandibular joint muscle disorder-type, neck, and low back in the last 3 months, as well as prior-month joint pains. Analyses included survey prevalence estimation and survey logistic regression to obtain odds ratios and 95% confidence intervals. The study included 189,967 adults: 48% males, 52% females; 73% white, 12% Hispanic, and 11% black. Of the entire sample, 29,712 (15%) reported severe headache or migraine, and 19,228 (64%) had severe headache or migraine with at least 1 comorbid pain. Two or more comorbid pains were reported in 10,200 (33%), with no gender difference, and with Hispanics (n = 1847 or 32%) and blacks (n = 1301 or 30%) less likely to report 2 or more comorbid pains than whites (n = 6747 or 34%) (odds ratio = 0.91, P = .032; OR = 0.82, P < .001, respectively). This group also reported significantly lower ratings of self-rated health (P < .001). Differences in type of comorbid pain by age patterns were found. Severe headache or migraine is often associated with other common pains, seldom existing alone. Two or more comorbid pains are common, similarly affecting gender and racial/ethnic groups. © 2012 American Headache Society.

Assessment of Generalized Anxiety Disorder Diagnostic Criteria in the National Comorbidity Survey and Virginia Adult Twin Study of Psychiatric and Substance Use Disorders

ERIC Educational Resources Information Center

Kubarych, Thomas S.; Aggen, Steven H.; Hettema, John M.; Kendler, Kenneth S.; Neale, Michael C.

2008-01-01

The authors investigated measurement properties of the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition," generalized anxiety disorder (GAD) criteria in the National Comorbidity Survey and the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD). The two studies used different widely used…

Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates.

PubMed

Lipschitz, D S; Winegar, R K; Hartnick, E; Foote, B; Southwick, S M

1999-04-01

To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients. Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression. Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms. In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted.

What is the impact of comorbid depression on adolescent substance abuse treatment?

PubMed

Hersh, Jacqueline; Curry, John F; Kaminer, Yifrah

2014-01-01

Substance use disorders (SUDs) are among the most common psychiatric diagnoses in adolescents. Some research suggests that comorbid depression in adolescents with SUD is associated with increased likelihood of alcohol dependence, poorer social competence, and greater risk for suicide attempts. However, little is known about how depression influences adolescent substance abuse treatment retention and outcomes. This review aimed to summarize the effects of comorbid depression on treatment retention and outcomes across 13 adolescent SUD treatment studies. RESULTS indicated that depression has a mixed relationship with treatment retention and outcomes, exerting a negative, positive, or nonsignificant effect depending on aspects of the study. More research needs to be done, particularly addressing the potential mediators and moderators of the relationship between depression and SUD outcomes. Importantly, recognizing that the studies varied widely in hypotheses and research methods, the field needs to develop more standardized methods to allow for a clearer understanding of the role of comorbid depression.

Comorbidities of rheumatoid arthritis: Results from the Korean National Health and Nutrition Examination Survey.

PubMed

Jeong, Hyemin; Baek, Sun Young; Kim, Seon Woo; Eun, Yeong Hee; Kim, In Young; Kim, Hyungjin; Lee, Jaejoon; Koh, Eun-Mi; Cha, Hoon-Suk

2017-01-01

This study aimed to evaluate the prevalence of comorbidities in patients with rheumatoid arthritis (RA) compared with the non-RA population. The 2010-2012 Korea National Health and Nutrition Examination Survey (KNHANES), which assesses the general health status of populations in South Korea using interviews and basic health assessment, was analyzed retrospectively. Weighted prevalence and odds ratio (OR) of comorbidities were analyzed in patients with RA compared with the non-RA population. The overall weighted (n = 37,453,158) prevalence of RA was 1.5%. Patients with RA were older and more female predominant than subjects without RA. The prevalence of living in an urban area, college graduation, alcohol consumption and smoking was lower in patients with RA than non-RA. Patients with RA had more comorbidities including hypertension, dyslipidemia, myocardial infarction (MI) or angina, stoke, osteoarthritis, lung cancer, colon cancer, pulmonary tuberculosis, asthma, diabetes, depression, thyroid disease and chronic kidney disease. After adjusting socioeconomic and lifestyle characteristics, RA was associated with an increased prevalence of MI or angina (OR 1.86, 95% CI 1.17-2.96, p = 0.009), pulmonary TB (OR 1.95, 95% CI 1.24-3.09, p = 0.004), asthma (OR 1.97, 95% CI 1.05-3.71, p = 0.036), thyroid disease (OR 1.71, 95% CI 1.05-2.77), depression (OR 2.38, 95% CI 1.47-3.85, p < 0.001) and hepatitis B (OR 2.34, 95% CI 1.15-4.80, p = 0.020) compared with the non-RA population. Prevalence of solid cancer was not significantly associated with RA after adjustment.

The prevalence and comorbidity of social anxiety disorder among United States Latinos: a retrospective analysis of data from 2 national surveys.

PubMed

Polo, Antonio J; Alegría, Margarita; Chen, Chih-Nan; Blanco, Carlos

2011-08-01

Social anxiety disorder (SAD) is increasingly being recognized as a prevalent, unremitting, and highly comorbid disorder, yet studies focusing on this disorder among US Latinos and immigrant populations are not available. This article evaluates ethnic differences in the prevalence and comorbidity of SAD as well as the clinical and demographic characteristics associated with SAD. Cultural and contextual factors associated with risk of SAD are also examined within the Latino population more specifically. Data are analyzed from the National Latino and Asian American Study and the National Comorbidity Survey-Replication. Both studies utilized the World Health Organization-Composite International Diagnostic Interview, which estimates the prevalence of lifetime and 12-month psychiatric disorders according to DSM-IV criteria. Latinos reported a lower lifetime and 12-month SAD prevalence and a later age at onset than US-born non-Latino whites. On the other hand, Latinos diagnosed with 12-month SAD reported higher impairment across home, work, and relationship domains than their non-Latino white counterparts. Relative to non-Latino whites, Latinos who entered the United States after the age of 21 years were less likely to have lifetime SAD comorbidity with drug abuse and dependence and more likely to report lifetime SAD comorbidity with agoraphobia. The pattern of risk and associated characteristics of SAD varies for Latinos as compared to non-Latino whites. This is reflected by differences between these 2 groups across SAD prevalence, onset, impairment, and comorbidity. The particularly high comorbidity found with agoraphobia among Latinos who arrive in the United States as adults suggests that cultural factors and timing of immigration play a role in the manifestation and course of anxiety disorders. Interventions designed to decrease the levels of impairment associated with SAD are needed as well as efforts to target Latinos suffering from this disorder, specifically. �

Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

PubMed

Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

2016-02-01

To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

National Health and Nutrition Examination Survey: national youth fitness survey plan, operations, and analysis, 2012.

PubMed

Borrud, Lori; Chiappa, Michele M; Burt, Vicki L; Gahche, Jaime; Zipf, George; Johnson, Clifford L; Dohrmann, Sylvia M

2014-04-01

In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey.

PubMed

Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri

2016-04-01

Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Interpersonal Psychotherapy-Adolescent Skills Training: Anxiety Outcomes and Impact of Comorbidity

ERIC Educational Resources Information Center

Young, Jami F.; Makover, Heather B.; Cohen, Joseph R.; Mufson, Laura; Gallop, Robert J.; Benas, Jessica S.

2012-01-01

Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a…

Ethnic/racial differences in the prevalence of injurious spanking and other child physical abuse in a National Survey of Adolescents.

PubMed

Hawkins, Alesia Oscea; Danielson, Carla Kmett; de Arellano, Michael A; Hanson, Rochelle F; Ruggiero, Kenneth J; Smith, Daniel W; Saunders, Benjamin E; Kilpatrick, Dean G

2010-08-01

Limited research has examined whether similar patterns in injurious spanking and other forms of child physical abuse (CPA) exist across specific ethnic/racial groups. The authors examined and compared differences in the lifetime prevalence of injurious spanking and CPA in two national samples of adolescents across ethnic/racial groups and over time. Participants were 4,023 youth (12-17 years) and 3,614 youth (12-17 years) who participated in the 1995 National Survey of Adolescents (NSA) and 2005 National Survey of Adolescents-Replication (NSA-R), respectively. Adolescents, who were identified through random digit dial procedures, completed a telephone interview assessment. Results indicated significant ethnic/racial variation across groups in reports of injurious spanking in the NSA and the NSA-R samples; however, significant differences were not observed within groups between the two samples over time. Ethnic/racial differences also were found between groups in reports of CPA in the NSA-R sample. Limitations and future directions of this research are discussed.

Association between mental health and comorbid obesity and hypertension among children and adolescents in the US.

PubMed

Tevie, Justin; Shaya, Fadia T

2015-05-01

This paper examines the association between mental health and comorbid obesity and hypertension among US children and adolescents using data from the National Health and Nutritional Examination Survey (NHANES). Questionnaires from NHANES were used to assess mental health during the previous 30 days. Respondents were then categorized into two groups namely "poor mental health" and "good mental health" based on their responses to these survey questions. Three multiple logistic regression models, based on these categories, are estimated to compute the odds ratios and 95% confidence intervals in the association of obesity and hypertension and mental health. As a select example, the results of Model 2 reveal that compared with respondents who are not obese, obese respondents have increased odds (OR = 1.24; P < 0.0001) of poor mental health. Furthermore compared with non-hypertensive respondents, hypertensive respondents have higher odds (OR = 2.96; P < 0.0001) of poor mental health. These findings have important implications for mental health management in younger populations. It brings into focus the maintenance of a healthy body mass index and hypertension control in mitigating poor mental health.

[Symptoms of depression in children and adolescents in relation to psychiatric comorbidities].

PubMed

Baji, Ildikó; Gádoros, Júlia; Kiss, Enikô; Mayer, László; Kovács, Eszter; Benák, István; Vetró, Agnes

2012-01-01

The lifetime prevalence of MDD before adolescence is 4-5%, while the symptoms concern 13-20% of the adolescents. In the development of suicidal behaviour the most important risk factors are the use of psychoactive drugs and smoking. Psychiatric comorbidities are aggravating significantly the major depression. The comorbidities are high among major depression, anxiety and disruptive disorders. We examined 649 children being in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% of them were girls, and 54,1% were boys, the mean age was 11,7 years ( SD=2,00). The participants were enrolled into three groups according to their comorbidities: group with only depression without comorbidities, group with anxiety comorbidity, and group with disruptive comorbidity. We compared the three groups according to the frequency of their depressive symptoms. Anxiety comorbidities increase the incidence of depressive symptoms. Among the criteria symptoms irritability where the most frequent symptom independently from the comorbidities, the depressed mood is the most frequent within the anxiety group, while anhedonia occurred with a moderate frequency in each groups. In the anxiety group the vegetative symptoms, while in the disruptive group the psychomotor agitation and the feeling of worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision making was high in each group, the comorbidities didn't influence it's frequency. Among depressed boys irritability and feelings of worthlessness (low self-esteem) increase the presence of externalisation comorbidity. Among depressed girls guilt was significantly more frequent in the anxiety comorbidity group, and concentration problems are the most typical symptoms in the clear MDD group, without comorbidities.

Psychiatric comorbidities in adolescents with attention-deficit hyperactivity disorder and their siblings.

PubMed

Yang, Li-Kuang; Shang, Chi-Yung; Gau, Susan Shur-Fen

2011-05-01

Despite high psychiatric comorbidities in adolescents with clinical diagnosis of attention-deficit hyperactivity disorder (ADHD), little is known about psychiatric comorbidities in their siblings. We investigated the psychiatric comorbid conditions in adolescents with ADHD, their siblings, and healthy control subjects from their school. The sample included 136 adolescent probands with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria; 136 siblings (47 affected and 89 unaffected) and 136 age- and sex-matched healthy school control subjects. All participants and their parents received the structured psychiatric interviews for current and lifetime DSM-IV psychiatric disorders of the participants. The rate of ADHD (34.6%) in the siblings of probands with ADHD was about 7 times higher than in the general population. Probands with ADHD were significantly more likely than unaffected siblings (OR 6.38; 95% CI 3.43 to 11.88) and healthy school control subjects (OR 9.60; 95% CI 5.31 to 17.34) to have a DSM-IV psychiatric disorder, including oppositional defiant disorder (ODD), conduct disorder (CD), tic disorders, major depressive disorder, specific phobia (more than control subjects only), nicotine use disorder, and sleep disorders. The affected siblings were significantly more likely than healthy school control subjects to have ODD, CD, specific phobia, and to have consumed alcohol (ORs ranging from 2.30 to 20.16). Our findings suggest that siblings of probands with ADHD have increased risks for ADHD and that the affected siblings have more psychiatric comorbidities than healthy school control subjects. It warrants early identification of ADHD symptoms and other psychiatric comorbid conditions as well in siblings of adolescents with ADHD.

Prevalence of DSM-IV Intermittent Explosive Disorder in Black Adolescents: Findings from the National Survey of American Life, Adolescent Supplement

PubMed Central

Oliver, Diane Graves; Caldwell, Cleopatra H.; Faison, Nakesha; Sweetman, Julie; Abelson, Jamie M.; Jackson, James S.

2016-01-01

Little is known about the epidemiology of DSM-IV intermittent explosive disorder (IED) in adolescents and no information is currently available regarding the relationship between race/ethnicity and IED among Black youth in the US. Using the World Health Organization World Mental Health Composite International Diagnostic Interview (Adolescent Version), we estimated the prevalence, severity, and disability of IED in a national, probability sample of African American and Caribbean Black youth (ages 13-17) from the National Survey of American Life, Adolescent Supplement. Face-to-face surveys of 810 African American and 360 Caribbean Black youth were conducted between 2001 and 2003. We calculated lifetime and 12-month diagnoses of IED using diagnostic algorithms based on DSM-IV and assessed IED disability using a modified Sheehan Disability Scale. Overall findings indicated lifetime and 12-month IED prevalence rates of 9.2% and 7.0%, respectively. Lifetime prevalence rates of IED were 9.0 % for African American and 12.4% for Caribbean Black teens. Within the past 12 months 6.7% of African American and 11.5% of Caribbean Black adolescents met diagnostic criteria for IED. Lifetime and 12-month IED were associated with anxiety disorders. In addition, few teens with lifetime IED received any treatment. Findings are consistent with recent evidence that intermittent explosive disorder may be more common than previously considered, especially among adolescents. Significant acts of aggression and impairment are associated with IED and low treatment rates indicate that more research on this disorder and intervention options is warranted. PMID:27078052

Associations between motor vehicle crashes and mental health problems: data from the National Survey of Adolescents-Replication.

PubMed

Williams, Joah L; Rheingold, Alyssa A; Knowlton, Alice W; Saunders, Benjamin E; Kilpatrick, Dean G

2015-02-01

Motor vehicle crashes (MVCs) are a leading cause of physical injuries and mortality among children and adolescents in the United States. The purpose of this study was to examine associations between having an MVC and mental health outcomes, including posttraumatic stress disorder (PTSD), depression, and drug and alcohol misuse in a nationally representative sample of adolescents. A sample of 3,604 adolescents, aged 12-17 years, was assessed as part of the 2005 National Survey of Adolescents-Replication (NSA-R) study. Data were weighted according to the 2005 U.S. Census estimates. Within this sample, 10.2% of adolescents reported having at least 1 serious MVC. The prevalence of current PTSD and depression among adolescents having an MVC was 7.4% and 11.2%, respectively. Analyses revealed that an MVC among adolescents aged 15 years and younger was independently associated with depression (OR = 2.17) and alcohol abuse (OR = 2.36) after adjusting for other risk factors, including a history of interpersonal violence. Among adolescents aged 16 years and older, an MVC was associated only with alcohol abuse (OR = 2.08). This study was the first attempt to explore adverse mental health outcomes associated with MVCs beyond traumatic stress symptoms among adolescents in a nationally representative sample. Copyright © 2015 International Society for Traumatic Stress Studies.

The prevalence of COPD co-morbidities in Serbia: results of a national survey

PubMed Central

Nagorni-Obradovic, Ljudmila M; Vukovic, Dejana S

2014-01-01

Background: Research studies have found different prevalence rates for co-morbidities in patients with chronic obstructive pulmonary disease (COPD). Aims: The aim of our study was to investigate the prevalence of co-morbidities as well as functional limitations in subjects with COPD. Methods: The study was based on a nationally representative sample of the population of Serbia. Information on the health of the population was obtained from interviews and anthropometric measurements. In this study we analysed a total of 10,013 respondents aged 40 years or older. There were 653 subjects with COPD and 9,360 respondents without COPD. Results: Out of the 10,013 respondents, 5,377 were aged 40–59 years and 4,636 were 60 years or older. The prevalence of COPD was 5.0% in respondents aged 40–59 years and 8.3% in those aged 60 years or older; the total prevalence was 6.5%. The most prevalent co-morbidities among respondents with COPD were hypertension (54.5%) and dyslipidaemia (26.5%). The prevalence of all analysed co-morbidities was higher in respondents with COPD and the difference was highly statistically significant, except for stroke and malignancies, for which the difference was significant. Analysis showed that respondents with COPD had a higher prevalence of all analysed clinical factors (dizziness, obesity, anaemia and frailty) and functional impairments (mobility and hearing and visual impairment) compared with respondents without COPD. For those aged 40–59 years the difference was highest for mobility difficulty (four times higher prevalence in COPD patients) and anaemia (three times higher in COPD patients). Conclusion: Our analysis showed that the most prevalent co-morbidities in COPD were hypertension, dyslipidaemia, chronic renal disease and anxiety/depression. The finding suggests that health professionals should actively assess co-morbidities in patients with COPD. PMID:24921714

Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache.

PubMed

Wang, Shuu-Jiun; Juang, Kai-Dih; Fuh, Jong-Ling; Lu, Shiang-Ru

2007-05-01

To investigate the prevalence and correlates of comorbid psychiatric disorders and suicidal risk in community-based adolescents with chronic daily headache (CDH). We identified and recruited 122 adolescents with CDH from a non-referral student sample (n = 7,900). CDH subtypes were classified according to the most updated criteria of the International Classification of Headache Disorders, 2nd edition (ICHD-2). An in-person psychiatric interview was performed with each subject with CDH to assess depressive and anxiety disorders and suicidal risk based on the Mini-International Neuropsychiatric Interview-Kid (MINI-Kid). Clinical correlates and impacts were investigated. A total of 121 subjects (31 male/90 female, mean age 13.8 years) finished the psychiatric interview. Fifty-seven subjects (47%) had > or =1 assessed psychiatric comorbidity with major depression (21%) and panic disorder (19%) as the two most common diagnoses. Current suicidal risk was assessed as high (score > or = 10) in 20% of subjects. Female gender and older age were associated with depressive disorders. Presence of migraine was associated with psychiatric comorbidities (OR = 3.5, p = 0.002). The associations with psychiatric disorders were stronger for migraine with aura than for migraine without aura. Migraine with aura also independently predicted a high suicidal risk (score > or = 10) (adjusted OR = 6.0, p = 0.028). In contrast, CDH subtypes, headache frequencies, or medication overuse were not correlated. Comorbid psychiatric disorders were not related to physician consultations or more days of sick leave. This community-based study showed high comorbidity of psychiatric disorders and suicidal risk in adolescents with chronic daily headache. The presence of migraine attacks, especially migraine with aura, was the major predictor for these associations.

Parental bonding and adult psychopathology: results from the US National Comorbidity Survey.

PubMed

Enns, M W; Cox, B J; Clara, I

2002-08-01

Research using the parental bonding instrument (PBI) has suggested that lack of parental care and/or overprotection may be important risk factors for adult mental disorders. Much of this research, however, has relied on clinical populations with one or two disorders, or has used highly select community samples. The association between parenting experiences and the occurrence of 13 common mental disorders in adulthood was evaluated in the US National Comorbidity Survey (N = 5877). The effect of sociodemographic variables (age, education, income) was statistically controlled and the effects of six parenting variables (maternal and paternal care, overprotection and authoritarianism) were examined simultaneously. The effects in men and women were examined separately. Lack of care was the parenting variable most consistently associated with adult psychopathology. Parenting experiences with one's mother were more consistently associated with adult mental disorders. In general the impact of parenting was diagnostically non-specific. However, there appeared to be some unique effects for externalizing disorders (substance use disorders and antisocial personality disorder) in males; paternal overprotection and authoritarianism conferred a reduced risk of externalizing disorders in adult males. The overall impact of parenting as assessed by the PBI was modest, accounting for about 1 to 5 % of the variance in the occurrence of adult mental disorders. Parenting experiences, particularly lack of care, are potentially causally related in a non-specific manner to a wide variety of forms of adult psychopathology in both men and women. The overall magnitude of the effect is small but statistically significant in a nationally representative US sample.

Use of licit and illicit substances among adolescents in Brazil--a national survey.

PubMed

Madruga, Clarice S; Laranjeira, Ronaldo; Caetano, Raul; Pinsky, Ilana; Zaleski, Marcos; Ferri, Cleusa P

2012-10-01

We estimate the prevalence of alcohol, tobacco and illegal substance use in a national representative sample of adolescents. We also estimate how socio demographic characteristics, household environment and mental health are associated with substance misuse. This is a cross-sectional study using data from the first Brazilian National Alcohol Survey, which gathered information on the use of psychoactive substances in 761 participants aged 14 to 19 years old. Weighted logistic regression was used to calculate adjusted odds ratios. More than half of the adolescents interviewed were regular alcohol users and one out of ten were abusers and/or dependents. Older male adolescents living in urban areas were more likely to present alcohol related disorders and to smoke. Age had an inverse association with illegal substance use. Smokers and those using illegal substances were more likely to report domestic violence while those with alcohol abuse/dependence were more likely to have depression. The high prevalence of alcohol, tobacco and illicit substance consumption among Brazilian adolescents is staggering. Young males with mood disorders from urban areas are more at risk of developing alcohol disorders while illegal drug use is highly associated to household dysfunction in early life. Brazilian growing economy will possibly lead to increased levels of substance use among adolescents if new prevention measures are not implemented. The intensification of law enforcement strategies to reduce psychotropic substances access is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

Generalizability of Clinical Trial Results for Adolescent Major Depressive Disorder.

PubMed

Blanco, Carlos; Hoertel, Nicolas; Franco, Silvia; Olfson, Mark; He, Jian-Ping; López, Saioa; González-Pinto, Ana; Limosin, Frédéric; Merikangas, Kathleen R

2017-12-01

Although there have been a number of clinical trials evaluating treatments for adolescents with major depressive disorder (MDD), the generalizability of those trials to samples of depressed adolescents who present for routine clinical care is unknown. Examining the generalizability of clinical trials of pharmacological and psychotherapy interventions for adolescent depression can help administrators and frontline practitioners determine the relevance of these studies for their patients and may also guide eligibility criteria for future clinical trials in this clinical population. Data on nationally representative adolescents were derived from the National Comorbidity Survey: Adolescent Supplement. To assess the generalizability of adolescent clinical trials for MDD, we applied a standard set of eligibility criteria representative of clinical trials to all adolescents in the National Comorbidity Survey: Adolescent Supplement with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of MDD ( N = 592). From the overall MDD sample, 61.9% would have been excluded from a typical pharmacological trial, whereas 42.2% would have been excluded from a psychotherapy trial. Among those who sought treatment ( n = 412), the corresponding exclusion rates were 72.7% for a pharmacological trial and 52.2% for a psychotherapy trial. The criterion leading to the largest number of exclusions was "significant risk of suicide" in both pharmacological and psychotherapy trials. Pharmacological and, to a lesser extent, psychotherapy clinical trials likely exclude most adolescents with MDD. Careful consideration should be given to balancing eligibility criteria and internal validity with applicability in routine clinical care while ensuring patient safety. Copyright © 2017 by the American Academy of Pediatrics.

12-Month and Lifetime Prevalence of Suicide Attempts among Black Adolescents in the National Survey of American Life

ERIC Educational Resources Information Center

Joe, Sean; Baser, Raymond S.; Neighbors, Harold W.; Caldwell, Cleopatra H.; Jackson, James S.

2009-01-01

The data from the National Survey of American life on the suicidal behavior of 1,170 African American and Caribbean black adolescents aged 13 to 17 shows that black adolescents report having a lifetime prevalence of 7.5 percent for suicidal ideation and 2.7 percent for attempts. The 12-month prevalence of suicidal ideation is 3.2 percent and…

Sexual behavior among adolescents reporting chronic conditions: a French national survey.

PubMed

Choquet, M; Du Pasquier Fediaevsky, L; Manfredi, R

1997-01-01

To compare sexual behavior in adolescents with a physical handicap or a chronic illness (HCI, n = 604) to a healthy group (HG, n = 7,332). Data drawn from a French national health survey carried out among 7,936 adolescents (mean age = 16.2 years) were used. A self-report questionnaire concerning health behavior, sexual behavior, and chronic illness was used in 136 public secondary schools. HCI and HG groups were compared on reported sexual behavior as well as on information (on sexuality, AIDS, and pregnancy) given by the parents. Logistic regression was performed for boys and girls to explore the relationship of health status (HCI or HG) to sexual intercourse, adjusted for sociodemographic variables. Fifty-two percent of HCI boys and 38% of HCI girls reported sexual intercourse (vs. 42% of HG boys and 28% of HG girls). The HCI girls reported more often than HG girls changing partners, pregnancy, and use of oral contraceptives. The HCI boys reported more often than HG boys receiving information on sexuality from their parents. French HCI adolescents were found to be at high risk for pregnancy and sexually transmitted diseases (STD).

A longitudinal investigation of the role of self-medication in the development of comorbid mood and drug use disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

PubMed

Lazareck, Samuel; Robinson, Jennifer A; Crum, Rosa M; Mojtabai, Ramin; Sareen, Jitender; Bolton, James M

2012-05-01

To examine whether self-medication with drugs confers risk of comorbid mood and drug use disorders. A longitudinal, nationally representative survey was conducted by the National Institute on Alcohol Abuse and Alcoholism. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) assessed DSM-IV-TR psychiatric disorders, self-medication, and sociodemographic variables at 2 time points. A total of 34,653 adult, US participants completed both waves of the survey. Wave 1 was conducted between 2001 and 2002, and Wave 2 interviews took place 3 years later (2004-2005). Logistic regression and population attributable fractions were calculated to obtain estimates of the association between self-medication and incident disorders. Logistic regression analyses revealed that self-medication with drugs conferred a heightened risk of new-onset drug dependence among those with baseline mood disorders (adjusted odds ratio [AOR] = 7.65; 95% CI, 3.70-15.82; P < .001) and accounted for over 25% of incident drug dependence disorders among people with mood disorders. Among those with comorbid mood and drug use disorders at baseline, self-medication with drugs was associated with the persistence of drug abuse (AOR = 2.47; 95% CI, 1.34-4.56; P < .01), accounting for over one-fifth of the persistence of drug use disorders at 3-year follow-up. Self-medication with drugs among individuals with mood disorders confers substantial risk of developing incident drug dependence and is associated with the persistence of comorbid mood and drug use disorders. These results clarify a pathway that may lead to the development of mood and drug use disorder comorbidity and indicate an at-risk population, with potential points of intervention for prevention of comorbidity. © Copyright 2012 Physicians Postgraduate Press, Inc.

Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study.

PubMed

Chen, Mu-Hong; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

2015-05-01

Previous studies have found that attention-deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with an increased risk of major depression and bipolar disorder in later life. However, the effect of ADHD comorbidity on the diagnostic conversion to bipolar disorder among patients with major depression is still uncertain. Using the Taiwan National Health Insurance Research Database, 58,023 subjects < 30 years of age who had major depression with (n = 1,193) or without (n = 56,830) ADHD comorbidity between the years 2000 and 2008 were enrolled in our study. Subjects who developed bipolar disorder during the follow-up to the end of 2011 were identified. Adolescents and young adults who had major depression with ADHD comorbidity had an increased incidence of subsequent bipolar disorder (18.9% versus 11.2%, p < 0.001) compared to those without ADHD. Cox regression analysis showed that ADHD comorbidity was an independent risk factor (hazard ratio = 1.50, 95% confidence interval 1.30-1.72) predicting subsequent bipolar disorder among those with major depression, adjusting for demographic data and psychiatric comorbidities. Patients with comorbid diagnoses of major depression and ADHD had an increased risk of diagnostic conversion to bipolar disorder compared to those who had major depression alone. Further studies would be required to validate this finding and to investigate the possible underlying mechanisms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comorbidity of Social Anxiety Disorder and Antisocial Personality Disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC)

PubMed Central

Galbraith, Todd; Heimberg, Richard G.; Wang, Shuai; Schneier, Franklin R.; Blanco, Carlos

2013-01-01

Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: 1) SAD and ASPD represent opposite ends of a single dimension, or 2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any “protective benefits.” SAD and ASPD appear to be two separate but correlated disorders. PMID:24384071

Comorbidity of social anxiety disorder and antisocial personality disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC).

PubMed

Galbraith, Todd; Heimberg, Richard G; Wang, Shuai; Schneier, Franklin R; Blanco, Carlos

2014-01-01

Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: (1) SAD and ASPD represent opposite ends of a single dimension, or (2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any "protective benefits." SAD and ASPD appear to be two separate but correlated disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use.

PubMed

Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

2009-01-01

Few studies have investigated the epidemiology of social phobia (SP) among early to middle adolescents, at the time of suggested mean onset of the disorder. The objective of this study was to investigate the prevalence, comorbidity, individual and familial correlates, and service use associated with SP among Finnish 12-17-year-old adolescents in general population. A sample of 784 adolescents was screened with the Social Phobia Inventory, and a sub-sample (n=350) was interviewed with a semi-structured clinical interview to identify SP, sub-clinical SP (SSP), and a range of other axis I DSM-IV disorders. Individual and familial correlates, and service use associated with SP were also inquired. We found a 12-month prevalence of 3.2% for SP, and 4.6% for SSP. The prevalence rose and the gender ratio shifted to female preponderance as age increased. SP was frequently comorbid with other anxiety disorders (41%) and depressive disorders (41%). Adolescents with SP/SSP were impaired in their academic and global functioning, and reported more parental psychiatric treatment contacts. Two thirds (68%) of adolescents with SP reported having been bullied by peers. Only one fifth of adolescents with non-comorbid SP had been in contact with a mental health professional. We conclude that adolescent SP is a relatively frequent, undertreated and highly comorbid condition, associated with educational impairment, depression and anxiety in parents, and peer victimization. (c) 2009 Wiley-Liss, Inc.

Comorbid Visual and Psychiatric Disabilities Among the Chinese Elderly: A National Population-Based Survey.

PubMed

Guo, Chao; Wang, Zhenjie; Li, Ning; Chen, Gong; Zheng, Xiaoying

2017-12-01

To estimate the prevalence of, and association between, co-morbid visual and psychiatric disabilities among elderly (>65 years-of-age) persons in China. Random representative samples were obtained using multistage, stratified, cluster sampling, with probabilities proportional to size. Standard weighting procedures were used to construct sample weights that reflected this multistage, stratified cluster sampling survey scheme. Logistic regression models were used to elucidate associations between visual and psychiatric disabilities. Among the Chinese elderly, >160,000 persons have co-morbid visual and psychiatric disabilities. The weighted prevalence among this cohort is 123.7 per 100,000 persons. A higher prevalence of co-morbid visual and psychiatric disabilities was found in the oldest-old (p<0.001); women (65-79 years-of-age, p=0.001; ≥80 years-of-age, p=0.004); illiterate (65-79 years-of-age, p<0.001; ≥80 years-of-age, p=0.02); and single elders (65-79 years-of-age, p=0.01; ≥80 years-of-age, p=0.001). Presence of a visual disability was significantly associated with a higher risk of having a psychiatric disability among persons aged ≥80 years-of-age [adjusted odds ratio, 1.24; 95% confidence interval (CI), 1.03-1.54]. A significant number of Chinese elderly persons were living with co-morbid visual and psychiatric disabilities. To address the challenge of these co-morbid disorders among Chinese elders, it is incumbent upon the government to implement additional and more comprehensive prevention and rehabilitation strategies for health-care systems, reinforce health promotion among the elderly, and improve accessibility to health-care services.

Anxiety disorders moderate the association between externalizing problems and substance use disorders: data from the National Comorbidity Survey-Revised.

PubMed

Hofmann, Stefan G; Richey, J Anthony; Kashdan, Todd B; McKnight, Patrick E

2009-05-01

Anxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6-8.1), alcohol dependence (OR: 7.6, CI: 5.9-9.6), substance abuse (OR: 9.9, CI: 8.1-12.2), and substance dependence (OR: 13.1, CI: 9.6-17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4-15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors.

Addictive Internet Use among Korean Adolescents: A National Survey

PubMed Central

Heo, Jongho; Oh, Juhwan; Subramanian, S. V.; Kim, Yoon; Kawachi, Ichiro

2014-01-01

Background A psychological disorder called ‘Internet addiction’ has newly emerged along with a dramatic increase of worldwide Internet use. However, few studies have used population-level samples nor taken into account contextual factors on Internet addiction. Methods and Findings We identified 57,857 middle and high school students (13–18 year olds) from a Korean nationally representative survey, which was surveyed in 2009. To identify associated factors with addictive Internet use, two-level multilevel regression models were fitted with individual-level responses (1st level) nested within schools (2nd level) to estimate associations of individual and school characteristics simultaneously. Gender differences of addictive Internet use were estimated with the regression model stratified by gender. Significant associations were found between addictive Internet use and school grade, parental education, alcohol use, tobacco use, and substance use. Female students in girls' schools were more likely to use Internet addictively than those in coeducational schools. Our results also revealed significant gender differences of addictive Internet use in its associated individual- and school-level factors. Conclusions Our results suggest that multilevel risk factors along with gender differences should be considered to protect adolescents from addictive Internet use. PMID:24505318

Addictive internet use among Korean adolescents: a national survey.

PubMed

Heo, Jongho; Oh, Juhwan; Subramanian, S V; Kim, Yoon; Kawachi, Ichiro

2014-01-01

A psychological disorder called 'Internet addiction' has newly emerged along with a dramatic increase of worldwide Internet use. However, few studies have used population-level samples nor taken into account contextual factors on Internet addiction. We identified 57,857 middle and high school students (13-18 year olds) from a Korean nationally representative survey, which was surveyed in 2009. To identify associated factors with addictive Internet use, two-level multilevel regression models were fitted with individual-level responses (1st level) nested within schools (2nd level) to estimate associations of individual and school characteristics simultaneously. Gender differences of addictive Internet use were estimated with the regression model stratified by gender. Significant associations were found between addictive Internet use and school grade, parental education, alcohol use, tobacco use, and substance use. Female students in girls' schools were more likely to use Internet addictively than those in coeducational schools. Our results also revealed significant gender differences of addictive Internet use in its associated individual- and school-level factors. Our results suggest that multilevel risk factors along with gender differences should be considered to protect adolescents from addictive Internet use.

The child and adolescent trichotillomania impact project: descriptive psychopathology, comorbidity, functional impairment, and treatment utilization.

PubMed

Franklin, Martin E; Flessner, Christopher A; Woods, Douglas W; Keuthen, Nancy J; Piacentini, John C; Moore, Phoebe; Stein, Dan J; Cohen, Sara B; Wilson, Michelle A

2008-12-01

Trichotillomania (TTM) is associated with significant morbidity, comorbidity, and functional impairment in adults. Despite the fact that TTM is typically a pediatric onset disorder, important questions remain about its phenomenology, comorbid symptoms, functional impact, and treatment utilization in youth. The current study was designed to provide an initial description of these factors using a convenience sample. An internet-based survey. Surveys completed by 133 youth ages 10 to 17 were analyzed. Scalp hair was the most common pulling site, followed by eyelashes and eyebrows. The majority reported tension before pulling and gratification/relief immediately after pulling. Severity of anxiety and depressive symptoms were somewhat elevated, as measured by standard instruments, and correlated positively with the severity of TTM symptoms. Moderate impairment in social and academic functioning was reported. For those who had received treatment specifically for TTM, parent ratings indicated that few (17%) children and adolescents were either very much improved or much improved after intervention. This study represents the largest survey of youth with TTM conducted thus far, and thus provides the most comprehensive description of TTM in youth to date. Data was obtained from an anonymous, Internet-based sample, and thus may not be generalizable to all youth with TTM.

Self- Reported Comorbid Pains in Severe Headaches or Migraines in a US National Sample

PubMed Central

Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2012-01-01

Aims To compare prevalence of self-reported comorbid temporomandibular joint muscle disorder (TMJMD)-type, neck, back and joint pains in people with severe headache or migraine; analyze these self-reported pains in the 2000–2005 US National Health Interview Survey (NHIS) by gender and age for Non-Hispanic Whites, Hispanics and Non-Hispanic Blacks (African Americans). Methods NHIS data included information on gender, age, race, ethnicity, health status, and common pain types: severe headache or migraine, TMJMD-type, neck, and low back in the last 3 months, as well as prior month joint pains. Analyses included survey prevalence estimation and survey logistic regression to obtain odds ratios and 95% confidence intervals. Results 189,967 adults, 48% males, 52% females; 73% White, 12% Hispanic, and 11% Black were included. 29,712 (15%) of the entire sample reported severe headache or migraine, 19,228 (64%) had severe headache or migraine with at least one comorbid pain. 10,200 (33%) reported 2 or more comorbid pains, with no gender difference, and with Hispanics (n=1,847 or 32%) and Blacks (n=1,301 or 30%) less likely to report 2 or more comorbid pains than Whites (n=6,747 or 34%) (OR=0.91, p=0.032; OR=0.82, p<0.001, respectively). This group also reported significantly lower ratings of self-rated health (p<0.001). Differences in type of comorbid pain by age patterns were found. Conclusions Severe headache or migraine is often associated with other common pains, seldom existing alone. Two or more comorbid pains are common, similarly affecting gender and racial/ethnic groups. PMID:22553936

National Adolescent Student Health Survey.

ERIC Educational Resources Information Center

Health Education (Washington D.C.), 1988

1988-01-01

Results are reported from a national survey of teenaged youth on their attitudes toward a variety of health related issues. Topics covered were Acquired Immune Deficiency Syndrome; sexually transmitted diseases, violence, suicide, injury prevention, drug abuse, nutrition, and consumer education. (JD)

Psychiatric Comorbidity in Adolescents and Young Adults with Autism

ERIC Educational Resources Information Center

Moseley, David S.; Tonge, Bruce J.; Brereton, Avril V.; Einfeld, Stewart L.

2011-01-01

This article reports the findings of a study investigating rates and types of comorbid mental disorder evident in adolescents and young adults with autism. A sample of 84 young people (M = 19.5 years, SD = 4.6) with "Diagnostic and Statistical Manual of Mental Disorders," 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric…

Association of physical activity and sedentary lifestyle patterns with obesity and cardiometabolic comorbidities in Greek adults: data from the National Epidemiological Survey.

PubMed

Hassapidou, Maria; Papadopoulou, Sousana K; Vlahavas, George; Kapantais, Efthymios; Kaklamanou, Daphne; Pagkalos, Ioannis; Kaklamanou, Myrto; Tzotzas, Themistoklis

2013-01-01

To investigate the association between physical activity (PA) and sedentary lifestyle (SL) patterns with overweight (OW), obesity (OB), abdominal obesity (AO) and cardiometabolic comorbidities in Greek adults based on data from the National Epidemiological Survey for the prevalence of obesity. Cross-sectional epidemiological survey. Participants were selected via stratified sampling. 17,887 men and women, 20-70 years old, underwent anthropometric measurements for the estimation of OW, OB and AO prevalence. Assessment of PA, SL patterns and metabolic comorbidities was performed using an in-home questionnaire allowing self-evaluation of diverse activities and self-report for the presence of hypercholesterolemia (HCE), type 2 diabetes mellitus (T2DM) or hypertension (HTN). In men, even small amounts of walking were associated with decreased risk of being OW and AO, while larger amounts were associated with decreased risk of being OB. In women, engagement in entertainment activities for more than 4 hours per week was associated with less risk of being OW. Concerning cardiometabolic comorbidities, substantial improvement was evident mainly for men, e.g. signfiicantly reduced risk for HCE, T2DM and HTN by frequent engagement in exercise. On the other hand, frequent TV watching and long hours of office work significantly increased the risk of HCE and HTN in men. In Greek adults, and men in particular, walking activity was significantly associated with lower risk for obesity. In addition, frequent exercise and less sedentary behaviour were associated with reduced risk for cardiometabolic factors, mainly hypercholesterolemia and hypertension.

Catatonic features in adolescents with schizophrenia with and without a comorbid pervasive developmental disorder.

PubMed

Waris, Petra; Lindberg, Nina; Kettunen, Kirsi; Lipsanen, Jari; Tani, Pekka

2014-01-01

Catatonia has been associated with both schizophrenia and pervasive developmental disorders. The aim of this study was to evaluate catatonic features among adolescents suffering from schizophrenia. Further, we compared these features between adolescents with a comorbid pervasive developmental disorder and those without one. Finally, we wanted to compare the profile of catatonia-like features of our schizophrenia patients to that described earlier among persons with autism spectrum disorders. The study comprised a consecutive sample of 18 adolescents with schizophrenia (mean age 15.6 years, SD 1.4) and their families. Diagnosis of schizophrenia was assessed with the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Life-Time (K-SADS-PL) for the DSM-IV. The Diagnostic Interview for Social and Communication Disorders version 11 was used to assess catatonic features. All adolescents with schizophrenia had showed some lifetime catatonic features. Approximately 78% of them had already expressed these features before the age of 10. The number of catatonic features before the age of 10 was significantly higher among the adolescents with a comorbid pervasive developmental disorder compared to those without one. The numbers of catatonic features after the age of 10 did not significantly differ between the two groups. Over three-quarters of schizophrenia patients shared four lifetime catatonic features: "lacks facial expression", "odd intonation", "poor eye contact" and "lack of cooperation". Adolescent schizophrenia patients with a comorbid pervasive developmental disorder show many catatonic features in childhood whereas those without one seem to develop these features first in adolescence. Catatonic features exhibited by adolescents with schizophrenia resemble those described among persons with pervasive developmental disorders without schizophrenia.

Risk factors for the incidence and persistence of suicide-related outcomes: A 10-year follow-up study using the National Comorbidity Surveys

PubMed Central

Borges, Guilherme; Angst, Jules; Nock, Matthew K.; Ruscio, Ayelet Meron; Kessler, Ronald C.

2008-01-01

Background We report prospective associations of baseline risk factors with the first onset and persistence of suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) over a 10-year interval among respondents who participated in both the 1990−02 National Comorbidity Survey (NCS) and the 2000−02 National Comorbidity Survey follow-up (NCS-2). Methods A total of 5001 NCS respondents were re-interviewed (87.6% of baseline sample) in the NCS-2. Three sets of baseline (NCS) risk factors were considered as predictors of the first onset and persistence of SROs: socio-demographics, lifetime DSM-III-R disorders, and SROs. Results New onsets included 6.2% suicide ideation, 2.3% plan, 0.7% gesture, and 0.9% attempts. More than one-third of respondents with a baseline history of suicide ideation continued to have suicide ideation at some time over the intervening decade. Persistence was lower for other SROs. The strongest predictors of later SROs were baseline SROs. Prospective associations of baseline mental disorders with later SROs were largely limited to the onset and persistence of ideation. Limitations Although data were gathered prospectively, they were based on retrospective reports at both baseline and follow-up. Conclusions Baseline history of SROs explained much of the association of mental disorders with later SROs. It is important clinically to note that many of the risk factors known to predict onset of SROs also predict persistence of SROs. PMID:17507099

Clinical features and axis I comorbidity of Australian adolescent pathological Internet and video game users.

PubMed

King, Daniel L; Delfabbro, Paul H; Zwaans, Tara; Kaptsis, Dean

2013-11-01

Although there is growing international recognition of pathological technology use (PTU) in adolescence, there has been a paucity of empirical research conducted in Australia. This study was designed to assess the clinical features of pathological video gaming (PVG) and pathological Internet use (PIU) in a normative Australian adolescent population. A secondary objective was to investigate the axis I comorbidities associated with PIU and video gaming. A total of 1287 South Australian secondary school students aged 12-18 years were recruited. Participants were assessed using the PTU checklist, Revised Children's Anxiety and Depression Scale, Social Anxiety Scale for Adolescents, revised UCLA Loneliness Scale, and Teenage Inventory of Social Skills. Adolescents who met the criteria for PVG or PIU or both were compared to normal adolescents in terms of axis I comorbidity. The prevalence rates of PIU and PVG were 6.4% and 1.8%, respectively. A subgroup with co-occurring PIU and PVG was identified (3.3%). The most distinguishing clinical features of PTU were withdrawal, tolerance, lies and secrecy, and conflict. Symptoms of preoccupation, inability to self-limit, and using technology as an escape were commonly reported by adolescents without PTU, and therefore may be less useful as clinical indicators. Depression, panic disorder, and separation anxiety were most prevalent among adolescents with PIU. PTU among Australian adolescents remains an issue warranting clinical concern. These results suggest an emerging trend towards the greater uptake and use of the Internet among female adolescents, with associated PIU. Although there exists an overlap of PTU disorders, adolescents with PIU appear to be at greater risk of axis I comorbidity than adolescents with PVG alone. Further research with an emphasis on validation techniques, such as verified identification of harm, may enable an informed consensus on the definition and diagnosis of PTU.

