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1.
BMC Psychiatry ; 22(1): 25, 2022 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-35012486

RESUMO

BACKGROUND: The COVID-19 pandemic and its associated national lockdowns have been linked to deteriorations in mental health worldwide. A number of studies analysed changes in mental health indicators during the pandemic; however, these studies generally had a small number of timepoints, and focused on the initial months of the pandemic. Furthermore, most studies followed-up the same individuals, resulting in significant loss to follow-up and biased estimates of mental health and its change. Here we report on time trends in key mental health indicators amongst Danish adults over the course of the pandemic (March 2020 - July 2021) focusing on subgroups defined by gender, age, and self-reported previously diagnosed chronic and/or mental illness. METHODS: We used time-series data collected by Epinion (N=8,261) with 43 timepoints between 20 March 2020 and 22 July 2021. Using a repeated cross-sectional study design, independent sets of individuals were asked to respond to the Copenhagen Corona-Related Mental Health questionnaire at each timepoint, and data was weighted to population proportions. The six mental health indicators examined were loneliness, anxiety, social isolation, quality of life, COVID-19-related worries, and the mental health scale. Gender, age, and the presence of previously diagnosed mental and/or chronic illness were used to stratify the population into subgroups for comparisons. RESULTS: Poorer mental health were observed during the strictest phases of the lockdowns, whereas better outcomes occurred during reopening phases. Women, young individuals (<34 yrs), and those with a mental- and/or chronic illness demonstrated poorer mean time-series than others. Those with a pre-existing mental illness further had a less reactive mental health time-series. The greatest differences between women/men and younger/older age groups were observed during the second lockdown. CONCLUSIONS: People with mental illness have reported disadvantageous but stable levels of mental health indicators during the pandemic thus far, and they seem to be less affected by the factors that result in fluctuating time-series in other subgroups.


Assuntos
COVID-19 , Adulto , Idoso , Controle de Doenças Transmissíveis , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Pandemias , Qualidade de Vida , SARS-CoV-2
2.
Environ Int ; 160: 107051, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34942407

RESUMO

INTRODUCTION: Prenatal exposure to arsenic is suspected to impair fetal health, including congenital malformations. Few studies investigated an association between maternal exposure to arsenic and congenital heart disease. OBJECTIVE: To examine the association between maternal exposure to arsenic through drinking water and congenital heart disease among offspring. METHODS: This nationwide cohort study included all liveborn children in Denmark, 1997-2014. Maternal addresses at fetal age 4 weeks were linked to drinking water supply areas. Exposure was arsenic concentration in drinking water in first trimester in four categories (<0.5 µg/L, 0.5-0.9 µg/L, 1.0-4.9 µg/L, ≥5.0 µg/L). Outcomes were defined as congenital heart disease diagnosed within the first year of life, with sub-categorization of severe, septal defects and valvular heart defect. Associations between arsenic levels and congenital heart disease were analysed using logistic regression, presented as odds ratios (OR) with 95% confidence interval (CI), and adjusted for year of birth, mother's educational level and ethnicity. RESULTS: A total of 1,042,413 liveborn children were included of whom 1.0% had a congenital heart disease. The OR of congenital heart disease was higher among children exposed to all levels of arsenic above 0.5 µg/L; the OR was 1.13 (95% CI: 1.08-1.19) for exposure of 0.5-0.9 µg/L, 1.33 (95% CI: 1.27-1.39) for 1.0-4.9 µg/L and 1.42 (95% CI: 1.24-1.63) for ≥5.0 µg/L. Similar associations were observed for congenital septal defects. The OR was also higher for severe congenital heart disease but at the same level among all exposure levels ≥0.5 µg/L. The OR of congenital valvular heart defects was only higher among children with maternal exposure to arsenic in drinking water ≥5.0 µg/L. The associations were similar for boys and girls. CONCLUSION: The findings indicate that maternal exposure to arsenic in drinking water even at low concentrations (i.e., 0.5-0.9 µg/L) increased the risk of congenital heart disease in the offspring.

