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Biomedical subjects

G C Patton

Publications and source records attributed to G C Patton.

36 records · Page 2Linked to original sources
PubMed1998

The course of early smoking: a population-based cohort study over three years.

AIMS: To examine the uptake and course of smoking in a representative adolescent cohort. DESIGN: Six-wave cohort study. PARTICIPANTS: Secondary school students initially aged 14-15 years at 44 schools in the state of Victoria, Australia. MEASUREMENTS: Computerized questionnaire including 7-day retrospective recall for tobacco use. FINDINGS: Prevalence rates for smoking in the past month rose from 25% to 31% and daily smoking 9% to 18% across the 3-year follow-up. Forty-five per cent of the sample smoked at some point but only 18% were daily smokers at the end-point. High rates of short-term cessation were observed for both experimental and daily smokers, but 70% of daily smokers relapsed within 12 months. Occasional smoking at the outset was the strongest predictor of later daily smoking and was also predictive of lower cessation and higher relapse rates. Parental divorce and parental daily smoking were associated with smoking at the outset and parental smoking was strongly predictive of the course of daily smoking. In contrast, prevalence rates of smoking in a subject's school did not significantly predict either smoking initiation or subsequent course. Female daily smokers were half as likely as males to cease smoking, a finding that accounted for gender differences in smoking prevalence in this sample. CONCLUSIONS: The strength of association between occasional and later daily smoking indicates the importance of primary prevention but the variability in the early course indicates that there should be much scope for promotion of adolescent efforts to quit. Both the diminished likelihood of smoking cessation in young women and parental influences on smoking course deserve further exploration.

Adolescent↗
PubMed1998

Depression, anxiety, and smoking initiation: a prospective study over 3 years.

OBJECTIVES: This report considers the extent to which depression and anxiety predict smoking onset in adolescence. METHODS: A 6-wave cohort design was used to study a sample of 14- and 15-year-old students (n = 2032) drawn from 44 secondary schools in the state of Victoria, Australia. The students were surveyed between 1992 and 1995 with a computerized questionnaire that included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS: Experimental smokers were 29 times more likely than non-smokers to make a transition into daily use in the subsequent 6 months. Depression and anxiety, along with peer smoking, predicted initiation of experimental smoking. Specifically, depression and anxiety accentuated risks associated with peer smoking and predicted experimentation only in the presence of peer smoking. CONCLUSIONS: The finding that experimental smoking is an overwhelmingly strong predictor of later daily smoking focuses attention on smoking initiation. Depressive and anxiety symptoms are associated with higher risks for initiation through an increased susceptibility to peer smoking influences. Promoting the psychological well-being of adolescents and addressing perceived interpersonal benefits of smoking may play a role in the prevention of adolescent tobacco use.

Adolescent↗
PubMed1998

Prediction of psychosis. A step towards indicated prevention of schizophrenia.

BACKGROUND: The identification of people at high risk of becoming psychotic within the near future creates opportunities for early intervention prior to the onset of psychosis to prevent or minimise later ill-health. The present study combines current knowledge about risk factors for schizophrenia with our knowledge of psychotic prodromes in an attempt to identify a group particularly vulnerable to impending psychosis. We wanted to identify people with high likelihood of transition to psychosis within a follow-up period of 12 months, and to determine the rate of transition to psychosis in this group. METHOD: Various state and trait risk factors for psychosis were used alone and in combination to operationally define a putatively high-risk group. Operationalised criteria for onset of psychosis were established. The individuals were assessed monthly on measures of psychopathology for six months. RESULTS: Eight out of 20 people made the transition to frank psychosis within a six-month follow-up period. Follow-up of this group is still in progress, and the 12 month transition rate might prove to be higher still. CONCLUSIONS: We have demonstrated that it is possible to identify individuals with a high likelihood of onset of psychosis within a brief follow-up period. This lays the foundation for early treatment in an attempt to prevent, delay or minimise the severity of first onset of schizophrenia.

Cognition Disorders↗
PubMed1997

Adolescent suicidal behaviours: a population-based study of risk.

BACKGROUND: Reports of adolescent suicidal behaviour have generally derived from clinical settings but population-based studies are likely to provide a clearer epidemiological view. METHODS: Non-fatal suicidal behaviours were studied in 1699 Australian 15- to 16-year-old secondary school students at 44 schools in the state of Victoria, Australia. Self-reported episodes of self-harm were characterized using items from the Beck Suicide Intent Scale. RESULTS: The 12 month weighted prevalence estimate for deliberate self-harm was 5.1%. The commonest forms were self-laceration (1.7%), self-poisoning (1.5%) and deliberate recklessness (1.8%). Self-poisoning and self-laceration were commoner in girls. The prevalence of 'true suicide attempts' was 0.2%. Most self-harmers did not perceive death as likely, plan self-harming episodes at length or inform others of the episodes. Psychiatric morbidity had the strongest association with self-harm, an association which held for all subtypes. Antisocial behaviour and substance abuse were associated with self-harm in girls but not boys. Sexual activity was independently associated with self-harm in both genders. CONCLUSIONS: Deliberate self-harm was common but the great majority of episodes were not 'true suicide attempts'. It is, therefore, possible that attributable mortality and morbidity may be greater in self-harmers without definite suicidal intent.