Sleep problems predict comorbid externalizing behaviors and depression in young adolescents with attention-deficit/hyperactivity disorder.

PubMed

Becker, Stephen P; Langberg, Joshua M; Evans, Steven W

2015-08-01

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) experience high rates of sleep problems and are also at increased risk for experiencing comorbid mental health problems. This study provides an initial examination of the 1-year prospective association between sleep problems and comorbid symptoms in youth diagnosed with ADHD. Participants were 81 young adolescents (75 % male) carefully diagnosed with ADHD and their parents. Parents completed measures of their child's sleep problems and ADHD symptoms, oppositional defiant disorder (ODD) symptoms, and general externalizing behavior problems at baseline (M age = 12.2) and externalizing behaviors were assessed again 1 year later. Adolescents completed measures of anxiety and depression at both time-points. Medication use was not associated with sleep problems or comorbid psychopathology symptoms. Regression analyses indicated that, above and beyond demographic characteristics, ADHD symptom severity, and initial levels of comorbidity, sleep problems significantly predicted greater ODD symptoms, general externalizing behavior problems, and depressive symptoms 1 year later. Sleep problems were not concurrently or prospectively associated with anxiety. Although this study precludes making causal inferences, it does nonetheless provide initial evidence of sleep problems predicting later comorbid externalizing behaviors and depression symptoms in youth with ADHD. Additional research is needed with larger samples and multiple time-points to further examine the interrelations of sleep problems and comorbidity.

Diagnostic Profiles among Urban Adolescents with Unmet Treatment Needs: Comorbidity and Perceived Need for Treatment

ERIC Educational Resources Information Center

Hogue, Aaron; Dauber, Sarah

2013-01-01

The goal of this study was to document comorbidity profiles of psychiatric disorder and perceived need for treatment among urban adolescents with unmet behavioral health needs. Participants were 303 community-referred adolescents and their primary caregivers. Adolescents included both boys (54%) and girls and were primarily Hispanic (58%), African…

Catatonic features in adolescents with schizophrenia with and without a comorbid pervasive developmental disorder

PubMed Central

2014-01-01

Background Catatonia has been associated with both schizophrenia and pervasive developmental disorders. The aim of this study was to evaluate catatonic features among adolescents suffering from schizophrenia. Further, we compared these features between adolescents with a comorbid pervasive developmental disorder and those without one. Finally, we wanted to compare the profile of catatonia-like features of our schizophrenia patients to that described earlier among persons with autism spectrum disorders. Methods The study comprised a consecutive sample of 18 adolescents with schizophrenia (mean age 15.6 years, SD 1.4) and their families. Diagnosis of schizophrenia was assessed with the Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Present and Life-Time (K-SADS-PL) for the DSM-IV. The Diagnostic Interview for Social and Communication Disorders version 11 was used to assess catatonic features. Results All adolescents with schizophrenia had showed some lifetime catatonic features. Approximately 78% of them had already expressed these features before the age of 10. The number of catatonic features before the age of 10 was significantly higher among the adolescents with a comorbid pervasive developmental disorder compared to those without one. The numbers of catatonic features after the age of 10 did not significantly differ between the two groups. Over three-quarters of schizophrenia patients shared four lifetime catatonic features: “lacks facial expression”, “odd intonation”, “poor eye contact” and “lack of cooperation”. Conclusions Adolescent schizophrenia patients with a comorbid pervasive developmental disorder show many catatonic features in childhood whereas those without one seem to develop these features first in adolescence. Catatonic features exhibited by adolescents with schizophrenia resemble those described among persons with pervasive developmental disorders without schizophrenia. PMID:24914405

Has Adolescent Suicidality Decreased in the United States? Data From Two National Samples of Adolescents Interviewed in 1995 and 2005

PubMed Central

Wolitzky-Taylor, Kate B.; Ruggiero, Kenneth J.; McCart, Michael R.; Smith, Daniel W.; Hanson, Rochelle F.; Resnick, Heidi S.; de Arellano, Michael A.; Saunders, Benjamin E.; Kilpatrick, Dean G.

2011-01-01

We compared the prevalence and correlates of adolescent suicidal ideation and attempts in two nationally representative probability samples of adolescents interviewed in 1995 (National Survey of Adolescents; N =4,023) and 2005 (National Survey of Adolescents-Replication; N =3,614). Participants in both samples completed a telephone survey that assessed major depressive episode (MDE), post-traumatic stress disorder, suicidal ideation and attempts, violence exposure, and substance use. Results demonstrated that the lifetime prevalence of suicidal ideation among adolescents was lower in 2005 than 1995, whereas the prevalence of suicide attempts remained stable. MDE was the strongest predictor of suicidality in both samples. In addition, several demographic, substance use, and violence exposure variables were significantly associated with increased risk of suicidal ideation and attempts in both samples, with female gender, nonexperimental drug use, and direct violence exposure being consistent risk factors in both samples. PMID:20390799

Insomnia, Comorbidity, and Risk of Injury Among Insured Americans: Results from the America Insomnia Survey

PubMed Central

Kessler, Ronald C.; Berglund, Patricia A.; Coulouvrat, Catherine; Fitzgerald, Timothy; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C.; Stephenson, Judith J.; Walsh, James K.

2012-01-01

Study Objectives: To estimate associations of broadly defined insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace injuries controlling for comorbid conditions among workers in the America Insomnia Survey (AIS). Design/Setting: Cross-sectional telephone survey. Participants: National sample of 4,991 employed health plan subscribers (age 18 yr and older). Interventions: None. Measurements and Results: Broadly defined insomnia with duration of at least 12 mo was assessed with the Brief Insomnia Questionnaire (BIQ). Injuries in the 12 mo before interview were assessed with a standard self-report measure of injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports. Insomnia had significant gross associations (odds ratios, ORs) with both workplace and nonworkplace injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total injuries with insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of insomnia. The associations of insomnia with injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically, insomnia was significantly associated with workplace and nonworkplace injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace injuries

Sex differences in prevalence and comorbidity of alcohol and drug use disorders: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Goldstein, Risë B; Dawson, Deborah A; Chou, S Patricia; Grant, Bridget F

2012-11-01

The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms.

A network perspective on comorbid depression in adolescents with obsessive-compulsive disorder.

PubMed

Jones, Payton J; Mair, Patrick; Riemann, Bradley C; Mugno, Beth L; McNally, Richard J

2018-01-01

People with obsessive-compulsive disorder [OCD] frequently suffer from depression, a comorbidity associated with greater symptom severity and suicide risk. We examined the associations between OCD and depression symptoms in 87 adolescents with primary OCD. We computed an association network, a graphical LASSO, and a directed acyclic graph (DAG) to model symptom interactions. Models showed OCD and depression as separate syndromes linked by bridge symptoms. Bridges between the two disorders emerged between obsessional problems in the OCD syndrome, and guilt, concentration problems, and sadness in the depression syndrome. A directed network indicated that OCD symptoms directionally precede depression symptoms. Concentration impairment emerged as a highly central node that may be distinctive to adolescents. We conclude that the network approach to mental disorders provides a new way to understand the etiology and maintenance of comorbid OCD-depression. Network analysis can improve research and treatment of mental disorder comorbidities by generating hypotheses concerning potential causal symptom structures and by identifying symptoms that may bridge disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Insomnia, comorbidity, and risk of injury among insured Americans: results from the America Insomnia Survey.

PubMed

Kessler, Ronald C; Berglund, Patricia A; Coulouvrat, Catherine; Fitzgerald, Timothy; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C; Stephenson, Judith J; Walsh, James K

2012-06-01

To estimate associations of broadly defined insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace injuries controlling for comorbid conditions among workers in the America Insomnia Survey (AIS). Cross-sectional telephone survey. National sample of 4,991 employed health plan subscribers (age 18 yr and older). None. Broadly defined insomnia with duration of at least 12 mo was assessed with the Brief Insomnia Questionnaire (BIQ). Injuries in the 12 mo before interview were assessed with a standard self-report measure of injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports. Insomnia had significant gross associations (odds ratios, ORs) with both workplace and nonworkplace injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total injuries with insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of insomnia. The associations of insomnia with injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically, insomnia was significantly associated with workplace and nonworkplace injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace injuries (OR 0.9 and 1.0, respectively) among workers having 2 or more comorbid conditions. The

Induced abortion and anxiety, mood, and substance abuse disorders: isolating the effects of abortion in the national comorbidity survey.

PubMed

Coleman, Priscilla K; Coyle, Catherine T; Shuping, Martha; Rue, Vincent M

2009-05-01

The purpose of this study was to examine associations between abortion history and a wide range of anxiety (panic disorder, panic attacks, PTSD, Agoraphobia), mood (bipolar disorder, mania, major depression), and substance abuse disorders (alcohol and drug abuse and dependence) using a nationally representative US sample, the national comorbidity survey. Abortion was found to be related to an increased risk for a variety of mental health problems (panic attacks, panic disorder, agoraphobia, PTSD, bipolar disorder, major depression with and without hierarchy), and substance abuse disorders after statistical controls were instituted for a wide range of personal, situational, and demographic variables. Calculation of population attributable risks indicated that abortion was implicated in between 4.3% and 16.6% of the incidence of these disorders. Future research is needed to identify mediating mechanisms linking abortion to various disorders and to understand individual difference factors associated with vulnerability to developing a particular mental health problem after abortion.

Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys

PubMed Central

Kessler, Ronald C.; Ormel, Johan; Petukhova, Maria; McLaughlin, Katie A.; Green, Jennifer Greif; Russo, Leo J.; Stein, Dan J.; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura; Benjet, Corina; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Fayyad, John; Haro, Josep Maria; Hu, Chi yi; Karam, Aimee; Lee, Sing; Lepine, Jean-Pierre; Matchsinger, Herbert; Mihaescu-Pintia, Constanta; Posada-Villa, Jose; Sagar, Rajesh; Üstün, T. Bedirhan

2010-01-01

CONTEXT Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. OBJECTIVE To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the WHO World Mental Health (WMH) surveys. SETTING/PARTICIPANTS Nationally or regionally representative community surveys in 14 countries with a total of 21,229 respondents. MAIN OUTCOME MEASURES First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the WHO Composite International Diagnostic Interview (CIDI). RESULTS Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (i.e., internalizing or externalizing) associations were generally stronger than between-domain associations. The vast majority of time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity disorder and oppositional-defiant disorder (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. CONCLUSIONS The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered here. These common pathways should be the focus of future research on the development of comorbidity, although several important pair-wise associations that cannot be accounted for by latent variables also

Neurodevelopmental and mental health comorbidities in children and adolescents with epilepsy and migraine: a response to identified research gaps.

PubMed

Wagner, Janelle L; Wilson, Dulaney A; Smith, Gigi; Malek, Angela; Selassie, Anbesaw W

2015-01-01

To determine the distribution and risk characteristics of comorbid neurodevelopmental and mental health comorbidities among children and adolescents (6-18y) with epilepsy or migraine (i.e. a neurological condition with shared features and potential etiology) compared with lower extremity fracture (LEF). This case-control study involved a subset analysis of surveillance data in South Carolina, USA. Hospital admission, outpatient, and emergency department visits for individuals with an International Classification of Disease, 9th revision Clinical Modification diagnosis of epilepsy (n=6730; 54.5% females, 45.5% males; mean age [SD] 14y 2mo [4y 5mo]); migraine (n=10 495; 74.5% females, 25.5% males; 15y 6mo [2y 6mo]), or LEF (n=15 305; 40.3% females, 59.7% males; 13y 11mo [2y 11mo]) from January 1 2000 to December 31 2011 were identified. The association of epilepsy, migraine, or LEF with any mental health comorbidity was evaluated with univariate and multivariate polytomous logistic regression. Comorbidities were highly prevalent in children and adolescents, with epilepsy with a rate of 29.7% (95% confidence interval [CI]: 28.6-30.8) for mental health comorbidities and 30.8% (95% CI: 29.7-31.9) for neurodevelopmental comorbidities. The odds of mental health comorbidity was 2.20 (95% CI: 2.02-2.39) for children and adolescents with epilepsy and 1.60 (95% CI: 1.48-1.73) for migraine, in reference to children and adolescents with LEF after adjusting for potential confounders. Prevalence and risk for specific comorbidities are presented. Neuropathophysiological and psychosocial factors specific to epilepsy may provide more risk for adolescents with epilepsy compared to migraine. © 2014 Mac Keith Press.

[Psychopathological and comorbid disorders of incarcerated adolescents in Austria].

PubMed

Plattner, Belinda; Aebi, Marcel; Steinhausen, Hans-Christoph; Bessler, Cornelia

2011-07-01

Incarcerated adolescents show a high prevalence rate of psychopathology and comorbid psychiatric conditions. Child and adolescent psychiatrists working in the penal system are confronted with the need to provide care and to develop specific treatment plans. The data gathered from incarcerated juveniles were analyzed with a special focus on gender-specific treatment aspects. The Mini-International Neuropsychiatric Interview for children and adolescents was used to assess psychopathology in detained juveniles in Austria. The final study sample consisted of 333 juveniles (58 girls and 275 boys). 90 % of the juveniles in our sample suffered from at least one psychiatric disorder, and more than 60 % were diagnosed with two or more simultaneous psychiatric disorders. Using factor analyses we found three clinically relevant disorder patterns according to psychopathological characteristics for males: ADHD/conduct disorder and drug abuse; anxiety and depression; separation anxiety disorder/PTSD and alcohol abuse. In females, we found four disorder patterns: separation anxiety disorder/social phobia/dysthymia; PTSD and drug abuse in combination with either ADHD or conduct disorder; depression and alcohol abuse. Considering that juvenile detainees are burdened by high rates of psychopathology and comorbidity, it is essential to develop a substantiated diagnostic procedure in order when making treatment decisions; different disorder patterns must be considered in conjunction with detained juveniles. The patterns of psychopathology observed might be related to different characteristics in the development of delinquent behavior, in treatment needs, and legal prognosis.

Severe Obesity and Comorbid Condition Impact on the Weight-Related Quality of Life of the Adolescent Patient

PubMed Central

Zeller, Meg H.; Inge, Thomas H.; Modi, Avani C.; Jenkins, Todd M.; Michalsky, Marc P.; Helmrath, Michael; Courcoulas, Anita; Harmon, Carroll M.; Rofey, Dana; Baughcum, Amy; Austin, Heather; Price, Karin; Xanthakos, Stavra A.; Brandt, Mary L.; Horlick, Mary; Buncher, Ralph

2014-01-01

Objectives To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight loss surgery (WLS) to inform clinical care. Study design Baseline (pre-operative) data from Teen-LABS, a prospective multicenter observational study of 242 adolescents with severe obesity (MdnBMI = 50.5 kg/m2; Mage=17.1; 75.6% female; 71.9% White) undergoing WLS, were utilized to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids; IWQOL-Kids). Results WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Males had a higher CLoad (p=.01) and BMI (p=.01), yet less impairment in total WRQOL (p<.01) than females. CLoad was a significant predictor of male WRQOL. For females, psychosocial (versus physical) comorbidities, BMI, and White race were significant predictors of WRQOL impairment. Less prevalent conditions (e.g., stress urinary incontinence) also emerged as contributors to lower WRQOL. Conclusions WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals prior to WLS. Further, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes following WLS, as weight and comorbidity profiles change over time. PMID:25556022

The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls.

PubMed

Brand-Gothelf, Ayelet; Leor, Shani; Apter, Alan; Fennig, Silvana

2014-10-01

We examined the impact of comorbid depression and anxiety disorders on the severity of anorexia nervosa (AN) in adolescent girls. Adolescent girls with AN (N = 88) were divided into one group with and another group without comorbid disorders, and selected subjective and objective measures of illness severity were compared between the two groups. The comorbid group had significantly higher scores than the noncomorbid group for all four subscales and total scores of the Eating Disorders Examination as well as for all Eating Disorders Inventory-2 subscales, except for bulimia. The comorbid group also had significantly more suicide attempts and hospitalizations compared with the noncomorbid group. There were no significant group differences for the lowest ever body mass index, duration of AN symptoms, and age at AN onset. Our findings suggest that AN with comorbid depression and anxiety disorder is a more severe clinical variant of the disorder, especially with respect to severity of psychological symptoms and suicide risk.

Factors Associated with Initiation of Ecstasy Use among US Adolescents: Findings from a National Survey

PubMed Central

Wu, Ping; Liu, Xinhua; Fan, Bin

2009-01-01

Aims To investigate adolescent pathways to ecstasy use by (1) examining how early onsets of smoking, drinking, and marijuana use are related to a child’s risk of initiation of ecstasy use and (2) assessing the influence of other individual and parental factors on ecstasy use initiation. Methods Data on 6,426 adolescents (12–17 years old at baseline) from the National Survey of Parents and Youth (NSPY), a longitudinal, nationally-representative household survey of youth and their parents, were used in the analyses. Information on youth substance use, including ecstasy use, as well as familial and parental characteristics, was available. Results Initiation of ecstasy use is predicted by an adolescent’s early initiation of smoking, drinking, or marijuana use. In particular, early initiation either of marijuana use, or of both smoking and drinking, increases a child’s risk for ecstasy use initiation. Among the familial and parental variables, parent drug use emerged as significantly predictive of child initiation of ecstasy use; living with both parents and close parental monitoring, on the other hand, are negatively associated with ecstasy use initiation, and may be protective against it. At the individual level, sensation seeking tendencies and positive attitudes toward substance use, as well as close associations with deviant peers, are predictive of adolescent initiation of ecstasy use. Conclusion Our findings on the risk and protective factors for initiation of ecstasy use, especially with regard to factors that are modifiable, will be useful for prevention programs targeting youth use not only of ecstasy, but also of other drugs. PMID:19781862

Vaccination coverage among foreign-born and U.S.-born adolescents in the United States: Successes and gaps - National Immunization Survey-Teen, 2012-2014.

PubMed

Healy, Jessica; Rodriguez-Lainz, Alfonso; Elam-Evans, Laurie D; Hill, Holly A; Reagan-Steiner, Sarah; Yankey, David

2018-03-20

An overall increase has been reported in vaccination rates among adolescents during the past decade. Studies of vaccination coverage have shown disparities when comparing foreign-born and U.S.-born populations among children and adults; however, limited information is available concerning potential disparities in adolescents. The National Immunization Survey-Teen is a random-digit-dialed telephone survey of caregivers of adolescents aged 13-17 years, followed by a mail survey to vaccination providers that is used to estimate vaccination coverage among the U.S. population of adolescents. Using the National Immunization Survey-Teen data, we assessed vaccination coverage during 2012-2014 among adolescents for routinely recommended vaccines for this age group (≥1 dose tetanus and diphtheria toxoids and acellular pertussis [Tdap] vaccine, ≥1 dose quadrivalent meningococcal conjugate [MenACWY] vaccine, ≥3 doses human papillomavirus [HPV] vaccine) and for routine childhood vaccination catch-up doses (≥2 doses measles, mumps, and rubella [MMR] vaccine, ≥2 doses varicella vaccine, and ≥3 doses hepatitis B [HepB] vaccine). Vaccination coverage prevalence and vaccination prevalence ratios were estimated. Of the 58,090 respondents included, 3.3% were foreign-born adolescents. Significant differences were observed between foreign-born and U.S.-born adolescents for insurance status, income-to-poverty ratio, education, interview language, and household size. Foreign-born adolescents had significantly lower unadjusted vaccination coverage for HepB (89% vs. 93%), and higher coverage for the recommended ≥3 doses of HPV vaccine among males, compared with U.S.-born adolescents (22% vs. 14%). Adjustment for demographic and socioeconomic factors accounted for the disparity in HPV but not HepB vaccination coverage. We report comparable unadjusted vaccination coverage among foreign-born and U.S.-born adolescents for Tdap, MenACWY, MMR, ≥2 varicella. Although coverage was

When social anxiety disorder co-exists with risk-prone, approach behavior: Investigating a neglected, meaningful subset of people in the National Comorbidity Survey-Replication

PubMed Central

Kashdan, Todd B.; McKnight, Patrick E.; Richey, J. Anthony; Hofmann, Stefan G.

2009-01-01

Little is known about people with social anxiety disorder (SAD) who are not behaviorally inhibited. To advance knowledge on phenomenology, functional impairment, and treatment seeking, we investigated whether engaging in risk-prone behaviors accounts for heterogeneous outcomes in people with SAD. Using the National Comorbidity Survey-Replication (NCS-R) dataset, our analyses focused on people with current (N = 679) or lifetime (N = 1143) SAD diagnoses. Using latent class analysis on NCS-R risk-prone behavior items, results supported two SAD classes: (1) a pattern of behavioral inhibition and risk aversion and (2) an atypical pattern of high anger and aggression, and moderate/high sexual impulsivity and substance use problems. An atypical pattern of risk-prone behaviors was associated with greater functional impairment, less education and income, younger age, and particular psychiatric comorbidities. Results could not be subsumed by the severity, type, or number of social fears, or comorbid anxiety or mood disorders. Conclusions about the nature, course, and treatment of SAD may be compromised by not attending to heterogeneity in behavior patterns. PMID:19345933

Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Stinson, Frederick S; Grant, Bridget F; Dawson, Deborah A; Ruan, W June; Huang, Boji; Saha, Tulshi

2005-10-01

To date, there have been no published data on 12-month comorbidity of DSM-IV alcohol and drug use disorders in the general U.S. population. The purposes of the present study were to examine the prevalence and comorbidity of alcohol and specific drug use disorders, and to identify sociodemographic and psychopathologic correlates and treatment seeking among three groups of respondents: (1) those with alcohol use disorders only; (2) those with drug use disorders only; (3) those with comorbid alcohol and drug use disorders. Information on 12-month alcohol and specific drug use disorders in the United States was derived from face-to-face interviews in the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC: n = 43,093). Prevalences were 7.35% for alcohol use disorders only, 0.90% for drug use disorder only and 1.10% for comorbid alcohol and drug use disorders. Sociodemographic and psychopathologic correlates of these three groups were quite different, with the drug use disorder and comorbid groups significantly more likely to be young, male, never married and of lower socioeconomic status than the alcohol use disorder only group. Associations between current alcohol use disorders and 25 specific drug use disorders were generally positive and statistically significant. The 12-month prevalence of treatment seeking significantly increased from 6.06% for those with an alcohol use disorder only to 15.63% for those with a drug use disorder only, and to 21.76% for those with comorbid alcohol and drug use disorders. This study provides detailed data on the homotypic comorbidity of alcohol use disorders and 25 different drug use disorders and confirms the high levels of association seen in previous studies based on lifetime measures. Implications of this study are discussed in terms of integrating alcohol and drug treatment services and refining prevention and intervention efforts.

Is breakfast skipping associated with physical activity among U.S. adolescents? A cross-sectional study of adolescents aged 12-19 years, National Health and Nutrition Examination Survey (NHANES).

PubMed

Lyerly, Jordan E; Huber, Larissa R; Warren-Findlow, Jan; Racine, Elizabeth F; Dmochowski, Jacek

2014-04-01

To examine the association between breakfast skipping and physical activity among US adolescents aged 12-19 years. A cross-sectional study of nationally representative 2007-2008 National Health and Nutrition Examination Survey (NHANES) data. Breakfast skipping was assessed by two 24 h dietary recalls. Physical activity was self-reported by participants and classified based on meeting national recommendations for physical activity for the appropriate age group. Multiple logistic regression analysis was used to model the association between breakfast skipping and physical activity while controlling for confounders. A total of 936 adolescents aged 12-19 years in the USA. After adjusting for family income, there was no association between breakfast skipping and meeting physical activity guidelines for age among adolescents aged 12-19 years (OR = 0.95, 95% CI 0.56, 1.32). Findings from the study differ from previous research findings on breakfast skipping and physical activity. Therefore, further research that uses large, nationally representative US samples and national recommended guidelines for physical activity is needed.

Psychiatric comorbidity and maternal distress among adolescent eating disorder patients: A comparison with substance use disorder patients.

PubMed

Anastasiadou, Dimitra; Parks, Melissa; Brugnera, Agostino; Sepulveda, Ana R; Graell, Montserrat

2017-01-01

High rates of comorbidity are found among eating disorder (ED) patients, which may negatively affect treatment outcome and prognosis. However, there is a shortage of studies in Spain using clinician administered interviews to assess rates of comorbidity among these patients, particularly in adolescents. This study aimed to evaluate Axis I psychiatric diagnoses in adolescent patients with an ED and to compare them with patients with a distinct disorder with adolescent onset, substance use disorder (SUD) patients. Considering that maternal psychological distress is another factor involved in ED prognosis, a secondary aim was to examine the relationship between patient's psychological variables and maternal distress (depression and anxiety). The cross-sectional study included 50 ED patients, 48 SUD patients, and their mothers. More than half of the patients received a diagnosis for a comorbid disorder. Internalizing problems were more common among EDs and externalizing disorders were the most common comorbidities among SUDs, similar to findings from other countries. Maternal distress was associated with higher levels of depression and symptom severity in patients. No differences in distress were found between mothers of patients with a comorbid diagnosis and those without. Elevated anxiety or depression in mothers did not increase the likelihood of patients having a particular primary diagnosis. In short, while both ED and SUD patients presented high rates of comorbidity, the types of comorbid diagnoses were specific to each group. Assessing for the presence of comorbid disorders and targeting maternal psychological distress may guide treatment interventions and improve patient prognosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Methodology of the National School-based Health Survey in Malaysia, 2012.

PubMed

Yusoff, Fadhli; Saari, Riyanti; Naidu, Balkish M; Ahmad, Noor Ani; Omar, Azahadi; Aris, Tahir

2014-09-01

The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings. © 2014 APJPH.

Pathological Internet Use—An Important Comorbidity in Child and Adolescent Psychiatry: Prevalence and Correlation Patterns in a Naturalistic Sample of Adolescent Inpatients

PubMed Central

Riedl, David; Bock, Astrid; Rumpold, Gerhard; Sevecke, Kathrin

2018-01-01

Background Few studies have examined the prevalence of problematic internet use (PIU) in young people undergoing inpatient treatment in child and adolescent psychiatry centers. The aims of our study were thus (a) to assess the frequency of comorbid PIU in a sample of adolescent psychiatric inpatients and compare it with a control group of nonreferred adolescents and (b) to gain insights into correlations between PIU and psychiatric comorbidities. Methods 111 child and adolescent psychiatry inpatients (CAP-IP, mean age 15.1 ± 1.4 years; female : male 72.4% : 27.6%) undergoing routine psychodiagnostics were screened for the presence of PIU. The widely used Compulsive Internet Use Scale (CIUS) was chosen for this purpose. Prevalence rates of PIU were then compared to matched nonreferred control subjects from a school sample. Additionally, comorbidities of inpatients with PIU were compared to inpatients without PIU. Results Our inpatient sample showed a much higher prevalence of PIU than that found in previous populational samples of young people. Compared with a matched school sample, addictive internet use was 7.8 times higher and problematic internet use 3.3 times higher among our adolescent sample. PIU was significantly associated with characteristic patterns of psychopathology, that is, suicidality, difficulties in establishing stable and consolidated identity, and peer victimization. Conclusion PIU among adolescents undergoing inpatient psychiatric treatment is much more frequent than among their peers in the general population and is associated with specific patterns of psychopathology. PMID:29789775

Treating Comorbid Anxiety in Adolescents With ADHD Using a Cognitive Behavior Therapy Program Approach.

PubMed

Houghton, Stephen; Alsalmi, Nadiyah; Tan, Carol; Taylor, Myra; Durkin, Kevin

2017-11-01

To evaluate an 8-week cognitive behavior therapy (CBT) treatment specifically designed for adolescents with ADHD and comorbid anxiety. Using a multiple baseline design, nine adolescents (13 years to 16 years 9 months) received a weekly CBT, which focused on four identified anxiety-arousing times. Participants self-recorded their levels of anxiety for each of the four times during baseline, intervention, and a maintenance phase. Anxiety was also assessed using the Multidimensional Anxiety Scale for Children (MASC). Paired samples t tests supported the success of the intervention. Interrupted time-series data for each participant revealed varying rates of success across the four times, however. The MASC data revealed significant reductions in Physical Symptoms of Anxiety, Social Anxiety, Separation Anxiety, Harm Avoidance, and Total Anxiety. The data demonstrate the efficacy of a CBT program for the treatment of comorbid anxiety in adolescents with ADHD.

Sex Differences in Prevalence and Comorbidity of Alcohol and Drug Use Disorders: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Goldstein, Risë B.; Dawson, Deborah A.; Chou, S. Patricia; Grant, Bridget F.

2012-01-01

Objective: The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Method: Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Results: Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Conclusions: Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms. PMID:23036212

[A Cross-sectional Study of School dropout in adolescents: National Mental Health Survey Colombia 2015].

PubMed

Gómez-Restrepo, Carlos; Padilla Muñoz, Andrea; Rincón, Carlos Javier

2016-12-01

School dropout in adolescents can have negative consequences, not only for the individual and the family, but also for the society. To identify the characteristics associated with the occurrence of this event might contribute to the planning of a prevention strategy. To evaluate the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old in Colombia. A cross sectional study was conducted from information taken from the results obtained in the 2015 National Mental Health Survey. A study was made of the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old RESULTS: A higher percentage of school dropouts was found in the older adolescents, females, and those who have children. Among the home characteristics, it was observed that those homes with more than two people, located in rural area, or that are classified as poor, have an increased percentage of school dropout adolescents. Strategies for which the main goal is to prevent school dropout should consider populations with higher prevalence of out-of-school adolescents (female, homes in rural area, or household poverty). Preventive actions of adolescent pregnancy might contribute to reduce the school dropout rate. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Grant, Bridget F.; Chou, S. Patricia; Goldstein, Risë B.; Huang, Boji; Stinson, Frederick S.; Saha, Tulshi D.; Smith, Sharon M.; Dawson, Deborah A.; Pulay, Attila J.; Pickering, Roger P.; Ruan, W. June

2009-01-01

Objectives To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of BPD among men and women. Methods Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Results Prevalence of lifetime BPD was 5.9% (99% CI: 5.4–6.4). There were no differences in the rates of BPD among men (5.6%, 99% CI: 5.0–6.2) and women (6.2%, 99% CI: 5.6–6.9). BPD was more prevalent among Native American men, younger and separated/divorced/widowed adults, and those with lower incomes and education, and less prevalent among Hispanic men and women and Asian women. BPD was associated with substantial mental and physical disability, especially among women. High co-occurrence rates of mood and anxiety disorders with BPD were similar. With additional comorbidity controlled, associations with bipolar disorder and schizotypal and narcissistic PDs remained strong and significant. Associations of BPD with other specific disorders were no longer significant or were considerably weakened. Conclusions Prevalence of BPD in the general population is much greater than previously recognized, equal prevalent among men and women, and associated with considerable mental and physical disability, especially among women. Unique and common factors may differentially contribute to disorder-specific comorbidity with BPD and some of these associations appear to be sex-specific. There is a need for future epidemiologic, clinical and genetically-informed studies to identify unique and common factors that underlie disorder-specific comorbidity with BPD. Important sex differences observed in rates of and associations with BPD can inform more focused, hypothesis-driven investigations of these factors. PMID:18426259

Ecstasy Use and Suicidal Behavior Among Adolescents: Findings from a National Survey

PubMed Central

Kim, Jueun; Fan, Bin; Liu, Xinhua; Kerner, Nancy; Wu, Ping

2011-01-01

This study examines the relationship between ecstasy use and suicidal behaviors among adolescents in the United States. Data from the adolescent subsample (ages 12–17, N=19,301) of the 2000 NHSDA were used in the analyses. Information on adolescent substance use, suicidal behaviors and related socio-demographic, family and individual factors was obtained in the survey. The rate of past year suicide attempt among adolescents with lifetime ecstasy use was almost double that of adolescents who had used other drugs only, and nine times that of adolescents with no history of illicit drug use. In multinomial logistic regression analyses, controlling for related factors, the effect of ecstasy use remained significant. Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts. PMID:21631573

Epilepsy, comorbid conditions in Canadian children: analysis of cross-sectional data from cycle 3 of the National Longitudinal Study of Children and Youth.

PubMed

Prasad, Asuri N; Burneo, Jorge G; Corbett, Bradley

2014-11-01

The purpose of this study was to analyze national survey data to provide estimates of prevalence of epilepsy and associated developmental disabilities and comorbid conditions. We analyzed data from Cycle 3 of Canada's National Longitudinal Survey of Children and Youth. The NLSCY captured, socio-demographic information, as well as age, sex, education, ethnicity, household income, chronic health related conditions from birth to 15 years old. The main survey question intended to identify "epilepsy", "cerebral palsy", "intellectual disability", "learning disability", and "emotional and nervous difficulties" in the population of children surveyed. Prevalence was based on the national cross-sectional sample and used 1000 bootstrap weights to account for survey design factors. Cycle 3 of the NLSCY had the largest number of patients with diagnosed epilepsy. Prevalence figures (n/1000) for epilepsy and cerebral palsy (EPI_CP), epilepsy and intellectual disability (EPI_ID), epilepsy and learning disability (EPI_LD), and epilepsy and emotional nervous difficulties (EPI_EMO_NERV) were 1.1, 1.17, 2.58 and 1.34 respectively. Amongst children with epilepsy, 43.17% reported the presence of one or more of the above comorbid conditions. These results provide an initial prevalence estimate of comorbid conditions with epilepsy in Canadian children. In a high proportion of children with epilepsy, the PMK had reported at least one comorbid disorder. These findings carry implications for health care utilization and long-term outcomes. We discuss methodological aspects related to the ascertainment of epilepsy in both surveys, and to the validity and implications of our findings. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Potential Mediators of Cognitive-Behavioral Therapy for Adolescents With Comorbid Major Depression and Conduct Disorder

ERIC Educational Resources Information Center

Kaufman, Noah K.; Rohde, Paul; Seeley, John R.; Clarke, Gregory N.; Stice, Eric

2005-01-01

Several possible mediators of a group cognitive-behavioral therapy (CBT) for depressed adolescents were examined. Six measures specific to CBT (e.g., negative cognitions, engagement in pleasurable activities) and 2 nonspecific measures (therapeutic alliance, group cohesion) were examined in 93 adolescents with comorbid major depressive disorder…

2007 Maryland Adolescent Survey

ERIC Educational Resources Information Center

Maryland State Department of Education, 2008

2008-01-01

Periodically, Maryland's sixth, eighth, tenth, and twelfth graders are surveyed to determine the nature, extent, and trend of alcohol, tobacco, and other drug (ATOD) use among adolescents. The "2007 Maryland Adolescent Survey (MAS)" presents the latest findings regarding ATOD use by Maryland's adolescents and compares State and local…

Work-family conflict and mental disorders in the United States: cross-sectional findings from The National Comorbidity Survey.

PubMed

Wang, Jianli; Afifi, Tracie O; Cox, Brian; Sareen, Jitender

2007-02-01

Work-family conflict (WFC) may have negative effects on workers' health and productivity. The objective of this analysis was to assess the association between WFC and mental disorders that occurred in the past month. Data from the U.S. National Comorbidity Survey were used. The 1-month prevalence of mental disorders was estimated by levels of WFC and by gender. Compared to participants who reported low WFC, those who reported high WFC had a significantly higher prevalence of mental and/or substance use related disorders in the past month. Working hours and domestic roles did not have significant impacts on the association between WFC and mental disorders, irrespective of gender. Work and family roles and the balance between the two are important for workers' mental health. The influence of WFC on mental health should be investigated in conjunction with important work environment characteristics in longitudinal studies.

An Investigation of Comorbid Psychological Disorders, Sleep Problems, Gastrointestinal Symptoms and Epilepsy in Children and Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mannion, Arlene; Leader, Geraldine; Healy, Olive

2013-01-01

The current study investigated comorbidity in eighty-nine children and adolescents with Autism Spectrum Disorder in Ireland. Comorbidity is the presence of one or more disorders in addition to a primary disorder. The prevalence of comorbid psychological disorders, behaviours associated with comorbid psychopathology, epilepsy, gastrointestinal…

Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: associations with functional impairment related to DSM-IV disorders.

PubMed

McLaughlin, K A; Green, J G; Gruber, M J; Sampson, N A; Zaslavsky, A M; Kessler, R C

2010-05-01

Despite evidence that childhood adversities (CAs) are associated with increased risk of mental disorders, little is known about their associations with disorder-related impairment. We report the associations between CAs and functional impairment associated with 12-month DSM-IV disorders in a national sample. We used data from the US National Comorbidity Survey Replication (NCS-R). Respondents completed diagnostic interviews that assessed 12-month DSM-IV disorder prevalence and impairment. Associations of 12 retrospectively reported CAs with impairment among cases (n=2242) were assessed using multiple regression analysis. Impairment measures included a dichotomous measure of classification in the severe range of impairment on the Sheehan Disability Scale (SDS) and a measure of self-reported number of days out of role due to emotional problems in the past 12 months. CAs were positively and significantly associated with impairment. Predictive effects of CAs on the SDS were particularly pronounced for anxiety disorders and were significant in predicting increased days out of role associated with mood, anxiety and disruptive behavior disorders. Predictive effects persisted throughout the life course and were not accounted for by disorder co-morbidity. CAs associated with maladaptive family functioning (MFF; parental mental illness, substance disorder, criminality, family violence, abuse, neglect) were more consistently associated with impairment than other CAs. The joint effects of co-morbid MFF CAs were significantly subadditive. Simulations suggest that CAs account for 19.6% of severely impairing disorders and 17.4% of days out of role. CAs predict greater disorder-related impairment, highlighting the ongoing clinical significance of CAs at every stage of the life course.

Childhood and Adolescent Risk Factors for Comorbid Depression and Substance Use Disorders in Adulthood

PubMed Central

Green, Kerry M.; Zebrak, Katarzyna A.; Fothergill, Kate E.; Robertson, Judith A.; Ensminger, Margaret E.

2012-01-01

The comorbidity of major depression and substance use disorders is well documented. However, thorough understanding of prevalence and early risk factors for comorbidity in adulthood is lacking, particularly among urban African Americans. With data from the Woodlawn Study, which follows a community cohort of urban African Americans from ages 6 to 42, we identify the prevalence of comorbidity and childhood and adolescent risk factors of comorbid depression and substance use disorders, depression alone, and substance use disorders alone. Prevalence of comorbid substance use disorders and major depression in adulthood is 8.3% overall. Comorbidity in cohort men is twice that for women (11.1% vs. 5.7%). Adjusted multinomial regression models found few differences in risk factors for comorbidity compared to either major depression or a substance use disorder on its own. However, results do suggest distinct risk factors for depression without a substance use disorder in adulthood compared to a substance use disorder without depression in adulthood. In particular, low socioeconomic status and family conflict was related to increased risk of developing major depression in adulthood, while dropping out of high school was a statistically significant predictor of adult-onset substance use disorders. Early onset of marijuana use differentiated those with a substance use disorder with or without depression from those with depression without a substance use disorder in adjusted models. In conclusion, comorbid substance use disorders and depression are highly prevalent among these urban African Americans. Insight into the unique childhood and adolescent risk factors for depression compared to substance use disorders is critical to intervention development in urban communities. Results suggest that these programs must consider individual behaviors, as well as the early family dynamic. PMID:22762959

Eating disorders with and without comorbid depression and anxiety: similarities and differences in a clinical sample of children and adolescents.

PubMed

Hughes, Elizabeth K; Goldschmidt, Andrea B; Labuschagne, Zandre; Loeb, Katharine L; Sawyer, Susan M; Le Grange, Daniel

2013-09-01

This study aimed to describe and compare the demographic and clinical characteristics of children and adolescents with an eating disorder (ED) and comorbid depression or anxiety. Data were drawn from intake assessments of children and adolescents at a specialist ED clinic. Demographic characteristics (e.g. age and gender) and clinical characteristics (e.g. body mass, binge eating and purging) were compared between 217 ED participants without comorbidity, 32 with comorbid anxiety, 86 with comorbid depression and 36 with comorbid anxiety and depression. The groups with comorbid depression had more complex and severe presentations compared with those with an ED and no comorbid disorder and those with comorbid anxiety alone, especially in regard to binge eating, purging, dietary restraint and weight/shape concerns. Depression and anxiety were differentially related to clinical characteristics of EDs. The findings have implications for understanding the relations between these disorders and their potential to impact outcome of ED treatments. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Adolescent Substance Use and Other Illegal Behaviors and Racial Disparities in Criminal Justice System Involvement: Findings From a US National Survey

PubMed Central

Kakade, Meghana; Duarte, Cristiane S.; Liu, Xinhua; Fuller, Cordelia J.; Drucker, Ernest; Hoven, Christina W.; Fan, Bin

2012-01-01

We used data from a national survey to examine arrest rate disparities between African American and White adolescents (aged 12–17 years; n = 6725) in relation to drug-related and other illegal behaviors. African American adolescents were less likely than Whites to have engaged in drug use or drug selling, but were more likely to have been arrested. Racial disparities in adolescent arrest appear to result from differential treatment of minority youths and to have long-term negative effects on the lives of affected African American youths. PMID:22594721

The Temporal Relation between Depression and Comorbid Psychopathology in Adolescents at Varied Risk for Depression

ERIC Educational Resources Information Center

Gallerani, Catherine M.; Garber, Judy; Martin, Nina C.

2010-01-01

Background: This study examined the temporal comorbidity of depressive disorders with anxiety, externalizing, and substance use disorders in adolescents who varied in risk for depression. Methods: Participants were 240 adolescents and their mothers who had either a history of depression (high-risk, n = 185) or were lifetime-free of psychiatric…

The determinants of intention to smoke waterpipe among adolescents in Lebanon: a national household survey.

PubMed

Schröder, Claudia; Chaaya, Monique; Saab, Dahlia; Mahfoud, Ziyad

2016-03-01

The phenomenon of waterpipe smoking (WPS) among adolescents has become eminent, and it is especially prevalent in Lebanon. Unlike cigarette smoking, WPS is parentally and socially acceptable. This study aims at examining the association between intention to smoke waterpipe in the next 6 months, and knowledge, attitudes and parental and social influences. This is a secondary data analysis from a national survey in 2007 on 1028 households. This study addresses 258 non-smoking adolescents and their parents. Consent was sought and the study was approved by the Institutional Review Board at the American University of Beirut. Face-to-face interviews were conducted. Descriptive analysis, crude and adjusted odds ratios (ORs) were generated. At the bivariate level, late adolescence, mothers without university education, prior adolescents' WPS experiences, best friends' and parents' WPS habits and adolescents' and parents' lower attitude scores were associated with smoking intention. In the adjusted model, adolescents' beliefs about positive effects, best friends' similar habits and prior smoking remained significant (respective ORs [95% confidence interval ]: 1.81 [1.33-2.45], 2.51 [1.24-5.10], 4.91 [2.35-10.36]). Parents' perceived attitude against smoking was protective (OR: 0.57 [0.39-0.83]). Adolescents' intention to smoke is highly influenced by parents' permissive attitudes and peer pressure. Interventions targeting these two groups and limiting access to smoking by adolescents should be instigated. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Family Consumer Behaviors, Adolescent Prediabetes and Diabetes in the National Health and Nutrition Examination Survey (2007-2010).

