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1.
Biosci Biotechnol Biochem ; 87(12): 1537-1542, 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-37723613

RESUMO

We evaluated the effects of long-term glycerophosphocholine (GPC) intake on microglia, the blood-brain barrier (BBB), and neurogenesis in senescence-accelerated mice prone 8 (SAMP8). The GPC intake suppressed microglial activation and BBB disruption and sustained doublecortin-positive cells in the hippocampus. The results indicate that GPC intake exerts anti-inflammatory and neuroprotective effects in the brain of aged mice.


Assuntos
Barreira Hematoencefálica , Microglia , Camundongos , Animais , Encéfalo , Hipocampo , Inflamação , Neurogênese
2.
J Pediatr ; 241: 196-202, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34678247

RESUMO

OBJECTIVE: To test whether a policy approach aimed at decreasing prescription drug misuse, specifically, state monitoring of controlled substance prescriptions-prescription drug monitoring programs (PDMPs)-were associated with changes in Child Protective Services-reported maltreatment prevalence. STUDY DESIGN: Using a difference-in-differences design and maltreatment data (2004-2018) from 50 states and the District of Columbia, we compared the prevalence of total maltreatment incidents and total victims, in states with and without PDMPs, before and after implementation. Exploratory analyses further examined models disaggregated by maltreatment type (neglect, physical abuse, sexual abuse, psychological abuse) and among different racial/ethnic groups. Quasi-Poisson models included state-level covariates, state- and year-fixed effects, and cluster-robust standard errors. RESULTS: Difference-in-differences models identified greater relative reductions in PDMP states relative to controls (total prevalence ratio, 0.87; 95% CI, 0.80, 0.940; victimization prevalence ratio, 0.92; 95% CI, 0.85-0.98) over the observation period. Decreases seemed to be driven by changes in neglect (prevalence ratio, 0.87; 95% CI, 0.80-0.93) and physical abuse (prevalence ratio, 0.78; 95% CI, 0.71-0.87) incidents, and may have been especially salient for American Indian/Alaskan Native children (prevalence ratio, 0.78; 95% CI, 0.65-0.94). CONCLUSIONS: We found evidence supporting an association between prescription drug monitoring and reduced maltreatment prevalence at the state level. Policies aimed at restricting the prescribing and dispensing of controlled substances may have indirect implications for child welfare.


Assuntos
Maus-Tratos Infantis/tendências , Política de Saúde , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Programas de Monitoramento de Prescrição de Medicamentos , Adolescente , Criança , Maus-Tratos Infantis/prevenção & controle , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estados Unidos
3.
Psychol Addict Behav ; 34(1): 201-208, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31613115

RESUMO

Sensation seeking has been proposed as a risk factor for gambling and gambling problems; however, existing evidence for a relationship between sensation seeking and gambling behaviors is inconclusive and data are lacking for emerging adults and racial and ethnic minorities. In this longitudinal study, we explored the association between developmental trajectories of sensation seeking in childhood and adolescence and gambling and gambling problems in early adulthood in individuals of Puerto Rican origin. Gambling data were collected during 2014-2018 from a subsample of participants in the Boricua Youth Study who were recruited in the South Bronx of New York City and in San Juan and Caguas, Puerto Rico. Sensation seeking was measured using a 10-item instrument modified from the scale created by Russo et al. for use in children as young as 5 years old. Developmental trajectories of age-adjusted sensation seeking were created using growth mixture models. Gambling and gambling problems were assessed based on the Canadian Adolescent Gambling Inventory (CAGI) Version 1.09. Data were analyzed using descriptive methods and multivariable logistic regression. Individuals in the high sensation-seeking class had lower adjusted odds of past-year gambling (OR = .36; 95% confidence interval [.14, .92]) than did those in the normative sensation-seeking class, whereas no differences were observed for individuals in the low and accelerated classes. No relationship was found between sensation seeking and past-year gambling problems. Given the severe consequences of early initiation of gambling and gambling problems, other early life risk factors and alternative hypotheses for the elevated prevalence of gambling problems in young adults and racial and ethnic minority populations should be explored. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Comportamento Infantil , Jogo de Azar/etnologia , Hispânico ou Latino/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Adulto , Criança , Pré-Escolar , Etnicidade , Feminino , Jogo de Azar/epidemiologia , Hispânico ou Latino/psicologia , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Grupos Minoritários , Cidade de Nova Iorque/epidemiologia , Prevalência , Porto Rico/etnologia , Fatores de Risco , Sensação , Adulto Jovem
4.
J Child Psychol Psychiatry ; 60(2): 169-177, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30052268

