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  • 151.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center for Neurology & Psychiatry, Tokyo, Japan.
    Ng, C F S
    Nagasaki University, Nagasaki, Japan.
    Watanabe, C
    University of Tokyo, Tokyo, Japan.
    Inoue, Y
    University of North Carolina at Chapel Hill, Chapel Hill, USA.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Konishi, S
    University of Tokyo, Tokyo, Japan / University of Washington, Seattle, USA.
    General thoughts of death and mortality: findings from the Komo-Ise cohort, Japan.2019In: Epidemiology and Psychiatric Sciences, ISSN 2045-7960, E-ISSN 1827-4331, Vol. 28, no 6, p. 662-669Article in journal (Refereed)
    Abstract [en]

    AimsDeath ideation (thinking about/wishing for one's own death, thinking that one would be better off dead) is linked to an increased mortality risk. However, comparatively little is known about more general thoughts of death (GTOD) where no wish to die or life value is expressed. This study examined whether GTOD predicted mortality in a community-based cohort of older adults.

    METHODS: Data came from the Komo-Ise cohort study in Gunma prefecture, Japan. The analytic sample comprised 8208 individuals (average age 61.3 (range 47-77)) who were asked in wave 2 of the study in 2000 if they had 'Thought about death more than usual, either your own, someone else's or death in general?' in the past 2 weeks. Death data were obtained from the municipal resident registration file. Cox proportional hazards regression analysis was used to examine associations.

    RESULTS: During the follow-up period (2000-2008), there were 672 deaths. In a model adjusted for baseline covariates, GTOD were significantly associated with all-cause mortality (hazards ratio 1.66, 95% confidence interval 1.20-2.29). Stratified analyses showed an association between GTOD and mortality in men, older subjects (⩾70 years), married individuals and those with higher social support.

    CONCLUSIONS: GTOD are associated with an increased mortality risk among older citizens in Japan. Research is now needed to determine the factors underlying this association and assess the clinical relevance of screening for GTOD in older individuals.

  • 152.
    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.
    Ng, Chris Fook Sheng
    University of Tokyo, Tokyo, JapanUniversity of Tokyo, Tokyo, Japan / Nagasaki Univiversity, Nagasaki, Japan.
    Inoue, Yosuke
    University of Tokyo, Tokyo, Japan.
    Yazawa, Aki
    University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Kodaka, Manami
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    DeVylder, Jordan E.
    University of Maryland, Baltimore, USA.
    Watanabe, Chiho
    University of Tokyo, Tokyo, Japan.
    Birthdays are associated with an increased risk of suicide in Japan: Evidence from 27,007 deaths in Tokyo in 2001-20102016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 200, p. 259-265Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has produced conflicting findings concerning whether birthdays are associated with an increased risk of suicide. This study examined the association in Tokyo, Japan. Methods: Suicide data (ICD-10 codes X60-X84) for the period 2001-2010 were obtained from the Japanese Ministry of Health, Labour and Welfare. A time-stratified case-crossover design was used with conditional logistic regression analysis being performed to estimate within-subject birthday exposures' while controlling for meteorological conditions and public holidays. Results: There were 27,007 suicides in the study period. For males the 5 days before the birthday and the week after the birthday were associated with significantly higher odds for suicide with the odds ratio being highest on the actual birthday (OR =1.677, 95% CI: 1.294, 2.172). For females, significantly higher odds for completed suicide were observed 7-11 days before the birthday. Stratified analyses showed different at risk time patterns among men from different age groups, and that married men had higher odds for suicide on, and for the 4 days before and in the 2 weeks after their birthday. Limitations: We lacked detailed information on suicides which would have enabled a better understanding of the observed associations. Conclusions: Birthdays are associated with an increased risk for suicide in Tokyo, Japan. Health professionals who work with individuals at risk of suicide should be made aware that birthdays are associated with an elevated suicide risk. This information should also be communicated in wider suicide prevention campaigns.

  • 153.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Kodaira, Tokyo, Japan.
    Oh, H.
    University of Southern California, Los Angeles, CA, USA.
    Sumiyoshi, T.
    National Institute of Mental Health, Kodaira, Tokyo, Japan.
    Mckee, M.
    London School of Hygiene and Tropical Medicine, London, UK.
    Koyanagi, A.
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Injury and depression among 212 039 individuals in 40 low- and middle-income countries2020In: Epidemiology and Psychiatric Sciences, ISSN 2045-7960, E-ISSN 1827-4331, Vol. 29, article id e32Article in journal (Refereed)
    Abstract [en]

    AimsAlthough injuries have been linked to worse mental health, little is known about this association among the general population in low- A nd middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey.MethodsCross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations.ResultsThe overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6-3.0%), 4.8% (4.6-5.0%) and 7.4% (7.1-7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48-1.99), and 2.04 (1.85-2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46).ConclusionsAlerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.

  • 154.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Oh, Hans
    University of Southern California, Los Angeles, USA.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / 5Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
    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.
    Narita, Zui
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
    Roberts, Bayard
    London School of Hygiene & Tropical Medicine, London, UK.
    McKee, Martin
    London School of Hygiene & Tropical Medicine, London, UK.
    Perceived discrimination and psychological distress in nine countries of the former Soviet Union2019In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 55, no 2, p. 158-168Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: Perceived discrimination has been linked to worse mental health. However, little is known about this association in the countries of the former Soviet Union (fSU).

    AIM:: To address this deficit, this study examined the link between perceived discrimination and psychological distress in nine fSU countries.

    METHODS:: Data were analyzed from 18,000 adults aged ⩾18 years obtained during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010 and 2011. A single-item measure was used to assess discrimination. Psychological distress was measured with a 12-item scale. Logistic regression analysis and meta-analysis were used to examine associations.

    RESULTS:: After adjusting for all potential confounders, when using none/little discrimination as the reference category, moderate and strong discrimination were associated with significantly increased odds for psychological distress in the total population and in men and women separately with odds ratios ranging from 1.93 to 2.64. Meta-analysis based on country-wise estimates showed that the level of between-country heterogeneity was negligible.

    CONCLUSION:: Perceived discrimination is associated with psychological distress in countries throughout the fSU. Quantitative and qualitative research is now warranted to determine its specific forms and impact on population health in individual fSU countries.

  • 155.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Oh, Hans
    University of Southern California, Los Angeles, USA.
    Sumiyoshi, Tomiki
    Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Narita, Zui
    Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
    DeVylder, Jordan E
    Fordham University, New York, USA.
    Jacob, Louis
    University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France / Universitat de Barcelona, Barcelona, Spain.
    Waldman, Kyle
    University of Southern California, Los Angeles, USA.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / ICREA, Barcelona, Spain.
    Perceived discrimination and psychotic experiences in the English general population2019In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 62, p. 50-57Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population.

