Hypersensitivity pneumonitis with Mycobacterium avium complex among spa workers.

BACKGROUND: The New Mexico Department of Health (NMDOH) investigated the cause of two cases of hypersensitivity pneumonitis (HP) in spa maintenance workers with laboratory confirmed Mycobacterium avium complex (MAC). The investigation occurred in tandem with worker protection and swimming pool regulatory investigations by the New Mexico Environment Department at the spa where the workers were employed. OBJECTIVES: The investigation was conducted in order to identify unreported cases, exposure source(s), and to prevent further worker exposure. METHODS: NMDOH surveyed 57 spa employees about symptoms and exposures, categorized jobs according to self-reported exposure to water, and computed odds ratios for symptom reporting by exposure category. Environmental isolates from spa water and filter swabs were cultured and compared to patient isolates by the Environmental and Applied Microbiology Team, Centers for Disease Control and Prevention (CDC). RESULTS: Workers with the highest exposure reported more HP-like symptoms (OR = 9.6), as did intermediate exposure workers (OR = 6.5), compared to workers with no aerosolized water exposure. Two of 13 environmental isolates were closely related to one of the patient isolates. CONCLUSIONS: Workers were likely exposed during spray cleaning of cartridge filters in a poorly ventilated work space. Recommendations include inhibiting organism growth in spa systems, assuring the use of respiratory protection, and adequately ventilating work spaces where filters and equipment are cleaned.

Does outpatient laboratory testing represent influenza burden and distribution in a rural state?

BACKGROUND: Laboratory testing results are often used to monitor influenza illness in populations, but results may not be representative of illness burden and distribution, especially in populations that are geographically, socioeconomically, and racially/ethnically diverse. OBJECTIVES: Descriptive epidemiology and chi-square analyses using demographic, geographic, and medical condition prevalence comparisons were employed to assess whether a group of individuals with outpatient laboratory-confirmed influenza illness during September-November 2009 represented the burden and distribution of influenza illness in New Mexico (NM). PATIENTS/METHODS: The outpatient group was identified via random selection from those with positive influenza tests at NM laboratories. Comparison groups included those with laboratory-confirmed H1N1-related influenza hospitalization and death identified via prospective active statewide surveillance, those with self-reported influenza-like illness (ILI) identified through random digit dialing, and the NM population. RESULTS: This analysis included 334 individuals with outpatient laboratory-confirmed influenza, 888 individuals with laboratory-confirmed H1N1-related hospitalization, 39 individuals with laboratory-confirmed H1N1-related death, 334 individuals with ILI, and NM population data (N = 2,036,112). The outpatient laboratory-confirmed group had a different distribution of demographic and geographic factors, as well as prevalence of certain medical conditions as compared to the groups of laboratory-confirmed H1N1-related hospitalization and death, the ILI group, and the NM population. CONCLUSIONS: The outpatient laboratory-confirmed group may reflect provider testing practices and potentially healthcare-seeking behavior and access to care, rather than influenza burden and distribution in NM during the H1N1 pandemic.

Prevalence of the metabolic syndrome in patients presenting to the University Hospital of the West Indies: a need to adopt proactive screening and specific management policy / Prevalencia del síndrome metabólico en pacientes que acuden al Hospital Universitario de West Indies: necesidad de adoptar un tamizaje proactivo y políticas de tratamiento específico

Studies have shown that the metabolic syndrome (MetS), a major risk factor for the development of Type 2 diabetes mellitus and cardiovascular disease, is higher among psychiatric patients on antipsychotic medications than the general population. While studies on the prevalence of MetS in the Jamaican adult population have been undertaken, no such study has been done on the corresponding psychiatric population. The purpose of this study was to determine the prevalence of MetS in a Jamaican adult psychiatric inpatient population. The study group comprised thirty-eight patients with a primary DSM-IV-TR Axis 1 diagnosis. Criteria for the diagnosis of MetS were the presence of any three or more of five factors as defined by using the International Diabetes Federation (IDF) and American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) consensus agreement. The prevalence of MetS in this cohort was 28.9% and was associated with significantly higher abdominal obesity (p = 0.010), elevated blood pressure (p = 0.000), elevated triglycerides (p = 0.019) and low high density lipoprotein-cholesterol (p = 0.016) when compared with patients not diagnosed with MetS. Metabolic syndrome was common in this group of psychiatric patients and likely represents a pathway to the future development of Type 2 diabetes mellitus and cardiovascular disease. Screening and continuous monitoring will allow for early intervention and possibly prevention of increased morbidity and mortality in this vulnerable population.