RESUMO

BACKGROUND: Parenting behaviors have been shown to moderate the association between sensation seeking and antisocial behaviors. METHODS: Data were obtained from the Boricua Youth Study, a longitudinal study of 2,491 Puerto Rican youth living in the South Bronx, New York, and the metropolitan area of San Juan, Puerto Rico. First, we examined the prospective relationship between sensation seeking and antisocial behaviors across 3 yearly waves and whether this relationship varied by sociodemographic factors. Second, we examined the moderating role of parenting behaviors-including parental monitoring, warmth, and coercive discipline-on the prospective relationship between sensation seeking and antisocial behaviors. RESULTS: Sensation seeking was a strong predictor of antisocial behaviors for youth across two different sociocultural contexts. High parental monitoring buffered the association between sensation seeking and antisocial behaviors, protecting individuals with this trait. Low parental warmth was associated with high levels of antisocial behaviors, regardless of the sensation seeking level. Among those with high parental warmth, sensation seeking predicted antisocial behaviors, but the levels of antisocial behaviors were never as high as those of youth with low parental warmth. CONCLUSIONS: Study findings underscore the relevance of person-family context interactions in the development of antisocial behaviors. Future interventions should focus on the interplay between individual vulnerabilities and family context to prevent the unhealthy expression of a trait that is present in many individuals.


Assuntos
Comportamento do Adolescente/etnologia , Hispânico ou Latino , Delinquência Juvenil/etnologia , Relações Pais-Filho/etnologia , Poder Familiar/etnologia , Comportamento Social , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/etnologia , Porto Rico/etnologia
5.
Breast Cancer Res Treat ; 173(2): 353-364, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30343455

RESUMO

PURPOSE: Breast cancer (BC) is a risk factor for major depressive disorder (MDD), yet little research has tested the efficacy of different psychotherapies for depressed women with BC. This study, the largest to date, compared outcomes of three evidence-based, 12-week therapies in treating major depressive disorder among women with breast cancer. METHODS: This randomized trial compared interpersonal psychotherapy (IPT), problem solving therapy (PST), and brief supportive psychotherapy (BSP). Conducted at the outpatient clinic of the New York State Psychiatric Institute/Columbia University, the trial offered bilingual treatment by treatment-specific psychotherapists supervised by treatment experts. The primary outcome was change in the Hamilton Depression Rating Scale (HAM-D) at 12 weeks. Secondary outcomes included other validated patient-reported outcomes for depression and quality of life. RESULTS: Of 179 women with breast cancer screening positive for depression at the Columbia Cancer Center, 134 eligible patients signed informed treatment consent. Half of patients were Hispanic and economically disadvantaged. Most women had stage I (35.2%) or II (36.9%) BC; 9% had stage IV. The three brief psychotherapies showed similar improvements on the HAM-D, with large pre-post effect sizes (d ~ 1.0); a priori defined response rates were 35% for IPT, 50% for PST and 31% for BSP, and remission rates 25%, 30% and 27%, respectively. The three treatments also showed similar improvements in the Quality of Life Enjoyment and Satisfaction Questionnaire. Dropout was high, ranging from 37 to 52% across treatments. Predictors of dropout included having < 16 years of education and annual family income < $20,000. CONCLUSIONS: Among patients who completed treatment, all three psychotherapies were associated with similar, meaningful improvements in depression. Physical distance between the oncology and psychiatric treatment sites might have contributed to high dropout. This study suggests various psychotherapy approaches may benefit patients with breast cancer and major depression.


Assuntos
Neoplasias da Mama/psicologia , Transtorno Depressivo Maior/terapia , Psicoterapia/métodos , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
6.
Biosci Biotechnol Biochem ; 83(4): 747-750, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30582404
7.
Biosci Biotechnol Biochem ; 82(4): 647-653, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29191088

RESUMO

Administration of alpha-glycerophosphocholine (GPC), a choline compound in food, is expected to contribute to human health. In this study, we evaluated its effect on aging in senescence-accelerated mouse prone 8 (SAMP8) mice. Male SAMP8 mice had free access to a commercial stock diet and drinking water with or without GPC (0.07 mg/ml). Mice in the GPC group had significantly lower total senescence grading score than that of the control group at 36 weeks of age. Administration of GPC decreased the deposition of transthyretin (TTR), an amyloidogenic protein, in the brain. Aggregated TTR activated microglia and led to neuroinflammation. Thus, GPC would protect the brain by reducing TTR deposition and preventing neuroinflammation. In a histological study of knee joints, it was found that SAMP8 mice administered GPC showed decreased joint degeneration. These results suggest that GPC delays the aging process and may be a useful compound in anti-aging functional food development.


