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Dwyer R, Fraser S. Engendering drug problems: Materialising gender in the DUDIT and other screening and diagnostic ‘apparatuses’. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017. [DOI: 10.1016/j.drugpo.2017.05.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Constant A, Sherlaw W, Kovess-Masfety V. Seeking mental health care from private health practitioners among individuals with alcohol dependence/abuse; results from a study in the French general population. Alcohol 2017; 59:1-6. [PMID: 28262183 DOI: 10.1016/j.alcohol.2016.09.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 09/08/2016] [Accepted: 09/12/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Better knowledge of the factors that have an impact on pathways to mental health care may contribute greatly to organizing optimum health-care delivery. However, surveillance systems concerning alcohol problems in the French general population are suboptimal. The objectives of this study were to investigate: 1) the prevalence of mental health-care seeking in individuals with alcohol abuse/dependence in France, 2) which category of medical practitioner was consulted, and 3) psychological and socio-environmental factors associated with mental health-care seeking. METHODS A total sample of 22,138 individuals was interviewed in a telephone survey. Individual data on alcohol dependence/abuse and other mental health disorders were collected using the Composite International Diagnosis Interview - short form. Mental health-care seeking was assessed, together with data on living conditions, deprivation, and self-reported drinking problems. Only respondents meeting criteria for alcohol dependence/abuse were included in analyses. RESULTS Less than half of the 722 respondents with alcohol abuse/dependence had sought mental health care in the preceding 12 months, of whom 90.5% consulted their general practitioner (GP) (56.1%), or both a general practitioner and a psychiatrist (34.4%). Mental health-care seeking was associated with female sex, previous alcohol discussion with a doctor, and the presence of psychiatric comorbidities arising in the preceding 12 months. Living environment, socio-economic status, or self-reported drinking problems had no influence. DISCUSSION A minority of people with alcohol abuse/dependence sought mental health care, mainly in relation to psychiatric comorbidities. In addition, most people consulting a GP were not referred to a psychiatrist. However, social deprivation and living in rural areas did not hinder mental health-care seeking among respondents. Adequate protocols to treat alcohol disorders could be implemented among private health-care providers to improve management of alcohol problems in France.
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Affiliation(s)
| | | | - Viviane Kovess-Masfety
- EHESP School of Public Health, Rennes, F-35043, France; Paris Descartes University, Paris, F-75006, France.
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Bloomfield K, Karlsson T, Grittner U. How do drinking cultures change? – or do they?: A provisional model based on evidence of transitions in Denmark. DRUGS: EDUCATION, PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1179719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Validity of the CAGE questionnaire for men who have sex with men (MSM) in China. Drug Alcohol Depend 2016; 160:151-6. [PMID: 26850511 PMCID: PMC4767580 DOI: 10.1016/j.drugalcdep.2015.12.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/03/2015] [Accepted: 12/31/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Detection of heavy drinking among men who have sex with men (MSM) is crucial for both intervention and treatment. The CAGE questionnaire is a popular screening instrument for alcohol use problems. However, the validity of CAGE for Chinese MSM is unknown. METHOD Data were from three waves of cross-sectional assessments among general MSM (n=523) and men who sell sex to other men ("money boys" or MBs, n=486) in Shanghai, China. Specifically, participants were recruited using respondent-driven, community popular opinion leader, and venue-based sampling methods. The validity of the CAGE was examined for different cutoff scores and individual CAGE items using self-reported heavy drinking (≥14 drinks in the past week) as a criterion. RESULTS In the full sample, 75 (7.4%) of participants were classified as heavy drinkers. 32 (6.1%) of general MSM and 43 (8.9%) of MBs were heavy drinkers. The area under curve statistics for overall sample was 0.7 (95% CI: 0.36-0.77). Overall, the sensitivities (ranging from 18.7 to 66.7%), specificities (ranging from 67.5 to 95.8%), and positive predictive values (ranging from 14.1 to 26.4%) for different cutoff scores were inadequate using past week heavy drinking as the criterion. The ability of CAGE to discriminate heavy drinkers from non-heavy drinkers was limited. CONCLUSIONS Our findings showed the inadequate validity of CAGE as a screening instrument for current heavy drinking in Chinese MSM. Further research using a combination of validity criteria is needed to determine the applicability of CAGE for this population.
