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Biomedical subjects

JianLi Wang

Publications and source records attributed to JianLi Wang.

16 recordsLinked to original sources
PubMed2006

Mental disorders in a population sample with musculoskeletal disorders.

BACKGROUND: Studies using clinical and volunteer samples have reported an elevated prevalence of mood disorders in association with rheumatoid arthritis and osteoarthritis. Clinical studies using anxiety rating scales have reported inconsistent results, but studies using diagnostic instruments have reported that anxiety disorders may be even more strongly associated with arthritis than is depression. One study reported an association between lifetime substance use disorders and arthritis. METHODS: Data from iteration 1.2 of the Canadian Community Health Survey (CCHS) were used. This was a large-scale national Canadian health survey which administered the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects randomly selected from the national population. In the CCHS 1.2, subjects were asked whether they had been diagnosed by a health professional with arthritis or rheumatism. RESULTS: Subjects reporting arthritis or rheumatism had an elevated prevalence of mood, anxiety and substance use disorders. The strength of association resembled that seen in an omnibus category reporting any chronic condition, but was weaker than that seen with back pain or fibromyalgia. The effect of arthritis or rheumatism interacted with age, such that the odds ratios became smaller with increasing age. Mood and anxiety disorders, along with arthritis or rheumatism made an independent contribution to disability. CONCLUSION: Arthritis is associated with psychiatric morbidity in the general population, and this morbidity is seen across a variety of mental disorders. The strength of association is consistent with that seen in persons with other self-reported medical conditions.

Adolescent↗
PubMed2006

Mental health and related disability among workers: a population-based study.

BACKGROUND: In past decades, the nature of work has undergone significant changes including increased psychological demands and job instability. A stressful psychosocial work environment has been shown to have adverse effects on workers' mental and physical health. This goal of this study is to estimate the prevalence of psychiatric syndromes and related disability in a population-based sample of employed adults and investigate associations between psychiatric syndromes and related disability. METHODS: A random-digit dial provincial wide mental health survey was conducted in Alberta, Canada (n = 5,383). The telephone interview included the Mini International Neuropsychiatric Interview (MINI) and the World Health Organization's Disability Assessment Schedule (WHO-DAS-II). In this analysis, participants who were currently employed were included (n = 4,149). RESULTS: In this population, 6.2% had had at least one MINI-defined psychiatric diagnosis with clinically significant interference. Without consideration of the clinical interference criterion, the prevalence of psychiatric syndromes was higher (33.5%). Psychiatric syndromes were strongly associated with disability. A dose-response relationship between the number of diagnoses and disability was found. CONCLUSIONS: Interventional strategies in the workplace should focus on mental disorders at both the clinical and sub-clinical levels.

Adult↗
PubMed2006

Perceived barriers to mental health service use among individuals with mental disorders in the Canadian general population.

BACKGROUND: Eliminating barriers to care is important for improving health service use. However, the barriers to mental health care have not been well investigated. OBJECTIVES: This study was designed to provide information about the barriers to mental health service use and to identify clinical factors associated with perceived barriers among individuals with depressive-, anxiety-, and substance use-related disorders in the communities. DESIGN: A cross-sectional analysis using data from the Canadian Community Health Survey-Mental Health and Well-being was instituted. SUBJECTS: Participants with depressive-, anxiety-, and substance use-related disorders in the past 12 months, assessed by the World Mental Health-Composite International Diagnostic Interview, were included (n = 4094). RESULTS: In participants with mental disorders, 19.5% reported barriers to mental health service use. The percentage of perceived barriers due to acceptability was higher than those for barriers due to accessibility and availability. Participants with comorbid mental disorders were more likely to have experienced barriers than those with one disorder in both mental health service users and in the nonusers. Role impairment was a significant factor predicting barriers to care, overall and in the service nonusers, in the groups having anxiety disorders only, having any depressive or anxiety disorders, and having any alcohol or drug dependence. CONCLUSIONS: Clinical characteristics play an important role in perceiving barriers to mental health care. Future efforts should pay particular attention to the needs of those with chronic and severe mental health problems and focus on improving the effectiveness of mental health services.

Adolescent↗
PubMed2006

Risk of harm among gamblers in the general population as a function of level of participation in gambling activities.