PubMed

Nagarajan, Sairaman; Khokhar, Aditi; Holmes, Danielle Sweetnam; Chandwani, Sheenu

2017-01-01

Prediabetes or diabetes (characterized by hemoglobin A1c [HbA1c] levels ≥ 5.7 gm%) has been associated with numerous long-term complications. Family consumer behaviors are important risk factors that lead to impaired glucose tolerance or diabetes. However, few studies have studied the association between the family consumer environment and prediabetes and diabetes in adolescents. The aim of this study was to examine the association between family consumer behaviors (healthy food availability and supermarket spending) and adolescent prediabetes and diabetes (ClinicalTrials.gov identifier #NCT03136289.) Methods: Data from a nationwide survey conducted by the Centers for Disease Control and Prevention (National Health and Nutrition Examination Survey [NHANES] 2007-2010 data) were used for these analyses. Adolescents aged 12-19 years were selected for this study. Bivariate analyses and logistic regression models assessed the relationship between family consumer behaviors and the prevalence of adolescent prediabetes and diabetes. Multivariable models adjusted for age, gender, ethnicity, physical activity, education, income, and household size. A total of 2520 adolescents were eligible for this study. Adolescents with healthier household food availability had negative odds (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.55-1.00), as did higher log supermarket spending (OR = 0.69; 95% CI, 0.57-0.85). Interaction models demonstrated that adolescent females had more negative odds of prediabetes/diabetes for both healthier food availability (OR = 0.79, 95% CI, 0.39-1.29) and for greater log supermarket spending (OR = 0.69, 95% CI, 0.57-0.85). This study shows that both healthy food availability and an increase in supermarket spending were associated with a decreased adjusted prevalence of prediabetes and diabetes in adolescents, with a greater effect in females. These results suggest the need for policy and dietary interventions targeting the consumer

Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Grant, Bridget F; Chou, S Patricia; Goldstein, Risë B; Huang, Boji; Stinson, Frederick S; Saha, Tulshi D; Smith, Sharon M; Dawson, Deborah A; Pulay, Attila J; Pickering, Roger P; Ruan, W June

2008-04-01

To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of borderline personality disorder (BPD) among men and women. Face-to-face interviews were conducted with 34,653 adults participating in the 2004-2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Personality disorder diagnoses were made using the Wave 2 Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Prevalence of lifetime BPD was 5.9% (99% CI = 5.4 to 6.4). There were no differences in the rates of BPD among men (5.6%, 99% CI = 5.0 to 6.2) and women (6.2%, 99% CI = 5.6 to 6.9). BPD was more prevalent among Native American men, younger and separated/divorced/widowed adults, and those with lower incomes and education and was less prevalent among Hispanic men and women and Asian women. BPD was associated with substantial mental and physical disability, especially among women. High co-occurrence rates of mood and anxiety disorders with BPD were similar. With additional comorbidity controlled for, associations with bipolar disorder and schizotypal and narcissistic personality disorders remained strong and significant (odds ratios > or = 4.3). Associations of BPD with other specific disorders were no longer significant or were considerably weakened. BPD is much more prevalent in the general population than previously recognized, is equally prevalent among men and women, and is associated with considerable mental and physical disability, especially among women. Unique and common factors may differentially contribute to disorder-specific comorbidity with BPD, and some of these associations appear to be sex-specific. There is a need for future epidemiologic, clinical, and genetically informed studies to identify unique and common factors that underlie disorder-specific comorbidity with BPD. Important sex differences observed in rates of BPD and associations with BPD can inform more focused

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

PubMed Central

2012-01-01

Background Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD. Methods This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item. Results Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning. Conclusions Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is

Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011

PubMed Central

Pradhan, Rina; Wynter, Karen; Fisher, Jane

2018-01-01

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. PMID:29385771

Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany - results of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009

PubMed Central

2013-01-01

Background Despite the major public health impact of diabetes, recent population-based data regarding its prevalence and comorbidity are sparse. Methods The prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. Information on physician-diagnosed diabetes and 20 other chronic health conditions was collected as part of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009. Overall, 51.2% of contacted persons participated. Among persons with diabetes, diabetes severity was defined according to the type and number of diabetes-concordant conditions: no diabetes-concordant condition (grade 1); hypertension and/or hyperlipidemia only (grade 2); one comorbidity likely to represent diabetes-related micro- or macrovascular end-organ damage (grade 3); several such comorbidities (grade 4). Determinants of diabetes severity were analyzed by multivariable ordinal regression. Results The 12-month prevalence of diabetes was 13.6% with no significant difference between men and women. Persons with diabetes had a significantly higher prevalence and average number of diabetes-concordant as well as diabetes-discordant comorbidities than persons without diabetes. Among persons with diabetes, 10.2%, 46.8%, 35.6% and 7.4% were classified as having severity grade 1–4, respectively. Determinants of diabetes severity included age (cumulative odds ratio 1.05, 95% confidence interval 1.03-1.07, per year) and number of discordant comorbidities (1.40, 1.25-1.55). With respect to specific discordant comorbidities, diabetes severity was correlated to depression (2.15, 1.29-3.56), respiratory disease (2.75, 1.72-4.41), musculoskeletal disease (1.53, 1.06-2.21), and severe hearing impairment (3.00, 1.21-7.41). Conclusions Diabetes is highly prevalent in the non-institutionalized German adult population 50 years and older. Diabetes

Adolescent Emotional Pathology and Lifetime History of Alcohol or Drug Use With and Without Comorbid Tobacco Use.

PubMed

Chuang, Cheng-Wei I; Chan, Connie; Leventhal, Adam M

2016-01-01

Use of drugs and alcohol, including tobacco, is linked to adolescent emotional psychopathology. Given that tobacco use is becoming less common over recent years, its co-use with drugs/alcohol may mark a more severe profile of emotional symptomatology. However, it is unclear whether teens with a lifetime history of using drug/alcohol and tobacco exhibit additional elevations in emotional psychopathology and/or multiple forms of emotional psychopathology compared to teens with lifetime drug/alcohol use without comorbid tobacco use. This cross-sectional study compared emotional disorder symptoms and emotional vulnerability traits among adolescents with varying histories of substance use. Ninth-grade students enrolled at two schools in Los Angeles, California, were recruited; 575 met eligibility criteria and provided both student assent and parental consent. Students completed self-report measures of emotional pathology, transdiagnostic, and lifetime substance use. Participants were classified into three groupings: (a) no history of substance use (n = 294); (b) lifetime history of drug/alcohol use without tobacco use (n = 166); and (c) lifetime history of drug/alcohol use with concomitant tobacco use (n = 115). Chi-square results showed that teens with lifetime alcohol/drug use with (vs. without) comorbid tobacco use were more likely to have used 10 of 16 substances assessed in the study. Post-ANOVA pairwise tests revealed that, compared to students with no history of substance use, those with any history of use (alcohol/drugs with and without tobacco use) had higher major depression symptoms and negative affect. Those with lifetime alcohol/drug use with comorbid tobacco use had higher generalized anxiety symptoms and distress, and those with lifetime alcohol/drug use without comorbid tobacco use had higher panic disorder symptoms and anhedonia. There were no significant differences between adolescents with lifetime drug/alcohol use with comorbid tobacco use versus

Examining the impact of psychiatric diagnosis and comorbidity on the medical lethality of adolescent suicide attempts.

PubMed

McManama O'Brien, Kimberly H; Berzin, Stephanie C

2012-08-01

Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders. © 2012 The American Association of Suicidology.

Depression and Anxiety among Transitioning Adolescents and College Students with ADHD, Dyslexia, or Comorbid ADHD/Dyslexia

ERIC Educational Resources Information Center

Nelson, Jason M.; Gregg, Noel

2012-01-01

Objective: To investigate depressive and anxious symptomatology among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Method: Transitioning adolescents and college students with these disorders along with a non-ADHD/dyslexia college sample completed self-report measures of depression and anxiety.…

12-step participation and outcomes over 7 years among adolescent substance use patients with and without psychiatric comorbidity.

PubMed

Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I; Weisner, Constance

2013-01-01

This study examines the associations between 12-step participation and outcomes over 7 years among 419 adolescent substance use patients with and without psychiatric comorbidities. Although level of participation decreased over time for both groups, comorbid adolescents participated in 12-step groups at comparable or higher levels across time points. Results from mixed-effects logistic regression models indicated that for both groups, 12-step participation was associated with both alcohol and drug abstinence at follow-ups, increasing the likelihood of either by at least 3 times. Findings highlight the potential benefits of 12-step participation in maintaining long-term recovery for adolescents with and without psychiatric disorders.

Abortion and mental health: findings from The National Comorbidity Survey-Replication.

PubMed

Steinberg, Julia R; McCulloch, Charles E; Adler, Nancy E

2014-02-01

To examine whether a first abortion increases risk of mental health disorders compared with a first childbirth with and without considering prepregnancy mental health and adverse exposures, childhood economic status, miscarriage history, age at first abortion or childbirth, and race or ethnicity. A cohort study compared rates of mental disorders (anxiety, mood, impulse-control, substance use, eating disorders, and suicidal ideation) among 259 women postabortion and 677 women postchildbirth aged 18-42 years at the time of interview from The National Comorbidity Survey-Replication. The percentage of women with no, one, two, and three or more mental health disorders before their first abortion was 37.8%, 19.7%, 15.2%, and 27.3% and before their first childbirth was 57.9%, 19.6%, 9.2%, and 13.3%, respectively, indicating that women in the abortion group had more prior mental health disorders than women in the childbirth group (P<.001). Although in unadjusted Cox proportional hazard models, abortion compared with childbirth was associated with statistically significant higher hazards of postpregnancy mental health disorders, associations were reduced and became nonstatistically significant for five disorders after adjusting for the aforementioned factors. Hazard ratios and associated 95% confidence intervals dropped from 1.52 (1.08-2.15) to 1.12 (0.87-1.46) for anxiety disorders; from 1.56 (1.23-1.98) to 1.18 (0.88-1.56) for mood disorders; from 1.62 (1.02-2.57) to 1.10 (0.75-1.62) for impulse-control disorders; from 2.53 (1.09-5.86) to 1.82 (0.63-5.25) for eating disorders; and from 1.62 (1.09-2.40) to 1.25 (0.88-1.78) for suicidal ideation. Only the relationship between abortion and substance use disorders remained statistically significant, although the hazard ratio dropped from 3.05 (1.94-4.79) to 2.30 (1.35-3.92). After accounting for confounding factors, abortion was not a statistically significant predictor of subsequent anxiety, mood, impulse-control, and eating

Tics and psychiatric comorbidity in children and adolescents.

PubMed

Gadow, Kenneth D; Nolan, Edith E; Sprafkin, Joyce; Schwartz, Joseph

2002-05-01

This study examined comorbid psychiatric symptoms in a large, community-based sample of children and adolescents. The study sample comprised a total of 3006 school children: 413 preschool (3 to 5 years; 237 males, 176 females; mean age 4 years 2 months, SD 8 months), 1520 elementary school (5 to 12 years; 787 males, 733 females; mean age 8 years 2 months, SD 1 year 11 months), and 1073 secondary school children (12 to 18 years; 573 males, 500 females; mean age 14 years 4 months, SD 1 year 10 months), all of whom were attending regular education programs. Children were evaluated with a teacher-completed DSM-IV-referenced rating scale. The sample was divided into four groups: attention-deficit-hyperactivity disorder with tics (ADHD+tics), ADHD without tics (ADHD), tics without ADHD (T), and a comparison group i.e. neither ADHD nor tics (Non). The percentage of children with tic behaviors varied with age: preschool children (22.3%), elementary school children (7.8%), and adolescents (3.4%). Tic behaviors were more common in males than females, regardless of comorbid ADHD symptoms. For many psychiatric symptoms, screening prevalence rates were highest for the ADHD groups (ADHD+tics>ADHD>T>Non). However, obsessive-compulsive and simple and social phobia symptoms were more common in the groups with tic behavior. Findings for a community-based sample show many similarities with studies of clinically referred samples suggesting that teacher-completed ratings of DSM-IV symptoms may be a useful methodology for investigating the phenomenology of tic disorders.

Relations among obesity, family socioeconomic status, oral health behaviors, and dental caries in adolescents: the 2010-2012 Korea National Health and nutrition examination survey.

PubMed

Kim, Jin Ah; Choi, Hayon Michelle; Seo, Yunhee; Kang, Dae Ryong

2018-06-22

The purpose of this study was to examine the relationships among obesity, family socioeconomic status, oral health behaviors, and dental caries and to identify possible differences in factors related with dental caries according to gender among a representative sample of Korean adolescents. Data were obtained from the Korean National Health and Nutrition Examination Survey, which was conducted between 2010 and 2012. This nationally representative cross-sectional survey included approximately 10,000 individuals, including adolescents, each year as a survey sample, and collected information on socioeconomic status, health-related behaviors, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases, and dietary intake via three component surveys (health interview, health examination, and nutrition survey). The health interview and health examination were conducted by trained staff members. A total of 1646 adolescents of ages 13 to 18 years old were included in this study; there were 879 males and 767 females. Data were analyzed by t-test, X 2 -test, and univariate and multivariate logistic regression analyses using SAS 9.4 and 'R' statistical software for Windows to account for the complex sampling design. In males, significant associations between family income and dental caries on permanent teeth were noted after adjusting for confounding variables; the odds ratios and 95% confidence intervals thereof were 0.43(0.24-0.76), 0.41(0.24-0.70), and 0.28(0.16-0.49) for low-middle, middle-high, and high family income, respectively. Smoking experience showed a significant association with dental caries on permanent teeth in females. Oral health behaviors, such as tooth brushing frequency, were associated with dental caries in only male adolescents. There was no association between obesity and dental caries on permanent teeth in either male or female adolescents. The present study demonstrated that

Mental Health Status of Double Minority Adolescents: Findings from National Cross-Sectional Health Surveys.

PubMed

Chiang, Szu-Ying; Fleming, Theresa; Lucassen, Mathijs; Fenaughty, John; Clark, Terryann; Denny, Simon

2017-06-01

Little population-based work has been published about the mental health of adolescents with both sexual/gender (SG) and ethnic minority (i.e. double minority) status. This study aimed to provide an overview on their mental health. Analysis of data from a total of 17,607 high school students from New Zealand's 2007 and 2012 cross-sectional nationally representative Adolescent Health Surveys, including a total of 1306 (7.4%) SG minority participants, of whom 581 (3.3%) were also an ethnic minority. SG minority status, minority ethnicity, and female sex were associated with higher mental distress and poorer well-being. Generally speaking, double minority students reported poorer mental health than SG majority students of the same ethnicity, but reported better mental health than SG minority New Zealand European students. Explanations and future directions for research were suggested to further explore how double minority students negotiate mental health in the context of their communities/cultures in New Zealand.

Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children's Health and the National Health Interview Survey.

PubMed

Strom, Mark A; Silverberg, Jonathan I

2016-01-01

To determine if eczema is associated with an increased risk of a speech disorder. We analyzed data on 354,416 children and adolescents from 19 US population-based cohorts: the 2003-2004 and 2007-2008 National Survey of Children's Health and 1997-2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%-5.0%) compared with 2.2% (95% CI 2.2%-2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57-2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02-1.81], P = .03) and severe eczema (3.56 [1.70-7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34-4.10], P = .003) and severe (2.28 [1.11-4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of abnormal eating behaviors in adolescents in Mexico: Mexican National Health and Nutrition Survey 2006.

PubMed

Barriguete-Meléndez, Jorge Armando; Unikel-Santoncini, Claudia; Aguilar-Salinas, Carlos; Córdoba-Villalobos, José Angel; Shamah, Teresa; Barquera, Simón; Rivera, Juan A; Hernández-Avila, Mauricio

2009-01-01

To describe the prevalence of abnormal eating behaviors in a population-based nationwide survey. A stratified, probabilistic, multistage design sampling process was used. The Brief Questionnaire for Risky Eating Behaviors was included in the Mexican Health and Nutrition Survey 2006 (ENSANUT 2006) and administered to participants 10-19 years old (n= 25 166). The study had the power to describe nationwide characteristics by age, regions and urban/rural settings. A high risk for having an eating disorder was found in 0.8% of the total participants (0.4% male adolescents and 1.0% female). Inhabitants in large cities showed higher risk for having an abnormal eating behavior compared to subjects living in other settings. The highest prevalences were found in males > 15 years old and females > 13 years old for all evaluated behaviors. Results show less prevalence of risky eating behaviors among adolescents in comparison to other populations. The female/male ratio was 3:1, far different from the 9:1 shown in a previous study in Mexico City, but similar to results from the US national eating disorders screening.

Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

PubMed

Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

2015-05-30

The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Gender and Racial/Ethnic Differences in Binge Eating Symptoms in a Nationally Representative Sample of Adolescents in the United States

PubMed Central

Lee-Winn, Angela E.; Reinblatt, Shauna P.; Mojtabai, Ramin; Mendelson, Tamar

2016-01-01

Objective Binge eating disorder (BED) is the most prevalent eating disorder in the U.S. adolescent population. Both BED and subthreshold binge eating disorder (SBED) are associated with physical and mental health problems. Gender and racial/ethnic differences in prevalence of binge eating in a nationally representative sample of adolescents have been reported but have not yet been assessed in relation to individual symptoms of binge eating. We examined gender and racial/ethnic differences in endorsement of eight binge eating symptoms in a nationally representative sample of U.S. adolescents. Methods We used data from the National Comorbidity Survey-Adolescent Supplement (NCS-A; 2001–2004), a nationally representative cross-sectional study of adolescents aged 13 to 18 years (n=9,336). We compared binge eating symptoms across genders and racial/ethnic groups using multivariable regression models. Results Females endorsed more binge eating symptoms than males associated with loss of control (‘eat when not hungry’ (adjusted prevalence ratio [aPR]=1.18, 95% confidence interval [CI]=1.02, 1.37, p=0.024) and distress (e.g., ‘afraid of weight gain while binge eating’ [aPR=3.29, CI=2.43, 4.47, p<0.001). Racial/ethnic minorities displayed different patterns of binge eating symptoms than non-Hispanic Whites. Hispanics reported being more ‘afraid of weight gain while binge eating’ (aPR=2.05, CI=1.25, 3.37, p=0.006) than non-Hispanic Blacks. Discussion Our findings suggest significant gender and racial/ethnic differences in binge eating symptom presentation. Future work should explore reasons for these gender and racial/ethnic differences and consider these differences when determining how best to prevent and treat binge eating in adolescents. PMID:27085166

Prevalence of metabolic syndrome and individual criterion in US adolescents: 2001-2010 National Health and Nutrition Examination Survey.

PubMed

Miller, Joshua M; Kaylor, Mary Beth; Johannsson, Mark; Bay, Curtis; Churilla, James R

2014-12-01

The prevalence of metabolic syndrome has increased in adolescents in previous years. The objectives of this study were to examine the prevalence in the past decade and the individual criteria in a nationally representative sample of US adolescents. This study was a descriptive analysis of 3495 US adolescents between the ages of 12 and 19 years using the National Health and Nutrition Examination Survey (NHANES) 2000-2010. Metabolic syndrome was defined as having three of the five following conditions: Waist circumference (WC),≥90(th) percentile (sex-specific); elevated resting blood pressure,≥90(th) percentile (age, height, sex-specific); elevated triglycerides (TGs); low high-density lipoprotein cholesterol; and/or impaired fasting glucose. Approximately 73.2% of the participants had at least one criterion, with the estimated metabolic syndrome prevalence being 10.1%. Prevalence was higher in males than females (13.0% vs. 6.4%, P<0.05). Both Hispanic males and females had significantly greater odds of metabolic syndrome. Abnormal WC and abnormal TG levels were the most common individual criteria; in comparison, abnormal blood pressure was the least common across racial ethnic backgrounds. An estimated one in 10 US adolescents has metabolic syndrome. These findings have important public health implications due to the known cardiovascular disease risk factors associated with metabolic syndrome.

General characteristics of adolescent sexual behaviour: national survey.

PubMed

Stanković, Miodrag; Miljković, Srbobran; Grbesa, Grozdanko; Visnjić, Aleksandar

2009-01-01

Investigation of adolescent sexual behaviour carried out on a large sample is primarily motivated by health and social problems which can occur when young people practice sex without protection and necessary information. There is no data that the national study on adolescent sexual behaviour has been conducted in the Serbian speaking area. Monitoring and follow-up of trends in adolescent sexual behaviour. The investigation sample comprised 1101 adolescents (472 male and 629 female), aged 13-25 years. As an instrument of polling, the questionnaire "Sexual Behaviour" was used specifically designed for the purpose of this investigation. Eighty-four percent of males and 65% of females reported having sexual experience. The age of the first sexual experience, total number of partners, number of sexual partners in the last year and the last month were investigated, and the number of loved and sexual partner compared. In addition, the length of foreplay, frequency of sexual activity, masturbation, sexual dreams and sexual daydreams and engagement into alternative sexual activities (oral sex, anal sex, group sex, exchange of partners) were estimated, as well as the reasons for their practicing. Sexual desire and its correlation with personality dimensions, the frequency of sexual disorders (erectile and ejaculation problems, anorgasmia), abortion, rape and identification of the rapist, the use of condoms and other methods of contraception were assessed. It could be postulated that biological influence on sexual behaviour is powerful and resistant to the influence of time and place, as well as socio-cultural religious influences. A high rate of premarital sexual activity with a number of sexual partners, a relatively low rate of condom use and the fact that 4% of the female adolescents in this sample had an induced abortion suggest that there are gaps in the education provided to adolescents about sexual and reproductive risks within the Serbian speaking territory. An

Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda

PubMed Central

2013-01-01

Background Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda. Objective To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda. Methods Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3–19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents. Results The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14–19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR�

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

PubMed

Tester, June M; Laraia, Barbara A; Leung, Cindy W; Mietus-Snyder, Michele L

2016-02-11

Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

Treatment of comorbid adolescent cannabis use and major depressive disorder.

PubMed

Kaminer, Yifrah; Connor, Daniel F; Curry, John F

2008-09-01

The comorbidity of unipolar depression with substance use disorders (SUD) in adolescents is well established and accounts for 24 to 50 percent in clinical samples. Very little empirical data exist on the treatment of dually diagnosed youth. The objective of this paper is twofold: 1) We will review the literature on SUD and unipolar depression; and 2) we will provide guidelines for a combined pharmacological and psychosocial intervention based on a clinical case example.

Panic Disorder among Adults

MedlinePlus

... 20855043 Statistical Methods and Measurement Caveats National Comorbidity Survey Replication (NCS-R) Diagnostic Assessment and Population: The ... the NIMH NCS-R study page . National Comorbidity Survey Adolescent Supplement (NCS-A) Diagnostic Assessment and Population: ...

Mental disorder comorbidity in Te Rau Hinengaro: the New Zealand Mental Health Survey.

PubMed

Scott, Kate M; McGee, Magnus A; Oakley Browne, Mark A; Wells, J Elisabeth

2006-10-01

To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.

Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children’s Health and the National Health Interview Survey

PubMed Central

Strom, Mark A.; Silverberg, Jonathan I.

2016-01-01

Objective To determine if eczema is associated with an increased risk of a speech disorder. Study design We analyzed data on 354 416 children and adolescents from 19 US population-based cohorts: the 2003–2004 and 2007–2008 National Survey of Children’s Health and 1997–2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. Results In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%–5.0%) compared with 2.2% (95% CI 2.2%–2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57–2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02–1.81], P = .03) and severe eczema (3.56 [1.70–7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34–4.10], P = .003) and severe (2.28 [1.11–4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Conclusions Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. PMID:26520915

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Schizotypal Personality Disorder: Results From the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pulay, Attila J.; Stinson, Frederick S.; Dawson, Deborah A.; Goldstein, Risë B.; Chou, S. Patricia; Huang, Boji; Saha, Tulshi D.; Smith, Sharon M.; Pickering, Roger P.; Ruan, W. June; Hasin, Deborah S.; Grant, Bridget F.

2009-01-01

Objective: To present nationally representative findings on the prevalence, correlates, and comorbidity of and disability associated with DSM-IV schizotypal personality disorder (SPD). Method: This study used the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, which targeted a nationally representative sample of the adult civilian population of the United States aged 18 years and older and residing in households and group quarters. In Wave 2, attempts were made to conduct face-to-face reinterviews with all respondents to the Wave 1 interview. Results: Lifetime prevalence of SPD was 3.9%, with significantly greater rates among men (4.2%) than women (3.7%) (p < .01). Odds for SPD were significantly greater among black women, individuals with lower incomes, and those who were separated, divorced, or widowed; odds were significantly lower among Asian men (all p < .01). Schizotypal personality disorder was associated with substantial mental disability in both sexes. Co-occurrence rates of Axis I and other Axis II disorders among respondents with SPD were much higher than rates of co-occurrence of SPD among respondents with other disorders. After adjustment for sociodemographic characteristics and additional comorbidity, associations remained significant in both sexes between SPD and 12-month and lifetime bipolar I disorder, social and specific phobias, and posttraumatic stress disorder, as well as 12-month bipolar II disorder, lifetime generalized anxiety disorder, and borderline and narcissistic personality disorders (all p < .01). Conclusions: Common and unique factors may underlie associations of SPD with narcissistic and borderline personality disorders, whereas much of the comorbidity between SPD and most mood and anxiety disorders appears to reflect factors common to these disorders. Some of the associations with SPD were sex specific. Schizotypal personality disorder and dependent, avoidant, and borderline personality disorders

Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012).

PubMed

Oliveira-Campos, Maryane; Nunes, Marília Lavocart; Madeira, Fátima de Carvalho; Santos, Maria Goreth; Bregmann, Silvia Reise; Malta, Deborah Carvalho; Giatti, Luana; Barreto, Sandhi Maria

2014-01-01

This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

Executive Functioning Characteristics Associated with ADHD Comorbidity in Adolescents with Disruptive Behavior Disorders

ERIC Educational Resources Information Center

Hummer, Tom A.; Kronenberger, William G.; Wang, Yang; Dunn, David W.; Mosier, Kristine M.; Kalnin, Andrew J.; Mathews, Vincent P.

2011-01-01

The nature of executive dysfunction in youth with disruptive behavior disorders (DBD) remains unclear, despite extensive research in samples of children with attention-deficit hyperactivity disorder (ADHD). To determine the relationship between DBD, ADHD, and executive function deficits in aggressive teens, adolescents with DBD and comorbid ADHD…

Psychosocial Correlates of Jordanian Adolescents' Help-Seeking Intentions for Depression: Findings From a Nationally Representative School Survey.

PubMed

Dardas, Latefa Ali; Silva, Susan G; van de Water, Brittney; Vance, Ashlee; Smoski, Moria J; Noonan, Devon; Simmons, Leigh Ann

2017-01-01

Little is known about help-seeking for depression among Jordanian adolescents who are a vulnerable population with high rates of depressive symptoms and few mental health services. The purpose of this study was to (1) explore Jordanian adolescents' helpseeking intentions for depression and (2) examine whether depression stigma, depression severity, or their interaction are associated with Jordanian adolescents' willingness to seek help for depression and the type of treatment they would seek. In collaboration with the Jordanian Ministry of Education, we conducted a nationally representative, school-based survey of adolescents aged 12-17 years ( N = 2,349). One fourth of the adolescents reported they would not seek professional help for depression, and those respondents had higher average depression scores. Among those adolescents willing to seek help, the most likely sources included family member (57%), school counselor (46%), psychiatrist (43%), religious leader (39%), and general health practitioner (28%). Lower stigma scores were associated with greater likelihood to seek psychotherapy or visit a psychiatrist, while higher stigma scores were associated with increased likelihood to seek help from a school counselor or a family member. Jordanian adolescents experience significant barriers to seeking professional help for depression. However, even among adolescents with greater depression severity and depression stigma, school counselors were identified as a key resource for help. These findings suggest that school-based interventions may fill a critical service need for adolescents with depression and other mental health problems. School nurses should be leveraged along with counselors to address mental health issues in this vulnerable population.

Socioeconomic disadvantage, mental disorders and risk of 12-month suicide ideation and attempt in the National Comorbidity Survey Replication (NCS-R) in US.

PubMed

Pan, Yi-Ju; Stewart, Robert; Chang, Chin-Kuo

2013-01-01

We aim to explore the distinctive interrelationships between family income and mental disorders on suicidality in recent 12 months. A stratified random subsample of adults in a household survey in US, National Comorbidity Survey Replication, was used for analyses. The ratio of family income to poverty threshold (RoFIPT) per capita was the primary predictor of interest to 12-month occurrence of suicide ideation and attempt. Effect modification by mental disorders was further explored. A total of 4,724 subjects were analyzed. Inverse associations were found with RoFIPT for both suicidal outcomes after confounding control. Furthermore, effect modification was revealed that RoFIPT was more strongly associated with suicide ideation for those with mental disorders (OR 0.87; 95 % CI 0.79, 0.95). An inverse gradient of RoFIPT was shown with suicide ideation and attempt. Moreover, having mental disorders was found to be an effect modifier for the relationships between family income and suicidality.

The Illinois 9th Grade Adolescent Health Survey. Full Report.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield.

A survey was conducted in Illinois to identify the risk of certain health problems among adolescents; to determine the health status of Illinois youth in relation to the Surgeon General's "Healthy People 2000 Objectives" and monitor progress toward national and state goals; and to help those working at national, state, and local levels…

The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample

PubMed Central

Kessler, Ronald C.; Borges, Guilherme; Sampson, Nancy; Miller, Matthew; Nock, Matthew K.

2009-01-01

Controversy exists about whether the repeatedly-documented associations between smoking and subsequent suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) are due to unmeasured common causes or to causal effects of smoking on SROs. We address this issue by examining associations of smoking with subsequent SROs with and without controls for potential explanatory variables in the National Comorbidity Survey (NCS) panel. The latter consists of 5001 people who participated in both the 199002 NCS and the 2001–03 NCS Follow-up Survey. Explanatory variables include socio-demographics, potential common causes (parental history of mental-substance disorders; other respondent childhood adversities) and potential mediators (respondent history of DSM-III-R mental-substance disorders). Small gross (i.e., without controls) prospective associations are found between history of early-onset nicotine dependence and both subsequent suicide ideation and, among ideators, subsequent suicide plans. None of the baseline smoking measures, though, predicts subsequent suicide gestures or attempts among ideators. The smoking-ideation association largely disappear, but the association of early-onset nicotine dependence with subsequent suicide plans persists (Odds-ratio = 3.0), after adjustment for control variables. However, the latter association is as strong with remitted as active nicotine dependence, arguing against a direct causal effect of nicotine dependence on suicide plans. Decomposition of the control variable effects, furthermore, suggests that these effects are due to common causes more than to mediators. These results refine our understanding of the ways in which smoking is associated with later SROs and for the most part argue against the view that these associations are due to causal effects of smoking. PMID:18645572

ADHD and Health Services Utilization in the National Health Interview Survey

ERIC Educational Resources Information Center

Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert

2009-01-01

Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…

Comorbidity of PTSD, Major Depression, and Substance Use Disorder Among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri.

PubMed

Adams, Zachary W; Danielson, Carla Kmett; Sumner, Jennifer A; McCauley, Jenna L; Cohen, Joseph R; Ruggiero, Kenneth J

2015-01-01

The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events.

Specific Phobia among U.S. Adolescents: Phenomenology and Typology

PubMed Central

Burstein, Marcy; Georgiades, Katholiki; He, Jian-Ping; Schmitz, Anja; Feig, Emily; Khazanov, Gabriela Kattan; Merikangas, Kathleen

2014-01-01

Background Investigators have proposed the diagnostic value of a generalized subtype of specific phobia, with classification based upon the number of phobic fears. However, current and future typologies of specific phobia classify the condition by the nature of phobic fears. This study investigated the clinical relevance of these alternative typologies by: (1) presenting the prevalence and correlates of specific phobia separately by the number and nature of phobia types; and (2) examining the clinical and psychiatric correlates of specific phobia according to these alternative typologies. Methods The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental United States. Results Most adolescents with specific phobia met criteria for more than one type of phobia in their lifetime, however rates were fairly similar across DSM-IV/5 subtypes. Sex differences were consistent across DSM-IV/5 subtypes, but varied by the number of phobic types, with a female predominance observed among those with multiple types of phobias. Adolescents with multiple types of phobias exhibited an early age of onset, elevated severity and impairment, and among the highest rates of other psychiatric disorders. However, certain DSM-IV/5 subtypes (i.e. blood-injection-injury and situational) were also uniquely associated with severity and psychiatric comorbidity. Conclusions Results indicate that both quantitative and DSM-IV/5 typologies of specific phobia demonstrate diagnostic value. Moreover, in addition to certain DSM-IV/5 subtypes, a generalized subtype based on the number of phobias may also characterize youth who are at greatest risk for future difficulties. PMID:23108894

Persistence of Specific Phobia From Adolescence to Early Adulthood: Longitudinal Follow-Up of the Mexican Adolescent Mental Health Survey.

PubMed

Albor, Yesica C; Benjet, Corina; Méndez, Enrique; Medina-Mora, María Elena

2017-03-01

Specific phobia is one of the most common psychiatric disorders in the general population, begins at a younger age, and has high comorbidity. However, it receives less treatment than other disorders, perhaps because it is circumscribed to a specific object or situation that can be avoided or is difficult to differentiate from developmentally adaptive fear. Longitudinal studies are needed to clarify its clinical significance, risk factors, and course. This study was designed to determine the persistence of specific phobia in participants during an 8-year period from adolescence to young adulthood and its predictors in a Mexican cohort. 1,071 respondents from a representative 2-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. DSM-IV disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. Of adolescents with specific phobia at baseline, 17.46% persisted into adulthood. Persistence of specific phobia was predicted by an age of onset of disorder in adolescence (risk ratio [RR] = 2.83, 95% CI, 1.30-6.13), parental neglect (RR = 2.76, 95% CI, 1.35-5.65), a first-degree relative with specific phobia (RR = 2.69, 95% CI, 1.34-5.39) and economic adversities (RR = 2.06, 95% CI, 1.21-3.53). Noncomorbid specific phobia in adolescence predicted incidence of other anxiety and substance use disorders in early adulthood (RR = 1.98; 95% CI, 1.11-3.54 and RR = 1.35; 95% CI, 1.07-1.69, respectively). While many adolescents with specific phobia remit in adulthood, there are early adult consequences of adolescent phobia and identifiable risk factors for persistence that suggest a group of adolescents that might benefit from early intervention. © Copyright 2017 Physicians Postgraduate Press, Inc.

Adjusting health spending for the presence of comorbidities: an application to United States national inpatient data.

PubMed

Dieleman, Joseph L; Baral, Ranju; Johnson, Elizabeth; Bulchis, Anne; Birger, Maxwell; Bui, Anthony L; Campbell, Madeline; Chapin, Abigail; Gabert, Rose; Hamavid, Hannah; Horst, Cody; Joseph, Jonathan; Lomsadze, Liya; Squires, Ellen; Tobias, Martin

2017-08-29

One of the major challenges in estimating health care spending spent on each cause of illness is allocating spending for a health care event to a single cause of illness in the presence of comorbidities. Comorbidities, the secondary diagnoses, are common across many causes of illness and often correlate with worse health outcomes and more expensive health care. In this study, we propose a method for measuring the average spending for each cause of illness with and without comorbidities. Our strategy for measuring cause of illness-specific spending and adjusting for the presence of comorbidities uses a regression-based framework to estimate excess spending due to comorbidities. We consider multiple causes simultaneously, allowing causes of illness to appear as either a primary diagnosis or a comorbidity. Our adjustment method distributes excess spending away from primary diagnoses (outflows), exaggerated due to the presence of comorbidities, and allocates that spending towards causes of illness that appear as comorbidities (inflows). We apply this framework for spending adjustment to the National Inpatient Survey data in the United States for years 1996-2012 to generate comorbidity-adjusted health care spending estimates for 154 causes of illness by age and sex. The primary diagnoses with the greatest number of comorbidities in the NIS dataset were acute renal failure, septicemia, and endocarditis. Hypertension, diabetes, and ischemic heart disease were the most common comorbidities across all age groups. After adjusting for comorbidities, chronic kidney diseases, atrial fibrillation and flutter, and chronic obstructive pulmonary disease increased by 74.1%, 40.9%, and 21.0%, respectively, while pancreatitis, lower respiratory infections, and septicemia decreased by 21.3%, 17.2%, and 16.0%. For many diseases, comorbidity adjustments had varying effects on spending for different age groups. Our methodology takes a unified approach to account for excess spending caused

Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

PubMed

Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

2016-09-01

Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

Sociodemographic Differences in Depressed Mood: Results from a Nationally Representative Sample of High School Adolescents

ERIC Educational Resources Information Center

Paxton, Raheem J.; Valois, Robert F.; Watkins, Ken W.; Huebner, E. Scott; Drane, J. Wanzer

2007-01-01

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…

Long-Term Effects of Mental disorders on Employment In the National Comorbidity Survey Ten-Year Follow-up

PubMed Central

Mojtabai, Ramin; Stuart, Elizabeth A.; Hwang, Irving; Susukida, Ryoko; Eaton, William W.; Sampson, Nancy; Kessler, Ronald C.

2015-01-01

Purpose Although significant negative associations of mental disorders with employment have been documented in epidemiological research, much of this research was based on cross-sectional samples and focused only on severe and persistent mental disorders. The present study examined the longitudinal associations of more common mental disorders with employment. Methods Data on the associations of common mental disorders with employment are presented here from 4,501 respondents in the National Comorbidity Survey panel study, a two-wave community epidemiological survey of respondents aged 15-54 at baseline (1990-1992) who were re-interviewed in 2001-2003 and were employed, unemployed in the labor force or student at baseline. Lifetime mental disorders at baseline and disorders with onset after baseline were assessed with the Composite International Diagnostic Interview, a fully-structured interview that assessed lifetime prevalence of internalizing fear disorders (panic, phobias), anxiety/misery disorders (major depression, generalized anxiety disorder, post-traumatic stress disorder), externalizing disorders (conduct disorder, alcohol and illicit drug abuse-dependence), and bipolar disorder. Results Both baseline lifetime disorders and disorders with onsets after baseline were associated with significantly reduced odds of subsequent employment among respondents who were either employed or students at baseline. Population projections based on the assumption that these associations represented causal effects suggest that the mental disorders considered here were associated with 1.7-3.2 million adults being unemployed in the US population at follow-up. Conclusions Expanded access to treatment among current employees and students with mental disorders might lead to improved employment outcomes in these segments of the population. PMID:26211661

Face Emotion Processing in Depressed Children and Adolescents with and without Comorbid Conduct Disorder

ERIC Educational Resources Information Center

Schepman, Karen; Taylor, Eric; Collishaw, Stephan; Fombonne, Eric

2012-01-01

Studies of adults with depression point to characteristic neurocognitive deficits, including differences in processing facial expressions. Few studies have examined face processing in juvenile depression, or taken account of other comorbid disorders. Three groups were compared: depressed children and adolescents with conduct disorder (n = 23),…

A Unified, Transdiagnostic Treatment for Adolescents with Chronic Pain and Comorbid Anxiety and Depression

ERIC Educational Resources Information Center

Allen, Laura B.; Tsao, Jennie C. I.; Seidman, Laura C.; Ehrenreich-May, Jill; Zeltzer, Lonnie K.

2012-01-01

Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional…

Improving Targets for the Prevention of Drug Use Disorders: Sociodemographic Predictors of Transitions Across Drug Use Stages in the National Comorbidity Survey Replication

PubMed Central

Swendsen, Joel; Anthony, James C.; Conway, Kevin P.; Degenhardt, Louisa; Dierker, Lisa; Glantz, Meyer; He, Jianping; Kalaydjian, Amanda; Kessler, Ronald C.; Sampson, Nancy; Merikangas, Kathleen R.

2010-01-01

Objectives Models of drug use etiology and prevention require precise information concerning the expression of population-based risk factors across the continuum of drug use. However, the majority of previous epidemiologic research on this topic has not addressed transitions between specific drug stages. The present investigation examined the sociodemographic predictors of progression across six stages of drug use in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of the U.S. population conducted between February, 2001 and April, 2003. Methods Lifetime history of opportunity to use illicit substances, initial drug use, and DSM-IV drug use disorders were collected using in-person structured diagnostic interviews. Results The median age of first opportunity to use drugs as well as drug use, abuse and dependence each occurred prior to age 20, while the median remission from abuse and dependence occurred at 26 and 30 years, respectively. Most sociodemographic variables, in particular sex and ethnicity, demonstrated highly differential associations with transitions depending on the stage examined. Conclusions The findings may partially explain the effectiveness of strategies designed to reduce drug use, abuse and dependence, and indicate that increased correspondence is needed between available epidemiologic data and existing models of etiology or prevention. PMID:18926848

HPV Vaccination among Adolescent Males: Results from the National Immunization Survey-Teen

PubMed Central

Reiter, Paul L.; Gilkey, Melissa B.; Brewer, Noel T.

2013-01-01

US guidelines provided a permissive recommendation forHPV vaccine for males in 2009, with an updated recommendation for routine vaccination in 2011. Dataon vaccine uptake among males, however, remain sparse. We analyzed 2010–2011 data (collected mostlyprior to the recommendation for routine vaccination) from the National Immunization Survey-Teen for a nationally representative sample of adolescent males ages 13–17 (n=22,365). We examined HPV vaccine initiation( receipt of at least one doseba sed on healthcare provider records) as the primary outcome. Analyses used weighted logistic regression. HPV vaccine initiation increased from 1.4% in 2010 to 8.3% in 2011. Parents who reported receiving a healthcare provider recommendation to get their sons HPV vaccine were much more likely to have vaccinated sons (OR=19.02, 95% CI: 14.36–25.19). Initiation was also higher among sons who were Hispanic (OR=1.83, 95% CI: 1.24–2.71) or who were eligible for the Vaccines for Children program (OR=1.53, 95% CI: 1.01–2.31). Only31.0% of parents with unvaccinated sons indicatedtheir sons were “somewhat likely” or “very likely” to receive HPV vaccine in the next year. The most common main reasons for parents not intending to vaccinate were believing vaccination is not needed or not necessary (24.5%), not having received a provider recommendation (22.1%), and lack of knowledge (15.9%). HPV vaccination is low among adolescent males in the US, and provider recommendation for vaccination is likely keyto improv ingvaccine uptake. Given the updated recommendation for routine vaccination and the changes in health insurance coverage that are likely to follow, continued efforts are needed to monitor HPV vaccination among males. PMID:23602667

Impact of the AYA HOPE Comorbidity Index on Assessing Health Care Service Needs and Health Status among Adolescents and Young Adults with Cancer.

PubMed

Wu, Xiao-Cheng; Prasad, Pinki K; Landry, Ian; Harlan, Linda C; Parsons, Helen M; Lynch, Charles F; Smith, Ashley W; Hamilton, Ann S; Keegan, Theresa H M

2015-12-01

Existing comorbidity indices were not developed for adolescent and young adults (AYA) 15 to 39 years of age. The aim of this study was to assess impact of comorbidities on health care service needs and health status among AYA cancer survivors using the newly developed AYA HOPE comorbidity index in comparison with the existing indices. Data on comorbid conditions were obtained from medical records and service needs and health status were from a survey of AYA cancer survivors. Prevalence of comorbidities was based on the AYA HOPE index. Charlson and NCI indices were compared. Multivariable logistic regression was used. Of the 485 patients, 14.6% had ≥2 comorbidities based on the AYA HOPE Index. Prevalence of mental illness and obesity/overweight, which were not included in existing indices, were 8.2% and 5.8%, respectively. Prevalence of cardiovascular, endocrine, gastrointestinal, and neurologic conditions were higher with the AYA HOPE Index than the other two indices. Forty percent of AYA patients reported service needs, particularly for mental health services (25.2%) and support groups (17.7%). Having ≥2 comorbidities on the AYA index was associated with higher mental health service needs [OR, 2.05; 95% confidence interval (CI), 1.10-3.82] adjusting for demographic and clinical factors. Comorbidities were associated with fair/poor self-reported health status. The AYA HOPE Index is a more comprehensive comorbidity index for AYA cancer patients than existing indices, and the number of comorbidities is associated with service needs and health status. The AYA HOPE index could identify patients' additional service needs early in therapy. ©2015 American Association for Cancer Research.

A Clinician's Guide to Co-Occurring ADHD among Adolescent Substance Users: Comorbidity, Neurodevelopmental Risk, and Evidence-Based Treatment Options

ERIC Educational Resources Information Center

Hogue, Aaron; Evans, Steven W.; Levin, Frances R.

2017-01-01

This article introduces neurodevelopmental and clinical considerations for treating adolescents with co-occurring attention deficit hyperactivity disorder (ADHD) and adolescent substance use (ASU) in outpatient settings. We first describe neurobiological impairments common to ADHD and ASU, including comorbidity with conduct disorder, that evoke a…

Risk of mental health problems in adolescents skipping meals: The Korean National Health and Nutrition Examination Survey 2010 to 2012.

