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Background: Fibromyalgia has been associated with various physical and mental disorders. However, these comorbidities need to be quantified in a population-based study.Method: We compared participants with and without self-reported fibromyalgia to assess (a) The prevalence of self-reported fibromyalgia and its sociodemographic characteristics in a US representative sample, (b) The associations between self-reported fibromyalgia and lifetime and past 12-month mental and physical disorders and (c) The quality of life associated with self-reported fibromyalgia. This cross-sectional study used a large national sample (n = 36,309) of the US population, the National Epidemiologic Survey on Alcohol and Related Conditions-III. Face to face interviews were conducted, collecting sociodemographic characteristics, diagnostic and statistical manual of mental disorders-5 structured diagnosis and self-reported medical conditions (including fibromyalgia).Results: The past 12-month prevalence of self-reported fibromyalgia was estimated at 2.05%. Participants with self-reported fibromyalgia were significantly at higher risk to report a lifetime history of mental disorder (adjusted odds ratio [aOR] = 2.32). Self-reported fibromyalgia was also positively associated with 24 of the 27 physical conditions assessed in this study. Participants with self-reported fibromyalgia were more likely to report a past 12-month history of suicide attempts (aOR = 5.81), substance use disorders (aOR = 1.40), mood disorders (aOR = 2.67), anxiety disorders (aOR = 2.75) and eating disorders (aOR = 2.45). Participants with self-reported fibromyalgia had lower levels of both mental and physical quality of life than those without fibromyalgia.Conclusions: Participants with self-reported fibromyalgia have a higher prevalence of comorbid mental and physical disorders, and lower mean levels of mental and physical quality of life than their counterparts without fibromyalgia.Significance: We showed here a strong association of self-reported fibromyalgia with both mental and physical comorbidities. We showed that among participants with self-reported fibromyalgia, more than 8 out of 10 had at least three other physical comorbidities, and almost half had at least three mental comorbidities. This is a cross-sectional study using a representative sample of the US population with highly reliable psychiatric diagnosis that makes our results generalizable. Practitioners managing fibromyalgia should search and treat these comorbidities. [ABSTRACT FROM AUTHOR]

Background & Aims Depression is common in patients with liver disease. Moreover, alcohol use is intricately linked with both major depression and liver disease, and has also been linked with suicidal behaviours, suggesting that the alcohol use may have an intermediate role in the relationship between liver disease and major depression or suicidal behaviours. This study presents nationally representative data on the prevalence of major depression in patients with liver disease in the United States and its association with suicide attempts. Methods Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC). The NESARC is a survey of 43 093 adults aged 18 years and older in the United States. Medically recognized liver diseases were self-reported, and diagnoses of major depression were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule- DSM- IV version. Result The prevalence of liver disease was estimated at 0.7%. Respondents with a liver disease reported 12-month rates of major depression (17.2%) that were significantly higher than among respondents without liver disease (7.0%; Adjusted OR:2.2; CI: 1.2-4.1). Lifetime rates of suicide attempts among participants with a major depression were also higher in participants with a liver disease (33.2%) than among respondents without liver disease (13.7%; OR: 3.1; CI: 1.3-7.6). Conclusions Liver diseases are associated with major depression and suicide attempts among adults in the community. Adjustment for the amount of alcohol used or sociodemographical factors did not explain the observed association of liver disease with both major depression and suicide attempts. [ABSTRACT FROM AUTHOR]

Background and aims There is growing evidence that driving under the influence of cannabis is associated with a higher risk of motor vehicle crash. Cannabis dependence has been reported to be associated with a three-fold increased risk of motor vehicle crash. The impact of the age at onset of cannabis use on the risk of both cannabis dependence and driving under the influence of cannabis has not been evaluated so far. Methods Data were drawn from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a survey of 43,093 adults aged 18 years and older. We limited our analyses to the sample of participants who reported having ever used cannabis ( n = 8172), of whom 8068 had a known age at onset of cannabis use. Results Of the 8068 participants included, 5.15% reported having driven under the influence of cannabis. Among those, only a minority (14.46%) were diagnosed with cannabis dependence. Compared to those who start using cannabis at age 21 years or after, participants who used cannabis before the age of 14 years were 4 times more likely to have a history of cannabis dependence and 3 times more likely to reported having driven under the influence of cannabis. An inverse relationship between the age at onset of cannabis use and driving under the influence and risk of cannabis dependence was found. Conclusions Starting to smoke cannabis younger than 21 years is associated with both cannabis dependence and driving under the influence of cannabis. [ABSTRACT FROM AUTHOR]

