RESUMO
Aim: Parental mental health conditions adversely affect the children. Information on the prevalence of parental mental health conditions is needed to help policymakers allocate resources appropriately. Therefore, the aim of this study was to estimate the prevalence of children with parental mental health conditions in Denmark and further estimate the age-specific prevalence and geographical variation. Methods: In this nationwide register-based cross-sectional study, we included all children born between 2000 and 2016 if they resided in Denmark on 31 December 2016. Information on both maternal and paternal mental health conditions was retrieved from primary and secondary healthcare registers. Parental mental health conditions were categorised in three severity groups: minor, moderate, and severe. We estimated the proportion of children with parental mental health conditions on 31 December 2016. Results: Of the 1,106,459 children aged 0-16 years, 39.1% had at least one parent with a mental health condition. The prevalence increased with age of the children until the age of six years. Geographical variation in the prevalence ranged from 29.0% to 48.3% in the 98 municipalities. Minor parental mental health conditions (23.5%) were more common than moderate (13.5%) and severe parental mental health conditions (2.2%). Hospital-diagnosed parental mental health conditions were prevalent in 12.8% of the children. Conclusions: Two in five children aged 0-16 years in Denmark have parents with a mental health condition and geographical variation exists. The high prevalence of children with parental mental health conditions is an important public health challenge, which calls for attention.
Assuntos
Transtornos Mentais , Saúde Mental , Criança , Masculino , Feminino , Humanos , Estudos Transversais , Prevalência , Estudos de Coortes , Pais/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Dinamarca/epidemiologiaRESUMO
Background Atrial fibrillation ( AF ) and cancer are frequent diseases worldwide. The timewise association between the diagnosis of AF and a subsequent diagnosis of cancer may clarify whether a mutual cause exists, and may also guide clinicians about time windows of high risk of cancer occurrence. Methods and Results We conducted a population-based cohort study among 26 222 men and 28 879 women free of AF and cancer at baseline based on the Danish Diet, Cancer and Health study. The participants were followed for the development of AF (the Danish National Patient Registry) and subsequent cancer (the Danish Cancer Registry) until 2013. We used Cox proportional hazard models with new-onset AF as time-dependent exposure. The men (median age 56 years) and women (median age 56 years) were followed for medians of 16.7 and 19.6 years, respectively. AF was associated with higher risks of any type of cancer (men: hazard ratio [ HR ] 1.41, 95% confidence interval [ CI ], 1.26-1.58; women: HR 1.15, 95% CI , 1.02-1.32), and for men only, lung ( HR 1.66, 95% CI , 1.19-2.30), and colorectal cancer ( HR 1.37, 95% CI , 1.02-1.85). Within the initial 90 days following the diagnosis of AF , the risks of any type of cancer (men: HR 2.89, 95% CI , 2.10-3.98; women: HR 3.72, 95% CI , 2.49-5.56), lung (men: HR 7.70, 95% CI , 4.34-13.68; women: HR 7.98, 95% CI , 3.96-16.09), and colorectal cancer (men: HR 3.35, 95% CI , 1.03-10.90; women: HR 5.91, 95% CI , 2.44-14.29) were higher for men and women. Conclusions A diagnosis of AF is associated with a higher incidence rate of cancer among men and women. The cancer incidence rate is particularly elevated within 90 days after the diagnosis of AF .
Assuntos
Fibrilação Atrial/epidemiologia , Neoplasias/epidemiologia , Idoso , Neoplasias da Mama/epidemiologia , Estudos de Coortes , Neoplasias Colorretais/epidemiologia , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Neoplasias da Próstata/epidemiologiaRESUMO
Aims: To examine the association between coronary artery calcium score (CACS) and risk of future atrial fibrillation (AF), and to estimate the predictive accuracy of CACS for AF development in patients undergoing non-contrast cardiac computed tomography (nCCT). Methods and results: We conducted a registry-based cohort study of 27 962 patients suspected of having coronary artery disease and without history of AF who were identified in the Western Denmark Heart Registry. The patients underwent nCCT between 2010 and 2015 and were followed until 2016 (median 2.9 years). CACSs were determined using nCCT. We used Cox proportional hazards models to estimate hazard ratios (HR) with 95% confidence intervals (CI). A receiver operating characteristic (ROC) curve for AF was used to assess the predictive accuracy of CACS. Among the patients, 52% had a CACS of 0, 26% of 1-99, 13% of 100-399, 6% of 400-999, and 4% of ≥ 1000. AF occurred in 622 patients after nCCT, corresponding to an overall incidence rate of 7.5 (95% CI: 6.9-8.1) per 1000 person-years. After multivariable adjustment, the HRs (95% CIs) were (ref. CACS 0) CACS 1-99: 1.00 (0.80-1.25); CACS 100-399: 1.36 (1.06-1.74); CACS 400-999: 1.76 (1.33-2.35); and CACS ≥ 1000: 1.67 (1.20-2.34). An ROC curve showed an area under the curve of 0.68 (0.65-0.71) for the prediction of AF within one year after nCCT. Conclusion: A high CACS is associated with a high risk of subsequent AF development and may have potential to guide future follow-ups for AF detection after CACS measurement in order to identify AF patients earlier.
Assuntos
Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/etiologia , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Sistema de Registros , Calcificação Vascular/complicações , Idoso , Fibrilação Atrial/epidemiologia , Estudos de Coortes , Angiografia Coronária/métodos , Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Vasos Coronários/fisiopatologia , Dinamarca , Feminino , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida , Fatores de Tempo , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/patologiaRESUMO
Evidence of a causal link between atherosclerosis and cancer is sparse and conflicting. Therefore, we examined the association between extent of coronary atherosclerosis determined by coronary artery calcium score (CACS) and risk of cancer. We conducted a historical population-based cohort study of 28,549 cancer-free patients identified in the Western Denmark Heart Registry. All patients underwent cardiac computed tomography for measurement of CACS for suspected coronary artery disease. The outcome was an incident cancer diagnosis: total, tobacco-related, lung, prostate, breast, and colorectal. We used Cox proportional hazards regression analyses stratified by gender to estimate hazard ratios (HRs) for relations between CACS and cancer with 95% confidence intervals (95% CI). During follow-up, 455 men and 527 women had a cancer diagnosis. In a multivariable model (reference group: CACS 0), adjusted hazard ratios (95% confidence interval) for total cancer were as follows: CACS 1 to 99: 1.07 (0.83 to 1.39), CACS 100 to 399: 1.24 (0.94 to 1.63), CACS 400 to 999: 0.88 (0.62 to 1.25), CACS ≥1,000: 0.96 (0.66 to 1.41) in men; and CACS 1 to 99: 0.96 (0.77 to 1.19), CACS 100 to 399: 0.99 (0.75 to 1.31), CACS 400 to 999: 1.11 (0.76 to 1.62), and CACS ≥1,000: 1.16 (0.73 to 1.83) in women. We found no significant association between CACS and the specified outcomes for men or women, except for an increased risk of lung cancer among women with a high CACS. In conclusion, extent of coronary atherosclerosis determined by CACS was not associated with development of total, tobacco-related, lung, prostate, breast, or colorectal cancer. However, we did observe an association between CACS and risk of lung cancer in women.