Exposure to potentially traumatic events in young Swiss men: associations with socio-demographics and mental health outcomes (alcohol use disorder, major depression and suicide attempts).

Background and objective: The aims of this study were to estimate the lifetime and 12-month prevalence of exposure to potentially traumatic events (PTEs) in young men in Switzerland and to assess factors and mental health outcomes associated with such events. Method: Data were drawn from the Cohort Study on Substance Use Risk Factors (C-SURF), encompassing 5,223 young men. Exposure to PTEs was assessed using the Post-traumatic Diagnostic Scale (PDS), Trauma History Questionnaire (THQ) and Life Event Checklist (LEC). Results: Lifetime prevalence of PTEs was 59.4%, with 37.3% reporting multiple types of events. Twelve-month prevalence was 31.2%, with 12.7% reporting multiple types of events. Low education level of participants, high maternal education, family affluence below average, and not living with biological parents were associated with a higher risk of having experienced one or more PTEs in one's lifetime. Low education level of participants and high maternal education were also related to exposure to one or more PTEs over the past 12 months. Logistic regression analyses demonstrated that PTE exposure was directly associated with all assessed mental health outcomes. The strongest relationship was found between exposure to multiple types of PTEs and suicide attempts (adjusted OR 4.9 [95% CI: 2.9-8.4]). Conclusions: These results indicate that having experienced one or multiple types of PTEs is common in Swiss young men. Efforts should be intensified to reduce exposure to PTEs and prevent and treat resulting problematic mental health outcomes in young adults.

Antecedentes y objetivos: Los objetivos de este estudio fueron estimar la prevalencia de vida y de 12 meses de exposición a eventos potencialmente traumáticos (PTEs) en varones jóvenes en Suiza y evaluar los factores y consecuencias en salud mental asociadas con tales eventos. Método: La información fue obtenida del Estudio de Cohorte en Factores de Riesgo de Uso de Sustancias (C-SURF, por sus siglas en inglés), que abarca 5.223 hombres jóvenes. La exposición a PTEs fue evaluada usando la Escala de Diagnóstico Postraumático (PDS), el Cuestionario de Historia de Trauma (THQ) y la Lista de Chequeo de Eventos Vitales (LEC). Resultados: La prevalencia de vida de PTEs fue de 59,4%, con un 37,3% que reportó múltiples tipos de eventos. La prevalencia a doce meses fue de 31.2%, con 12.7% que reportó múltiples tipos de eventos. El bajo nivel educacional de los participantes, la alta educación materna, la riqueza familiar por debajo del promedio y el hecho de no vivir con padres biológicos se asociaron con un mayor riesgo de haber experimentado una o más PTEs en la vida de una persona. Bajo nivel educativo de los participantes y alta educación materna también se relacionaron con la exposición a una o más PTE en los últimos 12 meses. El análisis de regresión logística demostró que la exposición a PTE estuvo directamente asociada con todos los resultados de salud mental evaluados. La relación más fuerte se encontró entre la exposición a múltiples tipos de PTEs e intentos suicidas (OR ajustada 4.9 [IC 95%: 2.9-8.4]. Conclusiones: Estos resultados indican que haber experimentado uno o múltiples tipos de PTEs es frecuente en los varones jóvenes Suizos. Se deberían intensificar esfuerzos para reducir la exposición a PTEs y prevenir y tratar las consecuencias problemáticas resultantes en salud mental en los adultos jóvenes.

Irritable bowel syndrome among a cohort of European travelers to resource-limited destinations.

BACKGROUND: Travelers' diarrhea (TD) remains a frequent travel-associated infection. Between 4 and 32% of enteric infections were followed by a postinfectious irritable bowel syndrome (pIBS) with long-term sequelae in various settings. Travel-related IBS incidence rates are based on small studies and IBS predictors have not been sufficiently evaluated. METHODS: Adult travelers to resource-limited destinations participated in a prospective questionnaire-based cohort study. Demographics, travel characteristics, and medical history were assessed and those with functional or organic gastrointestinal disorders were excluded. Immediately after return from abroad, the volunteers completed a second questionnaire on TD, other health impairments, and on nutritional hygiene. Six-months post-travel, a follow-up questionnaire assessed IBS based on Rome III criteria. Risk factors were analyzed by multiple logistic regression. RESULTS: Among a total of 2,476 subjects analyzed (participation rate 72.4%), 38 (1.5%) developed new IBS, and the 6-month incidence rate for pIBS was 3.0% (95% CI 1.9-4.2) following TD. Significant risk factors were TD during the surveyed journey (OR 3.7; 95% 1.8-7.4), an adverse life event experienced within 12 months pre-travel (OR 3.1; 1.4-6.8), and a diarrheal episode experienced within 4 months pre-travel (OR 2.7; 95% CI 1.3-5.6). Following multiple diarrheal episodes, the risk of acquiring IBS increased by six times. CONCLUSIONS: In a large population of European travelers IBS had a lower incidence rate as compared to previous studies. Particular risk groups were identified; those may need to be protected.

Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations.

BACKGROUND: Incidence rates of travellers' diarrhoea (TD) need to be updated and risk factors are insufficiently known. METHODS: Between July 2006 and January 2008 adult customers of our Centre for Travel Health travelling to a resource-limited country for the duration of 1 to 8 weeks were invited to participate in a prospective cohort study. They received one questionnaire pre-travel and a second one immediately post-travel. First two-week incidence rates were calculated for TD episodes and a risk assessment was made including demographic and travel-related variables, medical history and behavioural factors. RESULTS: Among the 3100 persons recruited, 2800 could be investigated, resulting in a participation rate of 89.2%. The first two-weeks incidence for classic TD was 26.2% (95%CI 24.5-27.8). The highest rates were found for Central Africa (29.6%, 95% CI 12.4-46.8), the Indian subcontinent (26.3%, 95%CI 2.3-30.2) and West Africa (21.5%, 95%CI 14.9-28.1). Median TD duration was 2 days (range 1-90). The majority treated TD with loperamide (57.6%), while a small proportion used probiotics (23.0%) and antibiotics (6.8%). Multiple logistic regression analysis on any TD to determine risk factors showed that a resolved diarrhoeal episode experienced in the 4 months pre-travel (OR 2.03, 95%CI 1.59-2.54), antidepressive comedication (OR 2.11, 95%CI 1.17-3.80), allergic asthma (OR 1.67, 95%CI 1.10-2.54), and reporting TD-independent fever (OR 6.56, 95%CI 3.06-14.04) were the most prominent risk factors of TD. CONCLUSIONS: TD remains a frequent travel disease, but there is a decreasing trend in the incidence rate. Patients with a history of allergic asthma, pre-travel diarrhoea, or of TD-independent fever were more likely to develop TD while abroad.