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J C Anthony

Publications and source records attributed to J C Anthony.

At least 145 records · Page 8Linked to original sources
PubMed1991

Trends of HIV-1 risk reduction among initiates into intravenous drug use 1982-1987.

To assess how injection practices may have changed during the course of the AIDS epidemic, active intravenous drug users (IVDUs) recruited from the community were asked to report year of first injection as well as specific details about the first 3 months after initial injection: frequencies of injection, using sterile needles, sharing needles and other equipment. For the analysis, the users were sorted into successive cohorts of initiation (by year of first injection), and tests for trends were completed using Mantel-Haenszel statistics. Among the 421 IVDUs who reported first injection between 1982 and 1987, the use of new sterile needles to self-administer drugs increased (p less than .05) along with its corollary behavior (i.e., using equipment one is sure that no one else had used before). Conversely, there was a decrease in the proportion of those who always used equipment previously used by another IVDU (p less than .05) and a decrease in the number of needle-sharing partners (p less than .01). Over the 6 years, heroin as first drug decreased and cocaine increased (p less than .01). Although these data are from a cross-sectional interview study, they suggest a shift toward lower risk practices among new IVDUs between 1982 and 1987. The shift from heroin to cocaine is compatible with other evidence on the cocaine epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1990

An epidemiologic investigation of potential risk factors for suicide attempts.

This is a report of new research on suicide attempts, based on an analysis of data from the Epidemiologic Catchment Area surveys in the United States. Risk of making a suicide attempt during a 1-2 year observation interval in the early 1980s was estimated in relation to selected personal and behavioral attributes of 13,673 study participants who completed baseline and follow-up interviews for these surveys. Being an active case of Major Depression was associated with increased risk of suicide attempt (estimated relative odds, RO = 41; 95% CL = 6.46-262), as was active alcoholism (RO = 18; 95% CL = 2.75-118) and being separated or divorced (RO = 11; 95% CL = 1.64-77). Being a user of cocaine was associated with increased risk of making a suicide attempt (RO = 62; 95% CL = 2.51-1528), but illicit use of marijuana, sedative-hypnotics, or sympathomimetic stimulants was not (P greater than 0.30). Educational achievement was inversely associated with risk of suicide attempt at a marginal level of statistical significance (P = 0.068). These multivariable conditional logistic regression results were obtained by applying a conventional epidemiologic strategy with post-stratification of subjects into homogeneous risk sets. Limitations of the study data and the analytic strategy are discussed in relation to directions for future epidemiologic field surveys.

Adult↗
PubMed1990

A note on the use of statistical models in epidemiologic research on illicit drug use.

This essay aims to stimulate thinking or to remind readers about the shortcomings of standardized regression coefficients and related statistical measures in epidemiologic research on illicit drug use. This is accomplished primarily with a set of examples based on simulated epidemiologic data in which the standardized regression coefficient is shown to co-vary dramatically with frequency of the outcome variable. The basic thrust of this critique of commonly used regression models is not new; it has appeared elsewhere several times. Nevertheless, in epidemiologic research on illicit drug use, there is a continuing use of standardized regression coefficients and other margin-sensitive statistical measures without comment on their shortcomings. Thus, a specific critique with illustrations might have value.

Adolescent↗
PubMed1990

Association between intravenous drug use and early misbehavior.

This investigation uses an epidemiologic strategy to examine a suspected association between misbehavior in early life and subsequent involvement in intravenous drug use. The 222 cases of i.v. drug use in this study were a subset of all persons recruited for a continuing study of drug use, HIV-1 infection, and the natural history of AIDS. It was possible to match these 222 i.v. drug users to 588 subjects from the NIMH Epidemiologic Catchment Area survey sample, for a total of 810 subjects in 60 matched sets. The matching factors were gender and census tract of residence. Conditional logistic regression models were used to estimate the degree of association between early misbehavior and i.v. drug use. The results showed a strong association between i.v. drug use and early misbehavior. For every unit increase in misbehavior score, the odds of being an i.v. drug user increased by a factor of 1.74 (P less than 0.001). Compared to subjects with low misbehavior scores, those with high scores were 24.67 times more likely to be i.v. drug users (P less than 0.001). Results of this study add to evidence now supporting field trials of public health strategies to modify the link between misbehavior in early life and later illicit drug use.

Adolescent↗
PubMed1990

The prevalence and self-reported consequences of cocaine use: an exploratory and descriptive analysis.