The article offers information on a survey titled "National Epidemiologic Survey on Alcohol and Related Conditions" (NESARC) conducted by the U.S. Census Bureau under the supervision of the organization National Institute on Alcoholism and Alcohol Abuse (NIAAA). The findings of survey shows that the clinical trials associated with the bipolar disorder should focus on the impact of eligibility criteria on the generalizability of their results and describe the basics of their uses.

Abstract: Background: Little is known about the prevalence and comorbidity of Major Depressive Episode (MDE) during pregnancy in the general population. This study presents nationally representative data on the prevalence, correlates, and psychiatric comorbidities of depression in women during pregnancy and postpartum in the United States. Method: Data were drawn from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The NESARC is a survey of 43,093 adults aged 18years and older residing in households in the United States of whom 14,549 were women 18 to 50years old with known past-year pregnancy status. Diagnoses of depression and other mood, anxiety, and drug disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule — DSM-IV version. Results: The overall prevalence of MDE during pregnancy was 12.4%. Among pregnant and postpartum women, depression was associated with younger age, ethnicity other than Latino, being widowed, divorced, separated or never married, traumatic events within the past 12months and pregnancy complication. Strong associations were found between MDE during pregnancy and postpartum and nearly all 12-month psychiatric disorders. Past-year depressed pregnant and postpartum women were more likely than nondepressed pregnant women to use substances (including alcohol, illicit drugs and cigarettes). Past-year pregnant and postpartum women were significantly less likely to receive past-year treatment for depression than nonpregnant women although not after adjusting for background sociodemographic characteristics. Conclusions: These results indicate that depression during pregnancy and postpartum is associated with a large range of psychiatric disorders. The high frequency of psychiatric comorbidities, the elevated use of any substances and the high rate of unmet needs should be kept in mind when considering the management of depression during pregnancy and postpartum. [Copyright &y& Elsevier]

OBJECTIVE: Despite the devastating impact of child marriage (marriage before the age of 18 years) on health, no study has yet evaluated its impact on mental health in the general adult population. This article presents nationally representative data on the prevalence, sociodemographic correlates, and psychiatric comorbidity of child marriage among women in the United States. METHODS: Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. We limited our analyses to the sample of women (N = 24 575) with a known age at first marriage, of whom 18 645 had been or were presently married. RESULTS: The prevalence of child marriage among women was 8.9%. Demographic factors associated with child marriage were black and American Indian/Alaska Native ethnicities, age at interview of >45 years, low educational level, low income, and living in the South and rural areas of the United States. The overall lifetime and 12-month rates of psychiatric disorders were higher for women who married as children, compared with women who married as adults. In addition, women who married as children were more likely to seek and access health services, compared with women who married in adulthood. CONCLUSIONS: Child marriage increases the risk of lifetime and current psychiatric disorders in the United States. Support for psychiatric vulnerabilities among women married in childhood is required. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and determinants for the peripartum depression.Methods: Data were extracted from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population corresponding to 34,653 participants. All women pregnant during the year before the second assessment were included. Peripartum depression was evaluated according a semi-structured interview at Wave 2. Risk factors covering life from childhood through adulthood, and including sexual abuse, family history of depression and psychiatric disorder lifetime were evaluated at wave 1. Stressful life event and obstetric factors were evaluated for the period of 12 months preceding the second interview.Results: In the sample of 1085 participants pregnant at wave 2, the prevalence of peripartum depression was 10.8%. Women with a peripartum depression reported higher rates of sexual abuse in childhood (OR=3.07), family history of depression (OR=3.27). A history of mental disorder was associated with a higher rate of peripartum depression (OR=3.43) Four disorders were specifically associated with higher rate of peripartum depression including depression (OR=4.91), substance use disorder (OR=2.37), bipolar disorder (OR=2.39) and history of suicide attempt (OR=3.79). Peripartum depression was associated with stressful life event in the last year (OR=3.03), and complications during pregnancy (OR=2.10).Limitations: Not distinguish between depressed women during pregnancy from postpartum depressed women.Conclusion: Depression affects more than one in 10 women during peripartum. The factors associated with peripartum depression are traumatic, personal or family history of mental disorder, in a timeframe covering life from childhood through adulthood. [ABSTRACT FROM AUTHOR]

