Tobacco use among college students in Kerala, India.

Background & objectives: Despite tobacco use among college students being a major health concern, data remain sparse from India. It is in this background that this study aimed to report the prevalence of tobacco use and its psychosocial correlates among college students in the State of Kerala, India. Methods: A total of 5784 students from 58 colleges from Ernakulam district, Kerala, selected by cluster random sampling and were provided with self-administered questionnaire. In addition to socio-demographic profile, the questionnaire incorporated alcohol, smoking, and substance involvement screening test (ASSIST, for assessing tobacco use and its severity, lifetime use of other substances); Kessler's scale (psychological distress) and Barkeley's scale (attention deficit hyperactivity disorder symptoms). Screening questions were used for assessing lifetime suicidality and sexual abuse. Results: The lifetime prevalence of tobacco use was 8.6 per cent (21.5% males and 1.4% female). Among users, hazardous and dependent use defined using ASSIST scores was 63.3 and 2.9 per cent, respectively. Tobacco use was associated with older age, being male, urban residence, having a part-time job, use of alcohol and illicit drugs and academic failures. Interpretation & conclusions: Although the prevalence of tobacco use in our study was relatively low, the proportionately higher rates of hazardous use and its association with the negative correlates suggest that more needs to be done to prevent its deleterious consequences.

Do High School Students in India Gamble? A Study of Problem Gambling and Its Correlates.

Studies from the West suggest that significant numbers of high school students gamble, despite it being illegal in this age group. To date, there have been no studies on the prevalence of gambling among senior high school and higher secondary school students in India. This study reports point prevalence of gambling and its psychosocial correlates among high school students in the State of Kerala, India. 5043 high school students in the age group 15-19 years, from 73 schools, were selected by cluster random sampling from the district of Ernakulam, Kerala, South India. They completed questionnaires that assessed gambling, substance use, psychological distress, suicidality, and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Of a total of 4989 completed questionnaires, 1400 (27.9 %) high school students reported to have ever gambled and 353 (7.1 %) were problem gamblers. Of those who had ever gambled, 25.2 % were problem gamblers. Sports betting (betting on cricket and football) was the most popular form of gambling followed by the lottery. Problem gamblers when compared with non-problem gamblers and non-gamblers were significantly more likely to be male, have academic failures, have higher rates of lifetime alcohol and tobacco use, psychological distress, suicidality, history of sexual abuse and higher ADHD symptom scores. Gambling among adolescents in India deserves greater attention, as one in four students who ever gambled was a problem gambler and because of its association with a range of psychosocial variables.

Prevalence of hoarding disorder among primary care patients.

OBJECTIVES: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. METHODS: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. RESULTS: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. CONCLUSION: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.

Insomnia in primary care-a study from India.

OBJECTIVES: To study the prevalence and clinical correlates of insomnia among a sample of primary care attendees, in the state of Kerala, India. DESIGN: Cross-sectional survey. SETTING: Primary care. PARTICIPANTS: 7017 adult patients [18-60 years] attending 71 primary health centers selected by cluster random sampling. MEASUREMENTS: Patients were assessed for insomnia using the Insomnia Severity Index. In addition to self-reported socio-demographic and chronic medical illness details, structured instruments were used to assess for mental disorders, disability and life satisfaction. RESULTS: Subclinical insomnia and clinical insomnia were reported by 17.7% and 4.7% subjects, respectively. Subjects with subclinical and clinical insomnia when compared to those without insomnia had higher odds of having older age, female gender, urban background, lower education, chronic medical and mental disorders, greater disability and poor life satisfaction. Subjects with clinical insomnia when compared to the subclinical group had higher odds of having older age, urban background, lower education, mental disorders and greater disability. Among mental disorders, depressive disorder was correlated with both clinical and subclinical insomnia. CONCLUSIONS: Clinical and subclinical insomnia is common among primary care attendees and both are associated with significant morbidity. This study highlights that it is a major public health concern, albeit neglected, which needs to be dealt as a priority.

Prevalence of hoarding disorder among primary care patients

Objectives: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. Methods: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. Results: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. Conclusion: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.