Itsuko Horiguchi

Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys

BACKGROUND Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity. AIMS To examine the associations of parent with respondent disorders. METHOD Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews. RESULTS Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0-19.9%) than other (7.1-14.0%) disorders. CONCLUSIONS Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders.

Relationship between an Interview-Based Health Promotion Program and Cardiovascular Risk Factors at Japanese Companies

Relationship between an Interview‐Based Health Promotion Program and Cardiovascular Risk Factors at Japanese Companies: Takashi Shimizu, et al. Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan— The present study investigated the relationship between an interview‐based health promotion program and cardiovascular risk factors at manufacturing companies. Excluding insufficient data and the workers who took medication prescribed by a physician in 1993, the subjects were six hundred and twenty‐nine 18–55‐yr‐old employees who had been working at two manufacturing companies in Kyushu from 1993 to 1997. The intervention company introduced an interview‐based health promotion program from 1993. The program consisted of health measuring, group education, and health interviewing all employees to help with their behavioral change. We subdivided the subjects into younger (18–34‐yr‐old) and older (35– 55‐yr‐old) groups. We defined changing degree (∆) with (the following data in 1997) minus (the initial data in 1993). With agreement of the subject companies, we compared the ∆ of each item, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (T‐cho), serum aspartate aminotransaminase (AST), serum alanine aminotransferase (ALT), and serum gammaglutamyl transpeptidase (GGTP), in the intervention with that in the reference. BMI and SBP decreased significantly after the program in the under 35‐yr‐old intervention group. On the other hand, Tcho, AST, ALT, and GGTP decreased and HDL increased significantly after the program in the over 34‐yr‐old intervention group. Our results showed that the worksite health promotion had the potential to improve cardiovascular risk factors of Japanese employees.

Relationship between Turnover and Periodic Health Check-Up Data among Japanese Hospital Nurses: A Three-Year Follow-Up Study

Relationship between Turnover and Periodic Health Check‐Up Data among Japanese Hospital Nurses: A Three‐year Follow‐Up Study: Takashi Shimizu, et al. University of Occupational and Environmental Health—The present study explored the relationship between turnover and periodic health check‐up data among Japanese hospital nurses. The subjects were 379 registered nurses in a Japanese hospital and the duration of our study period was three years. By the proportional hazard model, we investigated the relative risks (RRs) of the turnover rate associated with the following: lifestyles (irregularity of meals, taking breakfast), work environment (working hours, work schedule), and health status (body mass index [BMI], serum total cholesterol [T‐cho], taking medication, sleep disturbance). We obtained the data on turnover from October, 1997 to September, 2000. During the observed period we were able to follow up on 363 female nurses (96%) and the turnover total amongst them was 100. We divided the subjects into a younger (21–25‐yr‐old) and an older (>25‐yr‐old) group because of the interaction between age and turnover. In the younger group, we found that sleep disturbance influenced turnover significantly. On the other hand, in the older nurses, BMI and T‐cho contributed to turnover significantly. Our results imply the possibility of a partial association between turnover and periodic health check‐up data among the nurses.

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

AbstractOur aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Under-reporting bipolar disorder in large-scale epidemiologic studies

BACKGROUND To investigate if the prevalence of bipolar disorder in epidemiologic studies is an underestimate, as suggested by clinical studies. METHODS We analyzed data from 8 countries that participated in the World Mental Health Survey Initiative (n=47,552). We identified 6.8% and 18.9% of the sample who we think were screened out inappropriately (SCI) from the euphoric and irritable bipolar sections respectively. We compared them to those who were allowed to continue the section (CONT, 2.6% of the sample for euphoric; 1.0% for irritable) and to the reference group (REF, 69.5% of the sample). RESULTS The SCI group had consistently higher rates of major depression (29.1% vs. 6.4%), earlier age of onset (24.3y vs. 32.4y), more suicide attempts (13.3% vs. 5.9%), and more episodes (4.2 vs. 2.7) than the REF for the euphoric group. Similar findings exist for the irritable group. Also, comorbidity with anxiety, disruptive behavior disorders and substance use were much higher than the REF. LIMITATIONS As with all epidemiologic studies, recall bias cannot be ruled out. CONCLUSIONS The findings above suggest that a number of the SCI subjects belong to the bipolar group. A revision of instruments used in epidemiologic research will probably prove what clinical studies have been showing that bipolar disorder is more common than has been reported.

