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  • 151.
    Rydland, Håvard T
    et al.
    Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
    Fjær, Erlend L
    Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
    Eikemo, Terje A
    Norwegian University of Science and Technology (NTNU), Trondheim, Norway / Erasmus MC, Rotterdam, The Netherlands.
    Huijts, Tim
    Maastricht University, Maastricht, The Netherlands.
    Bambra, Clare
    Newcastle University, Newcastle, United Kingdom.
    Wendt, Claus
    University of Siegen, Siegen, Germany.
    Kulhánová, Ivana
    Erasmus MC, Rotterdam, The Netherlands.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Dibben, Chris
    University of Edinburgh, Edinburgh, United Kingdom.
    Kalėdienė, Ramunė
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Borrell, Carme
    Agència de Salut de Pública de Barcelona, Barcelona, Spain / CIBER of Epidemiology and Public Health, 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.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Mackenbach, Johan P
    Erasmus MC, Rotterdam, The Netherlands.
    Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 7, article id e0234135Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types.

    METHODS: This study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35-79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities.

    RESULTS: All countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences.

    CONCLUSIONS: This article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.

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  • 152.
    Saito, A.
    et al.
    National Center of Neurology and Psychiatry (NCNP), 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 (NCNP), Tokyo, Japan.
    Haraguchi, H.
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Takahashi, H.
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Ishitobi, M.
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Kamio, Y.
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Association Between Autistic Traits in Preschool Children and Later Emotional/Behavioral Outcomes2017In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 11, p. 3333-3346Article in journal (Refereed)
    Abstract [en]

    Although children with a greater number of autistic traits are likely to have other mental health problems, research on the association between earlier autistic traits in preschool children and later emotional/behavioral outcomes is scarce. Using data from 189 Japanese community-based children, this study examined whether autistic traits at age 5 were related to emotional/behavioral outcomes at age 7. The results showed that prior autistic traits were subsequently associated with all emotional/behavioral domains. After controlling for baseline emotional/behavioral scores autistic traits continued to predict later emotional symptoms and peer problems. This study highlights that in addition to clinical ASD, it is also important to focus on subthreshold autistic traits in preschool children for better subsequent emotional/behavioral outcomes.

  • 153.
    Saunderson, Jonathan Marshall
    et al.
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, Stockholm, Sweden.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Sturidsson, Knut
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, Stockholm, Sweden.
    Koposov, Roman
    Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Sechenov First Moscow State Medical University, Moscow, Russia.
    Sukhodolsky, Denis G
    Child Study Center, Yale University Medical School, New Haven, CT, USA.
    Ruchkin, Vladislav
    Child Study Center, Yale University Medical School, New Haven, CT, USA; Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, Sweden; Säter Forensic Psychiatric Clinic, Säter, Sweden.
    Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents2023In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 38, no 3-4, p. 3191-3214Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.

  • 154.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
    Baburin, Aleksei
    Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
    Jasilionis, Domantas
    Max Planck Institute for Demographic Research, Rostock, Germany; Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania.
    Krumins, Juris
    Demography unit, Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia.
    Martikainen, Pekka
    Max Planck Institute for Demographic Research, Rostock, Germany; Population Research Unit, University of Helsinki, Helsinki, Finland; Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden.
    Kondo, Naoki
    Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
    Economic cycles and inequalities in alcohol-related mortality in the Baltic countries and Finland in 2000-2015: a register-based study2021In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 16, no 12, p. 3357-3368Article in journal (Refereed)
    Abstract [en]

    AIM: To estimate whether large macroeconomic fluctuations in the 2000s affected inequalities in alcohol-related mortality in the Baltic countries and Finland.

    DESIGN: Longitudinal register-based follow up study.

    SETTING: Estonia, Latvia, Lithuania and Finland.

    PARTICIPANTS: General population in the 35-74 age group.

    MEASUREMENTS: Socioeconomic status was measured by the highest achieved educational level and was categorised using the International Standard Classification of Education 2011 as low (included categories 0-2), middle (3-4), and high (5-8). Educational inequalities in alcohol-related mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 were examined using census-linked longitudinal mortality data. We estimated age-standardised mortality rates and the relative and slope index of inequality.

    FINDINGS: Alcohol-related mortality increased in all countries in 2004-2007 except among Estonian women and decreased/remained the same from 2008 onwards except among Latvian men. By 2012-2015 alcohol-related mortality was still higher than in 2000-2003 in Finland, Latvia and Lithuania (women only). Relative inequalities increased across the study period in all countries (significantly in Lithuania and Latvia). The 2004-2007 increase in relative inequalities was mostly driven by a larger mortality increase among the low educated, whereas in 2008-2011 and in 2012-2015 inequalities often increased because of a larger relative mortality decline among the high educated. However, these period changes in relative inequalities and between educational groups were often not statistically significant. Absolute inequalities were larger in 2012-2015 vs. 2000-2003 in all countries except Estonia (decrease).

    CONCLUSION: In Estonia, Latvia, Lithuania and Finland, alcohol-related mortality tended to increase faster among the low educated during a period of economic expansion (2004-2007) and tended to decrease more among the high educated during a period of economic recession (2008-2011).

  • 155.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Kyoto, Japan.
    Baburin, Aleksei
    National Institute for Health Development, Tallinn, Estonia.
    Jasilionis, Domantas
    Max Planck Institute for Demographic Research, Rostock, Germany; Vytautas Magnus University, Kaunas, Lithuania.
    Krumins, Juris
    University of Latvia, Riga, Latvia.
    Martikainen, Pekka
    Max Planck Institute for Demographic Research, Rostock, Germany; University of Helsinki, Helsinki, Finland; Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden.
    Kondo, Naoki
    Kyoto University, Kyoto, Japan; The 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.
    Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015: a register-based study2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 2397Article in journal (Refereed)
    Abstract [en]

    This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.

