Eleonora Dal Grande

Suicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic events

Objective: To determine the attributable risk for suicidal ideation of depression and psychosocial and traumatic events in a random and representative population. Method: Data were gathered from a random and representative sample of 2501 South Australians. Suicidal ideation and clinical depression were determined by the general health questionnaire (GHQ-28) and the short-form health survey (SF-12) respectively, and information regarding psychosocial stressors and traumatic events was collated. These data were subjected to univariate and multivariate analyses to determine the population-attributable risks for suicidal ideation. Results: Overall, 5.6% of men and 5.3% of women had suicidal ideation. Univariate analyses demonstrated a significant attributable risk for suicidal ideation for depression and the majority of the psychosocial and traumatic events. Multivariate analysis demonstrated that clinical depression remained significantly associated with suicidal ideation, with a population-attributable risk of 46.9%. Because of the small number of people in the population who experience both suicidal ideation and specific events, multivariate analysis could not be applied to individual events. However, even when the psychosocial events were summed, they no longer remained significantly associated with suicidal ideation, whereas the summation of traumatic events remained significant, with a population-attributable risk of 38.0%. Conclusions: These results confirm the importance of traumatic events as significant factors in contributing to suicidal ideation. However, of even greater importance is that they indicate, unequivocally, the magnitude of the contribution of clinical depression to suicidal ideation, with the population-attributable risk of depression indicating that elimination of mood disorders would reduce suicidal ideation by up to 46.9%.

How valid are self-reported height and weight? A comparison between CATI self-report and clinic measurements using a large cohort study

Objective: To examine the relationship between self‐reported and clinical measurements for height and weight in adults aged 18 years and over and to determine the bias associated with using household telephone surveys.

The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases

The North West Adelaide Health Study is a population-based biomedical cohort study investigating the prevalence of a number of chronic conditions and health-related risk factors along a continuum. This methodology may assist with evidence-based decisions for health policy makers and planners, and inform health professionals who are involved in chronic disease prevention and management, by providing a better description of people at risk of developing or already diagnosed with selected chronic conditions for more accurate targeting groups for health gain and improved health outcomes. Longitudinal data will provide information on progression of chronic conditions and allow description of those who move forward and back along the continuum over time. Detailed methods are provided regarding the random recruitment and examination of a representative sample of participants (n = 4060), including the rationale for various processes and valuable lessons learnt. Self-reported and biomedical data were obtained on risk factors (smoking, alcohol consumption, physical activity, family history, body mass index, blood pressure, cholesterol) and chronic conditions (asthma, chronic obstructive pulmonary disease, diabetes) to classify participants according to their status along a continuum. Segmenting this population sample along a continuum showed that 71.5% had at least one risk factor for developing asthma, chronic obstructive pulmonary disease or diabetes. Almost one-fifth (18.8%) had been previously diagnosed with at least one of these chronic conditions, and an additional 3.9% had at least one of these conditions but had not been diagnosed. This paper provides a novel opportunity to examine how a cohort study was born. It presents detailed methodology behind the selection, recruitment and examination of a cohort and how participants with selected chronic conditions can be segmented along a continuum that may assist with health promotion and health services planning.

Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population.

Abstract.Background:A study of the prevalence, use of services and quality of life of those with subsyndromal depression in a random and representative Australian population.Methods:A face-to-face Health Omnibus survey of 3010 respondents administered the mood module of the PRIME-MD and the SF-36 and AQoL quality of life instruments.Results:Subsyndromal depressive symptoms were identified in 12.9% of respondents. There was a gradation of use of services from those with no depression, to those with subsyndromal, other and major depressions. Those with subsyndromal depression scored significantly worse on quality of life measures than those with no depression, but the effect size was small and less than the poorer functioning of those with other depressive syndromes, particularly major depression.Conclusions:Subsyndromal depression is very prevalent in the community and worthy of clinical consideration.

Population attributable risk of major depression for suicidal ideation in a random and representative community sample

BACKGROUND The importance of depression in suicidal behaviour and suicidal ideation is usually determined on clinical samples. However, public health planning also requires population data. This study utilised the population attributable risk statistic in determining the importance of major depression as a contributing factor to suicidal ideation in a random and representative sample of the population. METHOD Major depression and suicidal ideation as well as demographic and clinical data were delineated in a random and representative population sample of 3010 subjects. The population attributable risk statistic was used to determine the contribution of major depression to suicidal ideation. RESULTS Multivariate analysis demonstrated that major depression was the major contributor to the risk for suicidal ideation with a population attributable risk of 56.6%. CONCLUSIONS These results, utilising different measures of depression and suicidal ideation to those few previous population attributable risk studies examining this issue, confirm the overwhelming importance of major depression as a contributing factor to suicidal ideation in the community.

Do people with risky behaviours participate in biomedical cohort studies

BackgroundAnalysis was undertaken on data from randomly selected participants of a bio-medical cohort study to assess representativeness. The research hypotheses was that there was no difference in participation and non-participations in terms of health-related indicators (smoking, alcohol use, body mass index, physical activity, blood pressure and cholesterol readings and overall health status) and selected socio-demographics (age, sex, area of residence, education level, marital status and work status).MethodsRandomly selected adults were recruited into a bio-medical representative cohort study based in the north western suburbs of the capital of South Australia – Adealide. Comparison data was obtained from cross-sectional surveys of randomly selected adults in the same age range and in the same region. The cohort participants were 4060 randomly selected adults (18+ years).ResultsThere were no major differences between study participants and the comparison population in terms of current smoking status, body mass index, physical activity, overall health status and proportions with current high blood pressure and cholesterol readings. Significantly more people who reported a medium to very high alcohol risk participated in the study. There were some demographic differences with study participants more likely to be in the middle level of household income and education level.ConclusionPeople with risky behaviours participated in this health study in the same proportions as people without these risk factors.

Obesity in South Australian adults--prevalence, projections and generational assessment over 13 years.

Objectives: To examine the trend in obesity prevalence using annual representative cross‐sectional samples of the South Australian population, to project the increase of obesity using current trends, and to examine the increase in prevalence by generational assessment.

Detecting determinants of suicidal ideation: South Australian surveillance system results

SummaryObjective:To determine the self reported prevalence of suicidal ideation in South Australia and to examine the relationship of suicidal ideation with a range of risk, social and demographic factors and related health issues using data collected in a risk factor surveillance system.Method:Data were collected using a monthly risk factor surveillance system where each month a representative random sample of South Australian is selected from the Electronic White Pages with interviews conducted using computer assisted telephone interviewing (CATI).Results:In total, 4.7% of South Australian, aged 16 years and over, were determined to have suicidal ideation. There was no change in the trend over the years when surveys between 1997 and 2005 were compared. A wide range of variables were significant with suicidal ideation at the univariate level. In the final multivariate model, marital status, money situation, psychosocial stress (K10), physical activity, fruit consumption, health service use and mental health service use proved to be best joint predictors of suicidal ideation.Conclusions:Suicidal ideation in the community has not increased (or decreased) over time and questions assessing suicidal ideation can be used effectively in a surveillance system.

Is there a difference in health estimates between people with listed and unlisted telephone numbers

Objective: To examine the characteristics of people with a silent telephone by demographic and health‐related issues and to assess the potential bias in telephone surveys that use the White Pages as the sampling frame.

Mental health status of the South Australian population

Objective : To determine, by the use of a telephone survey, the mental health status of SA adults (18+ years) using the GHQ‐28, SF‐12 and self‐report as indicators of mental health, and to examine risk factors for mental health morbidity.