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PURPOSE: This study aimed to investigate the time lag between onset and treatment (treatment delay) for alcohol use disorders (AUD) and associations between demographic factors and treatment delay for AUD. METHODS: The study included 6,584 men registered in the Copenhagen Alcohol Cohort, containing information on civil status, employment status, estimated age at onset of alcohol problems, and age at first outpatient AUD treatment. Data on year of birth, intelligence, and educational level were obtained from the Danish Conscription Database. Information on first hospital AUD treatment was retrieved from Danish national psychiatric registers. Associations between the demographic factors and treatment delay were analysed in separate linear regression models adjusted for year of birth and in a mutually adjusted model including all demographic factors. RESULTS: The mean treatment delay for AUD was 6.9 years (SD = 4.1). After mutual adjustment, an SD increase in intelligence score was associated with 0.17 years increase in treatment delay. Educational level was unrelated to treatment delay. Men with estimated age at onset of alcohol problems at age 20 years or younger had a 5.30 years longer treatment delay than men who had estimated age at onset of alcohol problems at age 51 years or older. Employed men had shorter treatment delays than unemployed men, especially among the oldest birth cohorts. CONCLUSIONS: The treatment delay of 6.9 years highlights the necessity to promote access to AUD treatment, perhaps in particular among adolescents and young individuals. Cognitive factors may affect treatment delay more than non-cognitive personal factors.
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Trastornos Relacionados con Alcohol , Alcoholismo , Adolescente , Adulto , Trastornos Relacionados con Alcohol/diagnóstico , Trastornos Relacionados con Alcohol/epidemiología , Trastornos Relacionados con Alcohol/terapia , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Alcoholismo/terapia , Preescolar , Demografía , Dinamarca/epidemiología , Etanol , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Tratamiento , Adulto JovenRESUMEN
Associations of educational level and intelligence with age at onset and age at treatment of alcohol use disorders (AUD) are sparsely investigated; however, knowledge about these associations is important for an enhanced understanding of AUD. This study aimed to examine three measures of timing of AUD: estimated age at onset of alcohol problems, age at first registration in an outpatient alcohol clinic, and age at first AUD hospital diagnosis, and to estimate associations of educational level and intelligence with each measure of timing of AUD. The aims were investigated in a register-based study comprising 7,019 Danish men seeking outpatient AUD treatment. Data on educational level and intelligence were obtained from the Danish Conscription Database. Estimated age at onset of alcohol problems and age at first registration in an outpatient alcohol clinic were obtained from the Copenhagen Alcohol Cohort. Age at first AUD hospital diagnosis was retrieved from national Danish psychiatric registers. Among individuals with information on all measures of timing of AUD, 65.8% followed the developmental sequence: estimated age at onset of alcohol problems (M = 32.08 years, SD = 9.3), age at first registration in an outpatient alcohol clinic (M = 39.89 years, SD = 9.5), and age at first AUD hospital diagnosis (M = 42.27 years, SD = 12.4). Adjusted linear regression models revealed significant associations of high educational level and high intelligence with later onset and treatment of AUD, ranging from 0.61 to 0.89 years (p < 0.0001) for educational level and from 0.10 to 0.09 years (p < 0.0001) for intelligence. In conclusion, AUD develops sequentially. High educational level and intelligence were associated with later onset and treatment of AUD, but educational level explained most unique variance. This may indicate that in addition to cognitive factors reflected by both educational level and intelligence, non-cognitive factors only reflected by educational level also are important for the timing of AUD.
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Trastornos Relacionados con Alcohol , Alcoholismo , Edad de Inicio , Trastornos Relacionados con Alcohol/diagnóstico , Trastornos Relacionados con Alcohol/epidemiología , Trastornos Relacionados con Alcohol/terapia , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Alcoholismo/terapia , Humanos , Inteligencia , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: Long duration of untreated psychosis (DUP) has been linked with more severe psychotic and negative symptoms. However, it is uncertain which specific psychotic and negative domains that are affected over time and if these are stable over the course of illness. OBJECTIVE: To examine whether DUP is associated with psychotic and negative symptoms measured longitudinally up to 10 years after initial assessment. METHOD: Psychopathology of participants from the OPUS I trial, aged 18-45 years with a baseline ICD-10 schizophrenia spectrum diagnosis, excluding schizotypal disorder (468 participants left), was assessed at baseline and 2, 5 and 10 years after initial assessment. The associations between DUP and domains of positive and negative symptoms were calculated using linear regression analysis. RESULTS: Longer DUP was significantly associated with the severity of hallucinations, delusions and anhedonia-asociality at baseline. Longer DUP remained significantly associated with hallucinations, delusions and anhedonia-asociality after 2 years. DUP was significantly associated with hallucinations, delusions, avolition-apathy and anhedonia-asociality after 5 years. Longer DUP was still significantly associated with hallucinations and delusions but not with any of the negative symptom subdomains after 10 years. Results were not substantially changed after adjusting for treatment with antipsychotic medication at each point in time. CONCLUSION: We demonstrated associations between DUP and the severity of hallucinations and delusions which persist after at least 10 years of follow-up and an association between longer DUP and anhedonia-asociality which persist until 5 years of follow-up. Further, DUP was associated with avolition-apathy after 5 years.