Despite the severity of the loss of a parent and the frequency of parental divorce, few studies compared their impact on mental health in the general adult population. The aim of this study was to estimate the prevalence, sociodemographic correlates, and psychiatric comorbidity of parental loss and parental divorce during childhood and adolescence. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults (n = 43,093). Of the 43,093 participants, parental divorce during childhood or adolescence was reported by 5776 participants, whereas 3377 experienced parental death during childhood or adolescence. Participants reporting a history of parental divorce present a significantly higher prevalence of psychiatric disorders, particularly alcohol and drug use disorders compared with control subjects. While participants experiencing the death of a parent reported a poorer overall health, the prevalence of psychiatric disorder after 17 years of age was not significantly higher than that of the control subjects. [ABSTRACT FROM AUTHOR]

Abstract Background Receiving a diagnosis of cancer may be associated with increased risk of mental disorders. Yet, in this context, no factor predicts the onset of a mental disorder besides the diagnosis of cancer itself. If patients with a history of mental disorder are at particular risk is unknown. Methods Data were derived from a large national sample of the US population. Face-to-face surveys were conducted on 36309 adults during 2012–2013 period. Data were used to examine the associations among the past-year prevalence of mental disorders (according to the Diagnostic and Statistical Manual of Mental Disorders-5), the treatment-seeking rates and a recent cancer diagnosis. Data were analysed according to the antecedents of mental disorder in participants and according the presence of a recent cancer diagnosis. Results Participants recently diagnosed with cancer (n = 1300) were significantly at higher risk to present suicide attempt (adjusted odds ratio [AOR] = 3.52; 95% confidence interval [CI] = 1.23–10.04), post-traumatic stress disorder (AOR = 2.25; 95% CI = 1.71–2.96), bipolar disorder (AOR = 2.22; 95% CI = 1.46–3.38) and drug use disorder (AOR = 1.64; 95% CI = 1.13–3.39). The prevalence of most of the mental disorders considered was significantly higher for participants with a history of mental disorder compared with participants without such a history. Conversely, a recent diagnosis of cancer was not associated with significant differences in the incidence of mental disorders in participants with no history of mental disorder. Conclusions Patients with a history of mental disorder receiving a cancer diagnosis are at high risk of relapse and should be closely monitored. Highlights • This study is based on a population-based representative sample and uses interview-based diagnoses. • Persons with a recent diagnosis of cancer were at higher risk than other persons to present various mental disorders. • The prevalence of the mental disorders considered was higher for participants with a history of mental disorder. • No difference was observed in participants with no history of mental disorder after cancer diagnosis. [ABSTRACT FROM AUTHOR]

Abstract: Objective: There is growing clinical and epidemiological evidence that undiagnosed bipolar features are source of clinical heterogeneity in major depressive disorder (MDD). This study examined and compared the prevalence and correlates of lifetime major depressive episode plus subthreshold hypomania D(m) with pure MDD, bipolar II disorder, and bipolar I disorder. Method: Data were drawn from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large cross-sectional survey (n=43,093) representative of the U.S. population. Results: The lifetime prevalences were 2.53% for D(m), 1.12% for bipolar II disorder, 2.19% for bipolar I disorder and 10.70% for pure MDD. All bipolar disorders (i.e., D(m), BP-II, and BP-I) were half as frequent as MDD. Lifetime and 12-month psychiatric comorbidity, course and clinical characteristics, symptoms, health status and treatment-seeking rates were significantly different in participants with lifetime D(m) when compared to participants with pure MDD, but not when compared to participants with bipolar II disorder. Limitations: Subthreshold hypomania diagnostic was based on the lifetime presence of at least one of the three screening questions for criterion A for hypomania, without a lifetime history of manic or hypomanic episode. This narrow definition, both in terms of the choice of hypomanic symptoms and their duration, could have led to an underestimation of the proportion of participants with a lifetime history of D(m). In addition, the cross-sectional nature of this study does not allow causal associations to be drawn. Conclusions: Our data confirm and extend evidence of the clinical significance and validity of a subthreshold bipolarity-specifier applied to individuals with DSM-IV MDD. Major depression with subthreshold hypomania could be more accurately incorporated into the bipolar II disorder diagnosis. [Copyright &y& Elsevier]

