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PubMedDate not supplied

Cross-national epidemiology of major depression and bipolar disorder.

OBJECTIVE: To estimate the rates and patterns of major depression and bipolar disorder based on cross-national epidemiologic surveys. DESIGN AND SETTING: Population-based epidemiologic studies using similar methods from 10 countries: the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand. PARTICIPANTS: Approximately 38000 community subjects. OUTCOME MEASURES: Rates, demographics, and age at onset of major depression and bipolar disorder. Symptom profiles, comorbidity, and marital status with major depression. RESULTS: The lifetime rates for major depression vary widely across countries, ranging from 1.5 cases per 100 adults in the sample in Taiwan to 19.0 cases per 100 adults in Beirut. The annual rates ranged from 0.8 cases per 100 adults in Taiwan to 5.8 cases per 100 adults in New Zealand. The mean age at onset shows less variation (range, 24.8-34.8 years). In every country, the rates of major depression were higher for women than men. By contrast, the lifetime rates of bipolar disorder are more consistent across countries (0.3/100 in Taiwan to 1.5/100 in New Zealand); the sex ratios are nearly equal; and the age at first onset is earlier (average, 6 years) than the onset of major depression. Insomnia and loss of energy occurred in most persons with major depression at each site. Persons with major depression were also at increased risk for comorbidity with substance abuse and anxiety disorders at all sites. Persons who were separated or divorced had significantly higher rates of major depression than married persons in most of the countries, and the risk was somewhat greater for divorced or separated men than women in most countries. CONCLUSIONS: There are striking similarities across countries in patterns of major depression and of bipolar disorder. The differences in rates for major depression across countries suggest that cultural differences or different risk factors affect the expression of the disorder.

Adolescent↗
PubMed1996

Marriage and mortality in prostate cancer.

PURPOSE: We evaluated the association of marital status and survival in patients with prostate cancer. MATERIALS AND METHODS: Using the 146,979 prostate cancer patients of the 1973 to 1990 public use tape of the Surveillance, Epidemiology and End Results program we performed survival analysis and multivariate proportional hazards modeling to estimate the relative risk of mortality. RESULTS: Married patients had significantly longer median survival than those who were divorced, single, separated or widowed. In models that controlled for age, stage, race and treatment, married patients had a significantly lower risk of mortality than those who were divorced, single, separated or widowed. CONCLUSIONS: Several hypothetical models can explain the association of marital status and mortality in men with prostate cancer. The most attractive model relies on the putative salutary effects of being married on social support and/or mood. A social support and depressed mood model of mortality raises the possibility that in prostate cancer quality of life determines quantity of life. Understanding the relationships among marital status, social support, mood and mortality could open the way to rational strategies for postponing death in men with prostate cancer.

Aged↗
PubMed1996

The day of the week on which couples marry.

Saturday is the most popular day to marry: two thirds of all marriages in England and Wales take place then. However, Saturday marriages are not so popular as they were-in 1979, over three quarters of weddings were solemnised on Saturdays. Civil marriages are seven times as likely as religious marriages to take place during the week: the proportions were one in 2, and one in 14, respectively, in 1994. Friday was the relatively most frequent weekday. There was a small peak of weddings on St Valentine's Day in 1994-which fell on a Monday-particularly amongst couples both of whom were remarrying after divorce. The analyses in this article are based on new data on marriages by day of the week in England and Wales. These will be routinely published from 1994 onwards in the ONS annual reference volumes Marriage and divorce statistics (FM2 series).

Choice Behavior↗
PubMedDate not supplied

[Some insufficiently recognized risk factors for breast cancer].

