Biomedical subjects

S C Newman

Publications and source records attributed to S C Newman.

At least 37 records · Page 2Linked to original sources

PubMed1997

Help-seeking for psychiatric disorders.

OBJECTIVE: To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categories of professionals are sought by those who get care. METHOD: A 2-stage random sample of 3956 adult residents of Edmonton, Alberta, Canada was interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS) (73% completion rate). An average of 2.8 years later, a systematic random sample of 1964 subjects was reinterviewed (an 86% completion rate) using the DIS and a health care utilization questionnaire. After adjusting for age and sex, the reinterview sample was representative of those with and without a diagnosis at the first interview. RESULTS: Of the 1964 subjects, 570 (31%) met criteria for a DIS/DSM-III diagnosis in the year preceding the interview (one-year prevalence rate). These diagnoses included generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). For those with a diagnosis, sex, age, marital status, education, employment, and income were examined as determinants of help-seeking. Only sex (female) and age (under 45) were significant predictors. Comorbidity was highly significant: the help-seeking rate for those with one diagnosis was 20.3%; for those with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi 2 = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis saw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis made a difference: 46.7% of those with a major depressive episode sought help, but only 16.0% of those with alcohol abuse or dependence sought care. CONCLUSION: Major determinants of help-seeking are sex (female), age (under 45), severity of the illness, and comorbidity. A surprisingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DSM-III disorder.

Adolescent↗

PubMed1996

The cross-national epidemiology of social phobia: a preliminary report.

We present a preliminary report on cross-national rates, age at onset, comorbidity, suicide attempts and symptom profiles of social phobia. These data are based on epidemiologic community surveys using similar methods from the United States, Canada, Puerto Rico and Korea. The lifetime rate of social phobia (cases per 100 persons) varies by country, from 2.6 in the United States to 0.5 in Korea. Rates are higher in females than in males in all countries. The age of onset for any phobia is mid-teens to early twenties, and social phobia usually has its first onset before other psychiatric disorders. Only a third or fewer cases of social phobia are uncomplicated by another psychiatric disorder. The presence of social phobia increases the risk of suicide attempts in persons with any other psychiatric disorder. Symptom profiles vary by country. Our data indicate consistent patterns but different cultural expressions of social phobia in the countries studied. The early age of onset of social phobia followed subsequently by another psychiatric disorder raises the possibility that early treatment of social phobia could prevent the onset of other psychiatric disorders.

Adolescent↗

PubMed1994

The epidemiology of parasuicide in Edmonton.

The objective of this study was to examine some of the characteristics of parasuicides in Edmonton and to calculate rates of parasuicide. The method involved examining all records of parasuicides attending the University of Alberta Hospitals for a six month period (20% of all parasuicides in Edmonton are treated at the University of Alberta Hospitals). The results indicated that 58% of 275 subjects were single. The most frequent method (88.6%) of parasuicide was overdose. The peak age group was 25 to 29 years of age. The age range was 12 to 80 years (six percent < 15 years), mean age 30.2. The female to male ratio (cases) was 1.6:1; 30.2% were admitted; 46.5% received psychiatric emergency consultation; 41% had made a previous parasuicide. Calculated rates of parasuicide in Edmonton were at 448/100,000/year for those 15 years and older (men 357, women 534). The overall rate is higher than that found in any centre in the WHO/EURO investigation. The conclusion is that parasuicide presents a significant public health problem, and a cost burden on the health care system.

Adolescent↗

PubMed1994

The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group.

Data on the epidemiology of psychiatric disorders from different parts of the world using similar methods and diagnostic criteria have previously not been available. This article presents data on lifetime and annual prevalence rates, age at onset, symptom profiles, and comorbidity of obsessive compulsive disorder (OCD), using DSM-III criteria, from community surveys in seven countries: the United States, Canada, Puerto Rico, Germany, Taiwan, Korea, and New Zealand. The OCD annual prevalence rates are remarkably consistent among these countries, ranging from 1.1/100 in Korea and New Zealand to 1.8/100 in Puerto Rico. The only exception is Taiwan (0.4/100), which has the lowest prevalence rates for all psychiatric disorders. The data for age at onset and comorbidity with major depression and the other anxiety disorders are also consistent among countries, but the predominance of obsessions or compulsions varies. These findings suggest the robustness of OCD as a disorder in diverse parts of the world.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Mania.

3258 randomly selected household residents of Edmonton, Alberta were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). The lifetime prevalence of mania was 0.6%, for both sexes combined. Lifetime morbidity risk was 1.4% for men and 0.6% for women. The mean age of onset was 20 years of age for both men and women. Ninety-five percent of bipolar individuals had had their first onset by age 26, and less than 5% had their onset before the age of 10. The mean number of manic episodes was 23. Comorbidity with other disorders occurred in 92% of the manic subjects. Depression (62%), alcohol abuse (45%), substance abuse (35%), and phobias (54%) had an increased lifetime prevalence in individuals with a history of a manic episode(s).

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Obsessive-compulsive disorder.

