Search

Background This analysis estimates the association between smoking-related knowledge and smoking behaviour in a Chinese context. To identify the specific knowledge most directly related to smoking status, we used a novel latent variable analysis approach to adjust for the high correlations between different measures of knowledge about tobacco smoking. Method Data are from the Global Adult Tobacco China Survey, a nationally representative sample of 13 354 household-dwelling individuals 15 years of age or older. Multinomial logistic regressions estimated the association between smoking status (ie, never smoked, current smoker or past smoker) and four smoking-related beliefs: whether or not smoking causes lung cancer, heart attack and stroke, and whether or not low-tar cigarettes are less harmful. A latent variable approach reassessed these associations while taking into account the general level of knowledge about smoking. Results After demographic variables and general knowledge about smoking had been controlled for, the belief that low-tar cigarettes are not less harmful was more prevalent in persons who had never smoked than in current smokers (OR=1.3 (95% CI 1.0 to 1.7) in men and OR=2.8 (95% CI 1.3 to 5.9) in women); this association was even stronger when past smokers and current smokers were compared (OR=2.1 (95% CI 1.5 to 3.0) in men and OR=5.0 (95% CI 1.3 to 20.1) in women). Conclusions Compared with those who have never smoked and those who have ceased smoking, current smokers in China are more likely to believe that low-tar cigarettes are less harmful than regular cigarettes.

Background. It has been widely documented that males were more likely to drinking alcohol and have alcohol use disorders (AUD). The degrees of the male-female differences in drinking and AUD have varied across countries. The reasons behind these variations have not been fully understood. The current study compared the estimated male-female differences across US-born and foreign-born Latino and Asian Americans with respect to alcohol drinking behavior and AUD.Method. Data come from the National Latino and Asian American Study (NLAAS), a national household survey of adults with Latinos and Asian decent in the United States. Male-female differences were estimated for drinking behavior and AUD among drinkers for US-born and foreign-born individuals, respectively. Zero-inflated Poisson regressions were utilized to estimate male-female differences in the number of AUD clinical features once it occurs.Results. Larger male-female differences were found for foreign-born individuals as compared to US-born individuals, especially the occurrence of AUD among drinkers. Once AUD clinical feature occurs, there was no male-female difference for foreign-born individuals, while there was a males excess in the number of clinical features for US-born individuals.Conclusion. Results from this study supports the importance of sociocultural influence in drinking and AUD. Implications for prevention and intervention programs were discussed.

Background This study integrates data from high-quality mental health surveys in five provinces in China to examine the prevalence, demographic correlates, age of onset, and comorbidity of alcohol use disorder (AUD). Methods The five cross-sectional surveys initially screened a representative sample of 74,752 community-living adults (94% response rate) from a sampling population including over 12% of China’s adult population. Psychiatrists then administered a detailed diagnostic exam to an enriched sample of 21,015 respondents (95% response rate). The prevalence of AUD in females in China is below 0.5%, so we limited our analysis to 9619 males who completed the diagnostic interview. Results Using meta -analyses to summarize estimates across the five locations, the current (30-day) prevalence of AUD among adult Chinese males was 9.8% (95% CI = 5.7–16.9%), but there was wide cross-province variation. After adjusting for age and other demographic variables, the prevalence of AUD was significantly lower in single men than in married men (OR = 0.4, CI = 0.2–0.7), lower in men who were not currently working than in men who were currently working (OR = 0.7, CI = 0.5–0.96), and lower in men with comorbid mental disorders than in men without comorbid mental disorders (OR = 0.4, CI = 0.2–0.8). The risk of developing AUD peaked at 30 years of age. Conclusions Substantial differences in the demographic correlates and age of onset of AUD in men in China compared to those reported in other countries highlight the importance of understanding the country-specific and region-specific profile of AUD before developing intervention and prevention strategies.

Background To study male-female and age differences in estimates of rapid transition from first full drink to alcohol dependence among youthful newly incident drinkers in the United States (US). Method The study population included 12-to-25-year-old non-institutionalized US civilian residents, sampled for US National Surveys on Drug Use and Health 2002-2013, with assessments via confidential computer assisted self-interviews. Newly incident drinkers are those who had their first full drink soon before the assessment (n=32,562 12-to-25-year- olds). Alcohol dependence (AD) criteria are from DSM-IV. Results For 12-to-25-year-old females, the peak risk for making a rapid transition from first full drink to alcohol dependence is seen during adolescence, followed by declining estimates (meta-analysis summary=3% at 12-17 years of age, 95% CI=2%, 3%). Among males, corresponding estimates fluctuate around 2%, with no appreciable differences across age strata. Among 12-to-17-year-old newly incident drinkers, there is a female excess in the rapid transition to alcohol dependence; a male excess is observed among young adult newly incident drinkers. Evaluated cohort-wise, using an epidemiological mutoscope view, individual cohorts show a congruent pattern, with age at first drink held constant. Conclusions Studying multiple replication samples of young newly incident drinkers, we discovered a clear female excess in the risk of a rapid transition from first full drink to alcohol dependence among adolescents, with age patterns differing across males and females.