INTRODUCTION: In the most developed countries female breast cancer is the main cause of death due to the most common malignancy in women [1]. Over the period 1975-1982 and 1982-1991 women in Serbia died most frequently of malignant tumours of the breast [2, 3]. A tendency to increase mortality rate of the disease was recorded in this period. The aim of this paper was to determine the importance of some insufficiently known breast cancer risk factors. MATERIAL AND METHODS: The study was based on a case-control study conducted from July 1993 to March 1994. The patients were selected at the Department of Oncology in Nish, and included 106 female patients with histologically documented breast cancer (a two-year diagnosis). Controls were individually matched to patients by age (+/-3 years) and number of patients with mild injuries, hospitalized at the Clinical Centre in Nish. All the examined subjects, from both groups, were interviewed by the same doctor using a target and detailed questionnaire about different risk factors of breast cancer. McNemar test was used in the study. RESULTS: The results are presented in Table 1. The results confirmed a significant positive association between breast cancer risk and psychological stressogenic events (RR = 4.40 95% CI = 2.30-8.40 p = 0.0000). With reference to a previous history of mastitis, a frequent positive history was found in the examined patients and it was statistically significant (RR = 7.50 95% CI = 2.99-18.83 p = 0.000). The risk of developing breast cancer was strongly related to alcohol consumption (RR = 4.11 95% CI = 2.05-8.24 p = 0.0001). Two environmental factors were significantly associated with breast cancer: occupational exposure to organic dust (RR = 3.80 95% CI = 1.41-10.20 p = 0.0066) and to pesticides (RR = 4.25 95% CI = 1.43-12.58 p = 0.0072). DISCUSSION: In our patients stressful life-events were significantly frequent. Most of them reported death or a serious illness of the spouse or of a close family member, marital divorce, son's military service, etc., within the two years prior to the disease. The evidences related to the possible role of stressful life-events in mammary tumorigenesis are insufficient and controversial. Becker [4] suggested that separation from parents before fourteen, marital problems and death of the husband correlated positively with breast cancer risk. For et al. [5] observed that a cancer group had a higher proportion of women who experienced death of the spouse or of a close family member. In contrast, the results of one recent study [6] confirmed no clear evidence that death of the husband or marital divorce were associated with an increased risk of breast cancer. Further investigation of the role of stress in the onset of breast cancer should take into account not only the number of stressful life-events, but also the personality of an individual and effect on her ability to cope with stress [7]. As in many studies [8-11], but not in all [12-14], our results suggested a significant positive association between breast cancer risk and alcohol consumption. Studies have indicated that the increased risk is associated with the type of beverage used [15], the level of consumption [11], but not with the years of consumption [8, 11, 16]. Alcohol consumption at an early age [17] and at the late age [16] increase the risk of breast cancer. Although certain biologic mechanisms for this association have been suggested, such as interference with the cell membrane permeability in breast tissue, exposure to circulating cytotoxic products of ethanol and altered hepatic function, none is generally accepted [17]. The question remains as to whether the increased risk is attributable to alcohol or to some other characteristics in women who drink alcoholic beverages compared with those who do not. We observed a positive correlation among breast cancer risk related to a positive history of mastitis, occupational exposure to organic dust and to pesticides.

Alcohol Drinking↗
PubMed1997

[Epidemiology of bipolar disorders. Current studies].

The prevalence of bipolar disorder over a lifetime, which is similar to that for one year since this is a chronic disease, is around 1% of the general population. Estimates of incidence vary (0.3 to 3 cases per 10000). This general morbidity corresponds quite closely to that found in institutions, since patients presenting with bipolar disorders are not necessarily in care. Bipolar disorder affects men and women in equal proportions, and independently of ethnic and cultural background or of socio-economic status. It is nevertheless more prevalent in urban than in rural areas, and is more common in subjects who are divorced, separated or have never married than in married subjects who have never divorced. It mainly affects younger subjects, with the mean age of onset being about 20 years. Furthermore, it appears to be more common in subjects born since 1930-1940. Finally, it is often associated with other mental disorders, particularly alcoholism and drug dependence.

Adolescent↗
PubMed1997

[Nonparticipation as a factor influencing the value of follow-up studies. Results of a telephone 5-year follow-up interview of 55-74-year-old participants of the Augsburg 1989/90 MONICA Survey].

