Biomedical subjects

Jian Li Wang

Publications and source records attributed to Jian Li Wang.

9 recordsLinked to original sources

PubMed2006

Perceived work stress, imbalance between work and family/personal lives, and mental disorders.

BACKGROUND: Occupational mental health research has been focusing on the relationship between work stress and depression. However, the impacts of work stress on anxiety disorders and of imbalance between work and family life on workers' mental health have not been well studied. This analysis investigated the association between levels of perceived work stress and of imbalance between work and family/personal lives and current mood/anxiety disorders. METHOD: This was a cross-sectional study using data from the Canadian Community Health Survey-Mental Health and Well-being (CCHS-1.2) (n=36,984). Mood and anxiety disorders were measured using the World Mental Health-Composite International Diagnostic Interview. RESULTS: The 1-month prevalence of mood and anxiety disorders among those with a work stress score at the 75th percentile value and above was 3.6% and 4.0%. Among those who reported that their work and family/personal lives "never" balanced in the past month, the 1-month prevalence of mood and anxiety disorders was 21.2% and 17.9%. In multivariate analyses, work stress and imbalance between work and family/personal lives were independently associated with mood and anxiety disorders. There was no evidence that perceived work stress interacted with imbalance between work and family/personal lives to increase the likelihood of having mental disorders. Gender was associated with anxiety disorders, but not with major depressive disorder and mood disorders. CONCLUSIONS: Work stress and imbalance between work and family/personal lives may be part of the etiology of mood and anxiety disorders in the working population. Community based longitudinal studies are needed to delineate the causal relationships among work stress, imbalance between work and family/personal lives and mental disorders.

Adolescent↗

PubMed2006

Effect of oxygen affinity and molecular weight of HBOCs on cerebral oxygenation and blood pressure in rats.

PURPOSE: This study assessed the effect of oxygen affinity and molecular weight (MW) of o-raffinose cross-linked hemoglobin based oxygen carriers (HBOCs) on cerebral oxygen delivery and mean arterial blood pressure (MAP) following hemorrhage and resuscitation in rats. METHODS: Isoflurane anesthetized rats (n = 6-7 per group) underwent 30% hemorrhage and resuscitation with an equivalent volume of one of three different HBOCs: 1) High P50 Poly o-raffinose hemoglobin (Poly OR-Hb, P50 = 70 mmHg); 2) High P50 > 128 Poly OR-Hb (MW > 128 kDa, P50 = 70 mmHg) and 3) Low P50 > 128 Poly OR-Hb (MW >128 kDa, P50 = 11 mmHg). Hippocampal cerebral tissue oxygen tension, regional cerebral blood flow (rCBF), MAP, total hemoglobin concentration and arterial blood gases were measured. Data analysis by two-way ANOVA and post hoc Tukey tests determined significance (P < 0.05, mean +/- SD). RESULTS: Hippocampal tissue oxygen tension increased in all HBOC groups following resuscitation. The rCBF remained unchanged after HBOC resuscitation in all groups. Following resuscitation, the peak MAP was higher in the High P50 Poly OR-Hb group (152 +/- 13 mmHg) when compared to either the Low or High P50 large MW, (> 128 kDa) HBOC group (119 +/- 15 mmHg or 127 +/- 18 respectively, P < 0.05 for both). CONCLUSIONS: O-raffinose polymerized HBOC, with or without lower MW components, maintained cerebral tissue oxygen delivery following hemorrhage and resuscitation in rats. The higher MW HBOCs showed a decrease in peak MAP, which did not alter oxygen delivery. No significant effect of oxygen affinity on cerebral tissue oxygen tension or blood flow was observed.

Animals↗

PubMed2006

Epidemiological associations between gambling behavior, substance use & mood and anxiety disorders.

OBJECTIVE: To compare gambling behaviors in a random sample of community residents with and without mental disorders identified by the Composite International Diagnostic Interview (CIDI). METHOD: A large national community survey conducted by Statistics Canada included questions about problems arising from gambling activities as per the Canadian Problem Gambling Index (CPGI). We compared respondents within three gambling severity categories (non-problem, low severity and moderate/high severity gambling) across three diagnostic groupings (mood/anxiety disorders, substance dependence/harmful alcohol use, no selected psychiatric disorder). RESULTS: Of the 14,934 respondents age 18-64 years who engaged in at least one type of gambling activity in the previous 12 months, 5.8% fell in the low severity gambling category while 2.9% fell in the moderate/high severity category. Females accounted for 51.7% of the sample. The risk of moderate/high severity gambling was 1.7 times higher in persons with mood or anxiety disorder compared to persons with no selected disorder. For persons with substance dependence or harmful alcohol use, the risk of moderate/high severity gambling was 2.9 times higher. Persons with both mood/anxiety and substance/alcohol disorders were five times more likely to be moderate/high severity gamblers. The odds ratio for females was 0.6 and for those with less than post-secondary education it was 1.52. Differences in age and personal income were not significant. CONCLUSIONS: Individuals in the community suffering from mood/anxiety disorders and substance dependence/harmful alcohol, and especially those with both, experience a higher risk for gambling problems. The treatment of these comorbidities should be integrated into any problem gambling treatment program.