Los estudios han mostrado que el síndrome metabólico (SMet) - un factor de riesgo mayor para el desarrollo de la diabetes mellitus tipo 2 y la enfermedad cardiovascular - es más alto entre los pacientes psiquiátricos bajo medicamentos antipsicóticos que entre la población general. Si bien se han llevado a cabo estudios sobre la prevalencia del SMet en la población adulta jamaicana, no se han realizado estudios de esta clase en la población psiquiátrica correspondiente. El propósito de este estudio fue determinar la prevalencia del SMet en una población jamaicana adulta de pacientes hospitalizados. El grupo de estudio comprendió treinta y ocho pacientes con diagnóstico primario DSM-IV-TR de eje I. Los criterios para el diagnóstico de SMet se basaron en la presencia de tres o más de cinco factores, los cuales fueron definidos usando el acuerdo por consenso de la Federación Internacional de la Diabetes (FID) y la Asociación Nacional de Cardiología/Instituto Nacional del Corazón, el Pulmón y la Sangre (AHA/NHLBI). La prevalencia de SMet en esta cohorte fue 28.9%, y se hallaba asociada con obesidad abdominal significativamente más alta (p = 0.010), presión sanguínea elevada (p = 0.000), triglicéridos elevados (p = 0.019), y bajos niveles de colesterol-lipoproteína de alta densidad (p = 0.016), al compararse con pacientes no diagnosticados con SMet. El síndrome metabólico fue común en este grupo de pacientes psiquiátricos y probablemente representa una vía al desarrollo futuro de la diabetes mellitus tipo 2 y la enfermedad cardiovascular. El tamizaje así como el monitoreo continuos permitirán la intervención temprana y la posible prevención del aumento de la morbosidad y la mortalidad en esta población vulnerable.

Mental health policy and service system development in the English-speaking Caribbean / Políticas para la salud mental y desarrollo de sistemas de servicio en el Caribe anglófono

The countries and territories comprising the English-speaking Caribbean (ESC) have made some strides in the development of mental health policy, services and systems with the expenditure in mental health as a percentage of health budgets ranging from 1% to 7%. The ESC countries have well developed primary healthcare systems. However, mental health legislations in many countries are in need of reform. Some countries have developed an innovative community based, secondary care treatment model: treatment in the medical wards of general hospitals. These countries have made progress in integrating mental health into primary healthcare and have made psychotropic medication widely available at the primary care level. Notwithstanding the progress in some countries, greater effort is required in phasing out mental hospitals and integrating mental health into primary care in other ESC countries.

Los países y territorios que comprenden el Caribe Anglófono (CAF) han dado pasos extraordinarios en relación con el desarrollo de políticas, servicios y sistemas de salud mental, de modo tal que los gastos en salud mental en término del porcentaje de presupuestos de salud fluctúan entre el 1% y el 7%. Los países del CAF poseen sistemas de atención primaria de la salud bien desarrollados. Sin embargo, las legislaciones con respecto a la salud mental en muchos países necesitan reformas. Algunos países han desarrollado un modelo innovador comunitario para tratamientos de atención secundaria: tratamiento en las salas de los hospitales generales. Estos países han tenido progresos en cuanto a integrar la salud mental a la atención primaria de la salud, y han puesto la medicación psicotrópica ampliamente a la disposición del nivel de atención primaria. A pesar del progreso en algunos países, se requiere un mayor esfuerzo en cuanto a reducir gradualmente los hospitales psiquiátricos y acelerar la integración de la atención a la salud mental con la atención primaria en otros países anglófonos.

The epidemiology of suicide in Jamaica 2002-2010: rates and patterns / Epidemiología del suicidio en Jamaica de 2002 a 2010: tasas y patrones

OBJECTIVE: Suicide is increasingly recognized as a worldwide problem. There is a paucity of quality data pertaining to suicide in developing countries. Epidemiological analysis of suicide data elucidates prevailing patterns that facilitate risk factor identification and the development of germane programmatic responses. This paper analyses temporal variations in suicide rates for the years 2002-2010 in Jamaica and describes the sociodemographic profile of cases and method of suicide for the latter four years. METHOD: Data pertaining to suicides were extracted from the police (The Jamaica Constabulary Force) records. These were summarized and analysed with respect to person, place and time. Population statistics for the computation of rates were obtained from publications of the Statistical Institute of Jamaica. Age-standardized rates were generated for comparison of trends over time. Poisson and binomial probabilities were used to determine statistically significant differences in rates. RESULTS: Suicide rates in Jamaica have remained relatively stable for the period reviewed with mean overall annual incidence of 2.1 per 100 000 population. Rates for males were significantly higher than those for females. The majority (90.4%) of suicide cases were males. A trend for higher rates of suicide was generally noted in the 25-34-year and the 75-year and over age groups. Hanging was the main method used to commit suicide (77.5%). CONCLUSIONS: Age-adjusted rates of suicide indicate no significant changes in Jamaica over the period 2002 to 2010. Continued surveillance of suicide as well as improved recording of the circumstances surrounding suicides are recommended to promote greater understanding of suicides and this will ultimately inform intervention strategies.

