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8 results

  • Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers

  • Laura Campbell-Sills, Robert J. Ursano, Ronald C. Kessler, Xiaoying Sun, Steven G. Heeringa, Matthew K. Nock, Nancy A. Sampson, Sonia Jain, Murray B. Stein
  • Journal:
    Psychological Medicine / Volume 48 / Issue 10 / July 2018
    Published online by Cambridge University Press:
    17 October 2017, pp. 1624-1633
    Print publication:
    July 2018
  • Background

    Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse.

    Methods

    Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1–2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1–2×/week) and alcohol or substance use disorder (AUD/SUD).

    Results

    Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) – but not combat stress – was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06–1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25–1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08–1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57–4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27–2.70, p = 0.001).

    Conclusions

    Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.

  • The World Health Organization World Mental Health Survey Initiative

  • Ronald C. Kessler, Josep Maria Haro, Steven G. Heeringa, Beth-Ellen Pennell, T. Bedirhan Üstün
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 15 / Issue 3 / September 2006
    Published online by Cambridge University Press:
    18 May 2011, pp. 161-166
    • Article
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  • To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.

  • Lifetime prevalence of psychiatric disorders in South Africa

  • Dan J. Stein, Soraya Seedat, Allen Herman, Hashim Moomal, Steven G. Heeringa, Ronald C. Kessler, David R. Williams
  • Journal:
    The British Journal of Psychiatry / Volume 192 / Issue 2 / February 2008
    Published online by Cambridge University Press:
    02 January 2018, pp. 112-117
    Print publication:
    February 2008
    • Article
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  • Background

    Data on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances.

    Method

    A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups.

    Results

    Lifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).

    Conclusions

    In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.

  • 7 - Comparing data on mental health service use between countries

  • from Part II - Unmet need: general problems and solutions
  • Edited by Gavin Andrews, University of New South Wales, Sydney, Scott Henderson, Australian National University, Canberra
  • Book:
    Unmet Need in Psychiatry
    Published online:
    21 August 2009
    Print publication:
    06 January 2000, pp 97-118

  • Summary

    This chapter presents data on past-year mental health service use, and discusses the practical and methodological issues to be considered when developing a core set of questions about people's use of psychiatric services for use in psychiatric epidemiological surveys. It presents preliminary data on mental health service use from the first four countries that have contributed data on this topic to the International Consortium of Psychiatric Epidemiology (ICPE) master data bank. The chapter also illustrates the use of the multiple data sources by comparing use of any services for mental health problems in the 12 months prior to the survey. It is important to examine the utilization rates for mental health services across countries, adjusting for the presence of disorders. The cross-national comparisons offer over a reasonable basis to generate hypotheses about what accounts for similarities and differences in the rates of mental health service use between countries.