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  • 1.
    DeVylder, Jordan E
    et al.
    University of Maryland, Baltimore, USA.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Unick, Jay
    University of Maryland, Baltimore, USA.
    Oh, Hans
    University of California Berkeley, Berkeley, USA / Prevention Research Center, Oakland, USA.
    Nam, Boyoung
    University of Maryland, Baltimore, USA.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Stress Sensitivity and Psychotic Experiences in 39 Low- and Middle-Income Countries2016In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 42, no 6, p. 1353-1362Article in journal (Refereed)
    Abstract [en]

    Stress has a central role in most theories of psychosis etiology, but the relation between stress and psychosis has rarely been examined in large population-level data sets, particularly in low- and middle-income countries. We used data from 39 countries in the World Health Survey (n = 176 934) to test the hypothesis that stress sensitivity would be associated with psychotic experiences, using logistic regression analyses. Respondents in low-income countries reported higher stress sensitivity (P < .001) and prevalence of psychotic experiences (P < .001), compared to individuals in middle-income countries. Greater stress sensitivity was associated with increased odds for psychotic experiences, even when adjusted for co-occurring anxiety and depressive symptoms: adjusted odds ratio (95% CI) = 1.17 (1.15-1.19) per unit increase in stress sensitivity (range 2-10). This association was consistent and significant across nearly every country studied, and translated into a difference in psychotic experience prevalence ranging from 6.4% among those with the lowest levels of stress sensitivity up to 22.2% among those with the highest levels. These findings highlight the generalizability of the association between psychosis and stress sensitivity in the largest and most globally representative community-level sample to date, and support the targeting of stress sensitivity as a potential component of individual- and population-level interventions for psychosis.

  • 2.
    Koyanagi, Ai
    et al.
    Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
    Lara, Elvira
    entro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain / Universidad Autónoma de Madrid, Madrid, Spain.
    Stubbs, Brendon
    South London and Maudsley National Health Service Foundation Trust, London, UK / King's College London, London, UK / Anglia Ruskin University, Chelmsford, UK.
    Carvalho, Andre F
    Federal University of Ceará, Fortaleza, Brazil.
    Oh, Hans
    University of Southern California, Los Angeles, California, USA.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Veronese, Nicola
    National Relevance and High Specialization Hospital, Genova, Italy / National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.
    Vancampfort, Davy
    Katholieke Universiteit Leuven, Leuven, Belgium.
    Chronic Physical Conditions, Multimorbidity, and Mild Cognitive Impairment in Low- and Middle-Income Countries2018In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the association between chronic physical conditions and multimorbidity and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs).

    DESIGN: Nationally representative, cross-sectional, community-based study.

    SETTING: Six countries that participated in the World Health Organization Study on Global Ageing and Adult Health.

    PARTICIPANTS: Individuals aged 50 and older (N=32,715; mean age 62.1 ± 15.6; 51.7% female).

    MEASUREMENTS: The definition of MCI was based on the recommendations of the National Institute on Ageing and Alzheimer's Association. Ten chronic conditions were assessed (angina pectoris, arthritis, asthma, cataract, chronic lung disease, diabetes mellitus, edentulism, hearing problems, hypertension, stroke). Multivariable logistic regression analysis was conducted to assess the association between chronic physical conditions, multimorbidity (≥2 chronic conditions), and MCI.

    RESULTS: The prevalence of multimorbidity was 49.8% (95% confidence interval (CI)=48.1-51.5%) and of MCI was 15.3% (95% CI=14.4-16.3%). After adjustment for potential confounders, edentulism (odds ratio (OR)=1.24), arthritis (OR=1.24), chronic lung disease (OR=1.29), cataract (OR=1.33), stroke (OR=1.94), hearing problems (OR=2.27), and multimorbidity (OR=1.40) were significantly associated with MCI. There was a gradual increase in the likelihood of MCI (1 condition: OR=1.21, 95% CI=1.03-1.42; ≥4 conditions: OR=2.07, 95% CI=1.70-2.52).