OBJETIVO: El suicidio adquiere cada vez mayor reconocimiento como problema mundial. Existe una escasez de datos cualitativos en relación con el suicidio en los países en vías de desarrollo. El análisis epidemiológico de los datos sobre suicidio dilucida los patrones prevalecientes que facilitan la identificación de factores de riesgo y el desarrollo de respuestas programáticas relacionadas. El presente trabajo analiza las variaciones temporales de las tasas de suicidio durante los años 2002-2010 en Jamaica, y describe el perfil demográfico de los casos y métodos de suicidio durante los últimos cuatro años. MÉTODO: Datos relacionados con el suicidio fueron tomados de los archivos de la policía (Jamaica Constabulary Force). Los mismos fueron resumidos y analizados con respecto a la persona, el lugar y el tiempo. Se obtuvieron estadísticas de la población para el cómputo de tasas, Las estadísticas fueron tomadas de las publicaciones del Instituto Estadístico de Jamaica. Se generaron tasas estandarizadas por edad con el fin de hacer una comparación de las tendencias a través del tiempo. Se usaron probabilidades binomiales y de Poisson, para determinar las diferencias estadísticamente significativas en las tasas. RESULTADOS: Las tasas de suicidio en Jamaica han permanecido relativamente estables en el periodo bajo estudio, con una incidencia promedio anual general de 2.1 por 100 000 habitantes. Las tasas de los varones fueron significativamente más altas que las de las hembras. La mayoría (90.4%) de los casos de suicidio fueron varones. Se observó generalmente una tendencia a tasas más altas de suicidio en los grupos de edades de 25-34 años, y 75 años o más. El ahorcamiento fue el método principal usado para cometer suicidio (77.5%). CONCLUSIONES: Las tasas de suicidio ajustadas por edad no indican ningún cambio significativo en Jamaica en el periodo de 2002 a 2010. Se recomienda una vigilancia continuada de los actos de suicidio así como el mejoramiento de los registros de las circunstancias en torno a los mismos, a fin de promover un mayor entendiendo de estos, con lo cual se podrán lograr a la larga estrategias de intervención bien informadas.

Suicide among adolescents in Jamaica: what do we know? / El suicidio entre los adolescentes de Jamaica: ¿qué sabemos?

Suicide is increasingly acknowledged as a global problem. Yet little is known worldwide about suicide rates among adolescents. Several social factors that exist in Jamaica present as stressors and may predispose to suicide. Ascertaining prevailing patterns and associated factors is important for crafting interventions. This paper establishes adolescent suicide rates for the years 2007-2010 in Jamaica and provides related epidemiological data. METHOD: Data pertaining to suicides were extracted from standardized data collected by the police. Information regarding the number of suicides among adolescents, 9-19 years of age, was reviewed for the years 2007-2010. Sociodemographic characteristics of cases: gender, location and occupation along with related variables were also examined. Variation of rates over time was ascertained. Statistically significant associations were determined by reference to p-values and confidence intervals. RESULTS: The incidence for suicide in adolescents was 1.1 per 100 000. Rates for males were significantly higher than females. Most suicide cases were students and the majority of cases was from rural areas (65%). Hanging was the main method used to commit suicide (96.2%). Items of clothing were commonly used for this purpose. CONCLUSION: Male adolescent suicide rates showed an upward trend in contrast to the downward trend for females in the four-year period studied. Continued surveillance is needed for greater understanding of adolescent suicides. Collaboration among health services, parents, schools and communities is integral in prevention efforts. Recent media coverage of suicides provides a window of opportunity to galvanize support for research and the development of intervention strategies.

