Day-to-day variations in health behaviors and daily functioning: two intensive longitudinal studies.

In two intensive longitudinal studies we examined the daily dynamics in health behaviors and their associations with two important indicators of young adults' daily functioning, namely, affect and academic performance. Over a period of 8 months, university students (Study 1: N = 292; Study 2: N = 304) reported sleep, physical activity, snacking, positive and negative affect, and learning goal achievement. A subsample wore an actigraph to provide an additional measurement of sleep and physical activity and participated in a controlled laboratory snacking situation. Multilevel structural equation models showed that better day-to-day sleep quality or more physical activity than usual, but not snacking, were associated with improved daily functioning, namely, affect and learning goal achievement. Importantly, self-report measurements of health behaviors correlated with behavioral measurements. These findings have the potential to inform health promotion programs aimed at supporting young adults in their daily functioning in good physical and mental health.

Associations of specific phobia and its subtypes with physical diseases: an adult community study.

BACKGROUND: Specific phobia is the most prevalent anxiety disorder in the community and is associated with substantial impairment. Comorbidity with physical diseases is assumed and has important implications for etiology, treatment, or prevention of the comorbid conditions. However, due to methodological issues data are limited and subtypes of specific phobia have not been investigated yet. We examined the association of specific phobia and its subtypes with physical diseases in a representative community sample with physician-diagnosed physical diseases and diagnostic criteria of specific phobia. METHODS: Data of the German Mental Health Survey from 4181 subjects aged 18-65 years were used. Specific phobia was diagnosed using M-CIDI/DIA-X interview; physical diseases were assessed through a self-report questionnaire and a medical interview. Logistic regression analyses adjusted for sex were calculated. RESULTS: Specific phobia was associated with cardiac diseases, gastrointestinal diseases, respiratory diseases, arthritic conditions, migraine, and thyroid diseases (odds ratios between 1.49 and 2.53). Among the subtypes, different patterns of associations with physical diseases were established. The findings were partially replicated in the Swiss PsyCoLaus Study. CONCLUSIONS: Our analyses show that subjects with specific phobia have an increased probability for specific physical diseases. From these analyses etiological mechanisms of specific phobia and physical disease can be deduced. As subtypes differed in their patterns of associations with physical diseases, different etiological mechanisms may play a role. The findings are highly relevant for public health in terms of prevention and therapy of the comorbid conditions.

Physical diseases among persons with obsessive compulsive symptoms and disorder: a general population study.

PURPOSE: This study aimed at evaluating the comorbidity between DSM-IV obsessive compulsive disorder (OCD) and subthreshold forms and physical diseases in the general population as well as disability associated with comorbidity. METHODS: We used data from the 1998 German Mental Health Survey, a representative survey of the German population. Mental disorders and physical diseases of 4181 subjects (aged 18-65) were cross-sectionally assessed. Mental disorders were diagnosed using the M-CIDI/DIA-X interview. Physical diseases were assessed through a self-report questionnaire and a standardized medical interview. We created three groups of obsessive-compulsive symptoms: (1) no obsessive compulsive symptoms (n = 3,571); (2) obsessive compulsive symptoms (OCS, n = 371; endorsement of OCS (either obsession or compulsion) without fulfilling any core DSM-IV criteria); (3) subthreshold OCD/OCD (n = 239; fulfilling either some or all of the core DSM-IV criteria). RESULTS: In comparison to subjects without OCS, subjects with subthreshold OCD/OCD showed higher prevalence rates of migraine headaches (OR 1.7; 95% CI 1.1-2.5) and respiratory diseases (OR 1.7; 95% CI 1.03-2.7); subjects with OCS showed higher prevalence rates of allergies (OR 1.6; 95% CI 1.1-2.8), migraine headaches (OR 1.9; 95% CI 1.4-2.7) and thyroid disorders (OR 1.4; 95% CI 1.01-2.0). Subjects with both OCS and physical disease reported the highest number of days of disability due to physical or psychological problems during the past 30 days compared to subjects with only OCS, only physical disease or neither of them. CONCLUSIONS: OCD and subthreshold forms are associated with higher comorbidity rates with specific physical diseases and higher disability than subjects without OCS. Possible etiological pathways should be evaluated in future studies and clinicians in primary care should be aware of these associations.

'I feel better when ': An analysis of the memory-experience gap for peoples' estimates of the relationship between health behaviours and experiences.