Objective: To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender., Methods: Data were extracted from NESARC III, a representative U.S., Sample: We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13-18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses., Results: Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90-4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62-2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56-3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men., Limitations: Recall and classification biases inherent to survey design., Conclusion: Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression., Competing Interests: Declaration of competing interest None of the authors have any competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Stroke has been linked to various physical and mental disorders, with both stroke and its comorbidities significantly impacting public health. In this population-based study, we evaluate the relationships between stroke, physical conditions, mental disorders, and their effect on quality of life. Data were gathered from a nationally representative sample of 36,309 civilian participants aged 18 years and older in the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined the prevalence of past-year stroke, its sociodemographic characteristics, and its associations with past-year mental disorders (according to the DSM-5) and physical conditions. Furthermore, we explored the connections between stroke and health-related quality of life, accounting for comorbidities. The past 12-month stroke prevalence was estimated at 0.82%. Participants with stroke exhibited a significantly higher past 12-month mental disorder prevalence than those without stroke. Specifically, individuals with stroke faced a higher risk of mood disorders, anxiety disorders, tobacco use disorder, and opioid use disorder compared to those without stroke. Stroke was also positively associated with 24 out of the 27 physical conditions assessed in this study. Participants with stroke experienced lower mental and physical quality of life compared to those without stroke. Stroke was significantly related to numerous mental and physical disorders. The association of stroke with diminished health-related quality of life was not only mediated by these comorbidities but should also be considered as inherently linked to stroke itself., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Recent findings suggest an association between tobacco and psychosis, but whether this association is mediated by confounding factors is unknown. Psychosis-like experiences (PLEs) are a subclinical expression of psychosis. To disentangle the association of tobacco with PLEs, we examined data from a large US population-based, nationally representative sample., Methods: Analysis was conducted on Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (N = 34,653 adults, conducted from 2004 to 2005). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV. Twenty-two PLEs previously described as observed indicators of psychosis were used. Participants were stratified according to their smoking status (never/former/current) for 5 different types of tobacco., Results: There was a significant association (ie, with 95% CIs for which the lower value was ≥ 1) between smoking status and 14 of the 22 assessed PLEs. These associations remained significant after adjustment for sociodemographic variables (including urbanicity or ethnicity), lifetime drug use disorder, and past-year cannabis use. While 26.33% of nonsmokers reported at least 1 PLE, this prevalence was slightly higher in former smokers (27.48%) and rose as high as 39.09% in current smokers (for current smokers vs lifetime abstainers, adjusted OR = 1.33; 95% CI, 1.23-1.45). All 22 PLEs had higher prevalence in smokers than in former smokers or lifetime abstainers. A total of 8.56% of smokers reported at least 5 PLEs, compared to 3.42% in lifetime abstainers (aOR = 1.56; 95% CI, 1.32-1.84)., Conclusions: In a large population-based, nationally representative sample, smoking status was associated with various PLEs. This association was not explained only by other known risk factors of PLEs or schizophrenia. There is a need to identify the potential neurobiological mechanisms by which smoking and PLEs are associated, for patients and from a public health perspective., (© Copyright 2018 Physicians Postgraduate Press, Inc.)