    CONCLUSION: These results highlight the need to investigate the underlying mechanisms linking chronic conditions and MCI and whether prevention or treatment of chronic conditions or multimorbidity can reduce the onset of cognitive decline and subsequent dementia, especially in LMICs.

  • 3.
    Koyanagi, Ai
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Universitat de Barcelona, Spain / SIBERSAM, Madrid, Spain.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). niversity of Tokyo, Tokyo, Japan / National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    The association between psychosis and severe pain in community-dwelling adults: Findings from 44 low- and middle-income countries2015In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 69, p. 19-26Article in journal (Refereed)
    Abstract [en]

    Previous studies examining the association between schizophrenia and pain have produced mixed results and data on sub-threshold psychosis or psychotic symptoms and pain are scarce. This study assessed the association between psychosis and severe pain among community-dwelling adults in 44 low- and middle-income countries (LMICs) where no data exists.Data on 235,370 adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past 12-month psychotic symptoms was established using four questions from the Composite International Diagnostic Interview. Participants were categorized into four mutually exclusive groups based on whether they had at least one psychotic symptom and/or a lifetime psychosis or schizophrenia diagnosis. Multivariable logistic regression was used to estimate the association between psychosis and past 30-day severe pain. The prevalence of severe pain among those with 0, 1, 2, ≥3 psychotic symptoms was 8.7%, 16.7%, 21.8%, 30.5% respectively. Compared to those with no psychotic symptoms or diagnosis, the ORs (95%CIs) were: at least one symptom without diagnosis [2.17 (1.99-2.38)]; no symptom with diagnosis [2.33 (1.71-3.17)]; at least one symptom and diagnosis [4.27 (3.20-5.71)]. Associations were partly mediated by chronic physical conditions, anxiety, and depression. Despite some limitations such as the use of a single-item question to assess pain, the results of this study suggest that individuals with psychotic symptoms or a psychosis diagnosis should be systematically assessed for pain, and if necessary, receive treatment for pain and its underlying conditions. Future research on the effect of pain management on psychosis outcome is warranted.

  • 4.
    Koyanagi, Ai
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Fundacio St Joan de Deu, Parc Sanitari St Joan de Deu, Barcelona, Spain / Inst Salud Carlos III, CIBERSAM, Madrid, Spain.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan / Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Tokyo, Japan.
    The Association between Sleep Problems and Psychotic Symptoms in the General Population: A Global Perspective2015In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 38, no 12, p. 1875-1885Article in journal (Refereed)
    Abstract [en]

    Study Objectives: To assess the prevalence of sleep problems and their association with psychotic symptoms using a global database. Design: Community-based cross-sectional study. Setting: Data were analyzed from the World Health Organization's World Health Survey (WHS), a population-based survey conducted in 70 countries between 2002 and 2004. Patients or Participants: 261,547 individuals aged >= 18 years from 56 countries. Interventions: N/A. Measurements and Results: The presence of psychotic symptoms in the past 12 months was established using 4 questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Sleep problems referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression was used to estimate the associations. The overall prevalence of sleep problems was 7.6% and ranged from 1.6% (China) to 18.6% (Morocco). Sleep problems were associated with significantly higher odds for at least one psychotic symptom in the vast majority of countries. In the pooled sample, after adjusting for demographic factors, alcohol consumption, smoking, and chronic medical conditions, having sleep problems resulted in an odds ratio (OR) for at least one psychotic symptom of 2.41 (95% confidence interval [CI] 2.18-2.65). This OR was 1.59 (1.40-1.81) when further adjusted for anxiety and depression. Conclusions: A strong association between sleep problems and psychotic symptoms was observed globally. These results have clinical implications and serve as a basis for future studies to elucidate the causal association between psychotic symptoms and sleep problems.