Background. State-level ‘age 21’ drinking laws conform generally with the United States National Minimum Drinking Age Act of 1984 (US), and are thought to protect young people from adverse drinking experiences such as heavy episodic drinking (HED, sometimes called ‘binge drinking’). We shed light on this hypothesis while estimating the age-specific risk of transitioning from 1st full drink to 1st HED among 12-to-23-year-old newly incident drinkers, with challenge to a “gender gap” hypothesis and male excess described in HED prevalence reports.Methods. The study population consisted of non-institutionalized civilians in the United States, with nine independently drawn nationally representative samples of more than 40,000 12-to-23-year-olds (2006–2014). Standardized audio computer-assisted self-interviews identified 43,000 newly incident drinkers (all with 1st HED evaluated within 12 months of drinking onset). Estimated age-specific HED risk soon after first full drink is evaluated for males and females.Results. Among 12-to-23-year-old newly incident drinkers, an estimated 20–30% of females and 35–45% of males experienced their 1st HED within 12 months after drinking onset. Before mid-adolescence, there is no male excess in such HED risk. Those who postponed drinking to age 21 are not spared (27% for ‘postponer’ females; 95% CI [24–30]; 42% for ‘postponer’ males; 95% CI [38–45]). An estimated 10–18% females and 10–28% males experienced their 1st HED in the same month of their 1st drink; peak HED risk estimates are 18% for ‘postponer’ females (95% CI [15–21]) and 28% for ‘postponer’ males (95% CI [24–31]).Conclusions. In the US, one in three young new drinkers transition into HED within 12 months after first drink. Those who postpone the 1st full drink until age 21 are not protected. Furthermore, ‘postponers’ have substantial risk for very rapid transition to HED. A male excess in this transition to HED is not observed until after age 14.

OBJECTIVE: This study sought to discover recent age-specific and cohort-specific patterns of newly incident drinking of alcoholic beverages among young people in the United States, with identification of age at peak risk, cohort by cohort, and age by age. METHOD: Data are from the U.S. National Surveys on Drug Use and Health 2002-2013, with 12 independent successive replications of nationally representative surveys (n ≈ 420,000 12- to 25-year-olds). Drinking was assessed via confidential computer-assisted self-interviews. RESULTS: Looking across age strata, we found rising age-specific drinking incidence rates across adolescence to a plateau at age 16-18 years and made a new discovery of a statistically robust and highly reproducible dip in incidence at age 19-20 years, followed by the major peak at age 21 years, with sharply reduced incidence thereafter. Evaluated using an epidemiological mutoscope view, individual cohorts showed a congruent pattern, with starting age held constant. A completely different pattern was seen in age-specific prevalence estimates that showed monotonic linear increases. CONCLUSIONS: The novelty seen here, with multiple replications, is a set of clearly nonlinear, age-specific drinking incidence patterns not documented in prior studies. Evidence of noncongruent prevalence patterns is provided. We hope these simple examples will be useful in teaching the epidemiology of alcohol drinking. Language: en

Despite many studies on cognitive function and its influential factors among old population, relatively little research has been designed to study the relationship between dietary intake and cognitive function in elderly.We conducted a population-based, prospective nested case-control study to investigate the association between dietary habits and declines in cognitive function over three years among Chinese illiterate elderly.This study was part of the Chinese Longitudinal Health Longevity Study (CLHLS). Six thousand nine hundred and eleven illiterate residents aged 65 or older were investigated. Socio-demographic and dietary habits data were collected at baseline. The cognitive function of illiterate elderly persons was assessed using Chinese revised Mini Mental State Examination (MMSE-r) in 2002 and 2005. Cognitive decline was defined as MMSE-r score dropped to less than 18 at follow-up among those with normal cognitive function (MMSE-r≥18 at baseline). Odds ratios (OR) were calculated via logistic regression models.Five thousand six hundred and ninety one elderly were included in the current analysis. In bivariate analysis, cognitive decline was associated with gender, marital status ,financial status, smoking, drinking alcohol, drinking tea, eating fruits, vegetables, legumes, fishes, meat, egg and sugar. Multivariate logistic regression analysis found that always eating vegetable (Adjusted OR: 0.66; 95% confidence intervals, CI: 0.58, 0.75), always consuming legumes (AOR:0.78; 95% CI: 0.64, 0.96) were inversely associated with cognitive decline.Lower intakes of vegetables and legumes were associated with cognitive decline among illiterate elderly Chinese. Dietary factors may be important for prevention cognitive decline.