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Dwyer R, Fraser S. Addiction screening and diagnostic tools: ‘Refuting’ and ‘unmasking’ claims to legitimacy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:1189-97. [DOI: 10.1016/j.drugpo.2015.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
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Clesse F, Leray E, Bodeau-Livinec F, Husky M, Kovess-Masfety V. Bereavement-related depression: Did the changes induced by DSM-V make a difference? Results from a large population-based survey of French residents. J Affect Disord 2015; 182:82-90. [PMID: 25978718 DOI: 10.1016/j.jad.2015.04.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND DSM-V has been criticized for excessively expanding criteria for bereavement-related depression. The aim of this study was to quantify a potential increase in depression prevalence due to changes in diagnostic criteria and to assess the severity, clinical profile and healthcare use of new cases. METHODS A cross-sectional telephone survey was performed in 2005-2006 in four French regions. Twelve-month prevalence of psychiatric disorders was measured by CIDI-SF. Bereavement was assessed in those who endorsed the gate question to the depression module. Persons with bereavement-related depression according to DSM-IV and DSM-V diagnosis criteria were compared. RESULTS Of the 22,138 respondents, 692 were bereaved. The prevalence of depression among those bereaved was 49.9% (95% CI ¼=43.7−56.0) according to DSM-IV and 59.6% (53.1−66.1) according to DSM-V [corrected]. The overall prevalence of major depression increased from 8.6% (8.1–9.1) with DSM-IV to 8.8% (8.3−9.3) with DSM-V . Cases diagnosed using DSM-IV presented more symptoms than cases diagnosed using DSM-V but clinical features were similar except regarding criterion E׳s symptoms. Healthcare use was similar between the two groups regarding consultations and psychotropic drug prescription. LIMITATIONS Some DSM-IV and DSM-V criteria were difficult to operationalize in the survey. The observed difference in prevalence according to DSM-IV and DSM-V may be reduced when clinical judgment is taken into account. CONCLUSIONS The overall prevalence of major depression is only marginally increased by the new criteria. However, diagnostic changes increase the prevalence by 10 points among those bereaved. Diagnostic changes do not appear to modify service use.
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Affiliation(s)
- Florence Clesse
- Epidemiology department, EHESP, EA4057 Paris Descartes University, Sorbonne Paris Cité, France
| | - Emmanuelle Leray
- Epidemiology department, EHESP, EA4057 Paris Descartes University, Sorbonne Paris Cité, France
| | - Florence Bodeau-Livinec
- Epidemiology department, EHESP, EA4057 Paris Descartes University, Sorbonne Paris Cité, France; INSERM U1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), France; Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS), France
| | - Mathilde Husky
- Institut de psychologie, Université Paris Descartes, Institut Universitaire de France, Boulogne Billancourt, France
| | - Viviane Kovess-Masfety
- Epidemiology department, EHESP, EA4057 Paris Descartes University, Sorbonne Paris Cité, France.