OBJECTIVE: People often overestimate how strongly behaviours and experiences are related. This memory-experience gap might have important implications for health care settings, which often require people to estimate associations, such as "my mood is better when I exercise". This study examines how subjective correlation estimates between health behaviours and experiences relate to calculated correlations from online reports and whether subjective estimates are associated with engagement in actual health behaviour. DESIGN: Seven-month online study on physical activity, sleep, affect and stress, with 61 online assessments. MAIN OUTCOME MEASURES: University students (N = 168) retrospectively estimated correlations between physical activity, sleep, positive affect and stress over the seven-month study period. RESULTS: Correlations between experiences and behaviours (online data) were small (r = -.12-.14), estimated correlations moderate (r = -.35-.24). Correspondence between calculated and estimated correlations was low. Importantly, estimated correlations of physical activity with stress, positive affect and sleep were associated with actual engagement in physical activity. CONCLUSION: Estimation accuracy of relations between health behaviours and experiences is low. However, association estimates could be an important predictor of actual health behaviours. This study identifies and quantifies estimation inaccuracies in health behaviours and points towards potential systematic biases in health settings, which might seriously impair intervention efficacy.

The importance of physical activity and sleep for affect on stressful days: Two intensive longitudinal studies.

We investigated the potential stress-buffering effect of 3 health behaviors-physical activity, sleep quality, and snacking-on affect in the context of everyday life in young adults. In 2 intensive longitudinal studies with up to 65 assessment days over an entire academic year, students (Study 1, N = 292; Study 2, N = 304) reported stress intensity, sleep quality, physical activity, snacking, and positive and negative affect. Data were analyzed using multilevel regression analyses. Stress and positive affect were negatively associated; stress and negative affect were positively associated. The more physically active than usual a person was on a given day, the weaker the association between stress and positive affect (Study 1) and negative affect (Studies 1 and 2). The better than usual a person's sleep quality had been during the previous night, the weaker the association between stress and positive affect (Studies 1 and 2) and negative affect (Study 2). The association between daily stress and positive or negative affect did not differ as a function of daily snacking (Studies 1 and 2). On stressful days, increasing physical activity or ensuring high sleep quality may buffer adverse effects of stress on affect in young adults. These findings suggest potential targets for health-promotion and stress-prevention programs, which could help reduce the negative impact of stress in young adults. (PsycINFO Database Record

Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study.

AIM: To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors. METHODS: We used data from PsyCoLaus, a large Swiss Population Cohort Study (n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety (early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects. RESULTS: Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders (men), and measles/mumps/rubella-infections with early and late anxiety disorders (women). Gastric inflammatory diseases took effect in mood disorders (both sexes) and in early disorders (men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne (associations with mood disorders in men) and psoriasis (associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders (men), and neurodevelopmental and early anxiety disorders (women). CONCLUSION: Infectious, atopic and inflammatory diseases are important risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.

Comorbidity of infectious diseases and anxiety disorders in adults and its association with quality of life: a community study.

OBJECTIVE: Infectious diseases and anxiety disorders are common and both are associated with substantial burden to individual, families, and society. A better understanding of their association may be helpful in explicating possible etiological mechanisms related to both. The goal of the current study was to investigate the relationship between specific infectious diseases and anxiety disorders among adults in the community, and to examine whether the co-occurrence of the two is associated with poorer quality of life compared to subjects with one or neither condition. METHODS: We used data from the 1998 German Mental Health survey with 4181 subjects aged 18-65. Various infectious diseases (lifetime) and health-related quality of life were assessed via self-report questionnaires and anxiety disorders (past 12-months) were diagnosed using M-CIDI interviews. Logistic regression analyses were used to evaluate the association between infectious diseases and anxiety disorders; a linear model adjusted for sex was used to examine whether comorbidity of infectious diseases and anxiety disorders was associated with quality of life. RESULTS: Whooping cough [odds ratio (OR) = 1.69, 95% confidence intervals (CI) = 1.36-2.09], scarlet fever (OR = 1.31, 95% CI = 1.02-1.68), and diphtheria (OR = 1.79, 95% CI = 1.21-2.64) were associated with increased prevalence of any anxiety disorder. Subjects with both infectious diseases and anxiety disorders reported lower levels of both mental and physical quality of life, compared with subjects with only one or neither condition. CONCLUSION: Extending prior research, this study suggests a relationship between specific infectious diseases and anxiety disorders in an adult community sample. Research targeting etiological mechanisms related to the interplay between infectious diseases and anxiety disorders is warranted.