  • 5.
    Kravchenko, Zhanna
    et al.
    Södertörn University, School of Social Sciences, Sociology.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Japan.
    Koyanagi, Ai
    Univeristy of Barcelona, Spain / Inst Salud Carlos III, CIBERSAM, Madrid, Spain.
    Close Relationships Matter: Family Well-being and its Effects on Health in Russia2015In: Europe-Asia Studies, ISSN 0966-8136, E-ISSN 1465-3427, Vol. 67, no 10, p. 1635-1655Article in journal (Refereed)
    Abstract [en]

    Dramatic fluctuations have occurred in population health in Russia since the collapse of the Soviet Union. Although many factors have been examined in connection with this, there has been little focus on the role of the family, despite evidence from Western studies linking family functioning to individual health. Using data from 1,190 respondents collected during the Moscow Health Survey 2004 we examined the association between family relations and health outcomes. Poorer family functioning was strongly associated with worse self-rated physical health and mental health. Our results suggest that the proximal social environment of the family is important for understanding health outcomes in contemporary Russia.

  • 6.
    Ruchkin, V.
    et al.
    Uppsala University / Yale University Medical School, New Haven, USA / Säter Forensic Psychiatric Clinic.
    Koposov, R. A.
    UiT The Arctic University of Norway, Tromsø, Norway.
    Koyanagi, Ai
    Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Centre for Neurology and Psychiatry (NCNP), Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Suicidal Behavior in Juvenile Delinquents: The Role of ADHD and Other Comorbid Psychiatric Disorders2017In: Child Psychiatry and Human Development, ISSN 0009-398X, E-ISSN 1573-3327, Vol. 48, no 5, p. 691-698Article in journal (Refereed)
    Abstract [en]

    This study evaluated the role of psychiatric morbidity in relation to a history of suicidal behavior, with a particular focus on attention-deficit/hyperactivity disorder (ADHD). Suicidality and psychiatric diagnoses were assessed in 370 incarcerated male juvenile delinquents from Northern Russia using the semi-structured K-SADS-PL psychiatric interview. A lifetime history of suicidal ideation only (24.7 %) and suicidal ideation with suicide attempts (15.7 %) was common. Binary logistic regression analysis was used to assess the role of ADHD and other psychiatric disorders in suicidal ideation and suicide attempts. A history of suicidal ideation and of suicide attempts were associated with higher rates of psychiatric morbidity and with the number of comorbid psychiatric disorders. An ADHD diagnosis was associated with an increased risk for both suicidal ideation and for suicide attempts. The comorbidity of ADHD with drug dependence further increased the risk for suicidal ideation, while ADHD and alcohol dependence comorbidity increased the risk for suicide attempts. Our findings highlight the importance of adequately detecting and treating psychiatric disorders in vulnerable youths, especially when they are comorbid with ADHD.

  • 7.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koyanagi, Ai
    Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Physical multimorbidity and loneliness: A population-based study2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 1, article id e0191651Article in journal (Refereed)
    Abstract [en]

    Multimorbidity has been linked to a variety of negative outcomes although as yet, there has been little research on its association with loneliness. This study examined the association between physical multimorbidity (≥ 2 physical diseases) and loneliness in the general population and its potential mediators. Data came from the Adult Psychiatric Morbidity Survey 2007 (N = 7403, aged ≥16 years). Information was obtained on 20 doctor diagnosed physical conditions that were present in the previous year. An item from the Social Functioning Questionnaire (SFQ) was used to obtain information on loneliness. Multivariable logistic regression analysis was used to examine associations. An increasing number of physical diseases was associated with higher odds for loneliness. Compared to no physical diseases, the odds ratio (OR) (95% confidence interval: CI) for loneliness increased from 1.34 (1.13-1.59) to 2.82 (2.11-3.78) between one and ≥5 physical diseases. This association was particularly strong in the youngest age group (i.e. 16-44 years). The loneliness-physical multimorbidity association was significantly mediated by stressful life events (% mediated 11.1%-30.5%), anxiety (30.2%), and depression (15.4%). Physical multimorbidity is associated with increased odds for loneliness. Prospective research is now needed to further elucidate this association and the factors that underlie it.