PubMed

Lee, Gyungjoo; Han, Kyungdo; Kim, Hyunju

Adolescents frequently skip meals, doing so even more than once per day. This is associated with more mental health problems. This study identified mental health problems' associations with skipping meals and the frequency thereof among adolescents. This cross-sectional population-based study used a data set of 1,413 adolescents from the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Hierarchical multivariable logistic regression was conducted to determine the risk of mental health problems, including stress, depressive mood, and suicidal ideation in relation to skipping meals and the frequency thereof per day. Breakfast skipping significantly increased the risks of stress and depressive mood. Stress, depressive mood, and suicidal ideation were significantly prevalent as the daily frequency of skipping meals increased. Specific strategies should be developed at government or school level to decrease the frequency of skipping meals per day, associated with serious mental health problems in adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

Associations of Neuroticism-Impulsivity and Coping with Binge Eating in a Nationally Representative Sample of Adolescents in the United States

PubMed Central

Townsend, Lisa; Reinblatt, Shauna P.; Mendelson, Tamar

2016-01-01

Objective Binge eating behavior is a public health concern due to its negative physical and mental health consequences. Little is known about the interplay of personality traits, coping styles, and binge eating in the general adolescent population. We examined the associations among the combination of neuroticism and impulsivity (NI), maladaptive coping styles (poor problem solving, distraction, and escape-avoidance), and lifetime prevalence of binge eating in a nationally representative sample of U.S. adolescents. We also explored coping as a moderator of the NI–lifetime binge eating association and gender as a moderator of the NI–coping associations and coping–lifetime binge eating associations. Methods We used data from the National Comorbidity Survey: Adolescent Supplement (NCS-A: 2001–2004), a cross-sectional nationally representative study of adolescents aged 13 to 18 years (n=10,028). We studied the associations of NI and coping with lifetime binge eating using multivariate regression models. Results High NI was significantly associated with all three coping styles, especially escape-avoidance (β = 3.96, confidence interval [CI] = 3.62, 4.29, p < 0.001). Gender was a significant moderator of the NI–distraction coping association (β = −0.68, CI = −1.33, −0.03, p = 0.041), indicating a stronger association in males (β = 1.20, CI = 0.81, 1.58, p < 0.001) than females (β = 0.53, CI = 0.02, 1.03, p = 0.042). Lifetime prevalence of binge eating was 1.13 times higher with increased escape-avoidance coping (CI = 1.10, 1.18, p < 0.001). Discussion Our findings indicate significant associations among high NI, increased escape-avoidance coping, and higher lifetime prevalence of binge eating in adolescents. Findings of our study have potential to inform development of interventions that target modification of maladaptive personality traits and coping styles to reduce problematic eating. PMID:27289518

Associations between Attention Deficit Hyperactivity Disorder and Eating Disorders by Gender: Results from the National Comorbidity Survey Replication.

PubMed

Brewerton, Timothy D; Duncan, Alexis E

2016-11-01

Few studies have assessed the association between attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) separately in men and women, especially in representative samples. Using data from the National Comorbidity Survey Replication, lifetime and past 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders IV, ADHD was compared in men and women with and without diagnoses of Diagnostic and Statistical Manual of Mental Disorders IV ED and any binge eating (BE) using logistic regression models adjusted for gender and age. In both sexes, those with lifetime and past 12-month BE and binge eating disorder had significantly higher prevalence of ADHD than those without BE and binge eating disorder, respectively. Women with lifetime and past 12-month bulimia nervosa and lifetime anorexia nervosa also had significantly higher prevalence of ADHD compared with women without these diagnoses. Given that ADHD invariably began earlier than the ED, ADHD may be an important risk factor for subsequent BE and related ED, and there may be opportunities for intervention among youth with ADHD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Phenomenology and comorbidity of dysthymic disorder in 100 consecutively referred children and adolescents: beyond DSM-IV.

PubMed

Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Pascale, Rosa Rita; Perugi, Giulio; Akiskal, Hagop S

2003-03-01

Diagnostic criteria and nosological boundaries of juvenile dysthymic disorder (DD) are under-researched. Two different sets of diagnostic criteria are still discussed in the DSM-IV, the first giving major weight to somatic and vegetative symptoms and the second, included in the appendix, to more affective and cognitive symptoms. The aim of this study was to describe prototypical symptomatology and comorbidity of DD, according to DSM-IV criteria, in a consecutive series of referred children and adolescents, as a function of age and sex. One hundred inpatients and outpatients (36 children and 64 adolescents, 57 males, 43 females, age range 7 to 18 years, mean age 13.3 years) received a diagnosis of DD without comorbid major depressive disorder (MDD), using historical information, the Diagnostic Interview for Children and Adolescents-Revised (DICA-R), and symptoms ratings according to the DSM-IV criteria. Irritability, low self-esteem, fatigue or loss of energy, depressed mood, guilt, concentration difficulties, anhedonia, and hopelessness were present in more than 50% of subjects. Differences in symptomatic profile between male and female patients were not significant. Anxiety disorders were commonly comorbid with DD, mainly generalized anxiety disorder, simple phobias, and in prepuberal children, separation anxiety disorder. Externalizing disorders were reported in 35% of the patients, with higher prevalence in male patients. Adolescents showed more suicidal thoughts and anhedonia than children. The clinical picture of early-onset DD we found, based entirely on a pure sample without current and past MDD, is not totally congruent with the diagnostic criteria according to DSM-IV. A more precise definition of the clinical picture may help early diagnosis and prevention of superimposed mental disorders.

Comorbidity of PTSD, Major Depression, and Substance Use Disorder among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri

PubMed Central

Adams, Zachary W.; Danielson, Carla Kmett; Sumner, Jennifer A.; McCauley, Jenna L.; Cohen, Joseph R.; Ruggiero, Kenneth J.

2015-01-01

Objective The purpose of this study was two-fold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD), and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. Method A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African-American) aged 12–17 years (M=14.5, SD=1.7) and their parents was recruited from communities affected by the Spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, DSM-IV symptoms of PTSD and MDE, and SUD symptoms. Prevalence estimates were calculated for PTSD+MDE, PTSD+SUD, MDE+SUD, and PTSD+MDE+SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Results Overall prevalence since the tornado was 3.7% for PTSD+MDE, 1.1% for PTSD+SUD, 1.0% for MDE+SUD, and 0.7% for PTSD+MDE+SUD. Girls were significantly more likely than boys to meet criteria for PTSD+MDE and MDE+SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD+MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Conclusions Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents’ prior history of stressful events. PMID:26168094

Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

ERIC Educational Resources Information Center

Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

2008-01-01

Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…

Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders.

PubMed

Tuisku, Virpi; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Holi, Matti; Ruuttu, Titta; Punamäki, Raija-Leena; Marttunen, Mauri

2006-06-01

We aimed to analyse and compare prevalence and associated clinical features of suicidal ideation, self-harm behaviour with no suicidal intent and suicide attempts among adolescent outpatients with depressive mood disorders with or without comorbidity. A sample of 218 consecutive adolescent outpatients aged 13-19 years with depressive mood disorders was interviewed using K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report questionnaires assessing depressive and anxiety symptoms. Suicidal behaviour was assessed by K-SADS-PL suicidality items. Half of the subjects reported suicidal ideation or behaviour. There was no difference in prevalence of suicidal behaviour between non-comorbid and comorbid mood disorder groups. Multivariate logistic regression analyses produced the following associations: (1) suicidal ideation with self-reported depressive symptoms and poor psychosocial functioning, (2) deliberate self-harm behaviour with younger age and poor psychosocial functioning, and (3) suicide attempts with self-reported depressive symptoms and poor psychosocial functioning. Depressed mood disorders, whether comorbid or not, are associated with suicidal ideation and suicide attempts. Diagnostic assessment should be supplemented by self-report methods when assessing suicidal behaviour in depressed adolescents.

Factors that influence parental vaccination decisions for adolescents, 13 to 17 years old: National Immunization Survey-Teen, 2010.

PubMed

Dorell, Christina; Yankey, David; Kennedy, Allison; Stokley, Shannon

2013-02-01

We aim to describe factors that influence parental decisions to vaccinate their adolescents. Data from the July to December 2010 National Immunization Survey-Teen Parental Concerns Module were analyzed to determine factors that influence parental decisions to vaccinate their adolescents. Parents reported that their adolescent's health care provider recommended tetanus toxoid/tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Td/Tdap; 74.4%), meningococcal conjugate (MenACWY; 60.3%), and human papillomavirus (HPV; 71.3%). Vaccination coverage estimates were significantly higher among parents who reported receiving a provider recommendation: 85.2% versus 76.7% (Td/Tdap), 77.3% versus 49.7% (MenACWY), and 62.2% versus 21.5% (HPV). Compared with Td/Tdap and MenACWY, fewer HPV vaccination conversations included recommendations for vaccination. Other than health care providers, school requirements (46.1%), news coverage (31.2%), and family (31.0%) were most frequently reported influences on parental vaccination decisions. Many factors influence parental decisions to vaccinate their adolescents; one of the most important factors is the provider recommendation. Missed opportunities for vaccination persist when strong vaccination recommendations are not given or are delayed.

Prevalence and Axis I Comorbidity of Full and Partial Posttraumatic Stress Disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2010-01-01

The present study used data from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653) to examine lifetime Axis I psychiatric comorbidity of posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. adults. Lifetime prevalences±standard errors of PTSD and partial PTSD were 6.4%±0.18 and 6.6%±0.18, respectively. Rates of PTSD and partial PTSD were higher among women (8.6%±0.26 and 8.6%±0.26) than men (4.1%±0.19 and 4.5%±0.21). Respondents with both PTSD and partial PTSD most commonly reported unexpected death of someone close, serious illness or injury to someone close, and sexual assault as their worst stressful experiences. PTSD and partial PTSD were associated with elevated lifetime rates of mood, anxiety, and substance use disorders, and suicide attempts. Respondents with partial PTSD generally had intermediate odds of comorbid Axis I disorders and psychosocial impairment relative to trauma controls and full PTSD. PMID:21168991

Sleep Patterns and Mental Health Correlates in US Adolescents.

PubMed

Zhang, Jihui; Paksarian, Diana; Lamers, Femke; Hickie, Ian B; He, Jianping; Merikangas, Kathleen Ries

2017-03-01

To investigate systematically the associations of sleep patterns with a range of mental disorders and other outcomes among a nationally representative sample of US adolescents. Using the National Comorbidity Survey Adolescent Supplement, a nationally representative cross-sectional survey of 10 123 US adolescents 13-18 years of age, we assessed associations between adolescent-reported sleep patterns (tertiles of weeknight bedtime, weeknight sleep duration, weekend bedtime delay, and weekend oversleep) and past-year mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, smoking, injury, suicidality, and perceived mental and physical health, assessed via direct diagnostic interview. The average weeknight bedtime was at 22:37 and sleep duration was 7.72 hours. Average weekend bedtime delay was 1.81 hours and average weekend oversleep was 1.17 hours. Later weeknight bedtime, shorter weeknight sleep duration, greater weekend bedtime delay, and both short and long periods of weekend oversleep were associated with increased odds of mood, anxiety, substance use, and behavioral disorders, as well as suicidality, tobacco smoking, and poor perceived mental and physical health. ORs ranged from 1.27 to 2.15. The only outcomes not associated with any sleep patterns were past-year injury and eating disorder. Suboptimal sleep patterns were associated with an array of mental disorders and other health-related outcomes among adolescents. Abnormal sleep patterns may serve as markers of prodromal or untreated mental disorders among adolescents, and may provide opportunities for prevention and intervention in mental disorders. Copyright © 2016. Published by Elsevier Inc.

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003–2010

PubMed Central

Laraia, Barbara A.; Leung, Cindy W.; Mietus-Snyder, Michele L.

2016-01-01

Introduction Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. Methods We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003–2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Results Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14–3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11–2.82), and Apo B (OR = 1.98; 95% CI, 1.17–3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14–6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. Conclusion In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity

Money Lending Practices and Adolescent Dating Relationship Abuse: Results from a National Sample.

PubMed

Copp, Jennifer E; Mumford, Elizabeth A; Taylor, Bruce G

2016-09-01

Research on adult intimate partner violence has demonstrated that economic considerations and financial decision-making are associated with the use of violence in marital and cohabiting relationships. Yet limited work has examined whether financial behaviors influence the use of violence in adolescent dating relationships. We use data from the National Survey on Teen Relationships and Intimate Violence (STRiV) (n = 728), a comprehensive national household survey dedicated specifically to the topic of adolescent relationship abuse, to examine associations between requests for money lending, economic control/influence, financial socialization and adolescent relationship abuse among a large, diverse sample of male and female adolescents [48 % female; 30 % non-White, including Black (10 %), Hispanic (2 %), and other (18 %)]. Findings suggest that requests for money lending are associated with heightened risk of moderate and serious threats/physical violence perpetration and victimization, net of traditional predictors. We discuss the implications of our findings for intervention and prevention efforts.

Prevalence and Correlates of ADHD Symptoms in the National Health Interview Survey

ERIC Educational Resources Information Center

Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert E.

2005-01-01

Objective: Study the prevalence and correlates of ADHD symptoms in the National Health Interview Survey (NHIS). Methods: NHIS includes 10,367 children ages 4 to 17. Parents report lifetime diagnosis of ADHD and complete the Strengths and Difficulties Questionnaire (SDQ). Prevalences of clinically significant ADHD and comorbid symptoms by race and…

Specific phobia among U.S. adolescents: phenomenology and typology.

PubMed

Burstein, Marcy; Georgiades, Katholiki; He, Jian-Ping; Schmitz, Anja; Feig, Emily; Khazanov, Gabriela Kattan; Merikangas, Kathleen

2012-12-01

Investigators have proposed the diagnostic value of a generalized subtype of specific phobia, with classification based upon the number of phobic fears. However, current and future typologies of specific phobia classify the condition by the nature of phobic fears. This study investigated the clinical relevance of these alternative typologies by: (1) presenting the prevalence and correlates of specific phobia separately by the number and nature of phobia types; and (2) examining the clinical and psychiatric correlates of specific phobia according to these alternative typologies. The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13-18 years in the continental United States. Most adolescents with specific phobia met criteria for more than one type of phobia in their lifetime, however rates were fairly similar across DSM-IV/5 subtypes. Sex differences were consistent across DSM-IV/5 subtypes, but varied by the number of phobic types, with a female predominance observed among those with multiple types of phobias. Adolescents with multiple types of phobias exhibited an early age of onset, elevated severity and impairment, and among the highest rates of other psychiatric disorders. However, certain DSM-IV/5 subtypes (i.e. blood-injection-injury and situational) were also uniquely associated with severity and psychiatric comorbidity. Results indicate that both quantitative and DSM-IV/5 typologies of specific phobia demonstrate diagnostic value. Moreover, in addition to certain DSM-IV/5 subtypes, a generalized subtype based on the number of phobias may also characterize youth who are at greatest risk for future difficulties. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

School Mental Health Resources and Adolescent Mental Health Service Use

PubMed Central

Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Comparison of QEEG Findings between Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) without Comorbidity and ADHD Comorbid with Internet Gaming Disorder.

PubMed

Park, Jeong Ha; Hong, Ji Sun; Han, Doug Hyun; Min, Kyoung Joon; Lee, Young Sik; Kee, Baik Seok; Kim, Sun Mi

2017-03-01

Internet gaming disorder (IGD) is often comorbid with attention deficit hyperactivity disorder (ADHD). In this study, we compared the neurobiological differences between ADHD comorbid with IGD (ADHD+IGD group) and ADHD without comorbidity (ADHD-only group) by analyzing quantitative electroencephalogram (QEEG) findings. We recruited 16 male ADHD+IGD, 15 male ADHD-only adolescent patients, and 15 male healthy controls (HC group). Participants were assessed using Young's Internet Addiction Scale and ADHD Rating Scale. Relative power and inter- and intra-hemispheric coherences of brain waves were measured using a digital electroencephalography (EEG) system. Compared to the ADHD-only group, the ADHD+IGD group showed lower relative delta power and greater relative beta power in temporal regions. The relative theta power in frontal regions were higher in ADHD-only group compared to HC group. Inter-hemispheric coherence values for the theta band between F3-F4 and C3-C4 electrodes were higher in ADHD-only group compared to HC group. Intra-hemispheric coherence values for the delta, theta, alpha, and beta bands between P4-O2 electrodes and intra-hemispheric coherence values for the theta band between Fz-Cz and T4-T6 electrodes were higher in ADHD+IGD group compared to ADHD-only group. Adolescents who show greater vulnerability to ADHD seem to continuously play Internet games to unconsciously enhance attentional ability. In turn, relative beta power in attention deficit in ADHD+IGD group may become similar to that in HC group. Repetitive activation of brain reward and working memory systems during continuous gaming may result in an increase in neuronal connectivity within the parieto-occipital and temporal regions for the ADHD+IGD group.

Phenotypic characteristics of adolescents with concave and convex facial profiles - The National Health Examination Survey.

PubMed

Hujoel, P P; Bollen, A-M; Yuen, K C J; Hujoel, I A

2016-10-01

It has been suggested that facial traits are informative on the inherited susceptibility to tuberculosis and obesity, two current global health issues. Our aim was to compare the phenotypic characteristics of adolescents with dental markers for a concave (n=420), a convex (n=978), and a straight (n=3542) facial profile in a nationally representative sample of United States adolescents. The results show that adolescents with a concave facial profile, when compared to a straight facial profile, had an increased waist-to-height ratio (Δ, 1.1 [95% CI 0.5-1.7], p<0.003) and an increased acne prevalence (OR, 1.5 [95% CI 1.2-1.9], p<0.001). Adolescents with a convex facial profile, when compared to a straight facial profile, had an increased prevalence of tuberculosis (OR, 4.3 [95% CI 1.4-13.1], p<0.02), increased ectomorphy (Δ, 0.3 [95% CI 0.2-0.4], p<0.0001), increased left-handedness (OR, 1.4 [95% CI 1.1-1.7], p<0.007), increased color-blindness (OR, 1.7 [95% CI 1.3-2.3], p<0.004), and rhesus ee phenotype (OR, 1.3 [95% CI 1.1-1.5], p<0.008). Adolescents with a concave facial profile, when compared to a convex profile, had increased mesomorphy (Δ, 1.3 [95% CI 1.1-1.5], p<0.0001), increased endomorphy (Δ, 0.5 [95% CI 0.4-0.6], p<0.0001), lower ectomorphy (Δ, 0.5 [95% CI 0.4-0.6], p<0.0001), and lower vocabulary test scores (Δ, 2.3 [95% CI 0.8-3.8], p<0.008). It is concluded that population-based survey data confirm that distinct facial features are associated with distinct somatotypes and distinct disease susceptibilities. Copyright © 2016 Elsevier GmbH. All rights reserved.

Close Online Relationships in a National Sample of Adolescents.

ERIC Educational Resources Information Center

Wolak, Janis; Mitchell, Kimberly J.; Finkelhor, David

2002-01-01

Uses data from a national survey of adolescent Internet users to describe online relationships. Fourteen percent of the youths interviewed reported close online friendships during the past year, 7% reported face-to-face meetings, and 2% reported online romances. Few youths reported bad experiences with online friends. (GCP)

Factors Associated With Provider Reporting of Child and Adolescent Vaccination History to Immunization Information Systems: Results From the National Immunization Survey, 2006-2012.

PubMed

Cardemil, Cristina V; Cullen, Karen A; Harris, LaTreace; Greby, Stacie M; Santibanez, Tammy A

2016-01-01

Use of Immunization information systems (IISs) by providers can improve vaccination rates by identifying missed opportunities. However, provider reporting of children's vaccination histories to IISs remains suboptimal. To assess factors associated with provider reporting to an IIS. Analysis of 2006-2012 National Immunization Survey (NIS) and NIS-Teen data. NIS and NIS-Teen are ongoing random-digit-dial telephone surveys of households with children and adolescents, respectively, followed by a mail survey to providers to obtain the patient's vaccination history. A total of 115 285 children aged 19 to 35 months and 83 612 adolescents aged 13 to 17 years and their immunization providers in the United States. The percentage of children and adolescents with 1 or more providers reporting to or obtaining vaccination information from their local IISs. Multivariable logistic regression was used to examine patient and provider factors associated with provider reporting to IISs and adjusted prevalence of children and adolescents with 1 or more providers reporting to IISs. In 2012, 79.4% of children and 77.4% of adolescents had 1 or more providers report any of their vaccination data to an IIS, and 41.9% of children and 51.5% of adolescents had providers who obtained any of their vaccination histories from an IIS. During 2006-2012, children and adolescents were more likely to have any of their vaccination data reported to an IIS if they received care from all public versus all private providers (children: 84.4% vs 69.6%, P < .0001; adolescents: 84.6% vs 66.4%, P < .0001), had 1 or more providers who ordered vaccines from a state or local health department (children: 76.7% vs 59.5%, P < .0001; adolescents: 77.0% vs 55.6%, P < .0001), or had 1 or more providers obtain vaccination information from the IIS (children: 86.1% vs 71.2%, P < .0001; adolescents: 83.7% vs 64.6%, P < .0001). Health department staff should target providers less likely to use IIS services, including private

Comorbid Depression and Anxiety in Childhood and Adolescent Anorexia Nervosa: Prevalence and Implications for Outcome

ERIC Educational Resources Information Center

Hughes, Elizabeth K.

2012-01-01

Background: Comorbid conditions are common in individuals with anorexia nervosa (AN) and can raise issues for diagnosis, prognosis, and treatment planning. Methods: First, reported prevalence rates for depression and anxiety in children and adolescents with AN were reviewed. Diagnostic issues and current understanding of the temporal onset and…

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001-2013.

PubMed

Price, James H; Khubchandani, Jagdish

2017-06-01

Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African-American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.

Guns, anger, and mental disorders: Results from the National Comorbidity Survey Replication (NCS-R)

PubMed Central

Swanson, Jeffrey W.; Sampson, Nancy A.; Zaslavsky, Alan M.; Appelbaum, Paul S.; Swartz, Marvin S.; Kessler, Ronald C.

2016-01-01

Analyses from the National Comorbidity Study Replication provide the first nationally-representative estimates of the co-occurrence of pathological anger traits and possessing or carrying a gun among adults with and without certain mental disorders and demographic characteristics. The study found that a large number of individuals in the United States have anger traits and also possess firearms at home (10.4%) or carry guns outside the home (1.6%). These data document associations of numerous common mental disorders and combinations of anger traits with gun access. Because only a small proportion of persons with this risky combination have ever been hospitalized for a mental health problem, most will not be subject to existing mental-health-related legal restrictions on firearms due to involuntary commitment. Excluding a large proportion of the general population from gun possession is also not likely to be feasible. Behavioral risk-based approaches to firearms restriction, such as expanding the definition of gun-prohibited persons to include those with violent misdemeanor convictions and multiple DUI convictions, could be a more effective public health policy to prevent gun violence in the population. PMID:25850688

School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey.

PubMed

Kim, Yongjoo; Kawachi, Ichiro

2016-01-01

Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents' weight status estimation pattern among Korea adolescents. The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12-18 years. Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed. At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the

Human Papillomavirus Vaccination of Adolescents with Chronic Medical Conditions: A National Survey of Pediatric Subspecialists.

PubMed

Hofstetter, Annika M; Lappetito, Lauren; Stockwell, Melissa S; Rosenthal, Susan L

2017-02-01

Many adolescents with chronic medical conditions (CMCs) are at risk of human papillomavirus (HPV) infection, associated complications, and underimmunization and often identify a pediatric subspecialist as their main provider. This study aimed to assess the HPV-related understanding, beliefs, and practices of pediatric subspecialists, which are largely unknown. National cross-sectional study. Pediatric endocrinologists, hematologist/oncologists, pulmonologists, and rheumatologists identified using the American Medical Association Physician Masterfile (n = 418). Subspecialists who care for adolescents with CMCs in the outpatient setting were recruited to complete a Web-based survey on their HPV-related knowledge, attitudes, comfort, and practices. HPV vaccination recommendation. Over half of respondents (50.4%; n = 196/389) reported sometimes or always recommending HPV vaccination to adolescent patients with CMCs. Factors positively associated with recommendation included hematology/oncology (adjusted odds ratio [AOR], 4.69; 95% confidence interval [CI], 1.86-11.81) or rheumatology (AOR, 6.55; 95% CI, 1.67-25.74) specialization, seeing more adolescent patients with CMCs (AOR, 1.01; 95% CI, 1.00-1.02), and sometimes or always discussing sexual health (AOR, 2.53; 95% CI, 1.05-6.08) or checking vaccine status (AOR, 3.83; 95% CI, 1.59-9.20) with these patients. Those who thought it was important, but were uncomfortable discussing sexual health when recommending HPV vaccination (AOR, 0.28; 95% CI, 0.12-0.70) or who reported insufficient HPV vaccine information (AOR, 0.45; 95% CI, 0.23-0.88) or lack of primary-subspecialty care provider communication (AOR, 0.38; 95% CI, 0.16-0.93) as barriers to HPV vaccination were less likely to recommend HPV vaccination. This study revealed that many subspecialists fail to recommend HPV vaccination to adolescents with CMCs and highlights potential targets for future interventions. Copyright © 2016 North American Society for Pediatric

Blood cadmium concentrations in Korean adolescents: From the Korea National Health and Nutrition Examination Survey 2010-2013.

PubMed

Ahn, Borami; Kim, Shin-Hye; Park, Mi-Jung

2017-01-01

To assess blood cadmium levels in Korean adolescents with respect to demographic and lifestyle factors. We analyzed data from the Korea National Health and Nutrition Examination Survey from 2010 to 2013, totaling 1472 adolescents aged 10-18 years. Geometric means of blood cadmium were calculated using a complex samples general linear model to compare blood levels in different demographic and lifestyle groups. Multivariate logistic regression analyses were also used to find predictors for high blood cadmium (>90th percentile). The geometric mean of the blood cadmium concentrations was 0.30μg/L in Korean adolescents. Older age, type of housing (multifamily house and commercial building), smoking and alcohol consumption, and iron deficiency/iron deficiency anemia (IDA) were significantly associated with higher blood cadmium concentrations (P<0.05). Blood cadmium concentrations were not significantly affected by gender, region, body mass index status, or household income. In multivariate logistic regression analysis, independent predictors for higher blood cadmium levels included current smoker (OR=7.77), alcohol consumption (OR=4.31), living in a multifamily house or commercial building (OR=3.11-3.46), and IDA (OR=2.64). Possible associations between blood cadmium levels and type of housing or alcohol consumption in adolescents are suggested for the first time in this study. Further studies are needed to elucidate the mechanism of these findings. Copyright © 2016 Elsevier GmbH. All rights reserved.

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Stinson, Frederick S.; Dawson, Deborah A.; Goldstein, Rise B.; Chou, S. Patricia; Huang, Boji; Smith, Sharon M.; Ruan, W. June; Pulay, Attila J.; Saha, Tulshi D.; Pickering, Roger P.; Grant, Bridget F.

2009-01-01

Objectives To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of narcissistic personality disorder (NPD) among men and women. Methods Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Results Prevalence of lifetime NPD was 6.2%, with rates greater for men (7.7%) than women (4.8%). NPD was significantly more prevalent among Black men and women and Hispanic women, younger adults, and separated/divorced/widowed and never married adults. NPD was associated with mental disability among men but not women. High co-occurrence rates of substance use, mood, anxiety, and other personality disorders (PDs) were observed. With additional comorbidity controlled for, associations with bipolar I disorder, PTSD, and schizotypal and borderline PDs remained significant, but weakened, among men and women. Similar associations were observed between NPD and specific phobia, generalized anxiety disorder, and bipolar II disorder among women; and alcohol abuse, alcohol dependence, drug dependence, and histrionic and obsessive-compulsive PDs among men. Dysthymia was significantly and negatively associated with NPD. Conclusions NPD is a prevalent PD in the general U.S. population and is associated with considerable disability among men, whose rates exceed those of women. NPD may not be as stable as previously recognized or described in the DSM-IV. The results highlight the need for further research from numerous perspectives to identify the unique and common genetic and environmental factors underlying the disorder-specific associations with NPD observed in this study. PMID:18557663

School mental health resources and adolescent mental health service use.

PubMed

Green, Jennifer Greif; McLaughlin, Katie A; Alegría, Margarita; Costello, E Jane; Gruber, Michael J; Hoagwood, Kimberly; Leaf, Philip J; Olin, Serene; Sampson, Nancy A; Kessler, Ronald C

2013-05-01

Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This article examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources and policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Nearly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students to mental health providers was not associated with overall service use, but was associated with sector of service use. School mental health resources, particularly those related to early identification, may facilitate mental health service use and may influence sector of service use for youths with DSM disorders. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Prevalence, correlates, and comorbidity of DSM-IV obsessive-compulsive personality disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Grant, Jon E; Mooney, Marc E; Kushner, Matt G

2012-04-01

Although recognized for over 100 years, there is a relative dearth of empirical research on obsessive compulsive personality disorder (OCPD). The goal of the current study is to present nationally representative findings on prevalence, sociodemographic correlates, and comorbidity of OCPD among men and women. The current study uses nationally representative data to examine sociodemographic correlates and comorbidity of OCPD. Face-to-face interviews were conducted with 43,093 adults in the United States. The prevalence of lifetime OCPD was 7.8%, with rates the same for men and women. OCPD was significantly less common in younger adults and in Asians and Hispanics but was significantly more common in individuals with a high school education or less. When sociodemographic variables and other comorbidities were controlled for, current associations remained significant for all mood and anxiety disorders as well as lifetime personality disorders among both men and women. OCPD is a prevalent personality disorder in the US population and is equally represented in men and women. The results highlight the need for further research to identify common pathophysiological elements common to OCPD and associated disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Frequency, Comorbidity, and Psychosocial Impairment of Depressive Disorders in Adolescents.

ERIC Educational Resources Information Center

Essau, Cecilia A.; Conradt, Judith; Petermann, Franz

2000-01-01

Estimated the frequency, comorbidity, and psychosocial impairment of depressive disorders from survey of 1,035 German 12- to 17-year-olds. Found that 17.9 percent met the lifetime criteria for depressive disorders, according to DSM-IV criteria; criteria were higher in females than in males. Rates for all disorders increased with age, with…

Continuity, Comorbidity and Longitudinal Associations between Depression and Antisocial Behaviour in Middle Adolescence: A 2-Year Prospective Follow-Up Study

ERIC Educational Resources Information Center

Ritakallio, Minna; Koivisto, Anna-Maija; von der Pahlen, Bettina; Pelkonen, Mirjami; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

2008-01-01

The study investigated continuity, comorbidity and longitudinal associations between depression Beck depression inventory (RBDI) and antisocial behaviour Youth self-report (YSR) in middle adolescence. Data were used from a community sample of 2070 adolescents who participated in a 2-year prospective follow-up study. The results indicate that both…

Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005-2012.

PubMed

Rodríguez, Luis A; Madsen, Kristine A; Cotterman, Carolyn; Lustig, Robert H

2016-09-01

To examine the association between added sugar intake and metabolic syndrome among adolescents. Dietary, serum biomarker, anthropometric and physical activity data from the US National Health and Nutrition Examination Survey cycles between 2005 and 2012 were analysed using multivariate logistic regression models. Added sugar intake in grams per day was estimated from two 24 h standardized dietary recalls and then separated into quintiles from lowest to highest consumption. Multivariate logistic regression analyses were adjusted for physical activity, age, BMI Z-score and energy intake, and their interactions with race were included. Nationally representative sample, USA. US adolescents aged 12-19 years (n 1623). Added sugar was significantly associated with metabolic syndrome. The adjusted prevalence odds ratios for having metabolic syndrome comparing adolescents in the third, fourth and fifth quintiles v. those in the lowest quintile of added sugar were 5·3 (95 % CI 1·4, 20·6), 9·9 (95 % CI 1·9, 50·9) and 8·7 (95 % CI 1·4, 54·9), respectively. Our findings suggest that higher added sugar intake, independent of total energy intake, physical activity or BMI Z-score, is associated with increased prevalence of metabolic syndrome in US adolescents. Further studies are needed to determine if reducing intake of added sugar may help US adolescents prevent or reverse metabolic syndrome.

New Insights into the Comorbidity between ADHD and Major Depression in Adolescent and Young Adult Females

ERIC Educational Resources Information Center

Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Mick, Eric; Spencer, Thomas J.; McCreary, Michelle; Cote, Michelle; Faraone, Stephen V.

2008-01-01

The association between attention-deficit/hyperactivity disorder (ADHD) and major depression (MD) in adolescent and young adult females is evaluated. Findings indicate that MD emerging in the context of ADHD is an impairing and severe comorbidity that needs to be considered further clinically and scientifically.

Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample.

PubMed

Bányai, Fanni; Zsila, Ágnes; Király, Orsolya; Maraz, Aniko; Elekes, Zsuzsanna; Griffiths, Mark D; Andreassen, Cecilie Schou; Demetrovics, Zsolt

2017-01-01

Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs.

Comparison of QEEG Findings between Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) without Comorbidity and ADHD Comorbid with Internet Gaming Disorder

PubMed Central

2017-01-01

Internet gaming disorder (IGD) is often comorbid with attention deficit hyperactivity disorder (ADHD). In this study, we compared the neurobiological differences between ADHD comorbid with IGD (ADHD+IGD group) and ADHD without comorbidity (ADHD-only group) by analyzing quantitative electroencephalogram (QEEG) findings. We recruited 16 male ADHD+IGD, 15 male ADHD-only adolescent patients, and 15 male healthy controls (HC group). Participants were assessed using Young's Internet Addiction Scale and ADHD Rating Scale. Relative power and inter- and intra-hemispheric coherences of brain waves were measured using a digital electroencephalography (EEG) system. Compared to the ADHD-only group, the ADHD+IGD group showed lower relative delta power and greater relative beta power in temporal regions. The relative theta power in frontal regions were higher in ADHD-only group compared to HC group. Inter-hemispheric coherence values for the theta band between F3–F4 and C3–C4 electrodes were higher in ADHD-only group compared to HC group. Intra-hemispheric coherence values for the delta, theta, alpha, and beta bands between P4–O2 electrodes and intra-hemispheric coherence values for the theta band between Fz–Cz and T4–T6 electrodes were higher in ADHD+IGD group compared to ADHD-only group. Adolescents who show greater vulnerability to ADHD seem to continuously play Internet games to unconsciously enhance attentional ability. In turn, relative beta power in attention deficit in ADHD+IGD group may become similar to that in HC group. Repetitive activation of brain reward and working memory systems during continuous gaming may result in an increase in neuronal connectivity within the parieto-occipital and temporal regions for the ADHD+IGD group. PMID:28145657

Psychoactive substance use, family context and mental health among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012).

PubMed

Malta, Deborah Carvalho; Oliveira-Campos, Maryane; do Prado, Rogério Ruscitto; Andrade, Silvania Suely Caribé; de Mello, Flávia Carvalho Malta; Dias, Antonio José Ribeiro; Bomtempo, Denise Birche

2014-01-01

To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The study's findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.

Do adult focused anti-smoking campaigns have an impact on adolescents? The case of the Australian National Tobacco Campaign.

PubMed

White, V; Tan, N; Wakefield, M; Hill, D

2003-09-01

To examine adolescents' awareness of and response to an adult focused anti-smoking advertising campaign. Data were obtained from two cross sectional surveys of adolescents. The first study, a national evaluation study, involved a telephone survey of a randomly selected sample of 400 14-17 year olds across Australia in 1998. The second study involved a survey of 3714 students aged 12-17 years, randomly selected from a probability sample of secondary schools in the Australian State of Victoria. In both surveys, adolescents answered questions on their awareness of the advertising campaign and actions taken in response to the campaign. Adolescents in the national evaluation study also answered questions assessing knowledge of health effects of smoking, impact of the campaign on adolescents, and relevance of the campaign for adolescents and other groups. Responses for smokers and nonsmokers were examined. Among the national evaluation sample, 85% of adolescent smokers thought the campaign was relevant to them. Fifty three per cent indicated that the campaign had led some teenagers to at least try to quit and 85% thought it made smoking seem less cool and desirable. Among students who were established smokers the campaign generated quitting activity, with 27% cutting down the number of cigarettes they smoked and 26% having thought about quitting. Results indicate that adolescents were very aware of this adult focused anti-smoking campaign and thought it relevant to them. The findings suggest that a graphic health effects cessation focused campaign may have been successful in promoting anti-smoking attitudes among adolescents.

Impact of Treatments for Depression on Comorbid Anxiety, Attentional, and Behavioral Symptoms in Adolescents with Selective Serotonin Reuptake Inhibitor-Resistant Depression

ERIC Educational Resources Information Center

Hilton, Robert C.; Rengasamy, Manivel; Mansoor, Brandon; He, Jiayan; Mayes, Taryn; Emslie, Graham J.; Porta, Giovanna; Clarke, Greg N.; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Ryan, Neal; Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Brent, David A.

2013-01-01

Objective: To assess the relative efficacy of antidepressant medication, alone and in combination with cognitive behavioral therapy (CBT), on comorbid symptoms of anxiety, attention, and disruptive behavior disorders in participants in the Treatment of Resistant Depression in Adolescents (TORDIA) trial. Method: Adolescents with selective serotonin…

The Impact of an Eight-Day Intensive Treatment for Adolescent Panic Disorder and Agoraphobia on Comorbid Diagnoses

PubMed Central

Gallo, Kaitlin P.; Chan, Priscilla T.; Buzzella, Brian A.; Whitton, Sarah W.; Pincus, Donna B.

2012-01-01

Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for non-primary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for Panic Disorder with or without Agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; specifically Specific Phobias, Generalized Anxiety Disorder, and Social Phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets. PMID:22304887

Long-term effects of mental disorders on marital outcomes in the National Comorbidity Survey ten-year follow-up.

PubMed

Mojtabai, Ramin; Stuart, Elizabeth A; Hwang, Irving; Eaton, William W; Sampson, Nancy; Kessler, Ronald C

2017-10-01

Epidemiological research has consistently shown an association between mental disorders and marital dissolution. However, this research mostly examined the association of divorce as a risk factor for mental illness. This study prospectively examined the associations of mood, anxiety, and substance use disorders with future marital dissolution and new marriages in a representative population sample. The study used data from the National Comorbidity Survey panel study-a two-wave community epidemiological survey of 5001 participants interviewed in 1990-1992 and re-interviewed in 2001-2003. Mental disorders were ascertained with the Composite International Diagnostic Interview, a fully structured instrument. Associations of baseline lifetime disorders and disorders with onset after the baseline with subsequent divorce and marriage/remarriage were examined using discrete-time survival analysis models. Mental disorders at baseline or with onset after baseline were associated with significantly greater odds of subsequent divorce among respondents who either were married at baseline or got married after baseline. Mental disorders with onset after baseline were associated with smaller odds of marriage or remarriage. Projections assuming causal effects of mental illness on marital outcomes suggest that preventing the effects of common mood, anxiety, and substance use disorders would be associated with 6.7 million fewer divorces and 3.5 million more marriages in the US population over an 11-year period. Individuals with common mental disorders are at greater risk of marital dissolution and are less likely to enter new marriages. These factors contribute to the diminished social engagement and social support for individuals with these disorders. Interventions aimed at improving marital and family relationships could potentially ameliorate the effect of mental disorders on these vital social ties.

Obesity and Insulin Resistance Screening Tools in American Adolescents: National Health and Nutrition Examination Survey (NHANES) 1999 to 2010.

PubMed

Lee, Joey A; Laurson, Kelly R

2016-08-01

To identify which feasible obesity and insulin resistance (IR) screening tools are most strongly associated in adolescents by using a nationally representative sample. Adolescents aged 12.0 to 18.9 years who were participating in the National Health and Nutrition Examination Survey (NHANES) (n=3584) and who were measured for height, weight, waist circumference (WC), triceps and subscapular skinfold thickness, glycated hemoglobin, fasting glucose (FG) and fasting insulin (FI) level were included. Adolescents were split by gender and grouped by body mass index (BMI) percentile. Age- and gender-specific classifications were constructed for each obesity screening tool measure to account for growth and maturation. General linear models were used to establish groups objectively for analysis based on when IR began to increase. Additional general linear models were used to identify when IR significantly increased for each IR measure as obesity group increased and to identify the variance accounted for among each obesity-IR screening tool relationship. As the obesity group increased, homeostasis model assessment-insulin resistance (HOMA-IR) and FI significantly increased, while FG increased only (above the referent) in groups with BMI percentiles ≥95.0, and glycated hemoglobin level did not vary across obesity groups. The most strongly associated screening tools were WC and FI in boys (R(2)=0.253) and girls (R(2)=0.257). FI had the strongest association with all of the obesity measures. BMI associations were slightly weaker than WC in each in relation to IR. Our findings show that WC and FI are the most strongly associated obesity and IR screening tool measures in adolescents. These feasible screening tools should be utilized in screening practices for at-risk adolescents. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder among Older Adults in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2011-01-01

Objectives To present findings on the prevalence, correlates, and psychiatric comorbidity of DSM-IV posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults. Design, Setting, and Participants Face-to-face interviews with 9,463 adults aged 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Measurements Sociodemographic correlates, worst stressful experiences, comorbid lifetime mood, anxiety, substance use, and personality disorders, psychosocial functioning, and suicide attempts. Results Lifetime prevalences±standard errors of PTSD and partial PTSD were 4.5%±0.25 and 5.5%±0.27, respectively. Rates were higher in women (5.7%±0.37 and 6.5%±0.39) than men (3.1%±0.31 and 4.3%±0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders, and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders, and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD. Conclusions PTSD among older adults in the United States is slightly more prevalent than previously reported and associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders. PMID:22522959

Psychiatric comorbidity of full and partial posttraumatic stress disorder among older adults in the United States: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Pietrzak, Robert H; Goldstein, Risë B; Southwick, Steven M; Grant, Bridget F

2012-05-01

To present findings on the prevalence, correlates, and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults. Face-to-face interviews with 9,463 adults age 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Sociodemographic correlates; worst stressful experiences; comorbid lifetime mood, anxiety, substance use, and personality disorders; psychosocial functioning; and suicide attempts. Lifetime prevalences ± standard errors of PTSD and partial PTSD were 4.5% ± 0.25 and 5.5% ± 0.27, respectively. Rates were higher in women (5.7% ± 0.37 and 6.5% ± 0.39) than in men (3.1% ± 0.31 and 4.3% ± 0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and their own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD. PTSD among older adults in the United States is slightly more prevalent than previously reported and is associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders.

[Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey].

PubMed

Gómez-Restrepo, Carlos; Bohórquez, Adriana; Tamayo Martínez, Nathalie; Rondón, Martín; Bautista, Nubia; Rengifo, Herney; Medina Rico, Mauricio

2016-12-01

There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. To determine the prevalence and mental factors associated with major depression and anxiety disorders. Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering from any disorder were, being female (OR=2.1), having little family support (OR=2.0), having witnessed at least one traumatic event (OR=2.6), and having had a previous suicide attempt (OR=3.4). Participation in at least one group was a protective factor (OR=0.5). Mental disorders of anxiety and depression represent a major burden of disease for Colombia. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Relation of Early Menarche to Depression, Eating Disorders, Substance Abuse, and Comorbid Psychopathology among Adolescent Girls.

ERIC Educational Resources Information Center

Stice, Eric; Presnell, Katherine; Bearman, Sarah Kate

2001-01-01

Used interview data from a community study to test whether early menarche partially accounts for increased depression, eating pathology, substance abuse, and comorbid psychopathology among adolescent girls. Found that menarche prior to 11.6 years related to elevated depression and substance abuse. Findings support assertion that early menarche is…

Examining the Impact of Psychiatric Diagnosis and Comorbidity on the Medical Lethality of Adolescent "Suicide Attempts"

ERIC Educational Resources Information Center

Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.

2012-01-01

Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of "suicide attempts" among adolescents presenting to an urban general hospital (N = 375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without…

Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample

PubMed Central

Bányai, Fanni; Zsila, Ágnes; Király, Orsolya; Maraz, Aniko; Elekes, Zsuzsanna; Griffiths, Mark D.; Andreassen, Cecilie Schou

2017-01-01

Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs. PMID:28068404

Attention-deficit hyperactivity disorder and nonsuicidal self-injury in a clinical sample of adolescents: the role of comorbidities and gender.