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  • 156.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Japan.
    Baburin, Aleksei
    National Institute for Health Development, Estonia.
    Jasilionis, Domantas
    Max Planck Institute for Demographic Research, Germany; Vytautas Magnus University, Lithuania.
    Krumins, Juris
    University of Latvia, Latvia.
    Martikainen, Pekka
    Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Kondo, Naoki
    Kyoto University, Japan.
    Shin, Jae Il
    Yonsei University College of Medicine, Korea.
    Inoue, Yosuke
    National Center for Global Health and Medicine, Japan.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Estonia.
    Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000-2015: a register-based study2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1103Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Drowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000-2015.

    METHODS: Data for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65-W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30-74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.

    RESULTS: Drowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000-2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000-2015.

    CONCLUSION: Despite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000-2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.

  • 157.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Japan.
    Baburin, Aleksei
    National Institute for Health Development, Estonia.
    Jasilionis, Domantas
    Max Planck Institute for Demographic Research, Germany; Vytautas Magnus University, Lithuania.
    Krumins, Juris
    University of Latvia, Latvia.
    Martikainen, Pekka
    Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Kondo, Naoki
    Kyoto University, Japan.
    Shin, Jae Il
    Yonsei University College of Medicine, Korea.
    Oh, Hans
    University of Southern California, Los Angeles, USA.
    Waldman, Kyle
    Harvard University, Cambridge, USA.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Estonia.
    Educational inequalities in hypothermia mortality in the Baltic countries and Finland in 2000-152023In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 33, no 4, p. 555-560Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite an increased focus on cold-related mortality in recent years, there has been comparatively little research specifically on hypothermia mortality and its associated factors.

    METHODS: Educational inequalities in hypothermia mortality among individuals aged 30-74 in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in 2000-15 were examined using data from longitudinal mortality follow-up studies of population censuses (the Baltics) and from a longitudinal register-based population data file (Finland).

    RESULTS: Age-standardized mortality rates (ASMRs) were much higher in the Baltic countries than in Finland across the study period. From 2000-07 to 2008-15, overall ASMRs declined in all countries except among Finnish women. Although a strong educational gradient was observed in hypothermia mortality in all countries in 2000-07, inequalities were larger in the Baltic countries. Between 2000-07 and 2008-15, ASMRs declined in all educational groups except for high-educated women in Finland and low-educated women in Lithuania; the changes however were not always statistically significant. The absolute mortality decline was often larger among the low educated resulting in narrowing absolute inequalities (excepting Lithuania), whereas a larger relative decline among the high educated (excepting Finnish women) resulted in a considerable widening of relative inequalities in hypothermia mortality by 2008-15.

    CONCLUSION: Although some reduction was observed in absolute educational inequalities in hypothermia mortality in 2000-15, substantial and widening relative inequalities highlight the need for further action in combatting factors behind deaths from excessive cold in socioeconomically disadvantaged groups, including risky alcohol consumption and homelessness.

  • 158.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Kyoto, Japan.
    Kondo, N.
    Kyoto University, Kyoto, Japan.
    Inoue, Y.
    National Center for Global Health and Medicine, Tokyo, Japan.
    Kanamori, M.
    Kyoto University, Kyoto, Japan.
    Kino, S.
    Kyoto University, Kyoto, Japan; Tokyo Medical and Dental University, Tokyo, Japan.
    Arakawa, Y.
    Kyoto University, Kyoto, Japan.
    McKee, M.
    London School of Hygiene & Tropical Medicine, London, UK.
    Worry about crime and loneliness in nine countries of the former Soviet Union2023In: SSM - Population Health, ISSN 2352-8273, Vol. 21, article id 101316Article in journal (Refereed)
    Abstract [en]

    Worry about crime has been linked to several detrimental outcomes including worse mental health. However, there has been little research on the association between worry about crime and loneliness, even though loneliness is increasingly being recognised as a serious public health issue. To address this deficit, this study examined the association between worry about crime and loneliness in nine countries of the former Soviet Union (FSU - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine), using data from 18,000 respondents aged 18 and above that were collected during the Health in Times of Transition (HITT) survey in 2010/11. Results from a pooled logistic regression analysis showed that compared to those who reported no worry about crime, individuals with a high level of worry had significantly higher odds of loneliness (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.17–1.75). Sex- and age-stratified analyses further showed that the association was observed in women with a mid (OR: 1.37, 95%CI: 1.10–1.71) and a high level (OR: 1.70, 95%CI: 1.33–2.17) of worry about crime but not in men, and that a high level of worry about crime was linked to loneliness in adults aged 35–59 (OR: 1.39, 95%CI: 1.02–1.91) and 60 and above (OR: 1.64, 95%CI: 1.12–2.40) but not in those aged 18–34. High levels of worry about crime are associated with loneliness in the FSU countries. Reducing crime and its associated worries may have important public health benefits in these countries. 

  • 159.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Japan.
    Kondo, Naoki
    Kyoto University, Japan.
    Richardson, Erica
    London School of Hygiene and Tropical Medicin, UK.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Estonia.
    Waldman, Kyle
    Harvard University, USA.
    Oh, Hans
    University of Southern California, USA.
    Inoue, Yosuke
    National Center for Global Health and Medicine, Japan.
    Shakespeare, Tom
    London School of Hygiene and Tropical Medicine, UK.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, UK.
    Disability and loneliness in nine countries of the former Soviet Union2021In: Disability and Health Journal, ISSN 1936-6574, E-ISSN 1876-7583, Vol. 14, no 4, article id 101123Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People with disabilities (PWD) often face structural and other barriers to community involvement and may therefore be at risk of loneliness. Yet, so far, this issue has received little attention.

    OBJECTIVE: This cross-sectional study aimed to examine the association between disability and loneliness in nine countries of the former Soviet Union (FSU).

    METHODS: Data were analyzed from 18000 respondents aged ≥18 that came from the Health in Times of Transition (HITT) survey that was undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010/11. Respondents reported on whether they had a disability (no/yes) and its severity. A single-item question was used to assess loneliness. Logistic regression analysis was used to examine the associations.