3258 randomly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). One of the diagnostic categories studied was obsessive-compulsive disorder (OCD). The lifetime and six month prevalence rates of OCD were 2.9% and 1.6% respectively. The morbidity risk, was equal in males and females at 5.4%. The peak age of risk of onset for both sexes was from the ages of 10 to 19 and, closely followed by the decade 20-29. Obsessions were found to be more frequently experienced than compulsions. Having a lifetime diagnosis of OCD is associated with an increased likelihood of developing depression, alcohol abuse, drug abuse, phobic disorders, and antisocial personality disorder. The significance of these findings is discussed for clinical practice.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Phobic disorders.

3258 randomly selected adult household residents of the city of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). Using DMS-III criteria, hierarchy-free, the lifetime prevalence for all phobias was 8.9%. Rates for women (11.7%) were almost twice those for men (6.1%). The age at which first phobic symptoms had been reported by 50% of subjects was 12 years for men and 6 years for women. High rates of comorbidity with depression, alcohol abuse/dependence, drug abuse/dependence and obsessive-compulsive disorder were found in all types of phobia, an important point in clinical management.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Panic disorder.

A random sample of 3258 adult household residents of Edmonton, Alberta, Canada were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS), which gives DSM-III diagnostic data on each individual interviewed. This paper reports results for panic disorder. Panic disorder was found to affect women primarily (female:male morbidity risk 2.2:1). The mean age of onset (first symptom) was 19.3 years for men and 21.5 years for women. Rarely did symptoms first occur after the age of forty. The lifetime prevalence rate was 1.7% for women and 0.8% for men and the lifetime morbidity risk was 3.7% for females and 1.7% for males. All twelve panic symptoms were found to be highly specific for panic disorder. Women complained of more (means = 8.0) symptoms than men (means = 6.0). On average 7.3 symptoms were reported. Those with panic disorder showed increased lifetime prevalence rates for major depressive episode (73.4%), alcohol abuse/dependence (54.2%), drug abuse/dependence (43%) and phobia (44.2%). Altogether, 90.4% of those with panic disorder also met criteria for another DSM-III diagnosis, which was 2.7 times the rate in those who did not have panic disorder.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Drug abuse and dependence.

3258 randomly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). The lifetime prevalence of drug abuse/dependence was 6.9%, with a male:female ratio of 3:1. The most commonly used drug was cannabis followed by amphetamines, opiates, barbiturates, hallucinogens and cocaine. 80.3% of those with drug abuse/dependence also had a lifetime diagnosis of another psychiatric disorder. In those with a comorbid diagnosis, the mean age of onset for the other psychiatric disorder was generally found to be younger than for the onset of drug abuse/dependence. Different comorbid disorders were found to significantly affect patterns of drug use.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Antisocial personality disorders.

3258 randomly selected adult household residents of Edmonton, Canada, were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). 104 subjects fulfilled DSM-III antisocial personality disorder (ASP) criteria. Lifetime prevalence rates were found to be significantly higher in males and in the younger adult age groups. The age of onset (i.e. age at which conduct disorder symptoms first appeared) was found to be under 10 years in the majority of cases, with females lagging just slightly behind males. Symptom patterns and frequencies were examined and the relative risks for these symptoms were calculated. Comorbidity, calculated using full DSM-III severity criteria, but without exclusion criteria, revealed an increased prevalence of nearly every other psychiatric disorder in those with antisocial personality disorder, with 90.4% having at least one other lifetime psychiatric diagnosis.

Adolescent↗

PubMed1994

Epidemiology of psychiatric disorders in Edmonton. Major depressive disorder.

A random sample of 3258 adult household residents of Edmonton, Alberta, Canada, were interviewed by trained lay interviewers, using the Diagnostic Interview Schedule (DIS), which generated DSM-III diagnosis data. This paper reports results for major depressive disorder (MDD). MDD was found to affect women more than men by a ratio of nearly 2 to 1. The lifetime prevalence rate for both sexes combined was 8.6%. The period prevalence rates for both sexes combined were 3.2% and 4.6%, for six month and one year, respectively. The presence of a recurrent Major Depressive Disorder was associated with an increased risk of substance abuse, panic disorder and dysthymia, whereas a single major depressive episode was not associated with increased comorbidity.

Adolescent↗

PubMed1993

Epidemiology of pathological gambling in Edmonton.

Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were identified when 7,214 randomly selected household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The lifelong prevalence of pathological gambling was 0.42% (ratio of males to females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates of comorbidity with other psychiatric disorders. They were likely to have made suicide attempts (13.3%), to have been convicted of offences (26.7%), to be spouse and child abusers (23.3% and 16.7% respectively) and to have spent long periods unemployed (40%). In addition, 80% had trouble at home or work because of gambling, and 60% borrowed or stole to gamble.

Adolescent↗

PubMed1993

Psychiatric comorbidity and treatment seeking. Sources of selection bias in the study of clinical populations.