Assuntos
Envelhecimento/efeitos dos fármacos , Modelos Animais de Doenças , Glicerilfosforilcolina/farmacologia , Osteoartrite do Joelho/prevenção & controle , Pré-Albumina/metabolismo , Peptídeos beta-Amiloides/metabolismo , Animais , Encéfalo/metabolismo , Suplementos Nutricionais , Progressão da Doença , Alimento Funcional , Masculino , Aprendizagem em Labirinto , Camundongos Mutantes , Osteoartrite do Joelho/patologia
8.
Ann N Y Acad Sci ; 1394(1): 106-127, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28486792

RESUMO

Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.


Assuntos
Jogo de Azar/diagnóstico , Jogo de Azar/etiologia , Jogo de Azar/terapia , Animais , Terapia Combinada , Comorbidade , Modelos Animais de Doenças , Predisposição Genética para Doença , Humanos , Prognóstico , Punição , Recompensa , Fatores de Risco
10.
Am J Psychiatry ; 173(12): 1189-1195, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27444794

RESUMO

OBJECTIVE: The authors sought to ascertain the relationship between moderate and more severe pain and prescription opioid use disorders in the noninstitutionalized U.S. METHOD: A structural equation model was used to assess prospectively the interdependency of pain and prescription opioid use disorder at waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Pain was measured with a 5-point scale of pain-related interference in daily activities and dichotomized as "no pain" (no or little interference) or "pain" (moderate to extreme interference). Prescription opioid use disorder was assessed with a structured interview (the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version). Other covariates included age, sex, anxiety or mood disorders, and family history of drug, alcohol, and behavioral problems. RESULTS: In the structural equation model, pain and prescription opioid use disorders were significantly associated with one another at baseline and at 3-year follow-up. However, whereas pain at baseline was also significantly associated with prescription opioid use disorder at follow-up, prescription opioid use disorder at baseline was not associated with pain at follow-up. These associations were independent of several background demographic and clinical characteristics. The path for pain interference was associated with a 41% relative increase in the risk of developing a prescription opioid use disorder. CONCLUSIONS: Painful conditions contribute to the risk of prescription opioid use disorders. To help reduce the incidence of prescription opioid abuse and dependence among adults with moderate to severe pain, careful monitoring and consideration of nonopioid alternative treatments is warranted.


Assuntos
Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor/epidemiologia , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Modelos Estatísticos , Fatores de Risco , Estados Unidos/epidemiologia
11.
Curr Addict Rep ; 3(3): 280-292, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28824833

RESUMO

PURPOSE OF REVIEW: Previous studies demonstrate disparities in health and health services including gambling disorders (GD) among ethnic and racial minority groups. In this review, we summarize studies examining the prevalence of GD across different ethnic and racial minorities. RECENT FINDINGS: We describe the sociodemographic subgroup variations at heightened risk for GD and factors associated with GD in racial and ethnic minority groups including gambling availability, comorbid substance use, psychiatric conditions, stress, acculturation, and differences in cultural values and cognitions. We found that research of GD among minority groups is scant, and the prevalence of GD among these groups is at a magnitude of concern. SUMMARY: Racial and ethnic minority status in it of itself is not a risk factor for GD but may be a proxy for underlying potential risk factors. The need for prevention and treatment programs for different cultural group remains unmet.