Adult↗

PubMed2006

Descriptive epidemiology of major depression in Canada.

OBJECTIVE: The Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) is the first national study to use a full version of the Composite International Diagnostic Interview. For this reason, and because of its large sample size, the CCHS 1.2 is capable of providing the best currently available description of major depression epidemiology in Canada. Using the CCHS 1.2 data, our study aimed to describe the epidemiology of major depression in Canada. METHOD: All estimates used appropriate sampling weights and bootstrap variance estimation procedures. The analysis consisted of estimating proportions supplemented by logistic regression modelling. RESULTS: The lifetime prevalence of major depressive episode was 12.2%. Past-year episodes were reported by 4.8% of the sample; 1.8% reported an episode in the past 30 days. As expected, major depression was more common in women than in men, but the difference became smaller with advancing age. The peak annual prevalence occurred in the group aged 15 to 25 years. The prevalence of major depression was not related to level of education but was related to having a chronic medical condition, to unemployment, and to income. Married people had the lowest prevalence, but the effect of marital status changed with age. Logistic regression analysis suggested that the annual prevalence may increase with age in men who never married. CONCLUSIONS: The prevalence of major depression in the CCHS 1.2 was slightly lower than that reported in the US and comparable to pan-European estimates. The pattern of association with demographic and clinical variables, however, is broadly similar. An increasing prevalence with age in single (never-married) men was an unexpected finding.

Adolescent↗

PubMed2005

Antidepressant utilization in Canada.

OBJECTIVE: Antidepressant utilization can be used as an indicator of appropriate treatment for major depression. The objective of this study was to characterize antidepressant utilization in Canada, including the relationships of antidepressant use with sociodemographic variables, past-year and lifetime depression, number of past depressive episodes, and other possible indications for antidepressants. METHOD: We examined data from the Canadian Community Health Survey (CCHS) Cycle 1.2. The CCHS was a nationally representative mental health survey (N=36,984) conducted in 2002 that included a diagnostic instrument for past-year and lifetime major depressive episodes and other psychiatric disorders and a record of past-year antidepressant use. RESULTS: Overall, 5.8% of Canadians were taking antidepressants, higher than the annual prevalence of major depressive episode (4.8%) in the survey. Among persons with a past-year major depressive episode, the frequency of antidepressant use was 40.4%. After application of adjustments for probable successful outcomes of treatment, the estimated frequency of antidepressant use for major depression was more than 50%. Frequency of antidepressant treatment among those with a history of depression but without a past-year episode increased with the number of previous episodes. Among those taking antidepressants over the past year, only 33.1% had had a past-year episode of major depression. Migraine, fibromyalgia, anxiety disorder, or past depression was present in more than 60% of those taking antidepressants without a past-year episode of depression. CONCLUSIONS: The CCHS results suggest that antidepressant use has increased substantially since the early 1990s, and also that these medications are employed extensively for indications other than depression.

Adolescent↗

PubMed2005

Psychotropic medication use in Canada.

BACKGROUND: Psychotropic medication use can be employed as an indicator of appropriate treatment for mental disorders. The Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) offers the first opportunity to characterize Canadian psychotropic medication use on a national level within diagnostic groups as assessed by a full version of the Composite International Diagnostic Interview (CIDI). METHOD: We assessed the prevalence of antidepressant, sedative-hypnotic, mood stabilizer, psychostimulant, and antipsychotic use over 2 days overall and in subgroups defined by CIDI-diagnosed disorders and demographics. We employed sampling weights and bootstrap methods. RESULTS: Overall psychotropic drug utilization was 7.2%. Utilization was higher for women and with increasing age. With any lifetime CIDI-diagnosed disorder assessed in the CCHS 1.2, utilization was 19.3%, whereas without such disorders, it was 4.1%. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants for those with a past-year major depressive episode (17.8%), followed by venlafaxine (7.4%). Among people aged 15 to 19 years, antidepressant use was 1.8% overall and 11.7% among those with past-year depression; SSRIs made up the majority of use. Sedative-hypnotics were used by 3.1% overall, increasing with age to 11.1% over 75 years. CONCLUSIONS: International comparison is difficult because of different evaluation methods, but antidepressant use may be higher and antipsychotic use lower in Canada than in recent European and American reports. In light of the relative lack of contemporary evidence for antidepressant efficacy in adolescents, it is likely that antidepressant use among those aged 15 to 19 years will continue to decline. The increased use of sedative-hypnotics with age is of concern, given the associated risk of adverse effects among seniors.