3.
J Epidemiol ; 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34776498

RESUMO

BACKGROUND: The EU LifeCycle Project was launched in 2017 to combine, harmonise, and analyse data from more than 250,000 participants across Europe and Australia, involving cohorts participating in the EU-funded LifeCycle Project. The purpose of this cohort description is to provide a detailed overview over the major measures within mental health domains that are available in 17 European and Australian cohorts participating in the LifeCycle Project. METHODS: Data on cognitive, behavioural and psychological development has been collected on participants from birth until adulthood through questionnaire and medical data. We developed an inventory of the available data by mapping individual instruments, domain types, and age groups, providing the basis for statistical harmonization across mental health measures. RESULTS: The mental health data in LifeCycle contain longitudinal and cross-sectional data for ages 0-18+ years, covering domains across a wide range of behavioural and psychopathology indicators and outcomes (including executive function, depression, ADHD and cognition). These data span a unique combination of qualitative data collected through behavioural/cognitive/mental health questionnaires and examination, as well as data from biological samples and indices in the form of brain imaging (MRI, foetal ultrasound) and DNA methylation data. Harmonized variables on a subset of mental health domains have been developed, providing statistical equivalence of measures required for longitudinal meta-analyses across instruments and cohorts. CONCLUSION: Mental health data harmonized through the LifeCycle project can be used to study life course trajectories and exposure-outcome models that examine early life risk factors for mental illness and develop predictive markers for later-life disease.

4.
Pediatr Obes ; : e12871, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34783173

RESUMO

BACKGROUND: Despite the importance of oxytocinergic signalling for satiety regulation and energy balance, the impact of exposure to synthetic oxytocin during childbirth on obesity during childhood remains unknown. OBJECTIVES: To examine the association between oxytocin exposure during labour and the risk of being overweight or obese during childhood. METHODS: Synthetic oxytocin exposure data of mothers from the Danish Medical Birth Registry were linked with self-reported anthropometric data of their children from the Danish National Birth Cohort (5 months-11 years of age). Multinomial logistic regression and latent class growth analyses were performed to determine the association between oxytocin exposure and obesity during childhood. RESULTS: With the exception of the normal weight-to-overweight group between ages 5 and 12 months, none of the other analyses revealed a significant association between synthetic oxytocin use and the risk of being overweight until the age of 11 years. Furthermore, latent class growth analysis did not reveal an association between oxytocin exposure at birth and the risk of being overweight or obese during childhood. CONCLUSIONS: Our analysis of a large cohort of children who varied in their synthetic oxytocin exposure status at childbirth did not reveal an association between oxytocin exposure and the risk of childhood overweight/obesity.

5.
Am J Clin Nutr ; 2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34687208

RESUMO

BACKGROUND: Folate prevents neural tube defects and may play a role in some neurodevelopmental disorders. OBJECTIVE(S): To investigate whether higher intakes of periconceptional or midpregnancy folate as recommended were associated with a reduced risk of offspring cerebral palsy (CP). METHODS: We included participants from the Nordic collaboration cohort consisting of mother-child dyads in the Danish National Birth Cohort and the Norwegian Mother, Father and Child Cohort Study (MOBAND-CP). A total of 190 989 live-born children surviving the first year of life were included. Missing covariate data were multiply imputed. Our exposures were defined as any or no folic acid supplementation in gestational weeks (GWs) -4 to 8 (periconceptional), GWs 9 to 12, and -4 to 12, and supplemental, dietary, and total folate during midpregnancy (GWs 22 to 25). CP overall and the unilateral and bilateral spastic subtypes, as well as CP with low or moderate/high gross motor function impairment were our outcomes of interest. RESULTS: Periconceptional folic acid supplementation was not associated with CP (adjusted odds ratio (aOR) 1.02; 95% confidence intervals (CI) 0.82, 1.28). However, supplementation in GWs 9 to 12 was associated with a reduced risk of CP (aOR 0.74; 0.57, 0.96), and inverse associations were indicated for both the unilateral (aOR 0.68; 0.46, 1.02) and bilateral (aOR 0.70; 0.49, 1.02) spastic subtypes, although not statistically significant. Supplemental or dietary folate in midpregnancy alone were not associated with CP. Strong inverse associations were observed with low gross motor function impairment (aOR 0.49; 0.29, 0.83), while for unilateral CP the aOR was 0.63 (0.34, 1.22) for intakes of ≥ 500 compared to ≤ 199 dietary folate equivalents/day during midpregnancy. CONCLUSIONS: Our findings suggested that folate intakes in GWs 9 to 12 and midpregnancy were associated with a lower risk of CP, while no association was observed for periconceptional supplementation.