    RESULTS: Across the countries, 6.8% of respondents reported being disabled. In a fully adjusted combined country analysis, disability was associated with higher odds for loneliness (odds ratio: 1.30, 95% confidence interval: 1.06-1.60). In an analysis restricted to PWD, individuals in the most severe disability category (Group 1) had over two times higher odds for loneliness when compared to those in the least severe disability category (Group 3).

    CONCLUSIONS: Disability is associated with higher odds for reporting loneliness in the FSU countries and this association is especially strong among those who are more severely disabled. An increased focus on the relationship between disability and loneliness is now warranted given the increasing recognition of loneliness as a serious public health problem that is associated with a number of detrimental outcomes.

  • 160.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Kyoto, Japan.
    Kondo, Naoki
    Kyoto University, Kyoto, Japan.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, UK.
    Kizilova, Kseniya
    Kharkiv National University, Kharkiv, Ukraine.
    Waldman, Kyle
    Harvard University, Cambridge, MA, USA.
    Oh, Hans
    University of Southern California, USA.
    Inoue, Yosuke
    National Center for Global Health and Medicine, Japan.
    Shin, Jae Il
    Yonsei University College of Medicine, Korea.
    Shakespeare, Tom
    London School of Hygiene and Tropical Medicine, London, UK.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, UK.
    Disability and psychological distress in nine countries of the former Soviet Union2021In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 292, p. 782-787Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People with disabilities (PWD) are at increased risk of poor mental health. However, this association and the pathways involved remain under-researched in many parts of the world. This study examined the association between disability and psychological distress in nine countries of the former Soviet Union (FSU).

    METHODS: Data were analysed from 18,000 adults aged ≥18 years collected 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. Information was obtained on disability status, the severity of the disability and psychological distress. Logistic regression analysis was used to estimate associations.

    RESULTS: In a fully adjusted combined country analysis, disability was associated with over two times higher odds for psychological distress (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.86-2.58). The strength of the association varied across the individual countries. Among PWD more severe disability was associated with significantly higher odds for psychological distress (OR: 2.12, 95%CI: 1.26-3.55).

    LIMITATIONS: The data were cross-sectional and disability status was self-reported, possibly resulting in underreporting.

    CONCLUSIONS: Disability is associated with worse psychological health in FSU countries, especially among those with more severe disabilities. As poor mental health may also increase the risk of negative outcomes in PWD, this finding highlights the importance of the early detection and treatment of mental disorders in PWD in these countries.

  • 161.
    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.
    Koposov, R.
    The Arctic University of Norway, Norway.
    Koyanagi, A.
    Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
    Oh, H.
    University of Southern California, Los Angeles, USA.
    Ruchkin, V.
    Uppsala University, Sweden; Yale University Medical School, New Haven, USA.
    Attention-Deficit/Hyperactivity Disorder Symptoms and Community Violence Exposure in Russian Adolescents2021In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 36, no 17-18, p. NP9738-NP9756Article in journal (Refereed)
    Abstract [en]

    A large body of research has shown that exposure to community violence is common for many children across the world. However, less is known about exposure in particular subgroups such as those children with developmental disorders. To address this research gap, the aim of this study was to examine community violence exposure (CVE) in adolescents with attention-deficit/hyperactivity disorder (ADHD) symptoms and the role of gender in this association. Data were analyzed from 2,782 adolescents aged 13 to 17 years from Arkhangelsk, Russia that were collected during the Social and Health Assessment (SAHA). ADHD status was assessed with the hyperactivity/inattention scale of the Strengths and Difficulties Questionnaire (SDQ). Information was obtained on past-year witnessing and violence victimization in the community. Results showed that CVE was more prevalent in children with ADHD symptoms. Specifically, 75.1% of children with ADHD symptoms had been exposed to any violence versus 62.3% in the non-ADHD group (χ2 = 18.65, p <.001). Multivariate analyses of covariance (MANCOVAs) revealed that CVE was significantly higher for adolescents with ADHD symptoms for both witnessing and victimization, while exposure was significantly higher for ADHD boys compared with girls. The findings of this study suggest that CVE may be elevated in adolescents with higher ADHD symptoms. Given that CVE has been associated with a variety of negative social and psychological outcomes in typically developing children, an important task for future research is to determine what factors are associated with CVE in adolescents with ADHD symptoms including those relating to such phenomena as comorbid psychopathology, the family, and peer relations, so that interventions can be designed and implemented to reduce CVE and its detrimental effects in this population.

  • 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, Kodaira, Tokyo, Japan.
    Koposov, Roman
    UiT The Arctic University of Norway, Tromsö, Norway.
    Kamio, Yoko
    National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Takahashi, Hidetoshi
    National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, CIBERSAM, Madrid, Spain.
    Inoue, Yosuke
    University of North Carolina at Chapel Hill, Chapel Hill, USA.
    Yazawa, Aki
    University of Fukui, Fukui, Japan.
    Ruchkin, Vladislav
    Uppsala University / Yale University Medical School, New Haven, USA.
    Attention deficit/hyperactivity disorder and future expectations in Russian adolescents2019In: ADHD Attention Deficit and Hyperactivity Disorders, ISSN 1866-6116, E-ISSN 1866-6647, Vol. 11, no 3, p. 279-287Article in journal (Refereed)
    Abstract [en]

    In recent years, there has been an increasing focus on the role of future expectations-the extent to which a future outcome is deemed likely-in the health and well-being of adolescents, with research linking future expectations to outcomes such as an increased likelihood of engaging in risky health behaviors. As yet, however, there has been no research on future expectations and attention deficit/hyperactivity disorder (ADHD) in adolescence. To address this research gap, the current study examined the association between ADHD symptoms/possible ADHD status and future expectations in a school-based sample of adolescents. Data were analyzed from 537 Russian adolescents (aged 12-17) with teacher-reported ADHD symptoms and self-reported future expectations. Logistic regression analysis was used to examine associations. In fully adjusted analyses, inattention symptoms/possible ADHD inattentive status was associated with lower future educational expectations, while a possible ADHD hyperactivity status was associated with increased odds for negative future expectations relating to work, family and succeeding in what is most important. The findings of this study suggest that greater ADHD symptoms/possible ADHD status in adolescence may be linked to an increased risk for negative future expectations across a variety of different life domains.

