Dataset Information

Adolescents with better mental health have less problem alcohol use six months later.

ABSTRACT:

Purpose

Adolescents who report having mental health problems, including depression and anxiety, are at greater risk of alcohol use. We examined the longitudinal association between mental health and alcohol use six months later in a diverse adolescent sample attending a primary care appointment. The primary care setting provides a unique opportunity to reach this younger age group and address risk factors, including mental health problems and substance use.

Methods

Adolescents aged 12-18 (n = 668) recruited from waiting rooms at four primary care clinics in Los Angeles, California and Pittsburgh, Pennsylvania completed a baseline web-based survey (April 2013 to November 2015) and another survey six months later. Bivariate analysis and multi-variable regression assessed associations between baseline mental health and 6-month alcohol use outcomes (any use, heavy use, and maximum quantity).

Results

Adolescents were stratified by mental health scores using the Mental Health Inventory-5 (MHI-5) cut off at baseline. In unadjusted analyses of alcohol outcomes at six months, adolescents with more mental health problems reported higher alcohol use across all three measures (p < .01 for heavy use; p < .05 for any use and maximum quantity used). Adolescents' reports of better mental health at baseline were associated with fewer heavy drinking episodes (p < .05) and lower maximum number of drinks (p < .05) at six months, after adjusting for baseline alcohol use, intervention group, site, and demographic characteristics.

Conclusions

Addressing mental health in primary care may be important for decreasing alcohol problems in adolescents. Strategies for facilitating screening and intervention with adolescents at-risk of alcohol use are warranted.

SUBMITTER: Meredith LS

PROVIDER: S-EPMC6611548 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Adolescents with better mental health have less problem alcohol use six months later.

Meredith Lisa S LS Seelam Rachana R Stein Bradley D BD Parast Layla L Shadel William G WG D'Amico Elizabeth J EJ

Addictive behaviors 20190307

<h4>Purpose</h4>Adolescents who report having mental health problems, including depression and anxiety, are at greater risk of alcohol use. We examined the longitudinal association between mental health and alcohol use six months later in a diverse adolescent sample attending a primary care appointment. The primary care setting provides a unique opportunity to reach this younger age group and address risk factors, including mental health problems and substance use.<h4>Methods</h4>Adolescents age ...[more]

PMID: 30861475

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Project description:BackgroundAnimal studies demonstrate a clear link between prenatal exposure to glucocorticoids (GC) and altered offspring brain development. We aim to examine whether prenatal GC exposure programs long-term mental health in humans.MethodsUsing propensity-score-matching, children prenatally exposed to synthetic glucocorticoids (sGC), n=37, and controls, n=185, were balanced on important confounders related to sGC treatment--gestational age and pre-pregnancy BMI. We also used mixed-effects modeling to analyse the entire cohort--matching each sGC case, n=37, to all possible controls, n=6079, on gestational age and sex. We obtained data from the Northern Finland Birth Cohort 1986 at four waves--pregnancy, birth, 8 and 16 years. Data on pregnancy and birth outcomes came from medical records. Mental health was assessed at 8 years by teachers with the Rutter B2 scale, and at 16 years by parents with the Strengths and Weaknesses of ADHD symptoms and Normal behavior (SWAN) scale and adolescents by the Youth Self-Report (YSR) scale.ResultsPrenatal sGC treatment was consistently associated with adverse mental health in childhood and adolescence, as shown by both the propensity-score method and mixed-effects model. Using the propensity-score-matched subsample, linear multiple regression showed prenatal sGC was significantly linked with general psychiatric disturbance (B=8.34 [95% CI: .23-16.45]) and inattention (B= .97 [95% CI: .16-1.80]) at 8 years after control for relevant confounders. Similar findings were obtained at 16 years, but did not reach statistical significance. Mediation by birthweight/placental weight was not detected.ConclusionsThis study is the first to prospectively investigate the long-term associations between prenatal exposure to sGC treatment and mental health in children and adolescents. We report an association between prenatal exposure to sGC and child mental health, supportive of the idea that sGC has a programming effect on the fetal brain.

Project description:ObjectivesTo explore whether and for how long use of healthcare services is increased among children and adolescents after covid-19.DesignBefore and after register based study.SettingGeneral population of Norway.ParticipantsNorwegians aged 1-19 years (n=706 885) who were tested for SARS-CoV-2 from 1 August 2020 to 1 February 2021 (n=10 279 positive, n=275 859 negative) or not tested (n=420 747) and were not admitted to hospital, by age groups 1-5, 6-15, and 16-19 years.Main outcome measuresMonthly percentages of all cause and cause specific healthcare use in primary care (general practitioner, emergency ward) and specialist care (outpatient, inpatient) from six months before to about six months after the week of being tested for SARS-CoV-2, using a difference-in-differences approach.ResultsA substantial short term relative increase in primary care use was observed for participants during the first month after a positive SARS-CoV-2 test result compared with those who tested negative (age 1-5 years: 339%, 95% confidence interval 308% to 369%; 6-15 years: 471%, 450% to 491%; 16-19 years: 401%, 380% to 422%). Use of primary care for the younger age groups was still increased at two months (1-5 years: 22%, 4% to 40%; 6-15 years: 14%, 2% to 26%) and three months (1-5 years: 26%, 7% to 46%, 6-15 years: 15%, 3% to 28%), but not for the oldest group (16-19 years: 11%, -2% to 24% and 6%, -7% to 19%, respectively). Children aged 1-5 years who tested positive also showed a minor long term (≤6 months) relative increase in primary care use (13%, -0% to 26%) that was not observed for the older age groups, compared with same aged children who tested negative. Results were similar yet the age differences less pronounced compared with untested controls. For all age groups, the increase in primary care visits was due to respiratory and general or unspecified conditions. No increased use of specialist care was observed.ConclusionCovid-19 among children and adolescents was found to have limited impact on healthcare services in Norway. Preschool aged children might take longer to recover (3-6 months) than primary or secondary school students (1-3 months), usually because of respiratory conditions.

Dataset Information

Adolescents with better mental health have less problem alcohol use six months later.

Purpose

Methods

Results

Conclusions

Publications

Adolescents with better mental health have less problem alcohol use six months later.

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