6.
Eur J Epidemiol ; 36(10): 993-1004, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34046850

RESUMO

The potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother-child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4-12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07-1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07-1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/induzido quimicamente , Transtorno do Espectro Autista/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Atenção , Transtorno do Espectro Autista/epidemiologia , Desenvolvimento Infantil , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
7.
BMC Musculoskelet Disord ; 22(1): 393, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902525

RESUMO

BACKGROUND: To investigate how screen time and physical activity behavior were associated with spinal pain in pre-adolescence. METHODS: This study included 45,555 pre-adolescents who participated in the 11-year follow-up of the Danish National Birth Cohort. The 11-year follow-up included self-reported information on computer and TV behavior, aspects of physical activity, as well as frequency and intensity of spinal pain (neck-, mid back- and low back pain). Data were linked with parental socioeconomic data from Statistics Denmark registers. Associations were estimated using multinomial logistic regression models. To account for sample selection, we applied inverse probability weighting. RESULTS: Duration of screen time was stepwise associated with the degree of spinal pain. Compared with those spending < 2 h/day in front of a screen, screen time of ≥6 h/day was associated with a substantially increased relative risk ratio (RRR) of severe pain for both girls (RRR: 2.49, 95% CI: 2.13-2.92) and boys (RRR: 1.95, 95% CI: 1.65-2.32). Being physical inactive was likewise associated with higher likelihood of severe spinal pain (RRR: 1.22, 95% CI: 1.10-1.34) relative to those being moderately active. We observed that being physically active was seemingly associated with lower risk of spinal pain among boys with high frequency of screen time. CONCLUSION: Findings indicate that both duration of screen time and physical inactivity are correlated with spinal pain in pre-adolescents with the strongest associations for screen time. Reducing screen time or increasing physical activity might help preventing spinal pain in pre-adolescents, particularly among high frequent screen users. Future prospective studies investigating the causal relationship are necessary.


Assuntos
Atividade Motora , Tempo de Tela , Adolescente , Exercício Físico , Feminino , Humanos , Masculino , Estudos Prospectivos , Comportamento Sedentário
8.
Lancet Reg Health Eur ; 2: 100020, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33870246

RESUMO

Background: In response to the COVID-19 pandemic, governments around the world instituted various public-health measures. Our project aimed to highlight the most significant similarities and differences in key mental-health indicators between four Western and Northern European countries, and identify the population subgroups with the poorest mental-health outcomes during the first months of the pandemic. Methods: We analysed time-series survey data of 205,084 individuals from seven studies from Denmark, France, the Netherlands, and the UK to assess the impact of the pandemic and associated lockdowns. All analyses focused on the initial lockdown phase (March-July 2020). The main outcomes were loneliness, anxiety, and COVID-19-related worries and precautionary behaviours. Findings: COVID-19-related worries were consistently high in each country but decreased during the gradual reopening phases. While only 7% of the respondents reported high levels of loneliness in the Netherlands, percentages were higher in the rest of the three countries (13-18%). In all four countries, younger individuals and individuals with a history of mental illness expressed the highest levels of loneliness. Interpretation: The pandemic and associated country lockdowns had a major impact on the mental health of populations, and certain subgroups should be closely followed to prevent negative long-term consequences. Younger individuals and individuals with a history of mental illness would benefit from tailored public-health interventions to prevent or counteract the negative effects of the pandemic. Individuals across Western and Northern Europe have thus far responded in psychologically similar ways despite differences in government approaches to the pandemic. Funding: See the Funding section.

