Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis.

BACKGROUND: Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. METHODS: We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. FINDINGS: Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. INTERPRETATION: Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. FUNDING: Agencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.

Consumption of Alcohol Surrogates Among Alcohol-Dependent Women.

This is the first in-depth study of alcohol and surrogate drinking patterns, types, reasons, and correlates among alcohol-dependent women in Belarus. The structured interviews were performed in 2013 with 103 alcohol-dependent women admitted to a narcological clinic in Grodno, Belarus. The results suggest that at least 30.3% of alcohol-dependent women regularly consume samogon (moonshine) and 10.8% of women use surrogates, the most popular among which are medications with a high percentage of ethanol and industrial spirits. The belief that samogon exceeds licensed vodka in quality is the main motive for its consumption. The results from the present study confirm that noncommercial alcohol use is common among alcohol-dependent women although its use may be underreported. These findings emphasize that the implementation of a comprehensive alcohol policy must take fully into account the consumption of alcohol from illicit sources.

Alcohol consumption and pancreatitis mortality in Russia.

CONTEXT: Pancreatitis is a major public health problem with high associated economic costs. The incidence of pancreatitis has increased in many European countries in recent decade. Accumulated research and empirical evidence suggests that excessive alcohol consumption is a major risk factor for both acute and chronic pancreatitis. OBJECTIVE: The aim of this study was to examine the aggregate-level relation between the alcohol consumption and pancreatitis mortality rates in Russia. METHOD: Age-standardized sex-specific male and female pancreatitis mortality data for the period 1970-2005 and data on overall alcohol consumption were analyzed by means ARIMA (autoregressive integrated moving average) time series analysis. RESULTS: Alcohol consumption was significantly associated with both male and female pancreatitis mortality rates: a 1 liter increase in overall alcohol consumption would result in a 7.0% increase in the male pancreatitis mortality rate and in 2.3% increase in the female mortality rate. The results of the analysis suggest that 63.1% of all male pancreatitis deaths and 26.8% female deaths in Russia could be attributed to alcohol. Conclusions The outcomes of this study provide indirect support for the hypothesis that unfavorable mixture of higher overall level of alcohol consumption and binge drinking pattern is an important contributor to the pancreatitis mortality rate in Russian Federation.

Cognitive functions and neuropsychological status of medical students with different attitudes to alcohol use: a study conducted at the Belarusian State Medical University, Minsk, Belarus.

This article presents findings on the effects of alcohol use on cognitive performance, functional (well-being, activity, mood) and neuropsychological status and anxiety levels of medical students. A total of 265 medical students (107 males and 158 females) from the Belarusian State Medical University, Minsk (Belarus) were administered questionnaire, containing the AUDIT, CAGE, MAST, and PAS, and other alcohol related questions. Academic Performance questionnaire was administered together with other tests. For analysis of cognitive functions, a "correction probe" test was used. The number of students who reported consumption of alcohol was 74 males and 142 females. Medical students who reported alcohol consumption had lower cognitive performance and academic success, poor self-assessment of their functional and neuropsychological states, compared to the non-alcohol users. The results of this study suggest an inverse dose-dependent relationship between alcohol consumption, and cognitive functions, academic performance and neuropsychological status of medical students.

Adolescent binge drinking and risky health behaviours: findings from northern Russia.

BACKGROUND: Some evidence suggests that in recent years the prevalence of heavy drinking has increased among Russian adolescents. However, as yet, little is known about either heavy alcohol consumption or its relationship with other adolescent health risk behaviours in Russia. The aim of this study therefore was to investigate the association between binge drinking and health risk behaviours among adolescents in Russia. METHODS: Data were drawn from the Social and Health Assessment (SAHA), a survey carried out in Arkhangelsk, Russia in 2003. Information was obtained from a representative sample of 2868 adolescents aged 13-17 regarding the prevalence and frequency of binge drinking (five or more drinks in a row in a couple of hours) and different forms of substance use, risky sexual behaviour and violent behaviour. Logistic regression analysis was used to examine the association between binge drinking and adolescent involvement in various health risk behaviours. RESULTS: Adolescent binge drinking was associated with the occurrence of every type of health risk behaviour - with the sole exception of non-condom use during last sex. In addition, there was a strong association between the number of days on which binge drinking occurred and the prevalence of many health risk behaviours. CONCLUSIONS: Binge drinking is associated with a variety of health risk behaviours among adolescents in Russia. Public health interventions such as reducing the affordability and accessibility of alcohol are now needed to reduce binge drinking and its harmful effects on adolescent well-being.