Adolescent↗
PubMed1997

Adolescent dieting: healthy weight control or borderline eating disorder?

Dieting in adolescent girls is ubiquitous but its health significance is uncertain. On the one hand it might be seen as promoting healthy weight control and on the other it might be considered as a risk factor for eating disorders. Dieting levels were systematically assessed in a representative group of 2525 Australian teenagers and classified using item response theory. In this group, 38% of girls and 12% of boys were categorised as intermediate dieters; 7% of girls and 1% of boys fell into a group of extreme dieters. Body mass carried a strong positive association with intermediate dieting. Most female dieters, nevertheless, fell within a normal weight range. Psychiatric morbidity was the clearest factor associated with extreme dieting and 62% of extreme dieters reported high levels of depression and anxiety. Extreme dieting might reasonably be viewed as lying on a spectrum with clinical eating disorders. Most dieting is unjustified on the grounds of appropriate weight control and appears to reflect a widespread striving of teenage girls towards body shapes at the lower end of age-adjusted norms.

Adolescent↗
PubMed1996

Monitoring and care of young people at incipient risk of psychosis.

This article describes the theoretical background, origins, and development of a new clinical service for intervention in the putatively prodromal phase of schizophrenia and other psychotic disorders. Establishing such a service required examination of conceptual issues such as the meaning of the prodrome in psychosis and its association with risk of subsequent psychosis, and of practical issues related to identifying prodromal patients in the community and engaging them in monitoring and treatment. Patients' needs, timing, and mode of treatment had to be considered. Preliminary data from the service's 20-month pilot phase are presented to help inform these issues.

Adolescent↗
PubMed1996

Menarche and the onset of depression and anxiety in Victoria, Australia.

STUDY OBJECTIVE: Psychiatric disorder often begins at adolescence. This study aimed to examine the associations between puberty and social circumstances and the adolescent rise in depression and anxiety. DESIGN: A two stage cluster sampling procedure was used to identify a representative group of Australian secondary school students in years 7 (age 12-13 years), 9 (14-15 years), and 11 (16-17 years) of 45 Victorian schools. The computerised clinical interview schedule (CIS) was used to evaluate psychiatric morbidity. MAIN RESULTS: A total of 2525 subjects completed the survey - an overall participation rate of 83%. Levels of depression and anxiety increased with the secondary school years and girls had significantly higher rates at each school year level. For boys, the clearest independent associations with depression and anxiety were rising school year level and high parental educational achievement. For girls menarchal status emerged as the strongest predictor. Associations with age and school year level, evident on univariate analysis, did not persist when the recency of menarche was taken into account. After addition of measures of perceived social stress to a multivariate model, a significant association between depression/anxiety and parental divorce disappeared but the association with menarche persisted. CONCLUSIONS: Menarche marks a transition in the risk of depression and anxiety in girls. The pattern of findings is consistent with a biological mediation of this association.

Adolescent↗
PubMed1996

Is smoking associated with depression and anxiety in teenagers?

OBJECTIVES: An association of smoking with depression and anxiety has been documented in adult smokers. This study examines this association in a representative group of teenage smokers. METHODS: A two-stage cluster sample of secondary school students in Victoria, Australia, were surveyed by using a computerized questionnaire, which included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS: Subjects reporting high levels of depression and anxiety were twice as likely to be smokers after the potential confounders of year level, sex, alcohol use, and parental smoking were controlled for. Regular smokers were almost twice as likely as occasional smokers to report high levels of depression and anxiety. In a stratified analysis, an association between regular smoking and psychiatric morbidity was found in girls of all ages but for boys only in the youngest group. CONCLUSIONS: The cross-sectional association is consistent with the use of smoking by teenage girls as self-medication for depression and anxiety. Therefore, future health promotional campaigns might consider strategies that attend to perceived psychological benefits of smoking.

Adult↗
PubMed1995

The prevalence of prodromal features of schizophrenia in adolescence: a preliminary survey.

In most cases of schizophrenia the onset of frank psychosis is preceded by a period of prodromal features. This period has been relatively neglected by researchers and is potentially important in promoting early intervention. The prevalence of DSM-III-R schizophrenia prodrome symptoms was assessed as part (n = 657) of a large (n = 2525) questionnaire-based survey of high school students. Individual symptoms were highly prevalent and the prevalence of DSM-III-R prodromes ranged from 10 - 15% to 50%. Despite methodological weaknesses, the data suggest that DSM-III-R prodromal features are extremely prevalent among older adolescents and unlikely to be specific for subsequent schizophrenia. Clinically these features cannot be regarded as sufficient evidence of early schizophrenia and more accurate predictors of incipient schizophrenia need to be defined.

