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Introduction: Few studies have considered the factors independently associated with chronic fatigue syndrome (CFS) and/or fibromyalgia (FM) or considered the impact of these conditions on health status using population-based data. Methods: We used data from the nationally representative 2010 Canadian Community Health Survey (n= 59 101) to describe self-reported health professional-diagnosed CFS and/or FM, and their associations with 6 health status indicators. Results: In 2010, diagnosed CFS and FM are reported by 1.4% (95% confidence interval [CI]: 1.3%–1.6%) and 1.5% (1.4%–1.7%), respectively, of the Canadian household population aged 12 years and over, with comorbid CFS and FM affecting 0.3% (0.3%–0.4%) of that population. Prevalent CFS and/or FM were more common among women, adults aged 40 years and over, those with lowest income, and those with certain risk factors for chronic disease (i.e. obesity, physical inactivity and smoking). After controlling for differences between the groups, people with CFS and/or FM reported poorer health status than those with neither condition on 5 indicators of health status, but not on the measure of fair/poor mental health. Having both CFS and FM and having multiple comorbid conditions was associated with poorer health status. Conclusion: Co-occurrence of CFS and FM and having other chronic conditions were strongly related to poorer health status and accounted for much of the differences in health status. Understanding factors contributing to improved quality of life in people with CFS and/or FM, particularly in those with both conditions and other comorbidities, may be an important area for future research. [ABSTRACT FROM AUTHOR]

Background: Mental disorders constitute a significant public health problem worldwide. Ensuring that those who need mental health services access them in an appropriate and timely manner is thus an important public health priority. We used data from 4 cross-sectional, nationally representative population health surveys that employed nearly identical methods to compare MHSU trends in the Canadian military versus comparable civilians., Method: The surveys were all conducted by Statistics Canada, approximately a decade apart (Military-2002, Military-2013, Civilian-2002, and Civilian-2012). The sample size for the pooled data across the surveys was 35,984. Comparisons across the 4 surveys were adjusted for differences in need in the 2 populations at the 2 time points., Results: Our findings suggested that first, in the Canadian military, there was a clear and consistent pattern of improvement (i.e., increase) in MHSU over the past decade across a variety of provider types. The magnitudes of the changes were large, representing an absolute increase of 7.15% in those seeking any professional care, corresponding to an 84% relative increase. Second, in comparable Canadian civilians, MHSU remained either unchanged or increased only slightly. Third, the increases in MHSU over time were consistently greater in the military than in the comparable civilian sample., Conclusions: Our findings point to advantages with respect to MHSU of the military mental health system over the civilian system in Canada; these advantages have widened substantially over time. These findings speak strongly to the potential impact of analogous changes in other health systems, both military and civilian.

Background: There is a perception that the impacts of arthritis are greatest among older adults. However, the effect of age on health-related outcomes in individuals with arthritis has not been explicitly studied. This study examined whether the physical and mental health impacts of arthritis are greater in older (75+ years) versus younger (20-44, 45-64 and 65-74 years) Canadian adults., Methods: Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. The responses were weighted to be representative of Canadians (≥20 years) with arthritis. Associations between age and the prevalence of severe/frequent joint pain, severe/frequent fatigue, sleep limitations, instrumental activities of daily living (IADLs) limitations, high levels of stress, suboptimal general and suboptimal mental health, were examined descriptively prior to conducting multivariate log-binomial regression analyses., Results: A total of 4565 respondents completed the survey (78% response rate). Individuals with arthritis were mostly female (63%), of working age (57%) and overweight or obese (67%). Upon adjusting for covariates, younger (20-44 years) and/or middle aged (45-64 years) adults were more likely than those older (75+ years) to report severe/frequent joint pain, sleep limitations, high levels of stress and suboptimal mental health. After adjusting for covariates, age was not associated with IADL limitations, severe/frequent fatigue or suboptimal general health., Conclusions: Contrary to the belief that older adults with arthritis experience more severe physical and mental health outcomes, we found that older adults were less likely to report worse outcomes than younger adults. In light of these findings, public health messaging should stress that arthritis does not just affect the elderly and emphasize the importance of timely diagnosis and management at all ages in order to prevent or, minimize arthritis-related impairment.

Objective: An important minority of military personnel will experience mental health problems after overseas deployments. Our study sought to describe the prevalence and correlates of postdeployment mental health problems in Canadian Forces personnel., Method: Subjects were 16 193 personnel who completed postdeployment screening after return from deployment in support of the mission in Afghanistan. Screening involved a detailed questionnaire and a 40-minute, semi-structured interview with a mental health clinician. Mental health problems were assessed using the Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist-Civilian Version. Logistic regression was used to explore independent risk factors for 1 or more of 6 postdeployment mental health problems., Results: Symptoms of 1 or more of 6 mental health problems were seen in 10.2% of people screened; the most prevalent symptoms were those of major depressive disorder (3.2%), minor depression (3.3%), and posttraumatic stress disorder (2.8%). The strongest risk factors for postdeployment mental health problems were past mental health care (adjusted odds ratio [AOR] 2.89) and heavy combat exposure (AOR 2.57 for third tertile, compared with first tertile). These risk groups might be targeted in prevention and control efforts. In contrast to findings from elsewhere, Reservist status, deployment duration, and number of previous deployments had no relation with mental health problems., Conclusions: An important minority of personnel will disclose symptoms of mental health problems during postdeployment screening. Differences in risk factors seen in different nations highlight the need for caution in applying the results of research in one population to another.