Affordability of alcohol and alcohol-related mortality in Belarus.

Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm.

Accesibilidad al alcohol y mortalidad relacionada con el alcohol en Bielorrusia / Affordability of alcohol and alcohol-related mortality in Belarus

El abuso del alcohol tiene numerosas consecuencias negativas tanto sociales como para la salud. La respuesta de los consumidores a los cambios en la accesibilidad al alcohol es un problema importante de los debates sobre políticas sobre el alcohol. Los estudios realizados en varios países han demostrado una relación inversa entre los precios del alcohol y el consumo de alcohol en la población. Existen, sin embargo, dudas acerca de si el aumento del precio de alcohol a través de impuestos puede tener un efecto notorio sobre los problemas relacionados con el alcohol, de los bebedores excesivos a largo plazo pesado. El objetivo del presente estudio fue evaluar la relación entre la accesibilidad al alcohol y las tasas de mortalidad relacionadas con dicha sustancia en la Bielorrusia post-soviética. Con este propósito las tendencias en las tasas de mortalidad relacionadas con el alcohol (mortalidad por cirrosis hepática, pancreatitis, alcoholismo y psicosis alcohol) se compararon con la accesibilidad al vodka entre 1990 y 2010. El análisis de series temporales reveló que un 1% de aumento en la accesibilidad del vodka se asocia con un aumento en la mortalidad por cirrosis hepática de 0,77%, un aumento en la mortalidad por pancreatitis del 0,53% y un aumento en la mortalidad por alcoholismo y por psicosis alcohólica del 0,70%. La principal conclusión de este estudio es que la accesibilidad al alcohol es uno de los más importantes predictores de problemas relacionados con el alcohol en una población. Estos resultados proporcionan evidencia adicional de que una disminución en la accesibilidad al alcohol es una estrategia efectiva para reducir el consumo de alcohol y los problemas relacionados (AU)

Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm (AU)

Psychosocial distress as a risk factor of ischemic heart disease mortality.

BACKGROUND: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in the industrialized world. Recent research evidence suggests that psychosocial distress has been implicated as both a precursor to IHD and a significant risk factor for death in those with established IHD. According to WHO, psychosocial distress will be the most harmful risk factor for the development of IHD in the near future. Some experts have underlined the importance of the psychosocial distress of economic and political reforms as the main reason for the IHD mortality crisis in Russia in the 1990s. The aim of the present study was to estimate the effect of psychosocial distress on IHD mortality rate in Russia. SUBJECTS AND METHODS: Trends in age-adjusted, sex-specific suicide (as an integral indicator for psychosocial distress) and IHD mortality rate in Russia from 1965 to 2005 were analyzed employing a distributed lags analysis in order to assess the bivariate relationship between the two time series. RESULTS: Time series analysis indicates the presence of a statistically significant association between the two time series for males at lags 0 and females at lags 0 and 1. CONCLUSIONS: These findings suggest that the Russian IHD mortality crisis is most likely to have been precipitated by the psychosocial distress imposed by rapid societal transformation. The experience of Russia should serve as an example of how societal-level change can influence the health of a population.

Estimación de la fracción de la mortalidad en Rusia atribuible al alcohol / Estimation of alcohol attributable fraction of mortality in Russia