AIMS: To examine the relationship between gambling behaviours and risk of gambling-related harm in a nationally representative population sample. DESIGN: Risk curves of gambling frequency and expenditure (total amount and percentage of income) were plotted against harm from gambling. SETTING: Data derived from 19, 012 individuals participating in the Canadian Community Health Survey-Mental Health and Well-being cycle, a comprehensive interview-based survey conducted by Statistics Canada in 2002. MEASUREMENT: Gambling behaviours and related harms were assessed with the Canadian Problem Gambling Index. FINDINGS: Risk curves indicated the chances of experiencing gambling-related harm increased steadily the more often one gambles and the more money one invests in gambling. Receiver operating characteristic analysis identified the optimal limits for low-risk participation as gambling no more than two to three times per month, spending no more than 501-1,000 CAN dollars per year on gambling and investing no more than 1% of gross family income on gambling activities. Logistic regression modelling confirmed a significant increase in the risk of gambling-related harm (odds ratios ranging from 2.0 to 7.7) when these limits were exceeded. CONCLUSIONS: Risk curves are a promising methodology for examining the relationship between gambling participation and risk of harm. The development of low-risk gambling limits based on risk curve analysis appears to be feasible.

Adolescent↗
PubMed2005

Help-seeking behaviours of individuals with mood disorders.

OBJECTIVES: This study had the following objectives: 1) to estimate the 12-month prevalence of conventional and unconventional mental health service use by individuals with major depressive disorder (MDD) or mania in the past year, and 2) to identify factors associated with the use of conventional mental health services by individuals with MDD or mania in the past year. METHODS: We examined data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Respondents with MDD (n = 1563) or manic episodes (n = 393) in the past 12 months were included in this analysis. RESULTS: An estimated 63.9% of respondents with MDD and 59.0% of those with manic episodes reported having used some type of help in the past 12 months; 52.9% of those with MDD and 49.0% of those with manic episodes used conventional mental health services. Approximately 21% of respondents with either MDD or manic episodes used natural health products specifically for emotional, mental health, and drug or alcohol use problems. Respondents who reported comorbid anxiety disorders and long-term medical conditions were more likely to have used conventional mental health services. CONCLUSIONS: Relative to previous Canadian literature, our analysis suggests that the frequency of conventional mental health service use among persons with MDD has not increased significantly in the past decade. Further, the rate of conventional mental health service use by persons with manic episodes is unexpectedly low. These findings may reflect the lack of national initiatives targeting mood disorders in Canada. They have important implications for planning future education, promotion, and research efforts.

Adolescent↗
PubMed2005

Comorbidity of major depression with substance use disorders.

OBJECTIVES: In the Canadian adult population, we aimed to 1) estimate the 12-month prevalence of major depressive disorder (MDD) in persons with a diagnosis of harmful alcohol use, alcohol dependence, and drug dependence; 2) estimate the 12-month prevalence of harmful alcohol use, alcohol dependence, and drug dependence in persons with a 12-month and lifetime diagnosis of MDD; 3) identify socioeconomic correlates of substance use disorder-major depression comorbidity; 4) determine how comorbidity impacts the prevalence of suicidal thoughts; and 5) determine how comorbidity affects mental health care used. METHODS: We examined data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). RESULTS: The 12-month prevalences of MDD in persons with a substance use disorder (SUD) were 6.9% for harmful alcohol use (95% confidence interval [CI], 5.2 to 8.5), 8.8% for alcohol dependence (95%CI, 6.6 to 11.0), and 16.1% for drug dependence (95%CI, 10.3 to 21.9). Conversely, the 12-month prevalences of harmful alcohol use, alcohol dependence, and drug dependence in persons with a 12-month diagnosis of MDD were 12.3% (95%CI, 9.4 to 15.2), 5.8% (95%CI, 4.3 to 7.3), and 3.2% (95%CI, 2.0 to 4.4), respectively. Regression modelling did not identify any socioeconomic predictors of SUD-MDD comorbidity. Substance dependence and MDD independently predicted higher prevalence of suicidal thoughts and mental health treatment use. CONCLUSIONS: SUDs cooccur with a high frequency in cases of MDD. Clinicians and mental health services should consider routine assessment of SUDs in depression patients.