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Caetano R, Mills B, Madruga C, Pinsky I, Laranjeira R. Discrepant trends in income, drinking, and alcohol problems in an emergent economy: Brazil 2006 to 2012. Alcohol Clin Exp Res 2015; 39:863-71. [PMID: 25847677 DOI: 10.1111/acer.12692] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND To examine the association between increases in income and self-reported alcohol consumption, binge drinking, and alcohol problems in 2006 and 2012 in Brazil. METHODS Participants were interviewed as part of 2 multistage representative cluster samples of the Brazilian household population between November 2005 and April 2006 and between November 2011 and March 2012. The number of current drinkers during these 2 intervals (n = 1,379 and n = 1,907, respectively) comprised the sample analyzed. Four past-year outcome variables-standard drinks per week, binge drinking, presence of alcohol-related social/health problems, and DSM-5 alcohol use disorder (AUD)-were estimated across income, age, and gender groups. Regression models were estimated to evaluate these and other sociodemographic effects on drinking and problem outcomes and to test for possible wave by income interactions. RESULTS Response rates were 66.4% in 2006 and 77% in 2012. Income increases were seen in virtually all age-gender subgroups and were particularly pronounced for younger age groups and older women. Both genders reported increased drinks per week (men: 12.82, 2006; 15.78, 2012; p < 0.01; women: 4.89, 2006; 7.66, 2012; p < 0.001) and proportion binge drinking (men: 57%, 2006; 66%, 2012; p < 0.05; women: 39%, 2006; 48%, 2012; p < 0.05), although this was not seen in all gender and age groups. Social/health problem prevalence decreased among men (37%, 2006; 26%, 2012; p < 0.001) and remained the same among women (13%, 2006; 14%, 2012). DSM-5 AUD decreased among men (34%, 2006; 24%, 2012; p < 0.01) and remained stable among women (14%, 2006; 16%, 2012). CONCLUSIONS Brazilian economic development between 2006 and 2012 led to a rise in income in several gender and age groups. Although not always directly associated with an observed increase in alcohol consumption, the rise in income may have created a sense of optimism that inhibited a rise in alcohol-related problems.
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Affiliation(s)
- Raul Caetano
- University of Texas School of Public Health, Dallas Regional Campus, Dallas, Texas
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Graham K, Bernards S, Knibbe R, Kairouz S, Kuntche S, Wilsnack SC, Greenfield TK, Dietze P, Obot I, Gmel G. Alcohol-related negative consequences among drinkers around the world. Addiction 2011; 106:1391-405. [PMID: 21395893 PMCID: PMC3682406 DOI: 10.1111/j.1360-0443.2011.03425.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIMS This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences. DESIGN SETTING AND PARTICIPANTS Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration. MEASUREMENTS Measures included 17 negative consequences grouped into (i) high endorsement acute, (ii) personal and (iii) social. Country-level measures included average frequency and quantity of drinking, percentage who were current drinkers, gross domestic product (GDP) and Human Development Index (HDI). FINDINGS Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences, but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda and lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. CONCLUSIONS Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences.
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Affiliation(s)
- Kathryn Graham
- Social and Epidemiological Research, Centre for Addiction and Mental Health, London, Ontario, Canada.
| | - Sharon Bernards
- Research Associate, Social and Epidemiological Research, Centre for Addiction and Mental Health, London, Ontario, Canada
| | - Ronald Knibbe
- Professor of Social Epidemiology of Alcohol and Drug Use, Department of Health Promotion, University Maastricht, Maastricht, The Netherlands
| | - Sylvia Kairouz
- Assistant Professor, Department of Sociology and Anthropology, Concordia University, Montreal, Québec, Canada
| | - Sandra Kuntche
- Addiction Info Switzerland, Lausanne, Switzerland; Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland
| | - Sharon C. Wilsnack
- Chester Fritz Distinguished Professor, Department of Clinical Neuroscience, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, North Dakota, USA
| | | | - Paul Dietze
- Associate Professor, School of Public Health and Preventive Medicine, Monash University, Melbourne Australia; Centre for Population Health, Burnet Institute, Melbourne Australia
| | - Isidore Obot
- Department of Psychology, University of Uyo, Uyo, Nigeria
| | - Gerhard Gmel
- Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland; Addiction Info Switzerland, Lausanne, Switzerland; Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, United Kingdom
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Skogen JC, Øverland S, Knudsen AK, Mykletun A. Concurrent validity of the CAGE questionnaire. The Nord-Trøndelag Health Study. Addict Behav 2011; 36:302-7. [PMID: 21167648 DOI: 10.1016/j.addbeh.2010.11.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 11/06/2010] [Accepted: 11/20/2010] [Indexed: 12/14/2022]
Abstract
The aim of this study was to examine the psychometric properties of the CAGE questionnaire, and the questionnaire's concurrent validity with current and previous alcohol consumption. This study employed data from the Nord-Trøndelag Health Survey wave 1 (HUNT-1 in 1984-86: N=24,900) and wave 2 (HUNT-2 in 1995-97: N=36,350). The concurrent validity of the CAGE questionnaire was examined both as a dichotomous variable with the recommended cut-off (≥2 affirmative answers) for alcohol problems, and as a categorical scale. The categorical scale was constructed by counting responses from 0 to 4, and a separate category for current abstainers in HUNT-2. Current self-reported consumption above the gender specific 80th percentile was defined as "current excessive consumption". "Previous excessive consumers" were defined by meeting at least one of the two following criteria at the time of HUNT-1: reporting drinking too much alcohol in any period of their life, or reporting a high level of alcohol consumption. The internal reliability of CAGE was adequate, and in relation to alcohol consumption, there was a linear relationship between the CAGE score and both the current and previous excessive consumption. In conclusion, this study indicates good concurrent validity and adequate psychometric properties of the CAGE questionnaire. The dose-response pattern seen between the CAGE score and alcohol consumption, suggests that it can be used as an ordinal measure, rather than with a cut-off of two or more. The concurrent validity of the CAGE is better in women than in men.