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Antipsicóticos , Trastornos Psicóticos , Esquizofrenia , Antipsicóticos/uso terapéutico , Alucinaciones/tratamiento farmacológico , Alucinaciones/etiología , Humanos , Psicopatología , Trastornos Psicóticos/tratamiento farmacológico , Esquizofrenia/tratamiento farmacológicoRESUMEN
Purpose: To estimate the prevalence of utilization of mental health services (MHS) among Danish veterans with self-reported deployment-related mental problems and to identify predictors for help-seeking behavior for mental problems among veterans.Materials and methods: Data on deployment characteristics was obtained from a telephone survey in 2011 among a random sample of veterans deployed during 1996-2009. Only respondents reporting sustained or less sustained mental problems were included, and data from national registers on mental health service utilization and prescribed psychotropics covering up to 22 years of follow-up was obtained. Logistic regression analysis was performed to identify predictors of help-seeking.Results: Of 434 respondents with self-reported problems, 333 (77%) received any mental health service after deployment. Of those, 48 (23%) received any help within the first 2 years after deployment start while 128 (61%) did not receive help until after 4 years. Significant predictors for MHS utilization included sustained mental problems, combat exposure characteristics (being injured in combat, watching a fellow soldier suffer injuries), and deployment-related factors (being deployed to >1 mission and being deployed to Afghanistan).Conclusion: These findings highlight the importance of time, and hereunder of a long follow-up period, when measuring the prevalence of help-seeking behavior for individuals experiencing mental problems after military deployment.
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Conducta de Búsqueda de Ayuda , Trastornos Mentales/terapia , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Veteranos/psicología , Adulto , Dinamarca , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Autoinforme , Adulto JovenRESUMEN
OBJECTIVES: The aims were to estimate the association between intelligence measured in young adulthood and risk of alcohol use disorders (AUD) in men and to investigate the potential modification of this association by psychiatric disorders, parental AUD and parental psychiatric disorders. DESIGN: Prospective cohort study based on a linkage of intelligence test scores from draft board examinations and register data on AUD diagnoses during 36 years of follow-up. SETTING: Denmark. PARTICIPANTS: 3287 Danish men from the Copenhagen Perinatal Cohort (born 1959-1961) who appeared before the draft board at a mean age of 18.7 years. PRIMARY OUTCOME MEASURE: First registration with AUD during follow-up was the primary outcome. Information on AUD was based on diagnoses retrieved from national hospital and outpatient treatment registers, defined according to the International Classification of Diseases. RESULTS: 361 (11.0%) men were registered with AUD during follow-up. Low intelligence scores were associated with increased odds of AUD adjusting for parental AUD, parental psychiatric disorders, maternal smoking during pregnancy, birth weight, maternal age at birth, parity and childhood socioeconomic position (OR per SD decrease in intelligence=1.69, 95% CI 1.49 to 1.92). Separate analyses indicated significant interaction (p<0.001) between intelligence and psychiatric disorders. The adjusted OR per SD decrease in intelligence score was 2.04 (95% CI 1.67 to 2.49) in men without other psychiatric disorders whereas the OR was 1.21 (95% CI 1.01 to 1.46) in men with other psychiatric disorders. No interaction was found between intelligence and parental AUD or between intelligence and parental psychiatric disorders. CONCLUSIONS: The association between intelligence in young adulthood and AUD is modified by other psychiatric disorders as low intelligence is primarily a risk factor for men without other psychiatric disorders. Future studies should take other psychiatric disorders into account when investigating associations between intelligence and AUD.