  • 8.
    Stickley, Andrew
    et al.
    The University of Tokyo, Japan.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Kawakami, N.
    The University of Tokyo, Japan.
    Childhood adversities and adult-onset chronic pain: Results from the World Mental Health Survey, Japan2015In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 19, no 10, p. 1418-1427Article in journal (Refereed)
    Abstract [en]

    Background: Childhood adversities (CAs) have been associated with adult-onset chronic pain. However, to date, most single country studies on this association have been undertaken in Western countries. This study examined the association in Japan where information is scarce. Methods: Data were drawn from the World Mental Health Survey Japan, a population-based cross-sectional survey undertaken in 11 areas of Japan in 2002-2006. We analyzed data from adults aged ≥20 years who provided information on CAs occurring before age 18 years and chronic pain (n = 1740). Cox proportional hazard models were used to estimate the risk for different forms of adult-onset chronic pain (arthritis/rheumatism, neck/back pain, headache and any pain) as a function of the presence of 11 different types of CA and the number of CAs. Results: In the adjusted models, significant associations were observed between: physical abuse and neck/back pain (HR 2.55) and any pain (HR 1.88); sexual abuse and any pain (HR 2.84). Significant dose-dependent relationships were also observed between a greater number of CAs and some adult-onset chronic pain conditions (neck/back and any pain). Conclusions: The results of this study suggest that in Japan, some forms of CA may be associated with certain types of adult-onset chronic pain, in particular neck/back pain. © 2015 European Pain Federation - EFIC®.

  • 9.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    The Arctic University of Norway, Tromsø, Norway.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, UK.
    Murphy, Adrianna
    London School of Hygiene and Tropical Medicine, London, UK.
    Ruchkin, Vladislav
    Uppsala University.
    Binge drinking and eating problems in Russian adolescents2015In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 39, no 3, p. 540-547Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Binge drinking may be linked to problematic eating behavior, although as yet, little research has been conducted on this association. The objective of this study was to examine the relationship between binge drinking and eating problems in Russian adolescents.

    METHODS: Data were drawn from the Social and Health Assessment, a cross-sectional school-based survey of 6th to 10th grade students (aged 12 to 17 years old) carried out in Arkhangelsk, Russia. Information was collected on various eating problems (worries about weight, feeling fat, excessive eating, fasting and excessive exercise, and purging behaviors) and binge drinking (5 or more drinks in a row). Logistic regression analysis was used to examine the relationship between binge drinking and eating problems.

    RESULTS: Among the 2,488 adolescents included in the statistical analysis, nearly 50% of girls expressed worries about their weight, while 35.0 and 41.5% of adolescent boys and girls reported excessive eating, respectively. The prevalence of purging behaviors (vomiting/using laxatives) was, however, much lower among both sexes (females-2.6%; males-3.3%). In a regression model adjusted for demographic factors and depressive symptoms, among girls, binge drinking was associated with 5 of the 6 eating problems with odds ratios (ORs) ranging from 1.21 (upset about weight gain) to 1.68 (excessive eating). For boys, binge drinking was linked to feeling overweight (OR: 1.47, confidence interval [CI]: 1.20 to 1.81) and vomiting/used laxatives (OR: 4.13, CI: 1.58 to 10.80).

    CONCLUSIONS: Many adolescents in Russia report problematic eating attitudes and behaviors, and eating problems are associated with binge drinking. More research is now needed in this setting to better understand adolescent eating problems and their association with alcohol misuse, so that contextually suitable interventions can be implemented to reduce these behaviors and mitigate their potentially detrimental effects.