    METHODS: Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations.

    RESULTS: In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75-3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40-3.35) for strange experience to 3.36 (95%CI: 1.47-7.76) for auditory hallucination.

    CONCLUSION: Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.

  • 156.
    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.

  • 157.
    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).
    Sheng Ng, C. F.
    Nagasaki University, Nagasaki, Japan.
    Konishi, S.
    University of Tokyo, Tokyo, Japan / University of Washington, Seattle, WA, USA.
    Koyanagi, A.
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, Madrid, Spain.
    Watanabe, C.
    University of Tokyo, Tokyo, Japan.
    Airborne pollen and suicide mortality in Tokyo, 2001–20112017In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 155, p. 134-140Article in journal (Refereed)
    Abstract [en]

    Prior research has indicated that pollen might be linked to suicide mortality although the few studies that have been undertaken to date have produced conflicting findings and been limited to Western settings. This study examined the association between the level of airborne pollen and suicide mortality in Tokyo, Japan in the period from 2001 to 2011. The daily number of suicide deaths was obtained from the Japanese Ministry of Health, Labour and Welfare, with pollen data being obtained from the Tokyo Metropolitan Institute of Public Health. A time-stratified case-crossover study was performed to examine the association between different levels of pollen concentration and suicide mortality. During the study period there were 5185 male and 2332 female suicides in the pollen season (February to April). For men there was no association between airborne pollen and suicide mortality. For women, compared to when there was no airborne pollen, the same-day (lag 0) pollen level of 30 to <100 grains per cm2 was associated with an approximately 50% increase in the odds for suicide (e.g. 30 to <50 grains per cm2: odds ratio 1.574, 95% confidence interval 1.076–2.303, p=0.020). The estimates remained fairly stable after adjusting for air pollutants and after varying the cut-points that defined the pollen levels. Our results indicate that pollen is associated with female suicide mortality in Tokyo.

  • 158.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Sumiyoshi, T
    National Institute of Mental Health, Tokyo, Japan.
    Narita, Z
    Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    Oh, H
    University of Southern California, Los Angeles, CA, USA.
    DeVylder, J E
    Fordham University, New York, NY, USA.
    Jacob, L
    University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France / CIBERSAM, Barcelona, Spain.
    Koyanagi, A
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Physical injury and psychotic experiences in 48 low- and middle-income countries2019In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, p. 1-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- and middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs.

    METHOD: Cross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002-2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression.

    RESULTS: In fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85-2.31], traffic injury (OR 1.84, 95% CI 1.53-2.21) and other injury (OR 2.09, 95% CI 1.84-2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22-2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle).

    CONCLUSIONS: Different types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.

  • 159.
    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 Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Tachibana, Yoshiyuki
    National Medical Centre for Children and Mothers, Tokyo, Japan.
    Hashimoto, Keiji
    National Centre for Child Health and Development (NCCHD), Tokyo, Japan.
    Haraguchi, Hideyuki
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Miyake, Atsuko
    Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Morokuma, Seiichi
    Kyushu University, Fukuoka, Japan.
    Nitta, Hiroshi
    National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.
    Oda, Masako
    Kumamoto University, Kumamoto, Japan.
    Ohya, Yukihiro
    National Center for Child Health and Development (NCCHD), Tokyo, Japan.
    Senju, Ayako
    University of Occupational and Environmental Health, Fukuoka, Japan.
    Takahashi, Hidetoshi
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Yamagata, Takanori
    Jichi Medical University, Tochigi, Japan.
    Kamio, Yoko
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Assessment of Autistic Traits in Children Aged 2 to 4½ Years With the Preschool Version of the Social Responsiveness Scale (SRS-P): Findings from Japan2017In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806, Vol. 10, no 5, p. 852-865Article in journal (Refereed)
    Abstract [en]

    The recent development and use of autism measures for the general population has led to a growing body of evidence which suggests that autistic traits are distributed along a continuum. However, as most existing autism measures were designed for use in children older than age 4, to date, little is known about the autistic continuum in children younger than age 4. As autistic symptoms are evident in the first few years, to address this research gap, the current study tested the preschool version of the Social Responsiveness Scale (SRS-P) in children aged 2 to 4½ years in clinical (N = 74, average age 40 months, 26-51 months) and community settings (N = 357, average age 39 months, 25-50 months) in Japan. Using information obtained from different raters (mothers, other caregivers, and teachers) it was found that the scale demonstrated a good degree of internal consistency, inter-rater reliability and test-retest reliability, and a satisfactory degree of convergent validity for the clinical sample when compared with scores from diagnostic "gold standard" autism measures. Receiver operating characteristic analyses and the group comparisons also showed that the SRS-P total score discriminated well between children with autism spectrum disorder (ASD) and those without ASD. Importantly, this scale could identify autistic symptoms or traits distributed continually across the child population at this age irrespective of the presence of an ASD diagnosis. These findings suggest that the SRS-P might be a sensitive instrument for case identification including subthreshold ASD, as well as a potentially useful research tool for exploring ASD endophenotypes. Autism Res 2016.

  • 160.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Tachimori, Hisateru
    National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Inoue, Yosuke
    University of Tokyo, Tokyo, Japan.
    Shinkai, Takahiro
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Yoshimura, Reiji
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Nakamura, Jun
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Morita, Gihei
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Nishii, Shigeki
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Tokutsu, Yuki
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Otsuka, Yuka
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Egashira, Kazuteru
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Inoue, Miyuki
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Kubo, Takamitsu
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Tesen, Hirofumi
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Takashima, Naoyuki
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Tominaga, Hirotaka
    University of Environmental and Occupational Health, Fukuoka, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Kamio, Yoko
    National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients2018In: Psychiatry and Clinical Neurosciences, ISSN 1323-1316, E-ISSN 1440-1819, Vol. 72, no 9, p. 713-722Article in journal (Refereed)
    Abstract [en]

    AIMS: To examine the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders.

    METHODS: Cross-sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care (the J-PAAP study) which included psychiatric outpatients aged 18-65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan in April 2014 to January 2015 (N=864). The Adult ADHD Self-Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior.

    RESULTS: After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥ 14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose-response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD-10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder ADHD symptoms were significantly linked to all forms of suicidal behavior.

    CONCLUSION: ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior. This article is protected by copyright. All rights reserved.

