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1.
  • Griswold, Max G., et al. (författare)
  • Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
  • 2018
  • Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
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2.
  • Lozano, Rafael, et al. (författare)
  • Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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3.
  • Ruchkin, Vladislav V., 1969-, et al. (författare)
  • Suicidal Behavior in Juvenile Delinquents : The Role of ADHD and Other Comorbid Psychiatric Disorders
  • 2017
  • Ingår i: Child Psychiatry and Human Development. - : Springer. - 0009-398X .- 1573-3327. ; 48:5, s. 691-698
  • Tidskriftsartikel (refereegranskat)abstract
    • This study evaluated the role of psychiatric morbidity in relation to a history of suicidal behavior, with a particular focus on attention-deficit/hyperactivity disorder (ADHD). Suicidality and psychiatric diagnoses were assessed in 370 incarcerated male juvenile delinquents from Northern Russia using the semi-structured K-SADS-PL psychiatric interview. A lifetime history of suicidal ideation only (24.7 %) and suicidal ideation with suicide attempts (15.7 %) was common. Binary logistic regression analysis was used to assess the role of ADHD and other psychiatric disorders in suicidal ideation and suicide attempts. A history of suicidal ideation and of suicide attempts were associated with higher rates of psychiatric morbidity and with the number of comorbid psychiatric disorders. An ADHD diagnosis was associated with an increased risk for both suicidal ideation and for suicide attempts. The comorbidity of ADHD with drug dependence further increased the risk for suicidal ideation, while ADHD and alcohol dependence comorbidity increased the risk for suicide attempts. Our findings highlight the importance of adequately detecting and treating psychiatric disorders in vulnerable youths, especially when they are comorbid with ADHD.
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4.
  • Stickley, Andrew, et al. (författare)
  • ADHD and depressive symptoms in adolescents : the role of community violence exposure
  • 2019
  • Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 54:6, s. 683-691
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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5.
  • Stickley, Andrew, et al. (författare)
  • Adolescent binge drinking and risky health behaviours : Findings from northern Russia.
  • 2013
  • Ingår i: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 133:15, s. 838-844
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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6.
  • Stickley, Andrew, et al. (författare)
  • Attention deficit/hyperactivity disorder and future expectations in Russian adolescents
  • 2019
  • Ingår i: ADHD Attention Deficit and Hyperactivity Disorders. - : Springer. - 1866-6116 .- 1866-6647. ; 11:3, s. 279-287
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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7.
  • Stickley, Andrew, et al. (författare)
  • Attention-deficit/hyperactivity disorder and physical multimorbidity : A population-based study
  • 2017
  • Ingår i: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 45, s. 227-234
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e. = 2 physical diseases) among adults in the English general population.Methods:Data were analyzed from 7274 individuals aged = 18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.Results:There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score = 14). Compared to those with no diseases, individuals with = 5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48–4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3–24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.Conclusion:Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.
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8.
  • Stickley, Andrew, et al. (författare)
  • Attention-deficit/hyperactivity disorder symptoms and happiness among adults in the general population
  • 2018
  • Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 265, s. 317-323
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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9.
  • Stickley, Andrew, et al. (författare)
  • Attention-deficit/hyperactivity disorder symptoms and loneliness among adults in the general population
  • 2017
  • Ingår i: Research in Developmental Disabilities. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0891-4222 .- 1873-3379. ; 62, s. 115-123
  • Tidskriftsartikel (refereegranskat)abstract
    • 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 >16 years) 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 = 1.83-336). 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 affectihg well-being.
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10.
  • Stickley, Andrew, et al. (författare)
  • Attention-deficit/hyperactivity disorder symptoms and suicide ideation and attempts : Findings from the Adult Psychiatric Morbidity Survey 2007
  • 2016
  • Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 189, s. 321-328
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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