Evidence in support of a suspected causal association linking childhood physical punishment (CPP) and later alcoholic beverage-related disturbances has been found in metropolitan China. Here, the focus shifts to the CPP association with the estimated risk of starting to drink, having the first drinking problem, and transitioning from first drink to the first drinking problem.Data are from the World Mental Health Surveys-metropolitan China study, with representative samples of adult household residents living in two metropolitan cities, Beijing and Shanghai. Recalled information was available for early life experiences (including CPP, other childhood adversities, and parental alcohol and drug problems), as well as the onset age of drinking and drinking problems. Survival analyses were used to estimate the Hazard Ratio. A structural equation modeling approach was used to control for other inter-correlated childhood adversities.Cox proportional hazards modeling discloses statistically robust associations linking CPP with drinking and drinking problems, as well as more rapid transitions from first drink to first drinking problem, even after accounting for other childhood adversities and parental drinking problems. These associations cannot be attributed to a more general noxious family environment.These results lay a foundation for future experimental studies on the possible causal relationship linking CPP with the onset of drinking problems and the transition from drinking to drinking problems.

Alcohol problems are widespread throughout the United States. While treatment can be successful, many individuals continue to drink. One method to assess treatment results over time is by investigating abstinence as a measure of success.The main aim of this study is to investigate factors that may be associated with past-year (PY) abstinence among individuals who received prior-to-past-year (PPY) treatment for alcohol problems, while also assessing abstinence by treatment subtype.This study uses data from 1742 individuals who received PPY treatment for alcohol problems in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Logistic regression models were used to assess the strength of association between alcohol abstinence and key demographic and clinical factors.The level of PY abstinence was 36.5% among those who previously sought treatment for alcohol problems. Younger age groups and those who were nicotine dependent or had a cannabis use disorder were less likely to be abstinent. There were no differences based on sex or PY major depression or generalized anxiety disorder.While causal inferences cannot be made, these results suggest that the majority of people continue to drink, even after being treated for alcohol problems. Nonetheless, variation may exist depending on the form of treatment a person receives. More research is needed regarding long-term levels of abstinence after individuals receive treatment.

Sex differences in opportunities to use alcohol or drugs, and transition to use, were investigated in 15 surveys, in 2001-2004 (Europe 6; Americas 3; Africa 2, Asia 3; Oceania 1). The paper focuses on 18-29 year olds (N = 9,873). The World Mental Health Survey Initiative oversaw the surveys; each country obtained its own funding. A complex picture emerged with different results for alcohol and for drugs and for opportunity to use and the transition to use. Sex differences in opportunity to use alcohol were small except in Lebanon and Nigeria, whereas for drugs, the largest differences were in Mexico and Colombia.

This epidemiological study of a sample of smokers from the general population of Colombia examined the population distribution and dimensionality of eight hypothesized inter-correlated clinical features (CFs) associated with tobacco dependence syndrome (TDS). Data were drawn from interviews of 4 426 smokers conducted in a national survey in Colombia as part of the World Mental Health Survey Initiative. Daily smokers completed a Spanish-language TDS module, and the 237 smokers who had begun smoking during the five years prior to the assessment were selected. Confirmatory factor analysis (CFA) for a unidimensional TDS provided discrimination and difficulty parameter estimates. Two CFs that were reported very infrequently among the study sample were dropped from the CFA. Among the six remaining CFs, discrimination (D1) estimates ranged from 1.1 to 6.0 and difficulty (D2) estimates ranged from 1.1 to 2.2, providing evidentiary support for a unidimensional tobacco dependence construct. The Spanish-language TDS module used in this study could serve as a valuable tool in future studies for evaluating public health outreach and early intervention programs directed toward community residents who have begun smoking tobacco.En el presente estudio epidemiológico de una muestra de fumadores de la población general de Colombia se examinó la distribución y la magnitud de ocho características clínicas interrelacionadas en forma hipotética, que se asocian con el síndrome de dependencia del tabaco. Los datos se extrajeron de las entrevistas realizadas a 4-426 fumadores en una encuesta nacional en Colombia, que formó parte de la Iniciativa de la Encuesta de Salud Mental Mundial. Los fumadores habituales completaron un módulo de evaluación del síndrome de dependencia del tabaco y se escogieron los 237 fumadores que habían comenzado el consumo de tabaco en los cinco años que precedieron a la evaluación. El análisis factorial confirmatorio del modelo unidimensional del síndrome de dependencia del tabaco proporcionó los índices de discriminación y de dificultad de cada variable. Dos características clínicas que se notificaron con muy poca frecuencia en la muestra del estudio se excluyeron del análisis factorial. El índice de discriminación de las seis características restantes osciló entre 1,1 y 6,0, y el índice de dificultad fluctuó entre 1,1 y 2,2, con lo cual se demostró la validez de un modelo unidimensional de la dependencia. El módulo de evaluación en español del síndrome de dependencia del tabaco usado en este estudio podría constituir un instrumento valioso en estudios futuros destinados a evaluar los programas de salud pública de divulgación y de intervención temprana dirigidos a los residentes de la comunidad que han comenzado a fumar.