Adolescent↗

PubMed2005

Measurement issues related to the evaluation and monitoring of major depression prevalence in Canada.

Monitoring major depression prevalence is important because of the substantial impact of this condition on population health. Local or regional surveys using cost-efficient methods (e.g. data collection by telephone interview) may provide useful epidemiological data, as may the inclusion of brief diagnostic modules for major depression in general health surveys. In Canada, the Composite International Diagnostic Interview Short Form for Major Depression (CIDI-SFMD) has been widely employed for both purposes. The recent Canadian Community Health Survey 1.2 (2002), which employed a more detailed diagnostic interview (the World Mental Health 2000 CIDI), provides a standard against which to evaluate the performance of the CIDI-SFMD. A tendency to at times overestimate prevalence appears to be a characteristic of the CIDI-SFMD, and it has produced a broad range of prevalence estimates, suggesting a greater vulnerability to study-specific or contextual factors. However, the pattern of association of major depression with potential demographic determinants is not consistent with the classical "dilution" effect expected to occur with non-differential misclassification bias.

Adolescent↗

PubMed2004

Rural-urban differences in the prevalence of major depression and associated impairment.

BACKGROUND: The possibility of a rural and urban difference in the prevalence of major depression has been of interest to researchers and mental health service providers. The objectives of this analysis were to determine the rural and urban difference in the 12-month prevalence of major depressive episode(s) (MDE) in Canada and whether participants in rural and urban areas differed in the impairment levels due to depressive symptoms and in mental health service utilization. METHODS: Data from the 1998-1999 Canadian National Population Health Survey (NPHS) were used in this study. In the NPHS, MDE was measured by the Composite International Diagnostic Interview-Short Form for Major Depression. Two-week disability and daily life interference due to depressive symptoms were used as indicators of impairment in this analysis. The prevalence of MDE in rural and urban areas, at national and regional levels, was calculated. The association between urbanicity and MDE was evaluated by Odds Ratios, controlling for potential confounders. Impairment levels and mental health service utilization were also compared between the rural and urban groups. RESULTS: NPHS participants in rural areas had a lower prevalence of MDE than those in urban areas, controlling for the effects of race, immigration status, working status and marital status. Non-immigrants and those who are white in rural areas had a lower prevalence of MDE than did those in urban areas, and such differences depended on age and geographic regions. Rural and urban participants did not differ in 2-week disability and daily life interference due to depressive symptoms. However, rural participants were less likely to have contacted health professionals for mental health problems. CONCLUSIONS: The reasons for the rural and urban differences in the prevalence of MDE are complex. This may depend on individuals' age, immigration status, race, working status, marital status and the provinces where they live. These differences should be considered in future mental health service planning, particularly at provincial levels. There may be gaps between rural and urban areas in terms of availability of mental health services. This should be addressed in future studies and in mental health service planning.

Adolescent↗

PubMed2004

The difference between single and married mothers in the 12-month prevalence of major depressive syndrome, associated factors and mental health service utilization.

BACKGROUND: Previous studies suggest that single mothers are at a higher risk of major depression and more likely to use mental health services than are married mothers. The objectives of this analysis were to provide estimates of the prevalence of major depressive syndrome among single and married mothers, to investigate the factors which may affect the difference in the prevalence of major depressive syndrome among single and married mothers and to estimate the health care service utilization by single and married mothers. METHODS: This was a cross-sectional study using the data from the 1996-97 Canadian National Population Health Survey (NPHS). Major depressive syndrome was evaluated using the Composite International Diagnostic Interview-Short Form for major depression. The prevalence of major depressive syndrome was calculated among 3030 single and 10195 married mothers. The effects of demographic, socioeconomic and biological variables on the association between single-mother status and major depressive syndrome were evaluated by stratified analyses. RESULTS: In the NPHS, the difference between single and married mothers in the prevalence of major depressive syndrome was found among women who were between the ages of 25 and 50. The association in this age group depended on race and on whether they had one or more jobs. Education,problem drinking, daily smoking, having one or more long-term medical illnesses, financial hardship and social support did not affect the association between single-mother status and major depressive syndrome. Single mothers were more likely to visit health professionals for mental problems than were married mothers. CONCLUSION: The difference between single and married mothers in the prevalence of major depression is age-specific. Single mothers who reported having had one or more jobs and who are non-white had an increased risk of having major depressive syndrome, compared to married mothers. Future studies need to replicate the findings of this analysis and investigate why single mothers with ethnic minority backgrounds and those who are working are at high risk of having depressive disorders.

Adult↗