Adolescent↗
PubMed1995

Patterns of common drug use in teenagers.

To ascertain current levels of drug use among teenagers and to examine interrelationships in use, a two-stage cluster sample of Victorian secondary school students in years 7 (aged 12 to 13 years), 9 (14 to 15 years) and 11 (16 to 17 years) were surveyed using a questionnaire on computer. Tobacco use and alcohol consumption were evaluated by self-reported frequency of use and seven-day retrospective diaries. Marijuana and coffee consumption were assessed by self-reported frequency of recent use. The questionnaire was completed by 2525, a participation rate of 83 per cent. Tobacco use rose with year, with 24 per cent of young women and 16 per cent of young men in year 11 being regular smokers. Trends across year level for heavier alcohol consumption were also observed, with just under 10 per cent of year 11 students reporting a weekly consumption higher than the current recommended guidelines for adults. Strong interrelationships in drug use were found, with a pattern of association between smoking and drinking consistent with a mutual elevation of risk. Frequent use of tobacco and alcohol had a high risk for associated marijuana use. Coffee consumption carried a significant independent association with regular smoking. Teenage substance use is common and most occurs at low level and frequency. However, for a substantial and increasing minority across the teenage years, high levels of tobacco and alcohol consumption potentially compromise health. Frequent alcohol or tobacco use rather than heavy intermittent consumption is most likely to be associated with concurrent substance use potentially damaging to health.

Adolescent↗
PubMed1992

Eating disorders: antecedents, evolution and course.

Concepts of eating disorders have altered so that anorexia nervosa is now recognized as an important but uncommon syndrome within a spectrum of disordered eating. Behaviours used by dieters constitute the mild end of the eating disorder spectrum. Dieting in young women is for the most part a transient and benign activity without longer-term consequences. However, a group of dieters do progress to develop the symptoms and behaviour of eating disorders, so that dieting has been associated with an eight-fold rise in the risk of later eating disorder. Dieting or factors closely associated may account for most eating disorders in young women. Many antecedents of eating disorder appear to operate through increasing the risk of dieting rather than determining eating disorders specifically. Only the development of further neurotic and depressive symptoms characterizes dieters progressing to eating disorders. As the evidence implicating dieting in the origin of eating disorders becomes stronger so strategies for primary prevention become clearer.

Adolescent↗
PubMed1990

Abnormal eating attitudes in London schoolgirls--a prospective epidemiological study: outcome at twelve month follow-up.

The occurrence and course of eating disorder in a large representative population of 15-year-old London schoolgirls has been assessed using a two-stage survey methodology. Attempts to control weight were common and often transient. Dieting was in the great majority of girls found to be a benign practice without progression to more extreme concerns about food and weight. However, a small proportion of dieters did become cases and formed the majority of new cases found at follow-up. The relative risk of dieters becoming cases was eight times that of non-dieters. Many factors conventionally associated with eating disorder were associated more with attempting weight control than caseness. These included pre-morbid personality, pre-morbid obesity and family weight pathology. Other factors, including social class, career choice and psychosexual development, had no association either with attempting weight control or caseness.

Adolescent↗
PubMed1988

The spectrum of eating disorder in adolescence.

The concept of a spectrum of eating disorder in adolescence ranging from the feeling of being too fat to the syndrome of anorexia nervosa has gained considerable acceptance in epidemiological research into eating disorders. Dieting and the occasional use of more extreme methods of weight control are not uncommon in teenage girls. New findings from a prospective study of London schoolgirls support a view that dieting in adolescence, although for the most part unproblematic, is in some instances a precursor to more extreme methods of weight control and concerns about weight. Being of a higher weight and the presence of neurotic and depressive symptoms were found to be the factors, other than concerns about food and weight, which best distinguished the elements of the eating disorder spectrum.

Adolescent↗
PubMed1988

Mortality in eating disorders.

Crude mortality rates and mortality rates standardized against a British reference population have been calculated for a group of 460 consecutive patients with eating disorders seen between 1971 and 1981 in a tertiary referral centre for eating disorders. Crude mortality rates were 3.3% and 3.1% in the anorexia nervosa and bulimia nervosa groups respectively. Standardized rates demonstrated a six-fold increase in mortality in the anorexia nervosa group. The most common cause of death in this group was found to be suicide, with the risk of death remaining high for at least eight years after initial assessment. Specific associations of increased mortality were: being in the lowest weight group at the time of presentation, and having recurrent hospital admissions for eating problems.

Adult↗
PubMed1986

Physical illness. A risk factor in anorexia nervosa.

Reports have appeared in the literature suggesting an association between physical illness and the later development of anorexia nervosa. The histories of 326 patients with anorexia nervosa were examined for physical illness. A higher rate of severe physical illness was found in this group when compared with controls suggesting that it should be regarded as a risk factor for anorexia nervosa. No statistically significant differences were found when illness was examined by time in relation to onset of anorexia, system involved, or when subjects were stratified by age. Possible explanations for the observed association are discussed.

Acute Disease↗