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Alcoholismo/epidemiología , Inteligencia , Trastornos Mentales/epidemiología , Padres/psicología , Adolescente , Adulto , Estudios de Cohortes , Dinamarca/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Edad Materna , Hombres/psicología , Persona de Mediana Edad , Paridad , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Prospectivos , Factores de Riesgo , Fumar/epidemiología , Clase Social , Adulto JovenRESUMEN
BACKGROUND: Existing studies on intellectual consequences of alcohol-related disorders are primarily cross-sectional and compare intelligence test scores of individuals with and without alcohol-related disorders, hence mixing the influence of alcohol-related disorders and predisposing factors such as premorbid intelligence. In this large-scale study, the primary aim was to estimate associations of alcohol-related disorders with changes in intelligence test scores from early adulthood to late midlife. METHODS: Data were drawn from a follow-up study on middle-aged men, which included a re-examination of the same intelligence test as completed in young adulthood at military conscription (total analytic sample = 2,499). Alcohol-related hospital diagnoses were obtained from national health registries, whereas treatment for alcohol problems was self-reported at follow-up. The analyses included adjustment for year of birth, retest interval, baseline intelligence quotient (IQ) score, education, smoking, alcohol consumption, and psychiatric and somatic comorbidity. RESULTS: Individuals with alcohol-related hospital diagnoses (8%) had a significantly lower baseline IQ score (95.0 vs. 100.5, p < 0.001) and a larger decline in IQ scores from baseline to follow-up (-8.5 vs. -4.8, p < 0.001) than individuals without such diagnoses. The larger decline in IQ scores with alcohol-related hospital diagnoses remained statistically significant after adjustment for all the covariates. Similar results were revealed when IQ scores before and after self-reported treatment for alcohol problems (10%) were examined. CONCLUSIONS: Individuals with alcohol-related disorders have a lower intelligence test score both in young adulthood and in late midlife, and these disorders, moreover, seem to be associated with more age-related decline in intelligence test scores. Thus, low mean intellectual ability observed in individuals with alcohol-related disorders is probably a result of both lower premorbid intelligence and more intellectual decline.
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Alcoholismo/psicología , Pruebas de Inteligencia/estadística & datos numéricos , Personal Militar/estadística & datos numéricos , Adulto , Edad de Inicio , Alcoholismo/epidemiología , Estudios Transversales , Dinamarca/epidemiología , Estudios de Seguimiento , Humanos , Inteligencia/efectos de los fármacos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND: Microbial exposures early in life have been found to be associated with lower levels of inflammation in adulthood; however, the role of prenatal exposure to infection on offspring inflammatory profiles is unexplored. The aim was to study if maternal infections during pregnancy are associated with inflammation among offspring in later life and to determine if there are sensitive periods of exposure. METHODS: The study was comprised of 1719 participants in the Copenhagen Aging and Midlife Biobank (CAMB) who were also members of the Copenhagen Perinatal Cohort (CPC). When the CPC was established, information on maternal infections during pregnancy was prospectively collected by a trained medical doctor. The inflammatory measures collected in late midlife included, C-reactive protein (CRP), Interleukin-6 (IL-6), TNF-alpha (TNF-α) and Interleukin-10 (IL-10). Multivariable ordinary least squared regression models were implemented to explore associations between maternal infection and inflammatory measures in offspring, controlling for maternal smoking, pre-pregnancy body mass index, age, marital status and parity. RESULTS: Maternal infection was associated with a 7% lower CRP level (95% CI, - 17,5%) among offspring compared with offspring born to women without an infection and similarly an 8% lower level of IL-6 (95% CI -15,1%), and a 9% lower level of IL-10 (95% CI, - 23,20%). However, differences did not reach significance. The effects of infection during the first trimester did not differ from infections later in the pregnancy. CONCLUSIONS: Our results suggested that prenatal exposure to infection may be associated with lower levels of inflammatory markers among adult offspring. Additional prospective studies are needed to further explore this finding.
