Biomedical subjects

A M Sobol

Publications and source records attributed to A M Sobol.

27 records · Page 2Linked to original sources

PubMed1988

Incidence of depression and anxiety: the Stirling County Study.

Prevalence studies in psychiatric epidemiology out-number incidence investigations by a wide margin. This report gives descriptive information about the incidence of depression and anxiety disorders in a general population. Using data gathered in a 16-year follow-up of an adult sample selected as part of the Stirling County Study (Canada), the incidence of these types of disorders was found to be approximately nine cases per 1,000 persons per year. The data suggest that for every man who became ill for the first time with one of these disorders, three women became ill. Incidence tended to be higher among relatively young persons. These incidence rates are consistent with prevalence rates of approximately 10 per cent to 15 per cent for depression and anxiety disorders aggregated together, given an estimated average duration of illness of about 10 years. It is concluded that these incidence rates are fairly realistic in view of evidence that disorders of these types tend to be chronic.

Adult↗

PubMed1987

Increasing pediatric obesity in the United States.

Data from four national surveys indicate pronounced increases in the prevalence of pediatric obesity in the United States. Obese children are defined as those with triceps skinfolds greater than or equal to the 85th percentile of children of the same age and sex in 1963 to 1970. Superobese children are those with skinfolds greater than or equal to the 95th percentile. Compared with skinfold data from the 1963 to 1965 National Health Examination Survey, cycle 2, skinfold data from the second National Health and Nutrition Examination Survey, conducted from 1976 to 1980, indicate a 54% increase in the prevalence of obesity among children 6 to 11 years old and a 98% increase in the prevalence of superobesity. Compared with skinfold data from the 1966 to 1970 National Health Examination Survey, cycle 3, skinfold data from the second National Health and Nutrition Examination Survey indicate a 39% increase in the prevalence of obesity among children 12 to 17 years old and a 64% increase in the prevalence of superobesity. Increases occurred among children of all ages and both sexes and for both blacks and whites. Blood pressure data from the four surveys suggest that the share of pediatric hypertension associated with obesity has increased. Such rapid increases in obesity indicate that environmental causes are likely responsible.

Adolescent↗

PubMed1987

Affective disorders and mortality. A general population study.

A 16-year prospective study of a general population sample indicates that those who had reported a depression and/or anxiety disorder at baseline experienced 1.5 times the number of deaths expected on the basis of rates for a large reference population. As part of the Stirling County Study (Canada), the information was gathered from 1003 adults through structured interviews and was analyzed by means of a diagnostic computer program. The risk for mortality was assessed using external and internal standards, controlling for the effects of age and sex as well as for the presence of self-reported physical disorders at baseline. Increased risk was found to be significantly associated with affective but not physical disorders and with depression but not generalized anxiety. When this evidence about mortality was combined with information about subsequent psychiatric morbidity among survivors, 82% of those who were depressed at baseline had a poor outcome.

Adult↗

PubMed1987

Reducing infant mortality in rural America: evaluation of the Rural Infant Care Program.

The Rural Infant Care Program (RICP), initiated in 1979, was developed to improve perinatal health care in ten rural sites with histories of high infant mortality rates. Time-series regression models indicate that neonatal mortality rates were reduced, following program initiation, by 2.6 per 1,000 live births (p = .0002); black neonatal mortality rates were reduced by an estimated 4.5 per 1,000 (p = .0004). Three sets of comparison areas exhibited no significant changes in rates. Postneonatal mortality rates did not increase in the target areas following initiation of RICP, indicating that deaths were not merely being postponed. Nine of ten individual sites showed reductions in infant mortality following program initiation. Birthweight-specific mortality data indicated that the decline was due mainly to reductions in neonatal mortality among low-birthweight infants. No reductions in the incidence of low birthweight were observed in the target areas. Substantial gaps in the delivery of prenatal care remained due to the continuing poverty of the population and the resultant lack of financial coverage for health services. We conclude that improved perinatal medical care can reduce infant mortality in poor rural areas to average levels experienced in the United States, and that the high rates still observed in some rural counties are unnecessary.

Black or African American↗

PubMed1986

Diagnosis and outcome: depression and anxiety in a general population.

An assessment of the long-term outcome for depression and anxiety disorders in a general population was made as part of the Stirling County Study. Measuring outcome as a dichotomy between experiencing recurrent episodes or not during a 17-year cohort interval, it was found that 56% of the 'cases' had a poor prognosis. While sex, age and level of severity were not significantly related to outcome, an initial diagnosis of depression was predictive of unfavourable prognosis. Only a few of these 'cases' received psychiatric specialty treatment. Some disorders in the community appear, however, to be as serious as those that come to the attention of psychiatrists.