The aim of the current study is to estimate a link between early physical punishment in childhood and later alcohol outcomes, taking family history of drinking problems into account, with epidemiological data from China. The yield from previous studies on this relationship is mixed evidence, largely traceable to research design variations, including model specifications that concern parental alcohol or other drug problems (AODPs) that might account for both earlier discipline practices and later drinking problems in the offspring.Data are from the World Mental Health Surveys-metropolitan China study, with cross-sectional representative sample surveys of adult household residents living in two metropolitan cities, Beijing and Shanghai. Participants in this general mental health survey were asked about early life experiences (e.g., parental AODP, childhood misbehavior), as well as their own drinking outcomes. Stratification was used to control for parental AODP.Logistic regressions found robust associations linking childhood physical punishment with drinking outcomes, even with stratification for parental AODP and childhood misbehavior.These results from a cross-sectional survey lay a foundation for future prospective and longitudinal research on possible causal relationships that link childhood physical punishment with later drinking outcomes in China.

Aims This study investigates the occurrence of clinical features of alcohol dependence and socially maladaptive drinking during the first 24 months after the onset of alcohol use. Design Data for this study are from the nationally representative 2004-07 National Surveys on Drug Use and Health (NSDUH). Setting General population of the United States, aged 12 years and older. Participants New-onset alcohol users (NOAUs) were drinkers who started to drink alcohol within 24 months of the NSDUH assessment and consumed alcohol during the last 12 months. Measurements The NSDUH assessed for clinical features of alcohol dependence and socially maladaptive drinking, consistent with the DSM-IV. Findings NOAUs frequently experienced problems relating to self-reported tolerance, spending a great deal of time recovering from the effects of alcohol and unsuccessful attempts at cutting down on drinking. The likelihood of experiencing the clinical features increased steadily in the first 9 months after use, but appeared to plateau or only gradually increase thereafter. Strong evidence emerged that the clinical features measured a single latent dimensional of 'alcohol use disorder' (AUD) in this sample. The majority of the clinical features were good indicators of the underlying AUD continuum in the 2 years after first drinking onset. Conclusions There may be a period of time during the second year of alcohol use, when level of alcohol use disorder fluctuates rather than increases. Public health and safety efforts designed to target problematic alcohol use in the earliest stages of alcohol involvement could be useful in preventing the escalation of alcohol problems in this group of drinkers. Language: en

Aims The aim of the current study is to estimate the association between childhood physical punishment (CPP) and level of alcohol use disorder (AUD), using two different approaches to take other childhood adversities into account. Design and setting Population survey using face-to-face interviews to a representative sample of non-institutionalized adult residents of Beijing and Shanghai, China. Participants A total of 5201 participants aged 18-70 years. Measurements A version of the World Mental Health Composite International Diagnostic Interview was used. Standardized assessments covered early life experiences of childhood physical punishment, other childhood adversities, parental drinking problems, childhood conduct problems and clinical features of AUD. Findings A robust association linking CPP and level of AUD was found, holding other childhood adversities constant (probit coefficient = 0.70, 95% CI = 0.40, 1.00) via covariate terms in structural equations modeling. Furthermore, there was evidence that CPP might exert an additional influence on level of AUD over and above a generally noxious family environment (probit coefficient = 0.20, 95% CI = 0.02, 0.38). Conclusions There appears to be a robust association between reports of harsh punishment in childhood and alcohol dependence in adulthood adjusting for a range of possible confounding factors. Whether the association is causal or whether both are related to a common underlying factor or recall bias needs to be investigated further. Language: en

Differences in epidemiological survey estimates can sometimes occur from seemingly minor method variations; these variations deserve special attention when increases or declines are seen in study populations.

Drug-related social role impairments and social maladaptation are referenced explicitly in the case defi nitions for drug dependence within DSM-IV-TR. Nonetheless, cases of drug dependence without this type of secondary consequence have been observed in recent epidemiological studies. When an ‘impairment/maladaptation gating’ approach has been taken during recent large-scale psychiatric surveys (for example, to reduce participant fatigue or burden), the net effect may include (a) a reduced number of identifi ed drug dependence cases and (b) biases in the estimates of association linked to the occurrence of drug dependence. In this report, we probe these issues with respect to cannabis dependence, making use of data from the cross-sectional United States National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a household survey of 43,093 adults aged 18 years and over. In this process, we shed light on actual impact of the gating approach mentioned above. Specifi cally, when we simulated a social impairment/maladaptation ‘gated’ assessment of cannabis dependence, the end result was a very modest reduction in the estimated prevalence of cannabis dependence. It suggested that for every 10 000 general population survey respondents there would be no more than 12 cases of cannabis dependence without the above-referenced impairments/maladaptations. Patterns of association linking suspected background characteristics to the prevalence of cannabis dependence were not appreciably different when the ‘gated’ and ‘ungated’ approaches were applied. In summary, there are reasons to take the ungated approach in detailed research on cannabis use and dependence. Nevertheless, in panoramic mental health surveys, the ineffi ciency of an ‘ungated’ approach must be balanced against the anticipated yield of cannabis dependence cases who lack social role impairments or socially maladaptive behaviours. Copyright © 2007 John Wiley & Sons, Ltd.

