[What can be done in order to control the adverse effects of alcohol?].
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Alcohol Drinking↗
Biomedical subjects
Kari Poikolainen
Publications and source records attributed to Kari Poikolainen.
Alcohol intake and sickness absence: a curvilinear relation.
Little is known about the U-shaped relation between alcohol intake and health beyond findings related to cardiovascular disease. Medically certified sickness absence is a health indicator in which coronary heart disease is only a minor factor. To investigate the relation between alcohol intake and sickness absence, records regarding medically certified sick leaves from all causes were assessed for 4 years (1997-2000) in a cohort of 1,490 male and 4,952 female municipal employees in Finland. Hierarchical Poisson regression, adjusted for self-reported behavioral and biologic risk factors, psychosocial risk factors, and cardiovascular diseases, was used to estimate the rate ratios and their 95% confidence intervals, relating sickness absence to each level of alcohol consumption. For both men and women, a significant curvilinear trend was found between level of average weekly alcohol consumption and sickness absence. The rates of medically certified sickness absence were 1.2-fold higher (95% confidence interval: 1.1, 1.3) for never, former, and heavy drinkers compared with light drinkers. The U-shaped relation between alcohol intake and health is not likely to be explained by confounding due to psychosocial differences or inclusion of former drinkers in the nondrinkers category. Moderate alcohol consumption also may reduce health problems other than cardiovascular disease.
Absenteeism↗
Opposite associations of carbohydrate-deficient transferrin and gamma-glutamyltransferase with prevalent coronary heart disease.
BACKGROUND: Moderate alcohol consumption may reduce the risk of coronary heart disease (CHD), but excessive alcohol consumption is probably harmful to the heart. We analyzed the association of 2 commonly used markers of alcohol consumption-carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase (GGT)-and self-reported alcohol consumption with prevalent CHD. METHODS: The study included a random sample of 3666 Finnish men aged 25 to 74 years who participated in a risk factor survey in 1997. The cross-sectional association of CDT, GGT, and self-reported drinking with CHD was analyzed by means of logistic regression models. RESULTS: The CDT level was inversely and GGT level positively associated with CHD risk. The odds ratios (adjusted for age, smoking, total and high-density lipoprotein cholesterol levels, systolic blood pressure, and body mass index) of CHD among men in the fourth quartiles of CDT and GGT, as compared with the first quartiles, were 0.69 and 1.76, respectively. In a composite risk assessment, men with normal CDT levels (< or =20 U/L) and elevated GGT levels (>80 U/L) had nearly 8-fold adjusted risk of CHD as compared with the men with normal GGT levels and elevated CDT levels. Self-reported alcohol consumption had an inverse association with CHD risk, which disappeared after adjustment for the other risk factors. CONCLUSIONS: Levels of CDT and GGT may be indicators of factors behind the curvilinear association between alcohol consumption and CHD risk. The CDT level seems to be related to beneficial biological changes and GGT level with the changes that are detrimental to the cardiovascular system. The inverse association of CDT level with CHD risk will be examined further in a forthcoming prospective study.
Adult↗
Psychiatric treatment seeking and psychosocial impairment among young adults with depression.
BACKGROUND: We report data on 1-year prevalence and comorbidity of depression, related impairment, treatment need, and psychiatric treatment among young adults. METHODS: A sample of young urban adults (n=245) mean age 21.8 years was screened from a baseline population of 706 high-school students and given a semistructured clinical interview to evaluate 12-month prevalence of depression, psychosocial functioning according to DSM-IV GAF scale, need for psychiatric treatment, and use of mental health services. RESULTS: One in 10 young adults suffered from depression with associated psychosocial impairment, the female-to-male-ratio being approximately 2:1. Most depressive disorders were comorbid with other DSM-IV disorders, depression usually occurring secondary to other disorders. Comorbidity was related to impairment, treatment need, and treatment contacts. Less than half of the depressed young adults had ever contacted mental health services, and less than one-third reported treatment contacts during the index episode. Males were less likely than females to report previous treatment contacts or intention to refer to mental health services for their problems, but treatment contacts during the index episode were reported equally often by both sexes. CONCLUSIONS: A minority of the severely depressed young adults with associated impairment had sought treatment. Except for subjects with dysthymia, no gender difference emerged in treatment contact rates during the 12-month depression episode. Comorbidity showed important clinical implications by its relation to severity of depression and treatment contacts.