Adaptation, Psychological↗

PubMed1985

Computer diagnosis of depression and anxiety: the Stirling County Study.

A computer programme (DPAX) was constructed for a longitudinal study of psychiatric epidemiology in Stirling County (Canada). It identifies disorders involving the syndromes of depression and anxiety based on responses given in structured questionnaire interviews. The programme follows a diagnostic algorithm that uses criteria for: (1) essential features; (2) number, frequency, and pattern of associated symptoms; (3) impairment; and (4) duration. The programme reproduces case evaluations provided by psychiatrists, as conveyed by a sensitivity of 92% and a specificity of 98%.

Anxiety Disorders↗

PubMed1984

Stability of prevalence. Depression and anxiety disorders.

Information about point prevalence of depression and anxiety disorders from two cross-sectional surveys in Stirling County (Canada) indicates that an overall prevalence rate of 12.5% characterized a year close to midcentury and a prevalence rate of 12.7% characterized another year toward the end of the century's third quarter. The stability of the prevalence rates contrasts sharply with the fact that numerous social changes took place over this period of time in this place of study. There were, however, small trends in the distribution of depression and anxiety by sex and age, especially an increased similarity in the overall rates for men and women in the age range of 40 to 69 years. Hypotheses are offered about social circumstances that may have influenced the diminishing difference between the sexes.

Adolescent↗

PubMedDate not supplied

Household television access: associations with screen time, reading, and homework among youth.

OBJECTIVE: We examined how household factors that mediate television access are associated with screen time (television, videos, movies, and computer and video games), reading, and homework. METHODS: We conducted a self-report survey among 1197 sixth and seventh graders in 10 middle schools in 4 Boston-area communities in 1995. To assess independent associations, SUDAAN linear regressions were calculated to control for respondent characteristics and household access and to account for clustered sampling in the school-based design. RESULTS: Total viewing (television, videos, movies, and computer and video games) averaged 3.35 plus minus 2.2 hours per day. In multivariate regressions, independent direct associations with total viewing were observed for the following categories: youth has a television in the bedroom: 0.64 hours per day (P <.001), never/seldom has family dinners: 0.55 hours (P <.01); no parental limits on television time: 0.48 hours (P <.01); and each additional television outside the youth's bedroom, 0.12 hours (P <.05). Similar results held when television/video/movie use was examined separately from computer/video game use. Youth reported an average of 1.6 plus minus 1.1 hours of reading and homework per day. Parental limits on television time were associated with 0.21 hours more reading per day (P <.01), whereas a television in the bedroom was associated with 0.18 hours less (P <.01). CONCLUSIONS: Reducing intrahousehold television access may enhance clinical, school, and community strategies to reduce youth television viewing and other screen time.

Adolescent↗

PubMedDate not supplied

Home uterine activity monitoring in the prevention of very low birth weight.

OBJECTIVES: Despite controversy regarding the efficacy of home uterine activity monitoring (HUAM), it is currently licensed for detection of preterm labor in women with previous preterm deliveries. In practice, however, it is being more widely utilized in an effort to prevent preterm delivery. This study seeks to determine which group of mothers delivering very low birth weight (VLBW) infants would have qualified for HUAM given three different sets of criteria and in which women it could have been used to help prolong gestation. METHODS: The authors reviewed the medical records of mothers of VLBW infants born in five U.S. locations (N = 1440), retrospectively applying three sets of eligibility criteria for HUAM use: (a) the current FDA licensing criterion for use of HUAM, a previous preterm birth; (b) indication for HUAM commonly cited in published reports; (c) a broad set of criteria based on the presence of any reproductive or medical conditions that might predispose to premature delivery. The authors then analyzed the conditions precipitating delivery for each group to determine whether delivery might have been prevented with HUAM and tocolytic therapy. RESULTS: Only 4.4% of the total group of women delivering VLBW infants would have been eligible for HUAM under the FDA criterion and might potentially have benefited from this technology. If extremely broad criteria had been applied to identify those eligible for monitoring, under which almost 80% of all women who delivered VLBW infants would have been monitored, only 20.3% of the total group would have been found eligible and would potentially have benefited. If such broad criteria were applied to all pregnant women, a sizable proportion of pregnancies would be monitored at great expense with small potential clinical benefit. CONCLUSIONS: Because VLBW births are usually precipitated by conditions that are unlikely to benefit from HUAM, this technology will have little impact on reducing VLBW and neonatal mortality rates. More comprehensive preventive strategies should be sought.

Female↗