BACKGROUND: This research extends prior epidemiological estimates for the United States and re-examines a previously described male excess in alcohol drinking. Its aim was to estimate fine-grained age-specific incidence of becoming a drinker among 12- to 24-year-old U.S. males and females, and to compare incidence estimates with prevalence proportions. METHODS: The study population is 12- to 24-year-old noninstitutionalized U.S. civilian residents. Estimates are from 12 successive U.S. National Surveys on Drug Use and Health (NSDUH), with nationally representative samples drawn each year from 2002 to 2013 and assessed via computer-assisted self-interviews (n ~ 390,000). Analysis-weighted incidence and prevalence estimates are generated using the NSDUH Restricted Data Analysis System for 6 year-pairs. Meta-analysis-derived summary estimates are provided, treating each year-pair as a replication. RESULTS: In this 21st century evidence, there no longer is male excess of incidence with respect to underage drinking. Indeed, in mid-adolescence, there is a clear female excess for the risk of becoming an underage drinker. Meta-analytic summaries disclosed no other male-female differences in incidence. Nevertheless, a male excess in the prevalence of recently active drinking can be seen after the age of 19 years. CONCLUSIONS: This new evidence from the United States shows that the so-called "gender gap" in risk of becoming a drinker has narrowed to the point of there being no gap at all. Indeed, in mid-adolescence, risk of starting to drink is greater for females than for males.Copyright © 2016 by the Research Society on Alcoholism. Language: en

Aims This study examines the type of alcohol-related problems that commonly occur before the onset of depressive experiences to shed light on the mechanisms underlying the alcohol-depression comorbidity relationship. Methods Data were from the 1992 USA National Longitudinal Alcohol Epidemiologic Survey. Analytical sample comprised of drinkers with a prior to past year (PPY) history of alcohol-related problems with or without any experiences of depressed mood in the past year (PY). The prevalence of PPY alcohol-related problems was examined, as well as the ability of specific alcohol problems to predict PY experiences of depressed mood. The type of depressed mood experienced by drinkers with PPY history of alcohol-related problems was compared to those without. Results All but one alcohol-related problem PPY was more frequently endorsed among drinkers with PY experiences of depressed mood. Controlling for confounders, five alcohol-related problems experienced PPY were significantly predictive of depressed mood PY: tolerance, drinking longer than intended, inability to perform important social and occupational roles/obligations, as well as drinking in physically hazardous situations. Drinkers with alcohol-related problems PPY more frequently experienced difficulties with concentration, energy, and thoughts of death, than those without. Conclusions Alcohol-related problems are likely associated with depressive experiences through a complex network, whereby experiences of physical dependence and negative consequences increase the likelihood of negative affect. Novel study designs are necessary to fully understand the complex mechanisms underlying this comorbidity.

The 20-item Drinking Motives Questionnaire-Revised (DMQ-R)-which assesses social, enhancement, coping and conformity-related motives for drinking-has not previously been used in China. The aim of this paper is to evaluate the psychometric properties of the DMQ-R in China.DMQ-R was administered to 612 current drinkers identified from a representative sample of 2425 non-institutionalised adults living in Ningxia Province, China; 44 of these current drinkers were re-administered the questionnaire an average of 2.5 days later. Confirmatory factor analysis compared the adequacy of fit of alternative conceptual models. Due to the collectivist culture in China, we considered the possibility that item 12 ('to fit in the group I like') is an indicator of a 'social' motive (in Western studies, it is an indicator of a 'conformity' motive).Social motives for drinking were more frequently endorsed than other motives. The intraclass correlation coefficients for the test-retest reliability of the four subscales varied from 0.63 to 0.80. The originally conceptualised four-factor model showed good fit to the data [root mean square error of approximation (RMSEA) = 0.043, comparative fit index = 0.949 and Tucker-Lewis index = 0.941]. Fit indices improved (RSMEA = 0.034, comparative fit index = 0.968 and Tucker-Lewis index = 0.963) when item 12 was included in the 'social' dimension rather than the 'conformity' dimension. The 12-item short form of DMQ-R showed similar psychometric properties, but the fit indices were suboptimal.DMQ-R is a valid and reliable tool to assess drinking motives among current drinkers in China. Future studies in China using the DMQ-R should consider item 12 a social motive. [Cheng HG, Phillips MR, Zhang Y, Wang Z. Psychometric properties of the Drinking Motives Questionnaire-Revised among community-dwelling current drinkers in the Ningxia autonomous region of China. Drug Alcohol Rev 2016;35:433-441].