In prospective cohort studies losses to follow-up are the major source of bias. This article describes the results of the investigation whether there are systematic differences in socio-economic and health-related factors between participants in a follow up study and those who are lost to follow-up. Subjects included were 1,030 men and 957 women aged 55-74 who participated in the second MONICA Survey Augsburg, F.R.G., 1989/90 (MONICA = Monitoring of trends and determinants of cardiovascular disease). They were reexamined in 1994-95. In 1994/95 910 men and 912 women of the baseline study were still alive, 1305 persons (663 men, 642 women) took part in the follow up by telephone. Altogether 120 men and 45 women had died since 1989/90. 144 persons were not eligible for the study (15 moved away, 5 severely ill persons, 124 without telephone). 373 persons were classified as eligible non-responders. The response rate was 77.8% concerning 1678 eligible persons (men 79.1%, women 76.4%). Non-response has led to an underrepresentation of the lower social class (workers, less than 10 years of education; household income less than 1500 DM) and of persons living alone (single, divorced, widowed; single-person households). In females, non-responders were overrepresented by "never employed persons" (odds ratio 3.02; 1.89-4.85). We found that the odds of being non-responder for single, divorced or widowed men was 3.40 (95 %-CI: 2.20-5.23) compared to married men. Men "without chronic diseases" at the baseline study compared with ill men had an odds for non-response of 1.54 (95%-CI: 1.00-2.37); the odds was 1.38 (95%-CI: 1.02-1.85) among women who had described their health status as "not so good/bad" in comparison with women with good self reported health. The reported distortions by non-response could be important in analyses of social conditions of morbidity and mortality. The underrepresentation of men without chronic diseases and women with bad self-assessment of their health is relevant for the estimates of morbidity as health outcome. Both aspects have to be taken into account in the interpretation of the results.

Aged↗
PubMed1997

Drug and alcohol use in Spain: consumption habits, attitudes and opinions.

To estimate the lifetime prevalence of drug and alcohol use and its sociodemographic determinants and to investigate opinions towards drug use in Spain, we examined a representative nation-wide sample of 2495 adult Spaniards, males and females, aged 18 y or older, selected by a multistaged random strategy during 1989. Information was obtained by at-home interviews using a structured closed questionnaire. Participants were asked for their lifetime prevalence of use of cannabis, sedatives and sleeping pills, alcohol, amphetamines, inhalants, cocaine and heroin, as well as for their sociodemographic characteristics and their opinions towards drug use. Alcohol had the highest lifetime prevalence of consumption (55.7%), followed by cannabis (12.3%), sedatives and sleeping pills (12.0%), amphetamines (4.3%), cocaine (3.0%), inhalants (0.8%) and heroin (0.6%). Being male, young, separated or divorced, and unemployed were the main determinants of alcohol and drug use. A higher use of illicit drugs was also observed in the higher socio-economic groups. Regular use of any drug was considered a risky health habit by more than 80% of the sample. We conclude that the consumption of drugs and alcohol is a rather extended habit in Spain. Drug users tend to share some common sociodemographic characteristics (being male, young, separated or divorced, and unemployed) which may help target intervention programs.

Adult↗
PubMed1997

[Statistics for initial admission for schizophrenia in hospitals in Costa Rica].

The factors that influence hospital admissions for schizophrenia in Costa Rica were investigated in people of both sexes who were admitted for the first time with this diagnosis (codes 295.0 to 295.9 of the International Classification of Diseases, Ninth Revision) in the period 1979 to 1981. Annual incidence rates were calculated using the number of hospitalized cases and the total population of the country. The average annual incidence was found to be 48.2 cases per 100000 inhabitants. High frequencies of first admissions were seen among males 40 to 44 years of age and females 45 to 49. Incidence was highest among unmarried women, followed by divorced women. There was a significant inverse relationship between educational attainment and rates of admission for schizophrenia, and incidence rates were highest among unemployed women and housewives. The association between rate of hospitalization for schizophrenia and 10 characteristics of the cantons was studied by means of logistic regression. Only two variables-the distance between the canton's principal town and the hospital and the volume of coffee harvest per resident-showed a direct significant association with admission rates for schizophrenia. The cantons which had the highest number of births of children who were diagnosed as schizophrenic in adulthood were those closest to the psychiatric hospital and those that had a low level of industrial or agricultural activity, low population density, and high proportions of single or divorced persons.

Adult↗
PubMed1998

The impact of family transition on the development of delinquency in adolescent boys: a 9-year longitudinal study.