9.
Eur J Epidemiol ; 36(5): 565-580, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33884544

RESUMO

The Horizon2020 LifeCycle Project is a cross-cohort collaboration which brings together data from multiple birth cohorts from across Europe and Australia to facilitate studies on the influence of early-life exposures on later health outcomes. A major product of this collaboration has been the establishment of a FAIR (findable, accessible, interoperable and reusable) data resource known as the EU Child Cohort Network. Here we focus on the EU Child Cohort Network's core variables. These are a set of basic variables, derivable by the majority of participating cohorts and frequently used as covariates or exposures in lifecourse research. First, we describe the process by which the list of core variables was established. Second, we explain the protocol according to which these variables were harmonised in order to make them interoperable. Third, we describe the catalogue developed to ensure that the network's data are findable and reusable. Finally, we describe the core data, including the proportion of variables harmonised by each cohort and the number of children for whom harmonised core data are available. EU Child Cohort Network data will be analysed using a federated analysis platform, removing the need to physically transfer data and thus making the data more accessible to researchers. The network will add value to participating cohorts by increasing statistical power and exposure heterogeneity, as well as facilitating cross-cohort comparisons, cross-validation and replication. Our aim is to motivate other cohorts to join the network and encourage the use of the EU Child Cohort Network by the wider research community.


Assuntos
Bases de Dados Factuais/normas , Disseminação de Informação , Criança , Pré-Escolar , Estudos de Coortes , Europa (Continente) , Humanos , Saúde Pública
10.
J Epidemiol Community Health ; 75(9): 829-835, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33542032

RESUMO

BACKGROUND: During the COVID-19 pandemic, decreasing rates of hospitalisations for cardiovascular disease raised concerns for undertreatment, particularly for vulnerable groups. We investigated how the initial COVID-19 public lockdown, impacted the risk of being hospitalised with a major cardiovascular event (MCE: myocardial infarction/stroke/heart failure) according to educational level. METHODS: We grouped all Danish residents according to educational attainment level (low, medium, high) and age (40-59, 60-69, ≥70 years). In each group, we calculated the age-standardised and sex standardised risk of MCE hospitalisation in the initial COVID-19 lockdown-period (13 March 2020-3 May 2020) and in the corresponding calendar period in 2019. We calculated age-standardised and sex-standardised risks to investigate whether the COVID-19 lockdown had a differential effect on MCE incidence according to educational level. RESULTS: In the period in 2019, 2700 Danish residents were hospitalised with MCE, compared with only 2290 during the lockdown. During lockdown, the risk of hospitalisation for MCE decreased among residents aged ≥70 with low education (risk difference (RD) -46.2 (-73.2; -19.2) per 100,000) or medium education (RD -23.2 (-50.8; 4.3) per 100 000), but not among residents with high education (RD 5.1 (-32.3; 42.5), per 100 000). The risk of hospitalisation for MCE did not decrease significantly for the younger age groups. CONCLUSIONS: The COVID-19 lockdown is associated with a reduced incidence for MCE, especially among low educated, elderly residents. This raises concern for undertreatment that without clinical awareness and action may widen the educational gap in cardiovascular morbidity and mortality.


Assuntos
COVID-19 , Insuficiência Cardíaca , Infarto do Miocárdio , Pandemias , Quarentena , Acidente Vascular Cerebral , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Escolaridade , Feminino , Insuficiência Cardíaca/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Pandemias/prevenção & controle , Medição de Risco , Acidente Vascular Cerebral/epidemiologia
11.
Occup Environ Med ; 78(4): 286-292, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33531359