Background: An estimated 5.4 million Canadian adults have been diagnosed with sleep apnea or are at high risk of experiencing obstructive sleep apnea (OSA). There are no recent Canadian data regarding access to and predictors of referral for diagnostic testing in these populations., Methods: The Sleep Apnea Rapid Response survey sampled 8647 Canadian adults and captured information about risk, testing, diagnosis and treatment of sleep apnea. Predictors of sleep laboratory test referrals were assessed using log-linked binomial regression modelling. Information regarding sleep testing facilities was updated at the provincial and regional levels., Results: Approximately 76.8% (95% CI 70.1% to 83.6%) of adult Canadians with sleep apnea and 5.1% (95% CI 3.4% to 6.7%) of those at high risk for OSA reported being referred to a sleep laboratory. Significant predictors of sleep laboratory referral in the general population were male sex, middle age, overweight or obese, a chronic condition, having a regular medical doctor and reporting symptoms of sleep apnea. Region of residence was also a predictor of reported sleep laboratory referral, with individuals from Ontario being more likely to report being referred to a sleep laboratory versus individuals from other regions., Conclusion: Individuals reporting risk factors and symptoms associated with OSA were more likely to report a sleep laboratory testing referral compared with those without risk factors or symptoms. However, Canada's diagnostic sleep laboratory testing capacity varies across regions and is believed to be inadequate given the number of individuals at high risk for OSA who did not report testing referral.

Objective: To describe the exercise/physical activity and weight management efforts of Canadians with self-reported arthritis, to examine factors associated with their engagement in these strategies to help manage their arthritis, and to explore reasons for lack of engagement., Methods: Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. The responses (78% response rate; n = 4,565) were weighted to be representative of Canadians (ages ≥20 years) with arthritis. Logistic regression analyses were used to examine factors associated with engaging in exercise/physical activity and weight control/loss (among overweight/obese respondents) for arthritis management purposes., Results: Individuals with arthritis were mostly women (63%), ages ≥45 years (89%), overweight/obese (67%), married (68%), and white (87%), with postsecondary education (69%). Sixty-three percent were exercising and of those who were overweight or obese, 68% were trying to control/lose weight; only 46% were engaged in both. Having received a clinical recommendation was the factor most strongly associated with engaging in exercise/physical activity and/or controlling/losing weight. The most common reason for not exercising was a coexisting health condition/problem (22%), while the most common reason for not controlling/losing weight among those who were overweight/obese was that it was felt not to be necessary (51%)., Conclusion: The provision of clinical recommendations from a health professional, providing advice on safe and suitable exercises/physical activities, as well as addressing misperceptions of the need to lose weight among the overweight/obese, may facilitate engagement in these health behaviors and ultimately reduce the consequences of arthritis., (© Her Majesty the Queen in Right of Canada 2013.)

Objective: To estimate the prevalence of overweight and obese Canadians with arthritis and to describe their use of arthritis self-management strategies, as well as explore the factors associated with not engaging in any self-management strategies., Methods: Respondents to the 2009 Survey on Living with Chronic Diseases in Canada, a nationally representative sample of 4,565 Canadians age ≥20 years reporting health professional-diagnosed arthritis (including more than 100 rheumatic diseases and conditions), were asked about the impact of their arthritis and how it was managed. Among the overweight (body mass index [BMI] 25-29.9 kg/m(2)) and obese (BMI ≥30 kg/m(2)) individuals with arthritis (n = 2,869), the use of arthritis self-management strategies (i.e., exercise, weight control/loss, classes, and community-based programs) were analyzed. Log binomial regression analyses were used to examine factors associated with engaging in none versus any (≥1) of the 4 strategies., Results: More than one-quarter (27.4%) of Canadians with arthritis were obese and an additional 39.9% were overweight. The overweight and obese individuals with arthritis were mostly female (59.5%), age ≥45 years (89.7%), and reported postsecondary education (69.0%). While most reported engagement in at least 1 self-management strategy (84.9%), less than half (45.6%) engaged in both weight control/loss and exercise. Factors independently associated with not engaging in any self-management strategies included lower education, not taking medications for arthritis, and no clinical recommendations from a health professional., Conclusion: Fewer than half of the overweight and obese Canadians with arthritis engaged in both weight control/loss and exercise. The provision of targeted clinical recommendations (particularly low in individuals that did not engage in any self-management strategies) may help to facilitate participation., (Copyright © 2012 by the American College of Rheumatology.)