The purpose of this study was to examine prospectively the impact of family transition on deviant development in a sample of 427 French-Canadian boys participating in a longitudinal study from kindergarten onwards. During the course of the study some boys experienced family transition. We grouped the boys by developmental period and number of marital transitions they experienced: divorced between ages 6 and 11; divorced between ages 12 to 15; remarried between ages 6 and 11; and remarried between ages 12 and 15. From ages 11 to 15 we assessed boys' delinquency and their family processes (parental supervision, punishment, and communication) annually. The results suggest that boys who experienced remarriage between ages 12 and 15 are at greater risk for delinquency. In particular, they showed evidence of comparatively more theft and fighting at earlier ages than their peers from families that had remained intact. At similar points in development, they perceived less expressive parent-child relationships. Finally, these boys also perceived less monitoring by their parents, both overall and at different points in adolescence.

Adolescent↗
PubMed1997

Risk factors for HIV infection in a rural cohort in Zimbabwe: a pilot study.

OBJECTIVE: To identify demographic, sexual behavioural and cultural risk factors for human immunodeficiency virus (HIV) infection in a rural community in Zimbabwe. DESIGN: Prospective study. SETTING: Rural area in Zimbabwe. SUBJECTS: 207 subjects (81 males, 126 females) mean age 31.6 years (SD 15.3), range 12 to 76 years living in the area. MAIN OUTCOME MEASURES: HIV seropositivity and seroconversion, exposure or no exposure to risk factor. RESULTS: Prevalence of HIV was 7.7% and was associated with being divorced or widowed [Odds ratio (OR) 4.26, 95% confidence interval (CI) 1.17 to 14.97] and past history of sexually transmitted diseases (STDs) [(OR 3.54, 95% CI 1.31 to 9.89)]. Seroconversion rate was 3.6% per year and was associated with history of STD [Relative Risk (RR) 13.22, 95% CI 1.15 to 156.1)] during the follow up period. Individuals over 20 years of age, those reporting one or more sexual partners, those reporting irregular use of condoms and those scarified were at greater risk than their counterparts. Individuals who reported being circumcised were at slightly lesser risk than those who did not report circumcision. CONCLUSION: STDs were major determinants of HIV transmission in the study area. In addition being divorced or widowed was a risk factor for HIV infection. Scarification, tattooing and circumcision require further investigations.

Adolescent↗
PubMed1998

Survivors of sexual abuse: clinical, lifestyle and reproductive consequences.

BACKGROUND: In recent years, an increase in the prevalence of sexual abuse of women has been reported in Canada and elsewhere. However, there are few empirical data on the extent of the problem in Canadian aboriginal populations. The authors investigated the presence of a reported history of sexual abuse and other health determinants in a sample of women attending a community health centre with a substantial aboriginal population. This allowed determination of whether reported sexual abuse and its associated demographic and health-related effects were different for aboriginal and non-aboriginal women. METHODS: A sample of 1696 women was selected from women attending a community health centre in a predominantly low-income inner-city area of Winnipeg for a cross-sectional survey designed to study the association between sexual behavior and cervical infections. The survey was conducted between November 1992 and March 1995 and involved a clinical examination, laboratory tests and an interviewer-administered questionnaire. A substudy was conducted among 1003 women who were asked 2 questions about sexual abuse. RESULTS: The overall response rate for the main study was 87%. Of the 1003 women who were asked the questions about sexual abuse, 843 (84.0%) responded. Among the respondents, 368 (43.6%) were aboriginal. Overall, 308 (36.5%) of the respondents reported having been sexually abused, 74.0% of the incidents having occurred during childhood. The prevalence was higher among aboriginal women than among non-aboriginal women (44.8% v. 30.1%, p < 0.001). Women who had been sexually abused were younger when they first had sexual intercourse, they had multiple partners, and they had a history of sexually transmitted diseases. In addition, non-aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have had abnormal Papanicolaou smears. The proportion of smokers was higher among the abused women than among the non-abused women in both ethnic groups. INTERPRETATION: A history of sexual abuse was associated with other clinical, lifestyle and reproductive factors. This suggests that sexual abuse may be associated with subsequent health behaviors, beyond specific physical and psychosocial disorders. Aboriginal and non-aboriginal women who have suffered sexual abuse showed substantial differences in their subsequent health and health-related behaviours.

