INTRODUCTION: Few studies have examined the changes in the prevalence of comorbidity of mental and physical disorders in recent years. The present study sought to examine whether the prevalence of comorbidity of mental and physical disorders in Singapore showed any changes between 2010 and 2016. METHODS: We extracted data from two repeated nationally representative cross-sectional surveys conducted among resident adults aged ≥ 18 years in Singapore. Significant changes were tested using pooled multinomial logistic regression analyses. RESULTS: The prevalence of comorbid mental and physical disorders increased significantly from 5.8% in 2010 to 6.7% in 2016. Among those with physical disorders, there were significant increases over time in the prevalence of comorbid generalised anxiety disorder (GAD) (0.1% vs. 0.4%) and obsessive-compulsive disorder (OCD) (1.4% vs. 3.9%) in diabetes mellitus, and alcohol dependence in cardiovascular disorders (0.1% vs. 1.3%). Among those with mental disorders, there were significant increases over time in the prevalence of comorbid diabetes mellitus in OCD (4.1% vs. 10.9%), cancer in major depressive disorder (0.4% vs. 2.4%), and cardiovascular disorders in GAD (0.4% vs. 6.7%) and alcohol dependence (0.9% vs. 11.8%). Significant changes in the overall prevalence of comorbid mental and physical disorders were also observed across age group, education and employment status. CONCLUSION The prevalence of comorbid mental and physical disorders increased significantly over time. This finding supports the need for more appropriate clinical management with better integration between mental health and general medical care professionals across all aspects of the healthcare system to treat this comorbidity in Singapore.
Adult ; Alcoholism/epidemiology* ; Comorbidity ; Cross-Sectional Studies ; Depressive Disorder, Major/epidemiology* ; Humans ; Mental Disorders/epidemiology* ; Prevalence ; Singapore/epidemiology*

OBJECTIVES: To investigate the epidemiological characteristics of antisocial personality disorder (ASPD) in young men in Chengdu and explore the characteristics and risks of violence. METHODS: Stratified random sampling was used to conduct a self-assessment questionnaire survey in 4 108 males aged from 18 to 34 in Chengdu, including general demographic characteristics, structured clinical interview for the diagnostic and statistical manual of mental disorders-Ⅳ axis Ⅱ disorders (SCID-Ⅱ) personality disorder screen questionnaire, violence questionnaire, psychosis screening questionnaire (PSQ), Alcohol Use Disorders Identification Test (AUDIT) and drug use. χ² test, univariate and multivariate logistic regression were used for analysis and odds ratio (OR) was calculated. RESULTS: The positive rate of ASPD was 5.91%, which was associated with young age, unmarried, unemployment state, low educational level, violent behavior, psychotic symptoms, alcohol and drug use (P<0.05). Young men with ASPD also had a risk (P<0.05) of violence (OR was 8.51), multiple violence (OR was 16.57), injury (OR was 6.68), intentional violence (OR was 11.41), etc., the risk decreased after controlling for psychotic symptoms and substance abuse, but was still statistically significant. CONCLUSIONS The risk of violence, severe violence and intentional violence in young men in Chengdu is high, and psychotic symptoms and substance abuse increase the risk of ASPD violence and relate characteristics.
Alcoholism/epidemiology* ; Antisocial Personality Disorder/epidemiology* ; Comorbidity ; Humans ; Male ; Substance-Related Disorders/epidemiology* ; Surveys and Questionnaires

Alcohol is a substance that has a negative impact on public health according to the various drinking patterns and amount consumed. Alcohol epidemiology covers an investigation of the prevalence of alcohol use disorders, high risk drinking behaviors, and level of consumption per capita. The epidemiologic data of alcohol is an important guide to develop evidence-based alcohol policies. The high rate of drinking among middle aged males and young females is the result of recent socio-economic changes in South Korea and aggressive marketing from the alcohol industry. The high rate of treatment among middle-aged men indicates that the treatment of alcoholism begins later. Regarding alcohol policy, restrictions on alcohol accessibility and advertisement, and brief intervention systems might help reduce alcohol problems. In addition, a continuum of care system needs to be established to provide timely appropriate treatment and rehabilitation services.
Alcoholism ; Alcohols ; Continuity of Patient Care ; Drinking ; Drinking Behavior ; Epidemiology ; Female ; Humans ; Korea ; Male ; Marketing ; Middle Aged ; Prevalence ; Public Health ; Rehabilitation