Background. Psychiatric epidemiological surveys in China have repeatedly found much lower prevalence estimates than in most other parts of the world.Method. Face-to-face household interviews of 5201 subjects (2633 in Beijing and 2568 in Shanghai respectively) were conducted from November 2001 to February 2002 using a multistage household probability sampling method. A Chinese version of the World Health Organization Composite International Diagnostic Interview (CIDI) was used for assessment.Results. Twelve-month prevalence of any DSM-IV mental disorder in metropolitan China is estimated to be 7·0%, with major depressive disorder (2·0%), specific phobia (1·9%), and intermittent explosive disorder (1·7%) the most common disorders. Of these, 13·9% are classified as serious, 32·6% moderate, and 53·5% mild. Only 3·4% of respondents with any disorder sought treatment within the previous 12 months.Conclusions. Although the general pattern of disorders, risk factors, and unmet need for treatment are similar to those in other countries, a low prevalence of mental disorders is found in metropolitan China. Resolving methodological problems that cause downward bias in estimates, such as stigma-related under-reporting and diagnostic incongruity with a somatopsychic mode of symptom presentation may lead to more accurate and probably higher prevalence estimates in future epidemiological studies. As a low prevalence still translates into an enormous number of people in China, measures are urgently needed to address the huge unmet need for treatment of mental disorders.

OBJECTIVES: Age-specific incidence estimates are important and useful facts in psychiatric epidemiology, but incidence estimation can be challenging. Methods artifacts are possible. In the United States (US), where the minimum legal drinking age is 21 years, recent cross-sectional field research on 12-to-25-year-olds applied conventional ‘age-at-assessment’ approaches (AAA) for incidence estimation based on 12-month recall. Estimates disclosed unexpected non-linear patterns in age-specific incidence estimates for both drinking onset and for transitioning from 1(st) drink to heavy drinking. Here, our aim is to draw attention to an ‘age-of-onset’ (AOO) alternative to AAA approaches, and to verify whether the AOO approach also discloses non-linearity. METHODS: Yearly data are from US nationally representative samples drawn and assessed for National Surveys on Drug Use and Health, 2002–2014, with standardized audio computer-assisted self-interview assessments for drinking outcomes. RESULTS: Both AAA and AOO approaches show non-linearities, with an unexpected dip in drinking incidence rates after age 18 and before the age 21 minimum legal drinking age. CONCLUSIONS: The age-of-onset approach and the age-at-assessment approach disclosed similar age-specific patterns. We discuss advantages of the age-of-onset approach when non-linear incidence patterns can be anticipated, but we conclude that the age-at-assessment approach has not created an artifactual non-linear pattern.

In order to establish efficient regeneration system for ornamental tissue culture, we used Malus spp. ‘Indian Magic as the experimental materials and investigated the effects of disinfection and antibrowning agents, culture mediums and hormones proportion on differentiation, multiplication, callus induction and rooting, and also the effects of culture substrates on growth of transplants in greenhouse. The results showed that, the selection of stem tips without scale as the tissue culture material and the employment of HgCl2 5+3 min two-step method for stem tip disinfection could reduce contamination rate and the addition of 2.0 g/l PVP (polyvinylpyrrolidone) could effectively prevent the browning of culture medium and explants. When the three kinds of culture medium were fixed [Murshige and Skoog (MS) containing 1.0 mg/l 6-BA (6-benzyladenine) plus 0.01 mg/l NAA (anaphthaleneacetic acid), MS containing mg/l 6-BA plus 0.2 mg/l NAA and 1/2 MS containing 0.2 mg/l NAA] on inducing differentiation, multiplication and rooting, the differentiation rate, multiplication coefficient and rooting rate increased to 81.2, 6.13 and 100%, respectively. At the same time, leaves callus induction rate reached 100% on the medium of MS containing 1.5 mg/l 6-BA plus 1.0 mg/l 2,4- D(2,4-dichlorophexoxyace-tic acid) and adventitious shoots were directly regenerated from leaves on MS containing 1 mg/l 6-BA plus 0.1 mg/l NAA. The survival rate of the transplants was up to 95% and seedlings grew well after the transplant to the substrates containing vermiculite and perlite (1:1) in the greenhouse under relative humidity of 80 to 85%, temperature of 25 ± 2°C, light intensity of 1500 to 2000Lx and mist spraying condition. Based on the stated, we determined a technical framework of the leaves callus induction and regeneration for crabapple tissue culture, in which both the types and concentrations of hormones added in the medium played most important roles.Key words: Malus spp., regeneration, callus induction, propagation, hormones.

This study aims to estimate, using a unique quantile regression approach, the relationship linking alcohol use disorder (AUD) and disability (physical and mental) using data from a prospective study of household dwelling adults in the United States.Data from the two-wave National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) are used to assess AUD-associated disability. A total of 24,716 non-institutionalized adults are grouped into "never AUD" and "newly incident AUD" groups. The main outcome variables of interest are the changes in physical and mental disability levels between the two waves, as measured by summary scores of the Short Form Health Survey Version 2. Alcohol use disorder and other mental disorders are assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version. Linear regression and quantile regression approaches are used for analysis.The occurrence of AUD is associated with poorer mental disability outcomes, mainly due to the occurrence of alcohol dependence. The association for physical disability is dependent on the history of other mental disorders. Among those with antecedent mental disorders, alcohol dependence is associated with better physical health; among those without antecedent mental disorders, alcohol dependence is associated with poorer outcomes in physical health.Evidence tentatively supports a causal link between AUD and mental disability.