Adolescent↗
PubMed2004

Chronic back pain and major depression in the general Canadian population.

Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of epidemiological studies have investigated the relationship between these conditions in the general population. In the present study we examined the prevalence and correlates of major depression in persons with chronic back pain using data from the first cycle of Canadian Community Health Survey in a sample of 118,533 household residents. The prevalence of chronic back pain was estimated at 9% of persons 12 years and older. Rates of major depression, determined by the short-form of the Composite International Diagnostic Interview, were estimated at 5.9% for pain-free individuals and 19.8% for persons with chronic back pain. The rate of major depression increased in a linear fashion with greater pain severity. In logistic regression models, back pain emerged as the strongest predictor of major depression after adjusting for possible confounding factors such as demographics and medical co-morbidity. The combination of chronic back pain and major depression was associated with greater disability than either condition alone, although pain severity was found to be the strongest overall predictor of disability.

Adolescent↗
PubMed2004

A longitudinal population-based study of treated and untreated major depression.

BACKGROUND: Few studies have investigated the factors associated with different outcomes in individuals with major depressive episode (MDE) in relation to mental health service utilization. OBJECTIVES: This study was to, in depressed individuals who used and did not use mental health services, 1) compare the demographic, psychosocial, and clinical characteristics; 2) estimate the risk of MDE in a 6-year follow-up period; and 3) identify the factors associated with the persistence/recurrence of MDE. DESIGN: This was a population- based longitudinal analysis. SUBJECTS: Participants included the longitudinal cohort of the Canadian National Population Health Survey who reported MDE at the baseline survey (n = 609). MEASURES: MDE was measured by the Composite International Diagnostic Interview-Short Form for Major Depression. RESULTS: In the 6-year follow-up period, 49.8% of participants with treated depression developed subsequent MDE; 28.7% of those with untreated depression reported MDE. Multivariate analyses showed that, among those who reported the use of mental health services, childhood and adulthood traumatic events and functional impairment were related to the recurrence of MDE. Among those who did not use mental health services, reported negative life events and the severity of depressive symptoms were predictive of recurrent MDE. CONCLUSIONS: The risk of the recurrence of MDE and associated factors differ in mental health service users and nonusers. Future studies need to confirm these results and to identify service barriers for those who do not use the services and who are at a high risk of MDE.

Adolescent↗
PubMed2004

Sociodemographic factors associated with comorbid major depressive episodes and alcohol dependence in the general population.

OBJECTIVES: To estimate the 12-month prevalence of alcohol dependence (AD) among subjects with major depressive episodes (MDEs) and the 12-month prevalence of MDEs among those with AD; to investigate the associations between demographic and socioeconomic characteristics and comorbid MDE and AD, based on established theoretical models; and to compare the rates of mental health service use between groups having high and low risk for comorbid conditions. METHODS: We used data from the 1996-1997 Canadian National Population Health Survey. MDE and AD were measured using the World Health Organization's Composite International Diagnostic Interview Short Form (CIDI-SF). We calculated the 12-month prevalence of MDEs among participants with AD and of AD among those with MDEs. The associations between demographic and socioeconomic characteristics and comorbidity were investigated. RESULTS: Of participants with MDEs, 8.6% had AD; 19.6% of participants with AD reported having at least 1 MDE in the past 12 months. Being young (aged 12 to 24 years); being divorced, separated, or widowed; and having low family income level were positively associated with MDE, AD, and comorbidity. Among participants with comorbid MDE and AD, those who were aged 12 to 24 years were less likely to have used any mental health services in the past 12 months than were others. CONCLUSIONS: Young age, single marital status, and low family income may be potential risk factors for comorbid MDE and AD. Although AD is rare in the general population, public health interventions that target the groups identified as at risk may help to prevent MDE, AD, and comorbidity.

Adolescent↗
PubMed2003

Mental health services received by depressed persons who visited general practitioners and family doctors.