  • 163.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, KodairaJapan.
    Koposov, Roman
    UiT The Arctic University of Norway, Tromsö, Norway.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, Madrid, Spain.
    Inoue, Yosuke
    University of North Carolina at Chapel Hill, Chapel Hill, USA.
    Ruchkin, Vladislav
    Uppsala University / Yale University Medical School, New Haven, USA.
    ADHD and depressive symptoms in adolescents: the role of community violence exposure2019In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 54, no 6, p. 683-691Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Comorbid depression is common in adolescents with attention-deficit/hyperactivity disorder (ADHD). As yet, however, little is known about the factors associated with co-occurring depression in this population. To address this research gap, the current study examined the role of community violence exposure in the association between ADHD symptoms and depression.

    METHODS: Data came from 505 Russian adolescents [mean age 14.37 (SD = 0.96)] who had teacher-reported information on ADHD symptoms that was collected in conjunction with the Social and Health Assessment (SAHA). Adolescent self-reports of witnessing and being a victim of community violence were also obtained while depressive symptoms were self-assessed with an adapted version of the Center for Epidemiologic Studies-Depression Scale (CES-D). Logistic regression analyses were performed to examine associations.

    RESULTS: In univariable analyses, both witnessing and being a victim of violence were associated with significantly increased odds for depressive symptoms in adolescents with ADHD symptoms compared to non-ADHD adolescents who had not experienced community violence. However, in the multivariable analysis only being a victim of violence continued to be associated with significantly increased odds for depression [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.33-16.35].

    CONCLUSION: Exposure to community violence may be associated with depression in adolescents with ADHD symptoms. Clinicians should enquire about exposure to community violence in adolescents with ADHD/ADHD symptoms. Early therapeutic interventions to address the effects of violence exposure in adolescents with ADHD may be beneficial for preventing depression in this group.

  • 164.
    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 Institute of Mental Health, Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Koyanagi, A.
    Parc Sanitari Sant Joan de Déu, Madrid, Spain / CIBERSAM, Madrid, Spain.
    Koposov, R.
    Arctic University of Norway, Tromsø, Norway.
    Blatný, M.
    Institute of Psychology of the Czech Academy of Sciences, Brno, Czech Republic.
    Hrdlička, M.
    University Hospital Motol, Prague, Czech Republic.
    Schwab-Stone, M.
    Yale University, New Haven, USA.
    Ruchkin, V.
    Uppsala University.
    Loneliness and its association with psychological and somatic health problems among Czech, Russian and U.S. adolescents2016In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 16, no 1, article id 128Article in journal (Refereed)
    Abstract [en]

    Background: Loneliness is common in adolescence and has been linked to various negative outcomes. Until now, however, there has been little cross-country research on this phenomenon. The aim of the present study was to examine which factors are associated with adolescent loneliness in three countries that differ historically and culturally-the Czech Republic, Russia and the United States, and to determine whether adolescent loneliness is associated with poorer psychological and somatic health. Methods: Data from a school survey, the Social and Health Assessment (SAHA), were used to examine these relations among 2205 Czech, 1995 Russian, and 2050 U.S. male and female adolescents aged 13 to 15 years old. Logistic regression analysis was performed to examine if specific demographic, parenting, personal or school-based factors were linked to feeling lonely and whether lonely adolescents were more likely to report psychological (depression and anxiety) or somatic symptoms (e.g. headaches, pain). Results: Inconsistent parenting, shyness, and peer victimisation were associated with higher odds for loneliness in at least 4 of the 6 country- and sex-wise subgroups (i.e. Czech, Russian, U.S. boys and girls). Parental warmth was a protective factor against feeling lonely among Czech and U.S. girls. Adolescents who were lonely had higher odds for reporting headaches, anxiety and depressive symptoms across all subgroups. Loneliness was associated with other somatic symptoms in at least half of the adolescent subgroups. Conclusion: Loneliness is associated with worse adolescent health across countries. The finding that variables from different domains are important for loneliness highlights the necessity of interventions in different settings in order to reduce loneliness and its detrimental effects on adolescent health. © 2016 Stickley et al.

  • 165.
    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.
    Koyanagi, A.
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Ueda, M.
    Waseda University, Tokyo, Japan.
    Inoue, Y.
    The University of North Carolina at Chapel Hill, NC, USA.
    Waldman, K.
    Harvard University, Cambridge, MA, USA.
    Oh, H.
    University of Southern California, Los Angeles, CA, USA.
    Physical multimorbidity and suicidal behavior in the general population in the United States2020In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 604-609Article in journal (Refereed)
    Abstract [en]

    Background: As yet, there has been little research on the association between physical multimorbidity (the co-occurrence of two or more physical illnesses) and suicide, and results have been mixed. This study examined if physical multimorbidity is associated with suicidal behavior in the general population in the United States. Method: Data were analyzed from 15,311 adults that were obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES). Information was obtained on nine self-reported physical health conditions and lifetime suicidal behavior (suicidal ideation, plan, and attempts). Logistic regression analysis was used to examine associations. Results: An increasing number of physical health conditions was associated with higher odds for suicidal behavior. Compared to those with no physical conditions, individuals with ≥ 4 physical illnesses had 2.99, 4.82, and 4.39 times higher odds for reporting suicidal ideation, a suicide plan, and suicide attempts, respectively. An interaction analysis showed that for suicide attempts the association was stronger in younger rather than older adults. Limitations: The data were cross-sectional and information on physical conditions and suicidal behavior was self-reported and may have been subject to reporting bias. Conclusions: As multimorbidity has increased in recent decades in the United States, alerting medical practitioners to the increased risk of suicidal behavior in adults who have multiple medical conditions as well as screening for suicidality in this group may be important preventive measures to help reduce suicidal behavior in the general population.

  • 166.
    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
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey2016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 197, no June, p. 81-87Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Loneliness has been linked to an increased risk of engaging in suicidal behavior. To date, however, there has been comparatively little research on this in the general adult population, or on the role of common mental disorders (CMDs) in this association. The current study examined these associations using nationally representative data from England.