OBJECTIVE: To analyze the using of pre-hospital emergency resources and treatment characteristics of acute alcoholism patients in Guangzhou. METHODS: The pre-hospital emergency data of the emergency department of the Second Affiliated Hospital of Guangzhou Medical University from January 1st in 2009 to December 31st in 2018 were obtained from the database of the Guangzhou Emergency Medical Command Center. The related data of patients with acute alcoholism were collected, including gender, age, poisoning severity, treatment results, caller type, number of empty vehicles (empty vehicle was defined as the empty vehicle return caused by the ambulance who did not receive or refused to come to the hospital after the ambulance leaved), departure time (from the ambulance to the completion time), on-site time (from the ambulance to the patient boarding time) and the distribution of pre-hospital emergency time in 24 hours on weekdays and weekends. The relationship between acute alcoholism patients and the peak of in-hospital emergency treatment was analyzed. RESULTS: A total of 2 408 acute alcoholism patients were recorded, among whom 2 109 patients (87.58%) with acute alcoholism,126 (5.23%) with drug poisoning, 67 (2.78%) with chemical poisoning, 3 (0.13%) with pesticide poisoning, and 103 (4.28%) with other poisoning. Acute alcoholism patients were mainly male, with a total of 1 862 cases (88.29%), and the ratio between males and females was 7.54:1. In 2 109 patients with acute alcoholism, 93.41% were in the age range of 18-59 years old. The number of mild patients was 1 717 (81.41%), 1 178 (55.86%) needed further treatment, and no patient died. For the occupation of pre-hospital emergency resources, 43.24% (912/2 109) of acute alcoholism called 120 through 110 with empty vehicles of 36.79% (776/2 109), which were significantly higher than the acute cerebrovascular disease [3.83% (362/9 461), 5.80% (549/9 461), both P < 0.01], acute trauma [24.29% (1 708/7 033), 7.96% (560/7 033), both P < 0.01], acute circulation system disease [2.44% (90/3 694), 2.87% (106/3 694), both P < 0.01], and acute respiratory system disease [0.86% (31/3 606), 1.58% (57/3 606), both P < 0.01]. Furthermore, empty vehicles were more likely to happen through 110 with empty vehicles rate of 51.75% (472/912), which was significantly higher than that through the witness [40.82% (60/147), P < 0.01] and relatives and friends [23.24% (244/1 050), P < 0.01]. The driving time and on-site time of acute alcoholism were significantly shorter than those of acute cerebrovascular disease, acute circulation system disease, and acute respiratory system disease [driving time (minutes): 26 (20, 34) vs. 34 (26, 45), 38 (29, 49), 38 (29, 50); on-site time (minutes): 6 (4, 10) vs. 10 (7, 14), 10 (7, 15), 10 (8, 15), all P < 0.01], but there was no statistical difference as compared with acute trauma [driving time (minutes): 26 (20, 34) vs. 29 (20, 42), on-site time (minutes): 6 (4, 10) vs. 7 (4, 11), both P > 0.05]. The regularity of variation in number of critically acute alcoholism patients was distinctive, which peaked in the period of 21:00-00:00 and bottomed out in the period of 09:00-13:00, which overlapped with the peak flow in the hospital emergency department (17:00-22:00). CONCLUSIONS Acute alcoholism patients occupy excessive pre-hospital emergency resources, and overlap with the hospital emergency treatment peak. It is necessary to strengthen the public propaganda and education on the rational usage of 120 emergency resources and reduce waste.
Acute Disease ; Adolescent ; Adult ; Alcoholism/epidemiology* ; China/epidemiology* ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; Young Adult