  • 161.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Waldman, Kyle
    University of Southern California, Los Angeles, CA, USA.
    Koyanagi, Ai
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    DeVylder, Jordan E
    Fordham University, New York, NY, USA.
    Narita, Zui
    Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    Sumiyoshi, Tomiki
    National Institute of Mental Health, Tokyo, Japan.
    Jacob, Louis
    CIBERSAM, Barcelona, Spain / University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
    Oh, Hans
    University of Southern California, Los Angeles, CA, USA.
    Psychotic experiences and accidents, injuries, and poisonings among adults in the United States2019In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 282, article id 112610Article in journal (Refereed)
    Abstract [en]

    Psychotic experiences (PEs) have been linked to an increased risk for accidents and injuries. However, this association remains little researched in many countries. To address this research gap, the current study used cross-sectional data from the United States to examine the association between PEs and accidents, injuries, and poisoning in a general population sample. Data were analyzed from 2274 individuals who completed the psychosis screen as part of the National Comorbidity Survey Replication (NCS-R). Information was obtained on PEs (hallucinations and delusions) and the experience of past 12-month accidents, injuries, and poisoning. Logistic regression analysis was used to examine the association while adjusting for demographic variables and common mental disorders (CMDs). In a fully adjusted model past 12-month PEs were associated with almost three times higher odds for reporting accidents, injuries, and poisoning (odds ratio [OR]: 2.97, 95% confidence interval [CI]: 1.13-7.74). The results of this study indicate that PEs are associated with higher odds for accidents and injuries among adults in the United States. Research is now needed to determine the direction of this association and the factors linked to it.

  • 162.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, Tokyo, Japan.
    Waldman, Kyle
    Harvard University, Cambridge, Massachusetts, USA.
    Sumiyoshi, Tomiki
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Narita, Zui
    Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
    Shirama, Aya
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Shin, Jae Il
    Yonsei University College of Medicine, Seoul, South Korea.
    Oh, Hans
    University of Southern California, Los Angeles, California, USA.
    Childhood physical neglect and psychotic experiences: Findings from the National Comorbidity Survey Replication2020In: Early Intervention in Psychiatry, ISSN 1751-7885, E-ISSN 1751-7893Article in journal (Refereed)
    Abstract [en]

    AIM: Childhood adversities have been linked to an increased risk for psychosis. However, as yet, there has been comparatively little research on the effects of neglect. This study examined the association between childhood physical neglect and psychotic experiences (PEs) in a general population sample.

    METHODS: Data were analysed from 2308 individuals collected during the National Comorbidity Survey Replication (NCS-R). Information on lifetime PEs was collected with the WHO-CIDI Psychosis Screen. Respondents also reported on five forms of childhood neglect (went hungry, went without necessities, went unsupervised, lacked medical care, chores too difficult/dangerous). Multivariable logistic regression analysis was used to examine associations.

    RESULTS: In models adjusted for sociodemographic and psychiatric disorder variables, aggregated physical neglect scores (continuous/dichotomized) were associated with significantly increased odds for any lifetime PEs. All individual forms of neglect except went without necessities (odds ratio [OR]: 1.21, 95% confidence interval [CI]: 0.98-1.50) were significantly associated with PEs with ORs ranging from 1.28 (95% CI: 1.08-1.51, went unsupervised) to 1.53 (95% CI: 1.19-1.97, went without medical care). In models that were further adjusted for co-occurring forms of neglect and childhood physical abuse, doing chores that were too difficult/dangerous continued to be associated with significantly increased odds for PEs (OR: 1.29, 95% CI: 1.03-1.61).

    CONCLUSIONS: Childhood physical neglect is associated with significantly increased odds for PEs in the general population. Screening for childhood adversities and PEs among potential patients may be important for the early detection of individuals at high risk for psychosis, as well as for formulating comprehensive and effective treatment plans.

  • 163.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Waldman, Kyle
    Harvard University, Cambridge, USA.
    Ueda, Michiko
    Waseda University, Tokyo, Japan.
    Koyanagi, Ai
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Sumiyoshi, Tomiki
    National Institute of Mental Health, Tokyo, Japan.
    Narita, Zui
    The Johns Hopkins University School of Medicine, Baltimore, USA.
    Inoue, Yosuke
    National Center for Global Health and Medicine, Tokyo, Japan.
    DeVylder, Jordan E
    Fordham University, New York, USA.
    Oh, Hans
    University of Southern California, Los Angeles, USA.
    Childhood neglect and suicidal behavior: Findings from the National Comorbidity Survey Replication.2020In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 103, article id 104400Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although child neglect is common, there has been comparatively little research on it or its specific forms and their effects on mental health in adulthood.

    OBJECTIVE: This study aimed to examine the association between exposure to different forms of childhood neglect and lifetime suicidal behavior among a nationally representative sample of adults in the U.S. general population.

    METHODS: Data were analyzed from 5665 adults that were drawn from the National Comorbidity Survey Replication (NCS-R). Information was obtained on 'care', 'supervisory' and 'medical' neglect in childhood and lifetime suicidal behavior (ideation, plan, attempt). Lifetime psychiatric disorders were based on the World Mental Health - Composite International Diagnostic Interview. Logistic regression analysis was used to examine the associations.

    RESULTS: In fully adjusted models, any neglect was associated with significantly increased odds for all forms of suicidal behavior (suicidal ideation, odds ratio [OR]: 1.80, 95 % confidence interval [CI]: 1.42-2.29; plan, OR: 2.27, 95 % CI: 1.78-2.91; attempt, OR: 2.05, 95 % CI: 1.63-2.59, all p < 0.001). In unadjusted analyses all individual forms of neglect were significantly associated with all forms of suicidal behavior. However, when all forms of neglect were included together in the fully adjusted models, care neglect was no longer significantly associated with any form of suicidal behavior.

    CONCLUSION: Different forms of childhood neglect are associated with suicidal behavior in adults independent of common mental disorders. Future studies should focus on childhood neglect subtypes in order to better understand the effects of neglect on adult mental health.

  • 164.
    Takahashi, H.
    et al.
    National Center of Neurology and Psychiatry,Tokyo, Japan.
    Nakahachi, T.
    National Center of Neurology and Psychiatry,Tokyo, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry,Tokyo, Japan.
    Ishitobi, M.
    National Center of Neurology and Psychiatry,Tokyo, Japan.
    Kamio, Y.
    National Center of Neurology and Psychiatry,Tokyo, Japan.
    Stability of the acoustic startle response and its modulation in children with typical development and those with autism spectrum disorders: A one-year follow-up2017In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806, Vol. 10, no 4, p. 673-679Article in journal (Refereed)
    Abstract [en]

    Auditory hyper-reactivity is a common sensory-perceptual abnormality that interrupts behavioral adaptations in autism spectrum disorders (ASD). Recently, prolonged acoustic startle response (ASR) latency and hyper-reactivity to weak acoustic stimuli were reported in children with ASD. Indexes of ASR and its modulation are known to be stable biological markers for translational research in the adult population. However, little is known about the stability of these indexes in children. Thus, the objective of our study was to investigate the stability of neurophysiological ASR indexes in children with ASD and typical development (TD). Participants included 12 children with ASD and 24 with TD. Mean startle magnitudes to acoustic stimuli presented at 65-105 dB in increments of 10 dB were analyzed. Average peak startle latency (PSL), ASR modulation of habituation, and prepulse inhibition were also analyzed. These startle measures were examined after a follow-up period of 15.7±5.1 months from baseline. At both baseline and in the follow-up period, children with ASD had significantly greater startle magnitudes to weak stimuli of 65-85 dB and more prolonged PSL compared with controls. Intraclass correlation coefficients for these ASR measures between both periods were 0.499-0.705. None of the ASR measures differed significantly between the two periods. Our results suggest that prolonged PSL and greater startle magnitudes to weak stimuli in children with ASD might serve as moderately stable neurophysiological indexes of ASD.