    METHODS: Data came from the Adult Psychiatric Morbidity Survey 2007. Information was obtained from 7403 household residents aged ≥16 years on perceived loneliness and lifetime and past 12-month suicide ideation and attempts. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of CMD. Logistic regression analysis was used to examine these associations.

    RESULTS: Loneliness was associated with suicidal behavior. Although adjusting for CMDs attenuated associations, higher levels of loneliness were still significantly associated with suicidal ideation and suicide attempts with odds ratios (OR) for those in the most severe loneliness category ranging from 3.45 (lifetime suicide attempt) to 17.37 (past 12-month suicide attempt). Further analyses showed that ORs for suicidal behavior were similar for individuals who were lonely without CMDs, and for those respondents with CMDs who were not lonely. Lonely individuals with CMDs had especially elevated odds for suicidal ideation.

    LIMITATIONS: This study used cross-sectional data and a single-item measure to obtain information on loneliness.

    CONCLUSION: Loneliness is associated with suicidal behavior in the general adult population. This highlights the importance of efforts to reduce loneliness in order to mitigate its harmful effects on health and well-being.

  • 167.
    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, 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.

  • 168.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / nstituto de Salud Carlos III, CIBERSAM, Madrid, Spain.
    Inoue, Yosuke
    University of North Carolina at Chapel Hill, 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.
    Childhood hunger and thoughts of death or suicide in older adults2018In: The American journal of geriatric psychiatry, ISSN 1064-7481, E-ISSN 1545-7214, Vol. 26, no 10, p. 1070-1078Article in journal (Refereed)
    Abstract [en]

    Objective There is little research on the effects of childhood hunger on adult mental health. This study examined the association between childhood hunger and recurrent thoughts of death or suicide in older adults. Design Data were analyzed from adults aged 60 and above collected during the Estonian Health Interview Survey 2006 (N=2455). Retrospective information was obtained on the frequency (never, seldom, sometimes, often) of going to bed hungry in childhood, and on the presence of recurrent thoughts of death or suicide in the past 4 weeks. Multivariate logistic regression analysis was used to examine associations between the variables. Results Experiencing hunger in childhood was common (37.6%) with 14.3% of the respondents stating that they often went to bed hungry. In a univariate analysis going to bed hungry either sometimes or often more than doubled the odds for thoughts of death or suicide. Although adjustment for a range of covariates (including physical diseases and depressive episode) attenuated the associations, in the fully adjusted model going to bed hungry sometimes continued to be associated with significantly increased odds for thoughts of death or suicide in older adults (OR = 1.74, 95% CI = 1.10–2.74; Wald χ2 = 5.7, df = 1, p = 0.017). Conclusion The findings of this study suggest that the effects of childhood hunger may be long lasting and associated with mental health and well-being even in older adults.

  • 169.
    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®.

  • 170.
    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
    Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain..
    Koposov, Roman
    The Arctic University of Norway, Norway.
    Blatný, Marek
    Academy of Sciences of the Czech Republic, Brno, Czech Republic..
    Hrdlička, Michal
    University Hospital Motol, Prague, Czech Republic.
    Schwab-Stone, Mary
    Yale University Medical School, New Haven, CT, USA.
    Ruchkin, Vladislav
    Uppsala University.
    Correlates of Weapon Carrying in School among Adolescents in Three Countries2015In: American Journal of Health Behavior, ISSN 1087-3244, E-ISSN 1945-7359, Vol. 39, no 1, p. 99-108Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To determine the factors associated with weapon carrying in school among Czech, Russian, and US adolescents.

    METHODS: Logistic regression was used to analyze data drawn from the Social and Health Assessment (SAHA).

    RESULTS: Violent behavior (perpetration / victimization) was linked to adolescent weapon carrying in all countries. Substance use was associated with weapon carrying among boys in all countries. Greater parental warmth reduced the odds for weapon carrying among Czech and Russian adolescents. Associating with delinquent peers was important for weapon carrying only among US adolescents.

    CONCLUSIONS: Factors associated with weapon carrying in school vary among countries although violent behavior and substance use may be associated with weapon carrying across countries.

  • 171.
    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.

  • 172.
    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.

  • 173.
    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, 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.

  • 174.
    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.

  • 175.
    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, 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.

  • 176.
    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.

  • 177.
    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, E-ISSN 1472-6882, Vol. 13, article id 83Article 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.

  • 178.
    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 & Tropical Medicine , London, UK / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Fundacio St Joan Deu, Barcelona, Spain / Inst Salud Carlos III, CIBERSAM, Madrid, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, UK.
    Goryakin, Yevgeniy
    University of East Anglia, Norwich, UK .
    Mckee, Martin
    London School of Hygiene and Tropical Medicine, London, UK .
    Crime and subjective well-being in the countries of the former Soviet Union2015In: BMC Public Health, E-ISSN 1471-2458, Vol. 15, article id 1010Article in journal (Refereed)
    Abstract [en]

    Background: Criminal victimisation and subjective well-being have both been linked to health outcomes, although as yet, comparatively little is known about the relationship between these two phenomena. In this study we used data from nine countries of the former Soviet Union (fSU) to examine the association between different types of crime and subjective well-being. Methods: Data were obtained from 18,000 individuals aged 18 and above collected during the Health in Times of Transition (HITT) survey in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine. Information was obtained on respondents' experience of crime (violence and theft) and self-reported affective (happiness) and cognitive (life satisfaction) well-being. Ordered probit and ordinary least squares (OLS) regression analyses were undertaken to examine the associations between these variables. Results: In pooled country analyses, experiencing violence was associated with significantly lower happiness and life satisfaction. Theft victimisation was associated with significantly reduced life satisfaction but not happiness. Among the individual countries, there was a more pronounced association between violent victimisation and reduced happiness in Kazakhstan and Moldova. Conclusions: The finding that criminal victimisation is linked to lower levels of subjective well-being highlights the importance of reducing crime in the fSU, and also of having effective support services in place for victims of crime to reduce its detrimental effects on health and well-being.