12.
J Psychiatr Res ; 69: 42-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26343593

RESUMO

OBJECTIVE: Prior research indicates that different types of childhood maltreatment frequently co-occur and confer risk for adulthood intimate partner violence (IPV). However, it is unknown whether the risk of IPV is due to specific type(s) of maltreatment or to their shared association or both. Although these competing explanations have different implications for intervention, they have never been evaluated empirically. METHOD: Data were drawn from a nationally representative survey of 34,653 US adults, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Structural equation modeling was used to simultaneously examine the shared and specific effects of five types of childhood maltreatment (i.e., sexual abuse, physical and emotional abuse and neglect) on the risk of different IPV behaviors (i.e., perpetration, victimization and reciprocal violence). Analyses were stratified by sex and adjusted for sociodemographic characteristics (i.e., age, personal income, educational background and race/ethnicity). RESULTS: Most types of childhood maltreatment increased the risk of victimization, perpetration and reciprocal violence. Effects of maltreatment types on each IPV behavior were exerted mostly through a latent factor representing the shared effect across all different types of maltreatment in both sexes (CFI = 0.990, TLI = 0.990, RMSEA = 0.023), although sexual abuse had an additional effect on victimization. CONCLUSIONS: Because childhood maltreatment types increase the risk of each intimate partner violence behavior mainly through a general maltreatment dimension, underlying biological and developmental-ecological mechanisms should be considered important targets of prevention for both victimization and perpetration of abuse in adult relationships.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Estatísticos , Prevalência , Risco , Fatores Sexuais , Parceiros Sexuais/psicologia , Estados Unidos/epidemiologia
13.
CNS Spectr ; 20(2): 130-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25831968

RESUMO

INTRODUCTION: Little is known about the prevalence and correlates of anger in the community. METHODS: We used data derived from a large national sample of the U.S. population, which included more than 34,000 adults ages 18 years and older. We defined inappropriate, intense, or poorly controlled anger by means of self-report of the following: (1) anger that was triggered by small things or that was difficult to control, (2) frequent temper outbursts or anger that lead to loss of control, or (3) hitting people or throwing objects in anger. RESULTS: The overall prevalence of inappropriate, intense, or poorly controlled anger in the U.S. population was 7.8%. Anger was especially common among men and younger adults, and was associated with decreased psychosocial functioning. Significant and positive associations were evident between anger and parental factors, childhood, and adulthood adverse events. There were strong associations between anger and bipolar disorder, drug dependence, psychotic disorder, borderline, and schizotypal personality disorders. There was a dose-response relationship between anger and a broad range of psychopathology. CONCLUSIONS: A rationale exists for developing screening tools and early intervention strategies, especially for young adults, to identify and help reduce anger.


Assuntos
Ira , Adolescente , Adulto , Idoso , Transtornos Induzidos por Álcool/epidemiologia , Transtornos Induzidos por Álcool/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prevalência , Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
14.
J Trauma Stress ; 28(1): 49-56, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25624189

RESUMO

This study presents data on the association of intimate partner violence (IPV) perpetration and rates of psychiatric disorders, and other correlates. Data were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of adults in the United States, 18 years and older, residing in households and group quarters. The sample comprised adults who reported being in a relationship within the past 12 months (N = 25,631). Of these, 1,677 individuals reported perpetrating IPV (4.2% in men, 7.0% in women). Compared to non-IPV perpetrators, IPV perpetrators had greater odds of having any psychiatric disorder, 42.0% and 67.7%, respectively, OR = 2.89, 95% CI [2.51, 3.32]. After adjusting for the effects of nuisance variables, being younger, having an alcohol use disorder, a personality disorder, low levels of social support, and low income were associated with perpetration. Across a wide range of factors, IPV victimization itself had the strongest association with perpetration, AOR = 66.12, 95% CI [55.01, 79.48]. Mental health assessments of IPV perpetrators might offer an opportunity to identify and treat psychiatric disorders and improve the clinical course of conditions that can be affected by ongoing acts of violence.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Violência por Parceiro Íntimo/psicologia , Transtornos da Personalidade/epidemiologia , Adulto , Fatores Etários , Transtornos Relacionados ao Uso de Álcool/psicologia , Vítimas de Crime/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Violência por Parceiro Íntimo/etnologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Transtornos da Personalidade/psicologia , Fatores Sexuais , Apoio Social , Estados Unidos/epidemiologia , Adulto Jovem
15.
JAMA Psychiatry ; 71(11): 1246-53, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25208305