RESUMO

OBJECTIVES: Previous epidemiological studies have indicated that solar ultraviolet B radiation (UVR) may have a protective effect on breast cancer. However, the evidence remains inconclusive. Despite the fact that outdoor work history may be considered a reliable measure of long-term UVR exposure, objective information on lifetime employment has not been included in previous investigations focusing on breast cancer. To address this issue, we explored the association between occupational UVR exposure and female breast cancer, including subtypes. METHODS: A total of 38 375 women under the age of 70 years were identified with primary breast cancer using the Danish Cancer Registry. Five female controls born on the same year, alive and free of breast cancer at the time of diagnosis of the index case, were randomly selected from the Danish Civil Registration System. The Danish Supplementary Pension Fund Register was used to retrieve full employment history, and a job exposure matrix was used to assess occupational UVR exposure. Conditional logistic regression with adjustment for important confounders was used to estimate the OR. RESULTS: We observed no overall association between occupational UVR exposure and breast cancer. After the age of 50 years, longer duration of UVR exposure (≥20 years: OR=0.83, 95% CI 0.75 to 0.92) and highest cumulative exposure (OR=0.89, 95% CI 0.83 to 0.95) were inversely associated with risk. Our results did not reflect any notable risk difference by oestrogen receptor status. CONCLUSIONS: This study indicates an inverse association between long-term occupational UVR exposure and late-onset breast cancer. This finding needs further attention in future occupational studies.


Assuntos
Neoplasias da Mama/epidemiologia , Exposição Ocupacional/análise , Raios Ultravioleta , Adulto , Idoso , Dinamarca/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Sistema de Registros , Risco , Luz Solar
12.
Eur J Prev Cardiol ; 28(1): 78-86, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33623976

RESUMO

AIMS: Patients with heart failure and low income have a high mortality risk. We examined whether lower survival among low-income patients with heart failure could be explained by different use of ß -blockers, renin-angiotensin system inhibitors (RASi), and implanted devices compared with high-income patients. METHODS AND RESULTS: We linked Danish national registries to identify patients with new-onset heart failure between 2005 and 2016. A total of 18 308 patients was included in the main analysis. We collected information on medical treatment and device therapy after discharge. We investigated the remaining income disparity if everybody had the same probability of treatment as the high-income patients. We used causal mediation analysis to examine to what extent treatment differences mediate the association between income and 1-year mortality in strata defined by sex and cohabitation status. If low-income patients had the same probability of initiating ß-blockers and RASi treatment as high-income patients, low-income men who lived alone would increase initiation of treatment by 12.4% (CI: 10.0% to 14.9%) and as a result reduce their absolute 1-year mortality by 1.0% (CI: -1.4% to -0.5%). If low-income patients had the same probability of not having breaks in medical treatment and getting device therapy, as high-income patients, low-income patients would increase the probability of not having breaks in treatment between 1.8% and 5.8% and increase the probability of getting device therapy between 1.0% and 3.8%, across strata of sex and cohabitation status. CONCLUSION: Lower rates of treatment initiation appear to mediate the poorer survival seen among patients with heart failure and low income, but only in males living alone.

13.
Am J Epidemiol ; 190(6): 1009-1020, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33230558

RESUMO

Several studies have reported associations between prenatal acetaminophen exposure and behavioral outcomes in young children. We aimed to evaluate the associations of prenatal and postnatal exposures to acetaminophen with behavioral problems in children at age 11 years, using behavioral measures reported by parents and children. We studied 40,934 mother-child pairs from the Danish National Birth Cohort enrolled during 1996-2002. Parent-reported and child-reported Strengths and Difficulties Questionnaire (SDQ) responses were collected during the 11-year follow-up. We estimated risk ratios for behavioral problems including total difficulties as well as internalizing or externalizing behaviors following prenatal (during pregnancy) or postnatal (within the first 18 months after birth) acetaminophen exposure. Parent-reported and child-reported SDQ scores were moderately correlated; higher for externalizing (r = 0.59) than internalizing (r = 0.49) behaviors. Prenatal acetaminophen exposure was associated with 10%-40% higher risks for total difficulties and internalizing and externalizing problems based on parent- or child-reported SDQ, with the association being stronger for greater cumulative weeks of acetaminophen use. Postnatal exposure was associated with 16%-19% higher risks for parent-reported internalizing behaviors, but the associations were weak or null for child-reported scores except for prosocial behavior. Our study corroborates published associations between prenatal exposures to acetaminophen and behavioral problems and extends the literature to early adolescence.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Transtornos do Comportamento Infantil/induzido quimicamente , Comportamento Infantil/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Criança , Transtornos do Comportamento Infantil/psicologia , Estudos de Coortes , Dinamarca , Feminino , Humanos , Pais , Medidas de Resultados Relatados pelo Paciente , Gravidez , Efeitos Tardios da Exposição Pré-Natal/psicologia
14.
Scand J Work Environ Health ; 47(2): 154-162, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025024