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Etter JF, Gmel G. Paradoxical Changes in Alcohol Consumption and CAGE Ratings Between 1996 and 2006 in the General Population of Geneva. Alcohol Alcohol 2011; 46:128-32. [DOI: 10.1093/alcalc/agq102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gmel G, Kuntsche E, Wicki M, Labhart F. Measuring alcohol-related consequences in school surveys: alcohol-attributable consequences or consequences with students' alcohol attribution. Am J Epidemiol 2010; 171:93-104. [PMID: 19969527 DOI: 10.1093/aje/kwp331] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents' attribution of alcohol as the cause. The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF). In 2007, a total of 7,174 Swiss school students aged 13-16 years reported the numbers of 6 alcohol-related adverse consequences (e.g., fights, injuries) they had incurred in the past 12 months. Consequences were measured with and without attribution of alcohol as the cause. The alcohol-use measures were frequency and volume of drinking in the past 12 months and number of risky single-occasion (> or =5 drinks) drinking episodes in the past 30 days. Attributable fractions were derived from logistic (> or =1 incident) and Poisson (number of incidents) regression analyses. Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs). The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers.
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Affiliation(s)
- Gerhard Gmel
- Swiss Institute for the Prevention of Alcohol and Drug Problems, P.O. Box 870, CH-1001 Lausanne, Switzerland.
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Constant A, Lafont S, Chiron M, Zins M, Lagarde E, Messiah A. Failure to reduce drinking and driving in France: a 6-year prospective study in the GAZEL cohort. Addiction 2010; 105:57-61. [PMID: 19922521 PMCID: PMC3015101 DOI: 10.1111/j.1360-0443.2009.02725.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM An unprecedented decline in alcohol consumption and road mortality has been observed recently in France, but it is still unclear whether or not these changes affected driving while alcohol-intoxicated (DWI). The objective of the study was to estimate prospectively trends of excessive speed on the roads, alcohol consumption and DWI between 2001 and 2007 in a large cohort of experienced drivers. METHODS Participants were current employees or recent retirees of the French national electricity and gas company, who volunteered to participate in a research cohort established in 1989 under strict conditions of anonymity. An annual cohort questionnaire is sent to participants that includes two questions about overall alcohol consumption. In 2001 and 2007, 10,684 participants reported their driving behaviours using the same self-administered questionnaire. RESULTS Between 2001 and 2007, the proportion of participants (n = 10,684) who reported having driven at speeds at least 20 km/hour above the limit decreased from 23.7% to 4.1% in built-up areas (P < 0.001), from 34.3% to 9.3% on rural roads (P < 0.001) and from 24.3% to 2.7% on highways (P < 0.001). Regular and non-regular excessive alcohol consumption decreased from 22.7% to 19.7% and from 18.0% to 14.9%, respectively, whereas DWI increased from 22.9% to 25.3% over the same period (P < 0.001). CONCLUSIONS A recent crackdown on road violations by the French government has failed to deter DWI. Given that DWI seems to be a sporadic and rarely punished behaviour, its prevention requires more coercive measures, such as using a breath alcohol ignition interlock device.