OBJETIVO: El suicidio se reconoce cada vez más como un problema mundial. Sin embargo, poco se sabe sobre las tasas de suicidio entre los adolescentes. Varios factores sociales en Jamaica constituyen factores estresantes que pueden predisponer al suicidio. Determinar los patrones prevalecientes y los factores asociados, resulta importante a la hora de diseñar las intervenciones. El presente trabajo establece tasas de suicidio entre adolescentes en los años 2007-2010 en Jamaica, y proporciona datos epidemiológicos relacionados. MÉTODO: Se extrajeron datos en relación con los suicidios a partir de los datos estandarizados recopilados por la policía. Se examinó la información sobre el número de suicidios entre los adolescentes de 9-19 años de edad, durante los años 2007-2010. También se examinaron las características socio-demográficas de los casos - género, lugar, y ocupación - junto con otras variables relacionadas. Se estableció la variación de las tasas a través del tiempo. Se determinaron las asociaciones estadísticamente significativas mediante nm la referencia a los valores p y los intervalos de confianza. RESULTADOS: La incidencia de suicidios en adolescentes fue 1.1 por 100 000. Las tasas para los varones fueron significativamente más altas que para las hembras. La mayoría de los casos de suicidios se trató de estudiantes, y la mayor parte de los suicidios tuvo lugar en áreas rurales (65%). El ahorcamiento fue el método principal usado para cometer suicidio (96.2%). Artículos de vestir fueron comúnmente usados para este propósito. CONCLUSIÓN: Las tasas de suicidio entre adolescentes varones mostraron una tendencia creciente, en contraste con la tendencia descendente para las hembras en el periodo de cuatro años bajo estudio. Se necesita una vigilancia permanente a fin de lograr una mayor comprensión del suicidio entre adolescentes. La colaboración entre los servicios de salud, los padres, la escuela, y la comunidad, son fundamentales para lograr esfuerzos integrados para prevenir los casos de suicidio. La cobertura reciente de los medios de difusión sobre los casos de suicidio abre una ventana que impulsa el apoyo a la investigación y al desarrollo de estrategias de intervención.

Suicide ideation in Jamaican youth: sociodemographic prevalence, protective and risk factors / Ideación suicida en la juventud jamaicana: prevalencia sociodemográfica, factores de riesgo y factores de protección

OBJECTIVE: To determine the prevalence of suicidal ideation and examine the association between suicidal ideation and sociodemographic characteristics, protective and risk factors among Jamaican youth. METHOD: In this cross-sectional study, an interviewer administered school-based survey was conducted among 2997 students 10-15 years old in Jamaica. Although there were a number of questions on suicide, this paper focusses on one question "During the past year, did you ever seriously consider attempting suicide?" as the measure of suicidal ideation. RESULTS: The prevalence rate of suicidal ideation was 9.7%. Logistic regression analysis revealed that significant correlates of suicidal ideation were being female (odds ratio = 1.49), being depressed (odds ratio = 5.78), living in a rural area (odds ratio = 0.62), likes oneself (odds ratio = 0.58), indulging in aggressive behaviour (odds ratio = 1.43), has considered harming others (odds ratio = 3.11), protective factors in the home (odds ratio = 0.62), involvement in risky behaviour (odds ratio = 1.56) and being teased/bullied (odds ratio = 1.69). CONCLUSION: These findings have implication for prevention and treatment of suicidal behaviour in children and adolescents.

OBJETIVO: Determinar la prevalencia de ideación suicida y examinar la asociación entre la ideación suicida y las características sociodemográficas, así como los factores de protección y riesgo entre la juventud jamaicana. MÉTODO: En este estudio transversal, un entrevistador administró una encuesta escolar entre 2997 estudiantes de 10-15 años de edad en Jamaica. Aunque había varias preguntas sobre el suicidio, el documento se centraba en la siguiente, con el objeto de medir la ideación suicida: "¿Consideraste alguna vez seriamente cometer suicidio el año pasado?" RESULTADOS: La tasa de prevalencia de ideación suicida fue 9.7%. El análisis de regresión logística reveló que los correlatos significativos de ideación suicida fueron: ser mujer (cociente de probabilidades OR = 1.49), estar deprimido (cociente de probabilidades OR = 5.78), vivir en un área rural (cociente de probabilidades OR = 0.62), gustarse a sí mismo (cociente de probabilidades OR = 0.58), permitirse un comportamiento agresivo (cociente de probabilidades OR = 1.43), considerar hacer daño a otros (cociente de probabilidades OR = 3.11), factores de protección en la casa (cociente de probabilidades OR = 0.62), involucrarse en conductas arriesgadas (cociente de probabilidades OR = 1.56) y ser víctima de burla o acoso abusivo (cociente de probabilidades OR = 1.69). CONCLUSIÓN: Estos hallazgos tienen implicaciones en cuanto a prevenir y tratar la conducta suicida en niños y adolescentes.