RESUMO

IMPORTANCE: Adults who remit from a substance use disorder (SUD) are often thought to be at increased risk for developing another SUD. A greater understanding of the prevalence and risk factors for drug substitution would inform clinical monitoring and management. OBJECTIVE: To determine whether remission from an SUD increases the risk of onset of a new SUD after a 3-year follow-up compared with lack of remission from an SUD and whether sociodemographic characteristics and psychiatric disorders, including personality disorders, independently predict a new-onset SUD. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study where data were drawn from a nationally representative sample of 34 653 adults from the National Epidemiologic Survey on Alcohol and Related Conditions. Participants were interviewed twice, 3 years apart (wave 1, 2001-2002; wave 2, 2004-2005). MAIN OUTCOMES AND MEASURES: We compared new-onset SUDs among individuals with at least 1 current SUD at wave 1 who did not remit from any SUDs at wave 2 (n = 3275) and among individuals with at least 1 current SUD at wave 1 who remitted at wave 2 (n = 2741). RESULTS: Approximately one-fifth (n = 2741) of the total sample had developed a new-onset SUD at the wave 2 assessment. Individuals who remitted from 1 SUD during this period were significantly less likely than those who did not remit to develop a new SUD (13.1% vs 27.2%, P < .001). Results were robust to sample specification. An exception was that remission from a drug use disorder increased the odds of a new SUD (odds ratio [OR] = 1.46; 95% CI, 1.11-1.92). However, after adjusting for the number of SUDs at baseline, remission from drug use disorders decreased the odds of a new-onset SUD (OR = 0.66; 95% CI, 0.46-0.95) whereas the number of baseline SUDs increased those odds (OR=1.68; 95% CI, 1.43-1.98). Being male, younger in age, never married, having an earlier age at substance use onset, and psychiatric comorbidity significantly increased the odds of a new-onset SUD during the follow-up period. CONCLUSIONS AND RELEVANCE: As compared with those who do not remit from an SUD, remitters have less than half the risk of developing a new SUD. Contrary to clinical lore, achieving remission does not typically lead to drug substitution but rather is associated with a lower risk of new SUD onsets.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idade de Início , Comorbidade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Estado Civil , Estudos Prospectivos , Recidiva , Remissão Espontânea , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia
16.
Psychiatry ; 76(3): 223-40, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23965262

RESUMO

Sexual violence can cause acute and persistent negative psychological outcomes among children and adults in a community. Previous studies have frequently reported high prevalence of prior child and adolescent sexual abuse among adult victims of sexual violence. This raises uncertainty over the specific contribution of sexual victimization in adulthood to the adverse psychological outcomes. The present study draws on a large nationally representative sample of adults without history of childhood sexual abuse, and applies diagnostic criteria of DSM-IV, in order to investigate the risk factors and psychiatric comorbidities correlated with sexual victimization in adulthood. In a large representative sample of U.S. adults without history of childhood sexual abuse, 2.5% reported sexual victimization in adulthood. Female gender, living alone, economic disadvantage, and a history of childhood adversities and parental psychopathology were identified as risk factors. Adult sexual victimization increased the risk of developing a variety of psychiatric disorders, especially PTSD (HR = 3.43, 95% CI [2.67, 4.41]) and drug abuse (HR = 3.38, 95% CI [2.49, 4.58]). Conversely, pre-existing psychiatric psychopathology, particularly PTSD (HR = 3.99, 95% CI [2.68, 5.94]) and dysthymia (HR = 2.26, 95% CI [1.42, 3.59]), increased the likelihood of sexual victimization in adulthood. Childhood experience and adulthood sociodemographic characteristics are important in affecting the risk of being sexually victimized in adulthood. Psychiatric disorders can act as both risk factors and outcomes of adult sexual victimization.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Delitos Sexuais/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Filho de Pais com Deficiência/psicologia , Filho de Pais com Deficiência/estatística & dados numéricos , Comorbidade , Vítimas de Crime/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
17.
Alcohol Clin Exp Res ; 37(10): 1696-705, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23763329

RESUMO

BACKGROUND: An extensive clinical literature has noted gender differences in the etiology and clinical characteristics of individuals with alcohol dependence (AD). Despite this knowledge, many important questions remain. METHODS: Using the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093), we examined differences in sociodemographic characteristics, psychiatric and medical comorbidities, clinical correlates, risk factors, and treatment-utilization patterns of men (N = 2,974) and women (N = 1,807) with lifetime AD. RESULTS: Men with lifetime AD were more likely than women to be diagnosed with any substance use disorder and antisocial personality disorder, whereas women were more likely to have mood and anxiety disorders. After adjusting for sociodemographic characteristics and gender differences in psychiatric comorbidity in the general population, AD was associated with externalizing disorders and any mood disorder among women only. Men with AD met more criteria, had longer episodes, and were younger at the age of first drink. There were no gender differences in remission rates. Women with AD were more likely to have a family and a spouse with history of alcohol use disorders. Treatment rates were low for both genders, and women were more likely to report social stigmatization as a treatment barrier. CONCLUSIONS: There are important gender differences in the psychiatric comorbidities, risk factors, clinical characteristics, and treatment-utilization patterns among individuals with lifetime AD.