INTRODUCTION: Psoriasis is a chronic inflammatory disease with a global prevalence of approximately 2% and significant psychiatric comorbidity. There is a great deal of existing literature assessing different aspects of psychology in psoriasis. We aimed to conduct an in-depth review of current evidence linking psoriasis to personality traits and psychiatric comorbidities, as well as factors that put these patients at risk of psychopathology. MATERIALS AND METHODS: A search of the PubMed database identified 1632 articles. We included articles studying psychological comorbidity in patients with psoriasis, looking especially at personality characteristics, and data linking psoriasis with increased risks of psychological distress, depression, anxiety and suicidality. In particular, we also evaluated subgroups in psoriasis found to be at risk. RESULTS: Patients with psoriasis are more likely to be alexithymic, lack body awareness and possess a Type D personality. Alcohol, but not illicit drug use, disorders are also more common in patients with psoriasis. Patient groups who are especially at risk of psychological distress include women, younger patients, patients with a younger age of disease onset, those who self-assess their psoriasis to be severe, and those with lesions on visible or sensitive areas. Adopting motivational interviewing skills and incorporating the use of learning materials during consultations have been found to be useful. CONCLUSION The knowledge of personality characteristics, "at-risk" groups, and early recognition of psychological distress among patients with psoriasis can help clinicians provide better holistic care and encourage a change in patients' behaviour.
Affective Symptoms ; epidemiology ; psychology ; Age Factors ; Age of Onset ; Alcoholism ; epidemiology ; psychology ; Anxiety ; epidemiology ; psychology ; Comorbidity ; Depression ; epidemiology ; psychology ; Humans ; Mental Disorders ; epidemiology ; psychology ; Motivational Interviewing ; Personality ; Psoriasis ; epidemiology ; psychology ; Sex Factors ; Stress, Psychological ; epidemiology ; psychology ; Substance-Related Disorders ; epidemiology ; psychology ; Suicidal Ideation ; Type D Personality

Objective: To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013. Methods: The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used. The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction. Results: In 2013, alcohol use resulted in 381 200 deaths, including 97 100 hemorrhagic stroke deaths, 88 200 liver cancer deaths, 61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths, and prevented 76 500 deaths, including 68 500, 4 900 and 3 100 deaths which might be caused by ischemic heart disease, hemorrhagic stroke and diabetes respectively. If risk factor of alcohol use is removed, the people's life expectancy would rise by an average of 0.43 years, especially in western China by 0.52 years, which was 0.12 years higher than that in eastern and central China, and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively. Conclusions: Although alcohol has a protective effect on reducing ischemic heart disease, stroke and diabetes deaths, alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China. It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
Alcoholism/mortality* ; Cause of Death ; China/epidemiology* ; Humans ; Life Expectancy ; Male ; Middle Aged ; Risk Assessment ; Risk Factors ; Rural Population/statistics & numerical data* ; Urban Population/statistics & numerical data*

Objective: To investigate the drinking status and associated factors in adults in China. Methods: Based on the 2010-2012 China National Nutrition and Health Survey (CNNHS), a total of 135 824 participants aged ≥18 were included in this cross-sectional analysis. Multivariable logistic regression model was used to investigate the associated factors for drinking status. Results: The overall drinking rate was 30.5% in Chinese adults, 53.8% in men, and 12.2% in women. The excessive drinking rate was 14.0% in men and 1.1% in women. The daily drinking rate was 25.7% in men and 10.9% in women. Men mainly consumed multi-type wines, but women preferred beer. The overall harmful drinking rate was 7.1%. The excessive drinking rate, daily drinking rate, and harmful drinking rate increased first but then declined with age. All the four rates were positively related with physical activity. Conclusions: The drinking rate, excessive drinking rate, daily drinking rate and harmful drinking rate were high in adults in China. Drinking status was associated with age, sex, marital status, education level, smoking status and physical activity.
Adult ; Alcohol Drinking/epidemiology* ; Alcoholism/epidemiology* ; Asian People/statistics & numerical data* ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Male ; Smoking/epidemiology*