Population studies have shown that the co-occurrence of psychiatric disorders increases the likelihood of treatment seeking. This leads to a biased estimation of the prevalence of comorbidity in clinical samples, and this overestimation can be attributed to two different sources of selection bias. Using data from a population survey of psychiatric disorders, in which 3258 residents of Edmonton, Alberta, Canada, were interviewed with the Diagnostic Interview Schedule, we assessed the extent of each of these two mechanisms. The first source of selection bias is the mathematical bias known as Berkson's bias and arises from the fact that an individual affected with two psychiatric disorders can seek treatment for either one or the other of these disorders. The second source of selection bias is clinical and results from the changed probability of seeking a treatment for a specific disorder because of the existence of a comorbid disorder.

Alberta↗

PubMed1991

Suicide risk varies by subtype of affective disorder.

A cohort study of mortality was conducted in which 4022 patients with affective disorder who were treated during 1976-1985 in a mental institution or community clinic operated by the province of Alberta, Canada, were followed to the end of 1985. Vital status was determined by record linkage to the Statistics Canada Mortality Data Base. There were 326 deaths altogether, 96 from suicide. The standardized mortality ratio (SMR) for all causes of death combined was 2.3, and for suicide the SMR was 26.0. The SMR was also elevated for mental, circulatory and respiratory disorders, but not for neoplasms. The principal objective of the study was to determine whether there was a gradient of increasing mortality risk across the following diagnostic subgroups: manic disorder, bipolar affective disorder and major depressive disorder. A trend was found for suicide but not for all causes of death combined. The pattern of risk persisted after adjustment for the covariates sex, age and marital status in a Cox regression analysis.

Affective Disorders, Psychotic↗

PubMed1991

Mortality in a cohort of patients with schizophrenia: a record linkage study.

A retrospective study of mortality was conducted in which 3,623 patients with schizophrenia receiving treatment in Alberta between 1976 and 1985 were followed to the end of 1985. Vital status was determined by record linkage to the Statistics Canada Mortality Data Base. There were 301 deaths in the cohort, 97 of which were due to suicide. For all causes of death combined, the risk of mortality was approximately double that of the Alberta population; for suicide, risk was increased by a factor of 20. Mortality from circulatory, respiratory, digestive and genitourinary diseases was also greater than expected. It is estimated that those who suffer from schizophrenia have a life expectancy which is approximately 20% shorter than that of the general population. This study confirms earlier research demonstrating an increased risk of mortality associated with schizophrenia and extends those findings to specific causes of death.

Adolescent↗

PubMed1990

The efficiency of two-phase designs in prevalence surveys of mental disorders.

A two-phase survey of mental disorders uses a screening test to identify possible cases, thereby reducing the resources devoted to interviewing those not having the condition of interest. It is demonstrated using a mathematical model that in situations likely to be encountered in practice a two-phase design may lead to an increase in the efficiency of prevalence rate estimation, and also to an improvement in the efficiency of case detection. However, in certain applications the modest gain in efficiency may not warrant the additional complexity of a two-phase approach to data collection. Data from a survey of mental disorders in Edmonton, Canada, which collected information on 3258 community residents using the Diagnostic Interview Schedule and the General Health Questionnaire, are used to demonstrate how two-phase methods would have changed the efficiency of an actual survey.

Adult↗

PubMed1990

Health care utilization for emotional problems: results from a community survey.

A survey was conducted in which 865 randomly selected adult household residents of Edmonton, Alberta were interviewed to obtain information about health care in the preceding year. Eighty percent of the sample had seen a family physician, and eight percent of visits to family physicians involved a mental or emotional problem. Thirteen percent of the sample received professional help for a mental or emotional problem from some type of caregiver. The most frequently consulted professional was the family physician (eight percent of the sample), followed by psychologists and psychiatrists (each seeing two percent of the sample). Family physicians accounted for the greatest number of consultations for mental or emotional problems (41%), followed by psychologists (16%), social workers (12%) and psychiatrists (nine percent). Women were 27% more likely to seek a consultation than men, and consultation rates were highest in the group ranging in age from 35 to 44 years. There was also a strong relationship between having recent psychiatric symptoms and having had a consultation in the past year.

Adult↗

PubMed1990

Prevalence of psychiatric disorders and suicide attempts in a prison population.

A survey was conducted in which 180 randomly selected male prisoners ages 18 to 44 were interviewed using the Diagnostic Interview Schedule and other questionnaires. A comparison was made with 1,006 similarly aged male residents of Edmonton who were interviewed using the same instruments. Compared to the general population, prisoners were less likely to be married and were less well educated. There was a higher proportion of Native Indians in the prison sample and lower proportions of Oriental and other racial groups. Prisoners were twice as likely to have a lifetime psychiatric disorder compared with the general population, and all individual disorders investigated were more common in the prison population. Six month prevalence showed even greater rates compared with the general population, indicating recent symptoms. The number of individual disorders per prisoner was also higher than for the general population. Lifetime suicide attempts were seven times more frequent in prisoners than in the general population.

Adult↗