  • 10.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    McKee, Martin
    Roberts, Bayard
    Murphy, Adrianna
    Ruchkin, Vladislav
    Binge drinking among adolescents in Russia: Prevalence, risk and protective factors2013In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 38, no 4, p. 1988-1995Article in journal (Refereed)
    Abstract [en]

    Despite evidence that alcohol misuse has been having an increasingly detrimental effect on adolescent wellbeing in Russia in recent years this phenomenon has been little researched. Using data from 2112 children from the Arkhangelsk Social and Health Assessment (SAHA) 2003, this study examined which factors acted as 'risk' or 'protective' factors for adolescent binge drinking within three domains we termed the 'family environment', the 'alcohol environment' and 'deviant behaviour'. The results showed that in the presence of comparatively moderate levels of binge drinking among both boys and girls, being able to access alcohol easily, being unaware of the risks of binge drinking and having peers who consumed alcohol increased the risk of adolescent binge drinking - as did playing truant, smoking and marijuana use, while parental warmth was protective against binge drinking for girls. Our finding that risk and protective factors occur across domains suggests that any interventions targeted against adolescent binge drinking may need to simultaneously focus on risk behaviours in different domains, while at the same time, broader social policy should act to limit the availability of alcohol to adolescents in Russia more generally.

  • 11.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). London School of Hygiene and Tropical Medicine.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    McKee, Martin
    Roberts, Bayard
    Ruchkin, Vladislav
    Peer victimisation and its association with psychological and somatic health problems among adolescents in northern Russia2013In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 7, no 1, article id 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A growing body of evidence from countries around the world suggests that school-based peer victimisation is associated with worse health outcomes among adolescents. So far, however, there has been little systematic research on this phenomenon in the countries of the former Soviet Union. The aim of this study was to examine the relation between peer victimisation at school and a range of different psychological and somatic health problems among Russian adolescents.

    METHODS: This study used data from the Social and Health Assessment (SAHA) - a cross-sectional survey undertaken in Arkhangelsk, Russia in 2003. Information was collected from 2892 adolescents aged 12-17 about their experiences of school-based peer victimisation and on a variety of psychological and somatic health conditions. Logistic regression analysis was used to examine the association between victimisation and health.

    RESULTS: Peer victimisation in school was commonplace: 22.1% of the students reported that they had experienced frequent victimisation in the current school year (girls - 17.6%; boys - 28.5%). There was a strong relationship between experiencing victimisation and reporting worse health among both boys and girls with more victimisation associated with an increased risk of experiencing worse health. Girls in the highest victimisation category had odds ratios ranging between 1.90 (problems with eyes) and 5.26 (aches/pains) for experiencing somatic complaints when compared to their non-victimised counterparts, while the corresponding figures for boys were 2.04 (headaches) and 4.36 (aches/pains). Girls and boys who had the highest victimisation scores were also 2.42 (girls) and 3.33 (boys) times more likely to report symptoms of anxiety, over 5 times more likely to suffer from posttraumatic stress and over 6 times more likely to experience depressive symptoms.

    CONCLUSION: Peer victimisation at school has a strong association with poor health outcomes among Russian adolescents. Effective school-based interventions are now urgently needed to counter the negative effects of victimisation on adolescents' health in Russia.

  • 12.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    Razvodovsky, Yury
    Ruchkin, Vladislav
    Adolescent binge drinking and risky health behaviours: Findings from northern Russia.2013In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 133, no 15, p. 838-844Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Some evidence suggests that in recent years the prevalence of heavy drinking has increased among Russian adolescents. However, as yet, little is known about either heavy alcohol consumption or its relationship with other adolescent health risk behaviours in Russia. The aim of this study therefore was to investigate the association between binge drinking and health risk behaviours among adolescents in Russia.

    METHODS: Data were drawn from the Social and Health Assessment (SAHA), a survey carried out in Arkhangelsk, Russia in 2003. Information was obtained from a representative sample of 2868 adolescents aged 13-17 regarding the prevalence and frequency of binge drinking (five or more drinks in a row in a couple of hours) and different forms of substance use, risky sexual behaviour and violent behaviour. Logistic regression analysis was used to examine the association between binge drinking and adolescent involvement in various health risk behaviours.