La evidencia acumulada sugiere que el alcohol contribuye de forma importante a la cifra total de muertes prematuras en Rusia. El objetivo del presente estudio fue estimar la mortalidad adulta prematura atribuible al abuso de alcohol en Rusia sobre la base de datos a nivel agregado de todas las causas de mortalidad y de consumo de alcohol. Con este propósito se analizaron los datos de mortalidad por cualquier causa para el período 1980-2005 estandarizados por edad y por sexo junto con los datos sobre el consumo global de alcohol mediante series temporales ARIMA. Como resultado de la comparación, se encontró que el consumo de alcohol se asociaba significativamente con todas las causas de mortalidad masculina y femenina: un aumento de 1 litro en el consumo global de alcohol se traduciría en un aumento del 3,9% en la tasa de mortalidad masculina y en un 2,4% de aumento en la tasa de mortalidad femenina. Los resultados del análisis también indican que el 41,1% de las defunciones de hombres y el 27,8% las muertes de mujeres en Rusia podría atribuirse al alcohol. Podemos concluir que el alcohol es un importante contribuyente a la alta tasa de mortalidad en la Federación de Rusia. Por lo tanto la prevención de daños atribuibles al alcohol debe ser una prioridad de salud pública en Rusia (AU)

Accumulated research evidence suggests that alcohol is a major contributor to premature deaths toll in Russia. The aim of the present study was to estimate the premature adult mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of allcause mortality and alcohol consumption. With this purpose agestandardized sex-specific male and female all-cause mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. As a result alcohol consumption was significantly associated with both male and female all-cause mortality rates: a 1 liter increase in overall alcohol consumption would result in a 3.9% increase in the male mortality rate and in 2.4% increase in female mortality rate. The results of the analysis also suggest that 41.1% of all male deaths and 27.8% female deaths in Russia could be attributed to alcohol. We can conclude that alcohol is a major contributor to the high mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia (AU)

Estimation of alcohol attributable fraction of mortality in Russia.

Accumulated research evidence suggests that alcohol is a major contributor to premature deaths toll in Russia. The aim of the present study was to estimate the premature adult mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of all-cause mortality and alcohol consumption. With this purpose age-standardized sex-specific male and female all-cause mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. As a result alcohol consumption was significantly associated with both male and female all-cause mortality rates: a 1 liter increase in overall alcohol consumption would result in a 3.9% increase in the male mortality rate and in 2.4% increase in female mortality rate. The results of the analysis also suggest that 41.1% of all male deaths and 27.8% female deaths in Russia could be attributed to alcohol. We can conclude that alcohol is a major contributor to the high mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia.

Alcohol consumption and ischemic heart disease mortality in Russia.

It has been repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate of cardiovascular mortality rate and its dramatic fluctuations in Russia over recent decades, while other traditional risk factors identified in epidemiological studies have little predictive value. The aim of this study was to examine the relation between alcohol consumption and ischemic heart disease (IHD) mortality rates in Russia. A ge-standardized sex-specific male and female IHD mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means of ARIMA time series analysis. The results of the analysis showed that alcohol consumption was significantly associated with both male and female IHD mortality rates: a 1-liter increase in overall alcohol consumption would result in a 3.9% increase in the male IHD mortality rate and a 2.7% increase in the female IHD mortality rate. As a conclusion, the results of this study provide indirect support for the hypothesis that the drastic fluctuations in IHD mortality in Russia over recent decades are related to alcohol, as indicated by the close temporal association between number of deaths from IHD and overall alcohol consumption per capita.

Consumo de alcohol y mortalidad por cardiopatía isquémica en Rusia / Alcohol consumption and ischemic heart disease mortality in Russia

Se ha insistido reiteradamente en que el alcohol proporciona la explicación más plausible, tanto para la alta frecuencia en la tasa de mortalidad cardiovascular de Rusia, como para las drásticas fluctuaciones que experimenta durante las últimas décadas. Parecería también que otros factores de riesgo tradicionales identificados en estudios epidemiológicos tendrían poco valor predictivo. El objetivo de este estudio consiste en analizar la relación entre el consumo de alcohol y las tasas de mortalidad por cardiopatía isquémica (CI) en Rusia. Para ello se utiliza el análisis de series temporales estandarizadas por edad y por sexo de los datos de mortalidad por CI masculina y femenina durante el período 1980-2005 en relación con el consumo global de alcohol. El análisis muestra como efectivamente el consumo de alcohol se asocia significativamente con las tasas tanto de mortalidad masculina como femenina por CI. Un aumento de 1 litro en el consumo de alcohol anual se traduciría en un aumento del 3,9% en la tasa de mortalidad por CI en hombres y un 2,7% en las mujeres. Como conclusión, este estudio proporcionan apoyo indirecto a la hipótesis de que las profundas fluctuaciones en Rusia en la mortalidad por CI durante las últimas décadas podría estar relacionado con el alcohol, como lo indica la estrecha relación temporal entre ambos fenómenos(AU)