Suicide among adolescents in Jamaica: what do we know?

UNLABELLED: Suicide is increasingly acknowledged as a global problem. Yet little is known worldwide about suicide rates among adolescents. Several social factors that exist in Jamaica present as stressors and may predispose to suicide. Ascertaining prevailing patterns and associated factors is important for crafting interventions. This paper establishes adolescent suicide rates for the years 2007-2010 in Jamaica and provides related epidemiological data. METHOD: Data pertaining to suicides were extracted from standardized data collected by the police. Information regarding the number of suicides among adolescents, 9-19 years of age, was reviewed for the years 2007-2010. Sociodemographic characteristics of cases: gender, location and occupation along with related variables were also examined. Variation of rates over time was ascertained. Statistically significant associations were determined by reference to p-values and confidence intervals. RESULTS: The incidence for suicide in adolescents was 1.1 per 100 000. Rates for males were significantly higher than females. Most suicide cases were students and the majority of cases was from rural areas (65%). Hanging was the main method used to commit suicide (96.2%). Items of clothing were commonly used for this purpose. CONCLUSION: Male adolescent suicide rates showed an upward trend in contrast to the downward trend for females in the four-year period studied. Continued surveillance is needed for greater understanding of adolescent suicides. Collaboration among health services, parents, schools and communities is integral in prevention efforts. Recent media coverage of suicides provides a window of opportunity to galvanize support for research and the development of intervention strategies.

Mental health policy and service system development in the English-speaking Caribbean.

The countries and territories comprising the English-speaking Caribbean (ESC) have made some strides in the development of mental health policy, services and systems with the expenditure in mental health as a percentage of health budgets ranging from 1% to 7%. The ESC countries have well developed primary healthcare systems. However mental health legislations in many countries are in need of reform. Some countries have developed an innovative community based, secondary care treatment model: treatment in the medical wards of general hospitals. These countries have made progress in integrating mental health into primary healthcare and have made psychotropic medication widely available at the primary care level. Notwithstanding the progress in some countries, greater effort is required in phasing out mental hospitals and integrating mental health into primary care in other ESC countries.

Suicide attempt by self-poisoning: characteristics of suicide attempters seen at the Emergency Room at the University Hospital of the West Indies.

OBJECTIVE: To document the characteristics of self-poisoning suicide attempters who were brought to the University Hospital of the West Indies (UHWI) Emergency Room and to outline the type of drug used in the attempt. METHOD: This was a retrospective study conducted over the period 2005-2009. Data were gathered from patients' case records, log books and the hospital records using a questionnaire developed for this study. The questionnaire examined demographics, parameters of the drug ingested, patient's disposition, and reasons for attempt, final outcome and the type of discharge of patients who reported to the UHWI Emergency Room due to a suicide attempt by self-poisoning. RESULTS: Over the five-year period, 127 cases of suicide attempt by self-poisoning were reported. Significantly more females than males presented to the hospital due to self-poisoning (3:1, chi2 = 33.37; p < 0.001). Of this amount, 96 cases (75.6%) were females and 31 (24.4%) were males. The age group most recorded was 16-30 years (70.8%). The most common reason for the suicide attempt was an interpersonal conflict (52%). The drug category most often used in self-poisoning was analgesics (52%) with acetaminophens being the most common (26.2%). CONCLUSION: These findings are consistent with global suicide trends and indicate an urgent need to develop and implement national preventative and treatment measures for groups known to be at risk of suicidal attempts.

The epidemiology of suicide in Jamaica 2002-2010: rates and patterns.

OBJECTIVE: Suicide is increasingly recognized as a worldwide problem. There is a paucity of quality data pertaining to suicide in developing countries. Epidemiological analysis of suicide data elucidates prevailing patterns that facilitate risk factor identification and the development of germane programmatic responses. This paper analyses temporal variations in suicide rates for the years 2002-2010 in Jamaica and describes the sociodemographic profile of cases and method of suicide for the latter four years. METHOD: Data pertaining to suicides were extracted from the police (The Jamaica Constabulary Force) records. These were summarized and analysed with respect to person, place and time. Population statistics for the computation of rates were obtained from publications of the Statistical Institute of Jamaica. Age-standardized rates were generated for comparison of trends over time. Poisson and binomial probabilities were used to determine statistically significant differences in rates. RESULTS: Suicide rates in Jamaica have remained relatively stable for the period reviewed with mean overall annual incidence of 2.1 per 100 000 population. Rates for males were significantly higher than those for females. The majority (90.4%) of suicide cases were males. A trend for higher rates of suicide was generally noted in the 25-34-year and the 75-year and over age groups. Hanging was the main method used to commit suicide (77.5%). CONCLUSIONS: Age-adjusted rates of suicide indicate no significant changes in Jamaica over the period 2002 to 2010. Continued surveillance of suicide as well as improved recording of the circumstances surrounding suicides are recommended to promote greater understanding of suicides and this will ultimately inform intervention strategies.