    RESULTS: Adolescent binge drinking was associated with the occurrence of every type of health risk behaviour - with the sole exception of non-condom use during last sex. In addition, there was a strong association between the number of days on which binge drinking occurred and the prevalence of many health risk behaviours.

    CONCLUSIONS: Binge drinking is associated with a variety of health risk behaviours among adolescents in Russia. Public health interventions such as reducing the affordability and accessibility of alcohol are now needed to reduce binge drinking and its harmful effects on adolescent well-being.

  • 13.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    The Arctic University of Norway, Tromsø, Norway .
    Schwab-Stone, Mary
    Yale University Medical School, New Haven, CT, USA .
    Ruchkin, Vladislav
    Karolinska Institutet.
    Loneliness and health risk behaviours among Russian and US adolescents: a cross-sectional study2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 366Article in journal (Refereed)
    Abstract [en]

    Background: For some adolescents feeling lonely can be a protracted and painful experience. It has been suggested that engaging in health risk behaviours such as substance use and sexual behaviour may be a way of coping with the distress arising from loneliness during adolescence. However, the association between loneliness and health risk behaviour has been little studied to date. To address this research gap, the current study examined this relation among Russian and U.S. adolescents. Methods: Data were used from the Social and Health Assessment (SAHA), a school-based survey conducted in 2003. A total of 1995 Russian and 2050 U.S. students aged 13-15 years old were included in the analysis. Logistic regression was used to examine the association between loneliness and substance use, sexual risk behaviour, and violence. Results: After adjusting for demographic characteristics and depressive symptoms, loneliness was associated with a significantly increased risk of adolescent substance use in both Russia and the United States. Lonely Russian girls were significantly more likely to have used marijuana (odds ratio [OR]: 2.28; confidence interval [CI]: 1.17-4.45), while lonely Russian boys had higher odds for past 30-day smoking (OR, 1.87; CI, 1.08-3.24). In the U.S. loneliness was associated with the lifetime use of illicit drugs (excepting marijuana) among boys (OR, 3.09; CI, 1.41-6.77) and with lifetime marijuana use (OR, 1.79; CI, 1.26-2.55), past 30-day alcohol consumption (OR, 1.80; CI, 1.18-2.75) and past 30-day binge drinking (OR, 2.40; CI, 1.56-3.70) among girls. The only relation between loneliness and sexual risk behaviour was among Russian girls, where loneliness was associated with significantly higher odds for ever having been pregnant (OR, 1.69; CI: 1.12-2.54). Loneliness was not associated with violent behaviour among boys or girls in either country. Conclusion: Loneliness is associated with adolescent health risk behaviour among boys and girls in both Russia and the United States. Further research is now needed in both settings using quantitative and qualitative methods to better understand the association between loneliness and health risk behaviours so that effective interventions can be designed and implemented to mitigate loneliness and its effects on adolescent well-being.

  • 14.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Ferlander, Sara
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Sabawoon, W
    University of Tokyo, Tokyo, Japan.
    McKee, M
    London School of Hygiene and Tropical Medicine, London, UK.
    Loneliness and health in Eastern Europe: findings from Moscow, Russia2015In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 29, no 4, p. 403-410Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine which factors are associated with feeling lonely in Moscow, Russia, and to determine whether loneliness is associated with worse health.

    STUDY DESIGN: Cross-sectional study.

    METHODS: Data from 1190 participants were drawn from the Moscow Health Survey. Logistic regression analysis was used to examine which factors were associated with feeling lonely and whether loneliness was linked to poor health.

    RESULTS: Almost 10% of the participants reported that they often felt lonely. Divorced and widowed individuals were significantly more likely to feel lonely, while not living alone and having greater social support reduced the risk of loneliness. Participants who felt lonely were more likely to have poor self-rated health (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.38-3.76), and have suffered from insomnia (OR: 2.43; CI: 1.56-3.77) and mental ill health (OR: 2.93; CI: 1.88-4.56).