It has been repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate of cardiovascular mortality rate and its dramatic fluctuations in Russia over recent decades, while other traditional risk factors identified in epidemiological studies have little predictive value. The aim of this study was to examine the relation between alcohol consumption and ischemic heart disease (IHD) mortality rates in Russia. Age-standardized sex-specific male and female IHD mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means of ARIMA time series analysis. The results of the analysis showed that alcohol consumption was significantly associated with both male and female IHD mortality rates: a 1-liter increase in overall alcohol consumption would result in a 3.9% increase in the male IHD mortality rate and a 2.7% increase in the female IHD mortality rate. As a conclusion, the results of this study provide indirect support for the hypothesis that the drastic fluctuations in IHD mortality in Russia over recent decades are related to alcohol, as indicated by the close temporal association between number of deaths from IHD and overall alcohol consumption per capita(AU)

Contribution of alcohol in accident related mortality in Belarus: a time series approach.

BACKGROUND: High accidental death rates in the former Soviet republics (FSR) and its profound fluctuation over the past decades have attracted considerable interest. The research evidences emphasize binge drinking pattern as a potentially important contributor to accident mortality crisis in FSR. In line with this evidence we assume that higher level of alcohol consumption in conjunction with binge drinking pattern results in close aggregate-level association between alcohol psychoses and accidental death rates in the former Soviet Slavic republic Belarus. METHODS: Trends in alcohol psychoses rate (as a proxy for alcohol consumption) from 1979 to 2007 were analyzed employing a distributed lag analysis in order to asses bivariate relationship between the two time series. RESULTS: According to the Bureau of Forensic Medicine autopsy reports the number of deaths due to accidents and injuries increased by 52.5% (from 62.3 to 95.0 per 100.000 of residents), and fatal alcohol poisoning rate increased by 108.6% (from 12.8 to 26.7 per 100.000 of residents) in Belarus between 1979 and 2007. Alcohol in blood was found in 50.1% victims of deaths from accidents and injuries for the whole period, with the minimum figure 40% in 1986 and maximum 58.2% in 2005. The outcome of distributed lags analysis indicated statistically significant association between the number of alcohol psychoses cases and the number BAC-positive deaths from accidents at zero lag. CONCLUSIONS: The outcome of this study supports previous findings suggesting that alcohol and deaths from accidents are closely connected in a culture with prevailing intoxication-oriented drinking pattern, and add to growing body of evidence that a substantial proportion of accidental deaths in Belarus are due to effects of binge drinking.

The effects of beverage type on homicide rates in Russia, 1970-2005.

UNLABELLED: INTRODUCTION AND AIMS. Previous research from Western Europe and North America has suggested that consuming different types of alcoholic beverage may have differing effects on homicide rates both within and between countries. The aim of this study was to examine the relation between the consumption of different beverage types and homicide rates in Russia across the later-Soviet and post-Soviet periods. DESIGN AND METHODS: Age-standardised male and female homicide data for the period 1970-2005 and data on beverage-specific alcohol sales were obtained from the Russian State Statistical Committee (Rosstat). Time series analysis (autoregressive integrated moving average modelling) was used to examine the relation between the sale (consumption) of different alcoholic beverages and homicide rates. RESULTS: Total alcohol consumption and vodka consumption as measured by sales were significantly associated with both male and female homicide rates: a 1L increase in overall alcohol sales would result in a 5.9% increase in the male homicide rate and a 5.1% increase in the female homicide rate. The respective figures for vodka were 16.4% and 14.3%. The consumption of beer and wine was not associated with changes in homicide rates. DISCUSSION AND CONCLUSIONS: Our findings suggest that the consumption of distilled spirits has had an especially detrimental impact on lethal violence in Russia from at least 1970 onwards. In order to reduce homicide rates in this context, alcohol policy should focus on reducing overall consumption as well as attempting to shift the beverage preference away from distilled spirits.