OBJECTIVES: This study sought to investigate the relationship between age, sex and alterations in levels of % carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transferase (GGT) in patients admitted with alcohol dependence. METHODS: The study retrospectively enrolled 187 patients who were diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) and were admitted into a closed ward in Hallym University Hangang Sacred Heart Hospital from 2009 to 2012 and Hallym University Kangnam Sacred Heart Hospital from 2012 to 2017. Demographic factors (age, sex) and biochemical markers [%CDT, GGT, mean corpuscular volume (MCV), aspartate transferase (AST), alanine transferase (ALT)] were collected by reviewing medical records. Alterations in the levels of %CDT and GGT in different groups for each demographic factor were compared after correcting for confounding variables (age, initial %CDT, GGT, MCV, AST, ALT). RESULTS: Decreased %CDT and GGT were observed during the period of abstinence after admission. The normalization period for %CDT increased with age, while the normalization period for GGT was longer in female patients. CONCLUSIONS: These results suggest that alcohol-dependent patients that vary in age have different alterations in %CDT, while different sexes have different alterations in GGT. Age and sex can be potential indicators of treatment response after abstinence in patients with alcohol dependence. Further studies are needed to evaluate the relationship between these factors with regards to physiological and hematological changes in alcohol dependence.
Alanine ; Alcoholism ; Aspartic Acid ; Biomarkers ; Confounding Factors (Epidemiology) ; Demography ; Erythrocyte Indices ; Female ; Heart ; Humans ; Inpatients* ; Medical Records ; Retrospective Studies ; Transferases* ; Transferrin*

INTRODUCTIONLarge, recent population-based data for evaluating the predictors of oesophageal variceal bleeding (OVB) among cirrhotic patients is still lacking. This study aimed to determine the cumulative incidence of OVB among cirrhotic patients and identify the predictors of OVB occurrence.

METHODSPatient information on 38,172 cirrhotic patients without a history of OVB, who were discharged between 1 January 2007 and 31 December 2007, was obtained from the Taiwan National Health Insurance Database for this study. All patients were followed up for three years. Death was the competing risk when calculating the cumulative incidences and hazard ratios (HRs) of OVB.

RESULTSOVB was present in 2,609 patients (OVB group) and absent in 35,563 patients (non-OVB group) at hospitalisation. During the three-year follow-up period, the cumulative incidence of OVB was 44.5% and 11.3% in the OVB and non-OVB group, respectively (p < 0.001). Modified Cox regression analysis showed that the HR of OVB history was 4.42 for OVB occurrence (95% confidence interval [CI] 4.13-4.74). Other predictors for OVB occurrence included hepatocellular carcinoma (HR 1.16, 95% CI 1.09-1.24), young age (HR 0.98, 95% CI 0.98-0.98), ascites (HR 1.46, 95% CI 1.37-1.56), alcohol-related disorders (HR 1.20, 95% CI 1.12-1.28), peptic ulcer bleeding (HR 1.26, 95% CI 1.13-1.41) and diabetes mellitus (HR 1.14, 95% CI 1.06-1.23).

CONCLUSIONCirrhotic patients have a fourfold increased risk of future OVB following the first incidence of OVB.

Adult ; Aged ; Alcoholism ; complications ; Ascites ; complications ; Carcinoma, Hepatocellular ; complications ; Databases, Factual ; Diabetes Complications ; Esophageal and Gastric Varices ; epidemiology ; etiology ; Female ; Gastrointestinal Hemorrhage ; epidemiology ; etiology ; Humans ; Incidence ; Liver Cirrhosis ; complications ; physiopathology ; Liver Neoplasms ; complications ; Male ; Middle Aged ; Peptic Ulcer ; complications ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Risk ; Taiwan

PURPOSEThe aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.

METHODSThis is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.

RESULTSA total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).

CONCLUSIONScreening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.

Accidents, Traffic ; mortality ; statistics & numerical data ; Adult ; Age Distribution ; Alcoholism ; complications ; epidemiology ; Chi-Square Distribution ; Confidence Intervals ; Cross-Sectional Studies ; Developing Countries ; Humans ; Iran ; Male ; Middle Aged ; Motorcycles ; statistics & numerical data ; Odds Ratio ; Prevalence ; Risk Factors ; Risk-Taking ; Substance-Related Disorders ; complications ; epidemiology ; Survival Rate ; Urban Population ; Young Adult