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INTRODUCTION: Depressive episodes are often prevalent among patients with bipolar disorder, but little is known regarding the differential patterns of development over time. We aimed to determine and characterize trajectories of depressive symptoms among adults with bipolar disorder during 6 months of systematic treatment. METHODS: The pragmatic clinical trial, Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE), randomized 482 outpatients with bipolar disorder to lithium or quetiapine. Depressive symptoms were rated at up to 9 visits using the Montgomery-Asberg Depression Rating Scale (MADRS). Growth mixture modeling was utilized to identify trajectories and multinomial regression analysis estimated associations with potential predictors. RESULTS: Four distinct trajectories of depressive symptoms were identified. The responding class (60.3%) with a rapid reduction and subsequent low level; the partial-responding class (18.4%) with an initial reduction followed by an increase during the remaining weeks; the fluctuating class (11.6%) with a fluctuation in depressive symptoms; and the non-responding class (9.7%) with sustained moderate-severe depressive symptoms. Bipolar type I predicted membership of the non-responding class and randomization to quetiapine predicted membership of either the responding or the non-responding class. CONCLUSION: Approximately 30% experienced a partial or fluctuating course, and almost 10% had a chronic course with moderate-severe depression during 6 months. Patients diagnosed with bipolar type 1 had higher risk of being categorized into a class with a worse outcome. While no differences in average overall outcomes occurred between the lithium and quetiapine groups, trajectory analysis revealed that the lithium group had more variable courses.
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Trastorno Bipolar , Depresión , Compuestos de Litio/uso terapéutico , Fumarato de Quetiapina/uso terapéutico , Adulto , Antidepresivos/uso terapéutico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/psicología , Depresión/diagnóstico , Depresión/epidemiología , Depresión/psicología , Monitoreo de Drogas/métodos , Femenino , Humanos , Masculino , Prevalencia , Pronóstico , Escalas de Valoración Psiquiátrica , Resultado del TratamientoRESUMEN
AIMS: To (1) estimate sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol-dependent individuals versus a control population, and in the same population to (2) estimate sex-specific risks of dying from the examined somatic diseases. DESIGN: Register-based matched cohort study. Alcohol-dependent individuals were identified from the Copenhagen Alcohol Cohort. Controls were selected randomly from the Danish Civil Registration System. Information on somatic diseases was obtained from the Danish National Patient Registry and causes of death obtained from the Cause of Death Registry. Cox proportional hazards model was applied to estimate hazard ratios (HRs). SETTING: Denmark. PARTICIPANTS: A total of 19 002 alcohol-dependent individuals and 186 767 controls. MEASUREMENTS: Outcome variables included 11 disease groups and 29 subgroups, defined according to the International Classification of Diseases (ICD). The main predictor variable was diagnosis of alcohol dependence according to ICD. FINDINGS: Alcohol-dependent men and women compared with controls had statistically significantly higher risks of all disease groups and the majority of subgroups when analysed as disease events. HRs were elevated for well-established alcohol-related diseases but also for diseases such as dementia [men, HR = 2.0, 95% confidence interval (CI) = 1.6-2.3; women, HR = 2.4, 95% CI = 1.8-3.2], psoriasis (men, HR = 4.3, 95% CI = 3.5-5.2; women, HR = 5.4, 95% CI = 3.7-7.8) and breast cancer in men (HR = 3.3, 95% CI = 1.6-7.0). Similar results were found when disease groups and subgroups were analysed as causes of death. CONCLUSIONS: Alcohol-dependent men and women have significantly higher risks of a comprehensive spectrum of somatic diseases, both as disease events and as causes of death, relative to individuals from the general population.
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Trastornos Relacionados con Alcohol/epidemiología , Enfermedad Crónica/epidemiología , Adulto , Trastornos Relacionados con Alcohol/mortalidad , Enfermedad Crónica/mortalidad , Estudios de Cohortes , Comorbilidad , Dinamarca/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Sistema de Registros , Riesgo , Adulto JovenRESUMEN
BACKGROUND: Infections and activated immune responses can affect the brain through several pathways that might also affect cognition. However, no large-scale study has previously investigated the effect of infections on the general cognitive ability in the general population. METHODS: Danish nationwide registers were linked to establish a cohort of all 161,696 male conscripts during the years 2006-2012 who were tested for cognitive ability, which was based on logical, verbal, numerical and spatial reasoning at a mean age of 19.4 years. Test scores were converted to a mean of 100.00 and with a standard deviation (SD) of 15. Data were analyzed as a cohort study with severe infections requiring hospitalization as exposure using linear regression. RESULTS: Adjusted effect sizes were calculated with non-exposure to severe infections as reference, ranging from 0.12 SD to 0.63 SD on general cognitive ability. A prior infection was associated with significantly lower cognitive ability by a mean of 1.76 (95%CI: -1.92 to -1.61; corresponding to 0.12 SD). The cognitive ability was affected the most by the temporal proximity of the last infection (P<0.001) and by the severity of infection measured by days of admission (P<0.001). The number of infections were associated with decreased cognitive ability in a dose-response relationship, and highest mean differences were found for ≥10 hospital contacts for infections (Mean: -5.54; 95%CI: -7.20 to -3.89; corresponding to 0.37 SD), and for ≥5 different types of infections (Mean: -9.44; 95%CI: -13.2 to -5.69; corresponding to 0.63 SD). Hospital contacts with infections had occurred in 35% of the individuals prior to conscription. CONCLUSIONS: Independent of a wide range of possible confounders, significant associations between infections and cognitive ability were observed. Infections or related immune responses might directly affect the cognitive ability; however, associated heritable and environmental factors might also account for the lowered cognitive ability.