Adolescent↗
Alcohol sales and fatal alcohol poisonings: a time-series analysis.
AIMS: To discover whether the number of fatal alcohol peaks during festivities characterized by unrestrained drinking and relates to sales of alcoholic beverages. DESIGN: Time-series and cross-sectional. DATA: Fatal alcohol poisonings and retail alcohol sales in Finland in 1983-99. FINDINGS: Fatal alcohol poisonings were found to peak during weekends and in the May Day, Midsummer Day and Christmas celebrations. Regression analysis of quarterly series lead to a model showing that 1% increase in the sales of spirits increases the number of fatal alcohol poisonings by 0.4%. CONCLUSIONS: At the population level, increases in the sales of spirits and periods of hard drinking seem to increase deaths from alcohol poisoning. The findings could be of use in efforts to decrease hard drinking.
Alcohol Drinking↗
Predictors of mental distress in early adulthood: a five-year follow-up of 709 high-school students.
Mental health risk factors in adolescence were examined as predictors of mental distress in early adulthood. A cohort of 709 Finnish adolescents was studied in 1990 (mean age 16.8) and in 1995. Trait anxiety, defence styles, life events, self-esteem and somatic symptoms were evaluated as predictors of high scores in the General Health Questionnaire in adulthood. Females (36%) were more likely to be distressed than males (23%). High trait anxiety and somatic symptom scores among adolescent females, and high immature defence style scores among males predicted mental distress. Males with low trait anxiety in adolescence had less distress. The results indicate trait anxiety as an important predictor of mental distress. Gender differences in other predictors suggest gender differences in coping.
Adaptation, Psychological↗
Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment.
OBJECTIVE: The authors examined the association between self-reported depressive symptoms in adolescence and mental well-being in early adulthood. METHOD: A questionnaire assessing psychosocial well-being was given to a group of subjects (N=651) in their last 3 years of high school (mean age=16.8 years) and again when these subjects reached early adulthood (mean age=21.8 years). Diagnostic interview data were obtained from a subgroup of the young adults (N=245). Adolescents' depressive symptoms were analyzed in relation to their early adulthood mental health outcome data. RESULTS: Depressive symptoms in adolescence predicted early adulthood depressive disorders (major depression and dysthymia), comorbidity, psychosocial impairment, and problem drinking. CONCLUSIONS: Depressive symptoms in adolescence deserve attention as a potential risk for early adulthood mental disorders.
Adjustment Disorders↗
A nice try that fails: the Swedish Council on Technology Assessment in Health Care (SBU) evaluation of the effect of treatment of alcohol and drug problems: the epidemiologist's view.
BACKGROUND AND AIMS: The Swedish Council on Technology Assessment in Health Care (SBU) has recently published a large, >800-page systematic review. It reviews brief interventions to reduce alcohol intake, long-term prognosis of substance dependence, obstetric questions and economic aspects of addiction treatments. The main part aims to evaluate treatments on alcohol and other addictive substances by meta-analytical techniques. RESULTS AND CONCLUSIONS: The report summarizes 641 individual studies. Unfortunately, several methods are weak, some inadequately documented, and many conclusions rest on shaky grounds.
Alcoholism↗
Accuracy of quantity-frequency and graduated frequency questionnaires in measuring alcohol intake: comparison with daily diary and commonly used laboratory markers.
AIMS: To ascertain the accuracy of a quantity-frequency questionnaire (QF) and a graduated frequency questionnaire (GF) as methods of obtaining self-reported alcohol intake in relation to a daily diary and biochemical tests. METHODS: QF and GF data were obtained before and after a 1-month daily diary on alcohol intake in a sample of 52 volunteers aged 20-63 years, of whom 43 were female. A blood sample to measure serum aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), gamma-glutamyltransferase (GGT) and % carbohydrate-deficient transferrin (CDT) was obtained at the outset. RESULTS: Both QF and GF correlated closely with daily diary intake (r > 0.90). Compared with a daily diary, the mean QF intake was slightly lower, whereas the mean GF intake was 2-fold. The apparent overestimation by GF was independent of the actual consumption level. Self-reported alcohol intake by each method correlated closely with serum ASAT, ALAT and GGT (r = 0.41-0.67) but not with CDT. CONCLUSIONS: In adults motivated to recall alcohol intake, both QF and GF classify individuals in the correct rank order, but GF probably overestimates actual alcohol consumption.
Adult↗