  • 165.
    Takahashi, Hidetoshi
    et al.
    National Center of Neurology and Psychiatry, Japan.
    Nakahachi, Takayuki
    National Center of Neurology and Psychiatry, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, Japan.
    Ishitobi, Makoto
    National Center of Neurology and Psychiatry, Japan.
    Kamio, Yoko
    National Center of Neurology and Psychiatry, Japan.
    Relationship between physiological and parent-observed auditory over-responsiveness in children with typical development and those with autism spectrum disorders.2018In: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 22, no 3, p. 291-298Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate relationships between caregiver-reported sensory processing abnormalities, and the physiological index of auditory over-responsiveness evaluated using acoustic startle response measures, in children with autism spectrum disorders and typical development. Mean acoustic startle response magnitudes in response to 65-105 dB stimuli, in increments of 10 dB, were analyzed in children with autism spectrum disorders and with typical development. Average peak startle latency was also examined. We examined the relationship of these acoustic startle response measures to parent-reported behavioral sensory processing patterns in everyday situations, assessed using the Sensory Profile for all participants. Low-threshold scores on the Sensory Profile auditory section were related to acoustic startle response magnitudes at 75 and 85 dB, but not to the lower intensities of 65 dB. The peak startle latency and acoustic startle response magnitudes at low-stimuli intensities of 65 and 75 dB were significantly related to the low-threshold quadrants (sensory sensitivity and sensation avoiding) scores and to the high-threshold quadrant of sensation seeking. Our results suggest that physiological assessment provides further information regarding auditory over-responsiveness to less-intense stimuli and its relationship to caregiver-observed sensory processing abnormalities in everyday situations.

  • 166.
    Takahashi, Hidetoshi
    et al.
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Nakamura, Toru
    University of Tokyo, Tokyo, Japan.
    Kim, Jinhyuk
    University of Tokyo, Tokyo, Japan.
    Kikuchi, Hiroe
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Nakahachi, Takayuki
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Ishitobi, Makoto
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Ebishima, Ken
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Yoshiuchi, Kazuhiro
    University of Tokyo, Tokyo, Japan.
    Ando, Tetsuya
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, Tokyo, Japan.
    Yamamoto, Yoshiharu
    University of Tokyo, Tokyo, Japan.
    Kamio, Yoko
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    Acoustic Hyper-Reactivity and Negatively Skewed Locomotor Activity in Children With Autism Spectrum Disorders: An Exploratory Study2018In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 9, article id 355Article in journal (Refereed)
    Abstract [en]

    Investigation of objective and quantitative behavioral phenotypes along with neurobiological endophenotypes might lead to increased knowledge of the mechanisms that underlie autism spectrum disorders (ASD). Here, we investigated the association between locomotor dynamics and characteristics of the acoustic startle response (ASR) and its modulation in ASD (n = 14) and typically developing (TD, n = 13) children. The ASR was recorded in response to acoustic stimuli in increments of 10 dB (65-105 dB SPL). We calculated the average ASR magnitude for each stimulus intensity and peak-ASR latency. Locomotor activity was continuously measured with a watch-type actigraph. We examined statistics of locomotor activity, such as mean activity levels and the skewness of activity. Children with ASD had a significantly greater ASR magnitude in response to a weak acoustic stimulus, which reflects acoustic hyper-reactivity. The skewness of all-day activity was significantly more negative in children with ASD than those with TD. Skewness of daytime activity was also more negative, although only of borderline statistical significance. For all children, the higher mean and more negatively skewed daytime activity, reflecting hyperactivity that was associated with sporadic large daytime "troughs," was significantly correlated with acoustic hyper-reactivity. The more negatively skewed locomotor activity occurring in the daytime was also associated with impaired sensorimotor gating, examined as prepulse inhibition at a prepulse intensity of 70 dB. This comprehensive investigation of locomotor dynamics and the ASR extends our understanding of the neurophysiology that underlies ASD.

  • 167.
    Tanaka, Hirokazu
    et al.
    Erasmus University Medical Center, Rotterdam, The Netherlands / University of Tokyo, Tokyo, Japan.
    Nusselder, Wilma J
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Brønnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lee, Jung Su
    University of Tokyo, Tokyo, Japan.
    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.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Menvielle, Gwenn
    Sorbonne Universités, Paris, France.
    Kobayashi, Yasuki
    University of Tokyo, Tokyo, Japan.
    Mackenbach, Johan P
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–20152019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 8, p. 750-758Article in journal (Refereed)
    Abstract [en]

    Background: We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar.

    Methods: National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35–64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference.

    Results: Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6–2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers.

    Conclusion: Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.

  • 168.
    Tasmin, S.
    et al.
    Kyoto University, Kyoto, Japan.
    Ueda, K.
    Kyoto University, Kyoto, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Yasumoto, S.
    Ritsumeikan University, Japan.
    Phung, V. L. H.
    Kyoto University, Kyoto, Japan.
    Oishi, M.
    Kyoto University, Kyoto, Japan.
    Yasukouchi, S.
    Kyoto University, Kyoto, Japan.
    Uehara, Y.
    Kyoto University, Kyoto, Japan.
    Michikawa, T.
    National Institute for Environmental Studies (NIES), Japan.
    Nitta, H.
    National Institute for Environmental Studies (NIES), Japan.
    Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan2016In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 566-567, p. 528-535Article in journal (Refereed)
    Abstract [en]

    Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7 μg/m3. In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10 μg/m3 increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in &lt;3 weeks hospitalization or no hospitalization) when compared to severe medical conditions (e.g. critical cases, and cases that led to &gt;3 weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.

  • 169.
    Tasmin, Saira
    et al.
    University of Chicago, Chicago, IL, USA / University of Tokyo, Tokyo, Japan.
    Ng, Chris Fook Sheng
    University of Tokyo, Tokyo, Japan / Nagasaki University, Nagasaki, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Md, Nasiruddin
    Ministry of Environment and Forest, Dhaka, Bangladesh.
    Saroar, Golam
    Ministry of Environment and Forest, Dhaka, Bangladesh.
    Yasumoto, Shinya
    Ritsumeikan University, Kyoto, Japan.
    Watanabe, Chiho
    University of Tokyo, Tokyo, Japan / National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.
    Effects of Short-term Exposure to Ambient Particulate Matter on the Lung Function of School Children in Dhaka, Bangladesh2019In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 30, no Suppl 1, p. S15-S23Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ambient particulate pollution may adversely affect children's lung function. However, evidence on this association remains scarce in Asia despite this region having the greatest burden of disease due to air pollution.