PubMed

Balázs, Judit; Győri, Dóra; Horváth, Lili Olga; Mészáros, Gergely; Szentiványi, Dóra

2018-02-06

The aim of the present study was to investigate the possible association between attention-deficit hyperactivity disorder (ADHD) and non-suicidal self-injury (NSSI) with special focus on the role of comorbidities and gender in a clinical sample of adolescents with both a dimensional and a categorical approach to psychopathology. Using a structured interview, the Mini International Neuropsychiatric Interview Kid and a self-rated questionnaire, the Deliberate Self-Harm Inventory, the authors examined 202 inpatient adolescents (aged: 13-18 years) in the Vadaskert Child and Adolescent Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. Descriptive statistics, Mann-Whitney U test, chi-square test and mediator model were used. Fifty-two adolescents met full criteria for ADHD and a further 77 showed symptoms of ADHD at the subthreshold level. From the 52 adolescents diagnosed with ADHD, 35 (67.30%) had NSSI, of whom there were significantly more girls than boys, boys: n = 10 (28.60%), girls: n = 25 (71.40%) ((χ 2 (1) = 10.643 p < .001 ϕ = .452). Multiple mediation analyses resulted in a moderated mediation model in which the relationship between symptoms of ADHD and the prevalence of current NSSI was fully mediated by the symptoms of comorbid conditions in both sex. Significant mediators were the symptoms of affective and psychotic disorders and suicidality in both sexes and the symptoms of alcohol abuse/dependence disorders in girls. ADHD symptoms are associated with an increased risk of NSSI in adolescents, especially in the case of girls. Our findings suggest that clinicians should routinely screen for the symptoms of ADHD and comorbidity, with a special focus on the symptoms of affective disorders and alcohol abuse/dependence psychotic symptoms to prevent NSSI.

Developmental Course(s) of Lifetime Cigarette Use and Panic Attack Comorbidity

ERIC Educational Resources Information Center

Bernstein, Amit; Zvolensky, Michael J.; Schmidt, Norman B.; Sachs-Ericcson, Natalie

2007-01-01

The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M[Age] = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand…

Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions.

PubMed

Stinson, Frederick S; Dawson, Deborah A; Goldstein, Risë B; Chou, S Patricia; Huang, Boji; Smith, Sharon M; Ruan, W June; Pulay, Attila J; Saha, Tulshi D; Pickering, Roger P; Grant, Bridget F

2008-07-01

To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of narcissistic personality disorder (NPD) among men and women. Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions conducted between 2004 and 2005 in the United States. Prevalence of lifetime NPD was 6.2%, with rates greater for men (7.7%) than for women (4.8%). NPD was significantly more prevalent among black men and women and Hispanic women, younger adults, and separated/divorced/widowed and never married adults. NPD was associated with mental disability among men but not women. High co-occurrence rates of substance use, mood, and anxiety disorders and other personality disorders were observed. With additional comorbidity controlled for, associations with bipolar I disorder, post-traumatic stress disorder, and schizotypal and borderline personality disorders remained significant, but weakened, among men and women. Similar associations were observed between NPD and specific phobia, generalized anxiety disorder, and bipolar II disorder among women and between NPD and alcohol abuse, alcohol dependence, drug dependence, and histrionic and obsessive-compulsive personality disorders among men. Dysthymic disorder was significantly and negatively associated with NPD. NPD is a prevalent personality disorder in the general U.S. population and is associated with considerable disability among men, whose rates exceed those of women. NPD may not be as stable as previously recognized or described in the DSM-IV. The results highlight the need for further research from numerous perspectives to identify the unique and common genetic and environmental factors underlying the disorder-specific associations with NPD observed in this study.

Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey.

PubMed

Sitko, Katarzyna; Bentall, Richard P; Shevlin, Mark; O'Sullivan, Noreen; Sellwood, William

2014-07-30

Accumulated evidence over the past decade consistently demonstrates a relationship between childhood adversity and psychosis in adulthood. There is some evidence of specific associations between childhood sexual abuse and hallucinations, and between insecure attachment and paranoia. Data from the National Comorbidity Survey were used in assessing whether current attachment styles influenced the association between adverse childhood experiences and psychotic symptoms in adulthood. Hallucinations and paranoid beliefs were differentially associated with sexual abuse (rape and sexual molestation) and neglect, respectively. Sexual abuse and neglect were also associated with depression. The relationship between neglect and paranoid beliefs was fully mediated via anxious and avoidant attachment. The relationship between sexual molestation and hallucinations was independent of attachment style. The relationship between rape and hallucinations was partially mediated via anxious attachment; however this effect was no longer present when depression was included as a mediating variable. The findings highlight the importance of addressing and understanding childhood experiences within the context of current attachment styles in clinical interventions for patients with psychosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Child Abuse and Psychiatric Co-morbidity Among Chinese Adolescents: Emotional Processing as Mediator and PTSD from Past Trauma as Moderator.

PubMed

Chung, Man Cheung; Chen, Zhuo Sheng

2017-08-01

This study investigated whether child abuse was associated with psychiatric co-morbidity in a group of Chinese adolescents, and whether this association would be mediated by emotional processing difficulties and moderated by the severity of PTSD from other traumas in the past. Four hundred seventy-four adolescents participated in the study. They completed the Childhood Trauma Questionnaire-Short Form, General Health Questionnaire-28, the Posttraumatic Stress Diagnostic Scale, and Emotional processing scale-25. The results showed that after adjusting for the total number of traumatic events and how long ago the most traumatic event occurred, child abuse was associated with psychiatric co-morbidity. This association was not moderated by the severity of PTSD from past traumas but mediated by emotion processing difficulties. To conclude, adolescents who experience child abuse can develop emotional processing difficulties which in turn impact on psychiatric symptoms. Experience of past trauma does not influence these psychological processes.

Prevalence and Correlates of Mental Disorders in Israeli Adolescents: Results from a National Mental Health Survey

ERIC Educational Resources Information Center

Farbstein, Ilana; Mansbach-Kleinfeld, Ivonne; Levinson, Daphna; Goodman, Robert; Levav, Itzhak; Vograft, Itzik; Kanaaneh, Rasim; Ponizovsky, Alexander M.; Brent, David A.; Apter, Alan

2010-01-01

Background: The development of epidemiological instruments has enabled the assessment of mental disorders in youth in countries that plan policy according to evidence-based principles. The Israel Survey of Mental Health among Adolescents (ISMEHA) was conducted in 2004-2005 in a representative sample of 957 adolescents aged 14-17 and their mothers.…

Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample.

PubMed

Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2011-01-01

To compare prevalences of self-reported comorbid headache, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000-2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics, and NH Blacks (African Americans). Data from the 2000-2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status, and health care utilization. Estimates and test statistics (ie, Pearson correlations, regressions, and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design. A total of 189,977 people (52% female and 48% males, 73% NH Whites, 12% Hispanic, 11% NH Blacks, and 4% "Other") were included. A total of 4.6% reported TMJMD-type pain, and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (n = 8,964) reported ⋝ two comorbid pains. Females reported more comorbid pain than males (odds ratio [OR] = 1.41, P < .001); Hispanic and NH Blacks reported more than NH Whites (OR = 1.56, P <.001; OR= 1.38, P <.001, respectively). In addition, 53% of those with TMJMD-type pain had severe headache/migraines, 54% had neck pain, 64% low back pain, and 62% joint pain. Differences in gender and race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with a higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span, and higher among non-White males

The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses.

PubMed

Gallo, Kaitlin P; Chan, Priscilla T; Buzzella, Brian A; Whitton, Sarah W; Pincus, Donna B

2012-03-01

Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets. Copyright © 2011. Published by Elsevier Ltd.

Reasons for not vaccinating adolescents: National Immunization Survey of Teens, 2008-2010.

PubMed

Darden, Paul M; Thompson, David M; Roberts, James R; Hale, Jessica J; Pope, Charlene; Naifeh, Monique; Jacobson, Robert M

2013-04-01

To determine the reasons adolescents are not vaccinated for specific vaccines and how these reasons have changed over time. We analyzed the 2008-2010 National Immunization Survey of Teens examining reasons parents do not have their teens immunized. Parents whose teens were not up to date (Not-UTD) for Tdap/Td and MCV4 were asked the main reason they were not vaccinated. Parents of female teens Not-UTD for human papillomavirus vaccine (HPV) were asked their intent to give HPV, and those unlikely to get HPV were asked the main reason why not. The most frequent reasons for not vaccinating were the same for Tdap/Td and MCV4, including "Not recommended" and "Not needed or not necessary." For HPV, the most frequent reasons included those for the other vaccines as well as 4 others, including "Not sexually active" and "Safety concerns/Side effects." "Safety concerns/Side effects" increased from 4.5% in 2008 to 7.7% in 2009 to 16.4% in 2010 and, in 2010, approaching the most common reason "Not Needed or Not Necessary" at 17.4% (95% CI: 15.7-19.1). Although parents report that health care professionals increasingly recommend all vaccines, including HPV, the intent to not vaccinate for HPV increased from 39.8% in 2008 to 43.9% in 2010 (OR for trend 1.08, 95% CI: 1.04-1.13). Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV. The concern about safety of HPV grew with each year. Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines.

Physician tobacco screening and advice to quit among U.S. adolescents - National Survey on Drug Use and Health, 2013.

PubMed

Collins, Lauren; Smiley, Sabrina L; Moore, Rakiya A; Graham, Amanda L; Villanti, Andrea C

2017-01-01

Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking. Physician screening for tobacco use increases the odds of physicians intervening with patients who smoke; However, without appropriate follow-through by the physician, screening for tobacco use is not enough to significantly increase cessation rates. Given the critical phase of development adolescence poses in tobacco use and evidence that physician intervention improves adult cessation efforts, we sought to examine physician tobacco use screening and advice to quit among adolescents (12-17 years). Using data from the 2013 National Survey on Drug Use and Health (NSDUH), we examined the prevalence and correlates of tobacco use screening in adolescent respondents who reported visiting their physician within the past year ( N  = 12,798). Multivariable logistic regression analyses explored the relationship between tobacco use screening and physician advice to quit in a sub-set of the sample who reported on physician advice to quit ( n  = 1,868), controlling for sociodemographics, cigarette use, and substance use and screening. Only 49% of adolescents who visited a physician within the past year reported being screened for tobacco use. Adolescents who were screened by their physician were predominantly female (56.6%), White (60.1%), in late adolescence (83.0%), and covered by private health insurance (63.8%). Screening for tobacco use was highly correlated with physician advice to quit smoking, controlling for sociodemographic characteristics and cigarette use; this relationship was attenuated, but remained significant, after screening for alcohol and marijuana were added to the model. Hispanic adolescents were significantly less likely to receive physician advice to quit in all multivariable models. Our findings suggest missed opportunities for youth tobacco use prevention and cessation efforts in the clinical setting. Further research is needed to better

Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.

PubMed

Stanley, Ian H; Hom, Melanie A; Luby, Joan L; Joshi, Paramjit T; Wagner, Karen D; Emslie, Graham J; Walkup, John T; Axelson, David A; Joiner, Thomas E

2017-12-01

Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6-15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Usual intake of added sugars and lipid profiles among the U.S. adolescents: National Health and Nutrition Examination Survey, 2005-2010.

PubMed

Zhang, Zefeng; Gillespie, Cathleen; Welsh, Jean A; Hu, Frank B; Yang, Quanhe

2015-03-01

Although studies suggest that higher consumption of added sugars is associated with cardiovascular risk factors in adolescents, none have adjusted for measurement errors or examined its association with the risk of dyslipidemia. We analyzed data of 4,047 adolescents aged 12-19 years from the 2005-2010 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey. We estimated the usual percentage of calories (%kcal) from added sugars using up to two 24-hour dietary recalls and the National Cancer Institute method to account for measurement error. The average usual %kcal from added sugars was 16.0%. Most adolescents (88.0%) had usual intake of ≥10% of total energy, and 5.5% had usual intake of ≥25% of total energy. After adjustment for potential confounders, usual %kcal from added sugars was inversely associated with high-density lipoprotein (HDL) and positively associated with triglycerides (TGs), TG-to-HDL ratio, and total cholesterol (TC) to HDL ratio. Comparing the lowest and highest quintiles of intake, HDLs were 49.5 (95% confidence interval [CI], 47.4-51.6) and 46.4 mg/dL (95% CI, 45.2-47.6; p = .009), TGs were 85.6 (95% CI, 75.5-95.6) and 101.2 mg/dL (95% CI, 88.7-113.8; p = .037), TG to HDL ratios were 2.28 (95% CI, 1.84-2.70) and 2.73 (95% CI, 2.11-3.32; p = .017), and TC to HDL ratios were 3.41 (95% CI, 3.03-3.79) and 3.70 (95% CI, 3.24-4.15; p = .028), respectively. Comparing the highest and lowest quintiles of intake, adjusted odds ratio of dyslipidemia was 1.41 (95% CI, 1.01-1.95). The patterns were consistent across sex, race/ethnicity, and body mass index subgroups. No association was found for TC, low-density lipoprotein, and non-HDL cholesterol. Most U.S. adolescents consumed more added sugars than recommended for heart health. Usual intake of added sugars was significantly associated with several measures of lipid profiles. Published by Elsevier Inc.

Factors associated with caregiver burden among pharmacotherapy-treated children/adolescents with ADHD in the Caregiver Perspective on Pediatric ADHD survey in Europe.

PubMed

Fridman, Moshe; Banaschewski, Tobias; Sikirica, Vanja; Quintero, Javier; Erder, M Haim; Chen, Kristina S

2017-01-01

Burden on caregivers of children/adolescents with attention-deficit/hyperactivity disorder (ADHD) is multidimensional, but incompletely understood. To analyze caregiver burden across the concepts of work, social/family life, and parental worry/stress, in relation to selected contributing factors. The online Caregiver Perspective on Pediatric ADHD survey was fielded in ten European countries. Analysis included children/adolescents (6-17 years) who were receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers recorded their child's/adolescent's symptoms "on"/"off" medication (ie, when the caregiver reported that the child/adolescent forgot/chose not to take medication, before the onset of medication effect, or medication worn off). Effects of ADHD severity, comorbidities, and medication adherence on each burden outcome were assessed (multiple regression models). In total, 2,326 caregivers were included (children/adolescents' mean age: 11.5 years, 80% male). Caregivers reported missed/altered work, avoiding social activity, increased parental worry/stress, and strain on family life, despite using ADHD pharmacotherapy. Child/adolescent comorbidities and ADHD severity were significantly related to all burden concepts measured; the strongest comorbidity associations were with altered work (odds ratios [ORs] =1.68 [95% confidence interval {CI} 1.33, 2.12], 1.87 [1.37, 2.54], 3.47 [2.51, 4.78] for 1, 2, 3+ comorbidities, respectively) and planning the day around the child/adolescent (OR =1.42 [95% CI 1.17, 1.72], 1.73 [1.33, 2.15], 2.65 [1.99, 3.53]); the strongest severity associations were: quitting a job (OR =1.41 [95% CI 1.26, 1.59]) and planning a day around the child/adolescent (OR =1.26 [95% CI 1.20, 1.32]). Increased medication adherence was most associated with reducing the caregiver burden for altered work (OR =0.57 [95% CI 0.45, 0.72]), worrying about how they are being perceived as a parent (OR =0.68 [0.56, 0.83]), and avoiding social

Educational needs of epileptologists regarding psychiatric comorbidities of the epilepsies: a descriptive quantitative survey.

PubMed

Mula, Marco; Cavalheiro, Esper; Guekht, Alla; Kanner, Andres M; Lee, Hyang Woon; Özkara, Çiğdem; Thomson, Alfredo; Wilson, Sarah J

2017-06-01

Psychiatric disorders are relatively frequent comorbidities in epilepsy and they have an impact on morbidity, mortality, and quality of life. This is a report from the Task Force on Education of the ILAE Commission on Neuropsychiatry based on a survey about educational needs of epileptologists regarding management of the psychiatric comorbidities of epilepsy. The Task Force designed a quantitative questionnaire to survey the self-perceived confidence of child and adult epileptologists and psychiatrists in managing major psychiatric comorbidities of epilepsy to identify: (1) critical areas of improvement from a list of skills that are usually considered necessary for effective management of these conditions, and (2) the preferred educational format for improving these skills. A total of 211 respondents from 36 different countries participated in the survey. Confidence and usefulness scores suggest that responders would most value education and training in the management of specific clinical scenarios. Child neurologists identified major Axis I disorders, such as mood and anxiety disorders, while adult neurologists identified attention deficit hyperactivity disorder, intellectual disabilities, and autistic spectrum disorder as key areas. Both adult and child neurologists identified screening skills as the priority. Psychiatrists mainly valued specific training in the management of psychiatric complications of epilepsy surgery or psychiatric adverse events of antiepileptic drugs. Sessions during congresses and face-to-face meetings represent the preferred educational format, while e-learning modules and review papers were chosen by a minority of respondents. Results of this survey identify key areas for improvement in managing the psychiatric comorbidities of epilepsy and suggest specific strategies to develop better training for clinicians involved in epilepsy care.

Post-traumatic stress disorder, drug abuse and migraine: new findings from the National Comorbidity Survey Replication (NCS-R).

PubMed

Peterlin, B Lee; Rosso, Andrea L; Sheftell, Fred D; Libon, David J; Mossey, Jana M; Merikangas, Kathleen R

2011-01-01

Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse. This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH). Our sample consisted of 5,692 participants. Lifetime and 12-month prevalence rates of PTSD were increased in those with EM and CDH. After adjustments, the lifetime odds ratio (OR) of PTSD was greater in those with EM (OR 3.07 confidence interval [CI]: 2.12, 4.46) compared to those without headache; was greater in men than women with EM (men: OR 6.86; CI: 3.11, 15.11; women: OR 2.77; CI: 1.83, 4.21); and was comparable or greater than the association between migraine with depression or anxiety. The lifetime OR of PTSD was also increased in CDH sufferers. The OR of illicit drug abuse was not increased in those with EM or CDH unless co-occurring with PTSD or depression. The lifetime and 12-month OR of PTSD is increased in those with migraine or CDH, and is greater in men than women with migraine. The lifetime and 12-month OR of illicit drug abuse is not increased in those with migraine or CDH unless co-occurring with PTSD or depression.

Relationship of sodium intake with obesity among Korean children and adolescents: Korea National Health and Nutrition Examination Survey.

PubMed

Lee, Soo-Kyung; Kim, Mi Kyung

2016-03-14

We investigated whether dietary and urinary Na is associated with adiposity in Korean children and adolescents (10-18 years), a population with a high salt intake. Study subjects were Korean children and adolescents who participated in the cross-sectional nationally representative Korea National Health and Nutrition Examination Survey (2010-2011). This study used measures of dietary (24-h dietary recall) and urinary Na (Na:creatinine ratio) and three methods to determine obesity (BMI, waist circumference (WC) and total body per cent fat (TBPF)). Higher Na intake was significantly associated with obesity, adjusting for the covariates. Subjects in the highest tertile of urinary Na excretion had a significantly higher OR for higher adiposity compared with those in the lowest tertile (multivariate-adjusted OR 3·13 (95% CI 1·81, 5·50) for BMI, 2·15 (95% CI 1·27, 3·66) for WC and 1·92 (95% CI 1·29, 2·86) for TBPF, respectively). Na intake estimated by the 24-h recall method also showed significant association with adiposity (multivariate-adjusted OR 2·79 (95% CI 1·66, 4·68) for BMI and 2·14 (95% CI 1·25, 3·67) for WC, respectively). The significant associations between Na and adiposity remained significant after additionally adjusting for sugar-sweetened beverage (SSB) consumption. Our results revealed a significant positive association between urinary and dietary Na and adiposity in Korean children and adolescents, independent of SSB consumption.

School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey

PubMed Central

2016-01-01

Background Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents’ weight status estimation pattern among Korea adolescents. Objective The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12–18 years. Method Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed. Results At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status

Situations of violence experienced by students in the state capitals and the Federal District: results from the National Adolescent School-based Health Survey (PeNSE 2012).

PubMed

Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Dias, Antônio Ribeiro; do Prado, Rogério Ruscitto; Lima, Cheila Marina; da Silva, Marta Maria Alves; da Silva Júnior, Jarbas Barbosa

2014-01-01

To describe violent events experienced by school-aged adolescents in school, around the school and in the family context, and to compare the results of the National Adolescent School-based Health Survey of 2009 and 2012. Indicators related to violence involving teenagers were analyzed. The prevalence rates and confidence intervals of 95% were calculated for events of interest according to gender and type of school (public or private) and regions. Prevalence rates were: insecurity in the route between home-school (9.1%), insecurity in school (8.0%), physical assault in the last 12 months (18.2%), engaging in fights in the last 12 months (20.7%), fighting with a cold weapon (8.3%), fighting with firearms (6.9%), physical assault by a family member (11.6%) and having been seriously injured in the last 12 months (10.3%). The situations of violence were more prevalent among male students from public schools. The comparison with the 2009 survey showed increased prevalence in all the variables studied. Teenagers are exposed to different forms of violence, and the data from the National Survey of School Health can support the planning of preventive actions.

Clinical Differences Among Patients Treated for Mental Health Problems in General Medical and Specialty Mental Health Settings in the National Comorbidity Survey Replication (NCS-R)

PubMed Central

Uebelacker, Lisa A.; Wang, Philip S.; Berglund, Patricia; Kessler, Ronald C.

2009-01-01

Objective General medical (GM) treatments for mental health disorders are less likely to be adequate than specialty mental health (SMH) treatments. We explored whether differences in clinical characteristics of patients treated in each sector (GM-only or SMH-only) or in both sectors (GM + SMH) may help to explain this finding. Method We analyzed data from the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5692 English-speaking adult household residents that was carried out in 2001–03. The NCS-R used a fully-structured diagnostic interview to assess DSM-IV disorders, including mood, anxiety, impulse-control, and substance use disorders. We classified disorders in terms of a three-category severity gradient (serious, moderate, mild) based on information about clinically significant distress and role impairment. We collected self-report data on chronic physical conditions, socio-demographics, and type of treatment received for emotional and substance use problems in the 12 months before the interview. Results Patients who received GM+SMH treatment had more severe mental disorders and a higher prevalence of mood and anxiety disorders than patients who received treatment in only one of the two sectors. Patients seen in the GM-only and GM+SMH had more chronic physical conditions than patients seen in SMH-only. Conclusions Patient characteristics may partially explain the lower intensity and adequacy of GM treatment. PMID:16950373

Children and adolescents presenting to chiropractors in Norway: National Health Insurance data and a detailed survey.

PubMed

Allen-Unhammer, Anna; Wilson, Francis J H; Hestbaek, Lise

2016-01-01

The idea of chiropractors treating children is controversial, yet many parents seek chiropractic care for their children. The reasons for this are not well documented. Part one of this study aimed to document the profile of all paediatric patients consulting Norwegian chiropractors in 2013 using National Health Insurance data (NHI) with regards to age, gender and primary complaints. Part two aimed to provide a more detailed description of these patients in the form of a descriptive, paper-based survey. Part one involved Norwegian NHI data from 2013. Part two consisted of a year-long, paper-based survey. Chiropractors registered with the Norwegian chiropractic association (NKF) were invited to participate via email. Participating chiropractors were assigned one random month to collect data. All paediatric patients (or their parents) during that were asked to complete questionnaires containing information on presenting complaint, consequences of this complaint, age, and mode of referral. In general, there was good concordance between part one and two of the study in terms of age, gender and presenting complaint. The youngest children constituted the largest paediatric group in Norwegian chiropractic practice. Musculoskeletal problems were the most common reason for children visiting a chiropractor in all of the age categories, according to NHI data. Part two of the study found that one-third of young school children and adolescents reported pain lasting longer than 1-year. Eleven percent of children found that their complaint had severely affected their mood and 22 % felt their activities were very limited by their condition. Referrals from healthcare professionals were uncommon. The survey's results were based on 161 completed questionnaires, received from 15 % of the Norwegian chiropractors. Musculoskeletal problems constituted the most common presenting complaint for children and adolescents presenting to Norwegian chiropractors. A sizable proportion of children

Posttraumatic Stress Symptoms and Trajectories in Child Sexual Abuse Victims: An Analysis of Sex Differences Using the National Survey of Child and Adolescent Well-Being

ERIC Educational Resources Information Center

Maikovich, Andrea Kohn; Koenen, Karestan C.; Jaffee, Sara R.

2009-01-01

Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years…

Long-Term Effects of Mental disorders on Marital Outcomes In the National Comorbidity Survey Ten-Year Follow-up

PubMed Central

Mojtabai, Ramin; Stuart, Elizabeth A.; Hwang, Irving; Eaton, William W.; Sampson, Nancy; Kessler, Ronald C.

2018-01-01

Purpose Epidemiological research has consistently shown an association between mental disorders and marital dissolution. However, this research mostly examined the association of divorce as a risk factor for mental illness. This study prospectively examined the associations of mood, anxiety, and substance use disorders with future marital dissolution and new marriages in a representative population sample. Methods The study used data from the National Comorbidity Survey panel study—a two-wave community epidemiological survey of 5,001 participants assessed in1990–1992 and re-interviewed in 2001–2003. Mental disorders were ascertained with the Composite International Diagnostic Interview, a fully-structured interview. Association of baseline lifetime disorders and disorders with onset after the baseline with subsequent divorce and marriage/remarriage were examined using discrete-time survival analysis models. Results Mental disorders at baseline or with onset after baseline were associated with significantly greater odds of subsequent divorce among respondents who either were married at baseline or got married after baseline. Mental disorders with onset after baseline were associated with smaller odds of marriage or remarriage. Projections assuming causal effects of mental illness on marital outcomes suggest that preventing the effects of common mood, anxiety and substance use disorders would be associated with 6.7 million fewer divorces and 3.5 million more marriages in the US population over an 11 year period. Conclusions Individuals with common mental illnesses are at greater risk of marital dissolution, and are less likely to enter new marriages. These factors contribute to the diminished social engagement and social support for individuals with these disorders. Interventions aimed at improving marital and family relationships could potentially ameliorate the effect of mental disorders on these vital social ties. PMID:28378065

Bullying and associated factors among Brazilian adolescents: analysis of the National Adolescent School-based Health Survey (PeNSE 2012).

PubMed

Malta, Deborah Carvalho; do Prado, Rogério Ruscitto; Dias, Antônio José Ribeiro; Mello, Flavia Carvalho M; Silva, Marta Angelica Iossi; da Costa, Michelle Ralil; Caiaffa, Waleska Teixeira

2014-01-01

To estimate the prevalence of bullying from the victim's perspective in Brazilian school children and to analyze its association with individual and family context variables. An analysis of the data on 109,104 adolescents, obtained by the National Adolescent School-based Health Survey, held in schools in 2012, was carried out. An association model between bullying and explanatory variables was tested in different contexts: sociodemographic, risk behaviors, mental health and family context. Univariate and multivariate analyzes were performed, calculating the Odds Ratio and confidence intervals. The prevalence of bullying found in this study was of 7.2% (95%CI 6.6 - 7.8). A higher chance of bullying was found among male students (OR = 1.58; 95%CI 1.51 - 1.66), with an inverse relation between age and bullying, with the magnitude of risk among adolescents younger than 13 years of age being higher when compared to those with 16 years of age or more. Of individual risk behaviors, only being a smoker remained in the final model (OR = 1.11; 95%CI 1.01 - 1.23). Mental health variables associated with bullying were: feeling lonely (OR = 2.66; 95%CI 2.52 - 2.81), insomnia (OR = 1.92; 95%CI 1.80 - 2.05), not having friends (OR = 1.71; 95%CI 1.54 - 1.89), and, in the family context, those who skip class without telling their parents (OR = 1.13; 95%CI 1,07 - 1,19) and those who suffer physical abuse by family members (OR = 2.03; 95%CI 1.91 - 2.146). Bullying was associated to male students, younger, of black color, smokers, with mental health vulnerabilities and victims of domestic violence. This suggests the need for a holistic approach from education and health professionals, parents and the community in seeking measures for the prevention of bullying.

A Unified, Transdiagnostic Treatment for Adolescents With Chronic Pain and Comorbid Anxiety and Depression

PubMed Central

Allen, Laura B.; Tsao, Jennie C.I.; Seidman, Laura C.; Ehrenreich-May, Jill; Zeltzer, Lonnie K.

2017-01-01

Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional disorders and suggest the possibility of extending these interventions to chronic pain and pain-related dysfunction. This case report describes the use of a unified protocol for treatment of an adolescent boy with chronic daily headache and social anxiety and an adolescent girl with whole body pain and depression. Following weekly, 50-minute individual treatment sessions, the boy demonstrated notable improvement in emotional symptoms, emotion regulation skills, somatization, and functional disability. The girl showed some improvement on measures of anxiety and depression, although there appeared to be a worsening of pain symptoms and somatization. However, both patients demonstrated improvement over follow-up. This case study illustrates the potential utility of a unified treatment approach targeting pain and emotional symptoms from an emotion regulation perspective in an adolescent population. PMID:28824271

Self-Injurious Behavior and Fragile X Syndrome: Findings from the National Fragile X Survey

ERIC Educational Resources Information Center

Symons, Frank J.; Byiers, Breanne J.; Raspa, Melissa; Bishop, Ellen; Bailey, Donald B., Jr.

2010-01-01

We used National Fragile X Survey data in order to examine reported self-injurious behavior (SIB) to (a) generate lifetime and point prevalence estimates, (b) document detailed features of SIB (frequency, types, location, severity) in relation to gender, and (c) compare comorbid conditions between matched pairs (SIB vs. no SIB). Results indicate…

Adolescent vaccination: coverage achieved by ages 13-15 years, and vaccinations received as recommended during ages 11-12 years, National Health Interview Survey 1997-2003.

PubMed

McCauley, Mary Mason; Stokley, Shannon; Stevenson, John; Fishbein, Daniel B

2008-12-01

To present progress toward Healthy People 2010 vaccination objectives for adolescents aged 13-15 years, and to determine how much catch-up and routine vaccination was administered at the recommended ages of 11-12 years. Data from the 1997-2003 National Health Interview Survey were evaluated. In the first analysis, vaccination coverage levels for adolescents aged 13-15 years were determined for each survey year. Main outcome measures include the percent of adolescents who had received the three-dose hepatitis B vaccine (Hep B) series, the two-dose measles/mumps/rubella vaccine (MMR) series, the tetanus and diphtheria toxoids (Td) booster, and one dose of varicella vaccine. In the second analysis, data from all survey years were combined and vaccination dates were analyzed to determine the percentage of adolescents who were missing any vaccines at ages 11-12 and received them at that age. Data for varicella vaccine were sufficient only for the first analysis. Among the approximately 15%-20% of respondents who reported vaccination history from records in the home and who were reporting on a 13-15-year-old, coverage with three doses of Hep B increased significantly during 1997-2001, from 15.2% to 55.0%. Coverage with MMR and Td fluctuated, with no significant increase; highs were 76.7% for MMR in 2003 and 36.2% for Td in 2002. Examination of vaccination dates for all surveyed adolescents showed that among 11-12-year-olds who needed catch-up vaccine, 0.6%-31.3% were brought up to date for Hep B and 22.1%-31.8% were brought up to date for MMR. For Td, 2.6%-15.4% of 11-12-year-olds who had not previously received Td received the vaccine. Vaccination coverage among adolescents aged 13-15 years was below the Healthy People 2010 goals of 90%, but generally increased over the survey years. However, the suboptimal delivery of needed vaccines during ages 11 and 12 is concerning in light of recent vaccine recommendations targeted at this age. Continuing to focus on strategies to

Personality disorders and physical comorbidities in adults from the United States: data from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Quirk, Shae E; El-Gabalawy, Renée; Brennan, Sharon L; Bolton, James M; Sareen, Jitender; Berk, Michael; Chanen, Andrew M; Pasco, Julie A; Williams, Lana J

2015-05-01

There is a paucity of research examining the relationship between personality disorders (PDs) and chronic physical comorbidities. Consequently, we investigated associations between individual PDs and PD Clusters, and various common disease groups [cardiovascular disease (CVD), diabetes, arthritis and gastrointestinal disease (GI)] in a nationally representative survey of adults from the United States. This study utilized pooled data (n = 34,653; ≥20 years) from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Physical conditions were based on self-reports of being diagnosed by a health professional. Unadjusted and adjusted logistic regressions examined the relationship between PDs and physical conditions. After adjustment (sociodemographic factors, past-year mood, anxiety and substance use disorders), Clusters A, B and C PDs were each associated with physical conditions (all p ≤ 0.01). Of the individual PDs, schizoid, schizotypal, narcissistic, borderline and obsessive-compulsive PDs were associated with CVD (all p ≤ 0.01) among younger adults. Paranoid, antisocial, borderline and avoidant PDs and younger adults with schizoid, schizotypal and obsessive-compulsive PDs were each associated with arthritis (all p ≤ 0.01). Significant associations were seen between paranoid, schizoid and schizotypal PDs and diabetes (all p ≤ 0.01). Finally, schizotypal, antisocial, borderline and narcissistic PDs were associated with GI conditions (all p ≤ 0.01). PDs were consistently associated with physical conditions. Investigation of PDs and their relationship with physical health outcomes warrant further research attention as these findings have important clinical implications.

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012.

PubMed

Tester, June M; Leung, Cindy W; Leak, Tashara M; Laraia, Barbara A

2017-07-06

Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005-2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce-equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group.

Michigan Early Adolescent Survey: Final Report.

ERIC Educational Resources Information Center

Keith, Joanne; And Others

This document contains the final report from the Michigan Early Adolescent Survey, a study undertaken to: (1) develop a profile of Michigan early adolescents that focused on out-of-school time and included biological, psychological, and sociological information; (2) develop a profile of families which included early adolescents; (3) assess the…

Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents.

PubMed

Jaite, Charlotte; Hoffmann, Falk; Glaeske, Gerd; Bachmann, Christian J

2013-06-01

This study aimed at investigating the prevalence, psychiatric comorbidity and outpatient treatment in a sample of German children and adolescents with eating disorders (EDs). Data of a large German statutory health insurance company were analysed and outpatients aged between 10 and 21 years with an ED diagnosis in 2009 were identified. Of 248,558 insured children and adolescents, 1,404 patients (79.9 % females, mean age: 16.7; SD: 3.3 years) matched the inclusion criteria. The large majority of patients with anorexia nervosa (AN) and bulimia nervosa (BN) were females (94.7 and 92.7 %), on which we focus in the following analyses. The prevalence in females was 0.28 % (AN) and 0.20 % (BN). Psychiatric comorbidity was diagnosed in 59.8 % (AN) and 64.1 % (BN) of patients, respectively. Most patients were treated with psychotherapy (AN: 75.7 %, BN: 78.5 %), 16.4 % (AN) and 20.2 % (BN) of our patients received pharmacotherapy with either antidepressants or antipsychotics. 23.5 % (AN) and 21.1 % (BN) received no treatment with psychotherapy, antidepressants or antipsychotics. This naturalistic study suggests that in young ED outpatients, EDs seem to be underdiagnosed and treatment does not necessarily comply with current guidelines. Therefore, dissemination of state-of-the-art knowledge on diagnosis and treatment in children and adolescents with EDs constitutes an important educational goal.

Associations between adolescent seatbelt non-use, normative perceptions and screen media exposure: results from a national US survey.

PubMed

Dunlop, Sally M; Romer, Daniel

2010-10-01

Failure to use seatbelts in motor vehicles is a major source of youth injuries, and previous research has noted the widespread non-use of seatbelts in popular media. To explore whether increased exposure to entertainment screen media was associated with inflated normative perceptions regarding seatbelt non-use, and to determine any associations between normative perceptions and seatbelt non-use. A nationally representative telephone survey of school-aged American adolescents (14-17 years, n=915) measuring: screen media exposure; normative perceptions with reference to friends' disapproval of non-use, and prevalence of non-use among friends, school peers and peers; and self-reported seatbelt non-use. Using structural equation modelling, analyses indicate that, after demographic and individual characteristics relevant to screen media exposure and seatbelt non-use had been controlled for, frequent exposure to entertainment media was associated with positive normative perceptions about seatbelt non-use for boys, but not for girls. Normative perceptions related to friends' and school peers' seatbelt use were associated with seatbelt non-use for both boys and girls. Attempts to increase adolescent seatbelt use could include public communication campaigns to alter normative perceptions. Broadcasting these campaigns in conjunction with the media that under-represent seatbelt use may be a successful strategy for reducing the influence of such media on male adolescents.

Severity of complicated versus uncomplicated subthreshold depression: New evidence on the "Monotonicity Thesis" from the national comorbidity survey.

PubMed

Wakefield, Jerome C; Schmitz, Mark F

2017-04-01

"Complicated" subthreshold depression (CsD) includes at least one of six pathosuggestive "complicated" symptoms: >6 months duration, marked role impairment, sense of worthlessness, suicidal ideation, psychotic ideation, and psychomotor retardation. "Uncomplicated" subthreshold depression (UsD) has no complicated features. Whereas studies show that complicated (CMDD) versus uncomplicated (UMDD) major depression differ substantially in severity and prognosis, UsD and CsD severity has not been previously compared. This study evaluates UsD and CsD pathology validator levels and examines whether the complicated/uncomplicated distinction offers incremental concurrent validity over the standard number-of-symptoms dimension as a depression severity measure. Using nationally representative community data from the National Comorbidity Survey, seven depression lifetime history subgroups were identified: one MDD screener symptom (n=1432); UsD (n=430); CsD (n=611); UMDD (n=182); and CMDD with 5-6 symptoms (n=518), 7 symptoms (n=217), and 8-9 symptoms (n=291). Severity was evaluated using five concurrent pathology validators: suicide attempt, interference with life, help seeking, hospitalization, and generalized anxiety disorder. CsD validator levels are substantially higher than both UsD and UMDD levels, and similar to mild CMDD, disconfirming the "monotonicity thesis" that severity increase with symptom number. Complicated/uncomplicated status predicts severity, and when complicatedness is controlled, number of symptoms no longer predicts validator levels. Diagnoses were based on respondents' fallible retrospective symptom reports during a lay-administered structured interview, which may not yield diagnoses comparable to clinicians' assessments. CsD is more severe than UsD and comparable to mild MDD. Complicated status more validly indicates depression severity than the standard number-of-symptoms measure. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors relating to adolescent suicidal behavior: a cross-sectional Malaysian school survey.

PubMed

Chen, Paul C Y; Lee, Lai Kah; Wong, Kam Cheong; Kaur, Jagmohni

2005-10-01

This study was undertaken to examine factors relating to adolescent suicide behavior. This was a cross-sectional school survey of 4,500 adolescent students based on a structured questionnaire. Data were collected using the supervised self-administered questionnaire (modified version of the Youth Risk Behavior Surveillance in the Malaysian National Language, Bahasa Malaysia). Seven percent (312 of 4,454) of the adolescent students had seriously considered attempting suicide. Among the adolescents, 4.6% had attempted suicide at least once during the 12 months preceding the survey. Female adolescents were more likely to put their suicidal thoughts into suicidal action than were male adolescents. Malay and Indian people are more likely than the Chinese to respond, "Felt sad and hopeless." However, Malay adolescents had the lowest rate of attempted suicide. Based on multiple logistic regression, factors significantly related to urban adolescents' suicide behavior are "Felt sad or hopeless," "Number of days felt unsafe to go to school," "Riding with a driver who had been drinking alcohol," "Physical fight," and "Number of days absent from school." In comparison, factors relating to rural adolescents' suicide behavior are "Felt sad or hopeless," "Physical fight," "Physical fight resulting in injury," and "Drive a vehicle after drinking alcohol." Adolescent suicide behavior should be viewed as a serious problem. Measures can be taken to prevent suicide by looking at the factors significantly linked to suicidal behavior among adolescents. Steps can then be taken to identify adolescents who have serious suicidal ideation so that intervention can be taken to reduce the suicidal rate.

An inquiry into chiropractors' intention to treat adolescent idiopathic scoliosis: a telephone survey.

PubMed

Feise, R J

2001-01-01

The primary aim of this study was to (1) determine the clinical management approach of practicing chiropractors with regard to patients with adolescent idiopathic scoliosis and (2) measure the response rate of a telephone survey. A survey instrument was developed and pretested, and a case-specific clinical vignette was generated for a hypothetical typical 12-year-old girl with adolescent idiopathic scoliosis. The instrument addressed 3 domains: the specific management of idiopathic scoliosis, elements guiding the general selection of treatment recommendations, and demographics of respondents. The sample frame consisted of 62,000 US chiropractors, of whom 165 were randomly selected for the survey sample. Interviews were conducted by telephone through use of the tested survey instrument. The response rate was 69% (114/165). Of the 51 nonrespondents, 15 did not have a listed business telephone number and 24 were not in active practice. The response rate of those who met the inclusion criteria (practicing chiropractor with a listed telephone number) was 90% (114/126). The gender, chiropractic college, and years in practice of respondents in this survey were similar to those of respondents in 3 other national surveys. In general, the respondents would provide 6 months of "intensive" chiropractic therapy, then follow the patient for 4 years (near skeletal maturity). Eighty-two percent of respondents named diversified technique as their primary adjustive treatment, 87% would use exercise, and 30% would use electric muscle stimulation as an adjunct to manual therapy. Most surveyed chiropractors would use similar methods (frequency and length of treatment, manipulation technique, and exercise) in the treatment of patients with adolescent idiopathic scoliosis. A high response rate to a national survey can be achieved through use of telephone contact.

Parental Divorce or Death During Childhood and Adolescence and Its Association With Mental Health.

PubMed

Tebeka, Sarah; Hoertel, Nicolas; Dubertret, Caroline; Le Strat, Yann

2016-09-01

Despite the severity of the loss of a parent and the frequency of parental divorce, few studies compared their impact on mental health in the general adult population. The aim of this study was to estimate the prevalence, sociodemographic correlates, and psychiatric comorbidity of parental loss and parental divorce during childhood and adolescence. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults (n = 43,093). Of the 43,093 participants, parental divorce during childhood or adolescence was reported by 5776 participants, whereas 3377 experienced parental death during childhood or adolescence. Participants reporting a history of parental divorce present a significantly higher prevalence of psychiatric disorders, particularly alcohol and drug use disorders compared with control subjects. While participants experiencing the death of a parent reported a poorer overall health, the prevalence of psychiatric disorder after 17 years of age was not significantly higher than that of the control subjects.

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

PubMed Central

De Castro, Filipa; Barrientos-Gutiérrez, Tonatiuh; Leyva-López, Ahideé

2017-01-01

Objective Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world’s adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents. Methods This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015. Results At the national level 13.9% (95%CI: 6.9–26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4–77.3) medium quality and 17.5% (95%CI: 11.9–25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best. Conclusions The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care. PMID:28273129

With One Voice: America's Adults and Teens Sound Off about Teen Pregnancy. A National Survey.

ERIC Educational Resources Information Center

National Campaign To Prevent Teen Pregnancy, Washington, DC.

These charts describe adults' and adolescents' views on teen sex and pregnancy. Data come from national surveys of adults and adolescents that examined attitudes toward teen sex and pregnancy, factors influencing teens' sexual decisions, parents' roles, and adults' and teens' advice for policymakers. There is near unanimous agreement among both…

Usual Intake of Added Sugars and Lipid Profiles Among the U.S. Adolescents: National Health and Nutrition Examination Survey, 2005–2010

PubMed Central

Zhang, Zefeng; Gillespie, Cathleen; Welsh, Jean A.; Hu, Frank B.; Yang, Quanhe

2015-01-01

Purpose Although studies suggest that higher consumption of added sugars is associated with cardiovascular risk factors in adolescents, none have adjusted for measurement errors or examined its association with the risk of dyslipidemia. Methods We analyzed data of 4,047 adolescents aged 12–19 years from the 2005–2010 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey. We estimated the usual percentage of calories (%kcal) from added sugars using up to two 24-hour dietary recalls and the National Cancer Institute method to account for measurement error. Results The average usual %kcal from added sugars was 16.0%. Most adolescents (88.0%) had usual intake of ≥10% of total energy, and 5.5% had usual intake of ≥25% of total energy. After adjustment for potential confounders, usual %kcal from added sugars was inversely associated with high-density lipoprotein (HDL) and positively associated with triglycerides (TGs), TG-to-HDL ratio, and total cholesterol (TC) to HDL ratio. Comparing the lowest and highest quintiles of intake, HDLs were 49.5 (95% confidence interval [CI], 47.4–51.6) and 46.4 mg/dL(95% CI, 45.2–47.6; p = .009), TGs were 85.6 (95% CI, 75.5–95.6) and 101.2 mg/dL(95% CI, 88.7–113.8; p = .037), TG to HDL ratios were 2.28 (95% CI, 1.84–2.70) and 2.73 (95% CI, 2.11–3.32; p = .017), and TC to HDL ratios were 3.41 (95% CI, 3.03–3.79) and 3.70 (95% CI, 3.24–4.15; p = .028), respectively. Comparing the highest and lowest quintiles of intake, adjusted odds ratio of dyslipidemia was 1.41 (95% CI, 1.01–1.95). The patterns were consistent across sex, race/ethnicity, and body mass index subgroups. No association was found for TC, low-density lipoprotein, and non-HDL cholesterol. Conclusions Most U.S. adolescents consumed more added sugars than recommended for heart health. Usual intake of added sugars was significantly associated with several measures of lipid profiles. PMID:25703323

National Survey of Child and Adolescent Well-Being, No. 7: Special Health Care Needs among Children in Child Welfare, Research Brief: Findings from the NSCAW Study

ERIC Educational Resources Information Center

US Department of Health and Human Services, 2007

2007-01-01

This research brief, the seventh in a series of National Survey of Child and Adolescent Well-Being (NSCAW) briefs, examines the presence of special health care needs among children in the child welfare system (CWS). It specifically examines the presence of chronic health conditions (e.g., asthma, diabetes) and special needs (e.g., emotional…

Washington State Survey of Adolescent Health Behaviors.