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Affiliation(s)
- Aymery Constant
- INSERM U897-IFR99, Equipe Avenir Prévention et Prise en Charge des Traumatismes, ISPED, Bordeaux, France.
| | - Sylviane Lafont
- UMRESTTE, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
INRETSINVSUniversité Claude Bernard - Lyon I25, Avenue François Mitterrand, F-69675 BRON Cédex,FR
| | - Mireille Chiron
- UMRESTTE, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
INRETSINVSUniversité Claude Bernard - Lyon I25, Avenue François Mitterrand, F-69675 BRON Cédex,FR
| | - Marie Zins
- Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé
INSERM : U687IFR69Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesHôpital Paul Brousse 16, av Paul Vaillant Couturier 94807 VILLEJUIF,FR
| | - Emmanuel Lagarde
- Centre épidémiologie et biostatistique
INSERM : U897Université Victor Segalen - Bordeaux IIFR
| | - Antoine Messiah
- Centre épidémiologie et biostatistique
INSERM : U897Université Victor Segalen - Bordeaux IIFR
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Astudillo M, Kuntsche S, Graham K, Gmel G. The Influence of Drinking Pattern, at Individual and Aggregate Levels, on Alcohol-Related Negative Consequences. Eur Addict Res 2010; 16:115-23. [PMID: 20357455 PMCID: PMC2895741 DOI: 10.1159/000303379] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM To determine the extent drinking patterns (at the individual and country level) are associated with alcohol-related consequences over and above the total alcohol the person consumes. METHODS Hierarchical linear models were estimated based on general population surveys conducted in 18 countries participating in the GENACIS project. RESULTS In general, the positive association between drinking pattern scores and alcohol-related consequences was found at both the individual and country levels, independent of volume of drinking. In addition, a significant interaction effect indicated that the more detrimental the country's drinking pattern, the less steep the association between the volume of drinking and its consequences. CONCLUSION Drinking patterns have an independent impact on consequences over and above the relationship between volume and consequences.
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Affiliation(s)
- M. Astudillo
- Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne University Hospital, Lausanne, Switzerland,*Mariana Astudillo, Swiss Institute for the Prevention of Alcohol and Other Drug Problems, PO Box 870, CH–1001 Lausanne (Switzerland), E-Mail
| | - S. Kuntsche
- Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne University Hospital, Lausanne, Switzerland
| | - K. Graham
- Center for Addiction and Mental Health, London Ont., Canada
| | - G. Gmel
- Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne University Hospital, Lausanne, Switzerland,Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland
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Kovess-Masfety V, Briffault X, Sapinho D. Prevalence, risk factors, and use of health care in depression: a survey in a large region of France between 1991 and 2005. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2009; 54:701-9. [PMID: 19835677 DOI: 10.1177/070674370905401007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the prevalence, risk factors, and use of care for depression between 2 periods, concerning changes in social factors and health care provision. METHOD We compared data from 2 surveys carried out in a large urbanized French region (Ile-de-France) 15 years apart (1991, n = 1192; 2005, n = 5308), using comparable methodology and tools. RESULTS The overall prevalence of depression has slightly increased over this period. In contrast, the tendency of people who claim they feel depressed has dramatically increased. At-risk populations have also changed during this period. The proportion of people consulting a psychiatrist for depression has not changed, while general practitioner (GP) consultations have decreased and psychologist consultations have increased 3-fold. Psychotropic use by people who are depressed has decreased significantly. CONCLUSION The trend toward increased depressive symptoms does not correspond to an increase in depressed disorders. In a well-staffed urbanized French region, psychologists are playing a growing role in managing depression at the expense of GPs, when the use of a psychiatrist remains unchanged; decreased use of psychotropic drugs may be a consequence.
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Affiliation(s)
- Viviane Kovess-Masfety
- Université Paris Descartes (Equipe d'Accueil 4096), Fondation Mutuelle Générale de l'Education Nationale pour la Santé Publique, Paris, France.
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Giesbrecht N. Modern-day miracles: declining per capita consumption and increased awareness of alcohol's damage in a drinking-oriented society. Addiction 2008; 103:604-5. [PMID: 18339105 DOI: 10.1111/j.1360-0443.2008.02194.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Norman Giesbrecht
- Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1.
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