In this study, prevalence rates for cocaine use were estimated by sex and race, as well as for selected social role and lifestyle characteristics, including educational level, martial status, living arrangements, job type and employment status. Prevalence rates were based on an estimation procedure that made the age-race-sex distributions balanced to that of the nation as a whole. Data were gathered from a multi-site probability sample of adults interviewed in 1981-1984 as part of the National Institute of Mental Health Epidemiologic Catchment Area Program (ECA) (n = 14,333). In addition to prevalence of use, rates of self-reported consequences of cocaine use were generated, by level of cocaine use. Striking differences in prevalence were found by education and marital status, which remained after controlling for age of respondent. Respondents who were employed full-time had a higher prevalence of cocaine use than those who were not. Individuals residing in households at the time of interview had a 6.4% lifetime prevalence of cocaine use, vs. hospitalized respondents (22%) and incarcerated respondents (40%). Cocaine use consequence rates varied greatly across survey sites, with self-reported tolerance (28%-51%) and withdrawal sickness (8%-33%) figuring prominently among sustained daily users.

Adult↗
PubMed1990

Association of drug injection patterns with antibody to human immunodeficiency virus type 1 among intravenous drug users in Baltimore, Maryland.

During 1988 and 1989, intravenous drug users recruited through extensive community outreach efforts in Baltimore, Maryland, were interviewed about drug injection and sex practices in the prior 11 years, with screening for antibody to human immunodeficiency virus type 1 (HIV-1). Neither interviewers nor subjects were aware of HIV-1 serostatus until 2 weeks after the interview. Among 2,616 intravenous drug users who last injected drug within the same calendar year as screening, HIV-1 seroprevalence was 30.1% for those with any use of shooting galleries, 23.3% for those who shared needles but did not use shooting galleries, and 16.3% for drug users who denied both needle-sharing and gallery use between 1977 and 1987. Among 608 drug users who reported persistent use of shooting galleries since 1977 or subsequent initiation into drug use, there was a tendency for HIV-1 seroprevalence to increase with more recent onset of an injection career. Combined with a milder but similar tendency among 739 drug users who reported persistent sharing of needles, and a seroprevalence of 15.1% among participants who had just started injecting drugs in the 18 months prior to baseline, these data provide indirect evidence that a high risk for HIV-1 infection might occur early during a drug injection career.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Occupations and the prevalence of major depressive disorder.

The prevalence of depression has rarely been studied in a manner permitting comparisons across a range of occupations. This analysis reveals considerable range in prevalence in 104 occupations of major depressive disorder as defined by the Diagnostic and Statistical Manual (ed 3), and measured by the National Institute of Mental Health's Diagnostic Interview Schedule. Five occupations had prevalence rates above 10%. When adjusted for sociodemographic factors, three occupations yield prevalences with statistically significant elevations in the rate, compared with employed persons generally. The three are lawyers, with an odds ratio of 3.6; other teachers and counselors, with an odds ratio of 2.8; and secretaries, with an odds ratio of 1.9. Exploration of possible sources of these differences concludes the paper.

Computers↗
PubMed1990

Gender differences in initiation of psychotherapeutic medicine use.

It has been shown that women are more likely than men to have used prescription psychotherapeutic medicines. Gender differences in the determinants of such use have also been identified. In an earlier study of adult household residents aged 18-44, we found that antecedent illicit drug use was associated with prescribed psychotherapeutic medicine use, independent of psychiatric symptoms. In this study, we explore these predictive relationships separately for males and females. For both males (n = 604) and females (n = 933) illicit drug use was associated with psychotherapeutic medicine use, although the relationship was stronger among males. Psychiatric symptoms did not account for this relationship for either gender. Among males, symptoms and illicit drug use each increased the likelihood of psychotherapeutic medicine use. Among females, no additional likelihood of psychotherapeutic medicine use over and above that for illicit drug use resulted when psychiatric symptoms were also present. Help-seeking was strongly associated with prescription psychotherapeutic medicine use among both genders.

Adolescent↗
PubMed1990

A case-control study of Alzheimer's disease in Australia.

We conducted a case-control study of clinically diagnosed Alzheimer's disease (AD) on 170 cases aged 52 to 96 years, and 170 controls matched for age, sex and, where possible, the general practice of origin. Trained lay interviewers naive to the hypotheses and to the clinical status of the elderly person carried out risk-factor interviews with informants. Significant odds ratios were found for 4 variables: a history of either dementia, probable AD, or Down's syndrome in a 1st-degree relative, and underactivity as a behavioral trait in both the recent and more distant past. Previously reported or suggested associations not confirmed by this study include head injury, starvation, thyroid disease, analgesic abuse, antacid use (aluminum exposure), alcohol abuse, smoking, and being left-handed.