Depressive symptoms in adolescents in Jamaica.

BACKGROUND: Depression in adolescents is often overlooked and misdiagnosed; however it is an important mental health problem which is associated with major functional impairments across daily domains of living, and considerable morbidity. The aim of this research is to examine the prevalence of self-reported depressive symptoms among Jamaican adolescents, and the associated sociodemographic factors. SUBJECTS AND METHOD: This cross-sectional study included 3003 students between 10 and 15 years old in Jamaica. Survey methodology was used in the collection of the data. RESULTS: Of the sample of students, 47% were males. One hundred and thirty-four (4.5%) reported having depressive symptoms. The factors significantly associated with depressive symptoms were negative community attributes (B = 1.1; p = 0.001), protective factors within the home (B = 0.72; p = 0.000), gender (B = 1.92; p = 0.000), and learning problems (B = 3.1; p = 0.000). CONCLUSION: Results indicate rates of depressive symptomatology reported among adolescents in Jamaica are consistent with rates reported in the literature.

Suicide ideation in Jamaican youth: sociodemographic prevalence, protective and risk factors.

OBJECTIVE: To determine the prevalence of suicidal ideation and examine the association between suicidal ideation and sociodemographic characteristics, protective and risk factors among Jamaican youth. METHOD: In this cross-sectional study, an interviewer administered school-based survey was conducted among 2997 students 10-15 years old in Jamaica. Although there were a number of questions on suicide, this paper focusses on one question "During the past year did you ever seriously consider attempting suicide?" as the measure of suicidal ideation. RESULTS: The prevalence rate of suicidal ideation was 9.7%. Logistic regression analysis revealed that significant correlates of suicidal ideation were being female (odds ratio = 1.49), being depressed (odds ratio = 5.78), living in a rural area (odds ratio = 0.62), likes oneself (odds ratio = 0.58), indulging in aggressive behaviour (odds ratio = 1.43), has considered harming others (odds ratio = 3.11), protective factors in the home (odds ratio = 0.62), involvement in risky behaviour (odds ratio = 1.56) and being teased/bullied (odds ratio = 1.69). CONCLUSION: These findings have implication for prevention and treatment of suicidal behaviour in children and adolescents.

Prevalence of the metabolic syndrome in patients presenting to the university hospital of the West Indies: a need to adopt proactive screening and specific management policy.

Studies have shown that the metabolic syndrome (MetS), a major risk factor for the development of Type 2 diabetes mellitus and cardiovascular disease, is higher among psychiatric patients on antipsychotic medications than the general population. While studies on the prevalence of MetS in the Jamaican adult population have been undertaken, no such study has been done on the corresponding psychiatric population. The purpose of this study was to determine the prevalence of MetS in a Jamaican adult psychiatric inpatient population. The study group comprised thirty-eight patients with a primary DSM-IV-TR Axis 1 diagnosis. Criteria for the diagnosis of MetS were the presence of any three or more of five factors as defined by using the International Diabetes Federation (IDF) and American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) consensus agreement. The prevalence of MetS in this cohort was 28.9% and was associated with significantly higher abdominal obesity (p = 0.010), elevated blood pressure (p = 0.000), elevated triglycerides (p = 0.019) and low high density lipoprotein-cholesterol (p = 0.016) when compared with patients not diagnosed with MetS. Metabolic syndrome was common in this group of psychiatric patients and likely represents a pathway to the future development of Type 2 diabetes mellitus and cardiovascular disease. Screening and continuous monitoring will allow for early intervention and possibly prevention of increased morbidity and mortality in this vulnerable population.

Decriminalization of marijuana: is this a realistic public mental health policy for Jamaica?

Marijuana has potential benefits and adverse effects. Despite its popularity in Jamaica, decriminalization may not be possible given the international and regional obligations of Jamaica.