    OBJECTIVES: To investigate the effect of short-term exposure to ambient particulate matter (PM) on the lung function of school children in Dhaka city, Bangladesh. The possible seasonal modification of this association was also examined.

    METHODS: A panel of 315 school children who were 9-16 years of age were recruited from three schools in and around Dhaka. Lung function was assessed using a spirometry test during the cool and warm seasons in 2013, yielding six measurements per child. Daily PM data were retrieved from nearby air monitoring stations. Linear mixed effects models were used to examine associations. Seasonal modification was examined by stratification.

    RESULTS: An inverse association was observed for the lung function parameters with PM2.5; peak expiratory flow (PEF) and forced expiratory volume within 1 second (FEV1) decreased with increasing PM2.5. The percent deviation from the personal median was -4.19% [95% confidence interval (CI): -5.72, -2.66] for PEF and -2.05% (95% CI: -2.92, -1.18) for FEV1 for a 20 µg/m increase in PM2.5 on the previous day. Results for PM10 were less consistent. The estimated effects of PM on lung functions were generally greater in the warm season.

    CONCLUSIONS: Short-term exposure to PM is associated with worse lung function in children living in highly polluted settings, with the strength of these adverse PM effects varying by season.

  • 170.
    Tingstedt, Olga
    et al.
    Uppsala University.
    Lindblad, Frank
    Uppsala University.
    Koposov, Roman
    University of Norway, Tromsø, Norway.
    Blatný, Marek
    Academy of Sciences of the Czech Republic, Brno, Czech Republic.
    Hrdlicka, Michal
    Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Ruchkin, Vladislav
    Uppsala University / Yale University Medical School, New Haven, CT, USA / Säter Forensic Psychiatric Clinic.
    Somatic symptoms and internalizing problems in urban youth: a cross-cultural comparison of Czech and Russian adolescents.2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 3, p. 480-484Article in journal (Refereed)
    Abstract [en]

    Background: Although the association between somatic complaints and internalizing problems (anxiety, somatic anxiety and depression) is well established, it remains unclear whether the pattern of this relationship differs by gender and in different cultures. The aim of this study was to examine cross-cultural and gender-specific differences in the association between somatic complaints and internalizing problems in youth from the Czech Republic and Russia.

    Methods: The Social and Health Assessment, a self-report survey, was completed by representative community samples of adolescents, age 12-17 years, from the Czech Republic (N = 4770) and Russia (N = 2728).

    Results: A strong association was observed between somatic complaints and internalizing psychopathology. Although the levels of internalizing problems differed by country and gender, they increased together with and largely in a similar way to somatic complaints for boys and girls in both countries.

    Conclusion: The association between somatic symptoms and internalizing problems seems to be similar for boys and girls across cultures.

  • 171.
    Tyrovolas, Stefanos
    et al.
    University of Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Koyanagi, Ai
    University of Barcelona, 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). University of Tokyo, Tokyo, Japan.
    Maria Haro, Josep
    University of Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Weight Perception, Satisfaction, Control, and Low Energy Dietary Reporting in the US Adult Population: Results from the National Health and Nutrition Examination Survey 2007-20122016In: Journal of the Academy of Nutrition and Dietetics, ISSN 2212-2672, E-ISSN 2212-2680, Vol. 116, no 4, p. 579-589Article in journal (Refereed)
    Abstract [en]

    Background Prior research has indicated that several factors are associated with low energy dietary reporting; however, there is comparatively little information on the association between body image, weight control, and low energy reporting. Objective Our aim was to evaluate the association between low energy reporting and aspects of weight perception, satisfaction, and control in a nationally representative US adult sample. Design This was a cross-sectional study. Participants/setting Data were analyzed from 13,581 adults aged 20 years and older who participated in the 2007-2012 National Health and Nutrition Examination Survey. Data on sociodemographic, clinical, and lifestyle characteristics, and weight perception, satisfaction, and control were collected. The ratio of reported energy intake to estimated basal metabolic rate (EI/BMR) was calculated and used for the assessment of low energy reporting. Main outcome measures The relationship of low energy reporting with various aspects of weight perception, satisfaction, and control was evaluated. Statistical analyses performed Multivariable logistic regression was used to assess the association between the variables. Results Low energy reporters were significantly more likely to consider themselves overweight (perception), want to weigh less (satisfaction), and to have tried to lose weight in the past 12 months (control). Compared with having no desire for weight change, wanting to weigh less was associated with 1.28 (95% CI 1.07 to 1.53) times higher odds for low energy reporting. Trying to lose weight was also associated with low energy reporting (odds ratio = 1.56; 95% CI 1.38 to 1.76). Effect modification by obesity status was observed for the weight perception, satisfaction, and control variables where the odds ratios of these factors for low energy reporting were higher among those who were not obese. Conclusion Weight perception, satisfaction, and control are related to low energy reporting, and should be taken into account in nutritional assessments. In addition, the effect of these factors can differ by obesity status.

  • 172.
    Vals, Kaire
    et al.
    University of Tartu, Tartu, Estonia / National Institute for Health Development, Tallinn, Estonia.
    Kiivet, Raul-Allan
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia.
    Alcohol consumption, smoking and overweight as a burden for health care services utilization: a cross-sectional study in Estonia2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 772Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol consumption, smoking and weight problems are common risk factors for different health problems. We examine how these risk factors are associated with the use of health care services.

    Methods: Data for 6500 individuals in the 25-64 age group came from three cross-sectional postal surveys conducted in 2004, 2006, and 2008 in Estonia. The effect of alcohol consumption, smoking and weight problems on the use of primary and specialist care services, hospitalizations and ambulance calls was analysed separately for men and women by using binary logistic regression.

    Results: Overweight and/or obesity were strongly related to the use of primary care and out-patient specialist services for both genders, and to hospitalizations and ambulance calls for women. Current smoking was related to ambulance calls for both genders, whereas smoking in the past was related to the use of primary care and specialist services among men and to hospitalizations among women. Beer drinking was negatively associated with all types of health care services and similar   association was found between wine drinking and hospitalizations. Wine drinking was positively related to specialist visits. The frequent drinking of strong alcohol led to an increased risk for ambulance calls. Drinking light alcoholic drinks was positively associated with all types of health care services (except ambulance calls) among men and with the use of specialist services among women.