Aged↗
PubMed1990

Predictors of the initiation of psychotherapeutic medicine use.

This study examined the hypothesized predictive association between illicit drug use and the onset of prescribed psychotherapeutic medicine use. The effect of psychiatric symptoms on this relationship was also explored. Data were gathered retrospectively, through standardized household interviews conducted in 1981 for the Baltimore site of the National Institute of Mental Health Epidemiologic Catchment Area Program. For this analysis, the sample was restricted to 1,716 respondents ages 18-44 at the time of interview, drawn by probability sampling area household residents of all adult ages. Using Cox proportional hazards models, the onset of psychotherapeutic medicine use was modeled as a function of illicit drug use and psychiatric symptoms, both defined as time-dependent covariates. Newly observed in this analysis was an independent association of illicit drug use with psychotherapeutic medicine use, which was unexplained by psychiatric symptoms (relative hazard = 2.61, 95% confidence interval (CI) = 2.15, 3.18). Adjustment for age of onset of alcohol intoxication did not alter the impression that illicit drug users were more likely to initiate use of prescribed psychotherapeutic medicines (relative hazard = 2.52, 95% CI = 2.02, 3.11).

Adult↗
PubMed1990

Epidemiological analysis of alcohol and drug use as risk factors for psychotic experiences.

Clinical and laboratory studies link alcohol and other drug use to the occurrence of psychotic experiences, but epidemiologic evidence has been lacking. In this study, the quantitative relationships between alcohol or other drug use and psychotic experiences were examined by analysis of prospective data from 4994 adult household residents sampled in a multisite survey of mental disorders in the population, the NIMH Epidemiologic Catchment Area Program. After control for sociodemographic factors and preexisting psychiatric conditions, the risk for onset of self-reported delusions or hallucinations was observed to be greater for daily users of marijuana or cocaine and for users of anxiolytics or sympathomimetics compared with nonusers. After control for daily cocaine use and alcohol disorder, the risk of onset of psychotic experiences for daily users of marijuana was double that for nonusers. Alcohol disorder in men was associated with eightfold risk and in women with threefold risk. Baseline depressive episodes, manic episodes, agoraphobia, and obsessive-compulsive disorder also were associated with increased risk of onset of psychotic experiences.

Alcoholism↗
PubMed1989

An epidemiologic investigation of marijuana- and cocaine-related palpitations.

Laboratory studies and anecdotal reports by users suggest that palpitations often follow the administration of marijuana or cocaine. Epidemiologic strategies are used to detect this association using interview data from 6702 household residents sampled and followed prospectively for a collaborative multi-site study of mental disorders in five U.S. communities. The lifetime data indicated that those who used marijuana and/or cocaine were much more likely to report an occurrence of palpitations than non-users. These relationships remained strong after statistical adjustment for cardiovascular disease risk factors such as gender, race and the use of sympathomimetic drugs other than cocaine. The greater risk was found among those who reported use of cocaine but not marijuana (estimated relative risk = 3.41, 95% confidence interval = 1.60-7.29, P less than 0.001).

Adolescent↗
PubMed1989

Epidemiologic evidence on cocaine use and panic attacks.

Experienced drug takers and clinicians report that cocaine causes panic attacks. This claim is supported by laboratory evidence on the pharmacologic activity of the drug. In this paper, the authors have used an epidemiologic strategy to examine the suspected cocaine-panic association, with interview data from 5,896 adult household residents sampled in the early 1980s and followed prospectively for a collaborative multisite study of mental disorders in five US metropolitan areas: New Haven, Connecticut; Baltimore, Maryland; St. Louis, Missouri; Durham, North Carolina; and Los Angeles, California. The risk of panic attacks was observed to be greater for identified cocaine users in this sample, as compared with subjects who did not use cocaine during the follow-up interval. The cocaine-panic association remained strong after statistical adjustment for preexisting psychiatric conditions, use of alcohol and marijuana, and suspected sociodemographic risk factors for panic attacks. The risk was greatest among cocaine users who reported no marijuana use during the follow-up interval (estimated relative risk = 13.0, 95% confidence interval: 2.24-75.8). The study also identified other determinants for panic attack, including sex, marital status, employment status, job prestige, major depression, and heavy drinking.

Adult↗