OBJECTIVES: This study estimated the rates of mental health service provision and of specialist referral in primary care in Canada and investigated factors associated with receiving mental health services and with referral to mental health specialists among persons who reported major depressive episodes. METHOD: S: Data from the 1998-1999 Canadian National Population Health Survey were used. The 608 respondents who reported having major depressive episodes in the 12 months preceding the survey and who reported contacting a general practitioner or family doctor during that time were included in the study. The rates of provision of mental health services by general practitioners and family doctors and of referral to mental health specialists were calculated. Demographic, socioeconomic, and clinical characteristics associated with receiving mental health services and with referral to specialists were investigated. RESULTS: Among the 608 respondents who had contacted general practitioners or family doctors for any reason, 153 had contacted them for emotional or mental problems. Of this subgroup of 153, 64.5 percent received mental health services either from these practitioners or by referral to specialists, and 26 percent were referred to mental health specialists. Depressed respondents who reported having talked to a general practitioner or family doctor about mental health problems, who reported impairment, and whose depressive symptoms had lasted eight or more weeks were more likely to have received mental health services. Respondents aged 12 to 24 years were more likely to be referred to mental health specialists. CONCLUSION: S: Impairment associated with depression and chronicity of depressive symptoms appear to be the primary determinants of the decisions made by general practitioners and family doctors about providing mental health services. Patients' willingness to consult with general practitioners or family doctors for mental health problems may also be a key factor, both for effective management of depression in primary care settings and for referral to mental health specialists.

Adolescent↗
PubMed2002

Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population.

The objective of this study was to investigate the effect of persistent alcohol consumption on the risks of major and minor depression. A retrospective cohort study design was used. The data was derived from a large scale longitudinal national health study (Canadian National Population Health Survey). Depression status was evaluated by using the Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. Subjects who did not have major depression at baseline were classified into groups according to the persistence of alcohol consumption during the follow-up period. The incidence of major depression in each group was calculated in men and in women separately and were stratified by age. The same procedures were repeated for minor depression. Women who reported having 5+ drinks on one occasion at least once a month were at an elevated risk of major depression. The same pattern was not observed among men in this analysis. However, no difference was found between the groups in terms of the incidence of minor depression. Frequent heavy alcohol use may be a causal factor for major depression among women. Reducing the frequency and quantities of alcohol consumption may offer an opportunity for prevention of major depression among women.

Adult↗
PubMed2002

The moderating effects of coping strategies on major depression in the general population.

OBJECTIVES: To evaluate the moderating effects of various coping strategies on the association between stressors and the prevalence of major depression in the general population. METHODS: Subjects from the Alberta buy-in component of the 1994-1995 National Population Health Survey (NPHS) were included in the analysis (n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. The impacts of coping strategies in relation to psychological stressors on the prevalence of major depression were determined by examining interactions between coping and life stress on major depression using logistic regression modelling. RESULTS: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of "pray and seek religious help" and "talks to others about the situations" as coping strategies by women moderated the risk of major depression in the presence of financial stress and relationship stress (with a partner). Using emotional expression as a coping strategy by women might decrease the risk of major depression in the presence of 1 or more recent life events, personal stress, relationship stress (with a partner), and environmental stress. CONCLUSION: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

Adaptation, Psychological↗
PubMedDate not supplied

Suicidal behaviours among adolescents in northern Nova Scotia.

OBJECTIVES: To estimate the 12-month prevalence of suicidal behaviours by gender and to investigate the gender-specific factors associated with suicidal behaviours and to describe health service utilization by suicidal adolescents. METHODS: This was a cross-sectional study. The baseline data of the Adolescent Health Study conducted in northern Nova Scotia were used. RESULTS: Female students were more likely to report suicidal behaviours than male students (p < 0.005). There was no gender difference in injurious suicide attempts. Depression was the strongest risk factor for suicidal behaviours in the two genders (p < 0.005). Female students who reported drug use and living in a non-intact family were at higher risk of suicide attempts. Low self-esteem was positively associated with suicidal ideation and suicide planning among male students. Suicidal girls were more likely to seek professional help for emotional disturbance than boys. Family doctors were the most frequently contacted professional by suicidal adolescents. CONCLUSIONS: Some factors associated with suicidal behaviours among adolescents may be gender specific. Suicidal behaviours have been considered a depressive symptom. Most suicidal students, however, had not contacted a health professional for an emotional problem in this population. This presents challenges for prevention of suicidal behaviours among adolescents.

Adolescent↗