The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative

BackgroundThere is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis.MethodsData from 28 community surveys in the WMH Survey Initiative, with 142,405 respondents, were analyzed. We assessed the 30-day, 12-month, and lifetime prevalence of SAD, age of onset, and severity of role impairment associated with SAD, across countries. In addition, we investigated socio-demographic correlates of SAD, comorbidity of SAD with other mental disorders, and treatment of SAD in the combined sample. Cross-tabulations were used to calculate prevalence, impairment, comorbidity, and treatment. Survival analysis was used to estimate age of onset, and logistic regression and survival analyses were used to examine socio-demographic correlates.ResultsSAD 30-day, 12-month, and lifetime prevalence estimates are 1.3, 2.4, and 4.0% across all countries. SAD prevalence rates are lowest in low/lower-middle income countries and in the African and Eastern Mediterranean regions, and highest in high income countries and in the Americas and the Western Pacific regions. Age of onset is early across the globe, and persistence is highest in upper-middle income countries, Africa, and the Eastern Mediterranean. There are some differences in domains of severe role impairment by country income level and geographic region, but there are no significant differences across different income level and geographic region in the proportion of respondents with any severe role impairment. Also, across countries SAD is associated with specific socio-demographic features (younger age, female gender, unmarried status, lower education, and lower income) and with similar patterns of comorbidity. Treatment rates for those with any impairment are lowest in low/lower-middle income countries and highest in high income countries.ConclusionsWhile differences in SAD prevalence across countries are apparent, we found a number of consistent patterns across the globe, including early age of onset, persistence, impairment in multiple domains, as well as characteristic socio-demographic correlates and associated psychiatric comorbidities. In addition, while there are some differences in the patterns of impairment associated with SAD across the globe, key similarities suggest that the threshold for diagnosis is similar regardless of country income levels or geographic location. Taken together, these cross-national data emphasize the international clinical and public health significance of SAD.

Alcohol Abuse in Developed and Developing Countries in the World Mental Health Surveys: Socially Defined Consequences or Psychiatric Disorder?

BACKGROUND Previous single country research has raised concerns that: (1) the DSM-IV diagnosis of alcohol abuse (AA) is met primarily through the hazardous use criterion related to drinking and driving and (2) that the hazardous use and social consequences AA criteria primarily reflect varying socioeconomic and cultural factors rather than psychiatric disorder. METHODS Using representative cross-national data from the 21 countries in the World Mental Health surveys, adults meeting DSM-IV lifetime criteria for AA but not dependence from 10 developed (n=46,071) and 11 developing (n=49,761) countries were assessed as meeting AA with the hazardous use or the social consequences criteria. RESULTS Between 29.3% (developed) and 16.2% (developing) of respondents with AA met only the hazardous use criterion. AA cases with and without hazardous use were similar in age-of-onset, course, predictors, and psychopathological consequences in both developed and developing countries. DISCUSSION AND CONCLUSIONS Despite some associations of the AA criteria with socioeconomic factors, the hazardous use and social consequences criteria were significantly associated with psychiatric predictors and sequelae. The findings indicate that these criteria reflect psychiatric disorder and are appropriate for inclusion as DSM-5 Alcohol Use Disorder criteria. SCIENTIFIC SIGNIFICANCE These findings support a psychiatric rather than a sociocultural view of the hazardous use and social consequences symptoms and provide evidence that they are appropriate diagnostic criteria cross-nationally with utility in a wide range of socioeconomic environments. This suggests consideration for their adoption by ICD-11. Further research is needed on the implications of these results for prevention and treatment.

Sleep Duration, Snoring Prevalence, Obesity, and Behavioral Problems in a Large Cohort of Primary School Students in Japan

Study Objectives Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey. Methods We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The childrens parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics. Results In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school. Conclusions Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school.

Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8–9-year follow up: The Hizen-Oshima study

The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle‐aged and older women, and to determine whether there are differences in risk factors according to age groups.

Usefulness of chair stand time as a surrogate of gait speed in diagnosing sarcopenia

Determining gait speed as a measure of physical performance is recommended in diagnosing sarcopenia. Gait speed measurements require a certain amount of space (e.g. a 6‐m course), and might not be feasible in clinical settings or heath checkup examination sites. We developed a formula to estimate chair stand time based on gait speed, and examined the validity (sensitivity and specificity) of using the estimated chair stand time cut‐off point as a surrogate for the recommended gait speed cut‐off point.