  • 179.
    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, London, UK / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, UK.
    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.
    Goryakin, Yevgeniy
    University of East Anglia, Norwich, UK.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, UK.
    Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union2015In: Tobacco Control, ISSN 0964-4563, E-ISSN 1468-3318, Vol. 24, no 2, p. 190-197Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The US Food and Drug Administration has established a policy of substantially discounting the health benefits of reduced smoking in its evaluation of proposed regulations because of the cost to smokers of the supposed lost pleasure they suffer by no longer smoking. This study used data from nine countries of the former Soviet Union (fSU) to explore this association in a setting characterised by high rates of (male) smoking and smoking-related mortality.

    METHODS: Data came from a cross-sectional population-based study undertaken in 2010/2011 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Information was collected from 18 000 respondents aged ≥18 on smoking status (never, ex-smoking and current smoking), cessation attempts and nicotine dependence. The association between these variables and self-reported happiness was examined using ordered probit regression analysis.

    RESULTS: In a pooled country analysis, never smokers and ex-smokers were both significantly happier than current smokers. Smokers with higher levels of nicotine dependence were significantly less happy than those with a low level of dependence.

    CONCLUSIONS: This study contradicts the idea that smoking is associated with greater happiness. Moreover, of relevance for policy in the fSU countries, given the lack of public knowledge about the detrimental effects of smoking on health but widespread desire to quit reported in recent research, the finding that smoking is associated with lower levels of happiness should be incorporated in future public health efforts to help encourage smokers to quit by highlighting that smoking cessation may result in better physical and emotional health.

  • 180.
    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, London, United Kingdom / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Parc Sanitari Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Urban-rural differences in psychological distress in nine countries of the former Soviet Union2015In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 178, p. 142-148Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies have shown that the prevalence of mental illness can vary between urban and rural locations. This study extended research to the countries of the former Soviet Union (fSU) by assessing the association between settlement type and psychological distress and whether factors associated with psychological distress vary by settlement type.

    METHODS: Data on 18,000 adults aged ≥18 years from the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010/11 were analyzed. Settlement types were country capitals, regional capitals, cities/other urban settlements, and villages. Psychological distress was defined as the country-specific highest quintile of a composite score based on 11 questions. Logistic regression analysis with random effects was used to examine associations.

    RESULTS: In a pooled country analysis, living in a smaller urban settlement or village was associated with significantly higher odds for psychological distress compared to living in the country capital. Lower social support was a strong correlate of psychological distress in all locations except capital cities.

    LIMITATIONS: The psychological distress measure has not been formally validated in the study countries.

    CONCLUSIONS: Lower levels of urbanicity are associated with greater psychological distress in the fSU countries. As many Western studies have linked greater urbanization to poorer mental health, this highlights the need for caution in extrapolating findings from one part of the world to others and the importance of undertaking research on the geographical correlates of mental health in different world regions.

  • 181.
    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, London, United Kingdom / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain 7 CIBERSAM, Madrid, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Murphy, Adrianna
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Kizilova, Kseniya
    V.N. Karazin Kharkov National University, Kharkiv, Ukraine.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Male solitary drinking and hazardous alcohol use in nine countries of the former Soviet Union2015In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 150, p. 105-111Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite evidence that many people engage in solitary drinking and that it might be associated with negative consequences, to date, little research has focused on this form of drinking behaviour. This study examined the prevalence and factors associated with solitary drinking, and assessed whether it is linked with hazardous alcohol use among males in nine countries of the former Soviet Union (fSU).

    METHODS: Data came from a cross-sectional population-based survey undertaken in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. Information was obtained on the frequency of solitary drinking among male regular drinkers (i.e., those consuming alcoholic drinks at least once a month), and on problem drinking (CAGE) and heavy episodic drinking (HED). Logistic regression analysis was used to examine associations between the variables.

    RESULTS: The prevalence of occasional and frequent solitary drinking ranged from 8.4% (Georgia) to 42.4% (Azerbaijan), and 3.1% (Kazakhstan) to 8.2% (Armenia), respectively. Solitary drinking was associated with being older, divorced/widowed, living alone, having a bad/very bad household financial situation, lower levels of social support, and poor self-rated health. Occasional solitary drinking was linked to problem drinking and HED, while frequent solitary alcohol use was related to problem drinking.

    CONCLUSIONS: Solitary drinking is relatively common among male regular drinkers in the fSU and is linked to older age, social and economic disadvantage, and hazardous alcohol use.

  • 182.
    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, 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.

  • 183.
    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.

  • 184.
    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 for Neurology and Psychiatry (NCNP), Tokyo, Japan / University of Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
    Ruchkin, Vladislav
    Uppsala universitet / Yale University, USA / Säter Forensic Psychiatric Clinic.
    Kamio, Yoko
    National Institute of Mental Health, National Center for Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder symptoms and suicide ideation and attempts: Findings from the Adult Psychiatric Morbidity Survey 20072016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 189, p. 321-328Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Adults with attention-deficit/hyperactivity disorder (ADHD) may have an increased risk of engaging in suicidal behavior. This study examined this association in the general adult population where there has been little research.

    METHODS: Data came from the Adult Psychiatric Morbidity Survey 2007. This was a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) was used to obtain information on ADHD symptoms. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of common mental disorder (CMD). Information was also obtained on the lifetime and past 12-month occurrence of suicide ideation and attempts. Logistic regression analysis was used to examine these associations.

    RESULTS: After adjusting for comorbid disorders, adults with more ADHD symptoms had significantly higher odds for suicidal behavior. When a single cut-off point was used to classify ADHD (ASRS score ≥14), odds ratios ranged from 1.62 (lifetime suicide attempt) to 2.43 (past 12-month suicide ideation). When ADHD symptoms were categorized by strata (I: a score of 0-9; II: 10-13; III: 14-17; IV: 18-24), compared to adults in stratum I, those in stratum IV had odds ratios ranging from 2.16 (lifetime suicide ideation) to 3.68 (past 12-month suicide attempt).