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Infecciones Bacterianas/epidemiología , Trastornos del Conocimiento/epidemiología , Micosis/epidemiología , Sistema de Registros , Virosis/epidemiología , Adolescente , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/fisiopatología , Infecciones Bacterianas/psicología , Encéfalo/fisiopatología , Cognición/fisiología , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/fisiopatología , Trastornos del Conocimiento/psicología , Estudios de Cohortes , Dinamarca/epidemiología , Humanos , Pruebas de Inteligencia , Modelos Lineales , Masculino , Personal Militar , Micosis/complicaciones , Micosis/fisiopatología , Proyectos de Investigación , Virosis/complicaciones , Virosis/fisiopatología , Virosis/psicología , Adulto JovenRESUMEN
BACKGROUND: The Danish Neonatal Screening Biobank, containing dried blood spot samples from all newborn in Denmark, is a unique source of data that can be utilized for analyses of genetic and environmental exposures related to schizophrenia and other mental disorders. In previous analyses, we have found that early and late blood sampling, compared to sampling at day 5, was associated with increased risk of schizophrenia. As delay in sampling of blood for neonatal screening cannot in itself influence the risk of schizophrenia, it must be seen as a proxy for unknown underlying causes responsible for this association. Therefore, we investigated whether the increased risk can be explained by other risk factors for schizophrenia. METHODS: A case-control design was applied. A total of 846 cases with schizophrenia were selected from the Danish Psychiatric Case Register. One control was selected for each case, matched on sex and exact date of birth. RESULTS: Both early and late blood sampling was associated with increased risk for schizophrenia. Compared to blood sampling at day 5, sampling at days 0 to 4 after birth was associated with an incidence rate ratio (IRR) of 1.46 (95% CI 1.15-1.87) for development of schizophrenia, and sampling at days 6 to 9 and at days 10 to 53 was associated with an IRR of 1.5 (95% CI 1.13-1.98) and 3.00 (95% CI 1.59-5.67), respectively. After adjusting the estimates for place of birth, both parents' psychiatric illness, maternal and paternal age, parents' country of origin, child admission, and parental education and income, the estimates were slightly different. Thus, blood collection at 0-4days was associated with an IRR of 1.27 (95% CI 0.94-1.71), 6-9days 1.31 (95% CI 0.94-1.84) and 10+days 3.52 (95% CI 1.50 to 8.24). DISCUSSION: After adjusting risk estimates for well-known risk factors, delay in sampling of blood for neonatal screening was associated with unexplained increased risk of schizophrenia. Thus, a key finding is that age at test is a proxy for unobserved risk factors for schizophrenia due to unexplained reasons for late blood sampling. Date of sampling will be included in future analyses of genetic and environmental risk factors.
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Recolección de Muestras de Sangre , Tamizaje Neonatal , Esquizofrenia/epidemiología , Factores de Edad , Bancos de Muestras Biológicas , Estudios de Casos y Controles , Dinamarca/epidemiología , Femenino , Humanos , Recién Nacido , Masculino , Factores de Riesgo , Factores Socioeconómicos , Factores de TiempoRESUMEN
BACKGROUND: High intelligence early in life has consistently been associated with decreased mortality, but the mechanisms are still not fully understood. In this cohort study, we examined the association between intelligence in early adulthood and later mortality from natural and unnatural causes taking birth weight, parental socioeconomic position, participants' own education and body mass index into account. METHODS: 13 536 Danish men born in 1953 and 1959-1961 with data from birth certificates and intelligence test scores from conscription were followed until 2009. Information on vital status was obtained from the Civil Registration System. Mortality risks were analysed by the multiple Cox proportional hazards model. RESULTS: The risk of mortality from natural as well as unnatural causes was more than twice as high among men in the lowest scoring intelligence tertile (HRnatural deaths=2.24; 1.90-2.65 and HRunnatural deaths=2.67; 2.03-3.53). Adjusting for all covariates attenuated the estimates, but the association remained (HRnatural deaths=1.82; 1.48-2.25 and HRunnatural deaths=2.30; 1.63-3.25). CONCLUSIONS: In men, intelligence in early adulthood was inversely associated with midlife mortality from natural and unnatural causes. The associations remained after adjustments for a range of covariates.