RESUMO

Objective The aim of this study was to explore the association between occupational exposure to diesel exhaust and polycyclic aromatic hydrocarbons (PAH), respectively, and breast cancer subtypes. Methods The study included 38 375 women <70 years with incident breast cancer, identified in the Danish Cancer Registry, and 5 breast cancer-free controls per case who were randomly selected from the Danish Civil Registration System and matched on year of birth. Full employment history was obtained for all study subjects from a nationwide pension fund, and exposure to diesel exhaust and PAH was assessed using a job exposure matrix. Conditional logistic regression was used for estimation of odds ratios (OR) with adjustment for reproductive factors and socioeconomic status. Results No noteworthy associations were observed for overall breast cancer in women exposed to diesel exhaust. However, diesel exhaust modestly elevated the risk of estrogen receptor negative breast tumors before age 50 [OR 1.26, 95% confidence interval (CI) 1.09-1.46]. Duration- and dose-response relationships were further observed for this subtype in this age group. No notable risk patterns were generally observed for PAH exposure. Conclusion Occupational exposure to diesel exhaust may increase the risk of early-onset estrogen receptor negative breast tumors in women. Future studies exploring this association are warranted.

15.
Int J Eat Disord ; 54(4): 492-505, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33382143

RESUMO

OBJECTIVE: Binge-eating disorder (BED) was established as a diagnosis in 2013 with the DSM-5 and has been included in the ICD-11 in 2018. In adulthood, BED is prevalent and correlated with somatic and mental health problems. Less is known about BED in adolescence, although this age period could represent a window of opportunity for early intervention. This study aimed to investigate the 1-year prevalence, correlates, and impact of BED symptoms in a community sample of adolescents. METHOD: We included 1,404 girls and 1,105 boys from the 16-years-follow-up of the Copenhagen Child Cohort study, CCC2000. The adolescents self-reported on BED symptoms, weight-status, body perception, mental health problems, and self-rated impact of food and weight-related thoughts and behaviors. Information about socio-economic factors and hospital diagnosed psychiatric disorders were obtained from national registries. RESULTS: A total of 8.5% reported weekly overeating with loss of control (10.9% of girls, 4.8% of boys), and 2.6% (3.6% of girls, 1.2% of boys) reported symptoms consistent with BED according to the DSM-5. Regardless of sex, BED was correlated with concurrent overweight, body-dissatisfaction, low self-esteem, and mental health problems, especially emotional, but also with problems of behavior, inattention, and peer-relations, and with high self-rated impact on everyday life. Immigrant background and lower socio-economy were potential risk factors for BED in boys in this sample. DISCUSSION: BED was prevalent and correlated with mental health problems and overall impact among adolescents in this community sample, indicating the need for clinical attention and intervention towards binge-eating disorder in the adolescent period.


Assuntos
Transtorno da Compulsão Alimentar , Adolescente , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/epidemiologia , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Autorrelato
16.
Scand J Public Health ; 49(1): 79-87, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32907495

RESUMO

Aims: There is a need to document the mental-health effects of the COVID-19 pandemic and its associated societal lockdowns. We initiated a large mixed-methods data collection, focusing on crisis-specific worries and mental-health indicators during the lockdown in Denmark. Methods: The study incorporated five data sources, including quantitative surveys and qualitative interviews. The surveys included a time series of cross-sectional online questionnaires starting on 20 March 2020, in which 300 (3×100) Danish residents were drawn every three days from three population groups: the general population (N=1046), families with children (N=1032) and older people (N=1059). These data were analysed by trend analysis. Semi-structured interviews were conducted with 32 people aged 24-83 throughout Denmark to provide context to the survey results and to gain insight into people's experiences of the lockdown. Results: Absolute level of worries, quality of life and social isolation were relatively stable across all population groups during the lockdown, although there was a slight deterioration in older people's overall mental health. Many respondents were worried about their loved ones' health (74-76%) and the potential long-term economic consequences of the pandemic (61-66%). The qualitative interviews documented significant variation in people's experiences, suggesting that the lockdown's effect on everyday life had not been altogether negative. Conclusions: People in Denmark seem to have managed the lockdown without alarming changes in their mental health. However, it is important to continue investigating the effects of the pandemic and various public-health measures on mental health over time and across national contexts.