    LIMITATIONS: ADHD and suicide data came from self-reports which may have been affected by socially desirable responding.

    CONCLUSIONS: ADHD symptoms were linked to suicidal behavior after controlling for comorbid conditions. Health care professionals should be alerted to the increased suicide risk among adults with ADHD symptoms.

  • 185.
    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)
  • 186.
    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 Institute of Mental Health, Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, Madrid, Spain.
    Takahashi, Hidetoshi
    National Institute of Mental Health, Tokyo, Japan.
    Kamio, Yoko
    National Institute of Mental Health, Tokyo, Japan.
    ADHD Symptoms and Pain among Adults in England2016In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 246, p. 326-331Article in journal (Refereed)
    Abstract [en]

    Abstract Prior research has produced conflicting findings on the association between attention-deficit/hyperactivity disorder (ADHD) and pain, while studies among community-dwelling adults are lacking. This study examined the association between ADHD symptoms and pain in the general adult population, and the extent to which this association is influenced by comorbid common mental disorders (CMDs). Data came from the 2007 Adult Psychiatric Morbidity Survey which included a representative sample of the English adult population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) Screener was used to obtain information on ADHD symptoms, while pain was assessed by the degree to which it interfered with work activity in the previous month. The Clinical Interview Schedule Revised (CIS-R) was used to evaluate six categories of CMDs. In a binary logistic regression analysis adjusted for socio-demographic factors and physical health conditions, an ADHD symptom score ≥14 was strongly associated with extreme pain (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.09–4.74). The OR was attenuated greatly after further adjustment for CMDs (OR: 1.64, 95% CI: 1.05–2.58) but remained statistically significant. Adults with ADHD symptoms have higher odds for experiencing pain. CMDs are influential in this association but do not fully explain it.

  • 187.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Centre of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
    Takahashi, Hidetoshi
    National Centre of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Ruchkin, Vladislav
    Yale University Medical School, New Haven, USA / Uppsala University.
    Inoue, Yosuke
    University of North Carolina at Chapel Hill, Chapel Hill, USA.
    Yazawa, Aki
    Kamio, Yoko
    National Centre of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder symptoms and happiness among adults in the general population2018In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 265, p. 317-323Article in journal (Refereed)
    Abstract [en]

    Abstract Despite an increasing focus on the role of mood and emotions in attention-deficit/hyperactivity disorder (ADHD), as yet, there has been comparatively little research on positive emotions. To address this research gap, the current study examined the association between ADHD symptoms and happiness using data from the 2007 Adult Psychiatric Morbidity Survey. The analytic sample comprised 7274 adults aged 18 and above residing in private households in England. Information was collected on ADHD symptoms using the Adult ADHD Self-Report Scale (ASRS) Screener, while happiness was assessed with a single (3-point) measure. Multivariable ordinal logistic regression analysis and a mediation analysis were performed to examine associations. Greater ADHD symptom severity was associated with higher odds for feeling less happy. Emotional instability (percentage mediated 37.1%), anxiety disorder (35.6%) and depression (29.9%) were all important mediators of the association between ADHD and happiness. Given that happiness has been linked to a number of beneficial outcomes, the results of this study highlight the importance of diagnosing ADHD in adults and also of screening for and treating any comorbid psychiatric disorders in these individuals.

  • 188.
    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), Tokyo, Japan / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Takahashi, Hidetoshi
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Ruchkin, Vladislav
    Yale University Medical School, New Haven, USA / Uppsala universitet.
    Kamio, Yoko
    National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder symptoms and loneliness among adults in the general population2017In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 62, p. 115-123Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Research on the association between adult attention-deficit/hyperactivity disorder (ADHD) and loneliness is scarce even though factors which have been previously linked to loneliness, such as divorce and poorer mental health may be more prevalent among adults with ADHD. This study investigated the relation between ADHD symptoms/symptom severity and loneliness in the general adult population.

    METHODS: Data from the Adult Psychiatric Morbidity Survey 2007 (N=7403, aged ≥16years) were analyzed. ADHD symptoms and common mental disorders (CMDs) were assessed with the Adult ADHD Self-Report Scale (ASRS) Screener and the Clinical Interview Schedule Revised, respectively. Loneliness was measured with a question from the Social Functioning Questionnaire. Multivariable logistic regression analysis was used to examine the associations.

    RESULTS: In the fully adjusted model, an ASRS score ≥14 was strongly associated with loneliness (OR=2.48 95%CI=1.83-3.36). ADHD symptom severity was related to loneliness in a dose-response fashion. Over one-third of the association between ADHD symptoms and loneliness was explained by CMDs.

    CONCLUSIONS: Adults with more ADHD symptoms are at an increased risk of feeling lonely. Future research should determine how ADHD symptoms are linked to loneliness and if loneliness is affecting well-being.

  • 189.
    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).
    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.
    Childhood hunger and depressive symptoms in adulthood: findings from a population-based study2018In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 226, p. 332-338Article in journal (Refereed)
    Abstract [en]

    Background: Several studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample.

    Methods: Data were analyzed from 5095 adults aged 25–84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables.

    Results: In a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for adult depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model.

    Limitations: Data on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations.

    Conclusion: Childhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course.