Adult↗
PubMed1991

[[Changing patterns and projections of headship rates in Korea]].

"The purpose of this study was to calculate the headship rate for time-series analysis,...to review the patterns of changing headship rates and related factors and to estimate the headship rates to 2010 [for the Republic of Korea].... The data used for this study were derived from the Population and Housing Census Reports from 1960 through 1990, U.N. Manual VII and household-related literature....[The authors predict that] the total headship rate will maintain a uniform pattern of decrease and increase by specific age and peak headship rates will gradually extend to younger people.... Rural headship rates will decrease steadily and be greatly influenced by age structure.... In addition, the difference in headship rates between male and female will be great....Lastly, both the divorced and the single will have increasing headship rates for all ages [with] the single [having] the most rapid increase rate after their thirties." (SUMMARY IN ENG)

Age Distribution↗
PubMed1988

The aging of China's population: perspectives and implications.

"China's efforts to accelerate the pace of modernization emphasize the promotion of economic development and the reduction of its population growth through the adoption of a one-child per family policy. However, that policy has implications for the eventual aging of the country's population. This article reviews the changes in the status of the elderly, explores the changes in size of the elderly population, and various related social and policy implications." Topics considered include socioeconomic changes, underlying population dynamics, the current situation of the elderly, some international comparisons, implications of aging, planning for support of the elderly, health care, living arrangements and family support, retirement, and the status of the widowed, divorced, and unmarried in the elderly population.

Adult↗
PubMed1988

Civil Code (Amendment) Act, 1988 (No. 4 of 1988), 21 May 1988.

This Act amends the Civil Code of Saint Lucia to do the following, among other things: 1) allow marriage to be celebrated by giving notice; 2) legalize divorce; 3) allow all children to be legitimated by the subsequent marriage of their parents; 4) remove differences in the treatment of children born within marriage and those born outside of marriage; 5) lower to 18 the age of majority and the age under which consent must be obtained in order to marry. A number of these changes are consolidations of earlier amendments made to the Civil Code.

Americas↗
PubMed1988

Marriage and Matrimonial Property Law Amendment Act (No. 3 of 1988), 25 February 1988.

This Act puts Black civil marriages on the same footing as those of the rest of the population of South Africa. Such marriages entered into after the commencement of the Act are automatically governed by a community property regime, rather than by separation of property, and subject to Chapters 2 and 3 of the Matrimonial Property Act (Number 88 of 1984), which increased the legal protection afforded to women in marriage. The Act also forbids a Black man and woman from marrying according to a civil ceremony, if the man is involved in a customary union with another woman. Although the Act as a whole is not retrospective in effect, it does authorize a court to direct that the assets of one spouse be made over to the other spouse on divorce when the spouses were married by civil ceremony under Section 22(6) of the Black Administration Act (No. 38 of 1927) before the commencement of this Act. Under the Act, a couple may choose by antenuptial agreement not to be governed by a community property regime, and a couple married under a separation of property regime may choose to change it.

Africa↗
PubMed1988

Decree of 30 August 1988.

This Haitian Decree abolishes the status known as "civil death" whereby a person was convicted of serious crimes and deprived of all legal personality while physically still alive. The Decree also abolishes, as a ground of divorce, the existence of "civil death" on the part of one of the spouses.

Americas↗
PubMed1988

Law No. 27 of 1988, 9 February 1988.

This Law amends Iraq Law Number 77 of 1983 relating to the rights of a divorcee with respect to a "dwelling" to provide that a divorcee has the same rights in the dwelling stipulated in Law Number 77, even if the husband "has endowed the owned house or apartment to . . . others prior to . . . divorce."

Asia↗
PubMed1988

B.L. v. M.L., 3 October 1988.

The court held that a wife who had not made either a direct or indirect contribution to the family home would be given a 50% beneficial interest in that home upon divorce a mensa et thoro. It based its ruling on Article 41.2 of the Irish Constitution, under which the State has a specific duty to try to ensure that mothers are not obliged by economic necessity to engage in work to the neglect of their duties in the home. It ruled that a woman should have her work as a homemaker and mother taken into account in calculating her contribution toward acquisition of the home.

Demography↗