    Conclusions: Overweight and smoking had the largest impact on health care utilization in Estonia. Considering the high prevalence of these behavioural risk factors, health policies should prioritize preventive programs that promote healthy lifestyles in order to decrease the disease burden and to reduce health care costs.

  • 173.
    Vandenheede, H.
    et al.
    Vrije Universiteit Brussel, Brussels, Belgium / Erasmus University Rotterdam, Rotterdam, The Netherlands .
    Deboosere, P.
    Vrije Universiteit Brussel, Brussels, Belgium.
    Espelt, A.
    Autonomous University of Barcelona, Barcelona, Spain.
    Bopp, M.
    University of Zurich, Zurich, Switzerland .
    Borrell, C.
    Autonomous University of Barcelona, Barcelona, Spain.
    Costa, G.
    University of Turin, Turin, Italy.
    Eikemo, T. A.
    Norwegian University of Science and Technology, Trondheim, Norway .
    Gnavi, R.
    University of Turin, Turin, Italy / Local Health Agency of Collegno and Pinerolo, Turin, Italy .
    Hoffmann, R.
    Erasmus University Rotterdam, Rotterdam, The Netherlands .
    Kulhanova, I.
    Erasmus University Rotterdam, Rotterdam, The Netherlands .
    Kulik, M.
    Erasmus University Rotterdam, Rotterdam, The Netherlands / University of California, San Francisco, USA .
    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.
    Martikainen, P.
    University of Helsinki, Helsinki, Finland.
    Menvielle, G.
    French National Institute of Health and Medical Research,, Paris, France / Sorbonne University, Paris, France .
    Rodriguez-Sanz, M.
    Autonomous University of Barcelona, Barcelona, Spain.
    Rychtarikova, J.
    Charles University in Prague, Czech Republic .
    Mackenbach, J. P.
    Erasmus University Rotterdam, Rotterdam, The Netherlands.
    Educational inequalities in diabetes mortality across Europe in the 2000s: the interaction with gender2015In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 60, no 4, p. 401-410Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate educational inequalities in diabetes mortality in Europe in the 2000s, and to assess whether these inequalities differ between genders. Methods: Data were obtained from mortality registries covering 14 European countries. To determine educational inequalities in diabetes mortality, age-standardised mortality rates, mortality rate ratios, and slope and relative indices of inequality were calculated. To assess whether the association between education and diabetes mortality differs between genders, diabetes mortality was regressed on gender, educational rank and ‘gender × educational rank’. Results: An inverse association between education and diabetes mortality exists in both genders across Europe. Absolute educational inequalities are generally larger among men than women; relative inequalities are generally more pronounced among women, the relative index of inequality being 2.8 (95 % CI 2.0–3.9) in men versus 4.8 (95 % CI 3.2–7.2) in women. Gender inequalities in diabetes mortality are more marked in the highest than the lowest educated. Conclusions: Education and diabetes mortality are inversely related in Europe in the 2000s. This association differs by gender, indicating the need to take the socioeconomic and gender dimension into account when developing public health policies. © 2015 The Author(s)

  • 174.
    Vågerö, Denny
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). CHESS, Stockholm Universtiy / Karolinska Institutet.
    Koupil, Ilona
    CHESS, Stockholm Universtiy / Karolinska Institutet.
    Parfenova, Nina
    Russian Academy of Medicine Science, St. Petersburg, Russia.
    Sparen, Pär
    Karolinska Institutet.
    Long-term health consequences following the siege of Leningrad2013In: Early life nutrition and adult health and development: lessons from changing dietary patterns, famines and experimental studies / [ed] L.H. Lumey and Alexander Vaiserman, New York: Nova Science Publishers, Inc., 2013, p. 207-225Chapter in book (Other academic)
    Abstract [en]

    We are interested in the long-term health consequences associated with severe starvation and war trauma, and whether certain "age windows" exist when exposure to such events are particularly harmful.The siege of Leningrad (now St. Petersburg) during World War II provided an opportunity to study this. For 872 days, German troops prevented supplies from reaching Leningrad. Simultaneously, there was a food blockade and a steady and merciless bombardment by shells from guns and from the air. The first winter, 1941/42, represents the most severe food shortage, amounting to mass starvation or semi-starvation. Our late colleague, Professor Dimitri Shestov, had suffered the consequences of the Leningrad siege as a boy and believed that it had taken a toll on people beyond its immediate short- and medium-range consequences. He was particularly concerned about its long-term consequences for circulatory disease. A 1973 US-Soviet agreement, the socalled Lipid Research Clinics Collaboration, gave him an opportunity to study this. From 1975 to 1982 men and women living in Leningrad (now St. Petersburg) were randomly sampled and invited to examine their health and cardiovascular functioning. Dimitri Shestov added a simple question to this examination: "Were you in Leningrad during the blockade?" A third of the participants were. They had experienced peak starvation (in January 1942) at ages 1-31 (women) or 6-26 (men).The mortality follow-up began immediately after the first clinical examinations in 1975 and continued for three decades, until the end of 2005. Our analyses show that the siege of Leningrad, particularly when experienced in puberty, has had long-term effects on blood pressure both in men and women.We also found a raised IHD and stroke risk among those men. This was partly mediated via blood pressure but not by any other measured biological, behavioral, or social factors.Girls experiencing the siege around puberty suffered an elevated risk of dying from breast cancer later in life.The fact that the effect of siege exposure is modified by the age at exposure is highly interesting from a scientific point of view. It may suggest that a reprogramming of physiological systems can occur at specific age windows in response to starvation and/or war trauma. The team that worked from 1975-2005 to collect clinical information and death certificates for participants in the study included Svetlana Plavinskaya, born in Leningrad during the siege. Dimitri Shestov and Svetlana Plavinskaya died in 2010 and 2011, respectively. We dedicate this chapter to their memory.

  • 175.
    Wesolowski, Katharina
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS). Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Uppsala universitet, Sociologiska institutionen.
    Maybe Baby?: Reproductive Behaviour, Fertility Intentions, and Family Policies in Post-communist Countries, with a Special Focus on Ukraine2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis studies different aspects of reproductive behaviour on the international, national, and local levels in post-communist countries. The main focus is Ukraine, where fertility rates are very low and the population is in severe decline. The studies contribute new knowledge about the applicability of a family policy typology developed on the basis of Western countries’ experience for post-communist countries, and about the influence of family policies on fertility levels in these countries. Moreover, the studies investigate whether and how macro-level influences impact on individuals’ reproductive behaviour. Four articles are included in the thesis:

    Family policies in Ukraine and Russia in comparative perspective analyses the institutional set-up of family policies in both countries and compares the findings to 31 other countries. The results show that Ukrainian family policies support a male-breadwinner type of family, while the benefit levels of Russian family policies are low, compelling families to rely on relatives or the childcare market.