ERIC Educational Resources Information Center

Washington State Dept. of Social and Health Services, Olympia.

The 1992 Washington State Survey of Adolescent Health Behaviors (WSSAHB) was created to collect information regarding a variety of adolescent health behaviors among students in the state of Washington. It expands on two previous administrations of a student tobacco, alcohol, and other drug survey and includes questions about medical care, safety,…

Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder

PubMed Central

Ogundele, Michael O; Ayyash, Hani F

2018-01-01

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders (TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis (meta-analysis) was deemed appropriate. Meta-analysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors (Atomoxetine) and stimulants (Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette’s syndrome (TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs. PMID:29456930

Impact of Gender, Age at Onset, and Lifetime Tic Disorders on the Clinical Presentation and Comorbidity Pattern of Obsessive-Compulsive Disorder in Children and Adolescents

PubMed Central

Adaletli, Hilal; Gunes, Hatice; Kilicoglu, Ali Guven; Mutlu, Caner; Bahali, Mustafa Kayhan; Aytemiz, Tugce; Uneri, Ozden Sukran

2015-01-01

Abstract Background: Obsessive–compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern. Methods: A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age. Results: A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021). Conclusions: There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD. PMID:26091196

Perioperative comorbidities and complications among patients undergoing primary total knee arthroplasty: a retrospective analysis and prospective survey.

PubMed

Oviedo Baena, Ana M; Moeschler, Susan M; Smith, Hugh M; Duncan, Christopher M; Schroeder, Darrell R; Kopp, Sandra L

2015-11-01

To determine the demographic characteristics of patients undergoing primary total knee arthroplasty during the years 1989, 1999, and 2009 at our institution and determine whether their characteristics mirror the changing US demographic characteristics. Retrospective chart review of patients and prospective survey of experienced anesthesia providers in total knee arthroplasty. Tertiary care academic medical center. All patients 18 years and older who underwent unilateral primary total knee arthroplasty in 1989, 1999, and 2009 were identified through the Mayo Clinic Total Joint Registry. For each year, 200 patients were randomly selected. The demographic characteristics, comorbidities, perioperative care, and postoperative outcomes of patients, as well as survey responses from experienced anesthesia providers. During the 3 study years, a total of 591 patients were included for analysis. A statistically significant increase in body mass index (BMI) was observed over time in patients undergoing primary total knee arthroplasty (average BMI, 29.01 in 1989, 31.32 in 1999, and 32.32 in 2009 [P < .001]). Despite the increase in patient comorbidities, the percentage of patients who had postoperative complications decreased over time (P = .003), and postoperative disposition (general medicine ward vs intensive care unit) did not change. Our provider survey received a 76% response rate. In total, 82% of anesthesia providers who responded to the survey perceived that both BMI and the number of comorbidities had increased. Of survey respondents, 67% state that they have modified their perioperative anesthesia care because of changes in body habitus and patient comorbidities. The number of obese patients with comorbidities who present for total knee arthroplasty at our institution has increased over the past 20 years. Despite this fact, a reduction was detected in postoperative complications. Copyright © 2015 Elsevier Inc. All rights reserved.

A National Descriptive Portrait of Adolescent Relationship Abuse: Results From the National Survey on Teen Relationships and Intimate Violence.

PubMed

Taylor, Bruce G; Mumford, Elizabeth A

2016-03-01

This article reports results from the National Survey on Teen Relationships and Intimate Violence (STRiV) for 12- to 18-year-old youth (n = 1,804). STRiV provides the first nationally representative household survey focused on adolescent relationship abuse (ARA), covering perpetration and victimization. Among respondents (37%) reporting current- or past-year dating, 69% reported lifetime ARA victimization (63% lifetime ARA perpetration). Although psychological abuse was most common for these youth (more than 60%), the rates of sexual abuse (18%) and physical abuse victimization (18%), as well as 12% reporting perpetrating physical abuse and/or sexual abuse (12%) were substantial as well. Other than differences by age and gender, ARA rates were consistent by race/ethnicity, geographic region, urbanicity, and household characteristics, highlighting the importance of universal prevention programs. Compared with youth aged 15 to 18, those 12 to 14 years old reported lower rates of psychological and sexual ARA victimization. Similarly, we found lower ARA perpetration rates for those 12 to 14. We found no gender differences for ARA victimization but found that girls perpetrated more physical ARA than boys. Girls aged 15 to 18 reported perpetrating moderate threats/physical violence at more than twice the rate of younger girls and 3 times the rate compared with boys aged 15 to 18; girls aged 15 to 18 reported perpetrating more than 4 times the rate of serious psychological abuse than boys 15 to 18. Finally, these data document the significant positive correlation between ARA victimization and perpetration. Findings suggest that when working with youth in prevention services, interventions should not be designed for monolithic groups of "victims" or "perpetrators." © The Author(s) 2014.

Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

PubMed

Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

2016-12-01

To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

Prevalence, comorbidities, and cofactors associated with alcohol consumption among school-going adolescents in Malaysia.

PubMed

Manickam, Mala A; Abdul Mutalip, Mohd Hatta B; Abdul Hamid, Hamizatul Akmal Bt; Kamaruddin, Rozanim Bt; Sabtu, Mohd Yusoff B

2014-09-01

Alcohol is deleterious to physical and mental health as well as social well-being. This study aims to examine the prevalence of alcohol consumption and factors associated with its use among school-going Malaysian adolescents. The Global School-Based Student Health Survey (GSHS) 2012 employed 2-stage clustering design to Malaysian secondary school respondents aged 12 to 17 years. The prevalence of current alcohol usage was 8.9% (95% confidence interval [CI]: 7.8-10.07) overall, 11.2% (95% CI: 9.80-12.80) among males, and 23.4 (95% CI: 21.40-25.50) among Chinese students. Multivariate logistic regression showed that adolescents who had used alcohol were more likely to have used substance (adjusted odds ratio [aOR] = 3.39; 95% CI: 2.33-4.99), experienced injury (aOR = 1.53; 95% CI: 1.20-1.95), and engaged in sexual behaviors (aOR = 1.42, 95% CI: 1.12-1.79), and fights (aOR = 1.23; 95% CI: 1.08-1.41). The current national policies on alcohol should be strengthened to curb alcohol consumption among adolescents. © 2014 APJPH.

Work-family conflict and employee psychiatric disorders: the National Comorbidity Survey.

PubMed

Frone, M R

2000-12-01

This study examined the relation between work-family conflict and several types of psychiatric disorders: mood, anxiety, substance dependence, and substance abuse. Survey data were obtained from a representative national sample of 2,700 employed adults who were either married or the parent of a child 18 years old or younger. Hierarchical logistic regression analyses revealed that both work-to-family and family-to-work conflict were positively related to having a mood, anxiety, and substance dependence disorder. Depending on the type of work-family conflict and type of disorder, employees who reported experiencing work-family conflict often were 1.99-29.66 times more likely than were employees who reported no work-family conflict to experience a clinically significant mental health problem. No support was found for gender differences.

Treatment Utilization Among Adolescent Substance Users: Findings from the 2002 to 2013 National Survey on Drug Use and Health.

PubMed

Haughwout, Sarah P; Harford, Thomas C; Castle, I-Jen P; Grant, Bridget F

2016-08-01

Adolescent substance users face serious health and social consequences and benefit from early diagnosis and treatment. The objectives of this study were to observe trends in treatment utilization; examine correlates of treatment utilization and treatment types/settings among adolescent substance users with and without substance use disorder (SUD); and assess gender differences. National Survey on Drug Use and Health data were pooled across 2002 to 2013, with a combined sample of 79,885 past-year substance users ages 12 to 17 (17,510 with SUD and 62,375 without SUD). Treatment was defined as receiving treatment or counseling for use of alcohol or any drug, not counting cigarettes. Trends were assessed by joinpoint linear regression, and multivariable logistic regression assessed odds ratios of treatment utilization. Percentages of past-year treatment use did not change in 2002 to 2013. Treatment utilization was more prevalent among adolescents with SUD than without (11.4% vs. 1.4%) and among males than females. Among adolescents with and without SUD, criminal justice involvement and perceiving a need for treatment increased adolescent treatment utilization, while SUDs other than alcohol abuse, older age, and talking to parents increased treatment use among adolescents with SUD, and polysubstance use and male gender increased treatment among those without SUD. Treatment gaps persisted among non-Hispanic Blacks for both groups with and without SUD, male Hispanics with SUD, female non-Hispanic Asians without SUD, and private insurance coverages. Gender differences were observed in SUD, race/ethnicity, and insurance coverage. Most adolescents received treatment for both alcohol and drug use, and self-help group and outpatient rehabilitation facility were the most used treatment settings. Treatment utilization among adolescents with past-year substance use remained low and unimproved in 2002 to 2013. Treatment gaps among minority populations, insurance coverage, and in

[Sedentary leisure time and food consumption among Brazilian adolescents: the Brazilian National School-Based Adolescent Health Survey (PeNSE), 2009].

PubMed

Camelo, Lidyane do Valle; Rodrigues, Jôsi Fernandes de Castro; Giatti, Luana; Barreto, Sandhi Maria

2012-11-01

The objective of this paper was to investigate whether sedentary leisure time was associated with increased regular consumption of unhealthy foods, independently of socio-demographic indicators and family context. The analysis included 59,809 students from the Brazilian National School-Based Adolescent Health Survey (PeNSE) in 2009. The response variable was sedentary leisure time, defined as watching more than two hours of TV daily. The target explanatory variables were regular consumption of soft drinks, sweets, cookies, and processed meat. Odds ratios (OR) and 95% confidence limits (95%CI) were obtained by multiple logistic regression. Prevalence of sedentary leisure time was 65%. Regular consumption of unhealthy foods was statistically higher among students reporting sedentary leisure time, before and after adjusting for sex, age, skin color, school administration (public versus private), household assets index, and household composition. The results indicate the need for integrated interventions to promote healthy leisure-time activities and healthy eating habits among young people.

Brain connectivity and psychiatric comorbidity in adolescents with Internet gaming disorder.

PubMed

Han, Doug Hyun; Kim, Sun Mi; Bae, Sujin; Renshaw, Perry F; Anderson, Jeffrey S

2017-05-01

Prolonged Internet video game play may have multiple and complex effects on human cognition and brain development in both negative and positive ways. There is not currently a consensus on the principle effects of video game play neither on brain development nor on the relationship to psychiatric comorbidity. In this study, 78 adolescents with Internet gaming disorder (IGD) and 73 comparison subjects without IGD, including subgroups with no other psychiatric comorbid disease, with major depressive disorder and with attention deficit hyperactivity disorder (ADHD), were included in a 3 T resting state functional magnetic resonance imaging analysis. The severity of Internet gaming disorder, depression, anxiety and ADHD symptoms were assessed with the Young Internet Addiction Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Korean ADHD rating scales, respectively. Patients with IGD showed an increased functional correlation between seven pairs of regions, all satisfying q < 0.05 False discovery rates in light of multiple statistical tests: left frontal eye field to dorsal anterior cingulate, left frontal eye field to right anterior insula, left dorsolateral prefrontal cortex (DLPFC) to left temporoparietal junction (TPJ), right DLPFC to right TPJ, right auditory cortex to right motor cortex, right auditory cortex to supplementary motor area and right auditory cortex to dorsal anterior cingulate. These findings may represent a training effect of extended game play and suggest a risk or predisposition in game players for over-connectivity of the default mode and executive control networks that may relate to psychiatric comorbidity. © 2015 Society for the Study of Addiction.

Headache and co-morbid pains associated with TMD pain in adolescents.

PubMed

Nilsson, I-M; List, T; Drangsholt, M

2013-09-01

This case-control study evaluated the association of headache and other co-morbid pain with temporomandibular disorder (TMD) pain in adolescents and explored the temporal co-variance of headache and TMD pain. In a population-based sample of 12- to 19-year-olds, 350 patients with self-reported TMD pain and 350 healthy age- and sex-matched individuals were mailed questionnaires. Descriptive statistics, 95% CI, and OR analyses--logistic regression models with TMD pain as the outcome variable and adjusted for age and gender--were used for the analysis of individuals' responses. Headache, whether defined as once a week or more (OR = 6.6) or as moderate or severe (categorical), was significantly related to TMD pain. Severe headache (vs. mild) showed stronger associations with TMD (OR = 10.1) than between moderate and mild headache (OR = 5.5). Neck (OR = 4.0) and back (OR = 2.6) pain was also significantly related to TMD pain. When participants were grouped according to headache onset and TMD pain, the highest association between headache and TMD pain was found in the subgroup "Headache onset before TMD pain" (OR 9.4). In conclusion, headache appears to be independently and highly associated with TMD pain in adolescents. Neck pain and somatic complaints were also significantly associated with TMD pain. Headache seems to precede TMD pain in many adolescents with pain.

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005–2012

PubMed Central

Leung, Cindy W.; Leak, Tashara M.; Laraia, Barbara A.

2017-01-01

Introduction Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. Methods We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005–2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Results Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce–equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). Conclusion These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group. PMID:28682743

Parental supply of alcohol to Australian minors: an analysis of six nationally representative surveys spanning 15 years.

PubMed

Kelly, Adrian B; Chan, Gary C K; Weier, Megan; Quinn, Catherine; Gullo, Matthew J; Connor, Jason P; Hall, Wayne D

2016-04-14

Most adolescents begin alcohol consumption during adolescence, heavy alcohol use by adolescents is common, and alcohol-related harm amongst adolescents is a major public health burden. Parents are a common source of alcohol amongst adolescents, but little is known about how parental supply of alcohol has changed over recent years. This study examines national trends in parental supply of alcohol to adolescent children in Australia since 1998. Six Australian National Drug Strategy Household Surveys (1998-2013) yielded rates of parental supply of current and first ever alcohol consumed. Lifetime and current alcohol use were also estimated. The surveys were conducted for households across all Australian states and territories. Surveyed adolescents were aged 14-17 years (N = 7357, 47.6 % male). Measures included the reported source of currently consumed alcohol and first ever alcoholic beverage (parents/friends/others), lifetime alcohol use, number of standard alcohol units consumed on drinking days, and frequency of alcohol use. Corrected Pearson chi-squared tests were used to compare survey years. There was a significant drop in parental supply of current alcohol use from 21.3 % in 2004 to 11.79 % in 2013 (p < .001). The lower prevalence of parental supply coincided with legislative changes on parental supply of alcohol to adolescents, but causality cannot be established because of the variation in the timing and reach of parental supply legislation, and small samples in some states. There were downward trends in adolescent experimentation, quantity and frequency of alcohol use across years, with the largest drop in alcohol use in 2010 and 2013. In Australia, there has been a substantial reduction in parental supply of alcohol to adolescents from 2010, and this factor may partially account for reductions in adolescent alcohol use.

National Prevalence of PTSD Among Sexually Revictimized Adolescent, College, and Adult Household-Residing Women

PubMed Central

Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

2012-01-01

Context Despite empirical links between sexual revictimization (i.e., experiencing two or more sexual assaults) and posttraumatic stress disorder (PTSD), no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. Objective Estimate the prevalence of sexual revictimization and PTSD among three national female samples (adolescent, college, adult household probability). Design Surveys were used to collect data from The National Women’s Study – Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women’s Study-Replication (2006; household probability). Setting Households and college campuses across the U.S. Participants 1,763 adolescent girls, 2,000 college women, and 3,001 household-residing adult women. Main Outcomes Behaviorally specific questions assessed unwanted sexual acts occurring over the lifespan due to use of force, threat of force, or incapacitation via drug or alcohol use. PTSD was assessed with a module validated against the criterion standard, Structured Clinical Interview for DSM-IV. Results 52.7% of victimized adolescents, 50.0% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20.0% of revictimized adolescents, 40.0% of revictimized college women, and 27.2% of revictimized household-residing women. Compared to non-victims, odds of meeting past 6-month PTSD were 4.3–8.2 times higher for revictimized respondents and 2.4–3.5 times higher for single victims. Conclusions Population prevalence estimates suggest that 769,000 adolescent girls, 625,000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154,000 sexually revictimized adolescents, 250,000 sexually

Posttraumatic stress disorder and physical comorbidity among female children and adolescents: results from service-use data.

PubMed

Seng, Julia S; Graham-Bermann, Sandra A; Clark, M Kathleen; McCarthy, Ann Marie; Ronis, David L

2005-12-01

In adults, posttraumatic stress disorder (PTSD) is associated with adverse health outcomes and high medical utilization and cost. PTSD is twice as common in women and is associated with increased risk for a range of diseases, chronic conditions, and reproductive-health problems. Little is known about the health effects of PTSD in children. The purpose of this study was to explore patterns of physical comorbidity in female children and adolescents with PTSD by using population data. This study was a cross-sectional, descriptive epidemiologic case-control analysis of a Midwestern state's Medicaid eligibility and paid-claims data for girls (0-8 years old) and teens (9-17 years old). Data were from 1994-1997. All those with the PTSD diagnostic code were compared with randomly selected controls in relation to 3 sets of outcomes: (1) International Classification of Diseases, Ninth Revision (ICD-9) categories of disease; (2) chronic conditions previously associated with sexual trauma and PTSD in women; and (3) reproductive-health problems. Analyses included bivariate odds ratios (OR) and logistic-regression models that control for the extent of insurance coverage and the independent associations of victimization and psychiatric comorbidity with the 3 sets of outcomes. The mental health covariate was categorical to allow consideration of a range of severity. There were 4 categories for the young girls: neither PTSD nor depression, PTSD without depression, depression without PTSD, and PTSD + depression. For the adolescent analysis, a fifth category reflecting a "complex PTSD" was added, defined as having PTSD complicated by a dissociative disorder or borderline personality disorder diagnosis. There were 647 girls and 1025 adolescents with the PTSD diagnosis. Overall, PTSD was associated with adverse health outcomes in both age strata. Victimization was sometimes independently associated with adverse health outcomes, but PTSD often was a mediator, especially in the

Attitudes and Opinions from the Nation's High Achieving Teens. 24th Annual Survey of High Achievers.

ERIC Educational Resources Information Center

Who's Who among American High School Students, Lake Forest, IL.

This survey represents information compiled by the largest national survey of adolescent leaders and high achievers. Of the 5,000 students selected demographically from "Who's Who Among American High School Students," 1,957 responded. All students surveyed had "A" or "B" averages, and 98% planned on attending college. Questions were asked about…

Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility.

PubMed

Viana, Andres G; Rabian, Brian; Beidel, Deborah C

2008-06-01

We examined differences in self-reported anxiety and depression according to the number and pattern of DSM-IV comorbid diagnoses in 172 children and adolescents (mean age=11.87, S.D.=2.67; range=7-17) with a primary diagnosis of social phobia. Three hypotheses were tested: (1) children with comorbid anxiety disorders would show significantly higher scores than children with social phobia-only on self-report measures, (2) self-report measures would significantly differentiate between children with social phobia and comorbid internalizing versus externalizing disorders, and (3) self-report measures would significantly differentiate children according to the type of anxiety comorbidities present. Multinomial logistic regressions showed that children with three anxiety disorders scored significantly higher than children with one and two diagnoses on two of three self-report measures used. Logistic regressions revealed that children's scores on measures did not differ according to the nature of the comorbid diagnoses (internalizing vs. externalizing). Finally, ROC curves showed that the MASC and the SPAI-C accurately classified children with additional diagnoses of SAD and GAD, respectively. The potential of self-report measures to further our understanding of childhood anxiety comorbidity and the clinical implications of their use to screen for comorbidity are discussed along with suggestions for further study.

Temporomandibular Joint and Muscle Disorder (TMJMD) - type pain and Co-morbid Pains in a National US Sample

PubMed Central

Plesh, O; Adams, SH; Gansky, SA

2013-01-01

Aims To compare prevalences of self-reported comorbid headaches, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000–2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics and NH Blacks (African Americans). Methods Data from the 2000–2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically: TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status; and health care utilization. Estimates and test statistics (i.e. Pearson correlations, regressions and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design. Results A total of 189,977 people: 52% female and 48% males; 73% NH Whites, 12% Hispanic, 11% NH Blacks and 4% “Other” were included. A total of 4.6% reported TMJMD-type pain and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (N = 8,964) reported ≥two comorbid pain. Females reported more comorbid pain than males (odds ratio (OR) = 1.41, p <0.001), Hispanic and NH Blacks reported more than NH Whites (OR = 1.56, p <0.001; OR = 1.38, p <0.001, respectively). In addition, 53% of those with TMJMD-type pain had severe headache/migraines; 54% had neck pain, 64% low back pain and 62% joint pain. Differences in gender, race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span and higher

Childhood obesity: a review of increased risk for physical and psychological comorbidities.

PubMed

Pulgarón, Elizabeth R

2013-01-01

Worldwide estimates of childhood overweight and obesity are as high as 43 million, and rates continue to increase each year. Researchers have taken interest in the childhood obesity epidemic and the impact of this condition across health domains. The consequences of childhood and adolescent obesity are extensive, including both medical and psychosocial comorbidities. The purpose of this review was to consolidate and highlight the recent literature on the comorbidities associated with childhood obesity, both nationally and internationally. PubMed and PsychINFO searches were conducted on childhood obesity and comorbidities. The initial search of the terms obesity and comorbidity yielded >5000 published articles. Limits were set to include studies on children and adolescents that were published in peer-reviewed journals from 2002 to 2012. These limits narrowed the search to 938. Review of those articles resulted in 79 that are included in this review. The major medical comorbidities associated with childhood obesity in the current literature are metabolic risk factors, asthma, and dental health issues. Major psychological comorbidities include internalizing and externalizing disorders, attention-deficit hyperactivity disorder, and sleep problems. The high prevalence rates of childhood obesity have resulted in extensive research in this area. Limitations to the current childhood obesity literature include differential definitions of weight status and cut-off levels for metabolic risk factors across studies. Additionally, some results are based on self-report of diagnoses rather than chart reviews or physician diagnosis. Even so, there is substantial support for metabolic risk factors, internalizing disorders, attention-deficit hyperactivity disorder, and decreased health-related quality of life as comorbidities to obesity in childhood. Additional investigations on other diseases and conditions that might be associated with childhood obesity are warranted and

Impulsive Aggression as a Comorbidity of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

PubMed Central

Amann, Birgit H.

2016-01-01

Abstract Objective: This article examines the characteristics of impulsive aggression (IA) as a comorbidity in children and adolescents with attention-deficit/hyperactivity disorder (ADHD), focusing on its incidence, impact on ADHD outcomes, need for timely intervention, and limitations of current treatment practices. Methods: Relevant literature was retrieved with electronic searches in PubMed and PsycINFO using the search strategy of “ADHD OR attention deficit hyperactivity disorder” AND “impulsive aggression OR reactive aggression OR hostile aggression OR overt aggression” AND “pediatric OR childhood OR children OR pre-adolescent OR adolescent” with separate searches using review OR clinical trial as search limits. Key articles published before the 2007 Expert Consensus Report on IA were identified using citation analysis. Results: More than 50% of preadolescents with ADHD combined subtype reportedly display clinically significant aggression, with impulsive aggression being the predominant subtype. Impulsive aggression is strongly predictive of a highly unfavorable developmental trajectory characterized by the potential for persistent ADHD, increasing psychosocial burden, accumulating comorbidities, serious lifelong functional deficits across a broad range of domains, delinquency/criminality, and adult antisocial behavior. Impulsive aggression, which triggers peer rejection and a vicious cycle of escalating dysfunction, may be a key factor in unfavorable psychosocial outcomes attributed to ADHD. Because severe aggressive behavior does not remit in many children when treated with primary ADHD therapy (i.e., stimulants and behavioral therapy), a common practice is to add medication of a different class to specifically target aggressive behavior. Conclusions: Impulsive aggression in children and adolescents with ADHD is a serious clinical and public health problem. Although adjunctive therapy with an aggression-targeted agent is widely recommended when

Epidemiology of Attention Problems among Turkish Children and Adolescents: A National Study

ERIC Educational Resources Information Center

Erol, Nese; Simsek, Zeynep; Oner, Ozgur; Munir, Kerim

2008-01-01

Objective: To evaluate the epidemiology of attention problems using parent, teacher, and youth informants among a nationally representative Turkish sample. Method: The children and adolescents, 4 to 18 years old, were selected from a random household survey. Attention problems derived from the Child Behavior Checklist (CBCL) (N = 4,488), Teacher…

Correlates of generalized anxiety disorder: independent of co-morbidity with depression: findings from the first Israeli National Health Interview Survey (2003-2004).

PubMed

Muhsen, Khitam; Lipsitz, Joshua; Garty-Sandalon, Noga; Gross, Raz; Green, Manfred S

2008-11-01

Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder with chronic symptoms and is commonly comorbid with depression. To identify correlates of GAD among adults and to describe treatment patterns and functional limitations among individuals with this disorder. Data for 2,082 subjects aged >or=21 years from the first Israeli national health interview survey (INHIS-1) (2003-2004) were analyzed. Information on GAD was collected using the short form of the Composite International Diagnostic Interview. Data were also obtained on socio-demographic, physical health characteristics, history of life threatening events, treatment seeking behaviors, use of medication and functional impairment. The prevalence of GAD was highest among people aged 40-59 years, in those with asthma, hypertension and in those with osteoporosis. Regular exercise was associated with reduced prevalence for GAD (adjusted OR 0.46, 95% CI 0.22-0.95). The exclusion of individuals with major depression from analysis strengthened the association with age (adjusted OR 5.7, 95% CI 1.7, 19.7), weakened the association between GAD and osteoporosis (adjusted OR 3.4, 95% CI 1.2, 9.8), asthma (adjusted OR 3.4, 95% CI 1.2, 9.5) and regular exercise (adjusted OR 0.47 95% CI 0.2, 1.14). In this sub-sample, hypertension was no longer associated with GAD, and a significant association was found between GAD and past experience of life threatening events (adjusted OR 2.3, 95% CI 1.1-4.9). Psychiatric and psychological consultations were low among people with GAD (11.5% and 26.4% for those without and with comorbid depression, respectively), concurrent with a high degree of functional limitation. Middle age, history of traumatic life events, and certain chronic medical diseases (e.g., asthma and osteoporosis) are important risk factors for GAD. They could be used to help identify and treat people with GAD.

Children of the National Longitudinal Survey of Youth: A Unique Research Opportunity.

ERIC Educational Resources Information Center

Chase-Lansdale, P. Lindsay; And Others

1991-01-01

This article provides a history of the data set known as "the Children of the National Longitudinal Survey of Youth (NLSY)." Promising research agendas that use the data set are described. These agendas concern maternal employment and child care, adolescent pregnancy and parenthood, divorce, poverty, and multigenerational parenting. (BC)

The Effect of Alcohol Abuse and Dependence and School Experiences on Depression: A National Study of Adolescents

ERIC Educational Resources Information Center

Merianos, Ashley L.; King, Keith A.; Vidourek, Rebecca A.; Hardee, Angelica M.

2016-01-01

The study purpose was to examine the effect alcohol abuse/dependence and school experiences have on depression among a nationwide sample of adolescents. A secondary analysis of the 2013 National Survey on Drug Use and Health was conducted. The results of the final multivariable logistic regression model revealed that adolescents who reported…

Current national patterns of comorbid diabetes among acute ischemic stroke patients.

PubMed

Towfighi, Amytis; Markovic, Daniela; Ovbiagele, Bruce

2012-01-01

Type 2 diabetes rates in the general population have risen with the growing obesity epidemic. Knowledge of temporal patterns and factors associated with comorbid diabetes among stroke patients may enable health practitioners and policy makers to develop interventions aimed at reducing diabetes rates, which may consequently lead to declines in stroke incidence and improvements in stroke outcomes. Using the Nationwide Inpatient Sample (NIS), a nationally representative data set of US hospital admissions, we assessed trends in the proportion of acute ischemic stroke (AIS) patients with comorbid diabetes from 1997 to 2006. Independent factors associated with comorbid diabetes were evaluated using multivariable logistic regression. Over the study period, the absolute number of AIS hospitalizations declined by 17% (from 489,766 in 1997 to 408,378 in 2006); however, the absolute number of AIS hospitalizations with comorbid type 2 diabetes rose by 27% [from 97,577 (20%) in 1997 to 124,244 (30%) in 2006, p < 0.001]. The rise in comorbid diabetes over time was more pronounced in patients who were relatively younger, Black or 'other' race, on Medicaid, or admitted to hospitals located in the South. Factors independently associated with higher odds of diabetes in AIS patients were Black or 'other' versus White race, congestive heart failure, peripheral vascular disease, history of myocardial infarction, renal disease and hypertension. Although hospitalizations for AIS in the US decreased from 1997 to 2006, there was a steep rise in the proportion with comorbid diabetes (from 1 in 5 to almost 1 in 3). Specific patient populations may be potential targets for mitigating this trend. Copyright © 2012 S. Karger AG, Basel.

Reflections of Girls in the Media: A National Survey of Children. A Summary of Findings and Toplines.

ERIC Educational Resources Information Center

1997

This document presents a summary of a national telephone survey that examined messages sent to adolescent girls (ages 10 to 17) across 6 types of media most heavily used by adolescent girls: television, movies, magazines, music videos, television commercials, and magazine advertisements. The study asked what messages are sent about gender…

Guns, Impulsive Angry Behavior, and Mental Disorders: Results from the National Comorbidity Survey Replication (NCS-R).

PubMed

Swanson, Jeffrey W; Sampson, Nancy A; Petukhova, Maria V; Zaslavsky, Alan M; Appelbaum, Paul S; Swartz, Marvin S; Kessler, Ronald C

2015-06-01

Analyses from the National Comorbidity Study Replication provide the first nationally representative estimates of the co-occurrence of impulsive angry behavior and possessing or carrying a gun among adults with and without certain mental disorders and demographic characteristics. The study found that a large number of individuals in the United States self-report patterns of impulsive angry behavior and also possess firearms at home (8.9%) or carry guns outside the home (1.5%). These data document associations of numerous common mental disorders and combinations of angry behavior with gun access. Because only a small proportion of persons with this risky combination have ever been involuntarily hospitalized for a mental health problem, most will not be subject to existing mental health-related legal restrictions on firearms resulting from a history of involuntary commitment. Excluding a large proportion of the general population from gun possession is also not likely to be feasible. Behavioral risk-based approaches to firearms restriction, such as expanding the definition of gun-prohibited persons to include those with violent misdemeanor convictions and multiple DUI convictions, could be a more effective public health policy to prevent gun violence in the population. Copyright © 2015 John Wiley & Sons, Ltd.

Examining impacts of allergic diseases on psychological problems and tobacco use in Korean adolescents: the 2008-2011 Korean National Health and Nutrition Examination Survey.

PubMed

Chun, Yoon Hong; Han, Kyungdo; Park, Yong-Gyu; Yoon, Jong-Seo; Kim, Hyun Hee; Kim, Jin Tack; Jeong, Dae Chul

2015-01-01

Asthma during adolescence can induce social, psychological, and behavioral problems. We examined the impact of asthma and other allergic diseases on psychological symptoms and health risk behaviors among South Korean adolescents. In this population-based cross-sectional study, 3192 adolescents (10-18 years of age) participating in the 2008-2011 Korean National Health and Nutrition Examination Survey were enrolled. Psychological problems associated with clinically diagnosed asthma, allergic rhinitis, and atopic dermatitis were assessed using questionnaires and surveys. Data was analyzed using logistic regression to determine the association of depression with allergic disease while controlling for age, sex, body mass index, smoking experience, and alcohol use. Asthma and atopic dermatitis were associated with a higher prevalence of depression (17.2% and 13%, respectively). After adjusting for the covariates, asthma patients were approximately two times as likely to have depression as non-allergic participants (odds ratio, 1.81; 95% confidence interval, 1.22-2.68). Psychosocial stress significantly increased in the following order: no allergy, any allergy without asthma, asthma only, and asthma with any allergy (p for linear trend = 0.01). The asthma without other allergies group showed the highest prevalence of cigarette smoking (p = 0.007). In this study, asthma with or without other allergies was significantly related to increases in depression, psychosocial stress, and smoking experience. Thus, care should be taken to adjust treatment to account for the psychological symptoms and health risk behaviors common among asthmatic adolescents.

What are kids vaping? Results from a national survey of US adolescents.

PubMed

Miech, Richard; Patrick, Megan E; O'Malley, Patrick M; Johnston, Lloyd D

2017-07-01

To examine what substances US youth vape. Data come from Monitoring the Future, an annual, nationally representative survey of USA 12th-grade, 10th-grade and 8th-grade students. Respondents reported what substance they vaped the last time they used a vaporiser such as an e-cigarette. Among students who had ever used a vaporiser, 65-66% last used 'just flavouring' in 12th, in 10th and in 8th grade, more than all other responses combined. In all three grades, the percentage using 'just flavouring' was above 57% for males, females, African-Americans, Hispanics, Whites, and students both with and without a parent with a college degree. Nicotine use came in a distant second, at about 20% in 12th and 10th grade and 13% in 8th grade. Taking into account youth who vaped nicotine at last use increases national estimates of tobacco/nicotine prevalence in the past 30 days by 24-38% above and beyond cigarette smoking, which is substantial but far less than estimates that assume all vaporiser users inhale nicotine. These results challenge the common assumption that all vaporiser users inhale nicotine. They (a) call into question the designation of vaporisers and e-cigarettes as ENDS ('Electronic Nicotine Delivery System'), (b) suggest that the recent rise in adolescent vaporiser use does not necessarily indicate a nicotine epidemic, and (c) indicate that vaporiser users can be candidates for primary prevention programmes. Finally, the results suggest the importance of developing different rationales for the regulation of vaporiser devices as compared to the regulation of substances marketed for vaporiser use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Prevalence of anemia in Mexican children and adolescents: Results from three national surveys].

PubMed

de la Cruz-Góngora, Vanessa; Villalpando, Salvador; Mundo-Rosas, Verónica; Shamah-Levy, Teresa

2013-01-01

To describe the prevalence of anemia in Mexican children and adolescents from ENSANUT 2012. Data had the power to make distinctions at the national, regional and rural/urban dwelling. Hemoglobin was measured by Hemocue. Descriptions were made by adjusted frequencies and 95%CI. Confounders were tested in a logistic regression models. The prevalence of anemia in 2012 was: in children 1-4 y, 23.3%; 5-11y, 10.1%, and 12-19 y, 5.6%. The prevalence in female adolescents was 7.7% and 3.6% in males. Reductions in the prevalence of anemia from 1999 was 8.3pp in <5y, 5.1pp in children 5-11y and 3.6pp from 2006 in adolescents. Despite the decrease in the prevalence of anemia in children 1-4 y in the last 13 years, it still is of great concern. There is a need of awareness among social and medical communities about this, to extend the distribution of micronutrient supplements in children <3y, and to promote nutritional education to incentive mothers to provide foods rich in iron.

Prevalence and Determinants of Comorbid Diabetes and Hypertension in Nepal: Evidence from Non Communicable Disease Risk Factors STEPS Survey Nepal 2013.

PubMed

Pandey, A R; Karki, K B; Mehata, S; Aryal, K K; Thapa, P; Pandit, A; Bista, B; Dhakal, P; Dhimal, M

2015-01-01

Despite being preventable disease, diabetes and hypertension fall among top 10 leading causes of death globally. Diabetes and hypertension are independent risk factor for cardiovascular disease, and the risk is markedly increased by their co-occurrence.This study attempted to find out the prevalence of comorbid diabetes and hypertension in Nepal. A cross-sectional survey was conducted among 4,200 Nepalese adults selected through multistage cluster sampling.Out of 4,200 respondents of larger study, this article includes the analysis of 3,772respondents who granted permission for physical and biochemical measurement. Nepali version of WHO NCD STEPS instrument version 2.2 was used for data collection. In order to obtain national estimates sample weight was used. Chi-square test and multivariable binary logistic regression were used to assess the association of socio-economic predictors with comorbid conditions after adjusting effect of clusters and strata. The overall prevalence of comorbid diabetes and hypertension was found to be 2% in Nepal.Considering age group 15 to 29 years as reference, people in age group 45-69 and 30 to 44 years were found to have 33 folds (AOR=33.06, 95%CI=5.90-185.35) and 6 folds(AOR=6.36, 95%CI=1.08-37.43) higher odds of developing comorbid condition of diabetes and hypertension. Prevalence of comorbid diabetes and hypertension seem to be high in people of 45-69 years of age. Age and level of education seem to be associated with comorbid diabetes and hypertension.

Quantification of diabetes comorbidity risks across life using nation-wide big claims data.

PubMed

Klimek, Peter; Kautzky-Willer, Alexandra; Chmiel, Anna; Schiller-Frühwirth, Irmgard; Thurner, Stefan

2015-04-01

Despite substantial progress in the study of diabetes, important questions remain about its comorbidities and clinical heterogeneity. To explore these issues, we develop a framework allowing for the first time to quantify nation-wide risks and their age- and sex-dependence for each diabetic comorbidity, and whether the association may be consequential or causal, in a sample of almost two million patients. This study is equivalent to nearly 40,000 single clinical measurements. We confirm the highly controversial relation of increased risk for Parkinson's disease in diabetics, using a 10 times larger cohort than previous studies on this relation. Detection of type 1 diabetes leads detection of depressions, whereas there is a strong comorbidity relation between type 2 diabetes and schizophrenia, suggesting similar pathogenic or medication-related mechanisms. We find significant sex differences in the progression of, for instance, sleep disorders and congestive heart failure in diabetic patients. Hypertension is a highly sex-sensitive comorbidity with females being at lower risk during fertile age, but at higher risk otherwise. These results may be useful to improve screening practices in the general population. Clinical management of diabetes must address age- and sex-dependence of multiple comorbid conditions.

Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder.

PubMed

Wang, Hee Ryung; Cho, Hyun; Kim, Dai-Jin

2018-01-15

We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents. Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression. In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder. Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden. Copyright © 2017. Published by Elsevier B.V.

Parent-Child Connectedness and Long-Term Risk for Suicidal Ideation in a Nationally Representative Sample of US Adolescents.

PubMed

Kuramoto-Crawford, S Janet; Ali, Mir M; Wilcox, Holly C

2017-09-01

Few studies have addressed on the role of parent-child connectedness (PCC) on adolescents' risk for suicidal ideation from a longitudinal, developmental perspective. This study examined PCC during adolescence and risk of suicidal ideation into adulthood among a nationally representative sample of American adolescents. The study includes 13,234 adolescents aged 11-18 from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who were surveyed during adolescence (1994-1995) and then again in early adulthood (2008-2009). Multinomial logistic regression estimated the association between PCC during adolescence and having ideation during the adolescence period only, in adulthood only, and in both adolescence and adulthood as compared with those without suicidal ideation. After adjusting for depressive symptoms and other parent and adolescent characteristics, adolescents in two-parent households who reported higher PCC during adolescence had lower relative risk of having ideation during adolescence alone and in both adolescence and adulthood. In mother-only households, higher mother connectedness was also associated with decreased risk of having adolescent ideation. PCC is an important modifiable target for the prevention of suicidal ideation from adolescence into adulthood.

Adolescent Social Isolation as a Model of Heightened Vulnerability to Comorbid Alcoholism and Anxiety Disorders

PubMed Central

Butler, Tracy R.; Karkhanis, Anushree N.; Jones, Sara R.; Weiner, Jeffrey L.

2016-01-01

Individuals diagnosed with anxiety-related illnesses are at increased risk of developing alcoholism, exhibit a telescoped progression of this disease and fare worse in recovery, relative to alcoholics that do not suffer from a comorbid anxiety disorder. Similarly, preclinical evidence supports the notion that stress and anxiety represent major risk factors for the development of alcohol use disorder (AUD). Despite the importance of understanding the link between anxiety and alcoholism, much remains unknown about the neurobiological substrates underlying this relationship. One stumbling block has been the lack of animal models that reliably reproduce the spectrum of behaviors associated with increased vulnerability to these diseases. Here, we review the literature that has examined the behavioral and neurobiological outcomes of a simple rodent adolescent social isolation procedure and discuss its validity as a model of vulnerability to comorbid anxiety disorders and alcoholism. Recent studies have provided strong evidence that adolescent social isolation of male rats leads to the expression of a variety of behaviors linked with increased vulnerability to anxiety and/or AUD, including deficits in sensory gating and fear extinction, and increases in anxiety measures and ethanol drinking. Neurobiological studies are beginning to identify mesolimbic adaptations that may contribute to the behavioral phenotype engendered by this model. Some of these changes include increased excitability of ventral tegmental area dopamine neurons and pyramidal cells in the basolateral amygdala and significant alterations in baseline and stimulated catecholamine signaling. A growing body of evidence suggests that adolescent social isolation may represent a reliable rodent model of heightened vulnerability to anxiety disorders and alcoholism in male rats. These studies provide initial support for the face, construct, and predictive validity of this model and highlight its utility in

Adolescent Social Isolation as a Model of Heightened Vulnerability to Comorbid Alcoholism and Anxiety Disorders.

PubMed

Butler, Tracy R; Karkhanis, Anushree N; Jones, Sara R; Weiner, Jeffrey L

2016-06-01

Individuals diagnosed with anxiety-related illnesses are at increased risk of developing alcoholism, exhibit a telescoped progression of this disease and fare worse in recovery, relative to alcoholics that do not suffer from a comorbid anxiety disorder. Similarly, preclinical evidence supports the notion that stress and anxiety represent major risk factors for the development of alcohol use disorder (AUD). Despite the importance of understanding the link between anxiety and alcoholism, much remains unknown about the neurobiological substrates underlying this relationship. One stumbling block has been the lack of animal models that reliably reproduce the spectrum of behaviors associated with increased vulnerability to these diseases. Here, we review the literature that has examined the behavioral and neurobiological outcomes of a simple rodent adolescent social isolation procedure and discuss its validity as a model of vulnerability to comorbid anxiety disorders and alcoholism. Recent studies have provided strong evidence that adolescent social isolation of male rats leads to the expression of a variety of behaviors linked with increased vulnerability to anxiety and/or AUD, including deficits in sensory gating and fear extinction, and increases in anxiety measures and ethanol drinking. Neurobiological studies are beginning to identify mesolimbic adaptations that may contribute to the behavioral phenotype engendered by this model. Some of these changes include increased excitability of ventral tegmental area dopamine neurons and pyramidal cells in the basolateral amygdala and significant alterations in baseline and stimulated catecholamine signaling. A growing body of evidence suggests that adolescent social isolation may represent a reliable rodent model of heightened vulnerability to anxiety disorders and alcoholism in male rats. These studies provide initial support for the face, construct, and predictive validity of this model and highlight its utility in

Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003-2012.

PubMed

Murakami, Kentaro; Livingstone, M Barbara E

2016-06-01

To examine the associations of meal frequency (MF) and snack frequency (SF) with diet quality. Dietary intake was assessed using two 24 h dietary recalls. All eating occasions providing ≥210 kJ of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15 % or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours, or others). Diet quality was assessed using the Healthy Eating Index (HEI)-2010. Nationally representative sample of the US population. Children aged 6-11 years (n 4269) and adolescents aged 12-19 years (n 6193) in the National Health and Nutrition Examination Survey 2003-2012. Irrespective of the definition of meals, higher MF was associated with higher HEI-2010 in both children and adolescents. One additional meal per day increased HEI-2010 by 1·45-3·59 points (all P<0·005). Conversely, the associations for SF were inconsistent. While SF based on energy contribution was positively associated with HEI-2010 in both children and adolescents (0·70 (P=0·001) and 1·00 (P<0·0001) point increase by one additional snack, respectively), there were no associations for SF based on self-report or time. In analyses in which only plausible energy reporters (3425 children and 3753 adolescents) were included, similar results were obtained. In a representative sample of US children and adolescents, MF was associated with better diet quality, while the associations for SF varied depending on the definition of snacks. The findings highlight the importance of applying different definitions of meals and snacks when assessing the impact of dietary patterns on health.

Long-term effects of mental disorders on educational attainment in the National Comorbidity Survey ten-year follow-up.