    CONCLUSIONS: Feeling lonely is linked to poorer health in Moscow. More research is now needed on loneliness and the way it affects health in Eastern Europe, so that appropriate interventions can be designed and implemented to reduce loneliness and its harmful impact on population well-being in this setting.

  • 15.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Richardson, Erica
    Roberts, Bayard
    Balabanova, Dina
    McKee, Martin
    Prevalence and factors associated with the use of alternative (folk) medicine practitioners in 8 countries of the former Soviet Union2013In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 13, p. 83-Article in journal (Refereed)
    Abstract [en]

    Background: Research suggests that since the collapse of the Soviet Union there has been a sharp growth in the use of complementary and alternative medicine (CAM) in some former Soviet countries. However, as yet, comparatively little is known about the use of CAM in the countries throughout this region. Against this background, the aim of the current study was to determine the prevalence of using alternative (folk) medicine practitioners in eight countries of the former Soviet Union (fSU) and to examine factors associated with their use. Methods: Data were obtained from the Living Conditions, Lifestyles and Health (LLH) survey undertaken in eight former Soviet countries (Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine) in 2001. In this nationally representative cross-sectional survey, 18428 respondents were asked about how they treated 10 symptoms, with options including the use of alternative (folk) medicine practitioners. Multivariate logistic regression analysis was used to determine the factors associated with the treatment of differing symptoms by such practitioners in these countries. Results: The prevalence of using an alternative (folk) medicine practitioner for symptom treatment varied widely between countries, ranging from 3.5% in Armenia to 25.0% in Kyrgyzstan. For nearly every symptom, respondents living in rural locations were more likely to use an alternative (folk) medicine practitioner than urban residents. Greater wealth was also associated with using these practitioners, while distrust of doctors played a role in the treatment of some symptoms. Conclusions: The widespread use of alternative (folk) medicine practitioners in some fSU countries and the growth of this form of health care provision in the post-Soviet period in conditions of variable licensing and regulation, highlights the urgent need for more research on this phenomenon and its potential effects on population health in the countries in this region.

  • 16.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of London.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Roberts, Bayard
    University of London.
    Richardson, Erica
    University of London.
    Abbott, Pamela
    University of Aberdeen.
    Tumanov, Sergei
    Lomonosov Moscow State University.
    McKee, Martin
    University of London.
    Loneliness: Its Correlates and Association with Health Behaviours and Outcomes in Nine Countries of the Former Soviet Union2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 7, article id e67978Article in journal (Refereed)
    Abstract [sv]

    Background: Research suggests that the prevalence of loneliness varies between countries and that feeling lonely may be associated with poorer health behaviours and outcomes. The aim of the current study was to examine the factors associated with loneliness, and the relationship between feeling lonely and health behaviours and outcomes in the countries of the former Soviet Union (FSU) - a region where loneliness has been little studied to date.

    Methods: Using data from 18,000 respondents collected during a cross-sectional survey undertaken in nine FSU countries Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine - in 2010/11, country-wise logistic regression analysis was conducted to determine: the factors associated with feeling lonely; the association between feeling lonely and alcohol consumption, hazardous drinking and smoking; and whether feeling lonely was linked to poorer health (i.e. poor self-rated health and psychological distress).

    Results: The prevalence of loneliness varied widely among the countries. Being divorced/widowed and low social support were associated with loneliness in all of the countries, while other factors (e.g. living alone, low locus of control) were linked to loneliness in some of the countries. Feeling lonely was connected with hazardous drinking in Armenia, Kyrgyzstan and Russia but with smoking only in Kyrgyzstan. Loneliness was associated with psychological distress in all of the countries and poor self-rated health in every country except Kazakhstan and Moldova.