Recently active mental disorders are associated with substantial disability, but there is little research on residual disability once symptoms have subsided. The aim of this study is to estimate the degree to which recent disability might be due to recent or past history of mental disorders using a quantile regressions model that makes it possible to study the full range of disability. Data were from cross-sectional surveys of Chinese living in Beijing and Shanghai, China (n=1,628). The World Health Organization Disability Assessment Schedule and the WHO Composite International Diagnostic Interview was used to assess recent disability and common mental disorders, respectively. Recently active mental disorders are found to be associated with elevated levels of disability, especially for current substance use disorder. Anxiety disorders stand out with high levels of disability. Individuals at the higher disability levels show large variations in their disability levels. These epidemiological estimates from China add to the evidence base on the global burden of neuropsychiatric disorders, quantifying the hypothesized influence of recently active and past disorders with the novel quantile regression approach. In future studies, we hope to complete more detailed studies of the causal role of mental disorders in the development of disability.

We explore the association of depressive symptoms and chronic pain (arthritis, back or neck pain, headache, or other pain) in a community population of Beijing, China. Two thousand four hundred and sixty nine residents aged 16 years and older were investigated in 2010. Data were collected from face-to-face interviews using the Composite International Diagnostic Interview-3rd version. The presence of chronic pain condition and depressive symptoms were analyzed using univariate and multivariate analysis methods. We found a 12-month prevalence of MDD (Major depressive disorder) at 3.28%. Nearly half (41.01%) of respondents with depressive symptoms also had at least one chronic pain condition, and 64.20% of subjects with MDD (Major depressive disorder) experienced at least one chronic pain. After adjusting for selected demographic variables, it was found by multivariate logistic regression analysis that depressive symptom without MDD was significantly associated with back-or neck pain (Adjusted odds ratio (AOR)=1.97, 95% CI, 1.34-2.90), headache (AOR=3.17, 95% CI, 1.81-5.58), and other chronic pain (AOR=2.21, 95% CI, 1.07-4.49). MDD was significantly associated with arthritis (AOR=2.23) back or neck pain (AOR=4.17), headache (AOR=3.16), and other chronic pain (AOR=3.51). Multiple types of chronic pain are associated with depressive symptoms and MDD. Future studies are needed to infer causality.

This study investigates the occurrence of clinical features of alcohol dependence and socially maladaptive drinking during the first 24 months after the onset of alcohol use.Data for this study are from the nationally representative 2004-07 National Surveys on Drug Use and Health (NSDUH).General population of the United States, aged 12 years and older.New-onset alcohol users (NOAUs) were drinkers who started to drink alcohol within 24 months of the NSDUH assessment and consumed alcohol during the last 12 months.The NSDUH assessed for clinical features of alcohol dependence and socially maladaptive drinking, consistent with the DSM-IV.NOAUs frequently experienced problems relating to self-reported tolerance, spending a great deal of time recovering from the effects of alcohol and unsuccessful attempts at cutting down on drinking. The likelihood of experiencing the clinical features increased steadily in the first 9 months after use, but appeared to plateau or only gradually increase thereafter. Strong evidence emerged that the clinical features measured a single latent dimensional of 'alcohol use disorder' (AUD) in this sample. The majority of the clinical features were good indicators of the underlying AUD continuum in the 2 years after first drinking onset.There may be a period of time during the second year of alcohol use, when level of alcohol use disorder fluctuates rather than increases. Public health and safety efforts designed to target problematic alcohol use in the earliest stages of alcohol involvement could be useful in preventing the escalation of alcohol problems in this group of drinkers.

This epidemiological study of a sample of smokers from the general population of Colombia examined the population distribution and dimensionality of eight hypothesized inter-correlated clinical features (CFs) associated with tobacco dependence syndrome (TDS). Data were drawn from interviews of 4 426 smokers conducted in a national survey in Colombia as part of the World Mental Health Survey Initiative. Daily smokers completed a Spanish-language TDS module, and the 237 smokers who had begun smoking during the five years prior to the assessment were selected. Confirmatory factor analysis (CFA) for a unidimensional TDS provided discrimination and difficulty parameter estimates. Two CFs that were reported very infrequently among the study sample were dropped from the CFA. Among the six remaining CFs, discrimination (D1) estimates ranged from 1.1 to 6.0 and difficulty (D2) estimates ranged from 1.1 to 2.2, providing evidentiary support for a unidimensional tobacco dependence construct. The Spanish-language TDS module used in this study could serve as a valuable tool in future studies for evaluating public health outreach and early intervention programs directed toward community residents who have begun smoking tobacco.