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Índice de Masa Corporal , Causas de Muerte , Inteligencia , Mortalidad/tendencias , Clase Social , Factores de Edad , Certificado de Nacimiento , Peso al Nacer , Estudios de Cohortes , Interpretación Estadística de Datos , Dinamarca/epidemiología , Escolaridad , Disparidades en el Estado de Salud , Humanos , Pruebas de Inteligencia , Masculino , Persona de Mediana Edad , Relaciones Padres-Hijo , Modelos de Riesgos Proporcionales , Sistema de Registros , Factores de Riesgo , Población Urbana/estadística & datos numéricosRESUMEN
BACKGROUND: Recent studies have noted differences in social acquiescence and interpersonal relations among adults born preterm or with very low birth weight compared to full term adults. In addition, birth weight has been observed to be negatively correlated with lie-scale scores in two studies. We attempted to replicate and extend these studies by examining young adult lie-scale scores in a Danish birth cohort. METHOD: Weight, length and head circumference of 9125 children from the Copenhagen Perinatal Cohort were measured at birth and at 1, 3 and 6 years. A subsample comprising 1182 individuals participated in a follow-up at 20-34 years and was administered the Eysenck Personality Questionnaire (EPQ) which includes a lie-scale (indicating social acquiescence or self-insight). Associations between lie-scale scores and weight, length and head circumference respectively were analysed by multiple linear regression adjusting for single-mother status, parity, mother's age, father's age, parental social status, age at EPQ measurement, intelligence, and adult size. RESULTS: Male infants with lower weight, length, and head-circumference at birth and the following three years grew up to have higher scores on the lie-scale as young adults. Most of these associations remained significant after adjustment for the included covariates. No associations were found for females. Analyses were also conducted with neuroticism, extraversion and psychoticism as outcome variables, but no significant associations were found for these traits after adjustment. CONCLUSIONS: The findings replicate and extend findings from previous studies suggesting that size at birth and during the first three years of life is significantly associated with social acquiescence in adult men. They highlight the potential influence of prenatal and early postnatal development on personality growth and development.
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BACKGROUND: Registry-based studies have found no or weak associations between premorbid intelligence and the broad entity of affective spectrum disorder, but none of the studies compared bipolar/unipolar subgroups. METHODS: IQ and educational level were assessed at the draft board, and hospital diagnoses were followed up to the ages 43-54 years for 294 individuals hospitalized with bipolar disorder and 1434 with unipolar or depressive disorder. Controls comprised 20,531 individuals without psychiatric registration. RESULTS: Mean IQs of 98.32 and 96.71 were observed for patients with bipolar and depressive disorder respectively. For both patient groups a unimodal, slightly negatively skewed distribution was observed. The difference between the two patient samples was not statistically significant (p=0.10), but both obtained lower mean scores than the controls (p<0.0001 for unipolar and p=0.057 for bipolar patients). The means of the index of educational level were 5.22 and 4.82 for bipolar and unipolar patients (p=0.0006). The mean educational level was similar to the controls in bipolar disorder (p=0.15), while it was significantly lower compared to the controls in the unipolar group (p=0.0005). When possible prodromal patients were excluded, essentially the same results were observed. LIMITATIONS: The study was based on clinical hospital admission diagnoses. CONCLUSIONS: Clinicians should be aware of the relatively high intelligence and educational level in patients with bipolar disorder compared with patients with unipolar disorder. However, we were unable to confirm distinct subgroups of bipolar disorder with high and low premorbid intelligence and educational level.