Assuntos
Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Inquéritos Epidemiológicos/métodos , Estilo de Vida , Caracteres Sexuais , Adolescente , Adulto , Idoso , Transtornos Relacionados ao Uso de Álcool/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
18.
Drug Alcohol Depend ; 132(3): 630-8, 2013 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-23702490

RESUMO

BACKGROUND: Despite the high rates of comorbidity of post-traumatic stress disorder (PTSD) and alcohol dependence (AD) in clinical and epidemiological samples, little is known about the prevalence, clinical presentation, course, risk factors and patterns of treatment-seeking of co-occurring PTSD-AD among the general population. METHODS: The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Weighted means, frequencies and odds ratios (ORs) of sociodemographic correlates, prevalence of psychiatric disorders and rates of treatment-seeking were computed. RESULTS: In the general population, the lifetime prevalence of PTSD only, AD only and PTSD-AD was 4.83%, 13.66% and 1.59%, respectively. Individuals with comorbid PTSD-AD were more likely than those with PTSD or AD only to have suffered childhood adversities and had higher rates of Axis I and II disorders and suicide attempts. They also met more PTSD diagnostic criteria, had earlier onset of PTSD and were more likely to use drugs and alcohol to relieve their PTSD symptoms than those with PTSD only; they also met more AD diagnostic criteria than those with AD only and had greater disability. Individuals with PTSD-AD had higher rates of treatment seeking for AD than those with AD only, but similar rates than those with PTSD only. CONCLUSION: PTSD-AD is associated with high levels of severity across a broad range of domains even compared with individuals with PTSD or AD only, yet treatment-seeking rates are very low. There is a need to improve treatment access and outcomes for individuals with PTSD-AD.


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Inquéritos Epidemiológicos/métodos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Idoso , Alcoolismo/psicologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
19.
Drug Alcohol Depend ; 132(3): 479-85, 2013 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-23570817

RESUMO

BACKGROUND: The goal of this study was to estimate rates of relapse to smoking in the community and to identify predictors of relapse. METHODS: Data were drawn from the Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Logistic regression analyses were used to estimate the probability of relapse at Wave 2 among individuals who were abstinent at Wave 1 given length of abstinence as well as the presence of several sociodemographic, psychopathologic and substance use-related variables at Wave 1. RESULTS: The risk for relapse among individuals who had been abstinent for 12 months or less at the baseline assessment was above 50%. Among individuals who had been abstinent for over a year, risk of relapse decreased hyperbolically as a function of time, and stabilized around 10% after 30 years of abstinence. Although several sociodemographic, psychopathologic and tobacco-related variables predicted relapse in univariate analyses, only younger age at cessation and shorter duration of abstinence independently predicted risk of relapse in multivariable analyses. CONCLUSIONS: The first year after a quit attempt constitutes the period of highest risk for relapse. Although the risk for relapse decreases over time, it never fully disappears. Furthermore, younger age at smoking cessation also increases the risk for relapse. This information may help develop more targeted and effective relapse prevention programs.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Inquéritos Epidemiológicos/métodos , Probabilidade , Fumar/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Prevenção Secundária , Prevenção do Hábito de Fumar , Estados Unidos/epidemiologia , Adulto Jovem
20.
Psychiatr Serv ; 64(5): 458-65, 2013 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-23370397

RESUMO

OBJECTIVE This study examined changes in the prevalence of daily tobacco use in the United States between 1991-1992 and 2004-2005 by sociodemographic characteristics and psychiatric disorders. METHODS Secondary analyses were performed using data from the National Longitudinal Alcohol Epidemiologic Survey, conducted in 1991-1992 (N=41,612), and wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, conducted in 2004-2005 (N=34,653). RESULTS Although the overall prevalence of past-year daily tobacco use decreased significantly, the reduction was not uniform across all segments of the population. In both surveys, past-year daily tobacco use was higher among respondents with a drug use disorder, an alcohol use disorder, and major depressive disorder and among individuals from socioeconomically disadvantaged groups. Declines in use were slower among individuals with a lifetime alcohol use disorder or major depressive disorder. The prevalence of past-year daily tobacco use did not decrease among Native Americans. CONCLUSIONS Individuals with substance use disorders or major depressive disorder and Native Americans reported higher rates of past-year daily tobacco use than the general population. These findings suggest the need to emphasize specific interventions for these groups.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Fumar/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Asiático/estatística & dados numéricos , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Indígenas Norte-Americanos/estatística & dados numéricos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fumar/epidemiologia , Fumar/etnologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto Jovem
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