The effects of beverage type on suicide rate in Russia.

BACKGROUND: Research evidence has suggested that the consumption of different types of alcoholic beverage may have a differential effect on suicide rate. The aim of this study was to examine the relation between the consumption of different beverage types and suicide rates in Russia. SUBJECTS AND METHODS: Age-standardized sex- and age-specific suicide rate for the period 1980-2005 and data on beverage-specific alcohol sale were obtained from the Russian State Statistical Committee. Time-series analytical modeling techniques (ARIMA) were used to examine the relationship between the sale of different alcoholic beverages and suicide rates. RESULTS: Vodka consumption as measured by sale was significantly associated with both male and female suicide rate. The consumption of beer and wine were not associated with suicide rate. The estimates of the age specific models for men were positive (except for the 75+ age group) and ranging from 0.069 (60-74 age group) to 0.123 (30-44 age group). The estimates for women were positive for the 15-29 age group (0.08), 30-44 age group (0.096) and 45-59 age group (0.057). CONCLUSIONS: These findings suggest that public health efforts should focus on both reducing overall consumption and changing beverage preference away from distilled spirits in order to reduce suicide rate in Russia.

Alcohol poisonings and fatal accidents in Belarus.

BACKGROUND: High accidental deaths rate in the former Soviet republics (FSR) and its profound fluctuation over the past decades have attracted considerable interest. The mounting body of evidence point to binge drinking pattern as a potentially important contributor to accident mortality crisis in FSR. AIM: The aim of this study was to estimate the aggregate-level effect of binge drinking on the accident mortality rate in the former Soviet Slavic republic Belarus. METHOD: Trends in fatal alcohol poisoning (as a proxy for binge drinking) and accidental deaths rates from 1979 to 2007 were analyzed employing a distributed lag analysis in order to asses bivariate relationship between the two time series. RESULTS: According to Bureau of Forensic Medicine autopsy reports the number of deaths due to accidents and injuries increased by 94.5% (from 38.7 to 75.6 per 100.000 of residents), and fatal alcohol poisoning rate increased by 108.6% (from 12.8 to 26.7 per 100.000 of residents) in Belarus between 1979 and 2007. Alcohol in blood was found in 51.4% victims of deaths from accidents and injuries for the whole period, with the minimum figure 43.1% in 1986 and maximum 59.1% in 2005. The outcome of distributed lags analysis indicated statistically significant association between the number of alcohol poisoning deaths and the number BAC (blood alcohol concentration)- positive deaths from accidents and injuries at zero lag. CONCLUSION: The outcome of this study supports the hypothesis that alcohol and deaths from accidents and injuries are closely connected in culture with prevailing intoxication-oriented drinking pattern. This research evidence points to binge drinking pattern as a potentially important contributor to accident mortality crisis in Belarus.

Prevalence of alcohol-related problems among the Slavs and Arabs in Belarus: a university survey.

BACKGROUND: Alcohol abuse is a major problem among students in Belarus. Alcohol-related problems might vary among students of different cultural backgrounds. OBJECTIVES: To examine the different patterns in alcohol use and related problems among students of different cultural groups--the Slavs and Arabs, in major Belarusian universities. METHODS: 1465 university students (1345 Slavs and 120 Arabs) from three major universities in Minsk, Belarus, were administered the Alcohol Use Disorders Identification Test, the Cut, Annoyed, Guilty and Eye questionnaire, and the Michigan Alcohol Screening Test, including other alcohol-related questions. RESULTS: Overall, 91.08% (n = 1225) Slavs and 60.83% (n = 73) Arabs were alcohol users. A total of 16.28% (n = 219) Slavs and 32.50% (n = 39) Arabs were identified as problem drinkers. Different patterns of alcohol use and related problems were characterized for the Slavs and Arabs. The level of alcohol-related problems was higher among the Arabs, compared to the Slavs. CONCLUSION: Significant differences in the pattern of alcohol use and related problems exist among the students of various cultural groups--the Slavs and Arabs in Minsk, Belarus. SCIENTIFIC SIGNIFICANCE: This is the first empirical study to investigate the prevalence of alcohol use and related problems among the Arab and Slav students in Belarus.