    Family policies and fertility - Examining the link between family policy institutions and fertility rates in 33 countries 1995-2010 comparatively explores whether family policies have an effect on fertility rates across the case-countries. Pooled time-series regression analysis demonstrates that gender-egalitarian family policies are connected to higher fertility rates, but that this effect is smaller at higher rates of female labour force participation.

    To have or not to have a child? Perceived constraints on childbearing in a lowest-low fertility context investigates the influence of the perception of postmodern values, childcare availability and environmental pollution on individuals’ fertility intentions in a city in Eastern Ukraine. It is shown that women who already have a child perceive environmental pollution as a constraint on their fertility intentions.

    Prevalence and correlates of the use of contraceptive methods by women in Ukraine in 1999 and 2007 examines changes in the prevalence and the correlates of the use of contraceptive methods. The use of modern contraceptive methods increased during the period and the use of traditional methods decreased, while the overall prevalence did not change. Higher exposure to messages about family planning in the media is correlated with the use of modern contraceptive methods.

  • 176.
    Wesolowski, Katharina
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS). Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Uppsala universitet, Sociologiska institutionen.
    Prevalence and correlates of the use of contraceptive methods by women in Ukraine in 1999 and 20072015In: Europe-Asia Studies, ISSN 0966-8136, E-ISSN 1465-3427, Vol. 67, no 10, p. 1547-1570Article in journal (Refereed)
    Abstract [en]

    This essay examines the prevalence and the correlates of the use of contraceptive methods in Ukraine in 1999 and 2007. Between those years, the overall use of contraceptive methods decreased slightly. However, the use of modern contraceptive methods, and especially the use of condoms, increased considerably, while the use of traditional contraceptive methods decreased. Higher exposure to messages about family planning in the media was correlated with the use of modern contraceptive methods. It is posited that the results suggest that state policies influence individual behaviour in contraception.

  • 177.
    Wesolowski, Katharina
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS). Uppsala Universitet.
    To Have or Not to Have a Child?: Perceived Constraints on Childbearing in a Lowest-Low Fertility Context2015In: Population, Space and Place, ISSN 1544-8444, E-ISSN 1544-8452, Vol. 21, no 1, p. 86-101Article in journal (Refereed)
    Abstract [en]

    The influence of perceived macro-level constraints on childbearing on women’s fertility decision-making on the micro level was analysed in Stakhanov, a city with a shrinking population in Eastern Ukraine. The perceived macro-level constraints employed in the study were related to childcare arrangements, value changes regarding family formation, and pollution of the environment and health concerns. To study the influence of those constraints, logistic regression analyses were conducted whereby first-birth and second-birth intentions were analysed separately. None of the constraints influenced childless women’s first-birth intentions. Instead, sociodemographic factors such as age and civil status appeared as significant predictors. That none of the constraints influenced childless women’s fertility intentions is interpreted to be an indicator of the strong norm of having at least one child in Ukraine.For women with one child, the fact that pollution of the environment and health concerns connected to childbirth were perceived as a constraint on childbearing at the national level was significantly associated with lower second-birth intentions. Women in Ukraine seem to perceive environmental pollution as a constraint on their fertility, possibly influenced by public discourse related to the health consequences of the Chernobyl nuclear disaster. Moreover, the inhabitants of Stakhanov itself have experienced environmental pollution at close range. Those factors together could explain why environmental pollution and poor health were seen as constraints on childbearing at the national level, and the negative influence these had on second-birth intentions.It is argued that environmental pollution should be considered a factor influencing fertility decision-making. Copyright © 2013 John Wiley & Sons, Ltd.

  • 178.
    Wesolowski, Katharina
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Stockholms universitet.
    Borodachova, J.
    Shukhatovich, V.
    Institute of Sociology of the National Academy of Sciences of Belarus.
    Репродуктивные установки в Беларуси [Fertility intentions in Belarus]: анализ социальных и демографических детерминант [Analysis of social and demographic determinants]2017In: ЗДОРОВЬЕ НАСЕЛЕНИЯ: ПРОБЛЕМЫ И ПУТИ РЕШЕНИЯ [Health of the population: Problems and solutions]: Материалы международного научно-практического семинара, 18-19 мая 2017: СБОРНИК НАУЧНЫХ СТАТЕЙ, Minsk: Institute of Sociology of the National Academy of Sciences of Belarus , 2017, p. 342-350Chapter in book (Refereed)
  • 179.
    Wesolowski, Katharina
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS). Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Uppsala universitet, Sociologiska institutionen.
    Ferrarini, Tommy
    Stockholms universitet.
    Family policies and fertility: Examining the link between family policy institutions and fertility rates in 33 countries 1995-2010Article in journal (Refereed)
    Abstract [en]

    In what ways are family policies related to fertility? Previous studies of OECD countries have arrived at mixed results when analysing the effects of family policy expenditures or formal benefit rates. This study draws on new institutional family policy data from a wider set of 33 countries in a multidimensional analysis of the link between family policy institutions and fertility 1995-2010. Pooled time-series regressions show that more extensive gender-egalitarian family policies, i.e. earner-carer support, are linked to higher fertility, while policies supporting more traditional family patterns show no statistically significant effects. Analyses of the interaction between earner-carer support and female labour force participation indicate that the impact of introducing more gender-egalitarian policies is stronger in countries with lower levels of female labour force participation. Regressions with differenced data sustain ideas of earner-carer support being linked to total fertility increase.

  • 180.
    Wesolowski, Katharina
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, Centre for Baltic and East European Studies (CBEES), Baltic & East European Graduate School (BEEGS). Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Uppsala universitet, Sociologiska institutionen.
    Ferrarini, Tommy
    Stockholms universitet.
    Family policies in Ukraine and Russia in comparative perspectiveArticle in journal (Refereed)
    Abstract [en]

    This study compares the institutional setting of family policies in Ukraine and Russia with 31 countries, including post-communist countries and other EU and OECD countries. Large-scale systematic comparisons of family policies in Ukraine and Russia with longstanding welfare states and other post-communist European countries have so far been lacking. The analyses are based on a comparative institutional approach, which captures the content of legislation multidimensionally instead of focusing only on social expenditure. This enables an evaluation of the structure of Ukrainian and Russian family policies in relation to other countries in 2005. Analyses show that Ukraine and Russia differ considerably in terms of family policy, as do other post-communist countries. Ukraine more actively supports traditional family patterns, while Russia leaves greater room for market forces. The policies in Ukraine and Russia are likely to be insufficient when it comes to addressing work-family conflicts and increasing long-term fertility.