The aim of the study is to examine the association linking parenting and personality disorder controlling for parental personality disorder, and whether this association is moderated by parental PD. Data were from community-dwelling high school students aged 18 and above and their parents living in Beijing, China. A total of 181 cases and 2,605 controls were included in this study. Personality disorder in students was assessed via a two-stage approach, Personality Diagnostic Questionnaire as a screening tool and International Personality Disorder Examination as the diagnostic tool. Information about parenting was collected from students using Egna Minnen av. Betraffande Uppfostran. Negative parenting styles, e.g. rejective or over-protective parenting, were found to be associated with the occurrence of personality disorder. Conflictive parenting styles were also found to be associated with personality disorder. Generally stronger associations were found for students with parental personality disorder as compared to students without parental personality disorder. Findings from this study support the role of parenting in the occurrence of PD, especially for children with family history of personality disorder.

There is evidence that alcohol, tobacco, and other drug use may be rising in China, but epidemiological studies that examine several drugs simultaneously and the transition from initial try to current use are limited. The present study provides an epidemiological profile of drug use in contemporary metropolitan China.A multistage probability sampling method was used to select household-dwelling adults in Beijing and Shanghai. Standard face-to-face interviews with 5,201 participants were completed during 2002-2003.An estimated 70-76% had used any type of drug: alcohol and tobacco were the most commonly used drugs (alcohol, 67%; tobacco, 39%). Regarding extra-medical use of internationally regulated drugs, sedatives and analgesics were most common and illegal drug use was rare. The majority of tobacco users used it recently (82.5%), especially young adults. Male-female differences were observed in lifetime tobacco use, but not for recent use. Concurrent use of alcohol and tobacco was very common.Psychoactive drug use is common in metropolitan China. Public health policies and prevention initiatives may be needed to address associated problems that may increase following the country's rapid socioeconomic change.

OBJECTIVE: To contribute new multinational findings on basic descriptive features of smoking and cessation, based upon standardised community surveys of adults residing in seven low-income and middle-income countries and 10 higher-income countries from all regions of the world. METHODS: Data were collected using standardised interviews and community probability sample survey methods conducted as part of the WHO World Mental Health Surveys Initiative. Demographic and socioeconomic correlates of smoking are studied using cross-tabulation and logistic regression approaches. Within-country sample weights were applied with variance estimation appropriate for complex sample survey designs. RESULTS: Estimated prevalence of smoking experience (history of ever smoking) and current smoking varied across the countries under study. In all but four countries, one out of every four adults currently smoked. In higher-income countries, estimated proportions of former smokers (those who had quit) were roughly double the corresponding estimates for most low-income and middle-income countries. Characteristics of smokers varied within individual countries, and in relation to the World Bank's low-medium-high gradient of economic development. In stark contrast to a sturdy male-female difference in the uptake of smoking seen in each country, there is no consistent sex-associated pattern in the odds of remaining a smoker (versus quitting). CONCLUSION: The World Mental Health Surveys estimates complement existing global tobacco monitoring efforts. The observed global diversity of associations with smoking and smoking cessation underscore reasons for implementation of the Framework Convention on Tobacco Control provisions and prompt local adaptation of prevention and control interventions. The preparation of this manuscript was funded by the US National Institute on Drug Abuse (R01DA016558 and K05DA015799). These activities were supported by the United States National Institute of Mental Health (R01MH070884), the John D and Catherine T MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R01-TW006481). The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP). The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013) from the Japan Ministry of Health, Labour and Welfare. The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544- H). The South Africa Stress and Health Study (SASH) is supported by the US National Institute of Mental Health (R01- MH059575). The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the US National Institute of Mental Health (RO1-MH61905). The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the Robert Wood Johnson Foundation (RWJF; Grant 044708)

Background There has been evidence from Western countries of the familial aggregation of personality disorder (PD) in clinical populations. Nonetheless, it is not clear if the results apply to nonclinical population or non-Western countries. The aim of this study is to provide evidence about the familial aggregation of PD using an epidemiological sample of high school students and their parents in Beijing, China. Method A sample of high school students (at least 18 years old) and their parents was drawn by stratified cluster sampling. Personality disorder in students was assessed via a two-stage approach, Personality Diagnostic Questionnaire (PDQ) as a screening tool and International Personality Disorder Examination as the diagnostic tool. Parents completed the PDQ. Univariate and multivariate analyses were used to address the familial aggregation of PD. Results Students' PDQ scores were correlated with parents' PDQ scores. Parents of PD students scored higher in PDQ and were more likely to be PD cases than controls' parents (adjusted odds ratio, 6.4-18.8). Limitations Student controls and parents are only assessed by PDQ-4. Conclusion Obvious familial aggregation of PD was observed in this study. Psychiatrists may consider asking about family history when diagnosing PD.