Purpose: Major depression is frequent but underrecognized. Our objective was to investigate the usefulness of a single question as a clinical indicator for current major depressive disorder in the general population., Methods: Data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The NESARC is a survey of 43,093 adults aged 18years and older residing in households in the United States. Odds ratios (OR), 95% confidence intervals (CIs), and test characteristics (sensitivity, specificity, positive and negative predictive values and positive likelihood ratio) of the question "During the past 4weeks, how often did you felt downhearted and depressed?" for the detection of current DSM-IV major depressive disorder were determined., Results: Participants who reported having felt downhearted and depressed "a little of the time," "some of the time," "most of the time" or "all the time" were more likely than participants reporting those feeling "none of the time" during the last 4weeks to be diagnosed with current major depressive disorder (OR 4.15 [95% CI, 3.57-4.83]; OR, 9.23 [95% CI, 7.93-10.74]; OR, 23.97 [95% CI, 20.21-28.44]; and OR, 24.00 [95% CI, 19.08-30.18], respectively). The likelihood ratio for a positive test ranged between 6.49 (5.89-7.14) and 8.07 (7.18-9.07), going from a 7.1% pretest probability of major depression up to 31.9% if the participant report having felt downhearted and depressed "most of the time" or "all the time" during the past 4weeks., Conclusion: The single screening question has potential for use in primary care settings., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Growing evidence supports the validity of distinguishing major depressive disorder (MDD) plus a lifetime history of subthreshold hypomania (D(m)) from pure MDD in psychiatric classifications. The present study sought to estimate the proportion of individuals with D(m) that would have been included in RCTs for MDD using typical eligibility criteria, and examine the potential impact of including these participants on internal validity., Methods: Data were derived from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a national representative sample of 43,093 adults of the United States population. We examined the proportion of participants with a current diagnosis of pure MDD and D(m) that would have been eligible in clinical trials for MDD with a traditional set of eligibility criteria, and compared it with that of participants with bipolar 2 disorder if the same set of eligibility criteria was applied. We considered 4 models including different definitions of subthreshold hypomania., Results: We found that more than 7 out of ten participants with pure MDD and with D(m) would have been excluded by at least one classical eligibility criterion. Prevalence rate of individuals with D(m) in RCTs for MDD with traditional eligibility criteria would have ranged from 7.98% to 22.59%. Overall exclusion rate of individuals with MDD plus at least 4 lifetime concomitant hypomanic probes significantly differ from those with pure MDD, whereas it was not significantly different in those with at least 2 lifetime concomitant hypomanic probes compared to those with bipolar 2 disorder., Conclusions: The current design of clinical trials for MDD may suffer from impaired external validity and potential impaired internal validity, due to the inclusion of a substantial proportion of individuals with subthreshold hypomania presenting with similar pattern of exclusion rates to those with bipolar 2 disorder, possibly resulting in a selection bias.

This study presents the sex differences in sociodemographics and in psychiatric correlates of shoplifting in the United States. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults. Shoplifting was associated with numerous psychiatric and addictive disorders with significant sex effects. Women with a lifetime history of shoplifting were significantly more likely than men with a lifetime history of shoplifting to have a lifetime diagnosis of alcohol abuse or dependence, nicotine dependence, cannabis, amphetamine, cocaine, or inhalant use disorder, and antisocial personality disorder, whereas men were significantly more likely than women to have a lifetime diagnosis of generalized anxiety disorder. The findings suggest that shoplifting could be better understood as a behavioral manifestation of a broader impaired impulse control spectrum in women. Shoplifting could be more a part of the externalizing spectrum disorders rather than the internalizing spectrum disorders in women compared to men.

Background: There has been little research on the generalizability of clinical trials for generalized anxiety disorder (GAD). The present study examines the generalizability of pharmacological and psychotherapy clinical trials' results of individuals with DSM-IV GAD to a large community sample., Methods: Data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a large national representative face-to-face sample of 43,093 adults of the United States population. We applied a standard set of eligibility criteria representative of GAD pharmacological and psychotherapy clinical trials to all adults with past 12 months GAD (n = 894), and to a subgroup of participants seeking treatment (n = 329). Our aim was to assess how many participants with GAD would fulfil typical eligibility criteria., Results: We found that more than seven out of 10 participants with GAD were excluded by at least one criterion. In the subgroup of GAD participants who sought treatment, the exclusion rate by at least one criterion raised to more than eight out of 10 participants with GAD. For the overall sample and the treatment-seeking subsample, having a current depression was the criterion excluding the highest percentage of individuals. Having a lifetime history of bipolar disorder, a current significant medical condition, a current diagnosis of alcohol abuse or dependence, and a social or specific phobia also excluded a substantial proportion of individuals in both samples., Conclusions: Clinical trials exclude a majority of adults with GAD. Clinical trials should carefully consider the impact of eligibility criteria on the generalizability of their results., (© 2012 Wiley Periodicals, Inc.)