  • 181.
    Yazawa, Aki
    et al.
    University of Tokyo, Tokyo, Japan.
    Inoue, Yosuke
    University of Tokyo, Tokyo, Japan.
    Fujiwara, Takeo
    National Center for Child Health and Development, Tokyo, Japan.
    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.
    Shirai, Kokoro
    University of the Ryukyus, Okinawa, Japan.
    Amemiya, Airi
    National Center for Child Health and Development, Tokyo, Japan.
    Kondo, Naoki
    University of Tokyo, Tokyo, Japan.
    Watanabe, Chiho
    University of Tokyo, Tokyo, Japan.
    Kondo, Katsunori
    Chiba University, Chiba, Japan / Nihon Fukushi University, Aichi, Japan.
    Association between social participation and hypertension among older people in Japan: the JAGES Study2016In: Hypertension Research, ISSN 0916-9636, E-ISSN 1348-4214, Vol. 39, p. 818-824Article in journal (Refereed)
    Abstract [en]

    Hypertension is an important risk factor for cardiovascular disease, the leading cause of mortality in the world. Although previous studies have focused on individual-level behavioral risk factors associated with hypertension, there has been little research on how interacting with others, that is social participation, affects hypertension. To address this research gap, this study examined the association between social participation and hypertension in Japan, a country with a high prevalence of hypertension possibly linked to rapid population aging. Data were used from 4582 participants aged more than 65 years who participated in the Japan Gerontological Evaluation Survey (JAGES) with blood pressure data collected during a health check-up. The frequency of participation in vertical organizations (characterized by hierarchical relationships) and horizontal organizations (characterized by non-hierarchical, egalitarian relationships) was measured by a questionnaire. In a Poisson regression analysis, participation in vertical organizations was not associated with hypertension, whereas participation in horizontal organizations at least once a month was inversely associated with hypertension (prevalence ratio: 0.941). This association remained significant after adjusting for social support variables, although further adjustment for health behaviors attenuated the association. As the frequency of going out and average time spent walking were both associated with hypertension, physical activity may be a possible pathway that connects social participation and hypertension. The results of this study suggest that expanding social participation programs, especially those involving horizontal organizations, may be one way to promote better health among older people in Japan.

  • 182.
    Yazawa, Aki
    et al.
    University of Tokyo, Bunkyo, Tokyo, Japan .
    Inoue, Yosuke
    University of Tokyo, Bunkyo, Tokyo, Japan .
    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, Bunkyo, Tokyo, Japan .
    Li, Dandan
    Hainan Center for Disease Control and Prevention, Haikou, Hainan, China.
    Du, Jianwei
    Hainan Center for Disease Control and Prevention, Haikou, Hainan, China.
    Watanabe, Chiho
    University of Tokyo, Bunkyo, Tokyo, Japan.
    The Effects of Season of Birth on the Inflammatory Response to Psychological Stress in Hainan Island, China.2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 10, article id e0139602Article in journal (Refereed)
    Abstract [en]

    Season of birth (SOB) has been investigated as one of the environmental factors that might epigenetically determine the physiology of individuals. This study investigated the role of SOB in the association between Quality of Life (QOL), a proxy of psychological stress status, and C-reactive protein (CRP) concentration (i.e., inflammatory status) among 1,085 adults (aged 20-57 years old) in Hainan Island, China. High sensitivity CRP concentration was measured in dried blood spot samples, while the abbreviated version of the World Health Organization's QOL questionnaire was used to gather information on six QOL domains. Analysis stratified by three historically distinct age groups revealed a significant association between CRP concentration, SOB, QOL and an interaction between SOB and QOL among the youngest and oldest groups. In the oldest group, those born in the dry season had a higher CRP concentration with worse QOL whereas in the youngest group, there was a higher CRP concentration with better QOL. Annual per capita rice production, a proxy of population nutritional status in the year of birth, was found to predict CRP concentration only among the second oldest group. These findings suggest that the early environment might affect the immune response to psychological stress in adulthood and that its effect may differ by the time period in which people were born.

  • 183.
    Zachrison, Linnea
    et al.
    Uppsala University.
    Ruchkin, Vladislav
    Uppsala University / Yale University Medical School, New Haven, USA / Säter Forensic Psychiatric Clinic.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koposov, Roman
    Arctic University of Norway (UiT), Tromsø, Norway.
    Inhalant Use and Mental Health Problems in Russian Juvenile Delinquents2017In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 52, no 12, p. 1616-1623Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Inhalant use by children and adolescents has been linked to an increased risk of multiple drug use, mental health problems and antisocial behavior.

    OBJECTIVES: The purpose of this study was to examine the association between the frequency of inhalant use and psychiatric diagnoses among incarcerated delinquent youths in Russia.

    METHODS: A total of 370 incarcerated delinquents from a juvenile correction center in Northern Russia were assessed by means of a semi-structured psychiatric interview and by self-reports.

    RESULTS: Compared to non-users (N = 266), inhalant users (N = 104) reported higher rates of PTSD, early onset conduct disorder, ADHD, alcohol abuse and dependence, as well as higher levels of antisocial behavior, impulsiveness and more psychopathic traits. Frequent inhalant users also reported the highest rates of co-occurring psychopathology.

    CONCLUSIONS: Our findings suggest that inhalant use in delinquents is frequent and may require additional clinical measures to address the issue of psychiatric comorbidity.

  • 184.
    Östergren, Olof
    et al.
    Centre for Health Equity Studies (CHESS), Stockholm University / Karolinska Institutet.
    Lundberg, Olle
    Centre for Health Equity Studies (CHESS), Stockholm University / Karolinska Institutet.
    Artnik, Barbara
    University of Ljubljana, Ljubljana, Slovenia.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Borrell, Carme
    Agència de Salut Pública de Barcelona, Barcelona, Spain.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    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.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Regidor, Enrique
    Universidad Complutense de Madrid, Madrid, Spain.
    Rodríguez-Sanz, Maica
    Agència de Salut Pública de Barcelona, Barcelona, Spain.
    de Gelder, Rianne
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Mackenbach, Johan P
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Educational expansion and inequalities in mortality - A fixed-effects analysis using longitudinal data from 18 European populations2017In: PLoS ONE, E-ISSN 1932-6203, Vol. 12, no 8, article id e0182526Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this paper is to empirically evaluate whether widening educational inequalities in mortality are related to the substantive shifts that have occurred in the educational distribution.

    MATERIALS AND METHODS: Data on education and mortality from 18 European populations across several decades were collected and harmonized as part of the Demetriq project. Using a fixed-effects approach to account for time trends and national variation in mortality, we formally test whether the magnitude of relative inequalities in mortality by education is associated with the gender and age-group specific proportion of high and low educated respectively.

    RESULTS: The results suggest that in populations with larger proportions of high educated and smaller proportions of low educated, the excess mortality among intermediate and low educated is larger, all other things being equal.

    CONCLUSION: We conclude that the widening educational inequalities in mortality being observed in recent decades may in part be attributed to educational expansion.

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