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Trastorno Bipolar/psicología , Trastorno Depresivo/psicología , Escolaridad , Inteligencia , Personal Militar/psicología , Adulto , Trastorno Bipolar/epidemiología , Dinamarca/epidemiología , Trastorno Depresivo/epidemiología , Estudios de Seguimiento , Humanos , Pruebas de Inteligencia , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: The vast majority of studies investigating the association between social and psychological factors and anxiety disorders have been cross-sectional, making it difficult to draw causal conclusions. The purpose of the study was to investigate in a prospective longitudinal study whether social and psychological factors are associated with the later risk of being admitted to a hospital and receive a diagnosis of anxiety disorders. METHOD: The study population comprised 4,497 members of The Copenhagen Perinatal Cohort (CPC) who in 1993 answered a mailed questionnaire containing questions on a range of social and psychological factors. In 2007, the study population was linked to The Danish Hospital Discharge Register and the Danish Psychiatric Central Register to obtain information on registration with anxiety disorders. Multiple Cox regression analysis was used to analyze the risk of anxiety disorders according to social and psychological factors. RESULTS: A total of 5.3% of the study population had lifetime registration with an anxiety disorder diagnosis. The risk of admission for anxiety disorders was significantly associated with previous: discontentedness with partner-status, loneliness, self-rated low intelligence, not feeling part of a whole, unhappiness, low quality of life, and low meaningfulness. Estimates were adjusted for income and current diseases. CONCLUSION: The present study demonstrated that in a population without previous registration with anxiety disorders, contentment with social relations and a range of beneficial psychological factors reduced the later risk of being hospitalized with anxiety disorders.
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Trastornos de Ansiedad/diagnóstico , Autoimagen , Estrés Psicológico/psicología , Adulto , Trastornos de Ansiedad/epidemiología , Estudios de Cohortes , Factores de Confusión Epidemiológicos , Dinamarca/epidemiología , Escolaridad , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Renta , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Satisfacción Personal , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Parejas Sexuales/psicología , Conducta Social , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Our goal was to compare patients' satisfaction with their hospital stay at the Department of Psychiatry, Copenhagen University Hospital, Amager, before and after the department was moved to newly built facilities. MATERIALS AND METHODS: In 2000 and again in 2003, patients who were about to be discharged from the department were asked to anonymously fill in a 24-item questionnaire related to their satisfaction with their recent hospital stay. RESULTS: The percentage of participants was 39% of discharged patients in 2000 and 33% in 2003. A high percentage rated their general satisfaction with the hospital stay as either "good" or "very good" (94% in 2000 and 88% in 2003). From 2000 to 2003, we noted a significant (23%) increase in the percentage who rated their satisfaction with the buildings as either "good" or "very good". In other areas, there was reduced patient satisfaction. We noted a reduction with respect to the respondents' satisfaction with the hospital staff on specific matters; for instance, a significant (23%) reduction in the respondents' perception of the hospital staff having spent sufficient time with them. CONCLUSION: After the department was moved to newly built facilities, patients' satisfaction with the buildings appears to have increased. In other areas, such as satisfaction with the hospital staff on specific matters, patient satisfaction appears to have decreased. The results should be interpreted with caution due to the low participation rate.
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Arquitectura y Construcción de Hospitales , Trastornos Mentales/terapia , Satisfacción del Paciente , Servicio de Psiquiatría en Hospital , Dinamarca , Humanos , Trastornos Mentales/enfermería , Trastornos Mentales/psicología , Planificación de Atención al Paciente , Educación del Paciente como Asunto , Relaciones Profesional-Paciente , Encuestas y CuestionariosRESUMEN
BACKGROUND: Most research investigating the relationship between IQ and risk of mental disorder has focused on schizophrenia. AIMS: To illuminate the relationship between IQ test scores in early adulthood and various mental disorders. METHOD: For 3289 men from the Copenhagen Perinatal Cohort, military IQ test scores and information on psychiatric hospitalisation were available. We identified 350 men in the Danish Psychiatric Central Register, and compared the mean IQ test scores of nine diagnostic categories with the mean scores of 2939 unregistered cohort controls. RESULTS: Schizophrenia and related disorders, other psychotic disorders, adjustment, personality, alcohol and substance-use-related disorders were significantly associated with low IQ scores, but this association remained significant for the four non-psychotic disorders only when adjusting for comorbid diagnoses. For most diagnostic categories, test scores were positively associated with the length of the interval between testing and first admission. ICD mood disorders as well as neuroses and related disorders were not significantly associated with low IQ scores. CONCLUSIONS: Low IQ may be a consequence of mental disease or a causal factor in psychotic and non-psychotic disorders.