Assuntos
COVID-19/psicologia , Indicadores Básicos de Saúde , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distanciamento Físico , Quarentena/legislação & jurisprudência , Quarentena/psicologia , Adulto Jovem
17.
Int J Epidemiol ; 50(2): 446-456, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-32535618

RESUMO

BACKGROUND: Some studies have indicated an increased risk of attention deficit hyperactivity disorder (ADHD) and a small, sex-specific association with autism spectrum disorder (ASD) among children prenatally exposed to obstetric oxytocin. Since oxytocin is widely used in the obstetric ward, these potentially deleterious effects are of concern. Thus, we aimed to examine whether obstetric oxytocin treatment for labour induction or augmentation is associated with ADHD and ASD in offspring born in a two-country design based on data from Denmark and Finland. METHODS: This population-based study used data from national registers in Denmark and Finland. Singletons born in Denmark 2000-10 (n = 577 380) and Finland 1991-2010 (n = 945 543), who survived infancy, were followed until 31 December 2015. ADHD and ASD were defined using diagnostic codes. For ADHD, we also included information on prescribed and redeemed ADHD medication in the definition. Hazards ratios (HRs) with 95% confidence intervals (CI), modelled with age as the underlying time scale, were calculated to estimate the associations. RESULTS: Oxytocin was used in 31% and 46% of the included deliveries in Denmark and Finland, respectively. In crude analyses, prenatal oxytocin was associated with an approximately 20% increased risk of ADHD and ASD, but confounder adjustment attenuated the association. The adjusted HR was 1.03, 95% CI 1.01-1.05, for ADHD and 1.05, 95% CI 1.02-1.08, for ASD. The results were similar in across country and gender. CONCLUSIONS: We found an association between synthetic oxytocin and ADHD or ASD which is unlikely to reflect a causal association and thus should not support the concern of clinical use. Our results help to allay concerns of obstetric use of oxytocin causing ADHD or ASD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno do Deficit de Atenção com Hiperatividade/induzido quimicamente , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/induzido quimicamente , Transtorno do Espectro Autista/epidemiologia , Criança , Dinamarca/epidemiologia , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Ocitocina/efeitos adversos , Gravidez
18.
Occup Environ Med ; 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33093237

RESUMO

OBJECTIVE: To explore associations between occupational exposure to four specific organic solvents, respectively, and female breast cancer, including subtypes. METHODS: Using the Danish Cancer Registry, we identified 38 375 women under age 70 years with primary breast cancer. Five randomly selected breast-cancer-free controls per case matched on year of birth were retrieved from the Danish Civil Registration System . A nationwide pension fund was used to retrieve full employment history, and exposure to 1,1,1-trichloroethane, trichloroethylene (TCE), benzene and toluene was assessed using a job exposure matrix. ORs were estimated using conditional logistic regression with adjustment for reproductive factors and socioeconomic status. RESULTS: Overall results indicated no noteworthy associations between the specific organic solvents and breast cancer before and after age 50 years, except for a small increased risk after age 50 in women exposed to TCE (OR=1.15, 95% CI: 0.97-1.36). After age 50 years, exposure to TCE was associated with a small increased risk in women with over 20 years of latency (OR=1.26, 95% CI: 1.02-1.56). Further, an increased risk of oestrogen receptor positive (ER+) tumours was also observed (OR=1.21, 95% CI: 1.01-1.47), and high cumulative exposure and longer latency also increased the risk of this subtype. CONCLUSION: This study provides limited evidence supporting the association between occupational exposure to each of the four organic solvents and breast cancer. The risk of ER+ breast tumours after age 50 years may be increased in women with TCE exposure, and this possible association therefore needs further attention in future studies.