  • 190.
    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.
    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.
    DeVylder, Jordan E
    Fordham University, New York City, NY, USA.
    Inoue, Yosuke
    University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Koyanagi, Ai
    Universitat de Barcelon, Barcelona, Spain / ICREA, Barcelona, Spain.
    Sleep problems and depression among 237 023 community-dwelling adults in 46 low- and middle-income countries2019In: Scientific Reports, E-ISSN 2045-2322, Vol. 9, no 1, article id 12011Article in journal (Refereed)
    Abstract [en]

    Sleep problems are considered a core symptom of depression. However, there is little information about the comorbidity of sleep problems and depression in low- and middle-income countries (LMICs), and whether sleep problems with depression confer additional risk for decrements in health compared to sleep problems alone. This study thus examined the association between sleep problems and depression and whether sleep problems with depression are associated with an increased risk for poorer health in 46 LMICs. Cross-sectional, community-based data from 237 023 adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. Information on sleep problems (severe/extreme) and International Classification of Diseases 10th Revision depression/depression subtypes was collected. Multivariable logistic (binary and multinomial) and linear regression analyses were performed. Sleep problems were associated with subsyndromal depression (odds ratio [OR]: 2.23, 95% confidence interval [CI]: 1.84-2.70), brief depressive episode (OR = 2.48, 95% CI = 2.09-2.95) and depressive episode (OR = 3.61, 95% CI = 3.24-4.03). Sleep problems with depression (vs. sleep problems alone) conferred additional risk for anxiety, perceived stress and decrements in health in the domains of mobility, self-care, pain, cognition, and interpersonal activities. Clinicians should be aware that the co-occurrence of sleep problems and depression is associated with a variety of adverse health outcomes in LMICs. Detecting this co-occurrence may be important for treatment planning.

  • 191.
    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.
    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.
    Ruchkin, V.
    Uppsala University / Yale University Medical School, New Haven, USA.
    Oh, H.
    University of Southern California, USA.
    Narita, Z.
    Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
    Koyanagi, A.
    Universitat de Barcelona, Barcelona, Spain / nstituto de Salud Carlos III, Madrid , Spain.
    Attention-deficit/hyperactivity disorder symptoms and perceived mental health discrimination in adults in the general population2019In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 56, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Background: The experience of discrimination is common in individuals with mental health problems and has been associated with a range of negative outcomes. As yet, however, there has been an absence of research on this phenomenon in adults with attention-deficit/hyperactivity disorder (ADHD). The current study examined the association between ADHD symptoms and mental health discrimination in the general adult population. Methods: The analytic sample comprised 7274 individuals aged 18 and above residing in private households in England that were drawn from the Adult Psychiatric Morbidity Survey, 2007. Information on ADHD was obtained with the Adult ADHD Self-Report Scale (ASRS) Screener. A single-item question was used to assess mental health discrimination experienced in the previous 12 months. Logistic regression analysis was used to examine associations. Results: The prevalence of discrimination increased as ADHD symptoms increased but was especially elevated in those with the most severe ADHD symptoms (ASRS score 18–24). In a multivariable logistic regression analysis that was adjusted for a variety of covariates including common mental disorders, ADHD symptoms (ASRS ≥ 14) were associated with almost 3 times higher odds for experiencing mental health discrimination (odds ratio: 2.81, 95% confidence interval: 1.49–5.31). Conclusion: ADHD symptoms are associated with higher odds for experiencing mental health discrimination and this association is especially elevated in those with the most severe ADHD symptoms. Interventions to inform the general public about ADHD may be important for reducing the stigma and discrimination associated with this disorder in adults. 

  • 192.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). Kyoto University, Kyoto, Japan; National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
    Neligan, Aidan
    Homerton University Hospital NHS Foundation Trust, UK; UCL Queen Square Institute of Neurology, UK.
    Baburin, Aleksei
    National Institute for Health Development, Tallinn, Estonia.
    Jasilionis, Domantas
    Max Planck Institute for Demographic Research, Rostock, Germany; Vytautas Magnus University, Kaunas, Lithuania.
    Krumins, Juris
    University of Latvia, Riga, Latvia.
    Martikainen, Pekka
    Max Planck Institute for Demographic Research, Rostock, Germany; University of Helsinki, Helsinki, Finland; Stockholm University, Stockholm, Sweden.
    Kondo, Naoki
    Kyoto University, Kyoto, Japan.
    Sumiyoshi, Tomiki
    National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
    Shin, Jae Il
    Yonsei University College of Medicine, Korea.
    Oh, Hans
    University of Southern California, USA.
    Waldman, Kyle
    Harvard University, Cambridge, MA, USA.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Educational inequalities in epilepsy mortality in the Baltic countries and Finland in 2000-20152022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 4597Article in journal (Refereed)
    Abstract [en]

    Little is known about socioeconomic differences in epilepsy mortality. This study examined educational inequalities in epilepsy mortality in the general population in the Baltic countries and Finland in 2000-2015. Education-specific mortality estimates for individuals aged 30-74 in Estonia, Latvia and Lithuania were obtained from census-linked mortality datasets while data for Finland came from the register-based population and death data file of Statistics Finland. Trends and educational inequalities in epilepsy mortality were assessed using age-standardised mortality rates (ASMRs) per 100,000 person years and age-adjusted mortality rate ratios (RRs) calculated using Poisson regression. ASMRs were higher in men than women in all countries. ASMRs reduced in 2000-2015 among all men and women except for Finnish women. Among men, an inverse educational gradient in epilepsy mortality in 2000-2007 widened in 2008-2015 with ASMRs falling among high and mid educated men in all countries but increasing among low educated men in three countries. An inverse educational gradient in female mortality remained in all countries throughout 2000-2015. Although epilepsy mortality fell in the Baltic countries and Finland (men only) in 2000-2015, this masked a clear inverse educational gradient in mortality that became steeper across the period.

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  • 193.
    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 2045-7979, 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.

  • 194.
    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.

  • 195.
    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 2045-7979, 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.

  • 196.
    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.

  • 197.
    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.

  • 198.
    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, LA, USA.
    Sumiyoshi, Tomiki
    National Institute of Mental Health, Tokyo, Japan.
    Narita, Zui
    The Johns Hopkins University School of Medicine, Baltimore, USA.
    Shirama, Aya
    Yonsei University College of Medicine, Seoul, South Korea.
    Waldman, Kyle
    Harvard University, Cambridge, USA.
    The September 11, 2001, terrorist attacks, media exposure, and psychotic experiences among Asian and Latino Americans2020In: Psychiatry and Clinical Neurosciences, ISSN 1323-1316, E-ISSN 1440-1819, Vol. 74, no 10, p. 572-573Article in journal (Refereed)
  • 199.
    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, 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.

  • 200.
    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.

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