    Conclusions: Loneliness is associated with worse health behaviours and poorer health in the countries of the FSU. More individual country-level research is now needed to formulate effective interventions to mitigate the negative effects of loneliness on population well-being in the FSU.

  • 17.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of London.
    Koyanagi, Ai
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Roberts, Bayard
    Rotman, David
    McKee, Martin
    Criminal victimisation and health: Examining the relation in nine countries of the former Soviet Union2013In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 91, p. 76-83Article in journal (Refereed)
    Abstract [en]

    Previous research suggests that criminal victimisation can impact negatively on both physical and psychological health. However, as yet, little is known about crime and its effects on population health in the former Soviet Union (fSU) - despite a sharp growth in crime rates in the countries in this region after the collapse of the communist system. Given this gap in current knowledge, this study examined two forms of crime, theft and violent victimisation, in nine fSU countries - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Using nationally representative data from the Health in Times of Transition (HITT) study collected from 18,000 respondents in 2010/11, the study had two main objectives: (1) to identify which demographic and socioeconomic factors are associated with being a victim of crime; (2) to examine the relation between criminal victimisation and two health outcomes - self-rated health and psychological distress. We found that similar factors were associated with experiencing both forms of crime among respondents. Those who were younger, not married and who consumed alcohol more frequently were at increased risk of victimisation, while greater social capital was associated with lower odds for victimisation. Low education increased the risk of experiencing violence by 1.5 times. Victimisation was strongly associated with poorer health: victims of violence were 2.5 and 2.9 times more likely to report poor self-rated health and psychological distress, respectively, while the corresponding figures for theft victimisation were 1.9 and 1.8. The strong association we observed between criminal victimisation and poorer individual health suggests that, in addition to policies that reduce rates of crime, more research is now urgently needed on victimisation. Specifically, researchers should ascertain whether the association with poor health is causal, determine its potential mechanisms, and evaluate interventions that might mitigate its impact on health that are contextually appropriate in the fSU.

  • 18.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Centre for Neurology and Psychiatry (NCNP), Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, CIBERSAM, Madrid, Spain.
    Takahashi, H.
    National Centre for Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Ruchkin, V.
    Yale University Medical School, New Haven, USA / Uppsala University.
    Inoue, Y.
    University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Kamio, Y.
    National Centre for Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder and physical multimorbidity: A population-based study2017In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 45, p. 227-234Article in journal (Refereed)
  • 19.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Santini, Ziggi Ivan
    University of Southern Denmark, Copenhagen, Denmark.
    Koyanagi, Ai
    Universitat de Barcelona, Fundació Sant Joan de Déu/CIBERSAM, Barcelona, Spain.
    Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland.2017In: BMC Urology, ISSN 1471-2490, E-ISSN 1471-2490, Vol. 17, no 1, article id 29Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland.

    METHODS: Data were analyzed from 6903 community-dwelling adults aged ≥ 50 collected in the first wave of The Irish Longitudinal Study on Ageing (TILDA) in 2009-11. Information was obtained on the self-reported occurrence (yes/no) and severity (frequency/activity limitations) of UI in the past 12 months. Loneliness was measured using the UCLA Loneliness Scale short form. Information was also obtained on depression (CES-D), anxiety (HADS-A) and other sociodemographic variables. Logistic regression analysis was used to examine the association between variables.

    RESULTS: In a model adjusted for all potential confounders except mental disorders, compared to no UI, any UI was associated with significantly higher odds for loneliness (odds ratio: 1.51). When depression was included in the analysis, the association was attenuated and became non-significant while the inclusion of anxiety had a much smaller effect. Similarly, although frequency of UI and activity limitations due to UI were both significantly associated with loneliness prior to adjustment for mental disorders, neither association remained significant after adjustment for both depression and anxiety.

    CONCLUSION: UI is associated with higher odds for loneliness among older community-dwelling adults but this association is largely explained by comorbid mental health problems, in particular, depression.

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