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Aims Animal models show that a single dose of 3,4-methylenedioxymethamhetamine ( MDMA; 'ecstasy') can result in long-term disruption of sleep. We evaluated the relationship between ecstasy consumption and the use of sleep medications in humans after controlling for key factors. Design The Personality and Total Health Through Life project uses a longitudinal cohort with follow-up every 4 years. This study reports data from waves 2 and 3. Setting Participants were recruited from the electoral roll in the Australian Capital Territory and Queanbeyan, New South Wales, Australia. Participants Participants were aged 20-24 years at wave 1 (1999-2000). Measures The study collected self-reported data on ecstasy, meth/amphetamine, cannabis, alcohol, tobacco and use of sleeping medications (pharmaceutical or other substances). Depression was categorized using the Brief Patient Health Questionnaire ( BPHQ). Other psychosocial measures included life-time traumas. We used generalized estimating equations to model outcomes. Findings Ecstasy data were available from 2128 people at wave 2 and 1977 at wave 3: sleeping medication use was reported by 227 (10.7%) respondents at wave 2 and 239 (12.1%) at wave 3. Increased odds ratios ( OR) for sleeping medication use was found for those with depression [ OR = 1.88, 95% confidence interval ( CI): 1.39, 2.53], women ( OR = 1.44, 95% CI : 1.13, 1.84), and increased by 19% for each life-time trauma. Ecstasy use was not a significant predictor, but ≥monthly versus never meth/amphetamine use increased the odds ( OR = 3.03, 95% CI 1.30, 7.03). Conclusion The use of ecstasy appears to be associated with the use of sleeping medications but this association can be accounted for by other factors. [ABSTRACT FROM AUTHOR]

Aims: To examine predictors of self-harm, especially substance use and psychological distress, in an Australian adult general population sample., Design: Sequential-cohort design with follow-up every four years., Setting: Australian general population., Participants: A random sample of adults aged 20-24 and 40-44 years (at baseline) living in and around the Australian Capital Territory., Measurements: Self-report survey including items on four common forms of self-harm. Psychological distress was indexed by the combined Goldberg Anxiety and Depression scale scores and alcohol problems by the Alcohol Use Disorders Identification Test (AUDIT)., Findings: Four thousand one hundred and sixty people (84% of baseline) were re-interviewed at 8 years: 4126 reported their self-harm status. Past year self-harm was reported by 8.2% (95% CI 7.4-9.0%) of participants [males: 9.3% (8.0-10.6%), females: 7.3% (6.2-8.4%)]. Several forms of substance use-smoking (OR = 1.52), marijuana use (OR = 1.77) and drinking alcohol at a level likely to cause dependence (AUDIT score ≥ 20) (OR = 2.08)-were independently predictive of past year self-harm. Additional key risk factors for self-harm in the past year were childhood sexual abuse by a parent (OR = 3.07), bisexual orientation (OR = 2.65), younger age (OR = 2.23) and male gender (OR = 1.86). Other independent predictors were years of education, adverse life events, psychological distress and financial strain., Conclusions: Self-harm in young and middle-aged adults appears to be associated with current smoking, marijuana and 'dependent' alcohol use. Other independent predictors include younger age, male gender, bisexual orientation, financial strain, education level, psychological distress, adverse life events and sexual abuse by a parent., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

Background: National screening programs have reduced cervical cancer mortality; however participation in these programs varies according to women's personal and social characteristics. Research into these inequalities has been limited by reliance on self-reported service use data that is potentially biased, or administrative data that lacks personal detail. We address these limitations and extend existing research by examining rates and correlates of cervical screening in a large epidemiological survey with linked administrative data., Methods: The cross-sectional sample included 1685 women aged 44-48 and 64-68 years from the Australian Capital Territory and Queanbeyan, Australia. Relative risk was assessed by logistic regression models and summary Population Attributable Risk (PAR) was used to quantify the effect of inequalities on rates of cervical cancer screening., Results: Overall, 60.5% of women participated in screening over the two-year period recommended by Australian guidelines. Screening participation was associated with having children, moderate or high use of health services, employment, reported lifetime history of drug use, and better physical functioning. Conversely, rates of cervical screening were lower amongst women who were older, reliant on welfare, obese, current smokers, reported childhood sexual abuse, and those with anxiety symptoms. A summary PAR showed that effective targeting of women with readily observable risk-factors (no children, no partner, receiving income support payments, not working, obese, current smoker, anxiety, poor physical health, and low overall health service use) could potentially reduce overall non-participation in screening by 74%., Conclusions: This study illustrates a valuable method for investigating the personal determinants of health service use by combining representative survey data with linked administrative records. Reliable knowledge about the characteristics that predict uptake of cervical cancer screening services will inform targeted health promotion efforts.