19.
BMJ Open ; 10(10): e040056, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046476

RESUMO

OBJECTIVES: We assessed social inequalities in child mental health problems (MHPs) and how they are mediated by perinatal factors, childhood illness and maternal mental health in two national birth cohorts. DESIGN: Longitudinal cohort study SETTING: We used data from the UK Millennium Cohort Study and the Danish National Birth Cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: We applied causal mediation analysis to longitudinal cohort data. Socioeconomic conditions (SECs) at birth were measured by maternal education. Our outcome was child MHPs measured by the Strength and Difficulty Questionnaire at age 11. We estimated natural direct, indirect and total effects (TEs) of SECs on MHPs. We calculated the proportion mediated (PM) via three blocks of mediators-perinatal factors (smoking/alcohol use during pregnancy, birth weight and gestational age), childhood illness and maternal mental health. RESULTS: At age 11 years, 9% of children in the UK and 3.8% in Denmark had MHPs. Compared with high SECs, children in low SECs had a higher risk of MHPs (relative risk (RR)=4.3, 95% CI 3.3 to 5.5 in the UK, n=13 112; and RR=6.2, 95% CI 4.9 to 7.8 in Denmark, n=35 764). In the UK, perinatal factors mediated 10.2% (95% CI 4.5 to 15.9) of the TE, and adding maternal mental health tripled the PM to 32.2% (95% CI 25.4 to 39.1). In Denmark, perinatal factors mediated 16.5% (95% CI 11.9 to 21.1) of the TE, and including maternal mental health increased the PM to 16.9% (95% CI 11.2 to 22.6). Adding childhood illness made little difference in either country. CONCLUSION: Social inequalities in child mental health are partially explained by perinatal factors in the UK and Denmark. Maternal mental health partially explained inequalities in the UK but not in Denmark.


Assuntos
Disparidades nos Níveis de Saúde , Saúde Mental , Determinantes Sociais da Saúde , Adulto , Criança , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Análise de Mediação , Gravidez , Reino Unido/epidemiologia
20.
J Epidemiol Community Health ; 74(11): 969-975, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32855260

RESUMO

BACKGROUND: Both adverse childhood experiences (ACEs) and adverse childhood socioeconomic conditions (SECs) in early life are associated with poor outcomes across the life course. However, the complex interrelationships between childhood SECs and ACEs are unclear, as are the consequences for health outcomes beyond childhood. We therefore assessed the extent to which early-life ACEs mediate the relationship between SECs and socioemotional behavioural problems, cognitive disability and overweight/obesity in adolescence. METHODS: We used longitudinal data from the UK Millennium Cohort Study (MSC). Outcomes assessed at age 14 were socioemotional behavioural problems, cognitive disability and overweight/obesity. SECs at birth were measured by maternal education. Potentially mediating ACEs measured up to 5 years were verbal and physical maltreatment, parental drug use, domestic violence, parental divorce, maternal mental illness and high frequency of parental alcohol use. We used counterfactual mediation analysis to assess the extent to which ACEs mediate the association between SECs at birth and behavioural, cognitive and physical outcomes at age 14, estimating total (TE), natural direct and indirect effects, and mediated proportions. RESULTS: Children with disadvantaged SECs were more likely to have socioemotional behavioural problems (relative risk (RR) 3.85, 95% CI 2.48 to 5.97), cognitive disability (RR 3.87, 95% CI 2.33 to 6.43) and overweight/obesity (RR 1.61, 95% CI 1.32 to 1.95), compared to those with more advantaged SECs. Overall, 18% of the TE of SECs on socioemotional behavioural problems was mediated through all ACEs investigated. For cognitive disability and overweight/obese, the proportions mediated were 13% and 19%, respectively. CONCLUSION: ACEs measured up to age 5 years in the MCS explained about one-sixth of inequalities in adolescents behavioural, cognitive and physical outcomes.


Assuntos
Saúde do Adolescente , Experiências Adversas da Infância , Fatores Socioeconômicos , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Escolaridade , Humanos , Recém-Nascido , Reino Unido
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