PubMed

Mojtabai, Ramin; Stuart, Elizabeth A; Hwang, Irving; Eaton, William W; Sampson, Nancy; Kessler, Ronald C

2015-10-01

The study sought to examine the association of mental disorders with educational attainment in a community sample. Data were from 5001 respondents aged 15-54 in the 1990-1992 National Comorbidity Survey (NCS), re-interviewed in the 2001-2003 NCS follow-up (NCS-2). Discrete-time survival analysis was used to examine the association of disorders present at baseline (NCS) or having first onset after the baseline (assessed in NCS-2) with educational outcomes among 3954 eligible respondents. Mental disorders were categorized into internalizing fear disorders (simple phobia, social phobia, panic disorder with/without agoraphobia and agoraphobia without panic disorder), internalizing anxiety-misery disorders (major depressive disorder, generalized anxiety disorder and post-traumatic stress disorder), externalizing disorders (alcohol and drug use disorders, conduct disorder) and bipolar disorder. Analyses were conducted separately in students and non-students at baseline. Among students, baseline bipolar and externalizing disorders, as well as fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation; baseline anxiety-misery disorders with lower odds of going to college; and baseline externalizing disorders and bipolar disorder with onset after baseline with lower odds of college graduation. Among non-students, baseline fear disorders were associated with lower odds of high school graduation and bipolar disorder with lower odds of going to college. Assuming that the regression coefficients represent causal effects, mental disorders accounted for 5.8-11.0% of high school and 3.2-11.4% of college non-completion. Expanding access to mental health services for youth might have a net positive societal value by helping to prevent some of these adverse educational outcomes.

National prevalence of posttraumatic stress disorder among sexually revictimized adolescent, college, and adult household-residing women.

PubMed

Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L; Saunders, Benjamin E; Kilpatrick, Dean G; Resnick, Heidi S

2012-09-01

Despite empirical links between sexual revictimization (ie, experiencing 2 or more sexual assaults) and posttraumatic stress disorder (PTSD), to our knowledge, no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. To estimate the prevalence of sexual revictimization and PTSD among 3 national female samples (adolescent, college, and adult household probability). Surveys were used to collect data from the National Women's Study-Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women's Study-Replication (2006; household probability). Households and college campuses across the United States. One thousand seven hundred sixty-three adolescent girls, 2000 college women, and 3001 household-residing adult women. Behaviorally specific questions assessed unwanted sexual acts occurring over the life span owing to the use of force, threat of force, or incapacitation via drug or alcohol use. Posttraumatic stress disorder was assessed with a module validated against the criterion standard Structured Clinical Interview for DSM-IV. About 53% of victimized adolescents, 50% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20% of revictimized adolescents, 40% of revictimized college women, and 27.2% of revictimized household-residing women. Compared with nonvictims, odds of meeting past 6-month PTSD were 4.3 to 8.2 times higher for revictimized respondents and 2.4 to 3.5 times higher for single victims. Population prevalence estimates suggest that 769 000 adolescent girls, 625 000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154 000 sexually revictimized adolescents, 250 000 sexually

Prevalence of body dysmorphic disorder and associated features in German adolescents: A self-report survey.

PubMed

Möllmann, Anne; Dietel, Fanny A; Hunger, Antje; Buhlmann, Ulrike

2017-08-01

Prior research has not yet investigated the prevalence of body dysmorphic disorder (BDD) in adolescents and young adults based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In the current study, the point prevalence of BDD, comorbid symptoms, and associated features, such as appearance-related suicidality, level of insight or history of plastic surgeries, were examined in a non-clinical sample of German adolescents and young adults (n=308), between 15 and 21 years old, using self-report measures. Eleven participants (3.6%; 95% CI=[1.9, 5.8]) met DSM-5 criteria for BDD. Self-reported BDD (vs. no-BDD) was related to respondents showing significantly more obsessive-compulsive (OC) symptoms and lower degrees of insight regarding appearance concerns. Significantly more adolescents and young adults with vs. without self-reported BDD (36.4% vs. 8.8%) reported appearance-related suicidal ideation. In conclusion, body dysmorphic symptoms are common in adolescents and young adults and are associated with high rates of comorbid symptoms and suicidal ideation. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

What Are Kids Vaping? Results from a National Survey of U.S. Adolescents

PubMed Central

Miech, Richard; Patrick, Megan E.; O’Malley, Patrick M.; Johnston, Lloyd D.

2016-01-01

Objective To examine what substances U.S. youth vape. Methods Data come from Monitoring the Future, an annual, nationally-representative survey of U.S. 12th, 10th, and 8th grade students. Respondents reported what substance they vaped the last time they used a vaporizer such as an e-cigarette. Results Among students who had ever used a vaporizer, 65–66% last used “just flavoring” in 12th, in 10th, and in 8th grade, more than all other responses combined. In all three grades the percentage using “just flavoring” was above 57% for males, females, African-Americans, Hispanics, whites, and students both and without a parent with a college degree. Nicotine use came in a distant second, at about 20% in 12th and 10th grade and 13% in 8th grade. Taking into account youth who vaped nicotine at last use increases national estimates of tobacco/nicotine prevalence in the past 30 days by 24%–38% above and beyond cigarette smoking, which is substantial but far less than estimates that assume all vaporizer users inhale nicotine. Conclusions These results challenge the common assumption that all vaporizer users inhale nicotine. They (a) call into question the designation of vaporizers and e-cigarettes as ENDS (“Electronic Nicotine Delivery System”), (b) suggest that the recent rise in adolescent vaporizer use does not necessarily indicate a nicotine epidemic, and (c) indicate that vaporizer users can be candidates for primary prevention programs. Finally, the results suggest the importance of developing different rationales for the regulation of vaporizer devices as compared to regulation of substances marketed for vaporizer use. PMID:27562412

Including information about comorbidity in estimates of disease burden: Results from the WHO World Mental Health Surveys

PubMed Central

Alonso, Jordi; Vilagut, Gemma; Chatterji, Somnath; Heeringa, Steven; Schoenbaum, Michael; Üstün, T. Bedirhan; Rojas-Farreras, Sonia; Angermeyer, Matthias; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Karam, Aimee N.; Kovess, Viviane; Levinson, Daphna; Liu, Zhaorui; Mora, Maria Elena Medina; Ormel, J.; Posada-Villa, Jose; Uda, Hidenori; Kessler, Ronald C.

2010-01-01

Background The methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring comorbidity. A methodology that addresses this problem is proposed and illustrated here with data from the WHO World Mental Health Surveys. Although the analysis is based on self-reports about one’s own conditions in a community survey, the logic applies equally well to analysis of hypothetical vignettes describing comorbid condition profiles. Methods Face-to-face interviews in 13 countries (six developing, nine developed; n = 31,067; response rate = 69.6%) assessed 10 classes of chronic physical and 9 of mental conditions. A visual analog scale (VAS) was used to assess overall perceived health. Multiple regression analysis with interactions for comorbidity was used to estimate associations of conditions with VAS. Simulation was used to estimate condition-specific effects. Results The best-fitting model included condition main effects and interactions of types by numbers of conditions. Neurological conditions, insomnia, and major depression were rated most severe. Adjustment for comorbidity reduced condition-specific estimates with substantial between-condition variation (.24–.70 ratios of condition-specific estimates with and without adjustment for comorbidity). The societal-level burden rankings were quite different from the individual-level rankings, with the highest societal-level rankings associated with conditions having high prevalence rather than high individual-level severity. Conclusions Plausible estimates of disorder-specific effects on VAS can be obtained using methods that adjust for comorbidity. These adjustments substantially influence condition-specific ratings. PMID:20553636

Correlates of comorbid depression, anxiety and helplessness with obsessive-compulsive disorder in Chinese adolescents.

PubMed

Sun, Jing; Li, Zhanjiang; Buys, Nicholas; Storch, Eric A

2015-03-15

Youth with obsessive-compulsive disorder (OCD) are at risk of experiencing comorbid psychiatric conditions, such as depression and anxiety. Studies of Chinese adolescents with OCD are limited. The aim of this study was to investigate the association of depression, anxiety, and helplessness with the occurrence of OCD in Chinese adolescents. This study consisted of two stages. The first stage used a cross-sectional design involving a stratified clustered non-clinical sample of 3174 secondary school students. A clinical interview procedure was then employed to diagnose OCD in students who had a Leyton 'yes' score of 15 or above. The second phase used a case-control study design to examine the relationship of OCD to depression, anxiety and helplessness in a matched sample of 288 adolescents with clinically diagnosed OCD and 246 students without OCD. Helplessness, depression and anxiety scores were directly associated with the probability of OCD caseness. Canonical correlation analysis indicated that the OCD correlated significantly with depression, anxiety, and helplessness. Cluster analysis further indicated that the degree of the OCD is also associated with severity of depression and anxiety, and the level of helplessness. These findings suggest that depression, anxiety and helplessness are important correlates of OCD in Chinese adolescents. Future studies using longitudinal and prospective designs are required to confirm these relationships as causal. Copyright © 2014 Elsevier B.V. All rights reserved.

Parental supply of alcohol and adolescent drinking: a multilevel analysis of nationally representative data.

PubMed

Chan, Gary C K; Leung, Janni; Connor, Jason; Hall, Wayne; Kelly, Adrian B

2017-06-09

Existing research on parental supply of alcohol analyses the effects of self-reported parental supply on adolescent drinking using individual level data. This study examined the contextual effect of parental supply of alcohol on adolescent alcohol use by examining the association between the prevalence of parental supply in each Australian state and adolescent alcohol use using a multilevel analytic framework. Adolescent samples (Age: 12-17) were drawn from the four National Drug Strategy Household Surveys (2004, 2007, 2010 and 2013; N = 6803). The prevalence of parental supply of alcohol, defined as the weighted percentage of sample who reported obtaining alcohol from their parents, was estimated in each state and territory across the four surveys. Three multilevel logistic regressions were used to examine the contextual effects of parental supply prevalence on adolescents' alcohol use in the past 12 months, weekly drinking and heavy drinking. Overall, adolescents' rates of past 12 months alcohol use, heavy drinking and weekly drinking between 2004 and 2013 were 40.1, 14.4 and 6.4% respectively. The prevalence of parental supply was significantly associated with past 12 months alcohol use (OR = 1.06, p < .001) and heavy drinking (OR = 1.04, p < .001) but not with weekly drinking (OR = 1.03, p = .189). The results were adjusted for gender, age, socio-economic index for area, place of birth, survey year and prevalence of peer supply. A high prevalence of parental supply in a region was associated with heavier adolescent drinking, regardless of whether adolescents primarily obtained their alcohol from their own parents.

Impact of Treatments for Depression on Comorbid Anxiety, Attentional, and Behavioral Symptoms in Adolescents With Selective Serotonin Reuptake Inhibitor–Resistant Depression

PubMed Central

Hilton, Robert C.; Rengasamy, Manivel; Mansoor, Brandon; He, Jiayan; Mayes, Taryn; Emslie, Graham J.; Porta, Giovanna; Clarke, Greg N.; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Ryan, Neal; Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Brent, David A.

2013-01-01

Objective To assess the relative efficacy of antidepressant medication, alone and in combination with cognitive behavioral therapy (CBT), on comorbid symptoms of anxiety, attention, and disruptive behavior disorders in participants in the Treatment of Resistant Depression in Adolescents (TORDIA) trial. Method Adolescents with selective serotonin reuptake inhibitor (SSRI)–resistant depression (N = 334) were randomly assigned to a medication switch alone (to another SSRI or to venlafaxine) or to a medication switch plus CBT. Anxiety, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorder (DBD) symptoms were assessed by psychiatric interview and self-report at regular intervals between baseline and 24 weeks. The differential effects of medication and of CBT, and the impact of remission on the course of comorbid symptoms and diagnoses, were assessed using generalized linear mixed models. Results Remission was associated with a greater reduction in scalar measures of anxiety, ADHD, and DBDs, and a greater decrease in the rate of diagnosed anxiety disorders. The correlations between the changes in symptoms of depression on the CDRS-R and anxiety, ADHD, and oppositional symptoms were modest, ranging from r = 0.12 to r = 0.28. There were no significant differential treatment effects on diagnoses, or corresponding symptoms. Conclusion The achievement of remission had a beneficial effect on anxiety, ADHD, and DBD symptoms, regardless of the type of treatment received. There were no differential effects of medication or CBT on outcome, except for a nonsignificant trend that those adolescents treated with SSRIs showed a greater decrease in rates of comorbid DBDs relative to those treated with venlafaxine. PMID:23622849

Evaluation of diagnostic criteria for panic attack using item response theory: findings from the National Comorbidity Survey in USA.

PubMed

Ietsugu, Tetsuji; Sukigara, Masune; Furukawa, Toshiaki A

2007-12-01

The dichotomous diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) lose much important information concerning what each symptom can offer. This study explored the characteristics and performances of DSM-IV and ICD-10 diagnostic criteria items for panic attack using modern item response theory (IRT). The National Comorbidity Survey used the Composite International Diagnostic Interview to assess 14 DSM-IV and ICD-10 panic attack diagnostic criteria items in the general population in the USA. The dimensionality and measurement properties of these items were evaluated using dichotomous factor analysis and the two-parameter IRT model. A total of 1213 respondents reported at least one subsyndromal or syndromal panic attack in their lifetime. Factor analysis indicated that all items constitute a unidimensional construct. The two-parameter IRT model produced meaningful and interpretable results. Among items with high discrimination parameters, the difficulty parameter for "palpitation" was relatively low, while those for "choking," "fear of dying" and "paresthesia" were relatively high. Several items including "dry mouth" and "fear of losing control" had low discrimination parameters. The item characteristics of diagnostic criteria among help-seeking clinical populations may be different from those that we observed in the general population and deserve further examination. "Paresthesia," "choking" and "fear of dying" can be thought to be good indicators of severe panic attacks, while "palpitation" can discriminate well between cases and non-cases at low level of panic attack severity. Items such as "dry mouth" would contribute less to the discrimination.

National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults.

PubMed

Mojtabai, Ramin; Olfson, Mark; Han, Beth

2016-12-01

This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014. Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services. The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents. The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group. Copyright © 2016 by the American Academy of Pediatrics.

Weight-related behaviors among non-overweight adolescents: results from the Korean national survey from 2005 to 2007.

PubMed

Lee, Kayoung

2012-01-01

This study aimed to assess the prevalence of overweight misperception, unhealthy diet practices, and factors associated with these weight-related behaviors among Korean adolescents. The subjects were a nationally representative sample of non-overweight students (52,515 in 2005, 64,084 in 2006, and 67,113 in 2007) in middle and high schools who completed the Korea Youth Risk Behavior Web-Based Survey. The prevalence of weight-related behaviors and factors associated with these behaviors were assessed using a complex sampling design. Of non-overweight students, 14.9% of boys and 22.2% of girls reported their weight as overweight/obese. Dieting within the last year was reported by 19.8% of boys and 41.8% of girls. Of those who attempted dieting, 17.1% of boys and 24.6% of girls indicated practicing at least one unhealthy diet behavior within the last month. Overweight misperceptions were independently associated with diet attempts and unhealthy diets after adjustment for weight status, and demographic, social, and psychological factors. Additionally, these weight-related behaviors were also associated with psychosocial factors such as low school achievement, sadness, suicidal ideation, increased stress perception, and cigarette or alcohol use. In conclusion, the high prevalence of inappropriate weight-related behaviors suggests a need for comprehensive approaches to improve weight-related behaviors in non-overweight Korean adolescents.

Bullying Victimization, Binge Drinking, and Marijuana Use among Adolescents: Results from the 2013 National Youth Risk Behavior Survey.

PubMed

Priesman, Emily; Newman, Rameika; Ford, Jason A

2018-01-01

The current research examines the association between bullying victimization, binge drinking, and marijuana use among adolescents. We seek to determine if this association varies based on the type of bullying experienced, traditional or cyberbullying. We used data from the 2013 Youth Risk Behavior Survey, a nationally representative sample of high school students in the United States. The dependent variables were binge drinking and marijuana use. Our key independent variable, bullying victimization, included both traditional and cyberbullying. We estimated logistic regression models, by gender, to examine the association between bullying victimization and substance use. About 25% of the sample reported bullying victimization, including 10.39% for only traditional, 5.47% for only cyber, and 9.26% for both. Traditional bullying was not significantly associated with binge drinking, but was negatively related to marijuana use. Being the victim of cyberbullying and both types of bullying was significantly associated with binge drinking and marijuana use. We also found important gender differences. The current research adds to a growing list of studies that suggests that cyberbullying is associated with more adverse outcomes than traditional bullying. Bullying prevention and intervention efforts should focus on reducing cyberbullying and providing adolescents with the skills needed to effectively deal with cyberbullying.

Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

PubMed

Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

2013-08-01

To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities. We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral. We used multivariable analysis to examine factors associated with referral. We identified 34,225 database visits. A total of 17.1% were with overweight (body mass index=85th to 94th percentile) or obese (body mass index≥95th percentile) patients. A total of 7.1% of primary care visits with overweight/obese children ended in referral. Referral was more likely when obesity was the reason for visit (odds ratio=2.83; 95% confidence interval=1.61-4.97) but was not associated with presence of a comorbidity (odds ratio=1.35; 95% confidence interval=0.75-2.44). Most overweight or obese children are not referred, regardless of comorbidity status. One reason may be low levels of appropriate diagnosis.

Does the Outcome of a First Pregnancy Predict Depression, Suicidal Ideation, or Lower Self-esteem? Data from the National Comorbidity Survey

PubMed Central

Steinberg, Julia R.; Becker, Davida; Henderson, Jillian T.

2010-01-01

The present study examines the risk of depression, suicidal ideation, and lower self-esteem following an abortion versus delivery, adjusting for important correlates. Using the National Comorbidity Survey, we examined how first pregnancy outcome (abortion versus delivery) related to subsequent major depression, suicidal ideation, and self-esteem. Models controlling for risk factors, such as background and economic factors, pre-pregnancy violence experience, and pre-pregnancy mental health, as well as a model with all risk factors, were examined. When no risk factors were entered in the model, women who had abortions were more likely to have subsequent depression (OR = 1.53, CI 1.05-2.22) and suicidal ideation (OR = 2.02, CI 1.40-2.92), but not more likely to have lower self-esteem (B = -.02). When all risk factors were entered, pregnancy outcome was not significantly related to later depression (OR = .87, CI .54-1.37) and suicidal ideation (OR = 1.19, CI .70-2.02); predictors of mental health following abortion and delivery included pre-pregnancy depression, suicidal ideation, and sexual violence. Policies and practices implemented in response to the claim that abortion hurts women are not supported by our findings. Efforts to support women’s mental health should focus on known risk factors, such as programs to address gender-based violence, rather than abortion history. PMID:21486261

Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A)

ERIC Educational Resources Information Center

Merikangas, Kathleen Ries; He, Jian-ping; Burstein, Marcy; Swendsen, Joel; Avenevoli, Shelli; Case, Brady; Georgiades, Katholiki; Heaton, Leanne; Swanson, Sonja; Olfson, Mark

2011-01-01

Objective: Mental health policy for youth has been constrained by a paucity of nationally representative data concerning patterns and correlates of mental health service utilization in this segment of the population. The objectives of this investigation were to examine the rates and sociodemographic correlates of lifetime mental health service use…

Violence Related Behaviors and Weapon Carrying Among Hispanic Adolescents: Results from the National Youth Risk Behavior Survey, 2001-2015.

PubMed

Khubchandani, Jagdish; Price, James H

2018-04-01

Hispanic youths are disproportionately represented in gangs in the United States, are more likely to drink alcohol at younger ages, and to live in poverty; all are risks for violence and weapon carrying. No studies to date have assessed violence related behaviors and weapon carrying in Hispanic youth over an extended period. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of Hispanic adolescents. Our analyses found both physical fighting and fighting on school property had statistically significant reductions from 2001 to 2015 for Hispanic females and their suicide attempts increased from 2009 to 2015. Hispanic males had statistically significant decreasing trends for: being in a physical fight in the past year, being bullied on school property, being in a physical fight on school property within the past year; threatened or injured with a weapon on school property in the past year; and having attempted suicide in the past year. Hispanic females and males had two groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A's or B's in school were significantly less likely (about half as likely) to carry weapons. This data could be used to identify Hispanic adolescents at higher risk for weapon carrying and used as a basis for enriching programs to improve academic success of Hispanic adolescents.

Development of an international comorbidity education framework.

PubMed

Lawson, C; Pati, S; Green, J; Messina, G; Strömberg, A; Nante, N; Golinelli, D; Verzuri, A; White, S; Jaarsma, T; Walsh, P; Lonsdale, P; Kadam, U T

2017-08-01

The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions. Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education. We surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing clinical frameworks and the student survey data. This list was used to develop the International Comorbidity Education Framework. The survey sample consisted of 917 students from England (42%), India (48%), Italy (8%) and Sweden (2%). The majority of students across all disciplines said that they lacked knowledge, training and confidence in comorbidity care and were unable to identify specific teaching on comorbidities. All student groups wanted further comorbidity training. The health education institution representatives found no specific references to comorbidity in current health education curricula. Current clinical frameworks were used to develop an agreed list of core comorbidity content and hence an International Comorbidity Education Framework. Based on consultation with academics and clinicians and on student feedback we developed an International Comorbidity Education Framework to promote the integration of comorbidity concepts into current healthcare curricula. Copyright © 2017 Elsevier

Monitoring the Future National Survey Results on Drug Use, 1975-2010. Volume I, Secondary School Students

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2011-01-01

The Monitoring the Future (MTF) study involves an ongoing series of national surveys of American adolescents and adults that has provided the nation with a vital window into the important, but largely hidden, problem behaviors of illegal drug use, alcohol use, tobacco use, anabolic steroid use, and psychotherapeutic drug use. For more than a third…

Gambling disorders, gambling type preferences, and psychiatric comorbidity among the Thai general population: Results of the 2013 National Mental Health Survey.

PubMed

Assanangkornchai, Sawitri; McNeil, Edward B; Tantirangsee, Nopporn; Kittirattanapaiboon, Phunnapa

2016-09-01

Background and aims To estimate the prevalence of problem and pathological gambling, gender and age-group differences in gambling types, and comorbidities with other psychiatric disorders among the Thai general population. Methods Analysis was conducted on 4,727 participants of Thailand's 2013 National Mental Health Survey, a multistage stratified cluster survey, using the Composite International Diagnostic Interview. Diagnoses of problem and pathological gambling and other psychiatric disorders were based on the DSM-IV-TR criteria with the following additional criteria for gamblers: more than 10 lifetime gambling episodes and a single year loss of at least 365 USD from gambling. Results The estimated lifetime prevalence rates of pathological and problem gambling were 0.90% [95% confidence interval (CI): 0.51-1.29] and 1.14% (95% CI: 0.58-1.70), respectively. The most popular type of gambling was playing lotteries [69.5%, standard error (SE) = 1.9], the prevalence of which was significantly higher among females and older age groups. The most common psychiatric disorders seen among pathological gamblers were alcohol abuse (57.4%), nicotine dependence (49.5%), and any drug use disorder (16.2%). Pathological gambling was highly prevalent among those who ever experienced major depressive episodes (5.5%), any drug dependence (5.1%), and intermittent explosive disorder (4.8%). The association between pathological gambling was strongest with a history of major depressive episode [adjusted odds ratio (AOR) = 10.4, 95% CI: 2.80-38.4]. Conclusion The study confirms the recognition of gambling disorders as a public health concern in Thailand and suggests a need for culturally specific preventive measures for pathological gamblers and those with a history of substance use disorders or major depression.

Gambling disorders, gambling type preferences, and psychiatric comorbidity among the Thai general population: Results of the 2013 National Mental Health Survey

PubMed Central

Assanangkornchai, Sawitri; McNeil, Edward B.; Tantirangsee, Nopporn; Kittirattanapaiboon, Phunnapa

2016-01-01

Background and aims To estimate the prevalence of problem and pathological gambling, gender and age-group differences in gambling types, and comorbidities with other psychiatric disorders among the Thai general population. Methods Analysis was conducted on 4,727 participants of Thailand’s 2013 National Mental Health Survey, a multistage stratified cluster survey, using the Composite International Diagnostic Interview. Diagnoses of problem and pathological gambling and other psychiatric disorders were based on the DSM-IV-TR criteria with the following additional criteria for gamblers: more than 10 lifetime gambling episodes and a single year loss of at least 365 USD from gambling. Results The estimated lifetime prevalence rates of pathological and problem gambling were 0.90% [95% confidence interval (CI): 0.51–1.29] and 1.14% (95% CI: 0.58–1.70), respectively. The most popular type of gambling was playing lotteries [69.5%, standard error (SE) = 1.9], the prevalence of which was significantly higher among females and older age groups. The most common psychiatric disorders seen among pathological gamblers were alcohol abuse (57.4%), nicotine dependence (49.5%), and any drug use disorder (16.2%). Pathological gambling was highly prevalent among those who ever experienced major depressive episodes (5.5%), any drug dependence (5.1%), and intermittent explosive disorder (4.8%). The association between pathological gambling was strongest with a history of major depressive episode [adjusted odds ratio (AOR) = 10.4, 95% CI: 2.80–38.4]. Conclusion The study confirms the recognition of gambling disorders as a public health concern in Thailand and suggests a need for culturally specific preventive measures for pathological gamblers and those with a history of substance use disorders or major depression. PMID:27648744

Methodology of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

PubMed

Hafekost, Jennifer; Lawrence, David; Boterhoven de Haan, Katrina; Johnson, Sarah E; Saw, Suzy; Buckingham, William J; Sawyer, Michael G; Ainley, John; Zubrick, Stephen R

2016-09-01

To describe the study design of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The aims of the study, sample design, development of survey content, field procedures and final questionnaires are detailed. During 2013-2014, a national household survey of the mental health and wellbeing of young people was conducted involving a sample of 6310 families selected at random from across Australia. The survey included a face-to-face diagnostic interview with parents/carers of 4- to 17-year-olds and a self-report questionnaire completed by young people aged 11-17 years. The overall response rate to the survey was 55% with 6310 parents/carers of eligible households participating in the survey. In addition, 2967 or 89% of young people aged 11-17 years in these participating households completed a questionnaire. The survey sample was found to be broadly representative of the Australian population on major demographic characteristics when compared with data from the Census of Population and Housing. However, adjustments were made for an over-representation of younger children aged 4 to 7 years and also families with more than one eligible child in the household. Young Minds Matter provides updated national prevalence estimates of common child and adolescent mental disorders, describes patterns of service use and will help to guide future decisions in the development of policy and provision of mental health services for children and adolescents. Advancements in interviewing methodology, addition of a data linkage component and informed content development contributed to improved breadth and quality of the data collected. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Association between increased BMI and severe school absenteeism among US children and adolescents: findings from a national survey, 2005-2008.

PubMed

Li, Y; Raychowdhury, S; Tedders, S H; Lyn, R; Lòpez-De Fede, A; Zhang, J

2012-04-01

School absenteeism may be an underlying cause of poor school performance among overweight and obese children. We examined the associations between school absenteeism and body mass index (BMI) in a nationally representative sample. We analyzed the data of 1387 children (6-11 years) and 2185 adolescents (12-18 years), who completed an interview and anthropometric measurement as a part of the National Health and Nutrition Examination Survey, 2005-2008. The CDC 2000 growth chart was used to categorize BMI status, and the number of school days missed during the past 12 months was assessed by asking the proxies or interviewees. The prevalence of obesity and overweight were 18.96±1.44% (s.e.) and 16.41±0.78%, respectively, among study populations. The means of school days missed in the last 12 months were not statistically different between the normal-weight, overweight and obese groups, 3.79±0.56, 3.86±0.38 and 4.31±0.01 days, respectively. However, when >2 days missed per school month was defined as severe absence, the prevalence of severe absence were 1.57%, 2.99% and 4.94% respectively, among 6-11-year-old children with normal, overweight and obese. The adjusted odds of severe school absence were 2.27 (95% confidence interval=0.64-8.03) and 3.93 (1.55-9.95), respectively, among overweight and obese children compared with normal-weight peers (P for trend test <0.01). No significant association was found among adolescents. Increased body weight is independently associated with severe school absenteeism in children but not adolescents. Future research is needed to determine the nature, and academic and social significance of this association.

Reference Curves for Field Tests of Musculoskeletal Fitness in U.S. Children and Adolescents: The 2012 NHANES National Youth Fitness Survey.

PubMed

Laurson, Kelly R; Saint-Maurice, Pedro F; Welk, Gregory J; Eisenmann, Joey C

2017-08-01

Laurson, KR, Saint-Maurice, PF, Welk, GJ, and Eisenmann, JC. Reference curves for field tests of musculoskeletal fitness in U.S. children and adolescents: The 2012 NHANES National Youth Fitness Survey. J Strength Cond Res 31(8): 2075-2082, 2017-The purpose of the study was to describe current levels of musculoskeletal fitness (MSF) in U.S. youth by creating nationally representative age-specific and sex-specific growth curves for handgrip strength (including relative and allometrically scaled handgrip), modified pull-ups, and the plank test. Participants in the National Youth Fitness Survey (n = 1,453) were tested on MSF, aerobic capacity (via submaximal treadmill test), and body composition (body mass index [BMI], waist circumference, and skinfolds). Using LMS regression, age-specific and sex-specific smoothed percentile curves of MSF were created and existing percentiles were used to assign age-specific and sex-specific z-scores for aerobic capacity and body composition. Correlation matrices were created to assess the relationships between z-scores on MSF, aerobic capacity, and body composition. At younger ages (3-10 years), boys scored higher than girls for handgrip strength and modified pull-ups, but not for the plank. By ages 13-15, differences between the boys and girls curves were more pronounced, with boys scoring higher on all tests. Correlations between tests of MSF and aerobic capacity were positive and low-to-moderate in strength. Correlations between tests of MSF and body composition were negative, excluding absolute handgrip strength, which was inversely related to other MSF tests and aerobic capacity but positively associated with body composition. The growth curves herein can be used as normative reference values or a starting point for creating health-related criterion reference standards for these tests. Comparisons with prior national surveys of physical fitness indicate that some components of MSF have likely decreased in the United States over

Adolescent Alcohol Drinking Renders Adult Drinking BLA-Dependent: BLA Hyper-Activity as Contributor to Comorbid Alcohol Use Disorder and Anxiety Disorders

PubMed Central

Moaddab, Mahsa; Mangone, Elizabeth; McDannald, Michael A.

2017-01-01

Adolescent alcohol drinking increases the risk for alcohol-use disorder in adulthood. Yet, the changes in adult neural function resulting from adolescent alcohol drinking remain poorly understood. We hypothesized that adolescent alcohol drinking alters basolateral amygdala (BLA) function, making alcohol drinking BLA-dependent in adulthood. Male, Long Evans rats were given voluntary, intermittent access to alcohol (20% ethanol) or a bitter, isocaloric control solution, across adolescence. Half of the rats in each group received neurotoxic BLA lesions. In adulthood, all rats were given voluntary, intermittent access to alcohol. BLA lesions reduced adult alcohol drinking in rats receiving adolescent access to alcohol, but not in rats receiving adolescent access to the control solution. The effect of the BLA lesion was most apparent in high alcohol drinking adolescent rats. The BLA is essential for fear learning and is hyper-active in anxiety disorders. The results are consistent with adolescent heavy alcohol drinking inducing BLA hyper-activity, providing a neural mechanism for comorbid alcohol use disorder and anxiety disorders. PMID:29135933

Use of Corrective Lenses among Adolescents: Findings from the National Health and Nutrition Examination Survey

PubMed Central

Kemper, Alex R.; Gurney, James G.; Eibschitz-Tsimhoni, Maya; DelMonte, Monte A.

2007-01-01

Purpose To evaluate demographic variations in the use of corrective lenses among adolescent children. Methods Cross-sectional analysis of 3,916 children 12-18 years who participated in the 1999-2002 National Health and Nutrition Examination Survey (NHANES) vision examination component, which included: questions regarding use of corrective lenses; distance visual acuity, with corrective lenses if available; and non-cycloplegic autorefraction. Results reflect population-level estimates. Results Overall, 32.2% (95% confidence interval [CI]: 29.5%-35.0%) reported wearing corrective lenses. Girls and those with any private insurance had greater adjusted odds of reporting wearing corrective lenses. In contrast, children aged 15 through 18 years versus those 12 through 14 years, and white children compared to Black or Hispanic children had greater adjusted odds of actually having them available at the time of NHANES participation. Although 12.6% (95% CI: 8.8%-16.3%) of those who did not have their previously prescribed corrective lenses available had 20/25 or better distance visual acuity in both eyes without correction, 26.9% (95% CI:21.6%-32.1%) with their corrective lenses had distance visual acuity of 20/40 or worse in at least one eye when using their corrective lenses. Limitations Near visual acuity was not measured and children with corrective lenses available only had their corrected distance visual acuity measured. No data regarding the accuracy of the NHANES assessment of distance visual acuity are available. Autorefraction was performed without cycloplegia. Conclusions Many adolescent children report wearing corrective lenses. Variations across demographic characteristics appear to be due to a combination of undertreatment, overtreatment, and compliance with previously recommended corrective lenses. PMID:18062494

Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up

PubMed Central

Mojtabai, Ramin; Stuart, Elizabeth A.; Hwang, Irving; Eaton, William W.; Sampson, Nancy; Kessler, Ronald C.

2016-01-01

Purpose The study sought to examine the association of mental disorders with educational attainment in a community sample. Methods Data were from 5,001 respondents aged 15–54 in the 1990–1992 National Comorbidity Survey (NCS), re-interviewed in the 2001–2003 NCS follow-up (NCS-2). Discrete-time survival analysis was used to examine the association of disorders present at baseline (NCS) or having first onset after the baseline (assessed in NCS-2) with educational outcomes among 3,954 eligible respondents. Mental disorders were categorized into internalizing fear disorders (simple phobia, social phobia, panic disorder with/without agoraphobia and agoraphobia without panic disorder), internalizing anxiety-misery disorders (major depressive disorder, generalized anxiety disorder and post-traumatic stress disorder), externalizing disorders (alcohol and drug use disorders, conduct disorder) and bipolar disorder. Analyses were conducted separately in students and non-students at baseline. Results Among students, baseline bipolar and externalizing disorders, and fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation; baseline anxiety-misery disorders with lower odds of going to college; and baseline externalizing disorders and bipolar disorder with onset after baseline with lower odds of college graduation. Among non-students, baseline fear disorders were associated with lower odds of high school graduation and bipolar disorder with lower odds of going to college. Assuming that the regression coefficients represent causal effects, mental disorders accounted for 5.8–11.0% of high school and 3.2–11.4% of college non-completion. Conclusions Expanding access to mental health services for youth might have a net positive societal value by helping to prevent some of these adverse educational outcomes. PMID:26082040

Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review.

PubMed

Muskens, Jet B; Velders, Fleur P; Staal, Wouter G

2017-09-01

Somatic disorders occur more often in adult psychiatric patients than in the general adult population. However, in child and adolescent psychiatry this association is unclear, mainly due to a lack of integration of existing data. To address this issue, we here present a systematic review on medical comorbidity in the two major developmental disorders autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and formulate clinical recommendations. The literature was searched using the PubMed and PsycINFO databases (2000-1 May 2016) with the keywords "[((child and adolescent) AND (Autism OR Attention Deficit Hyperactivity Disorder* OR ADHD)) AND ("Cardiovascular Diseases" [Mesh] OR "Endocrine System Diseases" [Mesh] OR "Immune System Diseases" [Mesh] OR "Neurobehavioral Manifestations" [Mesh] OR "Gastrointestinal Disorders" [Mesh] OR Somatic OR Autoimmune disease OR Nervous system disease OR Infection OR Infectious disease)]. Two raters independently assessed the quality of the eligible studies. The initial search identified 5278 articles. Based on inclusion and exclusion criteria 104 papers were selected and subsequently subjected to a quality control. This quality was assessed according to a standardized and validated set of criteria and yielded 29 studies for inclusion. This thorough literature search provides an overview of relevant articles on medical comorbidity in ADHD and/or ASD, and shows that medical disorders in these children and adolescents appear to be widespread. Those who work with children with ASD and/or ADHD should be well aware of this and actively promote routine medical assessment. Additionally, case-control studies and population-based studies are needed to provide reliable prevalence estimates. Future studies should furthermore focus on a broader evaluation of medical disorders in children and adolescents with ADHD and/or ASD to improve treatment algorithm in this vulnerable group.

One factor or two parallel processes? Comorbidity and development of adolescent anxiety and depressive disorder symptoms.

PubMed

Hale, William W; Raaijmakers, Quinten A W; Muris, Peter; van Hoof, Anne; Meeus, Wim H J

2009-10-01

This study investigates whether anxiety and depressive disorder symptoms of adolescents from the general community are best described by a model that assumes they are indicative of one general factor or by a model that assumes they are two distinct disorders with parallel growth processes. Additional analyses were conducted to explore the comorbidity of adolescent anxiety and depressive disorder symptoms and the effects that adolescent anxiety and depressive disorder symptoms have on each other's symptom severity growth. Two cohorts of early (N = 923; Age range 10-15 years; Mean age = 12.4, SD = .59; Girls = 49%) and middle adolescent (N = 390; Age range 16-20 years; Mean age = 16.7, SD = .80; Girls = 57%) boys and girls from the general community were prospectively studied annually for five years. These two adolescent cohorts were divided into five groups: one group at-risk for developing a specific anxiety disorder and four additional groups of healthy adolescents that differed in age and sex. Self-reported anxiety and depressive disorder symptoms were analyzed with latent growth modeling. Comparison of the fit statistics of the two models clearly demonstrates the superiority of the distinct disorders with parallel growth processes model above the one factor model. It was also demonstrated that the initial symptom severity of either anxiety or depression is predictive of the development of the other, though in different ways for the at-risk and healthy adolescent groups. The results of this study established that the development of anxiety and depressive disorder symptoms of adolescents from the general community occurs as two distinct disorders with parallel growth processes, each with their own unique growth characteristics.

Prevalence and comorbidity of major depressive disorder in young black and white women.

PubMed

Franko, Debra L; Thompson, Douglas; Barton, Bruce A; Dohm, Faith-Anne; Kraemer, Helena C; Iachan, Ronaldo; Crawford, Patricia B; Schreiber, George B; Daniels, Stephen R; Striegel-Moore, Ruth H

2005-05-01

This study reports the prevalence and comorbidity of depression in two large samples of black and white young adult women. Clinical interviews of participants in a follow-up study of the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS-Wave II; N=378) were contrasted with a subsample of the National Comorbidity Survey (NCS; N=3749) to examine the rates and comorbidity of lifetime major depressive disorder in black and white women using methodology described by . The sequencing of disorders was also examined to determine which disorder was primary. Comorbidity and sequencing were examined for alcohol and drug use disorder, panic disorder, specific phobia, social phobia, and post-traumatic stress disorder. Prevalence estimates for depression, alcohol use disorder, and drug use disorder were higher for white women than for black women in both NGHS-Wave II and NCS. Over half of depressed participants in both samples had at least one comorbid disorder and depression was associated with an increased probability of all the investigated disorders. Only one ethnic difference was found in comorbidity, indicating that black women were more likely to have comorbid panic disorder than white women were. Depression was primary to alcohol and substance use disorders, whereas it was secondary to specific phobia and PTSD. High rates of comorbidity were found for both black and white women, though few ethnic differences in comorbidity were found. Preventive and treatment interventions are needed to address multiple disorders in young adult women.

Poor Adherence to US Dietary Guidelines for Children and Adolescents in the National Health and Nutrition Examination Survey Population.

PubMed

Banfield, Emilyn C; Liu, Yan; Davis, Jennifer S; Chang, Shine; Frazier-Wood, Alexis C

2016-01-01

Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, yet the dietary habits of American children and how they change across childhood and adolescence are unknown. This study sought to describe diet quality among children and adolescents by assessing adherence to the 2010 Dietary Guidelines for Americans (DGA) and to determine whether any differences in adherence occurred across childhood. We employed a cross-sectional design using data from the National Health and Nutrition Examination Survey (NHANES). Of 9,280 children aged 4 to 18 years who participated in NHANES from 2005 to 2010, those with insufficient data on dietary recall (n=852) or who were pregnant or lactating during the time of interview (n=38) were excluded from the final study sample (n=8,390). We measured adherence to the DGA using the Healthy Eating Index 2010 (HEI-2010) and stratified participants into three age groups (4 to 8, 9 to 13, and 14 to 18 years of age). We analyzed each of 12 HEI-2010 components and total HEI-2010 score. The youngest children had the highest overall diet quality due to significantly greater scores for total fruit, whole fruit, dairy, and whole grains. These children also had the highest scores for sodium, refined grains, and empty calories. Total HEI-2010 scores ranged from 43.59 to 52.11 out of 100, much lower than the minimum score of 80 that is thought to indicate a diet associated with good health. Overall, children and adolescents are failing to meet the DGA and may be at an increased risk of chronic diseases throughout life. By analyzing which food groups show differences between age groups, we provide data that can inform the development of dietary interventions to promote specific food groups targeting specific ages and improve diet quality among children and adolescents. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

National Aquatic Resource Surveys

EPA Pesticide Factsheets

EPA reports information on the condition of our nation's waters using probabilistic surveys. The National Aquatic Resource Surveys assess the status of and changes in water quality of the nation's coastal waters, lakes, rivers and streams, and wetlands.

Associations of Physical Activity, Sedentary Time, and Screen Time With Cardiovascular Fitness in United States Adolescents: Results From the NHANES National Youth Fitness Survey.

PubMed

Porter, Anna K; Matthews, Krystin J; Salvo, Deborah; Kohl, Harold W

2017-07-01

Most US adolescents do not meet guidelines of at least 60 daily minutes of moderate- to vigorous-intensity physical activity. In addition, sedentary behaviors among this age group are of increasing concern. This study examined the association of movement behaviors with cardiovascular fitness among US adolescents. Data from the 2012 NHANES National Youth Fitness Survey were used to assess the association of movement behaviors (physical activity, sedentary time, screen time) with cardiovascular fitness among adolescent males and females. Multiple logistic regressions were used to test the independent and interactive effects of movement behaviors on cardiovascular fitness. Among females, physical activity was directly associated with cardiovascular fitness; no significant association was observed between sedentary behaviors and CVF. Among males, sedentary time moderated the relationship between physical activity and cardiovascular fitness, such that a significant, direct association was only observed among those with high sedentary time (OR: 5.01; 95% CI: 1.60, 15.70). Results from this cross-sectional analysis suggest that among female US adolescents, physical activity, but not sedentary behavior, is associated with cardiovascular fitness. Among males, the interaction between physical activity and sedentary time seems to be important for cardiovascular fitness. Longitudinal studies are warranted to confirm these findings.

Availability of convenience stores and adolescent alcohol use in Taiwan: a multi-level analysis of national surveys.

PubMed

Wang, Shi-Heng; Lin, I-Chin; Chen, Chuan-Yu; Chen, Duan-Rung; Chan, Ta-Chien; Chen, Wei J

2013-12-01

To examine the association between alcohol in school environments and adolescent alcohol use over the previous 6 months. A multi-level logistic regression analysis was performed of cross-sectional surveys conducted in 2004, 2005 and 2006. A total of 52 214 students aged 11-19 years from 387 middle or high schools were selected from a nationally representative, multi-stage, stratified probability sampling across Taiwan. Information on socio-demographic features and substance use experiences was collected using self-administered questionnaires. The alcohol in the environment was measured using the availability of convenience stores surrounding the schools. Using geographical information systems, the weighted numbers of convenience stores within 1 km, a 12-15-minute walk, of a school were calculated. The schools were later categorized into three subgroups via the tertile of nearby convenience stores. Considering the compositional characteristics, the availability of convenience stores was found to account for 1.5% of the school-level variance of youthful drinking. The odds ratios (95% confidence interval) of alcohol use over the previous 6 months among youth attending schools with medium and high availability were 1.04 (0.96-1.13) and 1.08 (1.00-1.17), respectively, with a P-value of 0.04 in the trend test. The greater availability of convenience stores near a school is associated with an increased risk of alcohol use among adolescents over the previous 6 months. © 2013 Society for the Study of Addiction.

Empirically derived subtypes of serious emotional disturbance in a large adolescent sample.

PubMed

Peiper, Nicholas; Clayton, Richard; Wilson, Richard; Illback, Robert; O'Brien, Elizabeth; Kerber, Richard; Baumgartner, Richard; Hornung, Carlton

2015-06-01

The heterogeneity of serious emotional disturbance has been thoroughly documented among adolescents with nationally representative data derived from structured interviews, although use of these interviews may not be feasible within the context of brief and self-administered school surveys. This study seeks to identify distinct subtypes of serious emotional disturbance in a large school-based sample. A total of 108,736 students fully completed the K6 scale that was included on the 2012 Kentucky Incentives for Prevention Survey. Latent class analysis was used to derive subtypes of serious emotional disturbance among students receiving a positive screen (n = 15,147). To determine significant predictors of class membership, adjusted rate ratios and 95 % confidence intervals were calculated using multinomial logistic regression. A four-class model was the most parsimonious, with four distinct subtypes emerging that varied by both symptom type and severity: comorbid moderate severity, comorbid high severity, anxious moderate severity, and depressed high severity. Age, gender, race/ethnicity, family structure, substance use, antisocial behavior, role impairments, and peer victimization were significant predictors of class membership, although the magnitude of these effects was stronger for the two high severity groups. Our results suggest heterogeneity of serious emotional disturbance by both symptom type and severity. Prevention programs may benefit by shifting focus from specific disorders to the core features of serious emotional disturbance, including psychological distress, high comorbidity, and role impairments.

Smoking in school-aged adolescents: design of a social network survey in six European countries.

PubMed

Lorant, Vincent; Soto, Victoria Eugenia; Alves, Joana; Federico, Bruno; Kinnunen, Jaana; Kuipers, Mirte; Moor, Irene; Perelman, Julian; Richter, Matthias; Rimpelä, Arja; Robert, Pierre-Olivier; Roscillo, Gaetano; Kunst, Anton

2015-03-21

In Western countries, smoking accounts for a large share of socio-economic inequalities in health. As smoking initiation occurs around the age of 13, it is likely that school context and social networks at school play a role in the origin of such inequalities. So far, there has been little generic explanation of how social ties at school contribute to socio-economic inequalities in smoking. The SILNE (Smoking Inequalities - Learning from Natural Experiments) survey was designed to test the hypothesis that a combination of peer effect, homophilous social ties, and school context may explain how smoking inequalities are magnified at school - a theory known as network-induced inequality. In this paper, the survey theory and design are presented. The social network survey was carried out in 2013 in six medium-sized European cities with average incomes similar to the national average: Namur (Belgium), Tampere (Finland), Hannover (Germany), Latina (Italy), Amersfoort (The Netherlands), and Coimbra (Portugal). In each city, 6 to 8 schools were selected in a stratified sampling procedure. In each school, two grades in secondary education, corresponding to 14-16-year-olds, were selected. All adolescents in these two grades were invited to participate in the survey. Social ties were reported using the roster approach, in which each adolescent had to nominate up to 5 friends from a directory. The survey collected information from 11,015 adolescents in 50 schools, out of a total of 13,870 registered adolescents, yielding a participation rate of 79%. The SILNE survey yielded 57,094 social ties, 86.7% of which referred to friends who also participated in the survey. The SILNE survey was designed to measure the association between adolescents' social ties at school, their socio-economic background, and their smoking behaviour. Two difficulties were encountered, however: legal privacy constraints made it impossible to apply the same parental consent procedure in all countries

Food security and metabolic syndrome in U.S. adults and adolescents: findings from the National Health and Nutrition Examination Survey, 1999-2006.

PubMed

Parker, Emily D; Widome, Rachel; Nettleton, Jennifer A; Pereira, Mark A

2010-05-01

We sought to examine the association of food security and metabolic syndrome in a representative sample of U.S. adults and adolescents. We hypothesized that compared with those in food-secure households, adolescents and adults living in food-insecure households would have increased odds of (MetS). Data from the National Health and Nutrition Examination Surveys from 1999 to 2006 were combined and analyzed cross-sectionally. Logistic regression was used to compute odds ratios and 95% confidence intervals (95% CI) in the association of household food security (fully food secure, marginal, low, and very low food security) and MetS. Compared with those who were food secure, adults in households with marginal food security had 1.80-fold increased odds of MetS (95% CI, 1.30-2.49), and those with very low food security had a 1.65-fold increased odds of MetS (95% CI 1.12-2.42). There was no association with low food security. The association of marginal household food security and MetS was not significant in adolescents. In adults and adolescents, very low was food security not associated with increased odds of MetS compared with those who were food secure. Members of households with marginal and very low food security are at increased risk of MetS. A mechanism may be that foods that are inexpensive and easily accessible tend to be energy dense and nutrient poor. 2010 Elsevier Inc. All rights reserved.

Does the outcome of a first pregnancy predict depression, suicidal ideation, or lower self-esteem? Data from the National Comorbidity Survey.

PubMed

Steinberg, Julia R; Becker, Davida; Henderson, Jillian T

2011-04-01

This study examines the risk of depression, suicidal ideation, and lower self-esteem following an abortion versus a delivery, with and without adjusting for important correlates. Using the National Comorbidity Survey, we tested how first pregnancy outcome (abortion vs. delivery) related to subsequent major depression, suicidal ideation, and self-esteem. Models controlling for risk factors, such as background and economic factors, prepregnancy violence experience, and prepregnancy mental health, as well as a model with all risk factors, were examined. When no risk factors were entered in the model, women who had abortions were more likely to have subsequent depression, OR=1.53, 95% CI [1.05-2.22], and suicidal ideation, OR=2.02, 95% CI [1.40-2.92], but they were not more likely to have lower self-esteem, B=-.02. When all risk factors were entered, pregnancy outcome was not significantly related to later depression, OR=0.87, 95% CI [0.54-1.37], and suicidal ideation, OR=1.19, 95% CI [0.70-2.02]. Predictors of mental health following abortion and delivery included prepregnancy depression, suicidal ideation, and sexual violence. Policies and practices implemented in response to the claim that abortion hurts women are not supported by our findings. Efforts to support women's mental health should focus on known risk factors, such as gender-based violence and prior mental health problems, rather than abortion history. © 2011 American Orthopsychiatric Association.

Perceived Marital Support and Incident Mental Illness: Evidence from the National Comorbidity Survey.

PubMed

Feder, Kenneth A; Heatherington, Laurie; Mojtabai, Ramin; Eaton, William W

2018-06-26

Social support in marriage may be associated with reduced risk for mental illness. Past studies are limited by short follow up and a focus on depression. A two-wave nationally representative survey in the United States (n = 2,503) is used to examine whether social support in marriage is associated with the onset of each of four clusters of disorders-internalizing, externalizing, phobic, and bipolar-10 years later. Results indicate that higher levels of perceived marital support were protective against internalizing, fear, and bipolar disorders, and against incident externalizing disorders for women. Protective effects of social support in marriage against mental illness are long-lasting, and sometimes differ by gender. Findings suggest the importance of mental health assessment in clinical practice. © 2018 American Association for Marriage and Family Therapy.

How Do Parents Make Adolescents Feel Loved? Perspectives on Supportive Parenting from Adolescents in 12 Cultures

ERIC Educational Resources Information Center

McNeely, Clea A.; Barber, Brian K.

2010-01-01

The conceptualization and measurement of parental support is predominately the work of adult researchers from the West. This mixed-method study reports the parental behaviors that adolescents themselves perceive as supportive. Data come from the Cross-National Adolescent Project, a survey of adolescents in 12 nations or ethnic groups in Africa,…

Validity of Parent-Reported Vaccination Status for Adolescents Aged 13–17 Years: National Immunization Survey-Teen, 2008

PubMed Central

Dorell, Christina G.; Jain, Nidhi; Yankey, David

2011-01-01

Objective The validity of parent-reported adolescent vaccination histories has not been assessed. This study evaluated the validity of parent-reported adolescent vaccination histories by a combination of immunization card and recall, and by recall only, compared with medical provider records. Methods We analyzed data from the 2008 National Immunization Survey-Teen. Parents of adolescents aged 13–17 years reported their child's vaccination history either by immunization card and recall (n=3,661) or by recall only (n=12,822) for the hepatitis B (Hep B), measles-mumps-rubella (MMR), varicella (VAR), tetanus-diphtheria/tetanus-diphtheria-acellular pertussis (Td/Tdap), meningococcal conjugate (MCV4), and quadrivalent human papillomavirus (HPV4) (for girls only) vaccines. We validated parental report with medical records. Results Among the immunization card/recall group, vaccines with >20% false-positive reports included MMR (32.3%) and Td/Tdap (36.9%); vaccines with >20% false-negative reports included VAR (35.2%), MCV4 (36.0%), and Tdap (41.9%). Net bias ranged from −25.0 to −0.1 percentage points. Kappa values ranged from 0.22 to 0.92. Among the recall-only group, vaccines with >20% false-positive reports included Hep B (33.9%), MMR (61.4%), VAR (26.2%), and Td/Tdap (60.6%); vaccines with >20% false-negative reports included Hep B (58.9%), MMR (33.7%), VAR (51.6%), Td/Tdap (25.5%), Tdap (50.3%) MCV4 (63.0%), and HPV4 (20.5%). Net bias ranged from −46.0 to 0.5 percentage points. Kappa values ranged from 0.03 to 0.76. Conclusions Validity of parent-reported vaccination histories varies by type of report and vaccine. For recently recommended vaccines, false-negative rates were substantial and higher than false-positive rates, resulting in net underreporting of vaccination rates by both the immunization card/recall and recall-only groups. Provider validation of parent-reported vaccinations is needed for valid surveillance of adolescent vaccination coverage. PMID

Eligibility for bariatric surgery among adults in England: analysis of a national cross-sectional survey.

PubMed

Ahmad, Ahmir; Laverty, Anthony A; Aasheim, Erlend; Majeed, Azeem; Millett, Christopher; Saxena, Sonia

2014-01-01

This study aimed to determine the number eligible for bariatric surgery and their sociodemographic characteristics. We used Health Survey for England 2006 data, representative of the non-institutionalized English population. The number of people eligible for bariatric surgery in England based on national guidance is unknown. The UK National Institute for Health and Clinical Excellence criteria for eligibility are those with body mass index (BMI) 35-40 kg/m(2) with at least one comorbidity potentially improved by losing weight or a BMI > 40 kg/m(2). Of 13,742 adult respondents (≥18 years), we excluded participants with invalid BMI (n = 2103), comorbidities (n = 2187) or sociodemographic variables (n = 27) data, for a final study sample of 9425 participants. The comorbidities examined were hypertension, type 2 diabetes, stroke, coronary heart disease and osteoarthritis. Sociodemographic variables assessed included age, sex, employment status, highest educational qualification, social class and smoking status. 5.4% (95% CI 5.0-5.9) of the non-institutionalized adult population in England could meet criteria for having bariatric surgery after accounting for survey weights. Those eligible were more likely than the general population to be women (60.1% vs. 39.9%, p<0.01), retired (22.4% vs. 12.8% p<0.01), and have no formal educational qualifications (35.7% vs. 21.3%, p<0.01). The number of adults potentially eligible for bariatric surgery in England (2,147,683 people based on these results and 2006 population estimates) far exceeds previous estimates of eligibility. In view of the sociodemographic characteristics of this group, careful resource allocation is required to ensure equitable access on the basis of need.

Rapid onset of comorbidity of common mental disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).

PubMed

de Graaf, R; Bijl, R V; ten Have, M; Beekman, A T F; Vollebergh, W A M

2004-01-01

In a cohort of subjects with no history of psychopathology, we determined a 3-year incidence and the risk factors of comorbid and pure mood, anxiety and substance use disorders. Data were obtained from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a longitudinal community study in which 4796 adults were interviewed in 1996, 1997 and 1999 with the Composite International Diagnostic Interview. Of 2869 cases at risk, 10.8% developed an incident disorder within 3 years, of which 16.1% was comorbid. Neuroticism, childhood trauma and parental psychiatric history were more strongly associated with comorbid than with pure disorders. No differences emerged in events occurring in the first year after baseline, but events in the period thereafter showed markedly stronger associations with comorbidity and pure mood disorder than with pure anxiety and substance use disorder. Functional disability was also linked more strongly to comorbidity and pure mood disorder. Clear risk factors exist for the rapid onset of comorbidity. Interventions are needed to prevent rapid comorbidity in subjects who recently developed a primary disorder.

Adolescent Ecstasy and other drug use in the National Survey of Parents and Youth: the role of sensation-seeking, parental monitoring and peer’s drug use

PubMed Central

Martins, Silvia S.; Storr, Carla L.; Alexandre, Pierre K.; Chilcoat, Howard D.

2008-01-01

The association between high sensation-seeking, close friends’ drug use and low parental monitoring with Ecstasy (MDMA) use in adolescence was examined in a sample of US household-dwelling adolescents aged 12–18 years (N=5,049). We also tested whether associations were of stronger magnitude than associations between these correlates and marijuana or alcohol/tobacco use in adolescence. Data from Round 2 of the National Survey of Parents and Youth (NSPY) Restricted Use Files (RUF) was analyzed via Jackknife weighted multinomial logistic regression models. High sensation-seekers were more likely to be ecstasy, marijuana, and alcohol/tobacco users, respectively, as compared to low sensation-seekers. High sensation-seeking and close friends’ drug use were more strongly associated with ecstasy as compared to marijuana and alcohol/tobacco use. Low parental monitoring was associated with marijuana use and alcohol/tobacco use and there was a trend for it to be associated with ecstasy use. Ecstasy use is strongly associated with peer drug use and more modestly associated with high sensation-seeking. School prevention programs should target high-sensation-seeking adolescents and also encourage them to affiliate with non-drug using peers. PMID:18355973

Mental Health Need and Access to Mental Health Services by Youths Involved with Child Welfare: A National Survey.

ERIC Educational Resources Information Center

Burns, Barbara J.; Phillips, Susan D.; Wagner, H. Ryan; Barth, Richard P.; Kolko, David J.; Campbell, Yvonne; Landsverk, John

2004-01-01

Objective: This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Method: Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were…

Adolescent BMI at Northern Israel: From Trends, to Associated Variables and Comorbidities, and to Medical Signatures.

PubMed

Machluf, Yossy; Fink, Daniel; Farkash, Rivka; Rotkopf, Ron; Pirogovsky, Avinoam; Tal, Orna; Shohat, Tamar; Weisz, Giora; Ringler, Erez; Dagan, David; Chaiter, Yoram

2016-03-01

The increasing prevalence of abnormal body mass index (BMI), mainly obesity, is becoming a significant public health problem. This cross-sectional study aimed to provide a comprehensive view of secular trends of BMI, and the associated socio-demographic variables and comorbidities among adolescents with abnormal BMI. Individuals of the study population were born mainly between 1970 and 1993, and were examined at 16 to 19 years of age during the years 1987 to 2010, at 1 conscription center in the northern district of Israel.The study population included 113,694 adolescents. Univariate and multivariable logistic regression models were used to investigate the associations between BMI categories, socio-demographic variables, and medical conditions.A downward trend in the prevalence of normal BMI among both male and female adolescents was obtained, while trends of overweight and obesity (in both genders) and underweight (only among females) rose. Socio-demographic variables such as religion, education, family-related parameters, residential environment, country of birth, and origin were all associated with different risks for abnormal BMI. Obesity was associated with higher risk for hyperlipidemia, endocrine disorders (only in males), knee disorders, and hypertension type I + II (in both genders). Overweight was associated with knee disorders (only in females). Underweight, exclusively in males, was associated with increased risk for endocrine disorders, proteinuria, and cardiac disorders. Hierarchical clustering analysis revealed the intricate relations between gender, BMI, and medical signatures. It brought to light novel clusters of diseases that were abundant among populations having above-normal BMI or underweight males. Furthermore, above-normal BMI was associated with a lower rate of cardiac anomalies and scoliosis/kyphosis, whereas being underweight was associated with a lower risk for hypertension and flat foot.This study provides a reliable and in-depth view

Treatment Development and Feasibility Study of Family-Focused Treatment for Adolescents with Bipolar Disorder and Comorbid Substance Use Disorders

PubMed Central

Goldstein, Benjamin I.; Goldstein, Tina R.; Collinger, Katelyn A.; Axelson, David A.; Bukstein, Oscar G.; Birmaher, Boris; Miklowitz, David J.

2014-01-01

Background Comorbid substance use disorders (SUD) are associated with increased illness severity and functional impairment among adolescents with bipolar disorder (BD). Previous psychosocial treatment studies have excluded adolescents with both BD and SUD. Studies suggest that integrated interventions are optimal for adults with BD and SUD. Methods We modified family-focused treatment for adolescents with BD (FFT-A) in order to explicitly target comorbid SUD (FFT-SUD). Ten adolescents with BD who had both SUD and an exacerbation of manic, depressed, or mixed symptoms within the last 3 months were enrolled. FFT-SUD was offered as an adjunct to pharmacotherapy, with a target of 21 sessions over 12 months of treatment. The FFT-SUD manual was iteratively modified to integrate a concurrent focus on SUD. Results Six subjects completed a mid-treatment 6-month assessment (after a mean of 16 sessions was completed). Of the 10 subjects, 3 dropped out early ( after ≤ 1 session); in the case of each of these subjects, the participating parent had active SUD. No other subjects in the study had a parent with active SUD. Preliminary findings suggested significant reductions in manic symptoms and depressive symptoms and improved global functioning. Reduction in cannabis use was modest and did not reach significance. Limitations Limitations included a small sample, open treatment, concurrent medications, and no control group. Conclusions These preliminary findings suggest that FFT-SUD is a feasible intervention, particularly for youth without parental SUD. FFT-SUD may be effective in treating mood symptoms, particularly depression, despite modest reductions in substance use. Integrating motivation enhancing strategies may augment the effect of this intervention on substance use. Additional strategies, such as targeting parental substance use, may prevent early attrition. PMID:24847999

Prevalence of violence in childhood and adolescence and the impact on educational outcomes: evidence from the 2013 Peruvian national survey on social relations.

PubMed

Fry, Deborah; Anderson, Jeanine; Hidalgo, Rainaldo J T; Elizalde, Aldo; Casey, Tabitha; Rodriguez, Rosario; Martin, Amanda; Oroz, Carmen; Gamarra, Jhon; Padilla, Karina; Fang, Xiangming

2016-01-01

This study provides, for the first time, national population-based estimates describing violence during childhood and adolescence in Peru and the impact on educational outcomes. A population-based school survey was conducted among children aged 9-11 (n=1587) and adolescents aged 12-17 (n=1489). The relationship between violence and educational outcomes were analysed using bivariate logistic regressions, controlling for potential confounding factors. The results show that psychological (75.6%) and physical violence (72.5%) at home were the most prevalent forms of violence experienced by adolescent girls. Adolescent boys reported experiencing similar levels of psychological violence from their peers (69.4%) and at home (68.1%). For the younger cohort, peer-to-peer psychological violence was reported more frequently among girls (70.6%) and boys (74.0%) than other forms of violence. Equal percentages of adolescent girls and boys reported experiencing sexual violence in their lifetime (42.0%). The relationship between violence experiences and educational outcomes varied by gender with strong associations between violence at home and failing a course or repeating a grade for girls and being expelled for boys. Sexual violence experienced by boys was associated with all negative educational outcomes. The relationship between violence in childhood and poorer educational outcomes is multi-faceted, potentially bi-directional, and manifests differently between genders. This research highlights the need for targeted research, policy and programming responses for prevention of violence. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dietary Approaches to Stop Hypertension Diet, Weight Status, and Blood Pressure among Children and Adolescents: National Health and Nutrition Examination Surveys 2003-2012.

PubMed

Cohen, Juliana F W; Lehnerd, Megan E; Houser, Robert F; Rimm, Eric B

2017-09-01

The Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower blood pressure and reduced risk of cardiovascular disease among adults, but little is known about accordance with this dietary pattern or health benefits among children and adolescents. The objectives were to evaluate accordance with the DASH diet, differences over time, and the association with health attributes among a nationally representative sample of US children and adolescents. Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Surveys (NHANES) were analyzed. Data from 9,793 individuals aged 8 to 18 years were examined. DASH accordance was estimated based on nine nutrient targets: total fat, saturated fat, protein, cholesterol, fiber, calcium, magnesium, potassium, and sodium; possible score range is 0 to 9. Accordance with the DASH diet across time was examined comparing the 2011-2012 to 2003-2004 NHANES surveys. The association between DASH score and weight status was examined using multinomial logistic regression, and the associations with waist circumference, systolic blood pressure, and diastolic blood pressure were examined using multivariable linear regression. Accordance with the DASH diet was low across the age groups, with a range of mean DASH scores from 1.48 to 2.14. There were no significant changes across time. DASH score was inversely associated with systolic blood pressure (mm Hg) among 14- to 18-year-olds (β=-.46; 95% CI -.83 to -.09) among the larger sample of participants who completed at least one dietary recall, but no significant differences were seen in other age categories. In the subsample of participants with both dietary recalls, a significant inverse association was seen between DASH score and systolic blood pressure for 11- to 13-year-olds (β=-.57; 95% CI -1.02 to -.12). There were no significant associations between this dietary pattern and weight status, waist circumference, or diastolic blood pressure. Few US

Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

PubMed

Brinkman, Tara M; Li, Chenghong; Vannatta, Kathryn; Marchak, Jordan G; Lai, Jin-Shei; Prasad, Pinki K; Kimberg, Cara; Vuotto, Stefanie; Di, Chongzhi; Srivastava, Deokumar; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

2016-10-01

In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m(2) intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment

Association between family socioeconomic status and depressive symptoms among Chinese adolescents: Evidence from a national household survey.

PubMed

Zhou, Qin; Fan, Libo; Yin, Zhichao

2018-01-01

Depression is a common mental disorder due to high risk of the adolescence development stage. Few studies discussed the association between family socioeconomic status (SES) and depression and its mechanism. We aimed to provide a national view of depressive symptoms among Chinese adolescents to explore the relationship between family SES and depressive symptoms. We used the data from the Chinese Family Panel Studies (CFPS). Family SES include family income and parents' educational attainment. Depressive symptoms were measured by the Center for Epidemiological Study Depression. Family SES was found to be significantly associated with adolescents' depressive symptoms. The study indicated that adolescents were more likely to have depressive symptoms when family income decreased. Poor self-confidence, mathematics performance, and physical health were associated with high risk for depressive symptoms. The presence of these factors greatly weakened the association between family SES and depressive symptoms. Therefore, adolescents' mental health is vulnerable and connected to family SES. Physical health, school performance, and self-confidence might be important mediators in the pathways of family SES affecting depressive symptoms. Prevention and intervention programs are important and necessary to improve the mental health of Chinese adolescents, and the effect of family SES should be considered in these programs. Copyright © 2017 Elsevier B.V. All rights reserved.

The association between graduated driver licensing laws and travel behaviors among adolescents: an analysis of US National Household Travel Surveys.

PubMed

Zhu, Motao; Cummings, Peter; Zhao, Songzhu; Rice, Thomas

2016-07-27

Young novice drivers have crash rates higher than any other age group. To address this problem, graduated driver licensing (GDL) laws have been implemented in the United States to require an extended learner permit phase, and create night time driving or passenger restrictions for adolescent drivers. GDL allows adolescents to gain experience driving under low-risk conditions with the aim of reducing crashes. The restricted driving might increase riding with parents or on buses, which might be safer, or walking or biking, which might be more dangerous. We examined whether GDL increases non-driver travels, and whether it reduces total travels combining drivers and non-drivers. We used data from the US National Household Travel Survey for the years 1995-1996, 2001-2002, and 2008-2009 to estimate the adjusted ratio for the number of trips and trip kilometers made by persons exposed to a GDL law, compared with those not exposed. Adolescents aged 16 years had fewer trips and kilometers as drivers when exposed to a GDL law: ratio 0.84 (95 % confidence interval (CI) 0.71, 1.00) for trips; 0.79 (0.63, 0.98) for kilometers. For adolescents aged 17 years, the trip ratio was 0.94 (0.83, 1.07) and the kilometers ratio 0.80 (0.63, 1.03). There was little association between GDL laws and trips or kilometers traveled by other methods: ratio 1.03 for trips and 1.00 for kilometers for age 16 years, 0.94 for trips and 1.07 for kilometers for age 17. If these associations are causal, GDL laws reduced driving kilometers by about 20 % for 16 and 17 year olds, and reduced the number of driving trips by 16 % among 16 year olds. GDL laws showed little relationship with trips by other methods.

Relationship of white potato to other vegetable consumption by schoolchildren and adolescents in the U.S.A: National Health and Nutrition Examination Survey, 2003-2008.

PubMed

Olsho, Lauren E W; Fernandes, Meenakshi M

2013-11-01

Intake of white potatoes in and out of school was estimated to provide context for a recent proposal by the U.S. Department of Agriculture to limit provision of white potatoes in U.S. school meals. Mean daily servings of white potatoes and other vegetables consumed in and out of school for school-aged children were estimated from two days of 24 h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES). Total energy intake and percentage energy contribution from discretionary oils and solid fats were also estimated for all white potato dishes consumed. The NHANES is nationally representative of the U.S. civilian noninstitutionalized population. Children and adolescents aged 6–19 years (n 8466) from three combined NHANES cycles (2003–2004, 2005–2006 and 2007–2008). White potatoes represented 32% of all vegetable servings consumed by U.S. children and adolescents. Preparations high in fats and oils, including French fries, were most popular both in and out of school. Mean consumption of white potatoes obtained from school cafeterias was approximately 0.05 servings/d among all children and adolescents, and about 0.15 servings/d among children and adolescents acquiring at least one item from the school cafeteria, implying current weekly intake levels well below the limit of 2 servings/week proposed by the U.S. Department of Agriculture. Although white potatoes represent a substantial proportion of vegetable consumption among school-aged children, it is unclear that proposed limits would influence white potato intake from school cafeterias. Policy makers should consider targeting preparation methods to improve the healthfulness of white potato dishes.

Relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels in US adolescents: findings from the 1999-2004 National Health and Nutrition Examination Survey.

PubMed

Bremer, Andrew A; Auinger, Peggy; Byrd, Robert S

2009-04-01

To evaluate the relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels. A cross-sectional analysis of the National Health and Nutrition Examination Survey data collected by the National Center for Health Statistics. Nationally representative samples of US adolescents participating in the National Health and Nutrition Examination Survey during the years 1999-2004. A total of 6967 adolescents aged 12 to 19 years. Sugar-sweetened beverage consumption and physical activity levels. Glucose and insulin concentrations, a homeostasis model assessment of insulin resistance (HOMA-IR), total, high-density lipoprotein, and low-density lipoprotein cholesterol concentrations, triglyceride concentrations, systolic and diastolic blood pressure, waist circumference, and body mass index (calculated as weight in kilograms divided by height in meters squared) percentile for age and sex. Multivariate linear regression analyses showed that increased sugar-sweetened beverage intake was independently associated with increased HOMA-IR, systolic blood pressure, waist circumference, and body mass index percentile for age and sex and decreased HDL cholesterol concentrations; alternatively, increased physical activity levels were independently associated with decreased HOMA-IR, low-density lipoprotein cholesterol concentrations, and triglyceride concentrations and increased high-density lipoprotein cholesterol concentrations. Furthermore, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects of decreasing HOMA-IR and triglyceride concentrations and increasing high-density lipoprotein cholesterol concentrations. Sugar-sweetened beverage intake and physical activity levels are each independently associated with insulin resistance-associated metabolic parameters and anthropometric measurements in adolescents. Moreover, low sugar

NATIONAL NURSING HOME SURVEY (NNHS)

EPA Science Inventory

The National Nursing Home Survey (NNHS) is a continuing series of national sample surveys of nursing homes, their residents, and their staff.The survey was conducted in 1973-74, 1977, 1985, 1995, 1997, and 1999. Although each of these surveys emphasized different topics, they all...

ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

ERIC Educational Resources Information Center

Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

2015-01-01

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

Comorbidity between lifetime eating problems and mood and anxiety disorders: results from the Canadian Community Health Survey of Mental Health and Well-being.

PubMed

Meng, Xiangfei; D'Arcy, Carl

2015-03-01

This study was to examine profiles of eating problems (EPs), mood and anxiety disorders and their comorbidities; explore risk patterns for these disorders; and document differences in health service utilization in a national population. Data were from the Canadian Community Health Survey of Mental Health and Well-being. The lifetime prevalence of EPs was 1.70% among Canadians, compared with 13.25% for mood disorder, 11.27% for anxiety disorder and 20.16% for any mood or anxiety disorder. Almost half of those with EPs also suffered with mood or anxiety disorders. A similar pattern in depressive symptoms was found among individuals with major depression and EPs, but individuals with EPs reported fewer symptoms. Factors associated with the comorbidity of EPs and mood and anxiety disorders were identified. Individuals with EPs reported more unmet needs. Patients with EPs should be concomitantly investigated for mood and anxiety disorders, as similar interventions may be effective for both. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Perceptions of Food Advertising and Association With Consumption of Energy-Dense Nutrient-Poor Foods Among Adolescents in the United States: Results From a National Survey.

PubMed

Thai, Chan L; Serrano, Katrina J; Yaroch, Amy L; Nebeling, Linda; Oh, April

2017-08-01

The advertising and marketing of energy-dense, nutrient-poor (EDNP) food and drink has been cited as one contributor to unhealthy eating behaviors in adolescents. The present study examines perceptions about and trust in food advertising and their association with consumption of EDNP foods and drinks among adolescents in the United States. Data (n = 1,384) come from the U.S. National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Survey. One way ANOVAs were conducted to assess differences between population subgroups in advertising perceptions. Bivariate and multivariable linear regression models were used to examine the associations between perceptions toward and trust in food advertising and consumption of EDNP foods and drinks, controlling for sociodemographic factors. Results show that there are significant differences between racial/ethnic groups on advertising perceptions (F = 16.32, p = < .0001). As positive perceptions toward food advertising increase among adolescents, there is an associated increase in daily frequency of consumption of EDNP foods and drinks (β = 0.10, p < .01). Similarly, the more adolescents agreed that they trusted food advertising, the higher the reported daily frequency of EDNP food and drink consumption (β = 0.08, p = .01). Targeting perceptions about food advertising may be a worthy intervention strategy to reduce the impact of food marketing and the consumption of heavily advertised EDNP foods and drinks among adolescents.

Analysis of the healthcare process of patients with type 2 diabetes mellitus and associated comorbidity treated in Spain's National Health System: A perspective of medical professionals. IMAGINE study.

PubMed

Gómez-Huelgas, R; Artola-Menéndez, S; Menéndez-Torre, E

2016-04-01

To analyse the care received by patients with type 2 diabetes mellitus (DM2) and comorbidity in Spain's National Health System. Cross-sectional study using an online survey. A total of 302 family physicians, internists and endocrinologists participated in the study. The participants were recruited voluntarily by their respective scientific societies and received no remuneration. Patients with DM2 and comorbidity are mostly treated in Primary Care (71.8%). Forty percent are referred to hospital care, mainly due to renal failure, poor glycaemic control and for a retinopathy assessment. Only 52% of those surveyed conducted medication reconciliation in the transition between healthcare levels. Fifty-eight percent reported conducting interconsultations, clinical meetings or consultancies between healthcare levels. The 3 main factors identified for improving the follow-up and control of DM2 with comorbidity were the multidisciplinary study (80.8%), the continuing education of health professionals (72.3%) and therapeutic education programmes (72%). A lack of time, a lack of qualified personnel for lifestyle interventions and organisational shortcomings were mentioned as the main obstacles for improving the care of these patients. Most patients with DM2 and comorbidity are treated in Primary Care. Promoting multidisciplinary care and training programmes for practitioners and patients can help improve the quality of care. Therapy reconciliation represents a priority area for improvement in this population. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

2012 National Immunization Survey Data

MedlinePlus

... Coalition AIM Vaccine Education Center 2012 National Immunization Survey Data Released Recommend on Facebook Tweet Share Compartir ... this page kept for historical reasons. National Immunization Survey (NIS) – Children (19-35 months old) MMWR : National ...

Correlates of Suicidality: Investigation of a Representative Sample of Manitoba First Nations Adolescents

PubMed Central

Mota, Natalie; Elias, Brenda; Tefft, Bruce; Medved, Maria; Munro, Garry

2012-01-01

Objectives. We examined individual, friend or family, and community or tribe correlates of suicidality in a representative on-reserve sample of First Nations adolescents. Methods. Data came from the 2002–2003 Manitoba First Nations Regional Longitudinal Health Survey of Youth. Interviews were conducted with adolescents aged 12 to 17 years (n = 1125) from 23 First Nations communities in Manitoba. We used bivariate logistic regression analyses to examine the relationships between a range of factors and lifetime suicidality. We conducted sex-by-correlate interactions for each significant correlate at the bivariate level. A multivariate logistic regression analysis identified those correlates most strongly related to suicidality. Results. We found several variables to be associated with an increased likelihood of suicidality in the multivariate model, including being female, depressed mood, abuse or fear of abuse, a hospital stay, and substance use (adjusted odds ratio range = 2.43–11.73). Perceived community caring was protective against suicidality (adjusted odds ratio = 0.93; 95% confidence interval = 0.88, 0.97) in the same model. Conclusions. Results of this study may be important in informing First Nations and government policy related to the implementation of suicide prevention strategies in First Nations communities. PMID:22676500

Comorbidity and the concentration of healthcare expenditures in older patients with heart failure.

PubMed

Zhang, James X; Rathouz, Paul J; Chin, Marshall H

2003-04-01

To examine comorbidity and concentration of healthcare expenditures in older patients with heart failure (HF) in the Medicare program. Retrospective analysis of older fee-for-service HF patients, using the 1996 Medicare Current Beneficiary Survey and linked Medicare claims. Variety of clinical settings. One thousand two hundred sixty-six older HF patients from a nationally representative survey. Medicare expenditure per person and by types of healthcare services, prevalence of comorbid conditions, and multivariate regression on the association between comorbidities and healthcare expenditure. Medicare spent an average of 16,514 dollars on medical reimbursement for each HF patient in 1996. Eighty-one percent of patients had one or more comorbid diseases according to a 17-disease grouping index. The top 20% of HF patients accounted for 63% of total expenditure. Comorbidity was associated with significantly higher Medicare expenditure. HF patients with more-expensive comorbidities included those with peripheral vascular disease (24% of patients, mean total expenditure 26,954 dollars), myocardial infarction (16% of patients, mean total expenditure 29,867 dollars), renal disease (8% of patients, mean total expenditure 33,014 dollars), and hemiplegia or paraplegia (5% of patients, mean total expenditure 33,234 dollars). Diseases and disorders other than heart failure constituted a significant fraction of the causes of inpatient admissions. Comorbid conditions were more likely to be associated with expensive inpatient care, and patients with these diseases were more likely to spend more overall and more on other types of Medicare services including home health aid, skilled nursing facility, and hospice care. Disease management should consider comorbid conditions for improving care and reducing expenditures in older patients with HF.

Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents.

PubMed

Fröjd, Sari; Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Marttunen, Mauri

2011-01-01

This study explores whether associations between anxiety and alcohol and other substance use are already evident in middle adolescence, and whether general anxiety or symptoms of social phobia affect continuity of frequent alcohol use, frequent drunkenness and cannabis use. Data from the Adolescent Mental Health Cohort Study, a school-based Finnish survey among adolescents aged 15-16 years at baseline, was utilized to assess prevalence, incidence and continuity of symptoms of social phobia, general anxiety, frequent alcohol use, frequent drunkenness and cannabis use (which in this context was smoked 'hashish' of unknown constituency), and the associations between the substance use variables and the anxiety variables in 2-year follow-up. Anxiety preceded substance use while no reciprocal associations were observed. Depression mediated the associations between anxiety and substance use. Symptoms of social phobia did not elevate the incidence of substance use, but general anxiety did. Frequent drunkenness was less significantly associated with anxiety than the other two substance use variables. Co-morbid general anxiety increased the persistence of frequent alcohol use while co-morbid social phobia decreased its persistence. Continuity of frequent drunkenness and cannabis use were unaffected by co-morbid anxiety. General anxiety in middle adolescence places adolescents at risk for concurrent and subsequent substance use. The risk may, however, be associated with co-morbid depression. Social phobia in middle adolescence may protect from substance use. Adolescents with internalizing symptoms may need guidance in coping with the symptoms even if the symptoms do not fulfil the criteria of mood or anxiety disorder.

The Impact of Post-Traumatic Stress Disorder on the Burden of Migraine: Results From the National Comorbidity Survey-Replication.

PubMed

Rao, Aruna S; Scher, Ann I; Vieira, Rebeca V A; Merikangas, Kathleen R; Metti, Andrea L; Peterlin, B Lee

2015-01-01

Post-traumatic stress disorder (PTSD) has been linked with migraine in prior studies. To evaluate the individual and joint burdens of migraine and PTSD in a population-based cohort. The National Comorbidity Survey-Replication (NCS-R) is a general population study conducted in the United States from February 2001-April 2003. PTSD and migraine were assessed, and four groups defined based on their migraine and PTSD status. The four groups included those with no migraine and no PTSD (controls, n=4535), those with migraine and without PTSD (migraine alone, n=236), those with PTSD and without migraine (PTSD alone, n=244), and those with both migraine and PTSD (mig+PTSD, n=68). Logistic and Poisson regression models were used to assess the association between dichotomous/multilevel outcome variables indicating financial, health, and interpersonal burdens and each migraine/PTSD group. Compared to controls, those with Mig+PTSD were more likely to be in the low poverty index (48% vs 41%, AOR 2.16; CI: 1.10, 4.24) and were less likely to be working for pay or profit in the past week (50% vs 68%, AOR 0.42; CI: 0.24, 0.74) but not those with migraine or PTSD alone. Additionally, the number of days where work quality was cut due to physical or mental health or substance abuse in the past month was greater in all groups compared to controls: (1) migraine alone: mean 2.57 (SEM 0.32) vs mean 1.09 (SEM 0.08) days, ARR=2.39; CI: 2.19, 2.62; (2) PTSD alone: mean 2.43 (SEM 0.33) vs mean 1.09 (SEM 0.08) days, ARR=2.09; CI: 1.91, 2.29; (3) mig+PTSD: mean 8.2 (SEM 0.79) vs 1.09 (SEM 0.08) days, ARR 6.79; CI 6.16, 7.49; and was over 2.5-fold greater in those mig+PTSD than migraine alone (mean 8.0 [SEM 0.79] vs 2.6 days [SEM 0.72], ARR 2.77; CI: 2.45, 3.14). The likelihood of having difficulty getting along or maintaining a social life was also increased in all groups relative to controls: (1) migraine alone: 21% vs 5.4%, AOR 4.20; CI: 2.62, 6.74; (2) PTSD alone: 18% vs 5.4%, AOR 3.40; CI

Family Meals and Adolescent Emotional Well-Being: Findings From a National Study.

PubMed

Utter, Jennifer; Denny, Simon; Peiris-John, Roshini; Moselen, Emma; Dyson, Ben; Clark, Terryann

2017-01-01

To describe the relationship between family meals and adolescent mental health and determine whether the relationship differs by sex. Secondary analyses of a cross-sectional survey. A total of 8,500 nationally representative students. Reynolds Adolescent Depression Scale; Strengths and Difficulties Questionnaire; World Health Organization Well-being Index. Multiple regression models determined the relationships between family meals and mental health indicators; sociodemographic variables and family connection were included as covariates. Approximately 60% of adolescents shared family meals ≥5 times in the previous week, whereas 22% reported that they shared ≤2 meals in the previous week. Greater frequency of family meals was associated with fewer depressive symptoms (P < .001), fewer emotional difficulties (P < .001) and better emotional well-being (<.001). These relationships between family meals and depressive symptoms were attenuated by sex; the relationship was stronger for females than for males. Frequent family meals may have a protective effect on the mental health of adolescents, particularly for depressive symptoms in girls. Interventions that aim to increase the frequency of family meals are needed to evaluate whether family meals alone can have an emotional benefit for adolescents. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Trends in opioid prescriptions among children and adolescents in the United States: a nationally representative study from 1996 to 2012.

PubMed

Groenewald, Cornelius B; Rabbitts, Jennifer A; Gebert, J Thomas; Palermo, Tonya M

2016-05-01

Prescription opioid misuse is a major public health concern in the United States, yet little is known about national prescription patterns. We aimed to assess trends in opioid prescriptions made to children and adolescents, to their families, and to adults in the United States from 1996 to 2012. The sample was drawn from nationally representative data, the Medical Expenditure Panel Surveys. We used survey design methods to examine trends in prescription opioid use over time and a logistic regression analysis to examine predictors associated with opioid use. Findings indicated that from 1996 to 2012 opioid prescriptions to children and adolescents remained stable and low. In 1996, 2.68% of children received an opioid prescription, and in 2012, 2.91% received an opioid prescription. In contrast, opioid prescriptions to family members of children and adolescents and adults in general significantly increased during this period. The most common opioid prescriptions to children and adolescents in 2012 were codeine, hydrocodone, and oxycodone. Using multivariate logistic regression models, the white non-Hispanic race, older age, health insurance, and parent-reported fair to poor general health were associated with higher rates of opioid prescriptions in children and adolescents. Our main finding was that although the rates of opioid prescriptions have increased among adults in the United States, the rates have not changed among children and adolescents. Recent epidemiologic association studies have identified a strong link between increased opioid prescriptions and increased rates of opioid misuse and abuse in adults. Future studies should assess the association between adult opioid prescriptions and children or adolescent opioid misuse.

A National Description of Treatment among United States Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

PubMed

Danielson, Melissa L; Visser, Susanna N; Chronis-Tuscano, Andrea; DuPaul, George J

2018-01-01

To characterize lifetime and current rates of attention-deficit/hyperactivity disorder (ADHD) treatments among US children and adolescents with current ADHD and describe the association of these treatments with demographic and clinical factors. Data are from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a follow-back survey of parents from the 2011-2012 National Survey of Children's Health. Weighted analyses focused on receipt of ADHD treatment among children aged 4-17 years with current ADHD (n = 2495) by 4 treatment types: medication, school supports, psychosocial interventions, and alternative treatments. Medication and school supports were the most common treatments received, with two-thirds of children and adolescents with ADHD currently receiving each treatment. Social skills training was the most common psychosocial treatment ever received (39%), followed by parent training (31%), peer intervention (30%), and cognitive behavioral therapy (20%). Among alternative treatments, 9% were currently taking dietary supplements, and 11% had ever received neurofeedback. Most children (67%) had received at least 2 of the following: current medication treatment, current school supports, or lifetime psychosocial treatment; 7% had received none of these 3 treatment types. A majority of school-aged children and adolescents with ADHD received medication treatment and school supports, whereas fewer received recommended psychosocial interventions. Efforts to increase access to psychosocial treatments may help close gaps in service use by groups currently less likely to receive treatment, which is important to ensure that the millions of school-aged US children diagnosed with ADHD receive quality treatment. Published by Elsevier Inc.

National Lakes Assessment: A Collaborative Survey of the Nation's Lakes

EPA Science Inventory

The National Lakes Assessment A Collaborative Survey of the Nation's Lakes presents the results of an unprecedented assessment of the nation’s lakes. This report is part of the National Aquatic Resource Surveys, a series of statistically based surveys designed to provide the pub...

The use of reconsent in a national evaluation of adolescent reproductive health programs.

PubMed

Palen, Lori-Ann; Ashley, Olivia Silber; Jones, Sarah B; Lyons, Jeffrey D; Derecho, Azucena A; Kan, Marni L; Richmond Scott, Alicia

2012-08-01

Reconsent involves asking research participants to reaffirm their consent for study participation when there have been significant changes in the study's procedures, risks, or benefits. We described the reconsent process, identified the reconsent rate, and examined the comparability of youths enrolled via consent and reconsent in a national evaluation of adolescent reproductive health programs. Evaluation participants from five abstinence education projects (N = 2,176) and nine projects serving pregnant or parenting adolescents (N = 878) provided either parent or youth consent or reconsent to participate in the national evaluation. Participants completed surveys that included demographic characteristics; sexual intentions, norms and behaviors; and pregnancy history. Multivariate logistic regression was used to examine associations between consent status, demographic characteristics, and risk indicators. The reconsent rates in the abstinence education and pregnant or parenting samples were 45% and 58%, respectively. Participant's age was positively associated with reconsent. Hispanic adolescents (and, for abstinence education, other racial/ethnic minorities) were underrepresented among youth with reconsent. Among abstinence education study participants, risk indicators were not associated with consent status. Among pregnant or parenting teens, those who had experienced repeat pregnancy were less likely than those who had experienced only one pregnancy to have been enrolled via reconsent. Reconsent can bolster sample size but may introduce bias by missing some racial/ethnic and age-groups. Among high-risk adolescents, reconsent may also yield a sample that differs from consented samples on risk characteristics, necessitating statistical adjustments when analyzing data. Copyright © 2012 Society for Adolescent Health and Medicine. All rights reserved.